Tic-related cognition, sensory phenomena, and anxiety in children and adolescents with Tourette syndrome

Steinberg, Tamar; Harush, Adva; Barnea, Meirav; Dar, Reuven; Piacentini, John; Woods, Doug; Shmuel-Baruch, Sharona; Apter, Alan

doi:10.1016/j.comppsych.2012.12.012

Cited by 38 publications

(30 citation statements)

References 22 publications

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“…As reports have identified that different tics and different individuals have a varying degree of premonitory urges (Leckman et al 1993; McGuire et al 2015), an individualized urge assessment may provide important complementary information and offer the chance to evaluate urges along multiple dimensions (Brabson et al 2015; Reese et al 2014). Such an evaluation could clarify the mixed associations between the PUTS total score and tic severity identified in prior reports (Crossley and Cavanna, 2013; Eddy and Cavanna, 2014; Steinberg et al 2010; Steinberg et al 2013; Woods et al 2005), and further elucidate the contribution of premonitory urges in maintaining tic behaviors. Beyond examining multiple dimensions of urge phenomena, prior evaluations of premonitory urges have been largely restricted to common co-occurring psychopathological symptoms.…”

Section: Introductionmentioning

confidence: 88%

“…The PUTS has demonstrated good psychometric properties to assess an individual’s urge to tic across samples (McGuire et al 2012; Reese et al 2014; Steinberg et al 2010; Woods et al 2005). The PUTS total score has produced small-to-moderate associations with overall tic severity in some studies ( r =0.21–0.33) (Crossley and Cavanna, 2013; Eddy and Cavanna, 2014; Steinberg et al 2013; Woods et al 2005), with others identifying weak or non-significant associations (Steinberg et al 2010). When examining co-occurring symptoms, a moderate-to-strong relationship has been found between the PUTS total score and obsessive-compulsive symptoms ( r =0.31–0.50) (Steinberg et al 2010; Woods et al 2005), with smaller and mixed associations observed with overall anxiety symptoms ( r =0.33–0.35) (Eddy and Cavanna, 2014; Woods et al 2005) and somatic/panic symptoms ( r =0.18–0.40) (Rozenman et al 2014).…”

Section: Introductionmentioning

confidence: 99%

“…When examining co-occurring symptoms, a moderate-to-strong relationship has been found between the PUTS total score and obsessive-compulsive symptoms ( r =0.31–0.50) (Steinberg et al 2010; Woods et al 2005), with smaller and mixed associations observed with overall anxiety symptoms ( r =0.33–0.35) (Eddy and Cavanna, 2014; Woods et al 2005) and somatic/panic symptoms ( r =0.18–0.40) (Rozenman et al 2014). Although small associations with depressive symptoms have been identified ( r =0.10–0.25) (Eddy and Cavanna, 2014; Steinberg et al 2013), there has been inconsistent evidence regarding associations between ADHD severity and PUTS total score (Crossley and Cavanna, 2013; Eddy and Cavanna, 2014; Reese et al 2014; Steinberg et al 2010). …”

Section: Introductionmentioning

confidence: 99%

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The premonitory urge revisited: An individualized premonitory urge for tics scale

McGuire

McBride

Piacentini

et al. 2016

Journal of Psychiatric Research

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Background Premonitory urge ratings have advanced our understanding of urge phenomenology among individuals with tic disorders (TD). However, these ratings have been limited by their reliance on a single global dimension of urge severity. This study examined the psychometric properties of a novel scale called the Individualized Premonitory Urge for Tics Scale (I-PUTS) that assesses urge severity across multiple dimensions (number, frequency, and intensity). Method Seventy-five youth with a TD and their parents participated. Clinicians assessed youth’s tic severity, depression severity, rages, and premonitory urges. Parents completed ratings of youth’s anxiety, affect lability, and general psychopathology. Youth completed self-report ratings of anxiety, urge severity, and distress tolerance. Results The I-PUTS identified that youth experienced an average of three distinct urges, but had an average of seven tics over the past week. Urges were primarily localized in the head/face, neck/throat, and arm regions. All I-PUTS dimensions exhibited excellent inter-rater reliability. The I-PUTS dimensions exhibited good convergent validity with global urge ratings and tic severity, and appropriate divergent validity from other clinical constructs. Youth who exhibited discrepant reports between clinician-administered and self-report urge ratings had less anxiety and tic severity, and greater inattention and externalizing problems compared to youth who exhibited good agreement. Conclusions The I-PUTS is a reliable and valid assessment of urge phenomena, which provides additional and complementary information to existing urge scales. It highlights the existence of multiple dimensions of urge severity, and presents particular utility when assessing urges in youth with TD who have inattention and externalizing problems.

