Kevin J. Black finish Phenomenology  almost 7 years ago

Commit id: 6f623e75911cac549d887db57cb8b1e121959e94

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Many patients with TS describe sensory symptoms preceding or independent of their tics. One group recently took a new approach to studying sensation in TS based on a Theory of Event Coding \cite{27544346}. Their results suggested that details or features of percepts are less integrated in TS; this finding applied to the group as a whole rather than relating to any obvious symptom or demographic characteristic. The authors speculate as to the possible underlying neurobiology.  ### Premonitory urges  Premonitory urges are usually reported later in life than tics are first observed. However, a large case series (_N_>1000) from one clinic suggests that premonitory urges “emerge much earlier than previously thought”: by age 8-10, >60% of children reported premonitory urges, and >75% could suppress tics \cite{27672357}. Urges also “were found to be highly associated with ‘not just right experiences’.” The early onset of tic suppression is consistent with a report from the author's laboratory on tic suppression in the first few months of tic disorder onset \cite{25220075}.  \cite{Brandt_2016} performed a clever and well-thought-out  experiment to investigate the timing of urges in relation to tics, compulsions and blinks. and—as a comparison to a naturally arising urge—blinks when attempting to keep the eyes open.  Another group examined tics and urge to tic at 10- to 15-second intervals in 12 patients with moderate to severe TS; different patients had quite different relationships between urge and tic timing when examined at this temporal scale \cite{26255052}. These observations show that careful phenomenological studies still have much to teach us about tic disorders.  ### Other  The frequency of anxiety and impulsivity in TS has suggested the possibility of a deficit in emotional self-regulation in some patients. A recent study examined specific emotional regulation approaches taken by adults with TS \cite{27543829}. The TS and control groups did not differ on anxiety or depression symptom scores, but the TS group used suppression as a strategy more often than the control group.   Self-reported depressive symptoms were as common and severe in TS as in patients with major depression, though people with TS endorsed irritability more frequently \cite{27084230}.  \cite{27672357} felt that their data supported lumping self-injurious behavior (SIB) with coprophenomena, and argue for it to “be conceptualized as a complex tic rather than a compulsion.” Others have found similar results \cite{25714449,27672357}, though one large study found SIB to fit better with ADHD symptoms \cite{21436227}.  Self-reported depressive symptoms were as common and severe in TS as in tic-free patients with major depression, though people with TS endorsed irritability more frequently \cite{27084230}.