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| Recent Research in the Analysis and Treatment of Trichotillomania |
| Sunday, May 28, 2006 |
| 9:00 AM–10:20 AM |
| Baker |
| Area: CBM; Domain: Applied Research |
| Chair: Raymond G. Miltenberger (North Dakota State University) |
| CE Instructor: Raymond G. Miltenberger, Ph.D. |
| Abstract: This symposium includes four papers describing recent research on trichotillomania (chronic hair pulling) with adults and children and represents the most recent behavior analysis research in this area. The first paper describes a treatment study evaluating habit reversal and adjunct treatments for hair pulling by adults. The second study describes factors, identified from a descriptive functional assessment, that are functionally related to hair pulling by adults and that may predict treatment success and relapse. The third study reports the types of comorbid mental health conditions experienced by children diagnosed with trichotillomania seen at a specialty clinic for children with chronic hair pulling. The fourth study evaluates the utility of different self-monitoring methods for chronic hair pulling by children. |
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| Analysis of Habit Reversal and Adjunct Treatments in the Treatment of Trichotillomania. |
| CANDICE JOSTAD (Western Michigan University), Raymond G. Miltenberger (North Dakota State University), Amanda Bosch (North Dakota State University), Peter J. Knudson (North Dakota State University), Amy Mackner (North Dakota State University) |
| Abstract: The purpose of this study was to evaluate the effectiveness of habit reversal for treatment of chronic hair pulling in adults and to evaluate adjunct treatments if habit reversal was not entirely effective. Six women participated. We measured the number of hairs pulled daily through participant self-monitoring and the damage to the affected area through a rating scale of hair loss. Results showed that hair pulling was greatly diminished to near zero for three participants with habit reversal consisting of awareness training, competing response training, and social support. Adjunct treatments, consisting of relaxation training, a behavioral contract, and response prevention procedures, were needed for 3 participants. We discuss the need for individualized treatment planning when habit reversal is not effective. |
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| Factors Contributing to Hair Pulling, Treatment Effectiveness, and Relapse. |
| PETER J. KNUDSON (North Dakota State University), Raymond G. Miltenberger (North Dakota State University), Amanda Bosch (North Dakota State University), Candice Jostad (Western Michigan University), Amy Mackner (North Dakota State University) |
| Abstract: The purpose of this study was to identify the antecedents and consequences functionally related to hair pulling and to discuss factors related to the effectiveness of treatment and relapse. We collected functional assessment information via interview for 10 individuals who engage in chronic hair pulling. The antecedents consist of negative emotional experiences, stress or tension, boredom, lack of activity, and being alone, with all participants’ experiences being slightly different. The self-reported consequences are consistent with an automatic negative reinforcement function for the behavior (relief from negative emotions, tension, or unpleasant sensations). Factors related to the effectiveness of treatment and relapse, identified for 6 individuals receiving habit reversal treatment, include the presence of a social support person, compliance with the treatment procedures, and stressful events or negative life experiences (e.g., marital conflict). The implications of these factors for successful treatment are discussed. |
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| Children and Trichotillomania: Behavioral Problems and Comorbid Concerns. |
| CHRIS A. FLESSNER (University of Wisconsin, Milwaukee), Christine A. Conelea (University of Wisconsin, Milwaukee), Michael B. Himle (University of Wisconsin, Milwaukee), Andrew Busch (University of Wisconsin, Milwaukee), Chad Wetterneck (University of Wisconsin, Milwaukee) |
| Abstract: This paper provides an overview of behavioral problems and comorbid mental health concerns found in children diagnosed with Trichotillomania (TTM). Participants include children assessed as part of the third author’s Tic Disorder and Trichotillomania Specialty Clinic or children assessed as part of ongoing research at the University of Wisconsin-Milwaukee’s department of psychology. Each child, the child’s parent(s), and the child’s teacher completed several self-report forms, while the child and child’s parent(s) also completed a clinical interview. Results indicated that children diagnosed with TTM may display average to above average intelligence, and may experience increased levels of anxiety, somatic symptoms, and may be increasingly more withdrawn from their peers. Conclusions, implications for treatments recommendations, limitations, and future areas of research are discussed. |
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| The Assessment of Trichotillomania Severity in Children and Adolescents: An Examination of Several Self-Monitoring Procedures. |
| CHRIS A. FLESSNER (University of Wisconsin, Milwaukee), Douglas W. Woods (University of Wisconsin, Milwaukee) |
| Abstract: This paper provides an examination of several methods of self-monitoring for use in the assessment of hair pulling severity in children and adolescents diagnosed with TTM. Participants are currently being recruited through referrals to the second author’s Tic Disorder and Trichotillomania Specialty Clinic at the University of Wisconsin-Milwaukee’s department of psychology. The current study will follow an ABACA design and will examine three methods of self-monitoring; (1) use of a golf-counter, (2) golf-counter + frequent reminders from the participant’s parent(s), and (3) golf counter + reminders + daily reminders from the first author. This study is currently in progress, and data will be presented as to the method of assessment providing the most accurate and reliable data regarding the severity of an individual’s hair pulling problem. Conclusions, implications for the future assessment of hair pulling severity, limitations, and future areas of research will be discussed. |
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