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Abstract：
Trichotillomania (TTM) is associated with impairments in response inhibition and cognitive flexibility, but it is unclear how such impairments relate to treatment outcome. The present study examined pre-treatment response inhibition and cognitive flexibility as predictors of treatment outcome, change in these domains from pre-to post-treatment, and associations with TTM severity. Participants were drawn from a randomized controlled trial comparing acceptance-enhanced behavior therapy (AEBT) to psychoeducation and supportive therapy (PST) for TTM. Adults completed assessments at pre-treatment (n = 88) and following 12 weeks of treatment (n = 68). Response inhibition and cognitive flexibility were assessed using the Stop Signal Task and Object Alternation Task, respectively. Participants completed the MGH-Hairpulling Scale. Independent evaluators administered the NIMH-Trichotillomania Severity Scale and Clinical Global Impressions-Improvement Scale. Higher pre-treatment TTM severity was associated with poorer pre-treatment cognitive flexibility, but not response inhibition. Better pre-treatment response inhibition performance predicted positive treatment response and lower post-treatment TTM symptom severity, irrespective of treatment assignment. Cognitive flexibility did not predict treatment response. After controlling for age, neither neurocognitive variable changed during treatment. Response inhibition and cognitive flexibility appear uniquely related to hair pulling severity and treatment response in adults with TTM. Implications for treatment delivery and development are discussed.
摘要：
毛滴虫病（TTM）与反应抑制和认知灵活性的损害有关，但目前尚不清楚这些损伤与治疗结果有何关系.本研究检查了治疗前反应抑制和认知灵活性作为治疗结果的预测因子，这些领域从治疗前到治疗后的变化，以及与TTM严重程度的关联。参与者来自一项随机对照试验，比较了TTM的接受增强行为疗法（AEBT）与心理教育和支持疗法（PST）。成人在治疗前(n=88)和治疗12周后(n=68)完成评估。使用停止信号任务和对象交替任务评估反应抑制和认知灵活性，分别。参与者完成了MGH-理发量表。独立评估人员进行了NIMH-Trichotillomania严重程度量表和临床总体印象改善量表。较高的治疗前TTM严重程度与较差的治疗前认知灵活性相关，但不是反应抑制。更好的治疗前反应抑制性能预测积极的治疗反应和较低的治疗后TTM症状严重程度，不管治疗分配。认知灵活性不能预测治疗反应。在控制了年龄之后,治疗期间神经认知变量均无变化。反应抑制和认知灵活性似乎与患有TTM的成年人的拔发严重程度和治疗反应独特相关。讨论了治疗交付和发展的含义。
