Tic-suppression-based treatments (TSBTs) represent a safe and effective treatment option for Chronic
Tic Disorders (
CTDs). Prior research has demonstrated that treatment naive youths with
CTDs have the capacity to safely and effectively suppress
tics for prolonged periods. It remains unclear how
tic suppression is achieved. The current study principally examines how effective suppression is achieved and preliminary correlates of the ability to suppress
tics. Twelve youths, ages 10 to 17 years, with moderate-to-marked
CTDs participated in an alternating sequence of
tic freely and reinforced
tic suppression conditions during which urge intensity and
tic frequency were frequently assessed. Probability of
tics occurring was half as likely following high-intensity urges during
tic suppression (31%) in contrast to low-intensity urges during
tic freely conditions (60%). Age was not associated with ability to suppress. Intelligence indices were associated with or trended toward greater ability to suppress
tics. Attention difficulties were not associated with ability to suppress but were associated with
tic severity. In contrast to our "selective suppression" hypothesis, we found participants equally capable of suppressing their
tics regardless of urge intensity during reinforced
tic suppression.
Tic suppression was achieved with an "across-the-board" effort to resist urges. Preliminary data suggest that ability to suppress may be associated with general cognitive variables rather than age,
tic severity, urge severity, and attention. Treatment naive youths appear to possess a capacity for robust
tic suppression. TSBTs may bolster these capacities and/or enable their broader implementation, resulting in symptom improvement.