Investigating Distress Tolerance in Adults With Tourette Syndrome

Johns Hopkins University9 enrolled

Overview

Although behavior therapy is recognized as a first-line intervention for Tourette's Disorder (TD), less than 40% of adults with TD respond to this evidence-based treatment. Limited tolerance for aversive premonitory urges and affective states that accompany tics may be one likely factor that impedes behavior therapy outcomes. This study examines the relationship between distress tolerance and tic inhibition among adults with TD, and investigates the mechanism and effect of therapeutic skills training to enhance distress tolerance abilities. Findings will determine the optimal approach to enhance distress tolerance among adults with TD and ultimately lead to better behavior therapy outcomes.

Tourette's Disorder and other persistent tic disorders collectively affect about about 1% of the population, cause significant distress, and functional impairment. Although behavior therapy is recognized as a first-line intervention for Tourette's Disorder (TD), less than 40% of adults with TD respond to this evidence-based treatment. Limited tolerance for aversive premonitory urges and affective states that accompany tics may be one likely factor that impedes behavior therapy outcomes. This study examines the relationship between distress tolerance and tic inhibition among adults with TD, and investigates the mechanism and effect of therapeutic skills training to enhance distress tolerance abilities.

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Tourette Syndrome

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Participants will be eligible for participation if the following inclusion criteria are met: * at least 18 years of age * have moderate tic severity or greater as evidenced by a YGTSS Total Tic Score greater than 14 (\>9 for adults with motor or vocal tics only) * exhibit a tic frequency of at least one visible tic per minute * be fluent in English * have a total premonitory urge for tics scale (PUTS) total score greater than 17 at Visit 2 * have a total DTS score greater than 30 at Visit 2 Exclusion criteria for participants include: * history of cardiovascular disorder * history of fainting or seizures * history of frostbite * open cut or sore on hand to be immersed * fracture to the limb to be immersed * history of Reynaud's phenomenon * inability to complete rating scales * inability to attend study visits

Outcomes

Primary Outcomes

Distress Tolerance Scale (DTS)

The Distress Tolerance Scale is a 15-item self-report measure that measures the perceived capacity to tolerate distress from a multidimensional framework, including tolerance, appraisal, absorption, and regulation. Items are rated on a 1-5 Likert scale, and then summed. Score ranges from 15-75. Higher total scores indicate greater difficulty with tolerating distress.

Time frame: Within 1 week after completion of Distress Tolerance Skills Training

Secondary Outcomes

Yale Global Tic Severity Scale-Revised (YGTSS)

The YGTSS is a clinician-rated semi-structured interview that measures tic symptom severity over the previous week. It consists of 10-items that assess different dimensions of tic severity for motor and vocal tics, which are rated on a 0-5 scale. The YGTSS produces a Total Tic Score (range: 0-50), with higher ratings indicating greater tic severity.