A Comparison of Urge Intensity and the Probability of Tic Completion During Tic Freely and Tic Suppression Conditions.
Kids can suppress tics at any urge level, so teach them to resist every urge, not just the strong ones.
01Research in Context
What this study did
Murphy et al. (2014) asked kids with Tourette syndrome to sit through two back-to-back sessions.
In one session they could tic freely. In the other they earned points for keeping tics in.
The researchers rated how strong the pre-tic urge felt and whether a tic still slipped out.
What they found
Children suppressed tics equally well no matter how intense the urge felt.
Kids with higher IQ scores held tics back longer than kids with lower scores.
The study found positive results for both light and strong urges.
How this fits with other research
Ahlborn et al. (2008) saw urge ratings drop across long exposure sessions and linked that drop to fewer tics. Their single-case design looked at habituation, not moment-to-moment suppression.
Buse et al. (2014) warn that stress can spike tics through stress-hormone paths. Their review reminds you to check stress levels even when suppression looks good.
The papers don’t clash. W et al. show kids can win the battle at any single urge, while J et al. show the war gets easier as urges shrink over time.
Why it matters
You can stop teaching clients to wait for the “big urge.” Instead, train them to clamp down on every tickle, weak or strong. Track stress on the side so gains don’t wash away on tough days.
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02At a glance
03Original 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.
Behavior modification, 2014 · doi:10.1177/0145445514537059