Stepped Care in the Treatment of Trichotillomania

2014-07-23 21:09:18 | BioPortfolio


Trichotillomania (TTM), repetitive pulling out of one's own hair to the extent that noticeable hair loss occurs, is a distressing condition interfering substantially with functioning and quality of life. The longterm objective of this research is to determine whether psychological treatment of TTM could be disseminated more effectively by using a stepped care model in which less intensive interventions are tried first, with more intensive interventions used only if initial treatment proves insufficient. This project is a pilot study of the first two steps in a stepped care model of treatment. After baseline assessment, 50 participants with TTM will be randomly assigned to (a) Immediate condition, in which they are offered 10-week self-help treatment via an interactive website (Step 1) or (b) Wait List/Delayed Start condition, a 10-week wait list prior to being offered Step 1. In each condition, at the end of Step 1, participants will be offered 8 weeks of in-person habit reversal training provided by psychology graduate students (Step 2). TTM symptoms will be measured from baseline through a follow-up 3 months after the end of Step 2, as will depression, anxiety, quality of life, functional impairment , treatment utilization, and treatment satisfaction.

The specific aims of the study are:

1. To gather preliminary data on the efficacy of web-based self-help, compared to wait list control;

2. To characterize the acceptability of stepped care to patients with TTM by assessing the proportion of enrolled participants who proceed from step 1 to step 2 treatment;

3. To evaluate the convergent validity of four decision rules for concluding that a patient with TTM has benefited sufficiently from a treatment step: (a) No longer meeting TTM diagnostic criteria; (b) Showing a 25% or greater reduction in total scores on self-report and clinician-rated TTM symptoms; (c) achieving complete abstinence from hair-pulling; and (d) clinically significant response on both self-report and clinician-rated TTM symptom measures

4. To evaluate the concurrent and predictive validity of criteria for sufficient benefit from a treatment step by relating them to treatment satisfaction, treatment utilization, and scores on a measure of functional impairment from TTM.

Study Design

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Outcomes Assessor), Primary Purpose: Treatment





American University
District of Columbia
United States


Not yet recruiting


American University

Results (where available)

View Results


Published on BioPortfolio: 2014-07-23T21:09:18-0400

Clinical Trials [19 Associated Clinical Trials listed on BioPortfolio]

N-Acetylcysteine for Pediatric Trichotillomania

Trichotillomania (hair pulling) has an estimated lifetime prevalence of 1-3%. Children with trichotillomania can experience significant impairment due to peer teasing, avoidance of activi...

Testing a New Therapy for Trichotillomania

This study will test the effectiveness of a new behavioral therapy for adults with trichotillomania (compulsive hair pulling).

Dronabinol in Trichotillomania

The goal of the proposed study is to evaluate the efficacy and safety of dronabinol in trichotillomania. 50 subjects with DSM-5 trichotillomania will receive 6 weeks of double-blind dronab...

Methylphenidate in ADHD With Trichotillomania

This study will evaluate the safety and effectiveness of methylphenidate in treating attention deficit hyperactivity disorder (ADHD) in children with both ADHD and trichotillomania. ...

Naltrexone in the Treatment of Trichotillomania

This is an 8-week, double-blind study of Natrexone in the treatment of trichotillomania

PubMed Articles [5 Associated PubMed Articles listed on BioPortfolio]

Salivary Inflammatory Markers in Trichotillomania: A Pilot Study.

Immune dysregulation has been hypothesized to be important in the development and pathophysiology of compulsive disorders such as obsessive compulsive disorder (OCD), which has a high comorbid overlap...

Salivary sex hormones in adolescent females with trichotillomania.

Trichotillomania is several times more common in women and has peak onset around puberty. The role of sex hormones, however, has received little research. 11 adolescent girls with trichotillomania, po...

An fMRI Pilot Study of Cognitive Flexibility in Trichotillomania.

Trichotillomania is a relatively common psychiatric condition, although its neurobiological basis is unknown. Abnormalities of flexible responding have been implicated in the pathophysiology of obsess...

Therapeutic Aspects of Trichotillomania: A Review of Current Treatment Options.

Trichotillomania (TTM) is a disorder characterized by recurrent episodes of hair pulling that affects a growing and diverse patient population. The behavior is a result of conscious or unconscious sti...

Critical Review of the Use of Second-Generation Antipsychotics in Obsessive-Compulsive and Related Disorders.

Currently, all second-generation antipsychotics are approved for schizophrenia. Many are also approved for bipolar disorder, with some also approved as adjunctive treatment for depression and autism-r...

Medical and Biotech [MESH] Definitions

Compulsion to pull out one's hair.

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