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Identifying Subtypes Of Trichotillomania (Hair Pulling Disorder) And Excoriation (Skin Picking) Disorder Using Mixture Modeling In A Multicenter Sample, Jon E. Grant, Tara S. Peris, Emily J. Ricketts, Christine Lochner, Dan J. Stein, Jan Stochl, Samuel R. Chamberlain, Jeremiah M. Scharf, Darin D. Dougherty, Douglas W. Woods, John Piacentini, Nancy Keuthen

Psychology Faculty Research and Publications

Body-focused repetitive behavior disorders (BFRBs) include Trichotillomania (TTM; Hair pulling disorder) and Excoriation (Skin Picking) Disorder (SPD). These conditions are prevalent, highly heterogeneous, under-researched, and under-treated. In order for progress to be made in optimally classifying and treating these conditions, it is necessary to identify meaningful subtypes. 279 adults (100 with TTM, 81 with SPD, 40 with both TTM and SPD, and 58 controls) were recruited for an international, multi-center between-group comparison using mixture modeling, with stringent correction for multiple comparisons. The main outcome measure was to examine distinct subtypes (aka latent classes) across all study participants using item-level data …

Computerized Response Inhibition Training For Children With Trichotillomania, Han-Joo Lee, Flint M. Espil, Christopher C. Bauer, Stephan G. Siwiec, Douglas W. Woods

Psychology Faculty Research and Publications

Evidence suggests that trichotillomania is characterized by impairment in response inhibition, which is the ability to suppress pre-potent/dominant but inappropriate responses. This study sought to test the feasibility of computerized response inhibition training for children with trichotillomania. Twenty-two children were randomized to the 8-session response inhibition training (RIT; n = 12) or a waitlisted control (WLT; n = 10). Primary outcomes were assessed by an independent evaluator, using the Clinical Global Impression-Improvement (CGI-I), and the NIMH Trichotillomania Severity (NIMH-TSS) and Impairment scales (NIMH-TIS) at pre, post-training/waiting, and 1-month follow-up. Relative to the WLT group, the RIT group showed a higher …

Abnormal Perceptual Sensitivity In Body-Focused Repetitive Behaviors, David C. Houghton, Jennifer R. Alexander, Christopher C. Bauer, Douglas W. Woods

Psychology Faculty Research and Publications

Objective

Several compulsive grooming habits such as hair pulling, skin picking, and nail biting are collectively known as body-focused repetitive behaviors (BFRBs). Although subclinical BFRBs are common and benign, more severe and damaging manifestations exist that are difficult to manage. Researchers have suggested that BFRBs are maintained by various cognitive, affective, and sensory contingencies. Although the involvement of cognitive and affective processes in BFRBs has been studied, there is a paucity of research on sensory processes.

Methods

The current study tested whether adults with subclinical or clinical BFRBs would report abnormal patterns of sensory processing as compared to a healthy …

Clarifying The Relationship Between Trichotillomania And Anxiety, Jennifer R. Alexander, David C. Houghton, Michael P. Twohig, Martin E. Franklin, Stephen M. Saunders, Angela M. Neal-Barnett, Scott N. Compton, Douglas W. Woods

Psychology Faculty Research and Publications

Although research has consistently linked unidimensional anxiety with Trichotillomania (TTM) severity, the relationships between TTM severity and anxiety dimensions (e.g., cognitive and somatic anxiety) are unknown. This knowledge gap limits current TTM conceptualization and treatment. The present study examined these relationships with data collected from ninety-one adults who participated in a randomized clinical trial for TTM treatment. Based on prior research, it was hypothesized that TTM severity would be related to the cognitive anxiety dimension and that psychological inflexibility would mediate the association. Hypotheses were not made regarding the relationship between TTM severity and somatic anxiety. Regression analyses indicated that …

Act-Enhanced Behavior Therapy In Group Format For Trichotillomania: An Effectiveness Study, Ashild Tellefsen Haaland, Shirin O. Eskeland, Erna M. Moen, Patrick A. Vogel, Svein Haseth, Kjetil Mellingen, Joseph A. Himle, Douglas W. Woods, Benjamin Hummelen

Psychology Faculty Research and Publications

Background

This study sought to investigate the effectiveness of group treatment for trichotillomania (TTM) in ordinary clinical settings. Treatment consisted of a combination of habit reversal training (HRT) and acceptance and commitment treatment (ACT). Both short- and long-term effects were explored, as well as individual change trajectories.

