Testing a New Therapy for Trichotillomania

University of Wisconsin, Milwaukee

Status and phase

Completed

Phase 2

Conditions

Trichotillomania

Treatments

Behavioral: Psychoeducation and supportive therapy (PST)

Behavioral: Acceptance enhanced behavior therapy (AEBT)

Study type

Interventional

Funder types

Other

NIH

Identifiers

NCT00872742

1R01MH080966 (U.S. NIH Grant/Contract)

DATR A2-AIR

R01MH080966 (U.S. NIH Grant/Contract)

NIMH-3065236

Details and patient eligibility

About

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

Full description

Trichotillomania (TTM) is a disorder in which people compulsively pull out their own hair. Treatments for TTM sometimes do not have long-term effectiveness. Acceptance and commitment therapy (ACT) is a therapeutic approach thought to have longer lasting effects than standard cognitive behavioral therapy (CBT) approaches, because ACT focuses on accepting thoughts and behaviors as opposed to changing them. Previous research indicates that a combination of ACT and habit reversal behavioral therapy is more effective than no treatment. This study will test whether a combination of ACT and behavioral therapy, called acceptance enhanced behavioral therapy (AEBT), is more effective than the current standard treatment for TTM.

Participation in this study will last 12 weeks, and follow-up assessments will last for 6 months. At study entry, participants will complete a brief intelligence test and an in-person interview about their medical history, psychiatric history, and hair pulling. At their second visit, participants will have digital pictures taken of their hair-pulling sites and complete two computer tasks measuring their response inhibition and cognitive flexibility. After the second visit, participants will be randomly assigned to receive either AEBT or psychoeducation and supportive therapy (PST)-a standard treatment for TTM. Both treatments will involve ten 1-hour sessions completed over 12 weeks. Assessments of participants will occur after 6 weeks of treatment, at treatment completion, and after 6 months. These assessments will measure treatment effectiveness, based on several clinical scales and measures of TTM symptoms. Participants who receive PST during this study will be offered AEBT afterward.

Enrollment

85 patients

Sex

All

Ages

18 to 65 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Current DSM-IV diagnosis of trichotillomania
Massachusetts General Hospital Hair Scale score greater than 12
Wechsler Test of Adult Reading score greater than 85
Fluent in English
Outpatient status
Agreement to not alter the dosage of any psychotropic medication throughout the course of the study, or, if such a dosage change is required, understanding that the participant will continue to receive treatment, and data will continue to be collected on him or her
Individuals who eat their hair after pulling will be eligible for participation only after they have received a physical exam from their primary care physician to determine whether there is any gastrointestinal blockage due to hair pulling, which would require more immediate clinical care.

Exclusion criteria

Diagnosis of bipolar disorder, psychotic disorder, mental retardation, pervasive developmental disorder, or current substance dependence (with the exception of nicotine dependence)
Current mood or anxiety disorder with an active suicide risk
Currently receiving psychotherapy for trichotillomania or another psychiatric condition
Initiation or change in the dosage of any psychotropic medication for up to 8 weeks preceding participation in the study