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Journal/Book Title/Conference

Journal of Obsessive-Compulsive and Related Disorders

Author ORCID Identifier

Julie M. Petersen




Elsevier BV

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Last Page


Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.


Treatments for trichotillomania in adolescence have historically been under-researched. This paper presents secondary analyses of treatment moderators and processes of change from a pilot trial assessing the efficacy of teletherapy acceptance-enhanced behavior therapy (AEBT) in adolescents (N = 28). All participants received 10 sessions of AEBT and completed questionnaires at baseline, post-treatment, and longitudinal follow-up from three-, six-, and twelve-months. The moderation effects of baseline general psychological inflexibility, baseline trichotillomania-specific psychological inflexibility, age, and comorbid diagnoses were explored via multilevel modeling using longitudinal outcomes. Comorbid conditions significantly moderated treatment outcome, indicating that more comorbidity was associated with better outcome, even when controlling for pre-treatment trichotillomania severity. No other moderators were significant. Changes in trichotillomania-specific psychological inflexibility from session-by-session data were also examined via multilevel modeling. The results from the models indicated that there was a bidirectional relationship between trichotillomania symptom severity and distress with trichotillomania specific psychological inflexibility. However, review of the slopes from the models suggested that changes in trichotillomania-specific psychological inflexibility may contribute to subsequent improved symptom severity. This study highlights the importance of comorbidity and changes in trichotillomania-specific psychological flexibility during the treatment of youth trichotillomania.

Available for download on Monday, October 28, 2024

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