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Sapozhnikov Y, Mink JW, Augustine EF, Adams HR, Vierhile A, Lewin AB, Collins AT, McDermott MP, O'Connor T, Kurlan R, Murphy TK, Vermilion J. Teacher Knowledge of Tourette Syndrome and Associated Factors. Pediatr Neurol 2023; 145:80-87. [PMID: 37295059 DOI: 10.1016/j.pediatrneurol.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/03/2023] [Accepted: 05/10/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND TS is associated with learning disabilities and educational impairment. Teacher knowledge about TS may have a positive impact on students with TS, but factors associated with teacher knowledge of TS are not known. METHODS In this cross-sectional study, teachers of youth with TS and of a community control group completed a Teacher Understanding of Tourette Syndrome Survey (TUTS), a pilot questionnaire enquiring about self-perceived understanding, teacher knowledge, and sources of information. We compared TUTS scores between TS and control groups and between those who did and did not use specific sources of information about TS using Wilcoxon rank-sum tests. Bivariate correlation analyses were used to evaluate associations between teacher knowledge and potential contributing factors. RESULTS Data from 114 teachers of children with TS and 78 teachers of control subjects were included. Teachers of youth with TS had significantly more knowledge, had higher self-perceived understanding, and used more sources of information than teachers of the control group. Teachers who knew of the Tourette Association of America and who gathered information themselves had higher knowledge about TS than those who did not. CONCLUSION Teachers of children with TS know more about TS and use more sources to learn about TS than teachers of children without TS.
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Affiliation(s)
| | | | | | - Heather R Adams
- Department of Neurology, University of Rochester, Rochester, New York
| | - Amy Vierhile
- Department of Neurology, University of Rochester, Rochester, New York
| | - Adam B Lewin
- Department of Pediatrics, University of South Florida, St. Petersburg, Florida
| | - Alyssa T Collins
- Department of Pediatrics, University of Rochester, Rochester, New York
| | - Michael P McDermott
- Department of Neurology, University of Rochester, Rochester, New York; Department of Biostatistics and Computational Biology, University of Rochester, Rochester, New York
| | - Thomas O'Connor
- Department of Psychiatry, University of Rochester, Rochester, New York
| | - Roger Kurlan
- The Center for Neurological and Neurodevelopmental Health, Voorhees, New Jersey
| | - Tanya K Murphy
- Department of Pediatrics, University of South Florida, St. Petersburg, Florida
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Lewin AB, Murphy TK, Mink JW, Small BJ, Adams HR, Brennan E, Augustine EF, Vermilion J, Vierhile A, Collins A, Kudryk K, Dickinson S, Danielson ML, Bitsko RH. Brief youth self-report screener for tics: Can a subscale of the Motor tic, Obsession and compulsion, and Vocal tic Evaluation Survey (MOVES) identify tic disorders in youth? EVIDENCE-BASED PRACTICE IN CHILD AND ADOLESCENT MENTAL HEALTH 2023; 8:1-11. [PMID: 37323827 PMCID: PMC10267813 DOI: 10.1080/23794925.2023.2191354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Tics are unwanted, repetitive movements and sounds that frequently present during childhood. They are typically brief and purposeless, but can create significant distress for individuals, and often co-occur with other neuropsychiatric conditions. Thus, early identification of tics is warranted. Unfortunately, tics are often misdiagnosed, and because tics may wax and wane, identification can be difficult, especially in the context of routine clinical visits. There are limited tools that can be used to reliably identify tics in clinical practice, especially in non-specialty settings. The purpose of the current study was to evaluate the performance of the Motor tic, Obsession and compulsion, and Vocal tic Evaluation Survey (MOVES), a self-report scale with some support as a screening tool. In addition, the performance of a subset of questions (the MOVES-6) was evaluated for rapid screening. Participants were recruited across two study sites and included children and adolescents diagnosed with Tourette syndrome (n = 151) or another persistent tic disorder (n = 10) and community controls (n = 74). Results suggest both the MOVES and the MOVES-6 have high sensitivity (90% and 88%, respectively) and at least acceptable specificity (77% and 86%, respectively) compared with expert assessment of tic disorders, suggesting that both versions can identify tic disorders without high proportions of false negatives. Both versions were highly sensitive with acceptable specificity regardless of sex, race/ethnicity, and age. The MOVES and MOVES-6 show promise as a screener for tics or tic disorders, but additional research is needed, particularly in a general population setting.
