Effect of Behavior Therapy for Tourette's Disorder on Psychiatric Symptoms and Functioning in Adults

Authors

Joseph F. McGuire, Johns Hopkins University School of MedicineFollow
Emily J. Ricketts, University of California - Los AngelesFollow
Lawrence Scahill, Emory University
Sabine Wilhelm, Harvard Medical School
Douglas W. Woods, Marquette UniversityFollow
John Piacentini, University of California - Los AngelesFollow
John T. Walkup, Lurie Children's HospitalFollow
Alan L. Peterson, University of Texas - San AntonioFollow

Document Type

Article

Publication Date

9-2020

Publisher

Cambridge University Press

Source Publication

Psychological Medicine

Source ISSN

0033-2917

Abstract

Background

Although behavior therapy reduces tic severity, it is unknown whether it improves co-occurring psychiatric symptoms and functional outcomes for adults with Tourette's disorder (TD). This information is essential for effective treatment planning. This study examined the effects of behavior therapy on psychiatric symptoms and functional outcomes in older adolescents and adults with TD.

Method

A total of 122 individuals with TD or a chronic tic disorder participated in a clinical trial comparing behavior therapy to psychoeducation and supportive therapy. At baseline, posttreatment, and follow-up visits, participants completed assessments of tic severity, co-occurring symptoms (inattention, impulsiveness, hyperactivity, anger, anxiety, depression, obsessions, and compulsions), and psychosocial functioning. We compared changes in tic severity, psychiatric symptoms, and functional outcomes using repeated measure and one-way analysis of variance.

Results

At posttreatment, participants receiving behavior therapy reported greater reductions in obsessions compared to participants in supportive therapy (η²_p= 0.04, p = 0.04). Across treatments, a positive treatment response on the Clinical Global Impression of Improvement scale was associated with a reduced disruption in family life (η²_p = 0.05, p = 0.02) and improved functioning in a parental role (η²_p = 0.37, p = 0.02). Participants who responded positively to eight sessions of behavior therapy had an improvement in tic severity (η²_p = 0.75, p < 0.001), inattention (η²_p = 0.48, p < 0.02), and functioning (η²_p = 0.39–0.42, p < 0.03–0.04) at the 6-month follow-up.

Conclusion

Behavior therapy has a therapeutic benefit for co-occurring obsessive symptoms in the short-term, and reduces tic severity and disability in adults with TD over time. Additional treatments may be necessary to address co-occurring symptoms and improve functional outcomes.

Comments

Accepted version. Psychological Medicine, Vol. 50, No. 12 (September 2020): 2046-2056. DOI. © 2020 Cambridge University Press. Used with permission.

Recommended Citation

McGuire, Joseph F.; Ricketts, Emily J.; Scahill, Lawrence; Wilhelm, Sabine; Woods, Douglas W.; Piacentini, John; Walkup, John T.; and Peterson, Alan L., "Effect of Behavior Therapy for Tourette's Disorder on Psychiatric Symptoms and Functioning in Adults" (2020). Psychology Faculty Research and Publications. 509.
https://epublications.marquette.edu/psych_fac/509