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Tourette syndrome or Tourette's syndrome is a common neurodevelopmental disorder that begins in childhood or adolescence. It is characterized by multiple movement (motor) tics and at least one vocal (phonic) tic. Common tics are blinking, coughing, throat clearing, sniffing, and facial movements. These are typically preceded by an unwanted urge or sensation in the affected muscles known as a premonitory urge, can sometimes be suppressed temporarily, and characteristically change in location, strength, and frequency. Tourette's is at the more severe end of a spectrum of tic disorders. The tics often go unnoticed by casual observers.
A tic is a sudden, repetitive, nonrhythmic motor movement or vocalization involving discrete muscle groups. Tics can be invisible to the observer, such as abdominal tensing or toe crunching. Common motor and phonic tics are, respectively, eye blinking and throat clearing.
Psychopathology is the study of abnormal cognition, behaviour and experiences which differs according to social norms and rests upon a number of constructs that are deemed to be the social norm at any particular era.
Personality Assessment Inventory (PAI), developed by Leslie Morey, is a self-report 344-item personality test that assesses a respondent's personality and psychopathology. Each item is a statement about the respondent that the respondent rates with a 4-point scale. It is used in various contexts, including psychotherapy, crisis/evaluation, forensic, personnel selection, pain/medical, and child custody assessment. The test construction strategy for the PAI was primarily deductive and rational. It shows good convergent validity with other personality tests, such as the Minnesota Multiphasic Personality Inventory and the Revised NEO Personality Inventory.
Tic disorders are defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM) based on type and duration of tics. Tic disorders are defined similarly by the World Health Organization.
The Positive and Negative Syndrome Scale (PANSS) is a medical scale used for measuring symptom severity of patients with schizophrenia. It was published in 1987 by Stanley Kay, Lewis Opler, and Abraham Fiszbein. It is widely used in the study of antipsychotic therapy. The scale is known as the "gold standard" that all assessments of psychotic behavioral disorders should follow.
Stereotypic movement disorder (SMD) is a motor disorder with onset in childhood involving restrictive and/or repetitive, nonfunctional motor behavior, that markedly interferes with normal activities or results in bodily injury. To be classified as SMD, the behavior in question must not be due to the direct effects of a substance, Autism, or another medical condition. The cause of this disorder is not known.
Tourette syndrome is an inherited neurodevelopmental disorder that begins in childhood or adolescence, characterized by the presence of motor and phonic tics. The management of Tourette syndrome has the goal of managing symptoms to achieve optimum functioning, rather than eliminating symptoms; not all persons with Tourette's require treatment, and there is no cure or universally effective medication. Explanation and reassurance alone are often sufficient treatment; education is an important part of any treatment plan.
Causes and origins of Tourette syndrome have not been fully elucidated. Tourette syndrome is an inherited neurodevelopmental disorder that begins in childhood or adolescence, characterized by the presence of multiple motor tics and at least one phonic tic, which characteristically wax and wane. Tourette's syndrome occurs along a spectrum of tic disorders, which includes transient tics and chronic tics.
Habit reversal training (HRT) is a "multicomponent behavioral treatment package originally developed to address a wide variety of repetitive behavior disorders".
The obsessive–compulsive spectrum is a model of medical classification where various psychiatric, neurological and/or medical conditions are described as existing on a spectrum of conditions related to obsessive–compulsive disorder (OCD). "The disorders are thought to lie on a spectrum from impulsive to compulsive where impulsivity is said to persist due to deficits in the ability to inhibit repetitive behavior with known negative consequences, while compulsivity persists as a consequence of deficits in recognizing completion of tasks." OCD is a mental disorder characterized by obsessions and/or compulsions. An obsession is defined as "a recurring thought, image, or urge that the individual cannot control". Compulsion can be described as a "ritualistic behavior that the person feels compelled to perform". The model suggests that many conditions overlap with OCD in symptomatic profile, demographics, family history, neurobiology, comorbidity, clinical course and response to various pharmacotherapies. Conditions described as being on the spectrum are sometimes referred to as obsessive–compulsive spectrum disorders.
A depression rating scale is a psychiatric measuring instrument having descriptive words and phrases that indicate the severity of depression for a time period. When used, an observer may make judgements and rate a person at a specified scale level with respect to identified characteristics. Rather than being used to diagnose depression, a depression rating scale may be used to assign a score to a person's behaviour where that score may be used to determine whether that person should be evaluated more thoroughly for a depressive disorder diagnosis. Several rating scales are used for this purpose.
James Frederick Leckman, M.D., is a child psychiatrist and psychoanalyst and the Neison Harris Professor of Child Psychiatry, Psychiatry, Psychology and Pediatrics at the Yale School of Medicine, recognized for his research in Tourette syndrome (TS) and obsessive–compulsive disorder (OCD).
The Yale Global Tic Severity Scale (YGTSS) is a psychological measure designed to assess the severity and frequency of symptoms of disorders such as tic disorder, Tourette syndrome, and obsessive-compulsive disorder, in children and adolescents between ages 6 to 17.
The Tourette Syndrome Clinical Global Impression (TS-CGI) is a psychological measure used to briefly assess severity of tics.
The Tourette's Disorder Scale (TODS) is a psychological measure used to assess tics and co-occurring conditions in tic disorders.
The Premonitory Urge for Tics Scale (PUTS) is a psychological measure used to assess premonitory urges preceding tics in tic disorders. It is not recommended for children ten and under.
The Motor tic, Obsessions and compulsions, Vocal tic Evaluation Survey (MOVES) is a psychological measure used to screen for tics and other behaviors. It measures "motor tics, vocal tics, obsessions, compulsions, and associated symptoms including echolalia, echopraxia, coprolalia, and copropraxia".
The Autism – Tics, AD/HD, and other Comorbidities (A–TAC) is a psychological measure used to screen for other conditions occurring with tics. Along with tic disorders, it screens for autism spectrum disorders, attention deficit/hyperactivity disorder (ADHD) and other conditions with onset in childhood. The A-TAC has been reported as valid and reliable for detecting most disorders in children. One telephone survey found it was not validated for eating disorders.
Deanna Marie Barch is Chair and Professor of Psychological & Brain Sciences and the Gregory B. Couch Professor of Psychiatry at Washington University.
References
- ↑ Martino D, Pringsheim TM, Cavanna AE, et al. (March 2017). "Systematic review of severity scales and screening instruments for tics: Critique and recommendations". Mov. Disord. (Review). 32 (3): 467–473. doi:10.1002/mds.26891. PMC 5482361 . PMID 28071825.
- ↑ Sukhodolsky DG, Gladstone TR, Kaushal SA, Piasecka JB, Leckman JF (2017). "Tics and Tourette Syndrome". In Matson JL (ed.). Handbook of Childhood Psychopathology and Developmental Disabilities Treatment. Autism and Child Psychopathology Series. p. 248.
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