Factors associated with Tourette syndrome among adolescents in Taiwan: A cross-sectional correlational study

Adolescents with Tourette syndrome (TS) may suffer from learning difficulties (attention-deficit/hyperactivity disorder), challenges in interpersonal interactions (especially with peers), disruptions of daily routines (disruptive behavior disorders), and increased psychosocial stress, which can result in internalizing and externalizing behavioral problems, such as venting depression and stress through self-harm. The aim of this study was to investigate peer attachment in adolescents with TS and associated risk factors.

Adolescents with TS aged 13-18 years were recruited from the outpatient departments of 2 hospitals in Taiwan. Participants completed a basic data sheet, the Beck Depression Inventory-II, the Chinese version of the State-Trait Anxiety Inventory, and the Chinese version of the Youth Self-Report. Descriptive statistics were performed. Structural equation modeling was used to verify the model proposed in this study and to analyze the overall fit and internal structure.

A total of 452 adolescents with TS aged 10-19 years participated in this study, which aimed to investigate factors affecting peer attachment, depression, anxiety, and psychosocial maladaptation and to explore causal relationships between these factors. Peer attachment was significantly associated with grade point average (r_s = -0.240, p < .001), birth order (r_s = -0.118, p = .012), parental marital status (r_s = -0.111, p = .018), parenting style (r_s = -0.138, p = .003), family monthly income (r_s = 0.124, p = .008), and weekly hours on the internet (r = -0.164, p < .001).

These results suggest that depression, anxiety, and peer attachment affect psychosocial development.

The findings may help clinical staff manage adolescents' severe emotional distress and psychosocial maladaptation.