Background
Trichotillomania (TTM) is a disorder within Obsessive–Compulsive and Related Disorders, involving repetitive hair-pulling leading to hair loss and functional impairment. It remains under-investigated in the Middle East. The Trichotillomania Dimensional Scale (TTM-D) has not been validated in Arabic-speaking populations.
Methods
Arabic-speaking participants from Saudi Arabia, Egypt, Lebanon, Palestine, and Jordan were recruited online via snowball sampling (December 2024 and January 2025). The TTM-D was translated using forward-backward translation and expert panel review.
Results
A total of 1494 participants from five Arab countries completed the survey. The structure of the TTM-D showed mixed model fit (CFI = 0.957, TLI = 0.914, RMSEA = 0.139, SRMR = 0.044), with excellent internal consistency (α = 0.95, ω = 0.95) and satisfactory convergent validity (AVE = 0.55). Measurement invariance across gender (biological sex) was supported with no significant differences. Concurrent validity was demonstrated through significant correlations with depression-anxiety (r = 0.29), shame (r = 0.28–0.30), stress (r = 0.13), and loneliness (r = 0.27).
Conclusion
The Arabic TTM-D demonstrated strong psychometric properties. These results support it as a culturally sensitive and reliable tool for assessing TTM in Arab populations. Further validation is needed to enhance its diagnostic utility and establish clinical cut-off scores.
