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dc.contributor.advisor Curry, John F en_US
dc.contributor.author Best, Stephanie Helena en_US
dc.date.accessioned 2009-08-27T18:33:52Z
dc.date.available 2009-08-27T18:33:52Z
dc.date.issued 2009 en_US
dc.identifier.uri http://hdl.handle.net/10161/1318
dc.description Dissertation en_US
dc.description.abstract <p>Among some researchers, there is an emerging conceptualization of chronic tic disorders (CTDs) as conditions that are partially rooted in avoidance of tic-related private experiences (i.e., painful or difficult thoughts and feelings) and internal sensations (i.e., premonitory urges to tic). The first specific aim of the present research was to investigate the possibility that experiential avoidance is related to tic severity and perceived quality of life in individuals with CTDs. The second aim was to determine whether the efficacy of Habit Reversal Training (HRT), the most prevalent and effective behavioral intervention for CTDs to date, might be enhanced by combining it with Acceptance and Commitment Therapy (ACT), an intervention that directly targets experiential avoidance. These aims were addressed by conducting two related studies. Study I, an online survey, included 239 adults (<italic>M</italic> = 37.6 years; <italic>SD</italic> = 13.8 years) who reported having been previously diagnosed with a CTD. Results showed that levels of premonitory urges, as well as both general and tic-specific experiential avoidance, were significantly positively related to tic severity. General and tic-specific experiential avoidance were also significantly negatively related to perceived quality of life. Psychometric analyses of two novel measures developed for Study I (i.e., the Yale Global Tic Severity Scale-Self-Report Version and the Acceptance and Action Questionnaire-Tic-Specific Version) demonstrated excellent internal consistency and convergent validity. Study II, a multi-site pilot investigation, involved 13 adolescents (<italic>M</italic> = 15.4 years; <italic>SD</italic> = 1.3 years) who were treated with either HRT alone or a novel HRT+ACT intervention. Results suggest that the HRT+ACT treatment is feasible, highly acceptable to both patients and parents, and as effective as HRT alone at reducing tic severity from pre-treatment through week 22 follow-up. Participants in both groups reported clinically significant post-treatment decreases in general and tic-specific experiential avoidance and improvements in overall functioning. Researchers concluded that experiential avoidance plays an important role in tic expression and overall functioning for individuals with CTDs. Results support additional development and testing of the promising HRT+ACT intervention, to evaluate its efficacy alone and in comparison to other relevant psychosocial and pharmacological interventions.</p> en_US
dc.format.extent 1855366 bytes
dc.format.mimetype application/pdf
dc.language.iso en_US
dc.subject Psychology, Clinical en_US
dc.subject Health Sciences, Mental Health en_US
dc.subject Psychology, Behavioral en_US
dc.subject Acceptance and Commitment Therapy (ACT) en_US
dc.subject chronic tic disorders en_US
dc.subject experiential avoidance en_US
dc.subject Habit Reversal Training (HRT) en_US
dc.subject premonitory urge en_US
dc.subject Tourette Syndrome en_US
dc.title Experiential Avoidance in Chronic Tic Disorders: an Online Survey and Pilot Treatment Study Using Habit Reversal and Acceptance and Commitment Therapy en_US
dc.type Dissertation en_US
dc.department Psychology and Neuroscience en_US

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