Abstract
Objective: To determine the long-term durability of behavior therapy for tics among youth with Tourette disorder and persistent (chronic) motor or vocal tic disorders. Method: Of the 126 youth who participated in a randomized controlled trial of behavior therapy 11 years prior, 80 were recruited for this longitudinal follow-up. Consenting participants were interviewed in person or remotely (Web-based video) by trained evaluators to determine the course of tics, current tic severity, and tic-related impairment. Recruitment and data collection occurred between 2014 and 2019, with an average follow-up duration of 11.2 years. Results: Treatment responders to both conditions in the original trial achieved partial, but not full, tic remission. Tic severity also decreased significantly across the sample, with 40% reporting partial remission. Behavior therapy responders (n = 21) in the original trial were more likely (67%) to achieve remission at follow-up (Total Tic Score = 12.52, SD = 10.75) compared to psychoeducation/supportive therapy responders (n = 6, 0%) at follow-up (Total Tic Score = 20.67, SD = 6.92) on the Yale Global Tic Severity Scale. Tic-related impairment decreased across the sample, with no significant differences between treatment groups or responders. Conclusion: Despite limitations of unmeasured variables and veracity of self-report at follow-up, this study supports guidelines recommending behavior therapy as the first-line intervention for tics. Further investigation of behavior therapy as an early preventive intervention also merits attention.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 764-771 |
| Number of pages | 8 |
| Journal | Journal of the American Academy of Child and Adolescent Psychiatry |
| Volume | 61 |
| Issue number | 6 |
| DOIs | |
| State | Published - Jun 2022 |
Funding
This study was funded by the Tourette Association of America Research Grants Award.Disclosure: Dr. Espil has received research support from the Foundation for OCD Research and past support from the Tourette Association of America (TAA) and the American Academy of Neurology. Dr. Woods has received royalties from Guilford Press, Springer Press, and Oxford University Press. He has received speaking fees from TAA. Dr. Specht has received research support and speaking honoraria from the TAA. Dr. Bennett has received research support, speaking fees, and travel support for speaking engagements from the TAA. She has received royalties from Wolters Kluwer. Dr. Walkup has served on the advisory board and Speaker's Bureau of the TAA and has received royalties from Oxford Press, Guilford Press, and Wolters Kluwer. Dr. Ricketts has received research support from the National Institute of Mental Health (NIMH), TAA, and the TLC Foundation for Body-Focused Repetitive Behaviors, Body-Focused Repetitive Behavior Precision Medicine Initiative. She has received honoraria from the TAA and has served on their Diversity Committee. Dr. McGuire has received support from the TAA, the American Academy of Neurology, the Brain Research Foundation, the American Psychological Foundation, and the Hilda and Preston Davis Family Foundation. He has received royalties from Elsevier and has served as a consultant for Signant Health, Syneos Health, and Luminopia. Dr. Peterson has received royalties from Oxford University Press for treatment manuals on tic disorders and has received honoraria for CME presentations from the TAA. Dr. Scahill has received research support from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the US Department of Defense, and the Marcus Foundation. He has served on the advisory board/DSMB of Janssen Pharmaceuticals. He is a co-author of the Children's Yale–Brown Obsessive Compulsive Scale (CYBOCS), the Children's Yale–Brown Obsessive Compulsive Scale modified for Autism Spectrum Disorder (CYBOCS-ASD), and the Parent-Rated Anxiety Scale for youth with autism spectrum disorders (PRAS-ASD). He has served as a consultant to Roche, Impel NeuroPharma, Inc., Yamo Pharmaceuticals, and Teva Pharmaceutical Industries. He has served as associate editor of the Journal of Child and Adolescent Psychopharmacology and on the editorial board of the International Journal of Developmental Disabilities. He has received royalties from Guilford Press, Oxford University Press, and American Psychiatric Association Publishing. Dr. Wilhelm has been a presenter for the Massachusetts General Hospital Psychiatry Academy in educational programs supported through independent medical education grants from pharmaceutical companies. She has received royalties from Elsevier Publications, Guilford Publications, New Harbinger Publications, Springer, and Oxford University Press. She has received speaking honoraria from various academic institutions and foundations, including the International Obsessive-Compulsive Disorder Foundation, TAA, and Brattleboro Retreat. She has received payment from the Association for Behavioral and Cognitive Therapies for her role as Associate Editor for the Behavior Therapy journal, as well as from John Wiley & Sons, Inc. for her role as Associate Editor on the journal Depression & Anxiety. She has received honorarium from One-Mind for her role in PsyberGuide Scientific Advisory Board. She has received salary support from Novartis and Telefonica Alpha, Inc. Dr. Piacentini has received research support from NIMH, the TLC Foundation for BFRBs, and Pfizer Pharmaceuticals; publication royalties from Guilford Press and Oxford University Press; and travel/speaking honoraria from the TAA, International OCD Foundation, and the TLC Foundation for BFRBs. Dr. Chang, Mr. Stiede, and Ms. Schild have reported no biomedical financial interests or potential conflicts of interest.
Keywords
- Tourette
- long-term follow up
- tics
- youth
ASJC Scopus subject areas
- Psychiatry and Mental health
- Developmental and Educational Psychology
