Subjective versus objective measures of tic severity in Tourette syndrome – The influence of environment. (30th August 2016)

• Record Type: Journal Article
• Authors: Barnea, Meirav; Benaroya-Milshtein, Noa; Gilboa-Sechtman, Eva; Woods, Douglas W.; Piacentini, John; Fennig, Silvana; Apter, Alan; Steinberg, Tamar
• Is Part Of: Psychiatry research. Volume 242(2016)
• Page Start: 204
• Page End: 209
• Publication Date: 2016-08-30
• Subjects: Premonitory urge -- Video-recording -- Self-report -- Tic expression -- Environmental situations; Psychiatry -- Periodicals; Psychiatry -- periodicals; Psychiatrie -- Périodiques; 616.89
• DOI: 10.1016/j.psychres.2016.05.047
• Languages: English
• ISSNs: 0165-1781

Abstract

Abstract: The objective of this study was to examine the influence of environmental challenges on tic expression by subjective and objective measures. The study group consisted of 41 children aged 6–18 years (M=10.15, SD=2.73) with a primary diagnosis of Tourette syndrome. Subjective measures included the Functional Assessment Interview developed for this study and three standard validated instruments. The objective measure was a video-recording of the patients in five daily-life situations: watching television, doing homework, being alone, receiving attention when ticcing, and talking to a stranger. In addition, the effect of premonitory urges on assessment of tic expression was evaluated. The associations between the subjective and objective measures of tic expression were moderate to low. A significantly higher number of tics were observed in the television situation, and a significantly lower number in the alone situation, compared to the other situations. Higher levels of premonitory urge were associated with greater awareness of objectively measured tic expression. In conclusion, tic expression is significantly influenced by the environment. Subjective measures of tic expression may be misleading. These results have implications for refining the clinical assessment of tics, improving research methodology, and developing new therapeutic strategies. Highlights: Associations between YGTSS and objective recordings of tic activity were low. Tic expression was significantly influenced by the environmental situations. Watching television was associated with the highest level of tics. Subjective measures of tic expression poorly predicated objective measures. Premonitory urges were associated with greater awareness of tic expression.