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A prospective longitudinal study of Gilles de la Tourette's syndrome
A S Carter1, D L Pauls, J F Leckman
1Department of Psychology, Yale University, New Haven, CT 06510.
Objective:
The goals of this study were to estimate the frequency of Gilles de la Tourette's syndrome (TS), tics, and other behavioral disorders among children at risk for TS and to examine the association of family functioning with children's diagnostic status and social-emotional functioning.
Method:
A prospective longitudinal design was used. Young children who were not displaying any tic behaviors but who had a first-degree relative with TS were recruited. Children's diagnostic status, social-emotional functioning, and family functioning were assessed with the Schedule for Tourette and Other Behavioral Syndromes, Vineland Adaptive Behavior Scales, Child Behavior Checklist, the Harter Self Perception Profile, and Family Environment Scale.
Results:
Increased rates of tic disorders, obsessional and anxiety symptoms, and attentional and speech difficulties were observed. Family functioning, independent of parental psychopathology, was associated with attention-deficit and anxiety disorders, decreased adaptive and increased maladaptive behaviors, and lower self-esteem but not tic spectrum or learning disorders.
Conclusions:
The observed rates of tic disorders add support for an autosomal dominant mode of transmission. Family functioning appears to play an important role in non-tic disorders as well as adaptive and maladaptive behaviors. Family, cognitive-behavioral, and interpersonal therapies should be considered to address the social-emotional difficulties that often accompany TS.