Internet-based self-help for trichotillomania: a randomized controlled study comparing decoupling and progressive...

Area of Science:

• Psychiatry
• Clinical Psychology
• Behavioral Science

Background:

• Trichotillomania (TTM) is a disorder characterized by recurrent hair-pulling causing significant hair loss.
• Previous research suggested 'decoupling' (DC), an online self-help intervention, may be more effective than progressive muscle relaxation (PMR) for TTM symptoms.

Purpose of the Study:

• To conduct a robust randomized clinical trial comparing the efficacy of DC and PMR for TTM.
• To evaluate symptom reduction at immediate post-intervention and at a 6-month follow-up.

Main Methods:

• 105 adults with TTM were recruited online and randomized to either DC (n=55) or PMR (n=50).
• Interventions lasted 4 weeks, with TTM severity assessed using the Massachusetts General Hospital Hair-Pulling Scale (MGH-HPS) at baseline, post-intervention, and 6-month follow-up.
• Both intention-to-treat and completer analyses were performed.

Main Results:

• Both DC and PMR groups showed significant and comparable reductions in TTM symptoms (MGH-HPS), sustained at 6-month follow-up (p < 0.001).
• Participants reported greater satisfaction with DC compared to PMR in certain aspects.
• Completer analyses mirrored the intention-to-treat findings.

Conclusions:

• While both internet-based interventions (DC and PMR) appear beneficial for TTM, symptom reduction was comparable between the two.
• The study highlights the potential of short, online interventions for TTM.
• Further longitudinal studies with non-treated control groups are needed to rule out unspecific factors like regression to the mean.