Improving Symptom Trajectories of Tic Disorders and Co-Occurring Diagnoses: The Role of Integrative Intensive Intervention

Authors

Chelsea Faye Dale, Florida International UniversityFollow

Document Type

Dissertation

Degree

Doctor of Philosophy (PhD)

Major/Program

Psychology

First Advisor's Name

Jonathan Comer, Ph.D.

First Advisor's Committee Title

Committee Chair

Second Advisor's Name

Justin Parent, Ph.D.

Second Advisor's Committee Title

Committee Co-Chair

Third Advisor's Name

Gregory Fabiano, Ph.D.

Third Advisor's Committee Title

Committee Member

Fourth Advisor's Name

Andy Pham, Ph.D.

Fourth Advisor's Committee Title

Committee Member

Keywords

Tic Disorders, Comprehensive Behavioral Intervention for Tics, Intensive Interventions, Telemental Health, Co-occurring Diagnoses

Date of Defense

6-7-2022

Abstract

Tic Disorders (TDs) are neurodevelopmental disorders characterized by involuntary movements or sounds, which can often impact an individual’s quality of life and functioning. Youth with TDs frequently also meet criteria for an additional co-occurring diagnosis (i.e., attention-deficit/hyperactivity disorder (ADHD), anxiety, obsessive-compulsive disorder). Comprehensive Behavioral Intervention for Tics (CBIT) is a well-established and first-line behavioral intervention for youth with TDs, however, despite recent investigation into alternative treatment formats, co-occurring symptoms have not yet been explicitly addressed within the context of CBIT. Intensive intervention formats are well established for co-occurring diagnoses of TDs; however, the literature on the utility, feasibility, and acceptability of intensive interventions for TDs and co-occurring diagnoses is limited. The portfolio of graduate research presented in this dissertation consists of three separate studies of increasing rigor evaluating Taming Tics Together (TTT), which was developed by Chelsea Dale, M.S., and Justin Parent, Ph.D. TTT is a novel, 5-day, videoconference-based intensive intervention to concurrently address TD and co-occurring diagnosis symptoms. The first study (Study 1) uses a case study design, which evaluates the TTT program in an individual format with an 11-year-old biracial male diagnosed with Tourette’s Disorder and ADHD. The second study (Study 2) builds upon family feedback and lessons learned in Study 1 and uses a group-based case series design with three male youth (M_age = 9.67, Range = 9 - 11) and their caregivers. The third study (Study 3) builds upon Study 1 and 2 using a randomized controlled trial design with 21 youth (M_age=12.55, 50% male) and a caregiver (95% female) who were randomly assigned to an immediate treatment group vs. a 1-month waitlist. Primary outcomes across all three studies were TD-related, and secondary outcomes were related to co-occurring diagnostic symptom trajectories. Study 3 also incorporated exploratory outcomes related to caregiver-specific, youth quality of life, and interference outcomes. Satisfaction with treatment and attendance was high across all studies. Overall, results across all studies were promising, suggesting feasibility, acceptability, and preliminary support for TTT to simultaneously address TDs and co-occurring diagnoses. Strengths and limitations of each of the three studies, the clinical implications, and future directions are discussed.

Identifier

FIDC121425

Comments

Study 1 has already been published online. Please see the following link for the published article: https://www.sciencedirect.com/science/article/pii/S1077722921000444

Previously Published In

Dale, C., Ramos, M., & Parent, J. (2021). Intensive behavioral therapy for tics and co-occurring ADHD: A case report. Cognitive and Behavioral Practice. Advance online publication. https://doi.org/10.1016/j.cbpra.2021.02.004.

Recommended Citation

Dale, Chelsea Faye, "Improving Symptom Trajectories of Tic Disorders and Co-Occurring Diagnoses: The Role of Integrative Intensive Intervention" (2022). FIU Electronic Theses and Dissertations. 5465.
https://digitalcommons.fiu.edu/etd/5465