Styles of pulling in trichotillomania: Exploring differences in symptom severity, phenomenology, and functional impact
Styles of pulling in trichotillomania: Exploring differences in symptom severity, phenomenology, and functional impact
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DOI：
10.1016/j.brat.2007.12.009
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发表时间：
2008-03-01
影响因子：
4.1
通讯作者：
Cashin, Susan E.
中科院分区：
文献类型：
--
作者：
Flessner, Christopher A.;Conelea, Christine A.;Cashin, Susan E.
先前的研究已经检验了与拔毛癖（TTM）相关的“集中”（即具有强迫性质）和“自动”（即意识下降）拉动之间可能存在的现象学差异，但这些结构尚未使用心理测量学上合理的措施进行评估。在当前的研究中，对具有不同“专注”和“自动”拉力风格组合的个体在 TTM 严重程度、现象学、共病精神症状和功能影响方面的差异进行了检查。 18 岁及以上的参与者是通过互联网调查招募的。那些符合纳入标准并完成密尔沃基拔毛癖亚型清单的成人版（MIST-A；n = 1545）的人根据使用中值分割程序从 MIST-A 的聚焦和自动量表获得的分数被分为高聚焦或低聚焦以及高自动或低自动。结果显示拉动方式之间存在一些显着差异。例如，“高自动”拉手比“低自动”拉手报告更严重的 TTM 和更大的压力，而“高专注”拉手报告比“低专注”拉手更严重的 TTM、更大的压力和抑郁以及更大的功能影响。随后的分析表明，与经历低水平自动和集中拉动的个体相比，经历高水平每种拉动方式的个体报告了更大的严重性、心理影响和功能影响。讨论了临床和研究意义、研究局限性和未来的研究领域。 (C) 2008 Elsevier Ltd. 保留所有权利。
Previous research has examined possible phenomenological differences between "focused" (i.e., with a compulsive quality) and "automatic" (i.e., with decreased awareness) pulling associated with trichotillomania (TTM), but these constructs have not been assessed using psychometrically sound measures. In the current study, differences in TTM severity, phenomenology, comorbid psychiatric symptoms, and functional impact were examined across individuals with varying combinations of "focused" and "automatic" pulling styles. Participants aged 18 and older were recruited via an internet-based survey. Those meeting inclusion criteria and completing the Milwaukee Inventory for Subtypes of Trichotillomania-Adult Version (MIST-A; n = 1545) were classified as either high- or low-focused and either high- or low-automatic based on scores obtained from the focused and automatic scales of the MIST-A using a median split procedure. Results showed some significant differences between pulling styles. For example, "high-automatic" pullers reported more severe TTM and greater stress than "low-automatic" pullers, and "high-focused" pullers reported more severe TTM, greater stress and depression, and greater functional impact than "low-focused" pullers. Subsequent analyses suggest that, in comparison to individuals experiencing low levels of both automatic and focused pulling, those experiencing high levels of each pulling style reported greater severity, psychological impact, and functional impact. Clinical and research implications, study limitations, and future areas of research are discussed. (C) 2008 Elsevier Ltd. All rights reserved.