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Durability, Negative Impact, and Neuropsychological Predictors of Tic Suppression in Children with Chronic Tic Disorder

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Abstract

Chronic tic disorders are characterized by involuntary motor and vocal tics, which are influenced by contextual factors. Recent research has shown that (a) children can suppress tics for brief periods of time, (b) suppression is enhanced when programmed reinforcement is provided for tic-free intervals, and (c) short periods of suppression do not result in a paradoxical “rebound” in tic frequency when active suppression has ceased. The current study extended existing research in three important ways. First, we examined whether tic suppression ability decreased as suppression duration increased from 5 to 25 to 40 min. Second, we examined post-suppression tic frequency to test whether longer periods of suppression were more likely to be associated with a rebound effect. Finally, we explored neuropsychological predictors of tic suppression. Thirteen children with Tourette syndrome or a chronic tic disorder completed the study. Results showed that (a) tic suppression was sustained for all of the suppression durations, (b) rebound effects were not observed following any of the suppression durations, and (c) ability to suppress was correlated with omission, but not commission errors on a continuous performance task. Implications of these findings are discussed.

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Notes

  1. The reported 0% inter-observer reliability coefficient represents a case in which one rater observed and recorded a single tic during a suppression condition whereas the second rater observed zero tics during that same segment.

  2. We ran a 2 (WMU vs NDSU) × 4 (BL, 5, 25, 40 min) ANOVA for the suppression data. Results showed a main effect of site, F(1,10) = 6.22, p = 0.03, with the tic rate across the four conditions at NDSU being significantly higher than the tic rate from WMU participants. The interaction between site and condition was not significant, F(3, 30) = 0.13, p = 0.94. The results of the main effect of suppression were similar to those reported in the body of the paper.

  3. We ran a 2 (medicated vs nonmedicated) × 4 (BL, 5, 25, 40 min) ANOVA for the suppression data. The suppression data showed no main effect of med status, F(1, 11) = 0.13, p > 0.05, nor a med status × condition interaction, F(3,33) = 0.39, p > 0.05. The results of the main effect of suppression were similar to those reported in the body of the paper.

  4. We ran a 2 (WMU vs NDSU) × 4 (BL, 5, 25, 40 min) ANOVA for the rebound data. Results showed no main effect of site, F(1,11) = 3.99, p = 0.07. Results showed no significant interaction between site and condition, F(3, 33) = 1.0, p = 0.40. The results of the main effect of rebound were similar to those reported in the body of the paper.

  5. We ran a 2 (medicated vs nonmedicated) × 4 (BL, 5, 25, 40 min) ANOVA for the rebound data. There was no main effect of med status, F(1, 11) = 0.05, p > 0.05, nor a med status × condition interaction, F(3,33) = 1.65, p > 0.05. The results of the main effect of rebound were similar to those reported in the body of the paper (Table 1).

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Acknowledgement

This study was funded by a grant from the Tourette Syndrome Association, awarded to the first author. We would like to thank all the participants and their families for their assistance in this study. We would also like to thank Liviu Bunaciu, Chris Bauer, Kevin Rice, Geoffrey DeBery, Allison Jay, Margaret Strobel, Season Almason, Amy Gross, Peter Knudson, Pam Kelso, and Carrie Brower-Breitwieser for their work on the project.

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Author notes

  1. Raymond G. Miltenberger

    Present address: Department of Child and Family Studies, University of South Florida, Tampa, USA

  2. James E. Carr & Candice Jostad

    Present address: Department of Psychology, Western Michigan University, Kalamazoo, USA

  3. Michael B. Himle

    Present address: Department of Psychology, University of North Dakota, Grand Forks, USA

  4. Amanda Bosch

    Present address: Department of Psychology, University of Florida, Gainesville, USA

Authors and Affiliations

  1. Department of Psychology, University of Wisconsin-Milwaukee, 2441 E. Hartford Avenue, Garland Hall Room 224, Milwaukee, WI, 53211, USA

    Douglas W. Woods, Michael B. Himle & David C. Osmon

  2. Department of Psychology, Western Michigan University, Kalamazoo, USA

    Amanda M. Karsten

  3. North Dakota State University, Fargo, USA

    Candice Jostad & Amanda Bosch

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  1. Douglas W. Woods
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Correspondence to Douglas W. Woods.

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Woods, D.W., Himle, M.B., Miltenberger, R.G. et al. Durability, Negative Impact, and Neuropsychological Predictors of Tic Suppression in Children with Chronic Tic Disorder. J Abnorm Child Psychol 36, 237–245 (2008). https://doi.org/10.1007/s10802-007-9173-9

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  • DOI: https://doi.org/10.1007/s10802-007-9173-9

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