Cognitive control processes in behavior therapy for youth with Tourette's disorder.
Cognitive control processes in behavior therapy for youth with Tourette's disorder.
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DOI：
10.1111/jcpp.13470
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发表时间：
2022-03
影响因子：
7.6
通讯作者：
Piacentini, John
中科院分区：
文献类型：
--
作者：
McGuire, Joseph F.;Sturm, Alexandra;Ricketts, Emily J.;Montalbano, Gabrielle E.;Chang, Susanna;Loo, Sandra K.;Woods, Douglas W.;McCracken, James;Piacentini, John
认知控制过程与妥瑞氏症 (TD) 的行为治疗有关。然而，这些过程对治疗结果的影响却很少受到关注。这项研究检验了认知控制过程和/或抽动抑制是否可以预测抽动严重程度的降低和对行为疗法的治疗反应。 53 名患有 TD 或广泛性抽动障碍的青少年参加了一项随机等待名单行为治疗对照试验。在进行基线评估以评估精神病学诊断、抽动严重程度和认知控制过程（例如反应选择、抑制和压制）后，青少年被随机分配接受 8 次行为治疗（n=23）或同等持续时间的候补名单（n=28）。接受立即治疗的青少年完成了治疗后评估，以确定抽动严重程度的改善。与此同时，等待名单中的青少年完成了另一项评估，以重新评估抽动的严重程度和认知控制过程，随后接受了 8 次行为治疗，随后进行治疗后评估以确定改善情况。多元线性回归模型发现，治疗前抑制/开启 Delis-Kaplan 执行功能系统色词干扰测试可预测行为治疗后抽动严重程度的降低（β=−0.36，t=−2.35，p=0.025，ƞ2=0.15）。然而，其他认知控制过程和抽动抑制并不能预测治疗反应和/或抽动严重程度的降低。行为治疗后，在认知控制过程中观察到了较小的、不显着的影响。认知控制过程可能会影响行为治疗中抽动严重程度的减轻。值得注意的是，即使其他认知控制过程受损并且青少年最初无法自愿抑制抽动，患有 TD 的青少年仍然可以从行为治疗中受益。研究结果对 TD 的临床实践和研究具有重要意义。
Cognitive control processes are implicated in the behavioral treatment of Tourette’s Disorder (TD). However, the influence of these processes on treatment outcomes has received minimal attention. This study examined whether cognitive control processes and/or tic suppression predicted reductions in tic severity and treatment response to behavior therapy. Fifty-three youth with TD or a pervasive tic disorder participated in a randomized wait-list controlled trial of behavior therapy. Following a baseline assessment to evaluate psychiatric diagnoses, tic severity, and cognitive control processes (e.g., response selection, inhibition, and suppression), youth were randomly assigned to receive 8 sessions of behavior therapy (n=23) or a waitlist of equal duration (n=28). Youth receiving immediate treatment completed a post-treatment assessment to determine improvement in tic severity. Meanwhile, youth in the waitlist condition completed another assessment to re-evaluate tic severity and cognitive control processes, and subsequently received 8 sessions of behavior therapy followed by a post-treatment assessment to determine improvement. A multiple linear regression model found that pre-treatment inhibition/switching on the Delis-Kaplan Executive Function System Color Word Interference Test predicted reductions in tic severity after behavior therapy (β=−0.36, t=−2.35, p=0.025, ƞ2 =0.15). However, other cognitive control processes and tic suppression did not predict treatment response and/or reductions in tic severity. Small non-significant effects were observed in cognitive control processes after behavior therapy. Cognitive control processes may influence tic severity reductions in behavior therapy. Notably, even when other cognitive control processes are impaired and youth are initially unable to voluntarily suppress their tics, youth with TD can still benefit from behavior therapy. Findings offer implications for clinical practice and research for TD.
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