Validating indicators of treatment response: application to trichotillomania
Open accessAbstract
Different studies of the treatment of trichotillomania (TTM) have used varying standards to determine the proportion of patients who obtain clinically meaningful benefits, but there is little information on the similarity of results yielded by these methods or on their comparative validity. Data from a stepped-care (Step 1: Web-based self-help; Step 2: Individual behavior therapy; N = 60) treatment study of TTM were used to evaluate 7 potential standards: complete abstinence, ≥ 25% symptom reduction, recovery of normal functioning, and clinical significance (recovery + statistically reliable change), each of the last 3 being measured by self-report (Massachusetts General Hospital Hairpulling Scale; MGH-HPS) or interview (Psychiatric Institute Trichotillomania Scale). Depending on the metric, response rates ranged from 25 to 68%. All standards were significantly associated with one another, though less strongly for the 25% symptom reduction metrics. Concurrent (with deciding to enter Step 2 treatment) and predictive (with 3-month follow-up treatment satisfaction, TTM-related impairment, quality of life, and diagnosis) validity results were variable but generally strongest for clinical significance as measured via self-report. Routine reporting of the proportion of patients who make clinically significant improvement on the MGH-HPS, supplemented by data on complete abstinence, would bolster the interpretability of TTM treatment outcome findings.
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None of the TTM-participants demonstrated complete abstinence from hair pulling at posttreatment or at the 12-month follow-up, based on guidelines by Nelson et al. (2014).
“In addition, based on the guidelines by Nelson et al. (2014) none of the TTM-participants demonstrated complete abstinence from hair pulling at posttreatment or at the 12-month follow-up.”
From Internet-delivered acceptance-based behavior therapy for trichotillomania and skin-picking disorder in a psychiatric setting: A feasibility trial (2022) · cites this paper as Nelson et al. (2014)
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- Authors
- Nelson, S. O., Rogers, K., Rusch, N., McDonough, L., Malloy, E. J., Falkenstein, M. J., Banis, M., & Haaga, D. A. F.
- Affiliations
- American University (US)
- Venue
- Psychological Assessment
- Published
- 2014-09
- Volume
- 26
- Issue
- 3
- Pages
- 857-864
- ISSN
- 1040-3590 (ISSN-L)
- 1939-134X
- PMC
- PMC4152412
- OpenAlex
- W2322554599
- Cited by
- 17
- References
- 19
- Citations by year
- 2024: 2 · 2023: 2 · 2022: 4 · 2021: 3 · 2020: 1 · 2018: 1 · 2015: 3 · 2014: 1
- FWCI
- 1.58
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychological Assessment (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (1R15MH086852-01)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Keywords
- trichotillomania, treatment outcome assessment, clinical significance, symptom relief, stepped care, behavior therapy, treatment satisfaction, quality of life
- MeSH terms
- Adult, Behavior Therapy, Female, Humans, Interview, Psychological, Male, Middle Aged, Self-Help Groups, Therapy, Computer-Assisted, Trichotillomania, Reproducibility of Results, Outcome Assessment, Health Care, Internet, Young Adult, Self Report
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