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Bitsko RH, Holbrook JR, Fisher PW, Lipton C, van Wijngaarden E, Augustine EF, Mink JW, Vierhile A, Piacentini J, Walkup J, Firchow B, Ali AR, Badgley A, Adams HR. Validation of the Diagnostic Interview Schedule for Children (DISC-5) Tic Disorder and Attention-Deficit/Hyperactivity Disorder Modules. EVIDENCE-BASED PRACTICE IN CHILD AND ADOLESCENT MENTAL HEALTH 2023; 9:231-244. [PMID: 38883232 PMCID: PMC11177540 DOI: 10.1080/23794925.2023.2191352] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
Effective methods to assess mental disorders in children are necessary for accurate prevalence estimates and to monitor prevalence over time. This study assessed updates of the tic disorder and attention-deficit/hyperactivity disorder (ADHD) modules of the Diagnostic Interview Schedule for Children, Version 5 (DISC-5) that reflect changes in diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders (Fifth edition, DSM-5). The DISC-5 tic disorder and ADHD parent- and child-report modules were compared to expert clinical assessment for 100 children aged 6-17 years (40 with tic disorder alone, 17 with tic disorder and ADHD, 9 with ADHD alone, and 34 with neither) for validation. For the tic disorder module, parent-report had high (>90%) sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy, while the youth-report had high specificity and PPV, moderate accuracy (81.4%), and lower sensitivity (69.8%) and NPV (67.3%). The ADHD module performed less well: parent-report had high NPV (91.4%), moderate sensitivity (80.8%), and lower specificity (71.6%), PPV (50.0%), and accuracy (74.0%); youth-report had moderate specificity (82.8%) and NPV (88.3%), and lower sensitivity (65.0%), PPV (54.2%), and accuracy (78.6%). Adding teacher-report of ADHD symptoms to DISC-5 parent-report of ADHD increased sensitivity (94.7%) and NPV (97.1%), but decreased specificity (64.2%), PPV (48.7%), and accuracy (72.2%). These findings support using the parent-report tic disorder module alone or in combination with the child report module in future research and epidemiologic studies; additional validation studies are warranted for the ADHD module.
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Affiliation(s)
- Rebecca H Bitsko
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | - Joseph R Holbrook
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | - Prudence W Fisher
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute - Columbia University - Vagelos College of Physicians and Surgeons, New York, NY
| | - Corey Lipton
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
- Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, TN
| | - Edwin van Wijngaarden
- Department of Public Health Sciences, University of Rochester Medical Center (URMC), Rochester, NY
| | - Erika F Augustine
- Department of Neurology and Developmental Medicine, Kennedy Krieger Institute, Baltimore, MD; Adjunct Associate Professor, Department of Neurology, URMC, Rochester, NY
| | - Jonathan W Mink
- Departments of Neurology, Neuroscience, and Pediatrics, University of Rochester, Rochester, NY
| | - Amy Vierhile
- Departments of Neurology, Neuroscience, and Pediatrics, University of Rochester, Rochester, NY
| | - John Piacentini
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA
| | - John Walkup
- Pritzker Department of Psychiatry and Behavioral Health, Lurie Children's Hospital & Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Bradley Firchow
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | - Akilah R Ali
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | - Allison Badgley
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | - Heather R Adams
- Departments of Neurology, Neuroscience, and Pediatrics, University of Rochester, Rochester, NY
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Vermilion J, Augustine EF, Adams HR, Vierhile A, Collins AT, McDermott MP, O'Connor TG, Kurlan R, van Wijngaarden E, Mink JW. Risk Behaviors in Youth With and Without Tourette Syndrome. Pediatr Neurol 2022; 126:20-25. [PMID: 34736059 DOI: 10.1016/j.pediatrneurol.2021.10.