Long-term Outcomes of Behavior Therapy for Youth With Tourette Disorder

Espil, Flint M.; Woods, Douglas W.; Specht, Matthew W.; Bennett, Shannon M.; Walkup, John T.; Ricketts, Emily J.; McGuire, Joseph F.; Stiede, Jordan T.; Schild, Jennifer; Chang, Shih-Shin; Peterson, Alan L.; Scahill, Lawrence David; Wilhelm, Sabine; Piacentini, John

doi:10.1016/j.jaac.2021.08.022

Cited by 26 publications

(33 citation statements)

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“…Espil and colleagues 84 followed up young participants 11 years after receiving CBIT or supportive therapy and education (comparator) in the Piacentini and colleagues RCT from 2010. 85 This is the longest published prospective follow-up to date of TS/CTD individuals having received BT.…”

Section: Resultsmentioning

confidence: 99%

Tourette syndrome research highlights from 2021

et al. 2022

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Section: Resultsmentioning

confidence: 99%

Tourette syndrome research highlights from 2021

et al. 2022

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“…The present sample included 80 adults with TS who participated in a 11.17-year (SD = 1.25) long-term follow-up assessment for a randomized clinical trial of behavior therapy for tics in youth with TS ( 21 , 29 ). Participants needed to be enrolled in the original clinical trial of behavior therapy to participate in this long-term follow-up assessment.…”

Section: Methodsmentioning

confidence: 99%

“…Participants needed to be enrolled in the original clinical trial of behavior therapy to participate in this long-term follow-up assessment. There were no significant differences on demographic and clinical characteristics between participants who completed the long-term follow-up assessment, those who declined to participate in the long-term follow-up assessment, and those who were lost to follow-up [see Espil et al ( 21 ) for further details].…”

Section: Methodsmentioning

confidence: 99%

“…All procedures followed ethical standards for human subject research and were approved by local institutional review boards (IRBs). Participants from the original clinical trial were contacted to participate in a long-term follow-up assessment ( 21 , 29 ). Eighty participants (i.e., 63.4% of the original sample) were interviewed in-person or via Skype by trained raters to ascertain clinical history and psychiatric diagnoses on the Mini-International Neuropsychiatric Interview ( 37 ).…”

Section: Methodsmentioning

confidence: 99%

“…Behavioral therapies—such as habit reversal training (HRT), the Comprehensive Behavioral Intervention for Tics (CBIT), and Exposure with Response Prevention (ERP)—have emerged as first-line interventions for individuals with TS ( 16 – 18 ). For individuals who exhibit a positive response to behavioral treatments, therapeutic gains are maintained for over 6 months ( 19 , 20 ) and can have lasting benefits for up to 11 years ( 21 ). Despite the benefit of behavioral treatments for some adults with TS, less than 40% respond to this treatment approach ( 22 ).…”

Section: Introductionmentioning

confidence: 99%

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Urge intolerance predicts tic severity and impairment among adults with Tourette syndrome and chronic tic disorders

et al. 2022

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BackgroundIndividuals with Tourette Syndrome and Persistent Tic Disorders (collectively TS) often experience premonitory urges—aversive physical sensations that precede tics and are temporarily relieved by tic expression. The relationship between tics and premonitory urges plays a key role in the neurobehavioral treatment model of TS, which underlies first-line treatments such as the Comprehensive Behavioral Intervention for Tics (CBIT). Despite the efficacy of CBIT and related behavioral therapies, less than 40% of adults with TS respond to these treatments. Further examination of the relationship between premonitory urges, tic severity, and tic impairment can provide new insights into therapeutic targets to optimize behavioral treatment outcomes. This study examined whether urge intolerance—difficulty tolerating premonitory urges—predicted tic severity and tic-related impairment among adults with TS.MethodsParticipants were 80 adults with TS. Assessments characterized premonitory urge, distress tolerance, tic severity, and tic impairment. We used structural equation modeling (SEM) to examine the construct of urge intolerance—comprised of premonitory urge ratings and distress tolerance ratings. We first evaluated a measurement model of urge intolerance through bifactor modeling, including tests of the incremental value of subfactors that reflect premonitory urge severity and distress tolerance within the model. We then evaluated a structural model where we predicted clinician-rated tic severity and tic impairment by the latent variable of urge intolerance established in our measurement model.ResultsAnalyses supported a bifactor measurement model of urge intolerance among adults with TS. Consistent with theoretical models, higher levels of urge intolerance predicted greater levels of clinician-rated tic severity and tic impairment.ConclusionThis investigation supports the construct of urge intolerance among adults with TS and distinguishes it from subcomponents of urge severity and distress tolerance. Given its predictive relationship with tic severity and tic impairment, urge intolerance represents a promising treatment target to improve therapeutic outcomes in adults with TS.

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Internet-Based Cognitive Behavioral Therapy for Tourette Syndrome—Meaningfully Improving Access to Behavioral Therapy for Tics

Pringsheim

Piacentini

2022

JAMA Netw Open

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Long-term Outcomes of Behavior Therapy for Youth With Tourette Disorder

Cited by 26 publications

References 24 publications

Tourette syndrome research highlights from 2021

Tourette syndrome research highlights from 2021

Urge intolerance predicts tic severity and impairment among adults with Tourette syndrome and chronic tic disorders

Internet-Based Cognitive Behavioral Therapy for Tourette Syndrome—Meaningfully Improving Access to Behavioral Therapy for Tics

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