The Experts below are selected from a list of 1065 Experts worldwide ranked by ideXlab platform
Lawrence Scahill - One of the best experts on this subject based on the ideXlab platform.
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benchmarking treatment response in tourette s disorder a psychometric evaluation and signal detection analysis of the parent Tic questionnaire
Behavior Therapy, 2017Co-Authors: Emily J Ricketts, Lawrence Scahill, Douglas W Woods, Joseph F Mcguire, Susanna Chang, Deepika Bose, Madeline Rasch, Matthew W Specht, John T Walkup, Sabine WilhelmAbstract:Abstract This study assessed the psychometric properties of a parent-reported Tic severity measure, the Parent Tic Questionnaire (PTQ), and used the scale to establish guidelines for delineating clinically significant Tic treatment response. ParTicipants were 126 children ages 9 to 17 who parTicipated in a randomized controlled trial of Comprehensive Behavioral Intervention for Tics (CBIT). Tic severity was assessed using the Yale Global Tic Severity Scale (YGTSS), Hopkins Motor/Vocal Tic Scale (HMVTS) and PTQ; positive treatment response was defined by a score of 1 ( very much improved ) or 2 ( much improved ) on the Clinical Global Impressions – Improvement (CGI-I) scale. Cronbach’s alpha and intraclass correlations (ICC) assessed internal consistency and test-retest reliability, with correlations evaluating validity. Receiver- and Quality-Receiver Operating CharacterisTic analyses assessed the efficiency of percent and raw-reduction cutoffs associated with positive treatment response. The PTQ demonstrated good internal consistency (α = 0.80 to 0.86), excellent test-retest reliability (ICC = .84 to .89), good convergent validity with the YGTSS and HM/VTS, and good discriminant validity from hyperactive, obsessive-compulsive, and externalizing (i.e., aggression and rule-breaking) symptoms. A 55% reduction and 10-point decrease in PTQ Total score were optimal for defining positive treatment response. Findings help standardize Tic assessment and provide clinicians with greater clarity in determining clinically meaningful Tic symptom change during treatment.
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an empirical examination of symptom substitution associated with behavior therapy for tourette s disorder
Behavior Therapy, 2016Co-Authors: Alan L Peterson, Douglas W Woods, Joseph F Mcguire, John T Walkup, Sabine Wilhelm, John Piacentini, John P Hatch, Robert Villarreal, Lawrence ScahillAbstract:Over the past six decades, behavior therapy has been a major contributor to the development of evidence-based psychotherapy treatments. However, a long-standing concern with behavior therapy among many nonbehavioral clinicians has been the potential risk for symptom substitution. Few studies have been conducted to evaluate symptom substitution in response to behavioral treatments, largely due to measurement and definitional challenges associated with treated psychiatric symptoms. Given the overt motor and Vocal Tics associated with Tourette's disorder, it presents an excellent opportunity to empirically evaluate the potential risk for symptom substitution associated with behavior therapy. The present study examined the possible presence of symptom substitution using four methods: (a) the onset of new Tic symptoms, (b) the occurrence of adverse events, (c) change in Tic medications, and (d) worsening of co-occurring psychiatric symptoms. Two hundred twenty-eight parTicipants with Tourette's disorder or persistent motor or Vocal Tic disorders were randomly assigned to receive behavioral therapy or supportive therapy for Tics. Both therapies consisted of eight sessions over 10 weeks. Results indicated that parTicipants treated with behavior therapy were not more likely to have an onset of new Tic symptoms, experience adverse events, increase Tic medications, or have an exacerbation in co-occurring psychiatric symptoms relative to parTicipants treated with supportive therapy. Further analysis suggested that the emergence of new Tics was attributed with the normal waxing and waning nature of Tourette's disorder. Findings provide empirical support to counter the long-standing concern of symptom substitution in response to behavior therapy for individuals with Tourette's disorder.
