title: Pilot trial of dialectical behavior therapy-enhanced habit reversal for trichotillomania.
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 CBT consisting 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.
authors: Massachusetts General Hospital/Harvard Medical School, Boston, USA. nkeuthen@partners.org
authors: Nancy J
authors: NJ
authors: Keuthen
authors: Barbara O
authors: BO
authors: Rothbaum
authors: Stacy Shaw
authors: SS
authors: Welch
authors: Caitlin
authors: C
authors: Taylor
authors: Martha
authors: M
authors: Falkenstein
authors: Mary
authors: M
authors: Heekin
authors: Cathrine Arndt
authors: CA
authors: Jordan
authors: Kiara
authors: K
authors: Timpano
authors: Suzanne
authors: S
authors: Meunier
authors: Jeanne
authors: J
authors: Fama
authors: Michael A
authors: MA
authors: Jenike
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D004644:Emotions; D005260:Female; D006184:Habits; D006801:Humans; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014256:Trichotillomania / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*
chemical_list: D011619:Psychotropic Drugs