StopPulling.com: An Interactive, Self-Help Program for Trichotillomania

Despite the widespread nature and significant impact of trichotillomania (TTM), relatively few controlled studies have evaluated treatment options for people with this disorder. Pharmacological treatment and behavior therapy are the two most widely accepted approaches to treating TTM, but few mental health professionals with appropriate expertise are available to provide care. The cost of treatment also is prohibitive in some cases. A number of self-help books are available for people with TTM, but no empirical data have documented associated outcomes. This paper describes the development and two phases of program evaluation for an alternative, Internet-based self-help treatment strategy for repetitive hair pulling. StopPulling.com is an on-line, interactive self-help approach derived from evidence-based cognitive behavioral models of treatment for TTM. Following program development, an initial test phase elicited feedback from individuals with repetitive hair pulling and professionals with expertise in the treatment of TTM or Web site development. StopPulling.com was modified in accordance with feedback from this initial test phase, and a revised version was made available to the public in January 2003. Preliminary data from 265 users of the program during the first year of public availability suggested significant improvement in symptoms, with some evidence that duration of program use accounted for reductions in symptom severity. Response rates were comparable to long-term follow-up after more intense cognitive behavioral treatment. StopPulling.com may provide a potentially useful self-help alternative or adjunctive strategy for repetitive hair pulling.     

Neediness and narcissistic defensive action

Action-prone patients are difficult for most analysts to treat. The author describes patients who act in treatment by pressuring themselves and the analyst to get rid of what is wrong, to change the imperative, life-and-death qualities of need into something else. Viewing neediness in treatment as narcissistic defensive action helps the analyst address the patient's pressured flight away from focusing on the need of the analyst and toward action aimed at riddance. Ghent's (1992, 1993) views on neediness are discussed and seen to be complemented by a view of action as protection against narcissistic vulnerability. Analysts' intolerance, vulnerabilities, and needs with such patients are considered.     

“Assertion” and intentionality

Robert Stalnaker argues that his causal-pragmatic account of the problem of intentionality commits him to a coarse-grained conception of the contents of mental states, where propositions are represented as sets of possible worlds. Stalnaker also accepts the “direct reference” theory of names, according to which co-referring names have the same content. Stalnaker’s view of content is thus threatened by Frege’s Puzzle. Stalnaker’s classic paper “Assertion” is intended to provide a response to this threat. In this paper, I evaluate Stalnaker’s claim that the causal-pragmatic account of intentionality commits one to a coarse-grained conception of the contents of mental states, and argue that the apparatus laid out in “Assertion” is not sufficiently comprehensive to account for all versions of Frege’s Puzzle.     

Self-Objectification, Self-Esteem, and Gender: Testing a Moderated Mediation Model

The purpose of the present research was to test the mediating roles of body shame and appearance anxiety in the relation between self-surveillance and self-esteem; and to investigate whether gender (male, female) and stereotypical gender roles (masculinity, femininity) moderated the proposed mediation model. Canadian undergraduate university men and women (n?=?198) completed measures of self-surveillance, gender, gender roles, body shame, appearance anxiety, and self-esteem. Regression analyses demonstrated that greater self-surveillance predicted lower self-esteem, and this relation was fully mediated by body shame and appearance anxiety. With the exception of masculinity interacting with self-surveillance to predict body shame and appearance anxiety, neither gender nor stereotypical gender roles moderated the proposed paths. Implications are discussed.