Evaluating the Social Acceptability of Persons with Habit Disorders: The Effects of Topography, Frequency, and Gender Manipulation

  • Douglas W. Woods
  • R. Wayne Fuqua
  • Ryan C. Outman


In this study, 120 undergraduate students were asked to rate the social acceptability of a male and female who portrayed different habit behaviors (motor tics, vocal tics, Tourette's disorder, and trichotillomania). The portrayals of these behaviors were clinically valid as viewed by mental health professionals. Each habit behavior was portrayed in a variety of frequency/topography combinations including low frequency/mild topography, low frequency/severe topography, high frequency/mild topography, and high frequency/ severe topography. Participants were randomly assigned to one of four habit conditions (motor tic, vocal tic, Tourette's disorder, and trichotillomania) and were asked to rate the social acceptability of the frequency/topography combinations exhibited by each actor. Results showed that across the various habit conditions, the man with the habit was seen as less socially acceptable than the woman with the habit. In addition, low-frequency habit behaviors were more acceptable than high-frequency behaviors, and behaviors with mild topographies were more acceptable than those with severe topography habits. Motor tics were seen as more acceptable than vocal tics, Tourette's disorder, or trichotillomania. Implications and directions for future research are discussed.

tics trichotillomania Tourette's disorder 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorder (4th ed.). Washington, DC: APA.Google Scholar
  2. Bruun, R. D., & Bruun, B. (1994). A mind of its own: Tourette's disorder: A story and a guide. New York: Oxford University Press.Google Scholar
  3. Christenson, G. A., MacKenzie, T. B., & Mitchell, J. E. (1991). Characteristics of 60 adult hair pullers. American Journal of Psychiatry, 148, 365-370.Google Scholar
  4. Cohen, D. J., Riddle, M. A., & Leckman, J. F. (1992). Pharmacotherapy of Tourette's syndrome and associated disorders. Psychiatric Clinics of North America, 15, 109-129.Google Scholar
  5. Dowd, T., & Tierney, J. (1992). Teaching social skills to youth. Boys Town, NE: The Boys Town Press.Google Scholar
  6. Elliott, A. J., Miltenberger, R. G., Kaster-Bundgaard, J., & Lumley, V. A. (1996). A national survey of assessment and therapy techniques used by behavior therapists. Cognitive and Behavioral Practice, 3, 107-125.Google Scholar
  7. Finney, J. W., Rapoff, M. A., Hall, C. L., & Christopherson, E. R. (1983). Replication and social validation of habit reversal treatment for tics. Behavior Therapy, 14, 116-126.Google Scholar
  8. Friedrich, S., Morgan, S. B., & Devine, C. (1996). Children's attitudes and behavioral intentions toward a peer with Tourette's disorder. Journal of Pediatric Psychology, 21, 307-319.Google Scholar
  9. Friman, P. C., McPherson, K. M., Warzak, W. J., & Evans, J. (1993). Influence of thumb sucking on peer social acceptance in first-grade children. Pediatrics, 91, 784-786.Google Scholar
  10. Graber, J., & Arndt, W. B. (1993). Trichotillomania. Comprehensive Psychiatry, 34, 340-346.Google Scholar
  11. Greene, R. W., Biederman, J., Faraone, S. V., Sienna, M., & Garcia-Jetton, J. (1997). Adolescent outcome of boys with attention-deficit/hyperactivity disorder and social disability: Results from a 4 year longitudinal follow-up study. Journal of Consulting and Clinical Psychology, 65, 758-767.Google Scholar
  12. Hansen, D. J., Giacoletti, A. M., & Nangle, D. W. (1995). Social interactions and adjustment. In V. B. Van Hasselt & M. Hersen (Eds.), Handbook of Adolescent Psychopathology (pp. 102-129). New York: Lexington Books.Google Scholar
  13. Leckman, J. F., Riddle, M. A., Hardin, M. T., Ort, S. I., Swartz, K. L., Stevenson, J., & Cohen, D. J. (1989). The yale global tic severity scale: Initial testing of a clinician-rated scale of tic severity. Journal of the American Academy of Child and Adolescent Psychiatry, 28, 566-573.Google Scholar
  14. Long, E. S., Woods, D. W., Miltenberger, R. G., Fuqua, R. W., & Boudjouk, P. (1998). Examining the social effects of habit behaviors exhibited by individuals with mental retardation. Journal of Developmental and Physical Disabilities (in press).Google Scholar
  15. Peterson, A., Campise, R. L., & Azrin, N. H. (1994). Behavioral and pharmacological treatments for tic and habit disorders: A review. Developmental and Behavioral Pediatrics, 15, 430-441.Google Scholar
  16. Shimberg, E. F. (1995). Living with tourette syndrome. New York: Simon & Schuster.Google Scholar
  17. Spencer, T., Biederman, J., Harding, M., Wilens, T., & Faraone, S. (1995). The relationship between tic disorders and tourette's syndrome revisited. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 1133-1139.Google Scholar
  18. Stokes, A., Bawden, H. N., Camfield, P. R., Backman, J. E., & Dooley, J. M. (1991). Peer problems in Tourette's disorder. Pediatrics, 87, 936-942.Google Scholar
  19. Wisely, D. W., & Morgan, S. B. (1981). Children's ratings of peers presented as mentally retarded and physically handicapped. American Journal of Mental Deficiency, 86, 281-286.Google Scholar
  20. Woods, D. W., & Miltenberger, R. G. (1996). A review of habit reversal with childhood habit disorders. Education and Treatment of Children, 19, 197-214.Google Scholar
  21. Woods, D. W., Miltenberger, R. G., & Flach, A. D. (1996). Habits, tics, and stuttering: Prevalence and relation to anxiety and somatic awareness. Behavior Modification, 20, 216-225.Google Scholar
  22. Woods, D. W., Miltenberger, R. G., & Lumley, V. A. (1996). Sequential application of major habit reversal components to treat motor tics in children. Journal of Applied Behavior Analysis, 29, 483-493.Google Scholar
  23. Woods, D. W., Long, E. S., Fuqua, R. W., Miltenberger, R. G., Outman, R. C., & Boudjouk, P. (1997). Evaluating the social acceptability of persons with tic disorders. Paper presented at the meeting of the Association of Behavior Analysis, Chicago, IL.Google Scholar
  24. Yamamoto, K., & Dizney, H. F. (1967). Rejection of the mentally ill: A study of attitudes of student teachers. Journal of Counseling Psychology, 14, 263-268.Google Scholar

Copyright information

© Plenum Publishing Corporation 1999

Authors and Affiliations

  • Douglas W. Woods
    • 1
  • R. Wayne Fuqua
    • 1
  • Ryan C. Outman
    • 1
  1. 1.Department of PsychologyWestern Michigan UniversityKalamazoo
  2. 2.Department of Clinical Services and ResearchNebraska

Personalised recommendations