Patterned changes in urge ratings with tic suppression in youth with chronic tic disorders

•Current models posit that negative reinforcement maintains/worsens tic disorders.•Change in urge severity should follow a specific pattern predicted by these models.•Current results contrarily suggested five distinct patterns of urge severity change.•Results suggest a much more complex relationship between urges and tics.•Developmental considerations may modulate the relationship between urges and tics.