Impaired Executive Functioning in Pediatric Trichotillomania (Hair Pulling Disorder)

Flessner, Christopher A.; Brennan, Elle; Murphy, Yolanda E.; Francazio, Sarah

doi:10.1002/da.22450

Cited by 10 publications

(7 citation statements)

References 53 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, there were no group differences on the TSC-C Severity, F(1,17) = 0.68, p = .42, η 2 = .03, TSC-C Impairment, F(1,17)=.003, p = 0.957, η 2 = .00, TSC-C Total, F(1,17) = .41, p = 0.53, η 2 = .01, or TSC-P Impairment, F(1, 16) = 1.40, p = 0.253, η 2 = .04, at post-training. At baseline, there were no group differences on the indices of the SST: RT on Block 1, t (18) = .21, p = 0.84, RT on Block 2, t(18) = .1.15, p = 0.27, and overall commission errors, t (18) = .49, p = 0.63. In an ANCOVA controlling for commission errors at pre-training and the current RT, the RIT group made significantly fewer commission errors than the WLT group at posttraining, F(1,16) = 7.39, p = 0.015, η 2 = .30 (large effect).…”

Section: Self-and Parent-reported Symptom Scoresmentioning

confidence: 85%

Computerized response inhibition training for children with trichotillomania

Lee

Espil

Bauer

et al. 2018

Psychiatry Research

View full text Add to dashboard Cite

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.

show abstract

Section: Self-and Parent-reported Symptom Scoresmentioning

confidence: 85%

Computerized response inhibition training for children with trichotillomania

Lee

Espil

Bauer

et al. 2018

Psychiatry Research

View full text Add to dashboard Cite

show abstract

“…Moreover, one study only included children, which potentially increased sample heterogeneity since the cognitive differences between adult and child TTM patients are not known. 34 Both aforementioned studies also used pooled sample data, and it is unclear whether these samples were wholly discrete or included shared participants. It is possible that samples overlapped, resulting in a larger effect size.…”

Section: Discussionmentioning

confidence: 99%

Cognition in trichotillomania: a meta-analysis

Ali,

Ioannidis,

Grant

et al. 2024

CNS Spectr.

View full text Add to dashboard Cite

Objective Trichotillomania (TTM) is a mental health disorder characterized by repetitive urges to pull out one’s hair. Cognitive deficits have been reported in people with TTM compared to controls; however, the current literature is sparse and inconclusive about affected domains. We aimed to synthesize research on cognitive functioning in TTM and investigate which cognitive domains are impaired. Methods After preregistration on the International Prospective Register of Systematic Reviews (PROSPERO), we conducted a comprehensive literature search for papers examining cognition in people with TTM versus controls using validated tests. A total of 793 papers were screened using preestablished inclusion/exclusion criteria, yielding 15 eligible studies. Random-effects meta-analysis was conducted for 12 cognitive domains. Results Meta-analysis demonstrated significant deficits in motor inhibition and extradimensional (ED) shifting in people with TTM versus controls as measured by the stop-signal task (SST) (Hedge’s g = 0.45, [CI: 0.14, 0.75], p = .004) and ED set-shift task (g = 0.38, [CI: 0.13, 0.62], p = .003), respectively. There were no significant between-group differences in the other cognitive domains tested: verbal learning, intradimensional (ID) shifting, road map spatial ability, pattern recognition, nonverbal memory, executive planning, spatial span length, Stroop inhibition, Wisconsin card sorting, and visuospatial functioning. Findings were not significantly moderated by study quality scores. Conclusions Motor inhibition and ED set-shifting appear impaired in TTM. However, a cautious interpretation of results is necessary as samples were relatively small and frequently included comorbidities. Treatment interventions seeking to improve inhibitory control and cognitive flexibility merit exploration for TTM.

show abstract

“…14 It is thus difficult to compare these three disorders in terms of inhibition, because of the divergent findings in TTM. Second, altered flexibility was found in adults with OCD 12 (but not in children 13 ) and in TS, 15 but not in TTM 93,95,[97][98][99] (except in one study, which found a deficit in the Object Alternation task, but not in the Wisconsin Card Sorting Test [WCST] 100 ). Attention deficits are found in all three disorders, 12,101 but more mixed results are found in TS (some studies found a deficit, [102][103][104] whereas others did not [105][106][107] ).…”

Section: Neuropsychologymentioning

confidence: 99%

“…13 In TTM, no difference from controls was found. 97,100,108 In TS patients, some studies reported deficits 106,[109][110][111][112][113] while others did not. 114 Looking at these data, TTM seems closer to TS than to OCD.…”

Section: Neuropsychologymentioning

confidence: 99%

Trichotillomania is more related to Tourette disorder than to obsessive-compulsive disorder

Lamothe

Baleyte

Mallet

et al. 2020

Braz. J. Psychiatry

View full text Add to dashboard Cite

Objective: Trichotillomania (TTM) is characterized by the pulling out of one's hair. TTM was classified as an impulse control disorder in DSM-IV, but is now classified in the obsessive-compulsive related disorders section of DSM-5. Classification for TTM remains an open question, especially considering its impact on treatment of the disorder. In this review, we questioned the relation of TTM to tic disorder and obsessive-compulsive disorder (OCD). Method: We reviewed relevant MEDLINE-indexed articles on clinical, neuropsychological, neurobiological, and therapeutic aspects of trichotillomania, OCD, and tic disorders. Results: Our review found a closer relationship between TTM and tic disorder from neurobiological (especially imaging) and therapeutic standpoints. Conclusion: We sought to challenge the DSM-5 classification of TTM and to compare TTM with both OCD and tic disorder. Some discrepancies between TTM and tic disorders notwithstanding, several arguments are in favor of a closer relationship between these two disorders than between TTM and OCD, especially when considering implications for therapy. This consideration is essential for patients.

show abstract

Impaired Executive Functioning in Pediatric Trichotillomania (Hair Pulling Disorder)

Cited by 10 publications

References 53 publications

Computerized response inhibition training for children with trichotillomania

Computerized response inhibition training for children with trichotillomania

Cognition in trichotillomania: a meta-analysis

Trichotillomania is more related to Tourette disorder than to obsessive-compulsive disorder

Contact Info

Product

Resources

About