Stepped care in the treatment of trichotillomania.
Stepped care in the treatment of trichotillomania.
复制标题
治疗拔毛癖的分级护理。
DOI：
10.1037/a0035744
复制
发表时间：
2014
影响因子：
5.9
通讯作者：
Haaga,DavidAF
中科院分区：
文献类型：
--
作者：
Rogers,Kate;Banis,Maria;Falkenstein,MarthaJ;Malloy,ElizabethJ;McDonough,Lauren;Nelson,SamuelO;Rusch,Natalie;Haaga,DavidAF
有有效的治疗震颤躁狂症（TTM），但获得专家提供者是有限的。本研究测试了一个阶梯护理模式，旨在提高access.MethodParticipants是60（95%的妇女，75%的白人，2%的西班牙裔）成人（M= 33.18岁）TTM。他们被随机分配到第一步的即时与等待名单（WL）条件（通过StopPulling进行10周的基于网络的自助）。com）。在步骤1之后，参与者选择是否参与步骤2（8次面对面的习惯逆转训练[HRT]）。21)但在降低访谈者的TTM症状评分方面（对实验条件不知情，但对评估点不知情），相对于WL具有显著优势;在自我报告的TTM症状、脱发、功能障碍或生活质量方面没有差异。第一步对那些经常使用网站的人更有效。阶梯式护理是高度可接受的：在第1步中，动机没有下降;治疗满意度很高，76%的人参加了第2步。更多有症状的患者自我选择接受HRT，平均而言，他们得到了显着改善。超过三分之一（36%）的患者在自我报告的TTM症状方面取得了临床显著改善。考虑到整个阶梯护理计划，参与者显着减少症状，脱发和损伤，并提高生活质量。对于生活质量和症状的严重程度，有一些复发3个月的后续following.ConclusionsStepped护理是可以接受的，HRT与改善。需要进一步的工作来确定哪些TTM患者可以从自助中受益以及如何减少复发。
ObjectiveThere are effective treatments of trichotillomania (TTM), but access to expert providers is limited. This study tested a stepped care model aimed at improving access.MethodParticipants were 60 (95% women, 75% Caucasian, 2% Hispanic) adults (M= 33.18 years) with TTM. They were randomly assigned to immediate versus waitlist (WL) conditions for Step 1 (10 weeks of web-based self-help via StopPulling. com). After Step 1, participants chose whether to engage in Step 2 (8 sessions of in-person habit reversal training [HRT]).ResultsIn Step 1, the immediate condition had a small (d=. 21) but significant advantage, relative to WL, in reducing TTM symptom ratings by interviewers (masked to experimental condition but not to assessment point); there were no differences in self-reported TTM symptoms, alopecia, functional impairment, or quality of life. Step 1 was more effective for those who used the site more often. Stepped care was highly acceptable: Motivation did not decrease during Step 1; treatment satisfaction was high, and 76% enrolled in Step 2. More symptomatic patients self-selected into HRT, and on average they improved significantly. Over one third (36%) made clinically significant improvement in self-reported TTM symptoms. Considering the entire stepped care program, participants significantly reduced symptoms, alopecia, and impairment, and increased quality of life. For quality of life and symptom severity, there was some relapse by 3-month follow-up.ConclusionsStepped care is acceptable, and HRT was associated with improvement. Further work is needed to determine which patients with TTM can benefit from self-help and how to reduce relapse.