{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T18:49:38Z","timestamp":1774378178030,"version":"3.50.1"},"reference-count":57,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2023,11,14]],"date-time":"2023-11-14T00:00:00Z","timestamp":1699920000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Exposure and response prevention (ERP) has been shown to be an effective treatment for Tourette syndrome (TS) and chronic tic disorders (CTD). ERP is based on voluntary tic suppression in combination with prolonged exposure to premonitory urges preceding tics. A prevailing hypothesis of the working mechanism underlying ERP in tics is habituation to the premonitory urges as a result of prolonged exposure. However, results so far are equivocal. This study aims to further explore the relation between urges and ERP in tics, by investigating the course of premonitory urges during ERP sessions. Methods: Using a data-driven approach, within-session habituation to premonitory urge intensity was investigated. In total, 29 TS patients rated urge intensity at seven timepoints during ten 1 h ERP sessions. Results\/Conclusions: Latent growth modeling showed an increase in urge intensity during the first 15 min of each session followed by a plateau in the remaining 45 min of the session. This does not support the idea of within-session habituation to premonitory urges as a working mechanism of ERP. Other potential underlying working mechanisms are discussed and should be tested in future research.<\/jats:p>","DOI":"10.3390\/jcm12227087","type":"journal-article","created":{"date-parts":[[2023,11,14]],"date-time":"2023-11-14T11:04:32Z","timestamp":1699959872000},"page":"7087","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Working Mechanisms of Exposure and Response Prevention in the Treatment of Tourette Syndrome and Tic Disorders Revisited: No Evidence for within-Session Habituation to Premonitory Urges"],"prefix":"10.3390","volume":"12","author":[{"given":"Jolande M. T. M.","family":"van de Griendt","sequence":"first","affiliation":[{"name":"Behavioural Science Institute, Radboud University Nijmegen, Thomas van Aquinostraat 4, 6525 GD Nijmegen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nelleke M. E.","family":"van den Berg","sequence":"additional","affiliation":[{"name":"Department of Psychology, Erasmus University Rotterdam, \u2018s Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cara W. J.","family":"Verdellen","sequence":"additional","affiliation":[{"name":"PsyQ Nijmegen, Parnassia Group, Sint Annastraat 263, 6525 GR Nijmegen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dani\u00eblle C.","family":"Cath","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University Medical Center Groningen, Rijksuniversiteit Groningen, 9700 AD Groningen, The Netherlands"},{"name":"GGZ Drenthe, Dennenweg 9, 9404 LA Assen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9653-0935","authenticated-orcid":false,"given":"Marc J. P. M.","family":"Verbraak","sequence":"additional","affiliation":[{"name":"Behavioural Science Institute, Radboud University Nijmegen, Thomas van Aquinostraat 4, 6525 GD Nijmegen, The Netherlands"},{"name":"Pro Persona, Wolfheze 2, 6874 BE Wolfheze, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Association. [5th ed.].","DOI":"10.1176\/appi.books.9780890425596"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1007\/s00787-011-0164-6","article-title":"European clinical guidelines for Tourette Syndrome and other tic disorders. Part I: Assessment","volume":"20","author":"Cath","year":"2011","journal-title":"Eur. Child Adolesc. 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