of hoarding disorder, which characterizes most  but not all individuals with hoarding dis-
order, consists of excessive collecting, buying , or stealing of items that are not needed or
for which there is no available space.
Trichotillomania (hair-pulling disorder) is characterized by recurrent pulling out of
one's hair resulting in hair loss, and repeated  attempts to decrease or stop hair pulling.
Excoriation (skin-picking) disord er is characterized by recurrent picking of one’s skin re-
sulting in skin lesions and repeated attempts to decrease or stop skin picking. The body-
focused repetitive behaviors that characterize  these two disorders are not triggered by ob-
sessions or preoccupations; however, they ma y be preceded or accompanied by various
emotional states, such as feelin gs of anxiety or boredom. They may also be preceded by an
increasing sense of tension or may lead to gr atification, pleasure, or  a sense of relief when
the hair is pulled out or the skin is picked. In dividuals with these disorders may have vary-
ing degrees of conscious awareness of the beha vior while engaging in it, with some indi-
viduals displaying more focused attention on  the behavior (with preceding tension and
subsequent relief) and other individuals displaying more automatic behavior (with the be-
haviors seeming to occur without full awareness).
Substance/medication-i nduced obsessive-compulsive an d related disorder consists of
symptoms that are due to substance intoxicati on or withdrawal or to a medication. Obses-
sive-compulsive and related disorder due to another medica l condition involves symptoms
characteristic of obsessive-comp ulsive and related disorders th at are the direct pathophysio-
logical consequence of a medical disorder. Othe r specified obsessive-compulsive and related