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 09/01/2021] [Accepted: 10/10/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Specific health-risk behaviors are present in older adolescents and young adults wtih Tourette syndrome (TS), but little is known about health-risk behaviors in youth with TS. METHODS We compared responses on the Youth Risk Behavior Surveillance System (YRBS) in youth with TS with those in a concurrent community control group. The YRBS evaluates risk behaviors most closely associated with morbidity and mortality in young people. Tic severity, presence of comorbid attention-deficit/hyperactivity disorder (ADHD), measures of ADHD symptom severity, and whether or not the individual had been bullied in school were also compared between the groups. RESULTS Data from 52 youth with TS and 48 control youth were included. We did not detect any differences between control youth and youth with TS in the reporting of risky behaviors. Tic severity was not significantly associated with high-risk behavior. However, ADHD was significantly more common in youth with TS (P < 0.0002), and youth with TS who identified themselves as victims of bullying had significantly higher ADHD symptom severity scores (P = 0.04) compared with those who were not bullied. CONCLUSIONS Risk behaviors are not reliably or clinically different in youth with TS compared with control youth. ADHD severity, but not tic severity, was associated with being bullied in youth with TS.
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Affiliation(s)
- Jennifer Vermilion
- Department of Neurology, University of Rochester Medical Center, Rochester, New York.
| | - Erika F Augustine
- Department of Neurology, University of Rochester Medical Center, Rochester, New York
| | - Heather R Adams
- Department of Neurology, University of Rochester Medical Center, Rochester, New York
| | - Amy Vierhile
- Department of Neurology, University of Rochester Medical Center, Rochester, New York
| | - Alyssa T Collins
- Department of Pediatrics, University of Rochester Medical Center, Rochester, New York
| | - Michael P McDermott
- Department of Neurology, University of Rochester Medical Center, Rochester, New York; Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, New York
| | - Thomas G O'Connor
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York
| | - Roger Kurlan
- Kurlan Specialized Neurology, LLC, Springfield, New Jersey
| | - Edwin van Wijngaarden
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, New York
| | - Jonathan W Mink
- Department of Neurology, University of Rochester Medical Center, Rochester, New York
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Kahl CK, Swansburg R, Kirton A, Pringsheim T, Wilcox G, Zewdie E, Harris A, Croarkin PE, Nettel-Aguirre A, Chenji S, MacMaster FP. Targeted Interventions in Tourette's using Advanced Neuroimaging and Stimulation (TITANS): study protocol for a double-blind, randomised controlled trial of transcranial magnetic stimulation (TMS) to the supplementary motor area in children with Tourette's syndrome. BMJ Open 2021; 11:e053156. [PMID: 34952879 PMCID: PMC8712978 DOI: 10.1136/bmjopen-2021-053156] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Tourette's syndrome (TS) affects approximately 1% of children. This study will determine the efficacy and safety of paired comprehensive behavioural intervention for tics (CBIT) plus repetitive transcranial magnetic stimulation (rTMS) treatment in children with Tourette's syndrome. We hypothesise that CBIT and active rTMS to the supplementary motor area (SMA) will (1) decrease tic severity, and (2) be associated with changes indicative of enhanced neuroplasticity (eg, changes in in vivo metabolite concentrations and TMS neurophysiology measures). METHODS AND ANALYSIS This study will recruit 50 youth with TS, aged 6-18 for a phase II, double-blind, block randomised, sham-controlled trial comparing active rTMS plus CBIT to sham rTMS plus CBIT in a 1:1 ratio. The CBIT protocol is eight sessions over 10 weeks, once a week for 6 weeks and then biweekly. The rTMS protocol is 20 sessions of functional MRI-guided, low-frequency (1 Hz) rTMS targeted to the bilateral SMA over 5 weeks (weeks 2-6). MRI, clinical and motor assessments and neurophysiological evaluations including motor mapping will be performed 1 week before CBIT start, 1 week after rTMS treatment and 1 week after CBIT completion. The primary outcome measure is Tourette's symptom change from baseline to post-CBIT treatment, as measured by the Yale Global Tic Severity Scale. Secondary outcomes include changes in imaging, neurophysiological and behavioural markers. ETHICS AND DISSEMINATION Ethical approval by the Conjoint Health Research Ethics Board (REB18-0220). The results of this study will be published in peer-reviewed scientific journals, on ClinicalTrials.gov and shared with the Tourette and OCD Alberta Network. The results will also be disseminated through the Alberta Addictions and Mental Health Research Hub. TRIAL REGISTRATION NCT03844919.
