Randomized trial of anger control training for adolescents with tourette's syndrome and disruptive behavior

OBJECTIVE: To evaluate the efficacy of a 10-session individually administered anger control training (ACT) for adolescents with Tourette's syndrome (TS) and disruptive behavior. METHOD: Twenty-six subjects (24 boys and 2 girls; mean age 12.7 years, SD 0.88) with TS and high levels of disruptive behavior were randomly assigned to ACT or treatment-as-usual (TAU). The parent-rated Disruptive Behavior Rating Scale and the Clinical Global Impression-Improvement Scale rated by the independent evaluator were used as primary outcome measures. RESULTS: All randomized subjects completed end-point evaluation, and all subjects in the ACT group completed 3-month follow-up evaluation. The Disruptive Behavior Rating Scale score decreased by 52% in the ACT group compared with a decrease of 11% in the TAU control group (p <.001). On the Clinical Global Impression-Improvement Scale, the independent evaluator rated 9 (69%) of 13 subjects in the ACT condition as much improved or very much improved compared with 2 (15%) of 13 in the TAU condition (p <.01). This reduction of disruptive behavior in the ACT group was well maintained at 3-month follow-up. CONCLUSIONS: Anger control training seems to reduce disruptive behavior in adolescents with TS. Larger trials are needed to confirm these results.