{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T18:32:48Z","timestamp":1791484368212,"version":"4.3.4"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,2,20]],"date-time":"2021-02-20T00:00:00Z","timestamp":1613779200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,2,20]],"date-time":"2021-02-20T00:00:00Z","timestamp":1613779200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Child Adolesc Psychiatry Ment Health"],"published-print":{"date-parts":[[2021,12]]},"abstract":"Abstract<\/jats:title>\n Background<\/jats:title>\n Chronic tic disorders are neurodevelopmental disorders that can be treated with Habit Reversal Training (HRT) and Exposure Response Prevention (ERP). Intermediate and long-term effects have been examined after individual treatment with HRT, whereas evaluation of long-term outcome after an initial treatment with ERP, or a combination of HRT and ERP is lacking.<\/jats:p>\n The present study examines the long-term effect after a combined treatment with HRT and ERP delivered in an individual or a group setting<\/jats:p>\n <\/jats:sec>\n Methods<\/jats:title>\n Fifty-nine children and adolescents diagnosed with a chronic tic disorder were randomised to manualised treatment combining HRT and ERP as individual or group training. Forty-seven were re-examined 1\u00a0year after acute outcome. Outcome measures included Total Tic Severity score (TTS) measured by the Yale Global Tic Severity Scale (YGTSS) and Beliefs About Tics Scale (BATS)<\/jats:p>\n <\/jats:sec>\n Results<\/jats:title>\n In a mixed model, it was shown that the initial improvement with both individual and group treatment was maintained throughout the follow-up period. There were no significant differences between the two methods of treatment delivery. Of all participants completing the 12 months evaluation, 74.4% were considered responders. There was a significant positive association between the reduction of TTS and the reduction in BATS. In a latent class post-treatment trajectory analysis, two classes were identified, where high baseline severity increased the likelihood of being in the lesser responder class. Similar, but only as a trend, having ADHD, planning difficulties or hypersensitivity increased the risk of a lesser response.<\/jats:p>\n <\/jats:sec>\n Conclusions<\/jats:title>\n The present study compares the efficacy in individualised and group treatment of providing manualised therapy for child and adolescent tic disorders using two behavioural methods (combined HRT and ERP) both of which have been shown to have acute benefits but only one of which has been validated for longer term effectiveness. In the present study, both individualised and group treatments showed benefit throughout a 1-year follow-up period with several potential confounds affecting outcomes, while the relative benefits of either HRT and ERP were not addressed.<\/jats:p>\n Trial registration<\/jats:italic> NCT04594044, 1-10-72-216-15, registered 19th October 2020, retrospectively registered, https:\/\/register.clinicaltrials.gov\/prs\/app\/template\/Home.vm?uid=U0005BW2&ts=9&sid=S000ABEY&cx=-wlx7vb<\/jats:ext-link><\/jats:p>\n The study is approved by the National Ethical Committee (1-10-72-216-15) and the Danish Data Protection Agency (1\u201316-02-490-15), registered 12 October 2015.<\/jats:p>\n <\/jats:sec>","DOI":"10.1186\/s13034-021-00362-w","type":"journal-article","created":{"date-parts":[[2021,2,21]],"date-time":"2021-02-21T01:46:09Z","timestamp":1613871969000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["One-year outcome of manualised behavior therapy of chronic tic disorders in children and adolescents"],"prefix":"10.1186","volume":"15","clinical-trial-number":[{"clinical-trial-number":"nct04594044","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4063-6866","authenticated-orcid":false,"given":"J. B.","family":"Nissen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. H.","family":"Carlsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. H.","family":"Thomsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,2,20]]},"reference":[{"key":"362_CR1","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1016\/S0733-8619(05)70311-X","volume":"15","author":"J