Abstract
Obsessive-compulsive disorder (OCD) and persistent tic disorders (TD) are known to be highly comorbid, and recent research has suggested that the combination of OCD + TD may represent a distinct OCD subtype that has a different symptom profile than either disorder alone (Mansueto and Keuler, Behav Modif 29:784–799, 2005). In addition, a subset of individuals with OCD and/or TD present with repetitive behaviors that share some similarities with both tics and obsessions/compulsions, but differ from “classic” symptoms of TD and OCD in important ways. This presentation is commonly referred to as “Tourettic OCD” (TOCD) and introduces unique challenges for assessment, conceptualization, and treatment. In this chapter, we provide a brief review of TOCD and the challenges it poses to treatment, outline considerations for understanding and treating this unique OCD/TD subtype using a behavioral approach, and provide case illustration of how habit reversal training (HRT) and exposure and response prevention (ERP) were adapted and combined to successfully treat a youngster presenting with TOCD.
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The repetitive behaviors associated with TOCD have been described using a variety of terms including Tourette-related rituals, complex tics, tic-like compulsions, and impulsions. In agreement with Cath et al. (2001), we find each of these terms to be unsatisfying for a variety of reasons. However, in this chapter we use the term “impulsion” to refer to these behaviors to highlight that they differ from the “classic” definitions of tics and compulsions in important ways.
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Ramanujam, K., Himle, M. (2016). Treatment of a Youngster with Tourettic Obsessive-Compulsive Disorder. In: Storch, E., Lewin, A. (eds) Clinical Handbook of Obsessive-Compulsive and Related Disorders. Springer, Cham. https://doi.org/10.1007/978-3-319-17139-5_21
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