Development and validation of a metacognitive-cognitive-behavioral model for explaining trichotillomania

Background & Aims: Trichotillomania (TTM) is an unknown disorder and resistant to treatment. The purpose of this study was to develop and validate the new metacognitive-cognitive-behavioral model for trichotillomania. Methods: The present study was a description and correlation study. In this study, 635 participants (304 male and 331 female) were selected. The participants completed the Massachusetts general hospital hair pulling scale (MGH-HPS), dysfunctional attitude scale (DAS), cognitive distortion scale (CDS), automatic thought questionnaire (ATQ), metacognition questionnaire (MCQ), and the obsessive-compulsive behavior scale (OCBS). For reliability assessment of the factor structure of the metacognitive-cognitive-behavioral model, the structural equation modeling analysis was used by AMOS software. Results: The results of the structural equation modeling supported a metacognitive-cognitive-behavioral model for trichotillomania. Moreover, the results showed that the model had the best fit to the data and was closely related to the theoretical assumptions. Conclusion: The model presented in this study illustrates a multidimensional approach that focuses on the metacognitive, cognitive, and behavioral dimensions; hence, the model presented in this study is a new explanatory model. This model may prompt future research into trichotillomania and facilitate clinical treatment and case formulation. © 2014, Kerman University of Medical Sciences. All rights reserved

Temporal Artery Biopsy for Diagnosing Giant Cell Arteritis: A Ten-year Review

Purpose: To assess the use of temporal artery biopsy (TAB) in diagnosing giant cell arteritis (GCA) and to evaluate patients' clinical and laboratory characteristics. Methods: We conducted a retrospective chart review of patients with suspected GCA who underwent TAB and had complete workup in a tertiary center in Iran between 2008 and 2017. The 2016 American College of Rheumatology (ACR) revised criteria for early diagnosis of GCA were used for each patient for inclusion in this study. Results: The mean age of the 114 patients in this study was 65.54 ± 10.17 years. The mean overall score according to the 2016 ACR revised criteria was 4.17 ± 1.39, with 5.82 ± 1.28 for positive biopsies and 3.88 ± 1.19 for negative biopsies (p <0.001). Seventeen patients (14.9%) had a positive biopsy. Although the mean post-fixation specimen length in the biopsy-positive group (18.35 ± 6.9 mm) was longer than that in the biopsy-negative group (15.62 ± 8.4 mm), the difference was not statistically significant (P = 0.21). There was no statistically significant difference between the groups in terms of sex, serum hemoglobin, platelet count, and erythrocyte sedimentation rate. There were statistically significant differences between the biopsy-negative and biopsy-positive groups with respect to patients' age and C-reactive protein level (P < 001 and P = 0.012, respectively). Conclusion: The majority of TABs were negative. Reducing the number of redundant biopsies is necessary to decrease workload and use of medical services. We suggest that the diagnosis of GCA should be dependent on clinical suspicion