Trichotillomania, also known as hair pulling disorder, has a prevalence of around 2%, and is associated with significant distress.
This study conducted by Carlson et al. (2021) tested comprehensive behavioral (ComB) treatment of trichotillomania. ComB works by providing individualized treatment based on the factors that trigger and maintain hair pulling.
Key takeaways from the current study by Carlson et al. (2021):
Comprehensive Behavior Modification (ComB) reduced hair pulling
Posttreatment, approximately 20 percent of participants were no longer engaging in hair pulling
Effects of treatment were maintained for up to 6 months
The Comprehensive Behavioral model of trichotillomania treatment considers the wide range of factors that maintain hair pulling, noting that these factors need to be considered to provide successful individualized treatment.
According to the authors, the ComB model includes five modalities: “(1) Sensory (tactile, visual, oral, olfactory, or auditory triggers), (2) Cognitive (thoughts that provoke, facilitate or maintain hair pulling), (3) Affective (feeling states such as boredom, stress, or anxiety), (4) Motor (facilitative postural cues and unconscious motor habits), and (5) Place (external or environmental cues).” With this in mind, ComB provides a more diverse set of strategies for intervening and preventing hair pulling.
The researchers found immediate efficacy of ComB. ComB was likely to lead to abstinence from hair pulling by week 12. Follow-ups after treatment showed maintenance of effects for approximately 3 to 6 months. Additionally, ComB treatment for trichotillomania was delivered with good adherence. The treatment also was acceptable to patients, and after treatment, satisfaction scores were high.
These findings provide evidence of the efficacy for ComB in trichotillomania treatment, thereby increasing treatment options for those trying to overcome a hair pulling disorder. That being said, it is important to note that ComB might be highly effective but only in the hands of more experienced therapists. This treatment method requires more skill to implement properly than do other trichotillomania treatments, so its efficacy may only be seen if implemented by more experienced therapists.
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