Psychology Department, Texas State University, San Marcos, TX, USA.
Psychiatry and Behavioral Sciences, Baylor College of Medicine; Psychology Houston, PC, Director, Houston, TX, USA.
J Behav Ther Exp Psychiatry. 2023 Dec;81:101882. doi: 10.1016/j.jbtep.2023.101882. Epub 2023 Jun 8.
Reasons for compulsive hair pulling are heterogeneous and not fully understood. Given that many people who experience compulsive hair pulling do not respond to treatment, identifying subgroups can inform potential mechanisms and treatment design.
We sought to identify empirical subgroups among participants in an online treatment program for trichotillomania (N = 1728). A latent class analysis was used to identify patterns of emotions associated with compulsive hair-pulling episodes.
Six classes of participants were found which reflected three predominant themes. One theme reflected expected patterns, where emotional changes were seen following pulling. Two other themes were more surprising, where one reflected high overall emotional activation that did not show consistent change in response to pulling, and another showed low emotional activation overall. These results suggest that there are multiple types of hair-pulling and a sizeable group of people may benefit from treatment adjustments.
Participants did not receive semi-structured diagnostic assessment. A majority of participants were Caucasian, and future research would benefit from increased participant diversity. Emotions associated with compulsive hair-pulling were measured across an entire treatment program, but the relationship between specific intervention components and change in specific emotions was not systematically collected.
While previous research has addressed overall phenomenology and comorbidity, the present study is the first to identify empirical subgroups of people who experience compulsive hair-pulling at the level of individual pulling episodes. Identified participant classes had distinguishing features that can aid in personalizing treatment to individual symptom presentations.
拔毛癖的发病原因多种多样，目前尚未完全阐明。鉴于许多患有拔毛癖的人对治疗没有反应，确定亚组可以为潜在的发病机制和治疗设计提供信息。
我们试图在一项在线治疗拔毛癖的参与者中识别经验亚组（N=1728）。采用潜在类别分析来识别与强制性拔毛发作相关的情绪模式。
发现了六类参与者，反映了三个主要主题。一个主题反映了预期的模式，即情绪变化发生在拔毛之后。另外两个主题则更加出人意料，其中一个主题反映了总体情绪高度激活，而这种激活在对拔毛的反应中没有表现出一致的变化，另一个主题则反映了总体情绪低度激活。这些结果表明，存在多种类型的拔毛，相当一部分人可能受益于治疗调整。
参与者未接受半结构化诊断评估。大多数参与者是白种人，未来的研究将受益于参与者多样性的增加。与强制性拔毛相关的情绪是在整个治疗过程中测量的，但特定干预措施成分与特定情绪变化之间的关系没有系统地收集。
虽然先前的研究已经解决了总体表现和共病问题，但本研究首次在个体拔毛发作的水平上确定了患有强制性拔毛的经验亚组。确定的参与者类别具有区分特征，可以帮助针对个体症状表现个性化治疗。
