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Behavior Modification
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*Tourette Syndrome
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Habituation of Premonitory Sensations During Exposure and Response Prevention Treatment in Tourette's Syndrome

Cara W. J. Verdellen

Nijmegen University, c.verdellen{at}hsk.nl

Cees A. L. Hoogduin

Nijmegen University

Bernet S. Kato

Utrecht University

Ger P. J. Keijsers

Nijmegen University

Danielle C. Cath

GGZ Buitenamstel Amsterdam/Vrije University Medical Center

Herbert B. Hoijtink

Utrecht University

Exposure to premonitory sensations and response prevention of tics (ER) has been shown to be a promising new treatment for Tourette's syndrome (TS). The present study tested the hypothesis that habituation to unpleasant premonitory sensations associated with the tic is an underlying mechanism of change in ER. Patients rated the severity of sensations and urges at 15-minute intervals during ten 2-hour ER sessions. Multilevel models using multiple time trend analyses showed significant reductions of the sensory severity ratings both within and between sessions. The decrease of these severity ratings was related to the frequency of tics exhibited during sessions, regardless of tic severity at baseline. These results support the hypothesis that habituation may be at least part of the underlying working mechanism of exposure in the treatment of tics in TS and that effective tic suppression during sessions is an important factor in this habituation process.

Key Words: Tourette's syndrome • premonitory sensory sensations • exposure and response prevention • tic suppression • habituation

Behavior Modification, Vol. 32, No. 2, 215-227 (2008)
DOI: 10.1177/0145445507309020
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