DBT-enhanced habit reversal treatment for trichotillomania: 3- and 6-month follow-up results

Background: Maintenance of gains with cognitive-behavioral treatment for trichotillomania (TTM) has historically been problematic. Methods: We conducted follow-up assessments 3 and 6 months after completion of a 3-month maintenance phase on 10 individuals with DSM-IV-TR TTM who participated in an open trial of a dialectical behavior therapy (DBT)-enhanced habit reversal treatment (HRT). Results: Significant improvement from baseline was reported at 3- and 6-month follow-up on all measures of hair pulling severity and emotion regulation, although some worsening was reported on some measures from earlier study time points. At 6-month follow-up, five and four participants were full and partial responders, respectively. Significant correlations were reported at both follow-up time points between changes in hair pulling severity and emotion regulation capacity. Conclusions: DBT-enhanced HRT offers promise for improved long-term treatment results in TTM. Changes in TTM severity from baseline to 3- and 6-month follow-up is correlated with changes in emotion regulation capacity.