B-33 Cognitive Mechanisms Associated with Emotion-Focused Pulling in Trichotillomania

Objective

A revised version of the Milwaukee Inventory for Subtypes of Trichotillomania-Adult (MIST-A) provides scores for two distinct behavioral patterns of hair pulling in trichotillomania: emotion and intention pulling. The current study explored the relationship between these scales and several cognitive domains.

Method

This study used baseline data from a randomized controlled trial of a cognitive-behavior therapy intervention for trichotillomania. Participants from the general community were eligible if they met diagnostic criteria for trichotillomania. Thirty-two individuals were enrolled and completed baseline measures. The sample was 78% female, and the mean age was 34. At baseline, participants completed diagnostic interviews, self-report symptom questionnaires, and tasks from the Cambridge Neuropsychological Test Automated Battery (the stop-signal test, the intra/extra dimensional shift task, and the Cambridge gambling task ). These provided scores of intra and extra dimensional set-shifting, response inhibition, decision making quality, and sensitivity to risk. Correlational analyses were conducted comparing each cognitive score to each MIST-A score.

Results

Analyses revealed significant negative correlations between emotion pulling score and decision making quality r (30) = -.383, = .031 and emotion pulling score and sensitivity to risk r (30) = -.396, p = .025.

Conclusion

These findings provide initial insight into some of the cognitive mechanisms associated with emotion focused pulling. Individuals who pull their hair with the aim of reducing negative emotions (e.g. boredom, anxiety) showed themselves on the gambling task to be more willing to bet on an unlikely outcome, and less willing to adjust their betting amount according to the likelihood of an outcome.

Postpartum mental health screening and diagnosis by obstetrician-gynecologists

Postpartum depression (PPD) and postpartum psychosis (PPP) can impact mother, infant, and family. Obstetrician-gynecologists (ob-gyns) are often the most frequent medical contact for postpartum women, and so are in a position to identify women needing psychological care. This study assessed ob-gyns' knowledge, attitudes, and practices regarding diagnosing PPD/PPP. A survey was sent to 400 members of the American College of Obstetricians and Gynecologists who have volunteered to participate in research. Response rate was 56%. Routine screening for PPD and PPP is conducted by 72% and 30% of respondents, respectively. Personal experience (through friend, family, or self) was associated with increased screening. Perceived PPP screening barriers are similar to those found in the PPD literature: time constraints, lack of training, and lack of knowledge of diagnostic criteria. In responding to standardised vignettes, physicians were more likely to over-diagnose, than under diagnose PPD/PPP. This study is the first to provide exploratory data of ob-gyns' knowledge, attitudes, and practice regarding PPD and PPP. Ob-gyns are screening for PPD/PPP, though not universally so. Future research should identify ways to mitigate screening barriers.

Binge eating in overweight treatment-seeking adolescents

OBJECTIVE

To examine the frequency and recency of binge eating in relation to psychopathology in overweight, treatment-seeking adolescents.

METHODS

We investigated psychological correlates of the frequency and recency of reported loss of control (LOC) eating episodes in 160 overweight (body mass index [BMI]: 40.7 +/- 8.8 kg/m(2)) adolescents. On the basis of the responses to the eating disorder examination (EDE), participants were categorized into one of four groups: full-syndrome binge eating disorder (BED); recent but infrequent binge eating (episodes within the 3 months before interview; RECENT-BINGE); remote and infrequent LOC eating (episodes occurring >3 months before assessment; PAST-LOC), or no history of LOC episodes (NE).

RESULTS

The BED group reported higher EDE scores (global, p < .01), and more negative mood and anxiety than all other groups (p's < .01). Compared with NE, RECENT-BINGE also reported more anxiety and higher EDE scores (p's < .01).

CONCLUSIONS

Overweight, treatment-seeking adolescents with BED are clearly distinguishable from teens without the disorder on measures of eating-related psychopathology, mood, and anxiety. RECENT-BINGE, but not PAST-LOC, is also associated with significantly greater eating-related and general psychopathology.