Predictors of Relapse Following Treatment of Trichotillomania

This study sought to identify predictors of relapse in a stepped-care behavior therapy trial for trichotillomania, or hair-pulling disorder. More information is needed about patient variables that may predict relapse, which could be helpful to clinicians in planning how to better serve patients during treatment. The roles of abstinence from pulling, residual urges during abstinence, comorbid depression, hair pulling severity, and intrinsic motivation were evaluated. Of these possible predictors, abstinence at the conclusion of treatment was found to significantly predict maintenance. Another contribution was the introduction of the Probability of Treatment Benefit (PTB) charts (Lindhiem, Kolko, & Cheng, 2012) to the trichotillomania literature. These charts were used to quantify the probability of being able to maintain gains according to predictors of maintenance. Finally, this study highlighted the need for a consensus on operational definitions of "treatment response" and "maintenance of response" due to the variety of results obtained when these definitions differed.