Tourette Syndrome and Tic Disorders
Research in the Division of Child and Adolescent Psychiatry
Prolonged Tic Suppression and Habituation to the Premonitory Urge
Principal Investigator: Matt W. Specht, Ph.D.
This study is sponsored by the Tourette Syndrome Association (TSA) to examine the means through which behavioral treatments produce reductions in tic symptoms. A growing body of research supports the efficacy of behavioral treatments for Tourette Syndrome (TS) and tic disorders as an adjunct to medication or as a front-line intervention. Habit Reversal Training (HRT) is now considered a well-established treatment for reducing tic severity in children, adolescents, and adults. Critiques of behavioral treatments for tic disorders focus on the lack of large multi-site clinical trials and an established mechanism of action as well as concerns regarding potential negative treatment effects. The Comprehensive Behavioral Intervention for Tics (CBIT) study is intended to further address the efficacy of HRT. However, for psychosocial treatments to be widely accepted by practitioners, a mechanism of treatment action needs to be clarified and legitimate concerns need to be addressed.
The current study is designed to examine the Urge Habituation Hypothesis or the notion that urges subside under prolonged reinforced tic suppression and active component of HRT. The current study is also designed to replicate and extend existing research regarding the negative reinforcement hypothesis of tic maintenance, the effects of attending to tics and prolonged tic suppression (i.e., symptom rebound), and the attention requirements of suppression.
Taken together these results will (a) further clarify the means by which tic suppression results in decreased tic symptoms, (b) provide further support for the negative reinforcement hypothesis of tic maintenance, (c) address concerns regarding potential negative treatment consequences, (c) improve treatment recommendations, and (d) facilitate the refinement behavioral treatments for tic disorders.
For more information visit John Hopkins Medicine.
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