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Biomedical subjects

Douglas W Woods

Publications and source records attributed to Douglas W Woods.

At least 19 recordsLinked to original sources
PubMed2006

Reactivity of tic observation procedures to situation and setting.

Tic frequency was assessed and compared across home and clinic as well as three experimentally-manipulated situations in order to assess the phenomenon of tic reactivity. Forty-three youngsters with chronic tic disorder recruited from two geographically-distinct sites were videotaped over three weekly laboratory visits under each of the following conditions: (1) alone/camera present, (2) other present/camera present, and (3) alone/camera hidden. Contrary to expectation, more tics were observed during overt as compared to covert observation, while the presence of another person had no overall impact on tic expression. Mean tic counts obtained from clinic observation did not significantly differ from those obtained at home collected either one day before or after. Tic frequency counts were remarkably stable over the three weekly assessments both at home and clinic. Study findings are consistent with past observations that tic expression can be influenced by environmental factors and suggest the stability of tic frequency may exhibit greater temporal and setting stability than previously thought. The clinical and research implications of these results are discussed.

Adolescent↗
PubMed2006

Understanding and treating trichotillomania: what we know and what we don't know.

This article reviews current issues in the understanding and clinical management of trichotillomania (TTM). After diagnostic considerations and epidemiology are discussed, a brief update on biologic and environmental precipitants is provided, and emerging research on possible TTM subtypes is discussed. Current strategies for assessing TTM and t heir applicability to clinical practice are reviewed, as is the current state of pharmacologic and nonpharmacologic treatments for the disorder. The article concludes with suggestions for future research and descriptions of the authors'research agenda.

Adult↗
PubMed2006

Investigating healthcare providers' knowledge of trichotillomania and its treatment.

Given the low prevalence rate and rather secretive nature of trichotillomania, it is uncertain how much trichotillomania-related knowledge physicians and psychologists possess, what the perceived role of a psychologist is in the treatment process, what level of familiarity practitioners have with effective treatments and whether providers have resource materials available for patients. In a postal survey of 501 psychologists and physicians in the USA, providers responded correctly to 61% of the general knowledge items about trichotillomania. Most providers believed that psychologists may play a variety of roles in the clinical management of the disorder. Although providers were fairly accurate about the effectiveness of certain treatments for trichotillomania (e.g. medication, habit-reversal), a number of non-empirically supported treatments were endorsed as being effective. Furthermore, an overwhelming majority of healthcare providers did not have resources or referral information available for patients with trichotillomania. Implications of the findings and limitations of the study are discussed.

Attitude of Health Personnel↗
PubMed2006

Habit reversal as a treatment for chronic skin picking: a pilot investigation.

The purpose of this study was to compare the effectiveness of habit reversal (HR) to a wait-list control as a treatment for chronic skin picking in adults. Twenty-five adults with a chronic skin-picking problem were randomly assigned to a wait-list control or HR group. At pretreatment, posttreatment, and a 3-month follow-up, self-reported skin picking was assessed, and photographs were taken of the damaged areas and later rated by independent observers. Treatment acceptability data were collected at posttreatment only. Results showed that HR produced a greater decrease in skin picking at posttreatment and follow-up when compared to the wait-list control group. Data from the independent raters confirmed these findings. HR was also viewed as an acceptable intervention by the participants.

Adolescent↗
PubMed2006

Phenomenological characteristics, social problems, and the economic impact associated with chronic skin picking.

In this study, the authors collected data on the demographic characteristics, phenomenology, and social and economic impact of skin picking. A total of 92 participants completed an anonymous, Internet-based survey through a link to the Trichotillomania Learning Center's home page. Results indicated that skin pickers experienced social, occupational, and academic impairment, a number of medical or mental health concerns, and financial burdens, which they attributed to skin picking. Results also revealed moderate, statistically significant relationships between skin picking severity and symptoms of depression, anxiety, and experiential avoidance. Subsequent mediational analyses demonstrated that the relationship between skin picking severity and symptoms of anxiety and depression was partially mediated by experiential avoidance. Implications, conclusions, and future areas of research are discussed.

