Acceptance-enhanced behavior therapy for trichotillomania in adults: A randomized clinical trial. (November 2022)

• Record Type: Journal Article
• Authors: Woods, Douglas W.; Ely, Laura J.; Bauer, Christopher C.; Twohig, Michael P.; Saunders, Stephen M.; Compton, Scott N.; Espil, Flint M.; Neal-Barnett, Angela; Alexander, Jennifer R.; Walther, Michael R.; Cahill, Shawn P.; Deckersbach, Thilo; Franklin, Martin E.
• Is Part Of: Behaviour research and therapy. Volume 158(2022)
• Publication Date: 2022-11
• Subjects: Behavior therapy -- Habits -- Trichotillomania -- Treatment effectiveness -- Mindfulness -- Obsessive compulsive disorder; Cognitive therapy -- Periodicals; Psychotherapy -- Periodicals; 616.891
• DOI: 10.1016/j.brat.2022.104187
• Languages: English
• ISSNs: 0005-7967

Abstract

Abstract: Given the limited treatment options for trichotillomania (TTM), or Hair Pulling Disorder, this large randomized clinical trial evaluated the efficacy of acceptance-enhanced behavior therapy for TTM (AEBT-TTM) in reducing TTM severity relative to psychoeducation and supportive therapy (PST). Eighty-five adults (78 women) with TTM received 10 sessions (over 12 weeks) of either AEBT-TTM or PST. Independent evaluators masked to treatment assignment assessed participants at baseline (week 0), midpoint (week 6), and endpoint (week 12). Consistent with a priori hypotheses, 64% of the adults treated with AEBT-TTM were classified as clinical responders at post-treatment relative to 38% treated with PST. Clinical responders were identified by a score of 1 or 2 on the Clinical Global Impressions-Improvement (CGI-I) scale. Relative to the PST group, the AEBT-TTM group demonstrated significantly greater pre-to post-treatment reductions on the self-report Massachusetts General Hospital-Hairpulling Scale (MGH-HS) and the evaluator-rated National Institute of Mental Health Trichotillomania Severity Scale (NIMH-TSS). There were no significant post-treatment group differences on the Clinical Global Impressions-Severity (CGI-S) scale, or rate of TTM diagnoses. Results suggest AEBT-TTM provides greater treatment benefit than PST. Future research should continue to investigate AEBT-TTM along with mediators and moderators of its efficacy. Highlights: Limited treatment options exist for trichotillomania (TTM). This RCT evaluated acceptance-enhanced behavior therapy for adult TTM (AEBT-TTM). Results support efficacy of AEBT-TTM above psychoeducation and supportive therapy. Research on mediators/moderators of AEBT-TTM is necessary.