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Affiliation(s)
- Cynthia K Kahl
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Rose Swansburg
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Adam Kirton
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Tamara Pringsheim
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
- Community Health Sciences, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - Gabrielle Wilcox
- School and Applied Child Psychology, Werklund School of Education, University of Calgary, Calgary, Alberta, Canada
| | - Ephrem Zewdie
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Ashley Harris
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada
| | - Paul E Croarkin
- Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Alberto Nettel-Aguirre
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
- Community Health Sciences, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - Sneha Chenji
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Frank P MacMaster
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
- Provincial Addictions and Mental Health, Alberta Health Services, Calgary, Alberta, Canada
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Vermilion J, Pedraza C, Augustine EF, Adams HR, Vierhile A, Lewin AB, Collins AT, McDermott MP, O'Connor T, Kurlan R, van Wijngaarden E, Murphy TK, Mink JW. Anxiety Symptoms Differ in Youth With and Without Tic Disorders. Child Psychiatry Hum Dev 2021; 52:301-310. [PMID: 32519083 DOI: 10.1007/s10578-020-01012-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
We compared anxiety symptoms in youth with and without tic disorders by comparing scores on the Multidimensional Anxiety Scale for Children (MASC) in youth with tic disorders to those in a concurrent community control group and in a group of treatment-seeking anxious youth from the Child/Adolescent Anxiety Multimodal Study (CAMS). Data from 176 youth with tic disorders, 93 control subjects, and 488 CAMS participants were included. Compared to youth with tic disorders, controls had lower total MASC scores (p < 0.0001) and CAMS participants had similar total MASC scores (p = 0.13). Separation Anxiety (p = 0.0003) and Physical Symptom (p < 0.0001) subscale scores were higher in youth with tic disorders than in CAMS participants. We conclude that the anxiety symptom profile differs in youth with and without tic disorders, which may have important implications for targeting treatment of anxiety in youth with tic disorders.
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Affiliation(s)
- Jennifer Vermilion
- Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA. .,Division of Child Neurology, Department of Neurology, Box 631, 601 Elmwood Ave, Rochester, NY, 14642, USA.
| | | | - Erika F Augustine
- Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA
| | - Heather R Adams
- Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA
| | - Amy Vierhile
- Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA
| | - Adam B Lewin
- Department of Pediatrics, University of South Florida, Tampa, FL, USA
| | - Alyssa T Collins
- Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, USA
| | - Michael P McDermott
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA
| | - Thomas O'Connor
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Roger Kurlan
- Center for Neurological and Neurodevelopmental Health, Voorhees, NJ, USA
| | - Edwin van Wijngaarden
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Tanya K Murphy
- Department of Pediatrics, University of South Florida, Tampa, FL, USA
| | - Jonathan W Mink
- Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA
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Hammack Johnson A, Cazzell M, Turner-Henson A. Bio-behavioural research in a rare disease population: a doctoral student's experience. Nurse Res 2020; 28:16-23. [PMID: 32583653 DOI: 10.7748/nr.2020.e1715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND Novice researchers who aspire to contribute to the body of knowledge concerning rare diseases face unique challenges in developing and conducting studies. These include unknown effect sizes in previous research, limitations in recruitment and enrolment, and managing data from a multi-site sample. AIM To describe the challenges in researching rare diseases and possible solutions using a doctoral student exemplar from a cross-sectional correlational study of fatigue. DISCUSSION The authors discuss the lessons learned from the study, including the challenges in recruitment, communication, collecting biological data and managing data in general. They posit possible solutions, including improving multi-site coordination, feasible methods for exploring sleep and stress, and measures to prevent equipment and data loss. CONCLUSION Rare populations, such as young survivors of childhood brain tumours, deserve a voice in building the body of knowledge needed for more precise, personalised healthcare. It is possible with foresight for the novice researcher to make such a contribution. IMPLICATIONS FOR PRACTICE Improved knowledge and assessment of symptoms during childhood will improve the detection of health risk factors and enable earlier intervention.