Adolescent↗
PubMed2006

Brief review of habit reversal training for Tourette syndrome.

It is well established that Tourette syndrome has a neurobiologic origin. Although pharmacotherapy is the most commonly prescribed intervention, there is considerable evidence to support the use of behavior therapy, specifically habit reversal training, as an alternative or adjunct treatment for some individuals with Tourette syndrome. Unfortunately, many professionals are unfamiliar with habit reversal training. The purpose of this review is to provide readers with a brief review of empiric studies on habit reversal training, update readers on the current state and future of behavior therapy for Tourette syndrome, and provide resources for those readers interested in additional information.

Adult↗
PubMed2006

The Trichotillomania Impact Project (TIP): exploring phenomenology, functional impairment, and treatment utilization.

BACKGROUND: Trichotillomania (TTM) occurs in 0.6% to 3.4% of adults. Questions remain about phenomenological features of the disorder, its impact on functioning, and treatment utilization. The current study (i.e., The Trichotillomania Impact Project) was designed to provide initial information regarding these issues. METHOD: An Internet-based survey was completed by 1697 individuals who self-reported symptoms consistent with a diagnosis of TTM (DSM-IV-TR). The survey assessed phenomenological experiences; social, occupational, academic, and psychological impact; as well as treatment-seeking experiences. The survey link operated from April 2005 through May 2005. RESULTS: Survey results suggest considerable variability in TTM phenomenology. Individuals with more severe TTM symptoms endorsed more frequent phenomenological experiences of physical or mental anxiety prior to pulling and relief, pleasure, or gratification after pulling. Mild to moderate life impairment in social, occupational, academic, and psychological functioning was reported for the entire study sample. These impairments were more pronounced as TTM symptoms became more severe. A summary of treatment seeking in the sample suggests that pharmacotherapy was the most commonly received treatment, followed by behavior therapy. Unfortunately, treatment in general was perceived as relatively ineffective. CONCLUSION: This study underscores the clinical significance of severe hair pulling and highlights the need for research on its pathogenesis and treatment.

Activities of Daily Living↗
PubMed2006

Behavior therapy: other interventions for tic disorders.

This chapter reviewed other behavioral interventions for TS and discussed their efficacy. Clearly, the majority of behavioral interventions (habit/reversal excluded) have not been systematically evaluated enough to be deemed empirically supported monotherapies for TS. In addition to reviewing these interventions, recent advances in behavioral research on TS and a function-based model of treatment development and implementation were presented. Both of these areas are in their infancy, but point to exciting new directions in the application of behavioral sciences to the understanding of TS.

Behavior Therapy↗
PubMed2005

A controlled evaluation of acceptance and commitment therapy plus habit reversal for trichotillomania.

This randomized trial compared a combined Acceptance and Commitment Therapy/Habit Reversal Training (ACT/HRT) to a waitlist control in the treatment of adults with trichotillomania (TTM). Twenty-five participants (12 treatment and 13 waitlist) completed the trial. Results demonstrated a significant reduction in hair pulling severity, impairment ratings, and hairs pulled, along with significant reductions in experiential avoidance and both anxiety and depressive symptoms in the ACT/HRT group compared to the waitlist control. Reductions generally were maintained at a 3-month follow-up. Decreases in experiential avoidance and greater treatment compliance were significantly correlated with reductions in TTM severity, implying that targeting experiential avoidance may be useful in the treatment of TTM. Other implications and suggestions for future research are noted.

Adult↗
PubMed2005

An experimental evaluation of tic suppression and the tic rebound effect.

