The Massachusetts General Hospital (MGH) Hairpulling Scale: 1. Development and Factor Analyses

Massachusetts General Hospital, Charlestown, Mass 02129, USA.
Psychotherapy and Psychosomatics (Impact Factor: 9.2). 02/1995; 64(3-4):141-5. DOI: 10.1159/000289003
Source: PubMed


We developed the MGH Hairpulling Scale to provide a brief, self-report instrument for assessing repetitive hairpulling. Seven individual items, rated for severity from 0 to 4, assess urges to pull, actual pulling, perceived control, and associated distress. We administered the scale to 119 consecutive patients with chronic hairpulling. Statistical analyses indicate that the seven items form a homogenous scale for the measurement of severity in this disorder.

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    • "Additionally, the Trichotillomania Diagnostic Interview (TDI; Rothbaum & Ninan, 1994) was employed for obtaining TTM diagnosis. The MGH-HPS has demonstrated adequate psychometric properties (Diefenbach et al., 2005; Keuthen et al., 1995; O'Sullivan et al., 1995). It consists of seven items that are scored on a 0–4 Likert scale, resulting in total scores ranging from 0 to 28, with higher scores indicating greater hair pulling severity. "
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    ABSTRACT: The Massachusetts General Hospital Hairpulling Scale (MGH-HPS) and the NIMH Trichotillomania Severity Scale (NIMH-TSS) are two widely used measures of trichotillomania severity. Despite their popular use, currently no empirically-supported guidelines exist to determine the degrees of change on these scales that best indicate treatment response. Determination of such criteria could aid in clinical decision-making by defining clinically significant treatment response/recovery and producing accurate power analyses for use in clinical trials research. Adults with trichotillomania (N = 69) participated in a randomized controlled trial of psychotherapy and were assessed before and after treatment. Response status was measured via the Clinical Global Impressions-Improvement Scale, and remission status was measured via the Clinical Global Impressions-Severity Scale. For treatment response, a 45% reduction or 7-pointraw score change on the MGH-HPS was the best indicator of clinically significant treatment response,and on the NIMH-TSS, a 30–40% reduction or 6-point raw score difference was most effective cutoff. For disorder remission, a 55–60% reduction or 7-point raw score change on the MGH-HPS was the best predictor, and on the NIMH-TSS, a 65% reduction or 6-point raw score change was the best indicator of disorder remission. Implications of these findings are discussed.
    Journal of Anxiety Disorders 10/2015; 36:44-51. DOI:10.1016/j.janxdis.2015.09.008 · 2.96 Impact Factor
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    • "On average, participants reported moderately severe TTM symptoms as measured by the MGHHPS (Keuthen et al., 1995) and PITS (Winchel et al., 1992), and moderately severe functional impact due to TTM-related thoughts and behaviours as measured by the YBOCS:TM (Stanley et al., 1993) (Table 3). "
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    ABSTRACT: Trichotillomania (TTM) is characterised by the removal of one's hair, causing hair loss. Phenomenological research on TTM has investigated its associated behavioural and affective factors. Few studies have investigated the possible role of cognitions and beliefs, despite emerging support for cognitive therapies in treating this disorder. This study aimed to explore and describe the cognitions and beliefs that contribute to the onset and maintenance of hairpulling in TTM. Eight women with TTM participated in semi-structured, in-depth interviews to explore their experience of cognitions and beliefs before, during and after typical hairpulling episodes. Interviews were analysed using the qualitative method of Interpretative Phenomenological Analysis. Six superordinate themes of beliefs were identified as important: negative self-beliefs, control beliefs, beliefs about coping, beliefs about negative emotions, permission-giving beliefs, and perfectionism. These preliminary findings suggest that cognitions may play an important role in TTM phenomenology. Future quantitative research on the role of cognitions and beliefs in TTM in larger samples has the potential to advance cognitive-behavioural models and treatments of this poorly understood disorder.
    Behaviour Change 08/2015; -1. DOI:10.1017/bec.2015.11 · 0.51 Impact Factor
    • "Repetitive behaviors were assessed using the Massachusetts General Hospital Hair Pulling Scale (MGH; Keuthen et al., 1995), Skin Picking Scale (SPS; Keuthen et al., 2001), and Nail Biting Scale (NBS). The NBS is a 6-item version of the SPS designed for use in the current study. "
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    ABSTRACT: Body-focused repetitive behaviors (BFRBs), including hair pulling, nail biting, and skin picking are repetitive, habitual, and compulsive in nature. Although characteristic of disorders such as trichotillomania and skin picking disorder, BFRBs are associated with other psychiatric conditions as well. To date, research has failed to examine neurocognitive risk factors, particularly executive functioning, implicated in BFRBs utilizing a transdiagnostic approach. The present study recruited 53 participants (n = 27 demonstrating BFRBs and n = 26 randomly selected controls) from a larger sample of young adults. Participants completed an automated neurocognitive test battery including tasks of cognitive flexibility, working memory, and planning and organization. Results revealed that participants in the BFRB group demonstrated significantly poorer cognitive flexibility (d = 0.63) than controls. No differences were noted in other neurocognitive domains. However, planning and organization demonstrated a significant relationship with various BFRB severity measures. Implications, limitations, and avenues for further research are discussed.
    The Journal of nervous and mental disease 07/2015; 203(7):555-8. DOI:10.1097/NMD.0000000000000327 · 1.69 Impact Factor
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