Computerized response inhibition training for children with trichotillomania

Abstract

Evidence suggests that trichotillomania is characterized by impairment in response inhibition, which is the ability to suppress pre-potent/dominant but inappropriate responses. This study sought to test the feasibility of computerized response inhibition training for children with trichotillomania. Twenty-two children were randomized to the 8-session response inhibition training (RIT; n = 12) or a waitlisted control (WLT; n = 10). Primary outcomes were assessed by an independent evaluator, using the Clinical Global Impression-Improvement (CGI-I), and the NIMH Trichotillomania Severity (NIMH-TSS) and Impairment scales (NIMH-TIS) at pre, post-training/waiting, and 1-month follow-up. Relative to the WLT group, the RIT group showed a higher response rate (55% vs. 11%) on the CGI-I and a lower level of impairment on the NIMH-TIS, at post-training. Overall symptom reductions rates on the NIMH-TSS were 34% (RIT) vs. 21% (WLT) at post-training. The RIT's therapeutic gains were maintained at 1-month follow-up, as indicated by the CGI-I responder status (= 66%), and a continuing reduction in symptom on the NIMH-TSS. This pattern of findings was also replicated by the 6 waitlisted children who received the same RIT intervention after post-waiting assessment. Results suggest that computerized RIT may be a potentially useful intervention for trichotillomania.

Feasibility and acceptability of an online response inhibition cognitive training program for youth with Williams syndrome

“…Part II: Treatment or waitlist crossover (6–7 h total) . The game-like cognitive training program utilized in this phase was developed for a recent series of clinical trials studies and showed promise for improving RI in individuals with disorders characterized by poor RI ( Lee, Espil, Bauer, Siwiec, & Woods, 2018 ). See Table 2 for a description of the training program.…”

ACT‐enhanced group behavior therapy for trichotillomania and skin‐picking disorder: A feasibility study

“…Delivering therapist-guided behavior therapy entirely via the Internet, which has been successful for OCD (Andersson et al, 2012) and body dysmorphic disorder (Enander et al, 2016) could substantially increase the accessibility, and as we suggest above, enable even more patients to participate in treatment, in spite of full-time employment or other obstructive factors. Indeed, some promising results of computer or internet-delivered self-help treatments for TTM (Lee et al, 2018;Mouton-Odum et al, 2006;Rogers et al, 2014) and SPD (Flessner et al, 2007;Gallinat et al, 2019) have already been presented.…”

Pediatric trichotillomania: Review of management

“…These monitors may be particularly helpful during the awareness and stimulus‐control components of HRT. A pilot clinical trial of computerized response inhibition training (RIT) in pediatric TTM patients demonstrated a 55% response rate using the Clinical Global Impression‐Improvement scale, though limited by a small sample size . The possibility of including technology in HRT may present an opportunity to target therapy at the unconscious pulling predominantly seen in the pediatric population.…”

“…A pilot clinical trial of computerized response inhibition training (RIT) in pediatric TTM patients demonstrated a 55% response rate using the Clinical Global Impression-Improvement scale, though limited by a small sample size. 19 The possibility of including technology in HRT may present an opportunity to target therapy at the unconscious pulling predominantly seen in the pediatric population. Additional longitudinal studies would be helpful in demonstrating if lasting effects are maintained throughout adulthood.…”