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patterns and correlates of Tic disorder diagnoses in privately and publicly insured youth
Journal of the American Academy of Child and Adolescent Psychiatry, 2011Co-Authors: Mark Olfson, Tobias Gerhard, James Walkup, Cecilia Huang, Stephen Crystal, Lawrence ScahillAbstract:Objective This study examined the prevalence and demographic and clinical correlates of children diagnosed with Tourette disorder, chronic motor or Vocal Tic disorder, and other Tic disorders in public and private insurance plans over the course of a 1-year period. Method Claims were reviewed of Medicaid (n = 10,247,827) and privately (n = 16,128,828) insured youth (4-18 years old) focusing on Tic disorder diagnoses during a 1-year period. Rates are presented for children with each Tic disorder diagnosis overall and stratified by demographic characterisTics and co-identified mental disorders. Mental health service use, including medications prescribed, and co-existing psychiatric disorders were also examined. Results In Medicaid-insured children, rates of diagnosis per 1,000 were 0.53 (95% confidence interval [CI] 0.51-0.55) for Tourette disorder, 0.08 (95% CI 0.07-0.08) for chronic motor or Vocal Tic disorder, and 0.43 (95% CI 0.41-0.44) for other Tic disorders. In privately insured children, comparable rates were 0.50 (95% CI 0.49-0.52), 0.10 (95% CI 0.10-0.11), and 0.59 (95% CI 0.58-0.61). In 1 year, children diagnosed with Tic disorders also frequently received other psychiatric disorder diagnoses. Compared with privately insured youth, children under Medicaid diagnosed with Tourette disorder had higher rates of attention-deficit/hyperactivity disorder (50.2% versus 25.9%), other disruptive behavior (20.6% versus 5.6%), and depression (14.6% versus 9.8%) diagnoses and higher rates of antipsychoTic medication use (53.6% versus 33.2%). Conclusions Despite similarities in annual rates of Tic disorder diagnoses in publicly and privately insured children, important differences exist in patient characterisTics and service use of publicly and privately insured youth who are diagnosed with Tic disorders.
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tourette syndrome the self under siege
Journal of Child Neurology, 2006Co-Authors: James F Leckman, Lawrence Scahill, Michael H Bloch, Robert A KingAbstract:Tourette syndrome is a neurodevelopmental disorder characterized by motor and Vocal Tics--rapid, repetitive, stereotyped movements or Vocalizations. Tourette syndrome typically has a prepubertal onset, and boys are more commonly affected than girls. Symptoms usually begin with transient bouts of simple motor Tics. By age 10 years, most children are aware of nearly irresistible somatosensory urges that precede the Tics. These urges likely reflect a defect in sensorimotor gating because they intrude into the child's conscious awareness and become a source of distraction and distress. A momentary sense of relief typically follows the completion of a Tic. Over the course of hours, Tics occur in bouts, with a regular interTic interval. Tics increase during periods of emotional excitement and fatigue. Tics can become "complex" in nature and appear to be purposeful. Tics can be willfully suppressed for brief intervals and can be evoked by the mere mention of them. Tics typically diminish during periods of goal-directed behavior, especially those that involve both heightened attention and fine motor or Vocal control, as occur in musical and athleTic performances. Over the course of months, Tics wax and wane. New Tics appear, often in response to new sources of somatosensory irritation, such as the appearance of a persistent Vocal Tic (a cough) following a cold. Over the course of years, Tic severity typically peaks between 8 and 12 years of age. By the end of the second decade of life, many individuals are virtually Tic free. Less than 20% of cases continue to experience clinically impairing Tics as adults. Tics rarely occur in isolation, and other coexisting conditions--such as behavioral disinhibition, hypersensitivity to a broad range of sensory stimuli, problems with visual motor integration, procedural learning difficulties, attention-deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder, depression, anxiety, and emotional instability--are often a greater source of impairment than the Tics themselves. Emerging behavioral treatments of Tourette syndrome are based in part on an understanding of the moment-to-moment experience of somatosensory urges and motor response. With identification of specific genes of major effect and advances in our understanding of the neural circuitry of sensorimotor gating, habit formation, and procedural memory--together with insights from postmortem brain studies, in vivo brain imaging, and electrophysiologic recordings--we might be on the threshold of a deeper understanding of the phenomenology and natural history of Tourette syndrome.