Tourette's syndrome (TS) is a neurobiological disorder consisting of motor and vocal tics that are thought to be temporarily suppressible. Many professionals, however, believe that a paradoxical increase in tic frequency (above baseline levels) occurs when efforts to suppress have ceased (i.e., a rebound effect). To date, little research has investigated tic suppression or its effects. This study examined tic frequency during baseline, suppression, and post-suppression conditions using an experimental preparation reported to reliably produce tic suppression in children. Six children with TS and one with chronic tic disorder (CTD) were recorded during baseline and repeated suppression and post-suppression conditions. Tic frequency was significantly lower during suppression as compared to baseline. Although tic frequency during post-suppression was higher than during suppression, it was lower than baseline levels, arguing against a "rebound" effect of tic suppression. Exploratory analyses revealed that scores on the attention problems subscale of the Child Behavior Checklist significantly predicted tic suppressibility. The relationships between age, tic severity, and tic suppressibility were also explored.

Behavior Therapy↗
PubMed2005

A comparison of thought suppression to an acceptance-based technique in the management of personal intrusive thoughts: a controlled evaluation.

Research suggests that suppressing unwanted thoughts is not possible, leads to a subsequent increase in frequency of the suppressed thoughts, and results in higher levels of distress. Because thought suppression may have negative effects, an alternative, acceptance-based approach has been proposed. The current paper reports the outcomes of two studies. Study I examined the relationships between two naturally occurring strategies of thought management (thought suppression and acceptance), symptoms of psychopathology, and experiences with personally relevant intrusive thoughts. Results showed that those who naturally suppress personally relevant intrusive thoughts have more, are more distressed by, and have a greater "urge to do something" about the thoughts, while those who are naturally more accepting of their intrusive thoughts are less obsessional, have lower levels of depression, and are less anxious. Study II compared three groups (thought suppression, acceptance, and monitor-only groups) on the frequency and distress associated with experiencing personally relevant intrusive thoughts. Results revealed that those instructed to suppress their personal intrusive thoughts were unable to do so and experienced an increased level of distress after suppression, whereas those instructed to use an acceptance-based strategy experienced a decrease in discomfort level (but not thought frequency) after having used such a strategy. These data offer initial evidence that acceptance may be a useful alternative to the suppression of personally relevant intrusive thoughts.

Adolescent↗
PubMed2005

Premonitory Urge for Tics Scale (PUTS): initial psychometric results and examination of the premonitory urge phenomenon in youths with Tic disorders.

Although motor tics and/or vocal tics are the defining features of chronic tic disorder (CTD) and Tourette syndrome (TS), older youths and adults often report their tics to be preceded by an unpleasant sensation or "premonitory urge." While premonitory urge phenomena may play an important role in behavioral interventions for CTD/TS, standardized assessments for premonitory urges do not exist. The current study of 42 youths with TS or CTD presents initial psychometric data for a new, brief self-report scale designed to measure tic-related premonitory urges. Results showed that the Premonitory Urge for Tics Scale (PUTS) was internally consistent (alpha = .81) and temporally stable at 1 (r = 0.79, p < .01) and 2 (r = 0.86, p < .01) weeks. PUTS scores were also correlated with overall tic severity as measured by the Yale Global Tic Severity Scale (YGTSS; r = 0.31, p < .05) and the YGTSS number (r = 0.35, p < .05), complexity (r = 0.49, p < .01), and interference (r = 0.36, p < .05) subscales. Finally, an examination of the psychiatric correlates of the premonitory urge phenomenon yielded significant correlations between the PUTS and the Child Behavior Checklist (CBCL) anxiety/depression (r = 0.33, p < .05), and withdrawal (r = 0.38, p < .05) subscales as well as the Children's Yale-Brown Obsessive Compulsive Scale (CYBOCS; r = 0.31, p < .05). However, a cross-sectional examination of the data showed that the psychometric properties of the PUTS were not acceptable for youths 10 years of age and younger. Likewise, significant correlations found between the YGTSS subscales, CBCL subscales, CYBOCS, and the PUTS did not emerge in this younger age group. The clinical and theoretical implications of these findings are discussed.

Adolescent↗
PubMed2005

Controlled evaluation of an educational intervention used to modify peer attitudes and behavior toward persons with Tourette's Syndrome.

