Recruiting Participants for Study on the Benefits of Exercise on Childhood Tourette syndrome and Obsessive-Compulsive Disorder Symptoms

A doctoral candidate in psychology sent me her institutional review board approval for this study and asked me to post the recruitment notice:

Participants sought for a study exploring the possible benefits of aerobic exercise on children and adolescents with Tourette syndrome (TS) and Obsessive-Compulsive Disorder (OCD). The study has received Institutional Review Board approval from Hofstra University, New York.

Children and adolescents ages 8-16 diagnosed with both TS and OCD are eligible to participate in a 6-week, 12-session aerobic exercise program. All sessions will be conducted in the participants’ home for ease and convenience.

Each exercise session will take approximately 30 minutes. Two-three 15-minute interviews will be conducted prior to beginning the exercise intervention, and one interview will be conducted one month after the end of the exercise intervention. Participants who complete the study and follow-up will receive $250.

Participants can be on medication, but cannot be undergoing medication changes during the study.

Study Location: Long Island, New York

For additional information or to sign up, contact Loren Packer-Hopke, M.S. via telephone: 516-359-0859 or e-mail: lpackerhopke@yahoo.com

And yes, in the interests of full disclosure: the doctoral candidate is related to me, but the study is her own and has been approved by her university.

Of Tics and Compulsions: Brain Imaging Teases Apart Tourette’s and Obsessive-Compulsive Disorder

Anyone who has parented, taught, or treated individuals with both Tourette syndrome (TS) and Obsessive-Compulsive Disorder (OCD) knows how difficult it can be at times to tease out whether something is a complex tic or a compulsion.  Can brain imaging help us?  Melinda Wenner Moyer writes in the September issue Scientific American:

… Now a new study published in Neurology may help scientists further understand how the disorders overlap and differ by revealing several key differences in the brain activity of Tourette’s patients with and without OCD.

Andrew Feigin and his colleagues at North Shore LIJ Health System in Manhasset, N.Y., scanned the brains of 12 unmedicated Tourette’s patients—some of whom also had OCD—and 12 healthy subjects using positron-emission tomography, which reveals patterns of brain activity. Compared with healthy controls, those who had Tourette’s exhibited more activity in the premotor cortex and cerebellum, regions that handle motor control, and less activity in the striatum and orbitofrontal cortex, areas involved in decision making and learning. These findings support the idea that the symptoms of the disorder may arise from the brain’s inability to suppress abnormal actions using decision-making skills.

When the researchers compared the Tourette’s patients who had OCD with those who did not, they found that the patients who had both disorders exhibited greater activity in the primary motor cortex and precuneus, an area that plays a role in self-awareness. Previous research has suggested that in patients who suffer from both disorders, OCD might show up more in the form of compulsions than obsessions, and these findings support that idea: the increased activity of the precuneus may reflect individuals’ efforts and ability to resist obsessive thought, and the motor cortex may be more active because OCD is manifesting itself more physically than mentally.

 

The full article is only available to those who subscribe to or have access to Scientific American

An important new resource on OCD in school

Parents and educators looking for information on Obsessive-Compulsive Disorder and its impact on school functioning, do check out this new book by Dr. Gail B. Adams: Students with OCD: A Handbook for School Personnel.  Dr. Adams draws upon her decades of professional experience and provides a comprehensive yet down-to-earth presentation of this important topic.

For other resources on OCD, see the OCD Resources page of my companion blog, ChallengingKids.com

Join Me at an All-Day Workshop for Educators & Parents on December 5th

I’ll be conducting an all-day workshop for educators on Monday, December 5, 2011 at the Grappone Conference Center in Concord, New Hampshire. The event is sponsored by the University of New Hampshire Institute on Disability and is geared to regular and special education teachers, school psychologists and social workers, behavior specialists, occupational therapists, administrators, and parents.