Jankovic","year":"1997","unstructured":"Jankovic J. Tourette syndrome. Phenomenology and classification of tics. Neurol Clin. 1997;15:267\u201375.","journal-title":"Neurol Clin"},{"key":"362_CR2","doi-asserted-by":"publisher","first-page":"997","DOI":"10.1016\/j.neubiorev.2012.11.013","volume":"37","author":"SC Cohen","year":"2013","unstructured":"Cohen SC, Leckmanc JF, Bloch MH. Clinical assessment of Tourette syndrome and tic disorders. Neurosci Biobehav Rev. 2013;37:997\u20131007.","journal-title":"Neurosci Biobehav Rev"},{"key":"362_CR3","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1007\/s00787-011-0164-6","volume":"20","author":"DC Cath","year":"2011","unstructured":"Cath DC, Hedderly T, Ludolph AG, Stern JS, Murphy T, Hartmann A, et al. European clinical guidelines for Tourette syndrome and other tic disorders. Part I: assessment. Eur Child Adoelsc Psychiatry. 2011;20:155\u201371.","journal-title":"Eur Child Adoelsc Psychiatry"},{"key":"362_CR4","doi-asserted-by":"publisher","first-page":"939","DOI":"10.1007\/s00787-016-0823-8","volume":"25","author":"J Evans","year":"2016","unstructured":"Evans J, Seri S, Cavanna AE. The effects of Gilles de la Tourette syndrome and other chronic tic disorders on quality of life across the lifespan: a systematic review. Eur Child Adolesc Psychiatry. 2016;25:939\u201348.","journal-title":"Eur Child Adolesc Psychiatry"},{"key":"362_CR5","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1080\/14737175.2018.1413938","volume":"18","author":"D Martino","year":"2018","unstructured":"Martino D, Pringsheim TM. Tourette syndrome and other chronic tic disorders: an update on clinical management. Expert Rev Neurother. 2018;18:125\u201337.","journal-title":"Expert Rev Neurother"},{"key":"362_CR6","doi-asserted-by":"publisher","first-page":"1929","DOI":"10.1001\/jama.2010.607","volume":"303","author":"J Piacentini","year":"2010","unstructured":"Piacentini J, Woods DW, Scahill L, Wilhelm S, Peterson AL, Chang S, et al. Behavior therapy for children with Tourette disorder: a randomized controlled trial. JAMA. 2010;303:1929\u201337. https:\/\/doi.org\/10.1001\/jama.2010.607.","journal-title":"JAMA"},{"key":"362_CR7","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1001\/archgenpsychiatry.2011.1528","volume":"69","author":"S Wilhelm","year":"2012","unstructured":"Wilhelm S, Peterson AL, Piacentini J, Woods DW, Deckersbach T, Sukhodolsky DG, et al. Randomized trial of behavior therapy for adults with Tourette syndrome. Arch Gen Psychiatry. 2012;69:795\u2013803.","journal-title":"Arch Gen Psychiatry"},{"key":"362_CR8","doi-asserted-by":"publisher","first-page":"1175","DOI":"10.1176\/appi.ajp.160.6.1175","volume":"160","author":"S Wilhelm","year":"2003","unstructured":"Wilhelm S, Deckersbach T, Coffey BJ, Bohne A, Peterson AL, Baer L. Habit reversal versus supportive psychotherapy for Tourette\u2019s disorder: a randomized controlled trial. Am J Psychiatry. 2003;160:1175\u20137.","journal-title":"Am J Psychiatry"},{"key":"362_CR9","doi-asserted-by":"publisher","first-page":"1079","DOI":"10.1016\/j.brat.2005.08.007","volume":"44","author":"T Deckersbach","year":"2006","unstructured":"Deckersbach T, Rauch S, Buhlmann U, Wilhelm S. Habit reversal versus supportive psychotherapy in Tourette\u2019s disorder: a randomized controlled trial and predictors of treatment response. Behav Res Ther. 2006;44:1079\u201390.","journal-title":"Behav Res Ther"},{"key":"362_CR10","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1016\/S0005-7967(03)00154-2","volume":"42","author":"CW Verdellen","year":"2004","unstructured":"Verdellen CW, Keijsers GP, Cath DC. Hoogduin CA Exposure with response prevention versus habit reversal in Tourette\u2019s syndrome: a controlled study. Behav Res Ther. 2004;42:501\u201311.","journal-title":"Behav Res Ther"},{"key":"362_CR11","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1007\/s00787-018-1187-z","volume":"28","author":"JB Nissen","year":"2019","unstructured":"Nissen JB, Kaergaard M, Laursen L, Parner E, Thomsen PH. Combined habit reversal training and exposure response prevention in a group setting compared to individual training: a randomized controlled clinical trial. Eur Child Adolesc Psych. 