Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-22T20:03:22.411Z Has data issue: false hasContentIssue false
  • English
  • Français

Psychopathology in boys with Tourette syndrome: Effects of age on the relationship between psychological and physical symptoms

Published online by Cambridge University Press:  31 October 2008

Linda J. Koenig  and
Robert A. Bornstein
Linda J. Koenig*
Affiliation:
Emory University
Robert A. Bornstein
Affiliation:
Ohio State University
*
Linda J. Koenig, Department of Psychology, Emory University, Atlanta, GA 30322.
Get access Rights & Permissions [Opens in a new window]

Abstract

Tourette syndrome (TS), a neuropsychiatric disorder that presents in childhood and is characterized by recurrent tics, is often associated with a variety of psychological problems. Most studies of concomitant problems have focused on psychiatric comorbidity, with less attention paid to nonsyndrome-specific or subsyndromal emotional and behavioral difficulties. Moreover, little is known about the factors that influence the specificity or severity of psychological problems. We hypothesized that level and type of psychological problem would be influenced by both severity of illness and developmental period. Children with severe tics were predicted to show increased levels of externalizing (undercontrolled) behavior, whereas adolescents with severe tics were predicted to show increased levels of internalizing (overcontrolled) behavior. Forty-one boys with TS were rated by their parents for tic severity (simple and complex motor tics) and psychological symptoms (Connors Parent Symptom Questionnaire and the Child Behavior Checklist). Results partially confirmed the hypothesis, indicating that greater illness severity was associated with greater psychological disturbance, but only in the younger subjects. Among the adolescents, even those with mild tics demonstrated relatively high levels of psychological symptoms. However, there was no indication that developmental period was related to the specific type of problem manifested. Regardless of age, patients with severe tics domonstrated high levels of externalizing behavior, and relatively high levels of internalizing behavior were also seen. Results are discussed in terms of the developmental factors that might influence the relationship between psychological and physical symptoms in children with TS.

Type
Research Article
Information
Development and Psychopathology , Volume 4 , Issue 2 , April 1992 , pp. 271 - 285
Copyright
Copyright © Cambridge University Press 1992