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Section: Introductionmentioning

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The premonitory urge revisited: An individualized premonitory urge for tics scale

McGuire

McBride

Piacentini

et al. 2016

Journal of Psychiatric Research

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“…Do anticipatory vigilance or psychological awareness play a part in exacerbating or even creating premonitory urges? Although the influence of general tic-related beliefs on tic severity has been documented,6 so far there has been no systematic exploration of the role of meta-cognitive factors (thinking about tics) preceding tic onset.…”

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confidence: 99%

Meta-Cognitions in Tourette Syndrome, Tic Disorders, and Body-Focused Repetitive Disorder

et al. 2014

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ObjectiveTo explore if self-reported presence of thinking about tics or body-focused repetitive behaviours (BFRBs; gests) are direct triggers of tic or gest onset in 3 groups: Tourette syndrome (TS; n =18), persistent chronic tic disorders (TDs; n = 42), and a comparison group with BFRB (n = 36).Method:The 3 groups completed a thinking about tics inventory, listing 22 items derived from clinician consensus that asked whether thoughts always, sometimes, or never exclusively triggered tic onset. Other questionnaires measured mood, perfectionism, impulsivity, premonitory urge, and self-rated tension. Sixty-three participants completed the inventory twice, and the inventory was completed pre- and post-behavioural intervention by a further 54.Results:The ranking of the thoughts reported as likely to trigger tics or gests was positively correlated across TD and BFRB groups. Exploratory principal components analysis of a reduced 12-item set (the thinking about tics inventory) in TS and TD groups revealed that such thoughts could be grouped into 3 separate subscales: thoughts about the interference of tics or gests, thoughts anticipating tics or gests, and thoughts about whether the person has permission to perform the tic or the gest. The 3 sets of subscales showed good and acceptable internal consistency and overall score showed good test–retest reliability, suggesting thoughts about tics or gests are robust and measurable. The subscales correlated with impulsivity, tic or behaviour severity, and ratings of frequency decreased post-behavioural treatment.Conclusions:Thinking about tics or gests is reported as triggering tics or gests in both TD and BFRB, and meta-cognition seems independent of premonitory sensations and relates to distinct clinical characteristics in each clinical group.

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“…The cognitions include appraisals and beliefs regarding inner (premonitory urges) and outer (environmental) sensory inputs, responses to these inputs (tics), and the ability to express, suppress, or modify one’s responses. To investigate the different thoughts of children about the origin and consequences of their tics, we designed a self-report inventory, the Beliefs About Tic Scale (BATS) (22), which we administered to a sample of 56 patients aged 10–18 years with Tourette syndrome. The results showed that patients’ negative beliefs about their ability to suppress tics (or to resist premonitory urges) were related to higher perceived urge intensity (measured by PUTS scores).…”

Section: Tic-related Cognitionsmentioning

confidence: 99%

Non-Motor Aspects of Tic Disorders—New Developments

et al. 2017

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The cardinal characteristics of tic-related disorders are stereotyped motor movements and vocalizations. However, they may be accompanied by non-motor features that appear sequentially during the course of the disorder and can sometimes be more disabling than the tics themselves. This review presents our perspectives on several non-motor aspects of Tourette syndrome based on the long experience of the Neuropsychiatric Tourette Clinic of a tertiary pediatric medical center. The effect of premonitory urges, sensory modulation disorder, tic-related cognitions, and environmental conditions on the expression and intensity of tics is elaborated, with suggestions for treatment approaches to each. We also describe the mediatory effect of parental attachment style on the link between maternal stress and ticcing intensity and the need to adjust psychotherapy interventions to account for the importance of this factor in emotion regulation. This review is intended to direct attention to the non-motor aspects of Tourette syndrome. An in-depth understanding of this complex and debilitating disorder will facilitate the formulation of innovative therapeutic protocols.

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Tic-related cognition, sensory phenomena, and anxiety in children and adolescents with Tourette syndrome

Cited by 38 publications

References 22 publications

The premonitory urge revisited: An individualized premonitory urge for tics scale

The premonitory urge revisited: An individualized premonitory urge for tics scale

Meta-Cognitions in Tourette Syndrome, Tic Disorders, and Body-Focused Repetitive Disorder

Non-Motor Aspects of Tic Disorders—New Developments

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