Online Response Inhibition Training for Trichotillomania

Although trichotillomania (TTM), an impulse control disorder characterized by compulsive hair
pulling, typically results in serious consequences including impaired individual functioning,
medical problems (e.g., skin infections), and elevated comorbidity with other psychiatric
disorders, it remains one of the most poorly-understood and inadequately-treated psychiatric
conditions. There is an urgent need for effective and accessible clinical interventions for
TTM, especially for young individuals who suffer from a marked lack of adequate treatment
resources despite the early onset of the condition. One promising therapeutic approach is to
improve cognitive problems believed to contribute to TTM, using a computerized cognitive
retraining method. Research has indicated impaired response inhibition (RI; the ability to
inhibit inappropriate but potent response) as an important cognitive feature underlying TTM.
Therefore, RI is considered to be an important target of cognitive retraining. Investigators
have developed a computerized training program that aims to improve RI capabilities in the
format of an online video game. Fifty children with TTM will be randomly assigned to (a)
online 8-session RIT (n=25), or (b) 1-month waitlist condition (n = 25), and will be assessed
at baseline, post-treatment, and 1-month follow-up. The waitlisted participants will also be
invited to undergo the training program after the 1-month follow-up assessment is completed.
Investigators hypothesize that the online RIT will show greater improvement in TTM symptoms
and RI capabilities at post-treatment and 1-month follow-up assessments, compared to the
waitlist condition. This study is expected to generate important data that will guide the
development of an accessible, cost-efficient, and effective cognitive intervention for
individuals suffering from TTM.

Inclusion Criteria:

- age between 8 and 17

- a diagnosis of trichotillomania

- a computer with high speed internet

Exclusion Criteria:

- current substance use problems

- current or past psychotic disorder, bipolar disorder, or schizophrenia

- current behavioral treatments for trichotillomania

- significant suicidality

- severe conditions known for poor response inhibition(ADHD, OCD, and tic disorders)

- recent or planned change in medication

- low intellectual functioning (below 80)