Pilot trial of dialectical behavior therapy-enhanced habit reversal for trichotillomania

Nancy J. Keuthen; Barbara O. Rothbaum; Stacy Shaw Welch; Caitlin Taylor; Martha Falkenstein; Mary Heekin; Cathrine Arndt Jordan; Kiara Timpano; Suzanne Meunier; Jeanne Fama; Michael A. Jenike

doi:10.1002/da.20732

Pilot trial of dialectical behavior therapy-enhanced habit reversal for trichotillomania

Nancy J. Keuthen, Barbara O. Rothbaum, Stacy Shaw Welch, Caitlin Taylor, Martha Falkenstein, Mary Heekin, Cathrine Arndt Jordan, Kiara Timpano, Suzanne Meunier, Jeanne Fama, Michael A. Jenike

Research output: Contribution to journal › Article › peer-review

49 Scopus citations

Abstract

Background: Not all hair pullers improve acutely with cognitive-behavioral treatment (CBT) and few maintain their gains over time. Methods: We conducted an open clinical trial of a new treatment that addresses affectively triggered pulling and emphasizes relapse prevention in addition to standard CBT approaches. Ten female participants satisfying DSM-IV criteria for trichotillomania (TTM) at two study sites received Dialectical Behavior Therapy (DBT)-enhanced CBTconsisting of 11 weekly sessions and 4 maintenance sessions over the following 3 months. Independent assessors rated hair pulling impairment and global improvement at several study time points. Participants completed self-report measures of hair pulling severity and emotion regulation. Results: Significant improvement in hair pulling severity and emotion regulation, as well as hair pulling impairment and anxiety and depressive symptoms, occurred during acute treatment and were maintained during the subsequent 3 months. Significant correlations were reported between changes in emotion regulation and hair pulling severity during both the acute treatment and maintenance phases. Conclusions: This study offers preliminary evidence for the efficacy of DBT-enhanced CBT for TTM and suggests the importance of addressing emotion regulation during TTM treatment.

Original language	English (US)
Pages (from-to)	953-959
Number of pages	7
Journal	Depression and anxiety
Volume	27
Issue number	10
DOIs	https://doi.org/10.1002/da.20732
State	Published - Oct 1 2010
Externally published	Yes

Keywords

Dialectical behavior therapy
Habit reversal
Hair pulling
Trichotillomania

ASJC Scopus subject areas

Psychiatry and Mental health
Clinical Psychology

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10.1002/da.20732

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Pilot trial of dialectical behavior therapy-enhanced habit reversal for trichotillomania. / Keuthen, Nancy J.; Rothbaum, Barbara O.; Welch, Stacy Shaw; Taylor, Caitlin; Falkenstein, Martha; Heekin, Mary; Jordan, Cathrine Arndt; Timpano, Kiara; Meunier, Suzanne; Fama, Jeanne; Jenike, Michael A.

In: Depression and anxiety, Vol. 27, No. 10, 01.10.2010, p. 953-959.

Research output: Contribution to journal › Article › peer-review

Keuthen, Nancy J. ; Rothbaum, Barbara O. ; Welch, Stacy Shaw ; Taylor, Caitlin ; Falkenstein, Martha ; Heekin, Mary ; Jordan, Cathrine Arndt ; Timpano, Kiara ; Meunier, Suzanne ; Fama, Jeanne ; Jenike, Michael A. / Pilot trial of dialectical behavior therapy-enhanced habit reversal for trichotillomania. In: Depression and anxiety. 2010 ; Vol. 27, No. 10. pp. 953-959.

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abstract = "Background: Not all hair pullers improve acutely with cognitive-behavioral treatment (CBT) and few maintain their gains over time. Methods: We conducted an open clinical trial of a new treatment that addresses affectively triggered pulling and emphasizes relapse prevention in addition to standard CBT approaches. Ten female participants satisfying DSM-IV criteria for trichotillomania (TTM) at two study sites received Dialectical Behavior Therapy (DBT)-enhanced CBTconsisting of 11 weekly sessions and 4 maintenance sessions over the following 3 months. Independent assessors rated hair pulling impairment and global improvement at several study time points. Participants completed self-report measures of hair pulling severity and emotion regulation. Results: Significant improvement in hair pulling severity and emotion regulation, as well as hair pulling impairment and anxiety and depressive symptoms, occurred during acute treatment and were maintained during the subsequent 3 months. Significant correlations were reported between changes in emotion regulation and hair pulling severity during both the acute treatment and maintenance phases. Conclusions: This study offers preliminary evidence for the efficacy of DBT-enhanced CBT for TTM and suggests the importance of addressing emotion regulation during TTM treatment.",

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