Addressing Self-Control Cognitions in the Treatment of Trichotillomania: A Randomized Controlled Trial Comparing Cognitive Therapy to Behaviour Therapy.

Ger P J Keijsers,Agnes Van Minnen,Joyce Maas,Amras Van Opdorp

doi:10.1007/s10608-016-9754-4

Ger P J Keijsers, Agnes Van Minnen + Show 2 more

Open Access

https://doi.org/10.1007/s10608-016-9754-4

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Journal: Cognitive therapy and research	Publication Date: Feb 2, 2016
Citations: 16	License type: CC BY 4.0

Affiliation: Radboud University Nijmegen

Abstract

People with trichotillomania often have persistent negative beliefs about giving into one’s habit. Central in the present study was the hypothesis that the follow-up effects of cognitive therapy (CT), in which these negative beliefs are directly addressed, are better compared to the follow-up effects of behaviour therapy (BT). Fifty-six trichotillomania patients were randomly assigned to either six sessions CT or BT. Forty-eight completed their treatment. Follow-up measurements took place after a 3 months treatment-free period, and at 12 and 24 months. CT and BT both resulted in clear reductions of trichotillomania symptoms (severity, urge, inability to resist, and negative beliefs) immediately after treatment. There were no differences between the groups. Following the treatment-free period, there was a reoccurrence of symptoms. In contrast to our expectation, we failed to show that CT compared to BT resulted in lower relapse rates after the treatment-free period.

Highlights

In several previous studies we investigated the effects of brief behaviour therapy (BT) for patients suffering from trichotillomania and from excoriation disorder (Keijsers et al 2006b; Schuck et al 2010; Van Minnen et al 2003)
To analyse treatment effects immediately after treatment, a Repeated Measures MANOVA was conducted with Time as within-subject factor and Condition (CT, BT) as between subjects factor for the outcome variables Massachusetts General Hospital Hair pulling Scale (MGHHS), SURF-urge, SURF-resistance, SCCQ-rewarding, and SCCQ-impossible
Post-hoc analyses showed that Time effects were significant for all five outcome variables, whereas the Condition effects and the Time by Condition effects were significant for none of the outcome measures

Summary

Introduction

In several previous studies we investigated the effects of brief behaviour therapy (BT) for patients suffering from trichotillomania and from excoriation disorder (Keijsers et al 2006b; Schuck et al 2010; Van Minnen et al 2003). Renewal effects have been demonstrated in animal (e.g., Bouton and Bolles 1979; Bouton and Peck 1989) and in human (e.g., Conklin and Tiffany 2002; Nelson et al 2011; Vansteenwegen et al 2005) studies, they have been found for fear extinction and for abated appetite reactions (Bouton and Peck 1989; Conklin and Tiffany 2002), and they have been associated with the occurrence of relapse in the treatments of alcoholics, smokers, and pathological gamblers, even when they were abstinent for months or years (Conklin and Tiffany 2002) Based on all these considerations, we wondered whether CT might be better suited to produce long lasting treatment effects compared to BT. There is the possibility that the large short-term effects of BT are mediated by changed beliefs about the patients’ ability to control their hair pulling behaviour Targeting these beliefs by means of CT may produce longer lasting treatment outcomes. To explore the effects of self-control cognitions on treatment outcomes in the long run, patients were followed up at 12 months and at 24 months

Participants

Procedure

Results

Discussion