An Idionomic Network Analysis of Trichotillomania Treatment Processes: Gathering Group-Level and Individual-Level Insights to Inform a Personalized Therapeutic Framework

Abstract

Trichotillomania, characterized by repetitive hair-pulling, leads to significant distress and impairment. Heterogeneity in symptom profiles challenges the effectiveness of treatment protocols for trichotillomania. Recent research endorses personalized treatment, emphasizing the assessment of biopsychosocial processes to tailor interventions more closely to the individual. This shift to a process-based, person-centered framework necessitates analytic methods capable of probing beyond nomothetic patterns to unveil nuanced individual-level processes. This study utilized Group Iterative Multiple Model Estimation (GIMME) to examine group-level and individual-level network dynamics as an initial step towards a process-based treatment framework for trichotillomania. Ecological momentary assessment data from 54 affected individuals were analyzed to identify shared patterns applicable at the group level and individual level for individualized treatment. Analysis revealed a nomothetic process dynamically related to cognitive fixation on the urge to pull. At the individual level, notable variability in network structures emerged. While centrality measures consistently identified the urge to pull as a pivotal process within GIMME individual-level networks, the influence of other processes differed considerably between individuals. Results indicate that despite some shared components, the heterogeneity within individual networks calls for customized treatment approaches, and the assessment of psychological process dynamics at the individual level. These insights support incorporating idionomic methods into the developmental stages of personalized interventions.