Randomized trial of anger control training for adolescents with Tourette's syndrome and disruptive behavior.
OBJECTIVE
To evaluate the efficacy of a 10-session individually administered anger control training (ACT) for adolescents with Tourette's syndrome (TS) and disruptive behavior.


METHODS
Twenty-six subjects (24 boys and 2 girls; mean age 12.7 years, SD 0.88) with TS and high levels of disruptive behavior were randomly assigned to ACT or treatment-as-usual (TAU). The parent-rated Disruptive Behavior Rating Scale and the Clinical Global Impression-Improvement Scale rated by the independent evaluator were used as primary outcome measures.


RESULTS
All randomized subjects completed end-point evaluation, and all subjects in the ACT group completed 3-month follow-up evaluation. The Disruptive Behavior Rating Scale score decreased by 52% in the ACT group compared with a decrease of 11% in the TAU control group (p <.001). On the Clinical Global Impression-Improvement Scale, the independent evaluator rated 9 (69%) of 13 subjects in the ACT condition as much improved or very much improved compared with 2 (15%) of 13 in the TAU condition (p <.01). This reduction of disruptive behavior in the ACT group was well maintained at 3-month follow-up.


CONCLUSIONS
Anger control training seems to reduce disruptive behavior in adolescents with TS. Larger trials are needed to confirm these results.Clinical trial registration information-Anger Control Training for Youth With Tourette's Syndrome. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00486551.
Sukhodolsky
Denis G
DG
Drs. Sukhodolsky, Vitulano, Leckman, and Mr. McGuire are with the Yale Child Study Center. Dr. Scahill and Ms. Carroll are with the Yale School of Nursing. Electronic address: denis.sukhodolsky@yale.edu.
Vitulano
Lawrence A
LA
Drs. Sukhodolsky, Vitulano, Leckman, and Mr. McGuire are with the Yale Child Study Center. Dr. Scahill and Ms. Carroll are with the Yale School of Nursing.
Carroll
Deirdre H
DH
Drs. Sukhodolsky, Vitulano, Leckman, and Mr. McGuire are with the Yale Child Study Center. Dr. Scahill and Ms. Carroll are with the Yale School of Nursing.
McGuire
Joseph
J
Drs. Sukhodolsky, Vitulano, Leckman, and Mr. McGuire are with the Yale Child Study Center. Dr. Scahill and Ms. Carroll are with the Yale School of Nursing.
Leckman
James F
JF
Drs. Sukhodolsky, Vitulano, Leckman, and Mr. McGuire are with the Yale Child Study Center. Dr. Scahill and Ms. Carroll are with the Yale School of Nursing.
Scahill
Lawrence
L
Drs. Sukhodolsky, Vitulano, Leckman, and Mr. McGuire are with the Yale Child Study Center. Dr. Scahill and Ms. Carroll are with the Yale School of Nursing.
D000293:Adolescent; D000786:Anger; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D015588:Observer Variation; D010290:Parents; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D013663:Teaching / Q000379:methods*; D005879:Tourette Syndrome / Q000453:epidemiology* / Q000523:psychology*