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Biomedical subjects

Michael B Himle

Publications and source records attributed to Michael B Himle.

8 recordsLinked to original sources
PubMed2006

Reactivity of tic observation procedures to situation and setting.

Tic frequency was assessed and compared across home and clinic as well as three experimentally-manipulated situations in order to assess the phenomenon of tic reactivity. Forty-three youngsters with chronic tic disorder recruited from two geographically-distinct sites were videotaped over three weekly laboratory visits under each of the following conditions: (1) alone/camera present, (2) other present/camera present, and (3) alone/camera hidden. Contrary to expectation, more tics were observed during overt as compared to covert observation, while the presence of another person had no overall impact on tic expression. Mean tic counts obtained from clinic observation did not significantly differ from those obtained at home collected either one day before or after. Tic frequency counts were remarkably stable over the three weekly assessments both at home and clinic. Study findings are consistent with past observations that tic expression can be influenced by environmental factors and suggest the stability of tic frequency may exhibit greater temporal and setting stability than previously thought. The clinical and research implications of these results are discussed.

Adolescent↗
PubMed2006

Brief review of habit reversal training for Tourette syndrome.

It is well established that Tourette syndrome has a neurobiologic origin. Although pharmacotherapy is the most commonly prescribed intervention, there is considerable evidence to support the use of behavior therapy, specifically habit reversal training, as an alternative or adjunct treatment for some individuals with Tourette syndrome. Unfortunately, many professionals are unfamiliar with habit reversal training. The purpose of this review is to provide readers with a brief review of empiric studies on habit reversal training, update readers on the current state and future of behavior therapy for Tourette syndrome, and provide resources for those readers interested in additional information.

Adult↗
PubMed2006

Behavior therapy: other interventions for tic disorders.

This chapter reviewed other behavioral interventions for TS and discussed their efficacy. Clearly, the majority of behavioral interventions (habit/reversal excluded) have not been systematically evaluated enough to be deemed empirically supported monotherapies for TS. In addition to reviewing these interventions, recent advances in behavioral research on TS and a function-based model of treatment development and implementation were presented. Both of these areas are in their infancy, but point to exciting new directions in the application of behavioral sciences to the understanding of TS.

Behavior Therapy↗
PubMed2005

An experimental evaluation of tic suppression and the tic rebound effect.

Tourette's syndrome (TS) is a neurobiological disorder consisting of motor and vocal tics that are thought to be temporarily suppressible. Many professionals, however, believe that a paradoxical increase in tic frequency (above baseline levels) occurs when efforts to suppress have ceased (i.e., a rebound effect). To date, little research has investigated tic suppression or its effects. This study examined tic frequency during baseline, suppression, and post-suppression conditions using an experimental preparation reported to reliably produce tic suppression in children. Six children with TS and one with chronic tic disorder (CTD) were recorded during baseline and repeated suppression and post-suppression conditions. Tic frequency was significantly lower during suppression as compared to baseline. Although tic frequency during post-suppression was higher than during suppression, it was lower than baseline levels, arguing against a "rebound" effect of tic suppression. Exploratory analyses revealed that scores on the attention problems subscale of the Child Behavior Checklist significantly predicted tic suppressibility. The relationships between age, tic severity, and tic suppressibility were also explored.

Behavior Therapy↗
PubMed2005

Premonitory Urge for Tics Scale (PUTS): initial psychometric results and examination of the premonitory urge phenomenon in youths with Tic disorders.

Although motor tics and/or vocal tics are the defining features of chronic tic disorder (CTD) and Tourette syndrome (TS), older youths and adults often report their tics to be preceded by an unpleasant sensation or "premonitory urge." While premonitory urge phenomena may play an important role in behavioral interventions for CTD/TS, standardized assessments for premonitory urges do not exist. The current study of 42 youths with TS or CTD presents initial psychometric data for a new, brief self-report scale designed to measure tic-related premonitory urges. Results showed that the Premonitory Urge for Tics Scale (PUTS) was internally consistent (alpha = .81) and temporally stable at 1 (r = 0.79, p < .01) and 2 (r = 0.86, p < .01) weeks. PUTS scores were also correlated with overall tic severity as measured by the Yale Global Tic Severity Scale (YGTSS; r = 0.31, p < .05) and the YGTSS number (r = 0.35, p < .05), complexity (r = 0.49, p < .01), and interference (r = 0.36, p < .05) subscales. Finally, an examination of the psychiatric correlates of the premonitory urge phenomenon yielded significant correlations between the PUTS and the Child Behavior Checklist (CBCL) anxiety/depression (r = 0.33, p < .05), and withdrawal (r = 0.38, p < .05) subscales as well as the Children's Yale-Brown Obsessive Compulsive Scale (CYBOCS; r = 0.31, p < .05). However, a cross-sectional examination of the data showed that the psychometric properties of the PUTS were not acceptable for youths 10 years of age and younger. Likewise, significant correlations found between the YGTSS subscales, CBCL subscales, CYBOCS, and the PUTS did not emerge in this younger age group. The clinical and theoretical implications of these findings are discussed.

Adolescent↗
PubMed2004

An evaluation of two procedures for training skills to prevent gun play in children.

OBJECTIVE: Unintentional firearm injuries threaten the safety of children in the United States. Despite the occurrence of these injuries, few studies have evaluated the effectiveness of child-based programs designed to teach children gun-safety skills. This study compared 2 programs that were designed to reduce gun play in preschool children. METHODS: A between-groups no-treatment control design was used. Children were randomly assigned to either 1 of 2 firearm-injury prevention programs or a no-treatment control condition. Participant recruitment, training, and data collection occurred in preschools and children's homes located in a midwestern city with a population of approximately 80,000. Thirty-one 4- and 5-year-old children participated in the study. The effectiveness of the National Rifle Association's Eddie Eagle GunSafe Program and a behavioral skills training program using instruction, modeling, rehearsal, and feedback was evaluated. Children were issued 0 to 3 ratings on the basis of their ability to say correctly the safety message and similar ratings on the basis of observations of their ability to perform correctly the skills in the classroom and when placed in a realistic simulation. RESULTS: Both programs were effective for teaching children to reproduce verbally the gun-safety message. The behavioral skills training program but not the Eddie Eagle GunSafe Program was effective for teaching children to perform gun-safety skills during a supervised role play, but the skills were not used when the children were assessed via real-life (in situ) assessments. CONCLUSIONS: Existing programs are insufficient for teaching gun-safety skills to children. Programs that use active learning strategies (modeling, rehearsal, and feedback) are more effective for teaching gun-safety skills as assessed by supervised role plays but still failed to teach the children to use the skills outside the context of the training session. More research is needed to determine the most effective way to promote the use of the skills outside the training session.

Child Behavior↗
PubMed2004

Teaching safety skills to children to prevent gun play.

Research has shown that children often engage in gun play when they find a firearm and that this behavior is often involved in unintentional firearm injuries. Previous research has shown existing programs to be ineffective for teaching children safety skills to reduce gun play. This study examined the effectiveness of a behavioral skills training (BST) program supplemented with in situ training for teaching children safety skills to use when they find a gun (i.e., don't touch, leave the area, tell an adult). Eight 4- to 5-year-old children were trained and assessed in a naturalistic setting and in a generalized setting in a multiple baseline across subjects design. Results showed that 3 of the children performed the skills after receiving BST, whereas 5 of the children required supplemental in situ training. All children in the study learned to perform the skills when assessed in a naturalistic setting and when assessed in a generalization setting. Performance was maintained at 2- to 8-week follow-up assessments.

Child Behavior↗