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21-02-2025 | Original Article
StopPulling.com: Real-World Effectiveness of a Self-Guided Online Intervention for Trichotillomania
Auteurs: Kathryn E Barber, Mercedes G Woolley, Kate Rogers, Sandra Hadlock, Douglas W Woods, Suzanne Mouton-Odum
Gepubliceerd in: Cognitive Therapy and Research
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Abstract
Background
Trichotillomania (TTM) is a prevalent yet under-treated disorder characterized by repetitive hair-pulling that causes distress and impairment. Self-guided digital interventions like StopPulling.com can address treatment barriers such as limited provider access and stigma. StopPulling.com is an online program that delivers structured self-monitoring (Module 1, Assessment) and personalized behavioral strategies (Module 2, Intervention), without therapist interaction.
Methods
This study evaluated StopPulling.com’s effectiveness using naturalistic data from program users between 2003 and 2022. TTM symptom severity was assessed using the abbreviated Massachusetts General Hospital-Hairpulling Scale (MGH-HS). Changes in symptoms were analyzed using mixed linear modeling in an intent-to-treat (ITT) sample (n = 2,211) and a Completer sample (n = 912). A clinical subgroup (baseline MGH-HS ≥ 5) was also examined. Self-monitoring log frequency and program use duration were tested as moderators.
Results
StopPulling.com users showed significant reductions in TTM severity across program use (ITT Hedge’s g = 0.64, Completers g = 0.63), with larger effects in the clinical subgroup (ITT g = 0.74, Completers g = 0.72). Clinically significant treatment response (> 35% reduction in MGH-HS) was found in 38% of Completers. Higher self-monitoring frequency was associated with greater symptom improvements. Earlier age of TTM onset and higher baseline symptom severity predicted higher self-monitoring frequency.
Conclusions
Findings suggest StopPulling.com facilitates modest reductions in TTM severity and highlight its value as a scalable, accessible intervention that can address barriers to care. Future research should explore strategies to enhance user engagement and further improve outcomes for self-guided online TTM interventions.
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Literatuur
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go back to reference Woods, D. W., Flessner, C. A., Franklin, M. E., Keuthen, N. J., Goodwin, R. D., Stein, D. J., & Walther, M. R. (2006). The Trichotillomania Impact Project (TIP): Exploring phenomenology, functional impairment, and treatment utilization. Journal of Clinical Psychiatry, 67(12), 1877–1888. https://doi.org/10.4088/jcp.v67n1207CrossRefPubMed
Woods, D. W., Flessner, C. A., Franklin, M. E., Keuthen, N. J., Goodwin, R. D., Stein, D. J., & Walther, M. R. (2006). The Trichotillomania Impact Project (TIP): Exploring phenomenology, functional impairment, and treatment utilization. Journal of Clinical Psychiatry, 67(12), 1877–1888. https://doi.org/10.4088/jcp.v67n1207CrossRefPubMed
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Woods, D. W., Ely, L. J., Bauer, C. C., Twohig, M. P., Saunders, S. M., Compton, S. N., Espil, F. M., Neal-Barnett, A., Alexander, J. R., Walther, M. R., Cahill, S. P., Deckersbach, T., & Franklin, M. E. (2022). Acceptance-enhanced behavior therapy for trichotillomania in adults: A randomized clinical trial. Behaviour Research and Therapy, 158, 104187. https://doi.org/10.1016/j.brat.2022.104187CrossRefPubMedPubMedCentral
Metagegevens
- Titel
- StopPulling.com: Real-World Effectiveness of a Self-Guided Online Intervention for Trichotillomania
- Auteurs
-
Kathryn E Barber
Mercedes G Woolley
Kate Rogers
Sandra Hadlock
Douglas W Woods
Suzanne Mouton-Odum
- Publicatiedatum
- 21-02-2025
- Uitgeverij
- Springer US
- Gepubliceerd in
-
Cognitive Therapy and Research
Print ISSN: 0147-5916
Elektronisch ISSN: 1573-2819 - DOI
- https://doi.org/10.1007/s10608-025-10584-3