Behavior therapy for pediatric trichotillomania: Exploring the effects of age on treatment outcome

<p>Abstract</p> <p>Background</p> <p>A randomized controlled trial examining the efficacy of behavior therapy for pediatric trichotillomania was recently completed with 24 participants ranging in age from 7 - 17. The broad age range raised a question about whether young children, older children, and adolescents would respond similarly to intervention. In particular, it is unclear whether the younger children have the cognitive capacity to understand concepts like "urges" and whether they are able to introspect enough to be able to benefit from awareness training, which is a key aspect of behavior therapy for trichotillomania.</p> <p>Methods</p> <p>Participants were randomly assigned to receive either behavior therapy (N = 12) or minimal attention control (N = 12), which was included to control for repeated assessments and the passage of time. Primary outcome measures were the independent evaluator-rated NIMH-Trichotillomania Severity Scale, a semi-structured interview often used in trichotillomania treatment trials, and a post-treatment clinical global impression improvement rating (CGI-I).</p> <p>Results</p> <p>The correlation between age and change in symptom severity for all patients treated in the trial was small and not statistically significant. A 2 (group: behavioral therapy, minimal attention control) × 2 (time: week 0, 8) × 2 (children < 9 yrs., children > 10) ANOVA with independent evaluator-rated symptom severity scores as the continuous dependent variable also detected no main effects for age or for any interactions involving age. In light of the small sample size, the mean symptom severity scores at weeks 0 and 8 for younger and older patients randomized to behavioral therapy were also plotted. Visual inspection of these data indicated that although the groups appeared to have started at similar levels of severity for children ≤ 9 vs. children ≥ 10; the week 8 data show that the three younger children did at least as well as if not slightly better than the nine older children and adolescents.</p> <p>Conclusions</p> <p>Behavior therapy for pediatric trichotillomania appears to be efficacious even in young children. The developmental and clinical implications of these findings will be discussed.</p> <p>Trial Registration</p> <p>Clinicaltrials.gov NCT00043563.</p

Directed assembly of layered perovskite heterostructures as single crystals

The precise stacking of different two-dimensional (2D) structures such as graphene and MoS2 has reinvigorated the field of 2D materials, revealing exotic phenomena at their interfaces1,2. These unique interfaces are typically constructed using mechanical or deposition-based methods to build a heterostructure one monolayer at a time2,3. By contrast, self-assembly is a scalable technique, where complex materials can selectively form in solution4,5,6. Here we show a synthetic strategy for the self-assembly of layered perovskite–non-perovskite heterostructures into large single crystals in aqueous solution. Using bifunctional organic molecules as directing groups, we have isolated six layered heterostructures that form as an interleaving of perovskite slabs with a different inorganic lattice, previously unknown to crystallize with perovskites. In many cases, these intergrown lattices are 2D congeners of canonical inorganic structure types. To our knowledge, these compounds are the first layered perovskite heterostructures formed using organic templates and characterized by single-crystal X-ray diffraction. Notably, this interleaving of inorganic structures can markedly transform the band structure. Optical data and first principles calculations show that substantive coupling between perovskite and intergrowth layers leads to new electronic transitions distributed across both sublattices. Given the technological promise of halide perovskites4, this intuitive synthetic route sets a foundation for the directed synthesis of richly structured complex semiconductors that self-assemble in water