Variables Associated With Tic Exacerbation in Children With Chronic Tic Disorders

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.

Assessing Environmental Consequences of Ticcing in Youth With Chronic Tic Disorders: The Tic Accommodation and Reactions Scale

“…Consistent with previous research (Carr et al, 1996; Himle et al, in press; Scotti et al, 1994; Watson & Sterling, 1998), this study found that the vast majority of youth with CTDs report experiencing consequences for ticcing (cf. Himle et al, in press), and that these consequences (as measured by TARS scores) are positively correlated with tic severity.…”

“…Only one study has evaluated perceived associations between tic exacerbation and environmental consequences among individuals with CTDs. Himle and colleagues (in press) analyzed data from clinical interviews with 51 youth receiving behavior therapy for CTDs and their parents. Children and their parents were asked about a number of social consequences that may occur during periods of tic exacerbation, and the clinician dichotomously recorded whether or not each consequence had been endorsed.…”

An initial study of family accommodation in children and adolescents with chronic tic disorders

“…Although the etiology of TS is primarily biologically determined, there is considerable evidence to suggest that behavioral antecedents and consequences may influence tic expression/suppression [15,16]. Additionally, emerging data suggests that expression of tic symptoms can also result in environmental consequences [17].…”

From Cook to Culinarian: Going Beyond the Manual When Delivering Behavior Therapy to Treat Tourette Disorder

“…Finally, it's worth noting that while the function-based elements of CBIT might not have been particularly relevant for Hiro, results from the child CBIT randomized controlled trial found that out of 51 children randomized to CBIT, all participants endorsed at least two ticexacerbating antecedents and all but two endorsed at least one tic-exacerbating consequence (Himle et al, 2014). These findings strongly suggest that not taking the time to conduct a thorough functional assessment could, more times than not, result in the therapist missing out on important treatment-related information.…”