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Affiliation(s)
| | - Mary Cazzell
- Nursing research and evidence-based practice, Cook Children's Medical Center, Fort Worth, Texas
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Zhu P, Wu M, Huang P, Zhao X, Ji X. Children from nuclear families with bad parental relationship could develop tic symptoms. Mol Genet Genomic Med 2020; 8:e1286. [PMID: 32419379 PMCID: PMC7336767 DOI: 10.1002/mgg3.1286] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 01/05/2020] [Accepted: 04/11/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Studies have reported the impact of chronic childhood and adolescent tic disorder (TD) on families. However, few researches focused on the relationship between family environment and diagnosis of TD. We aim to assess the influence of couple relationship and family structure on the onset of TD. METHODS A total of 660 parents of patients with TD (aged 6-12 years) and 641 parents of controls completed questionnaires. Couple relationship and family structure were selected by regression of binary logistic analysis as the risk factors. Couple relationship was divided into the harmonious, common, hostile, and divorced. Family structure included unconventional family, nuclear family, and unite family. Multivariate correspondence analysis was designed to explore relationships among categorical variables of couple relationship and family structure. RESULTS There were significant associations between TD and couple relationship (Exp B = 1.310, p = .006, 95% CI = 1.080-1.590), family structure (Exp B = 0.668, p = .001, 95% CI = 0.526 ~ 0.847), gender (Exp B = 0.194, p < .001, 95% CI = 0.149-0.254), respectively. Obviously contradicted and common couple relationships were risk factors for TD compared with the harmonious and divorced. Children form unconventional family or nuclear family were prone to develop TD. Interestingly, divorced parents had the same protective effect as harmonious parents. The OR value could increase with the number and level of those risk factors. CONCLUSIONS In conclusion, children from nuclear families with bad parental relationship could be more likely to develop tic symptoms. The family intervention of children with TD should focus on family structure and parental relationship.
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Affiliation(s)
- Pengcheng Zhu
- Department of Traditional Chinese Medicine, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Min Wu
- Department of Traditional Chinese Medicine, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Pinxian Huang
- Department of Preventive Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xin Zhao
- Department of Traditional Chinese Medicine, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoyi Ji
- Jiaxing Maternity and Child Health Care Hospital, Jiaxing, China
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Vermilion J, Augustine E, Adams HR, Vierhile A, Lewin AB, Thatcher A, McDermott MP, O'Connor T, Kurlan R, van Wijngaarden E, Murphy TK, Mink JW. Tic Disorders are Associated With Lower Child and Parent Quality of Life and Worse Family Functioning. Pediatr Neurol 2020; 105:48-54. [PMID: 32029331 DOI: 10.1016/j.pediatrneurol.2019.12.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 12/05/2019] [Accepted: 12/07/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Chronic tic disorders occur in approximately 3% of children. Neuropsychiatric symptoms of attention-deficit/hyperactivity disorder, obsessive-compulsive disorder, anxiety, and depression are common. We evaluated the impact of tic disorders and comorbid symptoms on individual and parent quality of life and family functioning. METHOD In two cross-sectional studies children with tic disorders were enrolled at the University of Rochester or the University of South Florida; data were pooled for analyses. Control subjects were enrolled at the University of Rochester. We compared quality of life and function in youth and families with and without tic disorders. We evaluated the associations between comorbid symptoms and individual quality of life and family impact in youth with tic disorders using multiple regression analyses. RESULTS We enrolled 205 youths with tic disorders and 100 control subjects. Psychosocial (P < 0.0001) and physical (P < 0.0001) quality of life were lower in individuals with tic disorders compared with controls. Severity of attention-deficit/hyperactivity disorder (P < 0.0001) and depression (P = 0.046) symptoms were associated with lower psychosocial quality of life in youth with tic disorders. Families of youths with tic disorders had worse parent quality of life (P < 0.001) and family functioning (P < 0.001) than control families. Severity of attention-deficit/hyperactivity disorder (P < 0.0001), obsessive-compulsive disorder (P = 0.0004), and depression (P = 0.01) symptoms were associated with predicted worse family impact. CONCLUSION Youths with tic disorders had lower individual and parent quality of life and worse family functioning than controls. The impact of tic disorders on the family may have significant implications for approaches to providing comprehensive care to these families.
