For example, themes that emerged from reports from HPD patients focus on problematic triggering events, negative affect (isolation, embarrassment and shame, anger and frustration fear, guilt, humiliation and pain, body image issues) and control difficulty (self-disclosure, lack of information from the medical community and lack of control).
Patients also live with the constant awareness of the impact their difficulty has on self and others in areas of social, occupational, academic and family functioning. Furthermore, patients may avoid accessing health care services due to feelings of shame, which contributes to delays in treatment seeking, incorrect diagnosis and reduced quality of life.
A study to improve symptoms related to Trichotillomania
An intervention study will be conducted at the Psychology Department at Stikland Hospital in Bellville (Cape Town), who is looking to recruit 40 participants with a diagnosis of HPD to participate in the study.
Cognitive training as intervention
There study aims to look at cognitive training as intervention for the condition. Cognitive training is a treatment method that focuses on improving cognitive functions (e.g. memory, attention, concentration, learning, planning).
There is evidence to suggest that this method of training can increase working memory ability which has shown positive effects on other impulse control difficulties (e.g. Attention Deficit Hyperactivity Disorder and Substance Abuse), thus there is reason to think that cognitive training may also be effective for treatment of HPD.
This study aims to assess whether cognitive training can reduce hair-pulling symptoms. To date, available treatments have not shown long-term reduction of symptoms.
Participating in the study
Once referred to the study, the participant will be contacted telephonically and asked a few questions to make sure they are appropriate for inclusion to the study.
The study will consist of 4 sessions:
1. A first contact session will be scheduled where the participant will complete working memory and impulse control tasks and questionnaires to assess their level of functioning before treatment.
2. During the second contact session, the participant will be introduced to the internet-based cognitive training program, which he/she will use, at home, during the next 5 weeks.
3. After completion of the training, a third contact session will be scheduled, during which the participant will complete working memory and impulse control tasks and questionnaires to assess change in hair-pulling symptoms and working memory.
4. A fourth contact session will be scheduled 3 months after completion of the training to assess whether the changes were maintained over a longer period.
Do you qualify to take part in the study?
The eligibility criteria for participants are as follows:
- A primary diagnosis of hair-pulling disorder
- No other significant current psychiatric conditions (such as depression, obsessive- compulsive disorder or substance use disorder)
- Should be between 18 years or older
- Access to the internet, via a computer for the duration of their study participation
- Preferably not be on any chronic psychiatric medication at the time of participation
- Not be undergoing psychotherapy (however eligible if is in process before start of screening and continues for time of trial).
All participants will undergo the same assessments and they will all do tasks on a daily base. The only difference in terms of the tasks is that half of HPD patients will receive the real cognitive training programme, and the other half will do the placebo training.
If you do qualify for participation, you will be asked to do the following things:
- To attend the 4 contact sessions scheduled with the principle investigator.
- To complete the internet-based cognitive training program - this entails 25 sessions, at home, over a period of 5 weeks.
- To do the training in a quiet environment where you can concentrate.
- To make use of an electronic device, preferably a computer or laptop, that has access to the internet (the whole 5 week program uses about 50Mb of data).