For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
22
views
18
references
 Top references
cited by
10
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
2 collections
    0
    shares
      218
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      DBT-enhanced cognitive-behavioral treatment for trichotillomania: A randomized controlled trial

      Read this article at

      ScienceOpenPublisher
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background and aims

          Limited treatment options are available for trichotillomania (TTM) and most have modest outcomes. Suboptimal treatment results may be due to the failure of existing approaches to address all TTM styles.

          Methods

          Thirty-eight DSM-IV TTM participants were randomly assigned across two study sites to Dialectical Behavior Therapy (DBT) -enhanced cognitive-behavioral treatment (consisting of an 11-week acute treatment and 3-month maintenance treatment) or a minimal attention control (MAC) condition. MAC participants had active treatment after the 11-week control condition. Follow-up study assessments were conducted three and six months after the maintenance period.

          Results

          Open trial treatment resulted in significant improvement in TTM severity, emotion regulation (ER) capacity, experiential avoidance, anxiety and depression with changes generally maintained over time. In the randomized controlled trial, those with active treatment had greater improvement than those in the MAC condition for both TTM severity and ER capacity. Correlations between changes in TTM severity and ER capacity were not reported at post-treatment but did occur in maintenance and follow-up indicating reduced TTM severity with improved ER capacity.

          Conclusions

          DBT-enhanced cognitive-behavioral treatment is a promising treatment for TTM. Future studies should compare this approach to other credible treatment interventions and investigate the efficacy of this approach in more naturalistic samples with greater comorbidity.

          Related collections

          Most cited references18

          • Record: found
          • Abstract: found
          • Article: not found

          A double-blind comparison of clomipramine and desipramine in the treatment of trichotillomania (hair pulling)

          J L Rapoport, Susan E Swedo, M Lenane … (1989)
          Trichotillomania, an irresistible impulse to pull out one's own hair, is a chronic psychiatric illness that causes severe discomfort, interferes with daily activities, and leads to social isolation. Treatment is usually unsatisfactory. Thirteen women with severe trichotillomania completed a 10-week double-blind, crossover trial of clomipramine, a new tricyclic antidepressant agent with selective antiobsessional effects, and desipramine, a standard tricyclic antidepressant. Treatment with clomipramine resulted in significantly greater improvement in symptoms than desipramine, as indicated by physicians' ratings of the women's clinical progress on a scale in which lower scores indicate improvement (mean [+/- SD] scores: at base line, 10.0; after desipramine treatment, 8.7 +/- 2.4; after clomipramine treatment, 4.7 +/- 3.1; P = 0.006) and by scores on a trichotillomania-impairment scale, in which higher scores indicate greater impairment (at base line, 6.8 +/- 1.7; after desipramine treatment, 6.2 +/- 1.7; after clomipramine treatment, 4.2 +/- 2.7; P = 0.03). The severity of symptoms (mean base-line score, 15.9 +/- 3.8) was reduced more by clomipramine (10.6 +/- 6.4) than by desipramine (14.4 +/- 3.9). The patients reported that the compulsion decreased in intensity and that they were more able to resist the urge to pull out their hair during treatment with clomipramine. We conclude that clomipramine appears to be effective in the short-term treatment of trichotillomania.
          Article 0 comments Cited 39 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            A controlled evaluation of acceptance and commitment therapy plus habit reversal for trichotillomania.

            Chad Wetterneck, Christopher Flessner, Christopher Woods (2006)
            This randomized trial compared a combined Acceptance and Commitment Therapy/Habit Reversal Training (ACT/HRT) to a waitlist control in the treatment of adults with trichotillomania (TTM). Twenty-five participants (12 treatment and 13 waitlist) completed the trial. Results demonstrated a significant reduction in hair pulling severity, impairment ratings, and hairs pulled, along with significant reductions in experiential avoidance and both anxiety and depressive symptoms in the ACT/HRT group compared to the waitlist control. Reductions generally were maintained at a 3-month follow-up. Decreases in experiential avoidance and greater treatment compliance were significantly correlated with reductions in TTM severity, implying that targeting experiential avoidance may be useful in the treatment of TTM. Other implications and suggestions for future research are noted.
            Article 0 comments Cited 34 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Systematic review: pharmacological and behavioral treatment for trichotillomania.

