@article{c820b15d49fa4e2cab890123f57efda9,
title = "A Comparison of Urge Intensity and the Probability of Tic Completion During Tic Freely and Tic Suppression Conditions",
abstract = "Tic-suppression-based treatments (TSBTs) represent a safe and effective treatment option for Chronic Tic Disorders (CTDs). Prior research has demonstrated that treatment naive youths with CTDs have the capacity to safely and effectively suppress tics for prolonged periods. It remains unclear how tic suppression is achieved. The current study principally examines how effective suppression is achieved and preliminary correlates of the ability to suppress tics. Twelve youths, ages 10 to 17 years, with moderate-to-marked CTDs participated in an alternating sequence of tic freely and reinforced tic suppression conditions during which urge intensity and tic frequency were frequently assessed. Probability of tics occurring was half as likely following high-intensity urges during tic suppression (31%) in contrast to low-intensity urges during tic freely conditions (60%). Age was not associated with ability to suppress. Intelligence indices were associated with or trended toward greater ability to suppress tics. Attention difficulties were not associated with ability to suppress but were associated with tic severity. In contrast to our {"}selective suppression{"} hypothesis, we found participants equally capable of suppressing their tics regardless of urge intensity during reinforced tic suppression. Tic suppression was achieved with an {"}across-the-board{"} effort to resist urges. Preliminary data suggest that ability to suppress may be associated with general cognitive variables rather than age, tic severity, urge severity, and attention. Treatment naive youths appear to possess a capacity for robust tic suppression. TSBTs may bolster these capacities and/or enable their broader implementation, resulting in symptom improvement.",
keywords = "Tourette's, tic suppression, tics, urges",
author = "Specht, {Matt W.} and Nicotra, {Cassandra M.} and Kelly, {Laura M.} and Woods, {Douglas W.} and Ricketts, {Emily J.} and Carisa Perry-Parrish and Elizabeth Reynolds and Jessica Hankinson and Grados, {Marco A.} and Ostrander, {Rick S.} and Walkup, {John T.}",
note = "Funding Information: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr. Specht also received payment from the Tourette Syndrome Association for speaking engagements. The terms of this arrangement are being managed by the Johns Hopkins University in accordance with its conflict of interest policies. Doug Woods has received book royalties from Guilford Press, Oxford University Press, Springer Press, and New Harbinger Publications. Dr. Woods has received grants from the Tourette Syndrome Association, Trichotillomania Learning Center, and the National Institutes of Health. Dr. Woods has received speaking honoraria from a partnership program between the Tourette Syndrome Association and Centers for Disease Control. Marco Grados has received payment from the Tourette Syndrome Association for a speaking engagement. John Walkup collects less than US$500 annually in royalties from books on Tourette{\textquoteright}s syndrome. Dr. Walkup receives travel expenses from the Tourette Syndrome Association for medical and scientific advisory board meetings. Dr. Walkup also receives honoraria and travel expenses from the Tourette Syndrome Association funded by the Center for Disease Control to do education and training for medical and allied professionals. Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Matt W. Specht has received funding for the current study from the Tourette Syndrome Association. This research was supported by a grant from the Tourette{\textquoteright}s Syndrome Association.",
year = "2014",
month = mar,
doi = "10.1177/0145445514537059",
language = "English (US)",
volume = "38",
pages = "297--318",
journal = "Behavior Modification",
issn = "0145-4455",
publisher = "SAGE Publications Inc.",
number = "2",
}