Sabine Wilhelm - One of the best experts on this subject based on the ideXlab platform.
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benchmarking treatment response in tourette s disorder a psychometric evaluation and signal detection analysis of the parent Tic questionnaire
Behavior Therapy, 2017Co-Authors: Emily J Ricketts, Lawrence Scahill, Douglas W Woods, Joseph F Mcguire, Susanna Chang, Deepika Bose, Madeline Rasch, Matthew W Specht, John T Walkup, Sabine WilhelmAbstract:Abstract This study assessed the psychometric properties of a parent-reported Tic severity measure, the Parent Tic Questionnaire (PTQ), and used the scale to establish guidelines for delineating clinically significant Tic treatment response. ParTicipants were 126 children ages 9 to 17 who parTicipated in a randomized controlled trial of Comprehensive Behavioral Intervention for Tics (CBIT). Tic severity was assessed using the Yale Global Tic Severity Scale (YGTSS), Hopkins Motor/Vocal Tic Scale (HMVTS) and PTQ; positive treatment response was defined by a score of 1 ( very much improved ) or 2 ( much improved ) on the Clinical Global Impressions – Improvement (CGI-I) scale. Cronbach’s alpha and intraclass correlations (ICC) assessed internal consistency and test-retest reliability, with correlations evaluating validity. Receiver- and Quality-Receiver Operating CharacterisTic analyses assessed the efficiency of percent and raw-reduction cutoffs associated with positive treatment response. The PTQ demonstrated good internal consistency (α = 0.80 to 0.86), excellent test-retest reliability (ICC = .84 to .89), good convergent validity with the YGTSS and HM/VTS, and good discriminant validity from hyperactive, obsessive-compulsive, and externalizing (i.e., aggression and rule-breaking) symptoms. A 55% reduction and 10-point decrease in PTQ Total score were optimal for defining positive treatment response. Findings help standardize Tic assessment and provide clinicians with greater clarity in determining clinically meaningful Tic symptom change during treatment.
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an empirical examination of symptom substitution associated with behavior therapy for tourette s disorder
Behavior Therapy, 2016Co-Authors: Alan L Peterson, Douglas W Woods, Joseph F Mcguire, John T Walkup, Sabine Wilhelm, John Piacentini, John P Hatch, Robert Villarreal, Lawrence ScahillAbstract:Over the past six decades, behavior therapy has been a major contributor to the development of evidence-based psychotherapy treatments. However, a long-standing concern with behavior therapy among many nonbehavioral clinicians has been the potential risk for symptom substitution. Few studies have been conducted to evaluate symptom substitution in response to behavioral treatments, largely due to measurement and definitional challenges associated with treated psychiatric symptoms. Given the overt motor and Vocal Tics associated with Tourette's disorder, it presents an excellent opportunity to empirically evaluate the potential risk for symptom substitution associated with behavior therapy. The present study examined the possible presence of symptom substitution using four methods: (a) the onset of new Tic symptoms, (b) the occurrence of adverse events, (c) change in Tic medications, and (d) worsening of co-occurring psychiatric symptoms. Two hundred twenty-eight parTicipants with Tourette's disorder or persistent motor or Vocal Tic disorders were randomly assigned to receive behavioral therapy or supportive therapy for Tics. Both therapies consisted of eight sessions over 10 weeks. Results indicated that parTicipants treated with behavior therapy were not more likely to have an onset of new Tic symptoms, experience adverse events, increase Tic medications, or have an exacerbation in co-occurring psychiatric symptoms relative to parTicipants treated with supportive therapy. Further analysis suggested that the emergence of new Tics was attributed with the normal waxing and waning nature of Tourette's disorder. Findings provide empirical support to counter the long-standing concern of symptom substitution in response to behavior therapy for individuals with Tourette's disorder.
