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The Manipulation of Arousal on the Intensity of Urges to Pull Hair in a 16 Year Old Female with Trichotillomania: A Single Case Study

Published online by Cambridge University Press:  17 October 2008

Emma Drysdale ,
Andrew Jahoda  and
Elizabeth Campbell
Emma Drysdale*
Affiliation:
Douglas Inch Centre, Glasgow, UK
Andrew Jahoda
Affiliation:
University of Glasgow, UK
Elizabeth Campbell
Affiliation:
University of Glasgow, UK
*
Reprint requests to Emma Drysdale, Douglas Inch Centre, 2 Woodside Terrace, Glasgow G3 7UY, UK. E-mail: [email protected] An extended version is also available online in the table of contents for this issue: http://journals.cambridge.org/jid_BCP
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Abstract

Hairpulling (trichotillomania) is often linked to stressful circumstances and may produce feelings of guilt, shame and humiliation. In a behavioural model, affective experience was identified as an important maintaining factor, as both a cue and reinforcer. Habit Reversal is one of the more successful behavioural treatment options. The present study evaluated the role of emotional arousal in the intensity of urges to pull hair in a teenaged patient with trichotillomania. Using an experimental ABCD/DCBA reversal design, the patient used imagery to increase her emotional arousal through the presentation of a manipulation script based on her own experience, after baseline and during a rumination, cognitive and a behavioural distraction phase. Subjective measures of urge intensity were collected at five time points during completion of a task, and a tally was made of an overt hair touching behaviour operationalized as a hairpulling substitute behaviour. The patient experienced more intense urges to pull whilst ruminating on the arousal script compared to either of the distraction phases. The findings support the view that the experience of negative emotional arousal can exacerbate and intensify the experience of urges to pull hair in patients with trichotillomania, and that both cognitive and behavioural distraction techniques have some effect in controlling them. Demonstrating this to the patient aided engagement in treatment.

Keywords

Trichotillomaniaarousaldistractionsingle-casecognitivebehavioural
Type
Brief Clinical Reports
Information
Behavioural and Cognitive Psychotherapy , Volume 37 , Issue 1 , January 2009 , pp. 115 - 120
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2008

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