2019;28:57\u201368.","journal-title":"Eur Child Adolesc Psych"},{"issue":"19","key":"362_CR12","doi-asserted-by":"publisher","first-page":"907","DOI":"10.1212\/\/WNL.0000000000007467","volume":"92","author":"T Pringsheim","year":"2019","unstructured":"Pringsheim T, Holler-Managan Y, Okun MS, Jankovic J, Piacentini J, Cavanna AE, Martine D, Muller-Vahl K, Woods DW, Robinson M, Jarvie E, Roessner V, Oskoui M. Comprehensive systematic review summary: Treatment of tics in people with Tourette syndrome and chronic tic disorders. Neurology. 2019;92(19):907\u201315. https:\/\/doi.org\/10.1212\/\/WNL.0000000000007467.","journal-title":"Neurology"},{"key":"362_CR13","doi-asserted-by":"publisher","first-page":"896","DOI":"10.1212\/WNL.0000000000007466","volume":"92","author":"T Pringsheim","year":"2019","unstructured":"Pringsheim T, Okun MS, Muller-Vahl K, Martine D, Jankovic J, Cavanna AE, Woods DW, Robinson M, Jarvie E, Roessner V, Oskoui M, Holler-Managan Y, Piacentini J. Practice guideline recommandations summary: Treatment of tics in people with Tourette syndrome and chronic tic disorders. Neurology. 2019;92:896\u2013906. https:\/\/doi.org\/10.1212\/WNL.0000000000007466.","journal-title":"Neurology"},{"issue":"11","key":"362_CR14","doi-asserted-by":"publisher","first-page":"1189","DOI":"10.1080\/14737175.2020.1826733","volume":"20","author":"L Yu","year":"2020","unstructured":"Yu L, Li Y, Zhang J, Yan C, Wen F, Yan J, Wang F, Liu J, Cui Y. The therapeutic effect of habit reversal training for Tourette syndrome: a meta-analysis of randomized control trials. Expert Rev Neurother. 2020;20(11):1189\u201396. https:\/\/doi.org\/10.1080\/14737175.2020.1826733.","journal-title":"Expert Rev Neurother"},{"issue":"3","key":"362_CR15","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1016\/j.beth.2017.10.005","volume":"49","author":"J Dabowski","year":"2018","unstructured":"Dabowski J, King J, Edwards K, Yates R, Heyman I, Zimmerman-Brenner S, Murphy T. The long-term effects of group-based psychological interventions for children with Tourette syndrome: a randomized controlled trial. Behav Ther. 2018;49(3):331\u201343. https:\/\/doi.org\/10.1016\/j.beth.2017.10.005.","journal-title":"Behav Ther"},{"issue":"2","key":"362_CR16","doi-asserted-by":"publisher","first-page":"024685","DOI":"10.1136\/bmjopen-2018-024685","volume":"9","author":"P Andren","year":"2019","unstructured":"Andren P, Aspvall K, de la Fernandez Cruz L, Wiktor P, Romano S, Andersson E, Murphy T, Isomura K, Serlachius E, Mataix-Cols D. Therapist-guided and parent-guided internet-delivered behaviour therapy for paediatric Tourette\u2019s disorder: a pilot randomised controlled trial with long-term follow-up. BMJ Open. 2019;9(2):024685. https:\/\/doi.org\/10.1136\/bmjopen-2018-024685.","journal-title":"BMJ Open"},{"key":"362_CR17","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1016\/j.brat.2016.03.003","volume":"80","author":"R Yates","year":"2016","unstructured":"Yates R, Edwards K, King J, Luzon O, Evangeli M, Stark D, McFarlane F, Heyman I, \u0130nce B, Kodric J, Murphy T. Habit reversal training and educational group treatments for children with tourette syndrome: a preliminary randomised controlled trial. Behav Res Ther. 2016;80:43\u201350. https:\/\/doi.org\/10.1016\/j.brat.2016.03.003.","journal-title":"Behav Res Ther"},{"key":"362_CR18","doi-asserted-by":"publisher","first-page":"566","DOI":"10.1097\/00004583-198907000-00015","volume":"28","author":"JF Leckman","year":"1989","unstructured":"Leckman JF, Riddle MA, Hardin MT, Ort SI, Swartz KL, Stevenson J, Cohen DJ. The Yale Global tic severity scale: initial testing of a clinician-rated scale of tic severity. J Am Acad Child Adolesc Psychiatry. 