Douglas W Woods - One of the best experts on this subject based on the ideXlab platform.
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benchmarking treatment response in tourette s disorder a psychometric evaluation and signal detection analysis of the parent Tic questionnaire
Behavior Therapy, 2017Co-Authors: Emily J Ricketts, Lawrence Scahill, Douglas W Woods, Joseph F Mcguire, Susanna Chang, Deepika Bose, Madeline Rasch, Matthew W Specht, John T Walkup, Sabine WilhelmAbstract:Abstract This study assessed the psychometric properties of a parent-reported Tic severity measure, the Parent Tic Questionnaire (PTQ), and used the scale to establish guidelines for delineating clinically significant Tic treatment response. ParTicipants were 126 children ages 9 to 17 who parTicipated in a randomized controlled trial of Comprehensive Behavioral Intervention for Tics (CBIT). Tic severity was assessed using the Yale Global Tic Severity Scale (YGTSS), Hopkins Motor/Vocal Tic Scale (HMVTS) and PTQ; positive treatment response was defined by a score of 1 ( very much improved ) or 2 ( much improved ) on the Clinical Global Impressions – Improvement (CGI-I) scale. Cronbach’s alpha and intraclass correlations (ICC) assessed internal consistency and test-retest reliability, with correlations evaluating validity. Receiver- and Quality-Receiver Operating CharacterisTic analyses assessed the efficiency of percent and raw-reduction cutoffs associated with positive treatment response. The PTQ demonstrated good internal consistency (α = 0.80 to 0.86), excellent test-retest reliability (ICC = .84 to .89), good convergent validity with the YGTSS and HM/VTS, and good discriminant validity from hyperactive, obsessive-compulsive, and externalizing (i.e., aggression and rule-breaking) symptoms. A 55% reduction and 10-point decrease in PTQ Total score were optimal for defining positive treatment response. Findings help standardize Tic assessment and provide clinicians with greater clarity in determining clinically meaningful Tic symptom change during treatment.
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an empirical examination of symptom substitution associated with behavior therapy for tourette s disorder
Behavior Therapy, 2016Co-Authors: Alan L Peterson, Douglas W Woods, Joseph F Mcguire, John T Walkup, Sabine Wilhelm, John Piacentini, John P Hatch, Robert Villarreal, Lawrence ScahillAbstract:Over the past six decades, behavior therapy has been a major contributor to the development of evidence-based psychotherapy treatments. However, a long-standing concern with behavior therapy among many nonbehavioral clinicians has been the potential risk for symptom substitution. Few studies have been conducted to evaluate symptom substitution in response to behavioral treatments, largely due to measurement and definitional challenges associated with treated psychiatric symptoms. Given the overt motor and Vocal Tics associated with Tourette's disorder, it presents an excellent opportunity to empirically evaluate the potential risk for symptom substitution associated with behavior therapy. The present study examined the possible presence of symptom substitution using four methods: (a) the onset of new Tic symptoms, (b) the occurrence of adverse events, (c) change in Tic medications, and (d) worsening of co-occurring psychiatric symptoms. Two hundred twenty-eight parTicipants with Tourette's disorder or persistent motor or Vocal Tic disorders were randomly assigned to receive behavioral therapy or supportive therapy for Tics. Both therapies consisted of eight sessions over 10 weeks. Results indicated that parTicipants treated with behavior therapy were not more likely to have an onset of new Tic symptoms, experience adverse events, increase Tic medications, or have an exacerbation in co-occurring psychiatric symptoms relative to parTicipants treated with supportive therapy. Further analysis suggested that the emergence of new Tics was attributed with the normal waxing and waning nature of Tourette's disorder. Findings provide empirical support to counter the long-standing concern of symptom substitution in response to behavior therapy for individuals with Tourette's disorder.
