Defining treatment response in trichotillomania: A signal detection analysis

David C. Houghton, Matthew R. Capriotti, Alessandro S. De Nadai, Scott N. Compton, Michael P. Twohig, Angela M. Neal-Barnett, Stephen M. Saunders, Martin E. Franklin, Douglas W. Woods

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

The Massachusetts General Hospital Hairpulling Scale (MGH-HPS) and the NIMH Trichotillomania Severity Scale (NIMH-TSS) are two widely used measures of trichotillomania severity. Despite their popular use, currently no empirically-supported guidelines exist to determine the degrees of change on these scales that best indicate treatment response. Determination of such criteria could aid in clinical decision-making by defining clinically significant treatment response/recovery and producing accurate power analyses for use in clinical trials research. Adults with trichotillomania (. N=69) participated in a randomized controlled trial of psychotherapy and were assessed before and after treatment. Response status was measured via the Clinical Global Impressions-Improvement Scale, and remission status was measured via the Clinical Global Impressions-Severity Scale. For treatment response, a 45% reduction or 7-point raw score change on the MGH-HPS was the best indicator of clinically significant treatment response, and on the NIMH-TSS, a 30-40% reduction or 6-point raw score difference was most effective cutoff. For disorder remission, a 55-60% reduction or 7-point raw score change on the MGH-HPS was the best predictor, and on the NIMH-TSS, a 65% reduction or 6-point raw score change was the best indicator of disorder remission. Implications of these findings are discussed.

Original languageEnglish (US)
Pages (from-to)44-51
Number of pages8
JournalJournal of Anxiety Disorders
Volume36
DOIs
StatePublished - Dec 1 2015

Keywords

  • Hair pulling
  • Obsessive-compulsive disorder
  • Psychotherapy
  • Signal detection
  • Trichotillomania

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

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    Houghton, D. C., Capriotti, M. R., De Nadai, A. S., Compton, S. N., Twohig, M. P., Neal-Barnett, A. M., Saunders, S. M., Franklin, M. E., & Woods, D. W. (2015). Defining treatment response in trichotillomania: A signal detection analysis. Journal of Anxiety Disorders, 36, 44-51. https://doi.org/10.1016/j.janxdis.2015.09.008