Individuals who exhibit motor and vocal tics are viewed as less socially acceptable than persons who do not exhibit tics. Efforts have been made to alter the negative perceptions through the use of education. However, the effectiveness of peer education and whether it need be Tourette syndrome (TS) specific remains unclear. One hundred and seventy college students were randomly assigned to view either an educational video about TS, a video about depression, or no educational video, before providing attitudinal and behavioral data on social acceptance of either an actor or actress engaging in motor and vocal tics. Those viewing the TS-specific educational video held more positive attitudes toward persons with tics than those receiving the other two interventions; however, the effect on social behavior intentions and actual social behavior was unclear. Implications of these findings and directions for future research are discussed.

Adult↗
PubMed2004

The relationship between experiential avoidance and the severity of trichotillomania in a nonreferred sample.

In this study 436 adults, who reported being diagnosed with trichotillomania (TTM), completed an anonymous survey examining the relationship between experiential avoidance (i.e., escape from or avoidance of unwanted thoughts or emotions) and TTM severity. Results showed a significant positive correlation between measures of experiential avoidance and TTM severity, indicating that more experientially avoidant individuals tended to exhibit more severe TTM. Subsequent analyses found that persons who scored higher on a measure of experiential avoidance reported more frequent and intense urges to pull, were less able to control their urges, and experienced more pulling-related distress than persons who were not experientially avoidant. Conversely, results also showed that individuals who were more experientially avoidant were no more likely to actually pull and were no less successful in actually stopping themselves from pulling than non-avoidant individuals. The results of this study suggest that experiential avoidance may be an important issue in understanding and possibly treating some persons with TTM.

Adolescent↗
PubMed2004

Relationships between tattling, likeability, and social classification: a preliminary investigation of adolescents in residential care.

Little research has been published on tattling, even less on its social impact, and we found none directly investigating tattling by adolescents. This study assessed the extent to which tattling, as perceived by peers and caregivers of adolescents in a residential care program, was associated with various dimensions of social status and other behavioral correlates. Eighty-eight adolescent participants rated their housemates on likeability, perceived rates of tattling, and other behavioral descriptors. In addition, caretakers also rated each youth in terms of perceived tattling. On the basis of likeability ratings, participants were classified into one of five categories: popular, average, controversial, neglected, and rejected. Results showed a significant negative correlation between likeability and perceived tattling rates. In addition, youth classified as socially rejected were more likely to be perceived by both their peers and care providers as engaging in high rates of tattling.

Adolescent↗
PubMed2003

Evaluating the efficacy of habit reversal: comparison with a placebo control.

BACKGROUND: The purpose of this study was to compare the effectiveness of habit reversal with a placebo control as a treatment for chronic nail biting in adults. METHOD: Thirty adults with a chronic nail-biting problem (occurring > or = 5 times/day nearly every day for > or = 4 weeks and causing physical damage or social impairment) were randomly assigned to a placebo control or habit reversal group. Five participants withdrew from the study prior to the completion of treatment. The remaining individuals in both groups received a total of 2 hours of treatment over 3 sessions. Individuals in the habit reversal group (N = 13) received the components of awareness training, competing response training, and social support. Individuals in the placebo control group (N = 12) simply discussed their nail biting. At pretreatment, posttreatment, and a 5-month follow-up, nail length was measured, photographs were taken of the damaged nails and later rated by independent observers, and data on participant depression, anxiety, and self-esteem were obtained. Treatment compliance and acceptability data were collected at posttreatment only. RESULTS: Results showed that habit reversal produced a greater increase in nail length at posttreatment and follow-up when compared with the placebo. Data from the independent raters confirmed these findings. Habit reversal was also viewed as a more acceptable intervention by the participants. At posttreatment, the habit reversal group had increased their nail length by 22% from pretreatment compared with a 3% increase for the placebo group. At follow-up, the habit reversal group maintained a 19% increase in nail length from pretreatment compared with a 0% increase for the placebo group. CONCLUSION: Findings from this study suggest habit reversal is more effective than a placebo control and should be considered a well-established intervention for body-focused repetitive behaviors.

Adult↗