Bothersome tics in patients with chronic tic disorders: Characteristics and individualized treatment response to behavior therapy. (July 2015) - McGuire, Joseph F.
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. Highlights: Nominated motor tics had greater severity relative to nominated phonic tics. Tics with a premonitory urge had greater severity relative to tics without urges. CBIT was efficacious relative to PST for tics with and without premonitory urges. Tics with a baseline premonitory urge were more likely to remit with CBIT. Individual tics had differential improvement and remission with CBIT relative to PST.