DBT-enhanced cognitive-behavioral treatment for trichotillomania: A randomized controlled trial

Abstract

Background and aims: Limited treatment options are available for trichotillomania (TTM) and most have modest outcomes. Suboptimal treatment results may be due to the failure of existing approaches to address all TTM styles. Methods: Thirty-eight DSM-IV TTM participants were randomly assigned across two study sites to Dialectical Behavior Therapy (DBT) -enhanced cognitive-behavioral treatment (consisting of an 11-week acute treatment and 3-month maintenance treatment) or a minimal attention control (MAC) condition. MAC participants had active treatment after the 11-week control condition. Follow-up study assessments were conducted three and six months after the maintenance period. Results: Open trial treatment resulted in significant improvement in TTM severity, emotion regulation (ER) capacity, experiential avoidance, anxiety and depression with changes generally maintained over time. In the randomized controlled trial, those with active treatment had greater improvement than those in the MAC condition for both TTM severity and ER capacity. Correlations between changes in TTM severity and ER capacity were not reported at post-treatment but did occur in maintenance and follow-up indicating reduced TTM severity with improved ER capacity. Conclusions: DBT-enhanced cognitive-behavioral treatment is a promising treatment for TTM. Future studies should compare this approach to other credible treatment interventions and investigate the efficacy of this approach in more naturalistic samples with greater comorbidity.

Stepped Care in the Treatment of Trichotillomania

“…Another challenge is to determine how to improve TTM treatment for the one-half who were still diagnosable after treatment and how to reduce relapse. Improved results might entail adding a third step, perhaps specialized behavioral interventions incorporating elements of ACT (Woods & Twohig, 2008) or DBT (Keuthen et al, 2012). Finally, we did not measure costs; future trials could compare stepped care to treatment as usual in cost-effectiveness.…”

Trikotillomani

“…Randomiserte placebokontrollerte studier av vaneendringstrening, forsterket med henholdsvis dialektisk atferdsterapi (13) og aksept-og forpliktelsesterapi (acceptance and commitment therapy) (14), har vist bedre effekt og resultater over tid (seks måneder) enn vaneendringstrening alene (13,15). Det er funnet samvariasjon mellom reduksjon i hårnappingssymptomer og økt kapasitet til å regulere følelser i forløpet av behandlingen (13).…”

Uso Da Terapia Cognitiva Baseada Em Mindfulness Na Prevenção De Recaída Para Pacientes Com Depressão: Revisão Sistemática

“…A literatura atualmente tem buscado investigar o uso do Mindfulness em diversos tratamentos e para diversos transtornos (Lopes, Castro & Neufeld, 2012), tais como: doenças crônicas, prevenção de recaída de depressão, abuso de substâncias psicoativas, transtornos de ansiedade, estresse, transtorno de personalidade borderline, transtorno da compulsão alimentar periódica (TCAP), tricotilomania, entre outros (Keuthen et al, 2012;Baer, 2003;Telch et al, 2001;Crane, 2009;Linehan, 1993;Teasdale et al, 1995Teasdale et al, , 2000Bishop et al, 2004;Kabat-Zinn, 1982, 1992. De acordo com Hardt et al (2012), há evidências de que as habilidades em Mindfulness está ligada à saúde física e mental.…”