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Randomized Controlled Trial
. 2011 Aug;50(8):763-71.
doi: 10.1016/j.jaac.2011.05.009. Epub 2011 Jul 1.

Behavior therapy for pediatric trichotillomania: a randomized controlled trial

Martin E Franklin  1 , Aubrey L Edson, Deborah A Ledley, Shawn P Cahill
Affiliations
Randomized Controlled Trial

Behavior therapy for pediatric trichotillomania: a randomized controlled trial

Martin E Franklin et al. J Am Acad Child Adolesc Psychiatry. 2011 Aug.

Abstract

Objective: To examine the efficacy and durability of a behavioral therapy (BT) protocol for pediatric TTM compared with a minimal attention control (MAC) condition. It was hypothesized that the BT condition would be superior to MAC at the end of acute treatment, and would also demonstrate durability of gains through the maintenance treatment phase.

Method: A randomized controlled trial in which 24 youths were assigned to either a pilot-tested BT protocol, consisting of eight weekly sessions, or to MAC, consisting of three sessions and five telephone calls over 8 weeks. Independent evaluators assessed outcome at pretreatment (week 0) and post-treatment (week 8) for BT and MAC, and again at week 16 for BT patients only. The primary outcome measure was the National Institute of Mental Health Trichotillomania Severity Scale (NIMH-TSS).

Results: For the BT condition, the week 8 mean NIMH-TSS score was significantly lower than that of the MAC condition. The BT condition's mean week 8 score was also significantly lower than their own mean week 0 score, whereas no such reductions were observed for the MAC condition. Upon completion of acute treatment at week 8, the BT group's gains were maintained through an 8-week maintenance treatment phase.

Conclusions: BT produced a superior outcome compared with a condition that controlled for participation in a pediatric TTM research study, nonspecific therapist contact effects, repeated assessments, and the passage of time. Maintenance of gains after acute BT provides preliminary support for the durability of treatment gains.

Clinical trial registration information: Cognitive Behavioral Treatment of Pediatric Trichotillomania; http://www.clinicaltrials.gov; R21 MH 61457.

Trial registration: ClinicalTrials.gov NCT00043563.

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Conflict of interest statement

Disclosure: Drs. Franklin, Ledley, and Cahill, and Ms. Edson report no biomedical financial interests or potential conflicts of interest.

Figures

Figure 1
Figure 1
CONSORT Diagram Note: ADD = Attention Deficit Disorder; ADHD = Attention-Deficit/Hyperactive Disorder; MDD = Major Depressive Disorder; TTM = Trichotillomania.
Figure 2
Figure 2
Behavior Therapy and Minimal Attention Control Outcomes on National Institute of Mental Health-Trichotillomania Severity Scale Note: BT = behavioral therapy; MAC = minimal attention control
See this image and copyright information in PMC

Comment in

  • Trichotillomania: awareness and advances.
    Woods DW. Woods DW. J Am Acad Child Adolesc Psychiatry. 2011 Aug;50(8):747-8. doi: 10.1016/j.jaac.2011.05.008. J Am Acad Child Adolesc Psychiatry. 2011. PMID: 21784294 No abstract available.

References

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