About Chronic Tic Disorder

Compulsive Tics

People with chronic tic disorders (often Tourette's Syndrome) have strong, unwanted urges to repeatedly make sudden, stereotyped movements or sounds. Tics can be brief, meaningless sounds or movements, or more complex, seemingly organized series of actions. Tic frequency may increase due to stress, tiredness, and changes in emotions. Tics may cause substantial life distress or disruption in role functioning, and often co-occur with other problems such as anxiety, depression, and attentional difficulties. Short-term cognitive behavioral therapy for adults, adolescents, and children with chronic tic disorders is offered through the center.

Description of Tic Disorder

Chronic Tic Disorders are an OCD-related condition, characterized by the presence of either involuntary motor or vocal tics. The tic(s) occur several times a day, nearly every day or intermittently for a period of more than a year and never less than 3 months with an onset before the age of 18. When multiple motor tics and at least one verbal tic are simultaneously present, the diagnosis is known as Tourette's syndrome.

Symptoms of Tic Disorder

Motor tics are involuntary and sudden body movements. Simple rapid movements, resembling a body spasm, are termed simple motor tics such as eye blinking, head jerks, and facial grimace. Complex motor tics are a series of intricate, seemingly organized sequence of movements (i.e. jumping, skipping, smelling objects, a string of movements). Verbal or phonic tics are involuntary, sudden vocalizations and classified in a similar manner. Simple verbal tics are short sporadic sounds (i.e., clicks, sniffs, coughs) whereas complex verbal tic are longer elaborate vocalization (i.e., barking, changes in pitch or tone, cursing).

Treatment for Tic Disorder

Medications are often used to manage tic symptoms, and can include the use of typical and atypical neuroleptics (e.g., haldol, risperidone). However, medications alone are usually inadequate. Family therapy and psychotherapy are also commonly used to help cope with the social and adjustment issues associated with these disorders. The best studied psychological treatment for Chronic Tic Disorders is a form of cognitive-behavioral therapy known as Habit Reversal Therapy (HRT), which has been found to be better than comparison treatments in several studies conducted around the country. Treatment of tic disorders and their associated problems may involve a multi-component approach (e.g., pharmacotherapy plus CBT), although research suggests that medication may not add much to therapy alone (O'Connor et al., 2009).

The best practice for getting better is Habit Reversal Therapy to treat Chronic Tic Disorders including Tourette's syndrome. The efficacy of this treatment has been shown in several adult and teen studies.

Related Scientific Studies

Kieron P. O'Connor, Anick Laverdure, Annie Taillon, Emmanuel Stip, François Borgeat, & Marc Lavoie. (2009). Cognitive behavioral management of Tourette's syndrome and chronic tic disorder in medicated and unmedicated samples. Behaviour Research and Therapy, (47)12, 1090-1095. https://doi.org/10.1016/j.brat.2009.07.021.

Eric A. Storch, Lisa J. Merlo, Caleb Lack, Vanessa A. Milsom, Gary R. Geffken, Wayne K. Goodman & Tanya K. Murphy. (2007). Quality of Life in Youth With Tourette's Syndrome and Chronic Tic Disorder. Journal of Clinical Child & Adolescent Psychology, 36:2, 217-227. https://doi.org/10.1080/15374410701279545

Bennett, S.M., Keller, A.E. & Walkup, J.T. (2013). The future of tic disorder treatment. Ann. N.Y. Academy of Science, 1304: 32-39. https://doi.org/10.1111/nyas.12296

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