Bothersome tics in patients with chronic tic disorders: Characteristics and individualized treatment response to behavior therapy

Abstract

This report examined the most frequently reported bothersome tics among individuals with chronic tic disorders and evaluated the improvement and remission of tics and their associated characteristics. Youths and adults (N = 240) were randomly assigned to receive the comprehensive behavioral intervention for tics (CBIT) or psychoeducation and supportive therapy (PST). At baseline, motor tics and tics with an urge were rated as more bothersome relative to vocal tics and tics without premonitory urges. The five most common bothersome tics included eye blinking, head jerks, sniffing, throat clearing, and other complex motor tics. While CBIT outperformed PST across tic type and urge presence, tics preceded by premonitory urges at baseline had higher severity at posttreatment across treatment condition. Six individual tic types had lower severity at posttreatment following CBIT relative to PST. Baseline urge presence was associated with tic remission for CBIT but not PST. Specific bothersome tics were more likely to remit with CBIT relative to PST. Findings suggest that individual tics respond and remit differently to CBIT relative to PST, with implications highlighting the negative reinforcement hypothesis in tic symptom maintenance. CLINICALTRIALS.

Gov identifiers: NCT00218777; NCT00231985.

Keywords: Behavior therapy; Comprehensive behavioral intervention for tics; Habit reversal training; Individualized treatment response; Tourette's disorder; Treatment outcome.

Published by Elsevier Ltd.

Figures

Figure 1

Baseline and Post Treatment Severity Ratings on the Hopkins Motor/Vocal Tic Scale by baseline premonitory urge status and treatment condition.