An Empirical Examination of Symptom Substitution Associated With Behavior Therapy for Tourette's Disorder

Behavior Therapy
Alan L PetersonLawrence Scahill

Abstract

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 wit...Continue Reading

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Citations

Dec 9, 2017·F1000Research·Kevin J Black
Jul 12, 2019·Expert Review of Neurotherapeutics·Joey Ka-Yee EssoeJoseph F McGuire
Aug 28, 2019·Psychological Medicine·Joseph F McGuireAlan L Peterson
Nov 7, 2015·Current Developmental Disorders Reports·Joseph F McGuireAdam B Lewin
Feb 7, 2018·Psychiatry Research·Susanna W ChangJohn Piacentini
Mar 27, 2021·Behaviour Research and Therapy·Joey K-Y EssoeJoseph F McGuire
Jun 23, 2021·Journal of Child Psychology and Psychiatry, and Allied Disciplines·Joseph F McGuireJohn Piacentini

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