Department of Psychology, University of Toledo, Toledo, OH, USA.
Department of Psychology, Marquette University, Milwaukee, WI, USA.
Behav Res Ther. 2023 May;164:104302. doi: 10.1016/j.brat.2023.104302. Epub 2023 Mar 21.
Trichotillomania is characterized by recurrent pulling out of one's hair, leading to significant hair loss and accompanied by clinically significant distress and/or functional impairment. The current study used data from a randomized controlled trial comparing the effectiveness of acceptance-enhanced behavior therapy (AEBT) to psychoeducation plus supportive therapy (PST; active control) for trichotillomania in an adult sample. The objectives were to examine the moderating and mediating influence of trichotillomania-specific psychological flexibility in treatment for trichotillomania. Participants with lower baseline flexibility performed better in AEBT than PST in terms of greater symptom reduction and quality of life. Lower baseline flexibility also predicted higher likelihood of disorder recovery in AEBT relative to PST. In addition, relative to PST, symptom reduction in AEBT was mediated by psychological flexibility, controlling for anxiety and depression. These findings suggest that psychological flexibility is a relevant process of change in the treatment of trichotillomania. Clinical implications and directions for future research are discussed.
拔毛癖的特征是反复拔自己的毛发，导致明显的脱发，并伴有明显的痛苦和/或功能障碍。本研究使用了一项随机对照试验的数据，该试验比较了接受增强行为疗法（AEBT）与心理教育加支持性治疗（PST；活性对照）对成人拔毛癖的疗效。目的是探讨在治疗拔毛癖时，拔毛癖特异性心理灵活性的调节和中介作用。与 PST 相比，基线灵活性较低的参与者在 AEBT 中的症状缓解和生活质量方面表现更好。较低的基线灵活性也预示着 AEBT 相对于 PST 恢复障碍的可能性更高。此外，与 PST 相比，AEBT 中的症状缓解通过心理灵活性来介导，同时控制了焦虑和抑郁。这些发现表明，心理灵活性是治疗拔毛癖的一个相关的变化过程。讨论了临床意义和未来研究的方向。