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Affiliation(s)
| | - Erika Augustine
- Department of Neurology, University of Rochester, Rochester, New York
| | - Heather R Adams
- Department of Neurology, University of Rochester, Rochester, New York
| | - Amy Vierhile
- Department of Neurology, University of Rochester, Rochester, New York
| | - Adam B Lewin
- Department of Psychiatry, University of South Florida, St. Petersburg, Florida
| | - Alyssa Thatcher
- Department of Neurology, University of Rochester, Rochester, New York
| | | | - Tom O'Connor
- Department of Neurology, University of Rochester, Rochester, New York
| | - Roger Kurlan
- The Center for Neurological and Neurodevelopmental Health, Voorhees, New Jersey
| | | | - Tanya K Murphy
- Department of Psychiatry, University of South Florida, St. Petersburg, Florida
| | - Jonathan W Mink
- Department of Neurology, University of Rochester, Rochester, New York
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Cumming MM, Poling D, Smith SW. Validation of the Anger Expression Scale for Children With Fourth and Fifth Graders: Implications for Identifying Students at Risk for Behavior Problems. Assessment 2020; 28:1418-1433. [PMID: 31893938 DOI: 10.1177/1073191119897119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
An inability to successfully regulate anger has been linked to adverse outcomes for students, including psychological problems and special education placement due to significant emotional and behavioral difficulties. Early identification, therefore, is critical to provide timely intervention for students before anger-related problems escalate. The Anger Expression Scale for Children was developed to address some of the limitations of previous measurement tools designed to assess anger expression with children and adolescents. Yet validation is needed with upper elementary school populations-a key identification and prevention period. Thus, we examined the factor structure of the scale with 2,020 fourth and fifth graders. Results revealed support for a modified two-factor model, with a general Anger Expression factor and Anger Control factor. Criterion-related validity analyses indicated that Anger Expression was positively associated with aggression and externalizing problems, whereas Anger Control was related to emotion control and less internalizing behaviors. We discuss implications of findings for both informed school use and future research.
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Kloft L, Steinel T, Kathmann N. Systematic review of co-occurring OCD and TD: Evidence for a tic-related OCD subtype? Neurosci Biobehav Rev 2018; 95:280-314. [PMID: 30278193 DOI: 10.1016/j.neubiorev.2018.09.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 09/19/2018] [Accepted: 09/25/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE The aim of this review is to summarize the current knowledge of associated features of co-occurring obsessive-compulsive disorder (OCD) and tic disorders (TD) and to critically evaluate hypotheses regarding the nature of their comorbidity. METHOD We conducted a systematic review following PRISMA guidelines. To this aim, the PubMed, PsychInfo and ISI Web of Knowledge databases were searched up to August 30, 2018. For gender and age-of-onset we additionally conducted meta-analyses. RESULTS One hundred eighty-nine studies met inclusion criteria. We substantiate some acknowledged features and report evidence for differential biological mechanisms and treatment response. In general, studies were of limited methodological quality. CONCLUSIONS Several specific features are reliable associated with co-occurring OCD + TD. The field lacks methodological sound studies. The review found evidence against and in favor for different hypotheses regarding the nature of comorbidity of OCD and TD. This could indicate the existence of a stepwise model of co-morbidity, or could be an artefact of the low methodological quality of studies.
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Affiliation(s)
- Lisa Kloft
- Humboldt-Universität zu Berlin, Berlin, Germany.
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