Date of Award

Summer 2023

Document Type


Degree Name

Doctor of Philosophy (PhD)



First Advisor

Woods, Douglas W.

Second Advisor

Kodak, Tiffany

Third Advisor

Himle, Michael B.


Tic disorders, such as Tourette’s Syndrome, are chronic, childhood-onset neurological conditions that involve sudden, repetitive, and involuntary motor movements and/or vocalizations. Individuals with tics often experience a premonitory urge, which is an aversive sensation that occurs right before a tic that may functionally influence tics. Previous research has suggested reinforced tic suppression can effectively reduce tics. Although effective, it may be useful to better understand the behavioral contingencies that most effectively lead to suppression. The purpose of the current study was to compare standard reinforced tic suppression with reinforced tic suppression that included an option for participant-initiated breaks using an alternating treatments design with four participants with motor and/or vocal tics. The current study also utilized individualized DRO intervals. Results showed that three of four participants saw a reduction in tics in both DRO conditions compared to baseline. Furthermore, DRO did not result in significantly higher urge ratings compared to baseline and DRO with breaks with any of the participants. Finally, preference for the conditions was idiosyncratic, with two participants preferring DRO and two participants preferring DRO-Break.

Included in

Psychology Commons