1989;28:566\u201373 (PMID: 2768151).","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"5","key":"362_CR19","doi-asserted-by":"publisher","first-page":"e74","DOI":"10.1192\/bjo.2019.56","volume":"5","author":"JB Nissen","year":"2019","unstructured":"Nissen JB, Parner ET, Thomsen PH. Predictors of therapeutic treatment outcome in adolescent chronic tic disorders. BJPsych Open. 2019;5(5):e74. https:\/\/doi.org\/10.1192\/bjo.2019.56.","journal-title":"BJPsych Open"},{"key":"362_CR20","doi-asserted-by":"publisher","first-page":"980","DOI":"10.1097\/00004583-199707000-00021","volume":"36","author":"J Kaufman","year":"1997","unstructured":"Kaufman J, Birmaher B, Brent D, Rao U, Flynn C, Moreci P, Williamson D, Ryan N. Schedule for affective disorders and schizophrenia for school-age children present and lifetime version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry. 1997;36:980\u20138. https:\/\/doi.org\/10.1097\/00004583-199707000-00021.","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"key":"362_CR21","volume-title":"Managing Tourette Syndrome: a behavioral intervention for children and adults","author":"DW Woods","year":"2003","unstructured":"Woods DW, Piacentini JC, Chang SW, Deckersbach T, Ginsberg GS, Peterson AL, Scahill LD, Walkup JT, Wilhelm S. Managing Tourette Syndrome: a behavioral intervention for children and adults. Oxford: University Press; 2003."},{"key":"362_CR22","unstructured":"Verdellen CWJ, van de Griendt J. Kriens S, van Oostrum I, Chang I. Tics\u2013Therapist manual and workbook for children. Boom cure and care, Amsterdam, 2011b"},{"key":"362_CR23","doi-asserted-by":"publisher","first-page":"414","DOI":"10.1016\/j.cct.2013.08.012","volume":"36","author":"S Jeon","year":"2013","unstructured":"Jeon S, Walkup JT, Woods DW, Peterson A, Picentinin J, Wilhelm S, et al. Detecting a clinically meaningful change in tic severity in Tourette syndrome: a comparison of three methods. Contemp Clin Trials. 2013;36:414.","journal-title":"Contemp Clin Trials"},{"key":"362_CR24","doi-asserted-by":"publisher","first-page":"545","DOI":"10.1097\/00004583-199704000-00018","volume":"36","author":"B Birmaher","year":"1997","unstructured":"Birmaher B, Khetarpal S, Brent D, Cully M, Balach L, Kaufman J, et al. The screen for child anxiety related emotional disorders (SCARED): scale construction and psychometric characteristics. J Am Acad Child Adolesc Psychiatry. 1997;36:545\u201353.","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"key":"362_CR25","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1111\/j.1469-7610.1995.tb01828.x","volume":"136","author":"A Wood","year":"1995","unstructured":"Wood A, Kroll L, Moore A, Harrington R. Properties of the mood and feelings questionnaire in adolescent psychiatric outpatients: a research note. J Child Psychol Psychiatry. 1995;136:327\u201334.","journal-title":"J Child Psychol Psychiatry"},{"key":"362_CR26","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1097\/00004703-200512000-00001","volume":"26","author":"DW Woods","year":"2005","unstructured":"Woods DW, Piacentini J, Himle MB, Chang S. Premonitory Urge for Tics Scale (PUTS): initial psychometric results and examination of the premonitory urge phenomenon in youths with Tic disorders. J Dev Behav Pediatr. 2005;26:397\u2013403.","journal-title":"J Dev Behav Pediatr"},{"key":"362_CR27","doi-asserted-by":"publisher","first-page":"462","DOI":"10.1016\/j.comppsych.2012.12.012","volume":"54","author":"T Steinberg","year":"2013","unstructured":"Steinberg T, Harush A, Barnea M, Dar R, Piacentini J, Woods D, et al. Tic-related cognition, sensory phenomena, and anxiety in children and adolescents with Tourette syndrome. Compr Psychiatry. 