Photographic Assessment of Change in Trichotillomania: Psychometric Properties and Variables Influencing Interpretation

David Houghton, Maddison R. Franklin, Michael P. Twohig, Martin E. Franklin, Scott N. Compton, Angela M. Neal-Barnett, Stephen M. Saunders, Douglas W. Woods

Research output: Contribution to journalArticle

Abstract

Although photographic assessment has been found to be reliable in assessing hair loss in Trichotillomania, the validity of this method is unclear, particularly for gauging progress in treatment. The current study evaluated the psychometric properties of photographic assessment of change in Trichotillomania. Photographs showing hair loss of adults with Trichotillomania were taken before and after participating in a clinical trial for the condition. Undergraduate college students (N = 211) rated treatment response according to the photos, and additional archival data on hair pulling severity and psychosocial health were retrieved from the clinical trial. Photographic assessment of change was found to possess fair reliability (ICC = 0.53), acceptable criterion validity (r = 0.51), good concurrent validity (r = 0.30–0.36), and excellent incremental validity (ΔR2 = 8.67, p < 0.01). In addition, photographic measures were significantly correlated with change in quality of life (r = 0.42), and thus could be considered an index of the social validity of Trichotillomania treatment. Gender of the photo rater and pulling topography affected the criterion validity of photographic assessment (partial η2 = 0.05–0.11). Recommendations for improving photographic assessment and future directions for hair pulling research are discussed.

Original languageEnglish (US)
Pages (from-to)505-513
Number of pages9
JournalJournal of Psychopathology and Behavioral Assessment
Volume38
Issue number3
DOIs
StatePublished - Sep 1 2016
Externally publishedYes

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Keywords

  • Assessment
  • Behavioral observation
  • Hair pulling
  • Psychometrics

ASJC Scopus subject areas

  • Clinical Psychology

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