Variables Associated With Tic Exacerbation in Children With Chronic Tic Disorders

• Type of Material: Article
• Authors: Michael B. Himle, University of Utah; Matthew R. Capriotti, University of Wisconsin; Loran P. Hayes, University of Utah; Krishnapriya Ramanujam, University of Utah; Lawrence Scahill, Emory University; Denis G. Sukhodolsky, Yale University; Sabine Wilhelm, Massachusetts General Hospital; Thilo Deckersbach, Massachusetts General Hospital; Alan L. Peterson, University of Texas Health Science Center; Matt W. Specht, Johns Hopkins Medical Institutions; John T. Walkup, Johns Hopkins Medical Institutions; Susanna Chang, University of California, Los Angeles; John Piacentini, University of California, Los Angeles
• Language: English
• Date: 2014-03-01
• Publisher: SAGE Publications (UK and US)
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © The Author(s) 2014.
• Final Published Version (URL): http://dx.doi.org/10.1177/0145445514531016
• Title of Journal or Parent Work: Behavior Modification
• ISSN: 0145-4455
• Volume: 38
• Issue: 2
• Start Page: 163
• End Page: 183
• Grant/Funding Information: This research was supported by Grant R01MH070802 from the National Institute of Mental Health to the Tourette Syndrome Association, Inc. (PI: Dr. John Piacentini); with subcontracts to Drs. Douglas Woods, Larry Scahill, Sabine Wilhelm, Alan Peterson, and John Walkup.; Dr Scahill received support from the Yale University Clinical and Translational Sciences Award Grant UL1 RR024139 from the National Center for Research Resources, NIH.
• Keywords: function-based assessment; Psychology; ADOLESCENTS; SYMPTOMS; SCREEN; BEHAVIOR-THERAPY; Psychology, Clinical; SUPPRESSION; Comprehensive Behavioral Intervention for Tics; FUNCTIONAL-ANALYSIS; TOURETTE-SYNDROME; SEVERITY-SCALE; RELIABILITY; DIFFERENTIAL REINFORCEMENT; chronic tic disorder; Tourette disorder; Social Sciences
• Research Categories: Biology, Neuroscience; Psychology, Developmental

Abstract

Research has shown that motor and vocal tics fluctuate in frequency, intensity, and form in response to environmental and contextual cues. Behavioral models have proposed that some of the variation in tics may reflect context-dependent interactive learning processes such that once tics are performed, they are influenced by environmental contingencies. The current study describes the results of a function-based assessment of tics (FBAT) from a recently completed study comparing Comprehensive Behavioral Intervention for Tics (CBIT) with supportive psychotherapy. The current study describes the frequency with which antecedent and consequence variables were reported to exacerbate tics and the relationships between these functional variables and sample baseline characteristics, comorbidities, and measures of tic severity. Results showed that tic-exacerbating antecedents and consequences were nearly ubiquitous in a sample of children with chronic tic disorder. In addition, functional variables were related to baseline measures of comorbid internalizing symptoms and specific measures of tic severity.