Living with tics: Reduced impairment and improved quality of life for youth with chronic tic disorders

McGuire, Joseph F.; Arnold, Elysse B.; Park, Jennifer M.; Nadeau, Joshua M.; Lewin, Adam B.; Murphy, Tanya K.; Storch, Eric A.

doi:10.1016/j.psychres.2014.11.045

Cited by 72 publications

(58 citation statements)

References 61 publications

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“…Of note, the findings of clinical studies published in the last few years suggested the potential efficacy of broader interventions focused on the adverse psychosocial consequences of tics (36,37) .…”

Section: Discussionmentioning

confidence: 99%

A preliminary examination of self-concept in older adolescents and young adults with Gilles de la Tourette syndrome

Silvestri

Chiarotti

Baglioni

et al. 2017

European Journal of Paediatric Neurology

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Gilles de la Tourette syndrome (GTS) is a childhood-onset neuropsychiatric disorder characterised by multiple tics and often associated with behavioural problems. Although there is evidence of significantly reduced self-esteem in children and adolescents with GTS, little is known about perceived self-concept and its clinical determinants at the transition age between adolescence and adulthood. We therefore set out to investigate self-concept in a clinical sample of young patients with GTS at this crucial age for personal development. In addition to standard demographic and clinical data, we collected self-ratings using a standardised battery of psychometric instruments, as well as the Multidimensional Self Concept Scale, a comprehensive questionnaire developed to assess self-concept in subjects aged 9 to 19 years, tapping into the social, competence, affect, academic, family, and physical domains. We found that patients diagnosed with at least one comorbid psychiatric disorder ("GTS-plus" phenotype) reported significantly lower self-concept than patients with "pure GTS", whereas tic-related variables had no impact on self-concept. Anxiety symptoms were the main determinants of self-concept, especially trait anxiety with regard to social and affective domains. Affective symptoms could also have a negative impact on the physical, affective, competence, and social domains of self-concept. Routine screening for these co-morbid conditions should be recommended in all patients with GTS seen at transition clinics from paediatric to adult care, in order to implement effective treatment interventions whenever possible.

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Section: Discussionmentioning

confidence: 99%

A preliminary examination of self-concept in older adolescents and young adults with Gilles de la Tourette syndrome

Silvestri

Chiarotti

Baglioni

et al. 2017

European Journal of Paediatric Neurology

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“…Thus, there is a need for more comprehensive interventions to reduce the distress, impairment and associated problems experienced by youth with TD (e.g., social problems, social deficits, peer victimization, self-concept) that may be contributing to the development of anxiety and/or depressive symptoms. Although recognized as important in practice parameter guidelines (Murphy et al, 2013), there have been only two studies that have sought to address these co-occurring concerns (McGuire et al, 2015a; Storch et al, 2012b). Beyond interventions to address these problems, future longitudinal data are needed to conclusively assesses the relative impact of tics, anxiety and depressive symptoms on SI in youth in order to fully elucidate the level of risk posed by these emotional symptoms, as well as evaluate the impact of evidence-based interventions on tic severity and emotional symptoms.…”

Section: Discussionmentioning

confidence: 99%

Suicidal ideation in youth with tic disorders

Johnco

McGuire

McBride

et al. 2016

Journal of Affective Disorders

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Background This study examined the incidence and clinical correlates of suicidal ideation (SI) in youth with tic disorders (TD). The independent contribution of tics, anxiety, depressive and externalizing symptoms on SI severity in youth with TD was assessed. Method Participants were 75 treatment-seeking youth with a TD (N = 75) aged 6–18. Participants completed diagnostic assessments, clinician-ratings, self- and parent-report measures of emotional functioning and the presence and/or severity of suicidal ideation. Results Based on youth-report, 61% of youth endorsed at least some symptoms of SI, and 8% endorsed symptoms that exceeded the clinically significant cut-off. Parents reported SI in 11% of cases, with generally poor agreement between parent- and youth-report. Suicidal ideation correlated with higher anxiety, depressive and externalizing symptoms, affective lability, and with poorer distress tolerance and overall functioning. Anxiety, depressive and externalizing symptoms showed an independent relationship with SI. Tic severity was not associated with SI. Rather, higher tic severity was associated with an increase in anxiety symptoms, which in turn, was associated with greater SI severity. Limitations Cross-sectional data limits causal conclusions. Diagnosis was based on unstructured assessments by expert clinicians, including consensus diagnosis, rather than structured clinical interviews. Conclusions Around 8–11% of youth with TD experienced SI. Tic severity did not have any direct influence on SI, however the presence of comorbid anxiety and depressive symptoms significantly increases this risk. Results suggest that it is psychiatric comorbidity, rather than tics themselves, that predispose youth with tic disorders to increased risk of suicidality.

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“…Moreover, tic reduction may not be the only path to positive global outcome. Intervention targeting tic-related psychosocial problems has shown initial promise in improving quality of life and psychosocial functioning in youth with tics (McGuire et al, 2015). Reducing tics may not have the desired effect of reducing impairment in school, and this intervention does not give recommendations regarding communications with schools.…”

Section: Utilitymentioning

confidence: 99%

Tic Treatment Goes Tech: A Review of TicHelper.com

Conelea

Wellen

2017

Cognitive and Behavioral Practice

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TicHelper.com (“TicHelper”) is an interactive online treatment program for youth with chronic tic disorders (CTDs) or Tourette Syndrome (TS) and their parents. It is based on Comprehensive Behavioral Intervention for Tics (CBIT), an individual, outpatient therapy protocol shown to effectively reduce tics in randomized controlled trials. The TicHelper website offers a user-friendly dashboard that is effective in making it easy to navigate through different treatment modules. Modules parallel core CBIT procedures and consist of interactive exercises, informational videos, and self-report ratings. TicHelper has some weaknesses (e.g., no outcomes research specific to the program has been published to date); however, its strengths (easily navigable, clear instructions, appropriate content) outweigh its weaknesses, making it a potentially useful dissemination tool to make CBIT more accessible to families and youth with tics.

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Living with tics: Reduced impairment and improved quality of life for youth with chronic tic disorders

Cited by 72 publications

References 61 publications

A preliminary examination of self-concept in older adolescents and young adults with Gilles de la Tourette syndrome

A preliminary examination of self-concept in older adolescents and young adults with Gilles de la Tourette syndrome

Suicidal ideation in youth with tic disorders

Tic Treatment Goes Tech: A Review of TicHelper.com

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