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using habit reversal to treat chronic Vocal Tic disorder in children
Behavioral Interventions, 2002Co-Authors: Douglas W Woods, Michael P TwohigAbstract:In the present study, a nonconcurrent multiple baseline design was used to evaluate the effectiveness of simplified habit reversal in three children diagnosed with chronic Vocal Tic disorder. In two children, Vocal Tics were substantially reduced. In a third child, Tics were not reduced, and the addition of a supplemental contingency management program was ineffective. Despite these mixed results, the treatment was viewed as acceptable to the children's parents in all cases as measured by a standard index of treatment acceptability. Implications of these findings are discussed. Copyright © 2002 John Wiley & Sons, Ltd.
Francisco Cardoso - One of the best experts on this subject based on the ideXlab platform.
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Complex phonic Tic and disinhibition in Tourette syndrome: case report
Arquivos de neuro-psiquiatria, 2001Co-Authors: Débora Palmini Maia, Francisco CardosoAbstract:Tourette syndrome (TS) is a neuropsychiatric disorder characterized by a combination of multiple motor Tics and at least one phonic Tic. TS patients often have associated behavioral abnormalities such as obsessive compulsive disorder, attention deficit and hyperactive disorder. Coprolalia, defined as emission of obscenities or swearing, is one type of complex Vocal Tic, present in 8% to 26% of patients. The pathophysiology of coprolalia and other complex phonic Tics remains ill-defined. We report a patient whose complex phonic Tic was characterized by repetitively saying "breast cancer" on seeing the son of aunt who suffered from this condition. The patient was unable to suppress the Tic and did not meet criteria for obsessive compulsive disorder. The phenomenology herein described supports the theory that complex phonic Tics result from disinhibition of the loop connecting the basal ganglia with the limbic cortex.
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Complex phonic Tic and disinhibition in Tourette syndrome: case report Tique fônico complexo e desinibição em síndrome de Tourette: relato de caso
Academia Brasileira de Neurologia (ABNEURO), 2001Co-Authors: Débora Palmini Maia, Francisco CardosoAbstract:Tourette syndrome (TS) is a neuropsychiatric disorder characterized by a combination of multiple motor Tics and at least one phonic Tic. TS patients often have associated behavioral abnormalities such as obsessive compulsive disorder, attention deficit and hyperactive disorder. Coprolalia, defined as emission of obscenities or swearing, is one type of complex Vocal Tic, present in 8% to 26% of patients. The pathophysiology of coprolalia and other complex phonic Tics remains ill-defined. We report a patient whose complex phonic Tic was characterized by repetitively saying "breast cancer" on seeing the son of aunt who suffered from this condition. The patient was unable to suppress the Tic and did not meet criteria for obsessive compulsive disorder. The phenomenology herein described supports the theory that complex phonic Tics result from disinhibition of the loop connecting the basal ganglia with the limbic cortex.Síndrome de Tourette (ST) é uma condição neuropsiquiátrica caracterizada pela combinação de múltiplos tiques motores e ao menos um tique fônico. Freqüentemente tiques se associam a distúrbios de comportamento como transtorno obsessivo compulsivo e déficit de atenção e hiperatividade. Coprolalia, definida como emissão de obscenidades, é um tique fônico complexo presente em 8% a 26% dos pacientes com ST. A fisiopatologia de tiques complexos permanece mal compreendida. Nós descrevemos um paciente com tique fônico complexo caracterizado por dizer repetidamente "câncer de mama" ao encontrar primo cuja mãe sofria dessa doença. O paciente não conseguia suprimir o tique e não apresenta transtorno obsessivo compulsivo. A fenomenologia desse paciente sustenta a teoria de que tiques fônicos complexos resultam de desinibição da alça límbica dos núcleos da base
Joseph F Mcguire - One of the best experts on this subject based on the ideXlab platform.
