Anger-Control Intervention for Children with Tourette Syndrome: A Randomized Controlled Study

Grant Type
Clinical
Grant Year
2001-2002
Institution Location
CT
Institution Organization Name
Yale Child Study Center
Investigators Name
Sukhodolsky, Denis, PhD

This research project will investigate whether a particular method of cognitive-behavioral psychotherapy works for those children with Tourette Syndrome (TS) who exhibit explosive, disruptive behavior. Such behaviors may take numerous forms, such as anger outbursts that have been described as rage attacks or rage storms because of their high intensity and unpredictability in response to minimal provocation. Other behavior problem areas in children with TS may include refusal to follow directions, excessive argumentativeness, and in a few cases physical aggression. Whether these problems are part of TS, or related to co-occurring conditions such as ADHD, or due to the burden of coping with a chronic illness is not clear. However, these behaviors can result in significant impairment in school, family, and peer functioning, and often require clinical attention. This study will be conducted at the Yale University Child Study Center in collaboration with the Tic Disorder Clinic. Thirty 12 to 16-yearold children will be selected and randomly assigned to receive anger control intervention either immediately or after a 14-week waiting period. Children in the waiting group will continue to receive standard treatment either at the Yale Child Study Center or through their local clinics. After the waiting period, they also will be invited to attend the anger control program. The anger control program consists of 10 fifty-minute, weekly sessions during which children are taught to manage their anger in conflict situations, and to use more effective problem-solving skills. These techniques have been shown to reduce anger-related behaviors, and improve social functioning in aggressive youths generally. This study will be the first, however, to evaluate this anger control intervention in children with TS. Children’s behavior will be assessed before and after treatment by a clinician who will not know whether the child is in the treatment group or on the waiting list. This research plan will permit demonstration of a clinical relevance of anger-control intervention for children with TS, as well as exploration of the intervention’s impact on tic symptoms and social adjustment in these subjects. In addition, data from this project will add to the understanding of psychological mechanisms that might mediate disruptive behavior in children with TS. Finally, if this study demonstrates that anger control intervention is effective, broader recommendations could be formulated for both families and clinicians who are involved with Tourette Syndrome treatment. Denis G. Sukhodolsky, Ph.D. Yale Child Study Center, New Haven, CT Award: $46,880 IN MEMORY OF WENDY A. OCHSMAN Tourette Association of America Inc. – Research Grant Award 2001-2002