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Tic and Habit Disorders


Two primary classes of repetitive behavior disorders—tic disorders and habit disorders or body-focused repetitive behaviors (BFRBs)—are relatively common among children, adolescents and young adults. These repetitive, unwanted behaviors focused on the body can be distressing, seem to occur without the awareness of the person performing the behavior and/or result in significant functional impairment. 

Tic disorders are characterized by repetitive, sudden movements and/or seemingly purposeless vocalizations. Two ways tics are classified include: 

Either as motor or vocal:

Motor: Repetitive, short-lasting, sudden movements 

Vocal: Uttered sounds 

Either as simple or complex:

Simple: Brief, involve fewer muscle groups 

Complex: Distinct, coordinated movements, involve more muscle groups

Examples include:

Simple motor: Eye blinking, head jerking, shoulder shrugging, eye darting, nose twitching, mouth movements 

Simple vocal: Grunting, coughing, throat clearing, barking

Complex motor: Touching or smelling objects, repeating observed movements, stepping in a certain pattern, obscene gesturing, bending or twisting, hopping

Complex vocal: Repeating one’s own or other’s words or phrases; using vulgar, obscene or swear words

Across a diverse spectrum, tics typically:

    • Vary in type, frequency, severity
    • Worsen when the person is ill, stressed, anxious, tired, excited
    • Change over time
    • Worsen in late childhood/early teenage years and improve during transition to adulthood  

Habit disorders are typified by repetitive behaviors focused on the body and include trichotillomania, skin picking and other disruptive nervous habits, such as nail biting, cheek chewing, thumb sucking, body rocking, stuttering or taping fingers. 

Although these disorders may be benign and short-lived, those experiencing psychosocial impairment, physical damage or emotional distress need clinical attention. 

Clinicians trained in habit reversal therapy (HRT) work with individuals to implement function-based interventions, which can involve the ability to modify treatment for complex or non-responsive cases. 

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