              R Wegner, P. Dombrowski, Angeli Landeros-Weisenberger … (2007)
              Trichotillomania is a psychiatric condition characterized by compulsive hair pulling. Three interventions have been studied in the treatment of trichotillomania: habit-reversal therapy (HRT) and pharmacotherapy with either selective-serotonin reuptake inhibitors (SSRI) or clomipramine. This systematic review compared the efficacy of these interventions in blinded, randomized clinical trials. The electronic databases of Medline, Premedline, PsychINFO, Embase, and the Cochrane Central Register of Controlled Trials were searched for relevant trials using the search terms "trichotillomania" or "hair pulling." Trials were eligible for inclusion if they compared habit-reversal therapy, SSRI pharmacotherapy, or clomipramine pharmacotherapy to each other or placebo and employed randomization and blinded assessment of outcome. Our primary outcome measure was mean change in trichotillomania severity. The summary statistic was standardized mean difference. Seven studies were eligible for inclusion in this review. Overall, meta-analysis demonstrated that habit-reversal therapy (effect size [ES] = -1.14, 95% confidence interval [CI] = -1.89, -.38) was superior to pharmacotherapy with clomipramine (ES = -.68, 95% CI = -1.28, -.07) or SSRI (ES = .02, 95% CI = -.32, .35). Clomipramine was more efficacious than placebo, while there was no evidence to demonstrate that SSRI are more efficacious than placebo in the treatment of trichotillomania. Future studies on trichotillomania should seek to determine if HRT can demonstrate efficacy against more rigorous control conditions that account for non-specific effects of therapy and determine if HRT can be an effective intervention for trichotillomania beyond the few sites where it is currently practiced in research studies. Future therapy and pharmacotherapy studies in trichotillomania should employ larger sample sizes and intention-to-treat analysis and seek to validate clinical rating scales of trichotillomania severity.
              Article 0 comments Cited 26 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Journal
                Journal ID (publisher-id): 2006
                Journal ID (MPID): 122266
                Title: Journal of Behavioral Addictions
                Abbreviated Title: JBA
                Publisher: Akadémiai Kiadó, co-published with Springer Science+Business Media B.V., Formerly Kluwer Academic Publishers B.V.
                ISSN (Print): 2062-5871
                ISSN (Electronic): 2063-5303
                Publication date (Print): 1 September 2012
                Publication date (Electronic): 31 July 2012
                Volume: 1
                Issue: 3
                Pages: 106-114
                Affiliations
                [ 1 ] Massachusetts General Hospital / Harvard Medical School, Boston, MA, USA
                [ 2 ] Emory University School of Medicine, Atlanta, GA, USA
                [ 3 ] American University, Washington D.C., USA
                [ 4 ] Anxiety Treatment Center of Northwest, Arkansas, AR, USA
                [ 5 ] Anxiety & Stress Reduction Center / University of Washington, Seattle, WA, USA
                [ 6 ] Trichotillomania Clinic & Research Unit, Massachusetts General Hospital, Simches Research Bldg, Fl. 2, 185 Cambridge St, Boston, MA, 02114, USA
                Author notes
                [* ] +1-617-643-3080, nkeuthen@ 123456partners.org
                Article
                Other ID: 3
                DOI: 10.1556/jba.1.2012.003
                SO-VID: b77802d0-ff5d-4af6-b323-ef71278d780c
                Copyright © © 2012 The Author(s)
                License:

                Open Access statement. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and reproduction in any medium for non-commercial purposes, provided the original author and source are credited, a link to the CC License is provided, and changes – if any – are indicated.

                History
                Date received : 9 April 2012
                Date: 25 May 2012
                Date accepted : 17 June 2012

                ScienceOpen disciplines: Evolutionary Biology,Medicine,Psychology,Educational research & Statistics,Social & Behavioral Sciences
                Keywords: dialectical behavior therapy,cognitive-behavioral treatment,hair pulling,trichotillomania
                Data availability:
                ScienceOpen disciplines: Evolutionary Biology, Medicine, Psychology, Educational research & Statistics, Social & Behavioral Sciences
                Keywords: dialectical behavior therapy, cognitive-behavioral treatment, hair pulling, trichotillomania

                Comments

                Comment on this article

                scite_

                Similar content218

                See all similar

                Cited by10

                See all cited by

                Most referenced authors288

                See all reference authors