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Achenbach, T. M. (1982). Developmental psychopathology (2nd ed.). New York: Wiley.Google Scholar
Achenbach, T. M., & Edelbrock, C. (1983). Manual for the Child Behavior Checklist. Burlington, VT: Authors.Google Scholar
American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd ed., rev.). Washington, DC: Author.Google Scholar
Azrin, N. H., & Peterson, A. L. (1988a). Behaviour therapy for Tourette syndrome and tic disorders. In Cohen, D. J., Leckman, J. F., & Bruun, R. D. (Eds.), Tourette syndrome and tic disorders: Clinical understanding and treatment. New York: Wiley.Google Scholar
Azrin, N. H., & Peterson, A. L. (1988b). Habit reversal for the treatment of Tourette's syndrome. Behaviour Research & Therapy, 26, 347–351.CrossRefGoogle Scholar
Barabas, G. (1990). Physical disorders. In Lewis, M. & Miller, S. (Eds.), Handbook of developmental psychopathology (pp. 431–440). New York: Plenum.CrossRefGoogle Scholar
Barabas, G., Matthews, W. S., & Ferrari, M. (1984a). Disorders of arousal in Gilles de la Tourette's syndrome. Neurology (Cleveland), 34, 815–817.CrossRefGoogle ScholarPubMed
Barabas, G., Matthews, W. S., & Ferrari, M. (1984b). Tourette's syndrome and migraine. Archives of Neurology, 41, 871–872.CrossRefGoogle ScholarPubMed
Bornstein, R. A. (1990). Neuropsychological performance in children with Tourette's syndrome. Psychiatry Research, 33, 73–81.CrossRefGoogle ScholarPubMed
Bornstein, R. A., Caroll, A., & King, G. (1985). Relationship of age to neuropsychological deficit in Tourette's syndrome. Developmental and Behavioral Pediatrics, 6, 284–286.CrossRefGoogle ScholarPubMed
Cohen, D. J. (1980). The pathology of the self in primary childhood autism and Gilles de la Tourette syndrome. Psychiatric Clinics of North America, 3, 383–402.CrossRefGoogle Scholar
Cohen, D. J., Detlor, J., Shaywitz, B. A., & Leckman, J. F. (1982). Interaction of biological and psychological factors in the natural history of Tourette syndrome: A paradigm for childhood neuropsychiatric disorders. In Friedhoff, J. J. & Chase, T. N. (Eds.), Gilles de la Tourette syndrome (pp. 31–40). New York: Raven Press.Google Scholar
Cohen, D. J., Leckman, J. F., & Shaywitz, B. A. (1985). The Tourette syndrome and other tics. In Shaffer, D., Ehrhardt, A. A., & Greenhill, L. L. (Eds.), The clinical guide to child psychiatry (pp. 3–28). New York: Free Press.Google Scholar
Comings, D. E. (1990). Tourette syndrome and human behavior. Duarte, CA: Hope Press.Google Scholar
Comings, D. E., & Comings, B. G. (1984). Tourette's syndrome and attention deficit disorder with hyperactivity: Are they genetically related? Journal of the American Academy of Child Psychiatry, 23, 138–146.CrossRefGoogle ScholarPubMed
Comings, D. E., & Comings, B. G. (1985). Tourette syndrome: Clinical and psychological aspects of 250 cases. American Journal of Human Genetics, 37, 435–450.Google ScholarPubMed
Comings, D. E., & Comings, B. G. (1987a). A controlled study of Tourette syndrome: V. Depression and mania. American Society of Human Genetics, 47, 804–821.Google Scholar
Comings, D. E., & Comings, B. G. (1987b). Hereditary agoraphobia and obsessive-compulsive behavior in relatives of patients with Gilles de la Tourette's syndrome. British Journal of Psychiatry, 151, 195–199.CrossRefGoogle Scholar
Comings, D. E., & Comings, B. G. (1988). Tourette syndrome and attention deficit disorder. In Cohen, D., Bruun, R. D., & Leckman, J. F. (Eds.), Tourettes syndrome and tic disorders: Clinical understanding and treatment (pp. 119–135). New York: Wiley.Google Scholar
Connors, C. K. (1973). Rating scales for use in drug studies with children. Psychopharmacology Bulletin [Special issue, Pharmacotherapy of children]. 24–84.Google Scholar
Cooper, J. (1970). The Leyton obsessional inventory. Psychological Medicine, 1, 48–64.CrossRefGoogle ScholarPubMed
Dykens, E., Leckman, J., Riddle, M., Hardin, M., Schwartz, S., & Cohen, D. (1990). Intellectual, academic, and adaptive functioning of Tourette syndrome children with and without attention deficit disorder. Journal of Abnormal Child Psychology, 18, 607–615.CrossRefGoogle ScholarPubMed
