Cognitive Behavioral Group Therapy for Trichotillomania (Hair Pulling Disorder)

Study Overview
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Brief Summary
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This study aims at evaluating the effectiveness of group-based cognitive behavioral therapy for trichotillomania at three clinical sites in Norway.

Detailed Description
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The Norwegian Trichotillomania Project is a multicenter study that aims at evaluating the effectiveness of behavioral group therapy for TTM, i.e., ACT (Acceptance and commitment therapy) enhanced habit reversal training (ACT-enhanced HRT). Participants are adults or adolescents (16 year or older) who fulfill criteria for TTM according to DSM-IV. Inclusion started in January 2013 and will be completed by Mai 2016. Treatment is delivered at three treatment sites in Norway; in Kristiansand, Oslo, and Trondheim. Treatment is manualized, following the manual of Twohig and Woods, and consists of ten group sessions of three hours delivered at consecutive weeks, and two or three booster sessions during the first year after treatment. Treatment outcome is evaluated by three outcome measures; the Massachusetts General Hospital - Hairpulling Scale (self-report); the National Institute of Mental Health Trichotillomania Severity Scale (clinical interview, conducted by independent evaluators); and the Clinical Global Impression Scale for TTM. Outcome is measured at three points in time; at baseline, at the end of treatment, and at one-year follow-up. Mixed models procedures in SPSS is used to analyze longitudinal data. The first paper will be written on patients admitted to treatment from January 2013 to September 2014, and includes 53 patients (49 women and four men). By January 2016, fifty-one patients (96%) had participated in the one-year follow-up evaluation.

Official Title
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The Norwegian Trichotillomania Project

Conditions
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Trichotillomania

Intervention / Treatment
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* Behavioral: Cognitive behavioral therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Clinical diagnosis of Trichotillomania Age between 16 and 67 Exclusion Criteria: schizophrenia spectrum disorder substance addiction severe antisocial, schizotypal, or paranoid personality disorder severe eating disorder, ongoing suicidal ideation pervasive developmental disorder mental retardation and severe sequelae after brain injury.

Ages Eligible for Study
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Minimum Age: 16 Years
Maximum Age: 67 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Behavioral: Cognitive behavioral therapy|10 sessions Group therapy during 10-12 weeks. The first three sessions focus on habit reversal training, the fourth to sixth session on acceptance and commitment therapy and the last four sessions aims at integrating the two approaches.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in National Institute of Mental Health Trichotillomania Severity Scale (NIMH-TSS) | clinical interview | baseline, 12 weeks, 12 months | 
| Change in Massachusetts General Hospital - Hairpulling Scale (MGH-HS) | self-report | baseline, 12 weeks, 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change Patient Health Questionnaire-9 (PHQ-9) | self-report depressive symptoms | baseline, 12 weeks, 12 months | 
| Change General Anxiety Disorder Scale (GAD-7) | self-report anxiety symptoms | baseline, 12 weeks, 12 months | 
| Change Metacognition Questionnaire (MCQ-30) | self-reported metacognitions | baseline, 12 weeks, 12 months | 
| Change in Acceptance and Action Questionnaire for Trichotillomania | self-report | baseline, 12 weeks, 12 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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effectiveness, trichotillomania, hair pulling, habit reversal training, acceptance and commitment therapy, cognitive behavioral therapy