Measuring the role of psychological inflexibility in Trichotillomania

David C. Houghton, Scott N. Compton, Michael P. Twohig, Stephen M. Saunders, Martin E. Franklin, Angela M. Neal-Barnett, Laura Ely, Matthew R. Capriotti, Douglas W. Woods

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


Psychological Inflexibility (PI) is a construct that has gained recent attention as a critical theoretical component of Acceptance and Commitment Therapy (ACT). PI is typically measured by the Acceptance and Action Questionnaire-II (AAQ-II). However, the AAQ-II has shown questionable reliability in clinical populations with specific diagnoses, leading to the creation of content-specific versions of the AAQ-II that show stronger psychometric properties in their target populations. A growing body of the literature suggests that PI processes may contribute to hair pulling, and the current study sought to examine the psychometric properties and utility of a Trichotillomania-specific version of the AAQ-II, the AAQ-TTM. A referred sample of 90 individuals completed a battery of assessments as part of a randomized clinical trial of Acceptance-Enhanced Behavior Therapy for Trichotillomania. Results showed that the AAQ-TTM has two intercorrelated factors, adequate reliability, concurrent validity, and incremental validity over the AAQ-II. Furthermore, mediational analysis between emotional variables and hair pulling outcomes provides support for using the AAQ-TTM to measure the therapeutic process. Implications for the use of this measure will be discussed, including the need to further investigate the role of PI processes in Trichotillomania.

Original languageEnglish (US)
Pages (from-to)356-361
Number of pages6
JournalPsychiatry Research
Issue number1-2
StatePublished - Dec 15 2014
Externally publishedYes


  • ACT
  • Behavior therapy
  • Impulse control disorders
  • Measurement
  • Obsessive-compulsive disorder

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry


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