Erenberg, G., Cruse, R. P., & Rothner, A. D. (1986). Tourette syndrome: An analysis of 200 pediatric and adolescent cases. Cleveland Clinic Quarterly, 53, 127–131.CrossRefGoogle ScholarPubMed
Ferrari, M., Matthews, W. S., & Barabas, G. (1984). Children with Tourette syndrome: Results of psychological tests given prior to drug treatment. Developmental and Behavioral Pediatrics, 5, 116–119.CrossRefGoogle ScholarPubMed
Frankel, M., Cummings, J. L., Robertson, M. M., Trimble, M. R., Hill, M. A., & Benson, D. F. (1986). Obsessions and compulsions in Gilles de la Tourette's syndrome. Neurology, 36, 378–381.CrossRefGoogle ScholarPubMed
Grad, L. R., Pelcovitz, D., Olson, M., Matthews, M., & Grad, G. J. (1987). Obsessive-compulsive symptomatology in children with Tourette's syndrome. Journal of the American Academy of Child and Adolescent Psychiatry, 26, 69–73.CrossRefGoogle ScholarPubMed
Incagnoli, T., & Kane, R. (1981). Neuropsychological functioning in Gilles de la Tourette's syndrome. Journal of Clinical Neuropsychology, 3, 165–169.CrossRefGoogle ScholarPubMed
Kerbeshian, J., & Burd, L. (1987). Are schizophreniform symptoms present in attenuated form in children with Tourette disorder and other developmental disorders. Canadian Journal of Psychiatry, 32, 123–135.CrossRefGoogle ScholarPubMed
Montgomery, M. A., Clayton, P. J., & Friedhoff, A. J. (1982). Psychiatric illness in Tourette syndrome patients and first-degree relatives. In Friedhoff, J. J. & Chase, T. N. (Eds.), Gilles de la Tourette syndrome (pp. 335–339). New York: Raven Press.Google Scholar
Morphew, J. A., & Sim, M. (1969). Gilles de la Tourette's syndrome: A clinical and psychopathological study. British Journal of Medical Psychology, 42, 292–301.CrossRefGoogle ScholarPubMed
Nee, L. E., Polinsky, R. J., & Ebert, M. H. (1982). Tourette syndrome: Clinical and family studies. In Friedhoff, J. J. & Chase, T. N. (Eds.), Gilles de la Tourette syndrome (pp. 291–295). New York: Raven Press.Google Scholar
Pauls, D. L., Cohen, D. J., Heimbuch, R., Detlor, J., & Kidd, K. K. (1981). The familial pattern and transmission of Tourette syndrome and multiple tics. Archives of General Psychiatry, 37, 1091–1093.CrossRefGoogle Scholar
Pauls, D. L., Towbin, K. E., Leckman, J. F., Zahner, G. E. P., & Cohen, D. J., (1986). Gilles de la Tourette syndrome and obsessive compulsive disorder: Evidence supporting an etiological relationship. Archives of General Psychiatry, 43, 1180–1182.CrossRefGoogle Scholar
Pitman, R. K., Green, R. C., Jenike, M. A., & Mesulam, M. M. (1987). Clinical comparison of Tourette's disorder and obsessive-compulsive disorder. A merican Journal of Psychiatry, 144, 1166–1171.Google ScholarPubMed
Riddle, M. A., Leckman, J. F., Anderson, G. M., Ort, S. I., Hardin, M. T., Stevenson, J., & Cohen, D. J. (1988). Tourette's syndrome: Clinical and neurochemical correlates. Journal of the American Academy of Child and Adolescent Psychiatry, 4, 409–412.CrossRefGoogle Scholar
Rosenberg, L., Harris, J. C., & Singer, H. J. S. (1984). Relationship of the child behavior checklist to an independent measure of psychopathology. Psychological Reports, 54, 427–430.CrossRefGoogle Scholar
Shapiro, A. K., Shapiro, E. S., Young, J. G., & Feinberg, T. E. (1988). Gilles de la Tourette syndrome (2nd ed.). New York: Raven Press.Google Scholar
Singer, H. S., & Rosenberg, L. A. (1989). Development of behavioral and emotional problems in Tourette syndrome. Pediatric Neurology, 5, 41–44.CrossRefGoogle ScholarPubMed
Sverd, J., Curley, A. D., Jandorf, L., & Volkersz, L. (1988). Behavior disorder and attention deficits in boys with Tourette syndrome. Journal of the American Academy of Child and Adolescent Psychiatry, 27, 413–417.CrossRefGoogle ScholarPubMed
Wilson, R. S., Garron, D. C., Tanner, C. M., & Klawans, H. L. (1982). Behavior disturbance in children with Tourette syndrome. In Friedhoff, J. J. & Chase, T. N. (Eds.), Gilles de la Tourette syndrome (pp. 329–333). New York: Raven Press.Google Scholar