Validation of the German Beliefs in Trichotillomania Scale (BiTS-D)

Abstract: Trichotillomania (TTM), a body-focused repetitive behavior disorder characterized by pathological hair pulling, remains under-researched. The Beliefs in Trichotillomania Scale (BiTS) is a self-report instrument assessing the cognitions of negative self-belief, low coping efficacy, and perfectionism. This study evaluated the psychometric properties of the German version of the BiTS (BiTS-D). In a cross-sectional study, the BiTS-D was administered to 163 participants with TTM ( M = 32.3; SD = 10.7; age range = 18 – 79 years). The psychometric evaluation included confirmatory factor analysis (CFA), reliability analyses (Cronbach’s α, item properties), and correlation analyses with related instruments. CFA replicated the original three-factor structure. Reliability analyses, including inter-item and Spearman correlations, supported the construct, content, and convergent validity of the BiTS-D. The BiTS-D demonstrated strong reliability and validity, establishing it as a robust instrument for assessing TTM-related cognitions in German-speaking populations.