TLC Blog

Current Research in the Behavior Therapy and Research Lab
University of Wisconsin – Milwaukee
Doug Woods, PhD
Department of Psychology
Behavior Therapy and Research Lab

Originally printed: InTouch 66, copyright 2012

The Behavior Therapy and Research Lab at the University of Wisconsin-Milwaukee specializes in conducting research on understanding and treating repetitive behavior disorders, including hair pulling disorder (HPD; trichotillomania), skin picking disorder (SPD), and other body focused repetitive behaviors (BFRBs).   Much of the research in the Lab is done in our Trichotillomania/BFRB Specialty Clinic.  We have a number of different projects in our lab.  Generally, they focus on three areas; treatment, understanding the social impact of the problems, and research that betters our understanding of how TTM/BFRBs should be classified.

Treatment
An important goal of the lab is to develop and test behavioral interventions for individuals with HPD, SPD and other BFRBs.  Currently, we are conducting a large randomized control trial funded by The National Institute of Mental Health (NIMH).  In this trial, we are comparing the efficacy of acceptance-enhanced behavioral therapy (AEBT) to a psychoeducation and supportive therapy intervention in the treatment for HPD.  We have reason to believe that both treatments may benefit hair pulling sufferers, but this is the first time that these interventions are examined in a large randomized controlled trial. Participation involves 10 psychotherapy sessions as well as several assessment sessions before, during and after treatment.   The treatment is free, and participants are paid up to $200 for their involvement in the study.  As of now, we have recruited several participants, and are looking to continue recruitment through 2013.

Unfortunately, very few studies have examined treatment for young children with BFRBs.  We recently developed a treatment manual for 5 to 9 year olds with hair pulling and conducted a pilot study examining the acceptability, feasibility and efficacy of the manual.  Seven children (and their parents) participated in the study.  Results showed that the treatment was rated as highly acceptable by the parents and the children, and most of the children showed significant improvement in hair pulling.

Impact and social perception
In recent years, we have conducted several Internet surveys among hair pullers and skin pickers in collaboration with other researchers.  The main aim of these studies has been to document the distress and disability associated with HPD and SPD.  Findings from adults and adolescent hair pullers as well as adult skin pickers have been reported previously.  Currently, we are analyzing data from a survey among parents of young children (0-10 years old) with hair pulling.  We are especially interested in examining the impact hair pulling has on preschool-aged children because some researchers think that hair pulling in young children may be more benign than hair pulling in older individuals.

Another line of research we are interested in is the social perception of individuals with BFRBs.  We have conducted several surveys among college students in order to identify factors that influence positive and negative social perception of individuals with HPD.  We are also in the process of designing similar studies examining social perception of other BFRBs.

Assessment /classification
Many researchers now believe that different BFRBs, including hair pulling, skin picking, nail biting and cheek/lip biting, are related problems that reflect similar etiology.  However, this idea has not been researched well.  Thus, we are conducting studies to better understand the relationship between these problems.  For example, we are conducting an Internet survey among college students to determine whether students with these problems have similar characteristics, if students with one problem are more likely to have the other ones too, and if different BFRBs run in same families.

In order to study BFRBs, it is important to have psychometrically sound instruments.  We are currently conducting studies on several instruments.   For example, we have recently developed a semi-structured interview for BFRBs  The interview examines diagnosis, impairment and family history of these problems.  We are also collecting data on the psychometric properties of the skin picking scale-revised, which is a self-report questionnaire assessing severity and impairment of skin picking.

Other studies
In addition to the above-mentioned studies we are involved in other research on BFRBs, including studies examining the parent-child relationships in families where the child has HPD, neurocognitive deficits associated with HPD and SPD, the role of emotions and attention in BFRBs, and more.