Methods

The sample consist of fifty-three patients with TTM. Treatment outcomes were evaluated at post-treatment and at one-year follow-up using self-report questionnaires (Massachusetts General Hospital Hair Pulling Scale, MGH-HS), structured clinical interviews (National Institute of Mental Health Trichotillomania Severity Scale, NIMH-TSS), and the Clinical Global Impression scale for TTM (CGI-TTM).

Results

Analyses by …

Evidence-Based Psychosocial Treatments For Pediatric Body-Focused Repetitive Behavior Disorders, Douglas W. Woods, David C. Houghton

Psychology Faculty Research and Publications

Habits, such as hair pulling and thumb sucking, have recently been grouped into a category of clinical conditions called body-focused repetitive behavior disorders (BFRBDs). These behaviors are common in children and, at extreme levels, can cause physical and psychological damage. This article reviews the evidence base for psychosocial treatment of pediatric BFRBDs. A review of academic databases and published reviews revealed 60 studies on psychosocial treatments for pediatric BFRBDs, 23 of which were deemed suitable for review. Based on stringent methodological and evidence base criteria, we provided recommendations for each specific BFRBD. Individual behavior therapy proved probably efficacious for thumb …

Comorbidity And Quality Of Life In Adults With Hair Pulling Disorder, David C. Houghton, Joyce Maas, Michael P. Twohig, Stephen M. Saunders, Scott N. Compton, Angela M. Neal-Barnett, Martin E. Franklin, Douglas W. Woods

Psychology Faculty Research and Publications

Hair pulling disorder (HPD; trichotillomania) is thought to be associated with significant psychiatric comorbidity and functional impairment. However, few methodologically rigorous studies of HPD have been conducted, rendering such conclusions tenuous. The following study examined comorbidity and psychosocial functioning in a well-characterized sample of adults with HPD (N=85) who met DSM-IV criteria, had at least moderate hair pulling severity, and participated in a clinical trial. Results revealed that 38.8% of individuals with HPD had another current psychiatric diagnosis and 78.8% had another lifetime (present and/or past) psychiatric diagnosis. Specifically, HPD showed substantial overlap with depressive, anxiety, addictive, and …

Personality Characteristics And Experiential Avoidance In Trichotillomania: Results From An Age And Gender Matched Sample, Chad T. Wetterneck, Eric B. Lee, Christopher A. Flessner, Rachel C. Leonard, Douglas W. Woods

Psychology Faculty Research and Publications

Despite its prevalence and a growing body of research, significant gaps remain in the knowledge of trichotillomania (TTM). The current study sought to address this issue by examining personality characteristics, impulsivity, and experiential avoidance of those with TTM compared to an age and gender matched sample. 56 Female participants (28 with TTM and 28 non-clinical age-matched controls) completed the Personality Assessment Inventory (PAI), Barratt's Impulsivity Scale (BIS), and the Acceptance and Action Questionnaire (AAQ). Paired-sample t-tests compared each of the 28 individuals who met criteria for TTM to an age and gender matched individual who did not meet criteria …

Defining Treatment Response In Trichotillomania: A Signal Detection Analysis, David C. Houghton, Matthew R. Capriotti, Alessandro S. De Nadai, Scott N. Compton, Michael P. Twohig, Angela M. Neal-Barnett, Stephen M. Saunders, Martin E. Franklin, Douglas W. Woods

Psychology Faculty Research and Publications

The Massachusetts General Hospital Hairpulling Scale (MGH-HPS) and the NIMH Trichotillomania Severity Scale (NIMH-TSS) are two widely used measures of trichotillomania severity. Despite their popular use, currently no empirically-supported guidelines exist to determine the degrees of change on these scales that best indicate treatment response. Determination of such criteria could aid in clinical decision-making by defining clinically significant treatment response/recovery and producing accurate power analyses for use in clinical trials research. Adults with trichotillomania (N = 69) participated in a randomized controlled trial of psychotherapy and were assessed before and after treatment. Response status was measured via the Clinical …