Description:

Neurological disorders that emerge in childhood often have significant impact on students’ academic, behavioral, and social-emotional functioning. Participants will learn about the cardinal features of Tourette’s Syndrome, Obsessive-Compulsive Disorder, Attention Deficit Hyperactivity Disorder, Executive Dysfunction, Mood Disorders such as Depression and Bipolar Disorder, and the memory deficits, sensory issues and “storms” that sometimes accompany them. Strategies and assistive technology to accommodate symptom interference in activities such as handwriting, homework, math calculation, and written expression and big projects will be described. Pitfalls in behavioral interventions, and simple social skills and problem-solving interventions will also be identified.

For more information on the workshop and registration information, download the brochure or register online at www.iod.unh.edu.

Hope to see you there!

 

New insight into how OCD develops

A new study conducted by researchers at the University of Cambridge and University of Amsterdam has me excited because it articulates nicely with some early research on cognitions and emotions and observations of many professionals about compulsive behavior in children.

First, the press release:

New scientific evidence challenges a popular conception that behaviors such as repetitive hand-washing, characteristic of obsessive-compulsive disorder (OCD), are carried out in response to disturbing obsessive fears.

The study, conducted at the University of Cambridge in collaboration with the University of Amsterdam, found that in the case of OCD the behaviors themselves (the compulsions) might be the precursors to the disorder, and that obsessions may simply be the brain’s way of justifying these behaviours. The research provides important insight into how the debilitating repetitive behavior of OCD develops and could lead to more effective treatments and preventative measures for the disorder.

The research, funded by the Wellcome Trust and published in the renowned American Journal of Psychiatry, tested 20 patients suffering from the disorder and 20 control subjects (without OCD) on a task which looked at the tendency to develop habit-like behavior. Subjects were required to learn simple associations between stimuli, behaviors and outcomes in order to win points on a task.

The team, led by Claire Gillan and Trevor Robbins at the University of Cambridge MRC/Wellcome Trust Behavioural and Clinical Neuroscience Institute and Sanne de Wit at the University of Amsterdam, found that patients suffering from the disorder had a tendency to continue to respond regardless of whether or not their behavior produced a desirable outcome. In other words, this behavior was habitual. The discovery that compulsive behavior – the irresistible urge to perform a task – can be observed in the laboratory, in the absence of any related obsessions, suggests that compulsions may be the critical feature of OCD.

Indeed, one of the most effective treatments for OCD is cognitive behavioral therapy (CBT), which typically involves a method known as “exposure and response prevention”. This technique challenges patients to discontinue compulsive responding, and learn that the feared consequence does not occur, whether or not the behavior is performed. The effectiveness of this treatment is compatible with the idea that compulsions, and not obsessions, are critical in OCD. Once the compulsion is stopped, the obsession tends to fade away.

“It has long been established that humans have a tendency to ‘fill in the gaps’ when it comes to behavior that cannot otherwise be logically explained,” said Claire Gillan, a PhD student at the University of Cambridge. “In the case of OCD, the overwhelming urge to senselessly repeat a behavior might be enough to instil a very real obsessive fear in order to explain it.”

Source: University of Cambridge

About 40 years, when I was first learning about Cognitive-Behavior Therapy (specifically, RET), I read a fascinating study by Schacter and Singer. The investigators found that when research participants had no available explanation for why they were experiencing arousal (due to a physiological agent), they looked around their environment and without prompting, generated an explanation for their arousal based on cues in the environment. In other words, when they were in an aroused state, they needed explanation and if there was none immediately apparent, generated one based on available cues.

Fast forward to OCD 40 years later. Many of us working with children with OCD have noted that children can articulate or recognize their compulsions but often deny having any preceding worrying thoughts. Are the children just not aware of their worrying or obsessive thoughts, or could it be that there really are no such obsessive thoughts and that, in time, they will generate thoughts to help explain their behavior?

The study certainly has fascinating clinical and treatment implications. There’s no point in trying to do “talk therapy” or challenge thoughts if there’s no cognition to alter.  Indeed, parents who try to help their child by talking to them about the “why” of the compulsive behavior are at best, probably just wasting time.  At worst, they may be planting seeds for obsessive worries.

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