title: Bothersome tics in patients with chronic tic disorders: Characteristics and individualized treatment response to behavior therapy.
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.
  NCT00218777; NCT00231985.
authors.affiliation: Semel Institute of Neuroscience and Human Behavior, University of California Los Angeles, 760 Westwood Plaza, Los Angeles, CA 90095, USA. Electronic address: jfmcguire@mednet.ucla.edu.
authors.forename: Joseph F
authors.initials: JF
authors.lastname: McGuire
authors.affiliation: Semel Institute of Neuroscience and Human Behavior, University of California Los Angeles, 760 Westwood Plaza, Los Angeles, CA 90095, USA. Electronic address: jpiacentini@mednet.ucla.edu.
authors.forename: John
authors.initials: J
authors.lastname: Piacentini
authors.affiliation: Marcus Center, Emory University School of Medicine, 1920 Briarcliff Rd NE, Atlanta, GA 30329, USA. Electronic address: lawrence.scahill@emory.edu.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Scahill
authors.affiliation: Department of Psychology, University of Texas A&M, 4235 TAMU, College Station, TX 77843, USA. Electronic address: dowoods@tamu.edu.
authors.forename: Douglas W
authors.initials: DW
authors.lastname: Woods
authors.affiliation: Department of Psychiatry, University of Texas Health Science Center at San Antonio, 7550 IH 10 West, Suite 1325, San Antonio, TX 78229, USA. Electronic address: villarrear10@uthscsa.edu.
authors.forename: Robert
authors.initials: R
authors.lastname: Villarreal
authors.affiliation: Massachusetts General Hospital and Harvard Medical School, 185 Cambridge St., Suite 2000, Boston, MA 02114, USA. Electronic address: swilhelm@mgh.harvard.edu.
authors.forename: Sabine
authors.initials: S
authors.lastname: Wilhelm
authors.affiliation: Weil Cornell Medical College, Cornell University, 525 E. 68th St., New York, NY 10065, USA. Electronic address: jtw9001@med.cornell.edu.
authors.forename: John T
authors.initials: JT
authors.lastname: Walkup
authors.affiliation: Department of Psychiatry, University of Texas Health Science Center at San Antonio, 7550 IH 10 West, Suite 1325, San Antonio, TX 78229, USA; South Texas Veterans Health Care System, 7400 Merton Minter Boulevard, San Antonio, TX 78229, USA; University of Texas at San Antonio, One UTSA Circle, San Antonio, TX 78249, USA. Electronic address: petersona3@uthscsa.edu.
authors.forename: Alan L
authors.initials: AL
authors.lastname: Peterson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001521:Behavior Therapy / Q000379:methods*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D013981:Tic Disorders / Q000523:psychology / Q000628:therapy*; D020323:Tics / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Behavior therapy; Comprehensive behavioral intervention for tics; Habit reversal training; Individualized treatment response; Tourette's disorder; Treatment outcome