Affective correlates of trichotillomania

Affective correlates of hair pulling were investigated in a sample of 44 participants diagnosed with trichotillomania (TM). Participants completed the Hair Pulling Survey on which they rated the intensity of ten different affective states across three different phases of hair pulling (before, during and after). Repeated measures analysis of variance was used to examine the change of emotional experience across the hair pulling cycle. Results indicated significant decreases in boredom, anxiety and tension, and significant increases in guilt relief, sadness and anger across time (p<0.005). The role of co-existent anxiety and mood disorders also was examined using repeated measures analysis of variance. Results of these analyses indicated that patients with and without co-existent disorders differed only on patterns of anger across time, and therefore do not support affective subtypes of TM patients based on co-existent diagnosis. Implications of these findings for conceptualization and treatment of TM are discussed.

Anxiety, depression, and the content of worries

Worry content as assessed by using a modified Worry Domains Questionnaire (WDQ) was compared among participants diagnosed with a depressive disorder, generalized anxiety disorder (GAD), and both a depressive disorder and GAD. A discriminant function analysis of worry domains yielded two significant functions. The worry domains Lack of Confidence, Aimless Future, Relationships, and Financial Concerns loaded significantly on Function 1, which was termed "Depressive Worries." The worry domain Loss of Control loaded significantly on Function 2, which was termed "Anxious Worries." The three participant groups differed in their pattern of worries in a way that lends support to the content-specificity hypothesis for both depression and anxiety. In addition, multiple regression analysis indicated that WDQ domain scores (in particular the Aimless Future domain) predicted the severity of depressive symptoms even after the variance contributed by anxiety symptoms was removed from the analysis. These findings suggest that the content of a person's worries may be significantly associated with the presence of depression, anxiety, or comorbid depression and anxiety.

Worry content reported by older adults with and without generalized anxiety disorder

This study investigated worry content in older adults with and without generalized anxiety disorder (GAD). This is an important topic of research, where findings may promote improved recognition and treatment of this disorder in late-life, as well as provide information about the nature of worry across the lifespan. Worry content was compared for 44 older adults diagnosed with GAD and 44 normal control (NC) volunteers matched for age, gender, and ethnicity. Results indicated that older adults with GAD reported a wider variety of worry topics than did NC participants. However, there were no differences in worry content patterns between older adults with and without GAD. These results suggest that pathological worry in later life is not uniquely defined by content, and implications of these findings for assessment and treatment of GAD in older adults are discussed. Worry content reported by older adults also was compared with previously published younger adult worry content data. Age differences in worry content were found in both the clinical and non-clinical groups in patterns that were generally consistent with common age-related developmental changes. Directions for future research of worry across the lifespan are proposed.

Psychometric properties and factor structure of the Worry Domains Questionnaire

The Worry Domains Questionnaire (WDQ) is a content-based measure of nonpathological worry. The current study investigates an adapted WDQ for clinical assessment. The WDQ was completed by 570 participants (286 clinical, 284 nonclinical). Internal consistency of the WDQ domains was found to be adequate. Clinical participants obtained significantly higher WDQ scores than control participants. WDQ scores were moderately correlated with several clinical self-report measures. A seven-factor structure and a higher order worry factor model were separately subjected to structural equation modeling in the clinical sample. The factor groupings originally outlined by the scale's authors (with minor revisions) provided the best description of the clinical data set. Evidence of differences in the worry factor structures of clinical and control samples did emerge. This study provides initial support of the psychometric suitability of the adapted WDQ for use in clinical populations.

Trichotillomania: a challenge to research and practice

This review explores several aspects of trichotillomania relevant to clinical theory and practice. It is concluded that research outlining the phenomenology and patterns of comorbidity of trichotillomania have been advanced significantly in recent years. However, no current diagnostic category appropriately classifies trichotillomania. Research with nonclinical populations suggests that trichotillomania is more common than previously believed and that additional epidemiological research is warranted. Continued elaboration of existing etiological models incorporating varying theoretical perspectives is also encouraged. Assessment of trichotillomania could also be improved by the continued development of reliable and valid standardized measures. This article reviews both pharmacological and psychological treatments for trichotillomania, with an emphasis on habit-reversal training. Though some interventions appear effective in the short-term, reported relapse rates are high and future research on treatment for trichotillomania should focus on improving long-term outcomes. It is clear that despite a recent flux of research centering on trichotillomania, significant challenges for understanding and treating this psychological disorder still exist for researchers and clinicians. Based on this review of the literature, and on our clinical experience with trichotillomania, we propose directions for future research with this underserved psychiatric group.

Portrayal of lobotomy in the popular press: 1935-1960

This study analyzed the content of popular press articles on lobotomy between the years 1935 and 1960. Both a qualitative and quantitative analysis provided evidence that the press initially used uncritical and sensational reporting styles, with the content of articles on lobotomy becoming increasingly negative through time. The initial positive bias occurred despite opposing views in the medical community, which provided a basis for more balanced coverage. These findings support the theory that biased reporting in popular press articles may have been a factor influencing the quick and widespread adoption of lobotomy as a psychiatric treatment.