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benchmarking treatment response in tourette s disorder a psychometric evaluation and signal detection analysis of the parent Tic questionnaire
Behavior Therapy, 2017Co-Authors: Emily J Ricketts, Lawrence Scahill, Douglas W Woods, Joseph F Mcguire, Susanna Chang, Deepika Bose, Madeline Rasch, Matthew W Specht, John T Walkup, Sabine WilhelmAbstract:Abstract This study assessed the psychometric properties of a parent-reported Tic severity measure, the Parent Tic Questionnaire (PTQ), and used the scale to establish guidelines for delineating clinically significant Tic treatment response. ParTicipants were 126 children ages 9 to 17 who parTicipated in a randomized controlled trial of Comprehensive Behavioral Intervention for Tics (CBIT). Tic severity was assessed using the Yale Global Tic Severity Scale (YGTSS), Hopkins Motor/Vocal Tic Scale (HMVTS) and PTQ; positive treatment response was defined by a score of 1 ( very much improved ) or 2 ( much improved ) on the Clinical Global Impressions – Improvement (CGI-I) scale. Cronbach’s alpha and intraclass correlations (ICC) assessed internal consistency and test-retest reliability, with correlations evaluating validity. Receiver- and Quality-Receiver Operating CharacterisTic analyses assessed the efficiency of percent and raw-reduction cutoffs associated with positive treatment response. The PTQ demonstrated good internal consistency (α = 0.80 to 0.86), excellent test-retest reliability (ICC = .84 to .89), good convergent validity with the YGTSS and HM/VTS, and good discriminant validity from hyperactive, obsessive-compulsive, and externalizing (i.e., aggression and rule-breaking) symptoms. A 55% reduction and 10-point decrease in PTQ Total score were optimal for defining positive treatment response. Findings help standardize Tic assessment and provide clinicians with greater clarity in determining clinically meaningful Tic symptom change during treatment.
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an empirical examination of symptom substitution associated with behavior therapy for tourette s disorder
Behavior Therapy, 2016Co-Authors: Alan L Peterson, Douglas W Woods, Joseph F Mcguire, John T Walkup, Sabine Wilhelm, John Piacentini, John P Hatch, Robert Villarreal, Lawrence ScahillAbstract:Over the past six decades, behavior therapy has been a major contributor to the development of evidence-based psychotherapy treatments. However, a long-standing concern with behavior therapy among many nonbehavioral clinicians has been the potential risk for symptom substitution. Few studies have been conducted to evaluate symptom substitution in response to behavioral treatments, largely due to measurement and definitional challenges associated with treated psychiatric symptoms. Given the overt motor and Vocal Tics associated with Tourette's disorder, it presents an excellent opportunity to empirically evaluate the potential risk for symptom substitution associated with behavior therapy. The present study examined the possible presence of symptom substitution using four methods: (a) the onset of new Tic symptoms, (b) the occurrence of adverse events, (c) change in Tic medications, and (d) worsening of co-occurring psychiatric symptoms. Two hundred twenty-eight parTicipants with Tourette's disorder or persistent motor or Vocal Tic disorders were randomly assigned to receive behavioral therapy or supportive therapy for Tics. Both therapies consisted of eight sessions over 10 weeks. Results indicated that parTicipants treated with behavior therapy were not more likely to have an onset of new Tic symptoms, experience adverse events, increase Tic medications, or have an exacerbation in co-occurring psychiatric symptoms relative to parTicipants treated with supportive therapy. Further analysis suggested that the emergence of new Tics was attributed with the normal waxing and waning nature of Tourette's disorder. Findings provide empirical support to counter the long-standing concern of symptom substitution in response to behavior therapy for individuals with Tourette's disorder.
