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9/22/2003
StopPulling.com Progress
We recently completed the first set of data analyses for StopPulling.com. The goal of these analyses was to evaluate statistically whether or not program users were making significant (better than chance) improvements over time. At the time of these first analyses, 75 users were signed on. Sixty-five of those users had logged hair-pulling episodes for more than one week, so we conducted analyses to look at whether frequency of hairs pulled, severity of urges, and MGH Hairpulling Scale severity ratings changed significantly across weeks. It is important to remember that these types of analyses use composite data from all users, so the performance of any one user will vary. Also, the number of weeks varied greatly, with some users having logged episodes for only 2 weeks, and others for over 20 weeks. However, even with this large amount of variability, the first set of statistical analyses showed that for all ratings of hair-pulling severity, users reported significantly improved symptoms over time. And in most cases, the longer someone used the program the more improvements were made. Because these data do not come from a “controlled” study, where some participants were assigned randomly (by chance) to StopPulling.com and others to a different intervention, we cannot say for sure why users are making changes. However, we can say with confidence that users of StopPulling.com are improving in significant ways over time. More details about each variable analyzed are presented below.
Number of hairs pulled. At the start of the program (a period we call baseline), users reported that they were pulling an average of 236 hairs per week. This average decreased to 60 hairs per week by the most recent week logged. This is a tremendous improvement. For users who had proceeded from the Assessment module to the Intervention module (a subgroup of 44), significant reductions in hair-pulling frequency were evident across both modules. In other words, users reduced the frequency of hairs pulled during the Assessment module from an average of 263 hairs per week to an average of 111 hairs per week, but then reduced the frequency even more during the Intervention phase from 111 hairs to 50 hairs per week. Again, the longer that users participated in the program, the more reductions they reported in number of hairs pulled.
Severity of urges. A very similar pattern was found in users’ ratings of urge severity at the beginning of each hair-pulling episode. At baseline, users reported on average a moderate urge to pull (a score of 2.7 on a 1-5 scale). Over time, the severity of this urge reduced to a moderately weak urge (a score of 1.9 on the 1-5 scale) This difference was statistically significant, and the data analyses again suggested that urge severity weakened during both the Assessment and Intervention phases. Greater reductions in urge severity were associated with increased numbers of weeks in the program.
MGH Hairpulling Scale. The MGH Hairpulling Scale is a standardized method of measuring improvements in hair-pulling symptoms that was created by one of the developers of StopPulling.com. This measure has been used in much of the available research about trichotillomania. Users of StopPulling.com are asked to complete this measure at baseline, at the start of the Intervention module, and then again each week as users continue through the Intervention and Maintenance phases. Total scores on this measure range from 0 – 15. At baseline, the average score for users was 8.1, indicating moderate severity. At the most recent week logged, the average MGH score was 6.3, indicating a lower subjective severity rating. This difference was statistically significant. As with the other variables, significant reductions in MGH scores were noted during both the Assessment and Intervention phases. However, number of weeks in the program had a less consistent relationship with amount of improvement reported on this scale.
In sum, we are very excited and encouraged by these preliminary numbers and improvements. We are working on collaboration with several other psychologists across the nation to get more controlled studies done on this program. We will keep you posted on progress as we continue to monitor the program and its efficacy.
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Trichotillomania
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People with hair loss due to pulling tend to avoid certain activities such as professional hair cuts, swimming, sports, intimate sexual encounters, and windy or well-lit places.
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