2013;54:462\u20136.","journal-title":"Compr Psychiatry"},{"key":"362_CR28","unstructured":"Achenbach TM. Child behavior checklist and related instruments. In The Use of Psychological Testing for Treatment Planning and Outcome Assessment (ed ME Maurish). Lawrence Erlbaum Associates, 1994"},{"key":"362_CR29","volume-title":"Sensory Profile 2 Manual","author":"W Dunn","year":"2014","unstructured":"Dunn W. Sensory Profile 2 Manual. Pearson: The Psychological Corporation; 2014."},{"issue":"6","key":"362_CR30","doi-asserted-by":"publisher","first-page":"882","DOI":"10.1111\/j.1530-0277.2000.tb02070.x","volume":"24","author":"B Muthen","year":"2000","unstructured":"Muthen B, Muthen LK. Integrating person-centered and variable-centered analyses: growth mixture modeling with latent trajectory classes. Alcohol Clin Exp Res. 2000;24(6):882\u201391.","journal-title":"Alcohol Clin Exp Res"},{"issue":"2\u20133","key":"362_CR31","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1159\/000360229","volume":"65","author":"DS Nagin","year":"2014","unstructured":"Nagin DS. Group-based trajectory modeling: an overview. Ann Nutr Metab. 2014;65(2\u20133):205\u201310.","journal-title":"Ann Nutr Metab"},{"key":"362_CR32","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1146\/annurev.clinpsy.121208.131413","volume":"6","author":"DS Nagin","year":"2010","unstructured":"Nagin DS, Odgers CL. Group-based trajectory modeling in clinical research. Annu Rev Clin Psychol. 2010;6:109\u201338.","journal-title":"Annu Rev Clin Psychol"},{"issue":"1","key":"362_CR33","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1002\/mdc3.12696","volume":"6","author":"TL Lowe","year":"2018","unstructured":"Lowe TL, Capriotti MR, McBurnett K. Long-term follow-up of patients with tourette\u2019s syndrome. Mov Disord Clin Pract. 2018;6(1):40\u20135. https:\/\/doi.org\/10.1002\/mdc3.12696 (eCollection 2019 Jan).","journal-title":"Mov Disord Clin Pract."},{"issue":"4","key":"362_CR34","first-page":"B5465","volume":"65","author":"C Groth","year":"2018","unstructured":"Groth C. Tourette syndrome in a longitudinal perspective clinical course of tics and comorbidities, coexisting psychopathologies, phenotypes and predictors. Dan Med J. 2018;65(4):B5465.","journal-title":"Dan Med J."}],"container-title":["Child and Adolescent Psychiatry and Mental Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13034-021-00362-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13034-021-00362-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13034-021-00362-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,10]],"date-time":"2021-08-10T15:58:53Z","timestamp":1628611133000},"score":1,"resource":{"primary":{"URL":"https:\/\/capmh.biomedcentral.com\/articles\/10.1186\/s13034-021-00362-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,20]]},"references-count":34,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["362"],"URL":"https:\/\/doi.org\/10.1186\/s13034-021-00362-w","relation":{},"ISSN":["1753-2000"],"issn-type":[{"value":"1753-2000","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,20]]},"assertion":[{"value":"26 October 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 February 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 February 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Trial registration: The study is approved by the National Ethical Committee (1-10-72-216-15) and the Danish Data Protection Agency (1-16-02-490-15), registered 12 October 2015. Oral and written information was given to parents and patients, and written consents from patients over 15\u00a0years of age and parents were received.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no conflict of interest. After the study was ended, the manual was published at Akademisk forlag (Danish publisher).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"9"}}