Kerry McBain

The Differential Impact of Tourette's Syndrome and Comorbid Diagnosis on the Quality of Life and Functioning of Diagnosed Children and Adolescents.

PROBLEM Tourettes syndrome (TS) is a neuropsychiatric disorder associated with adverse outcomes. High rates of comorbidity (80-90%) complicate presentation, yet the relationship among TS, common comorbid diagnoses, and adversity is not well understood. This research investigated the impact of comorbidity, and the discrete effects of common comorbid diagnoses, on quality of life (QoL) and functioning of youth with TS. METHODS A community sample of parents of youth with TS (n = 86) participated in this survey-based study. Differences in QoL (Pediatric Quality of Life Inventory) and rates of psychological, behavioral, and social difficulties (Strength and Difficulties Questionnaire) reported for youth with or without comorbid disorder were determined, in addition to outcomes associated with individual disorders. FINDINGS Parametric and nonparametric analyses revealed strong associations between comorbidity and decreased global QoL, impaired emotional and school functioning, and increased emotional symptomatology (p < .001). The impact of individual comorbid disorders was restricted and disorder specific, and TS was uniquely associated with impaired social functioning and peer relationship problems. CONCLUSIONS Understanding the risks associated with TS, particularly to psychosocial well-being, and the specific risks accompanying individual comorbid disorders, may improve assessment, prioritization of treatment goals, and interventions targeting the individual, multidimensional needs of youth with TS.

Factors impacting the quality of peer relationships of youth with Tourette’s syndrome

BackgroundTourette’s syndrome (TS) is a poorly understood neurodevelopmental disorder consistently associated with impaired peer relationships. This research aimed to investigate the relationship between TS and the ability of diagnosed youth to form secure attachment relationships with peers. A quantitative study examined differences between youth with TS and typically developing peers in social functioning, relationship problems and attachment security. Qualitative studies sought to identify factors that enhanced or impeded the ability to form secure peer relationships, including the impact of tic severity, comorbidity and personality traits. All research was conducted from the parental perspective.MethodsThe research consisted of a controlled, survey-based qualitative and quantitative study (Study One) of parents of youth with TS (n = 86) and control group peers (n = 108), and a qualitative telephone interview-based study of TS group parents (Study Two, n = 22). Quantitative assessment of social functioning, peer problems and peer attachment security was conducted using the Paediatric Quality of Life inventory, the Strengths and Difficulties Questionnaire and the Attachment Questionnaire for Children. Qualitative data relating to personality was classified using the Five Factor Model.ResultsResults revealed significantly higher rates of insecure peer attachment, problems in peer relationships, difficulty making friends, stigmatisation and lower levels of social functioning for the TS group. Significant between-group differences in number and type of factors impacting peer relationships were also determined with ‘personality’ emerging as the most prevalent factor. Whilst Extraversion and Agreeableness facilitated friendships for both groups, higher rates of Neuroticism were barriers to friendship for individuals with TS. The TS group also identified multiple ‘non-personality’ factors impacting peer relationships, including TS and comorbid symptom severity, the child’s psychological and behavioural adjustment to their disorder, coping strategies and the behaviour and attitudes of peers.DiscussionOur findings suggest that, whilst Extraversion and Agreeableness facilitated friendships for both groups, higher rates of Neuroticism were barriers to friendship for individuals with TS. Notwithstanding the fact that these findings are based on parental report and not the perceptions of youth themselves, this study may help clinicians to identify youth at increased risk of developing insecure peer relationships and guide the development of targeted supports.ConclusionsThe findings from the study may help clinicians, parents and individuals with TS to better understand and cope with the difficulties experienced in interactions with peers.

Comparing the effect of stigma on the recognition of suicide risk in others between Australia and Brazil

Few studies have considered how suicide is perceived and impacted by stigma across cultures. A sample of 478 participants from Australia and Brazil was used to investigate cross-cultural perceptions of suicide and the impact of stigma on the recognition of suicide risk in others. The Interpersonal-Psychological Theory of Suicide framed a mixed method within and between groups design. English and Portuguese versions of an online survey were developed to assess perception of thwarted belongingness, perceived burdensomeness, acquired capability for suicide, suicide stigma, and demographic characteristics. A significant model was identified predicting recognition of suicide risk in Australia and Brazil. However, not all constructs contributed uniquely. Suicide stigma was found to blind perception of suicide risk in others across cultures. Theoretical implications and future directions for research are outlined.

Youth with Tourette syndrome: parental perceptions and experiences in the Australian context

Abstract Objective To enhance understandings of the impact of Tourette Syndrome (TS) on the parents of diagnosed youth. Specifically, the current study aimed to explore and identify the multidimensional stressors associated with parenting a child or adolescent with TS in the Australian context. Method As part of a larger qualitative and quantitative community‐based study, semi‐structured telephone interviews with 22 mothers of youth with TS were conducted regarding their experiences. Results The study identified parent, child, and contextual factors that contributed to parental stress, with many mirroring the experiences of parents of children with other chronic paediatric disorders. However, several TS‐specific factors also emerged from the data analysis, highlighting the unique difficulties encountered by parents of diagnosed youth. Serious deficits in professional expertise and services currently available for the TS community were also identified. Conclusions Findings indicate the generally unacknowledged challenge of parenting a child with TS, which equates with that experienced in the context of other serious chronic paediatric disorders. Results also indicate the need for psychosocial support for both child and parent, and greatly improved access to well‐informed mental health and educational services in the Australian context.

How is self-sabotage presented in romantic relationships?

The aim of this paper is to present an integrated review exploring the theme of self-sabotage in romantic relationships. Self-sabotage or self-handicapping is a cognitive strategy employed by individuals as self-protection; primarily aimed at preserving self-esteem and self-image. When faced with failure, the individual can justify the outcome as due to the handicap itself (i.e., an external cause), whereas, if faced with success, the individual can emphasise their ability to withstand the barriers of handicap (i.e., an internal cause). The hypothesis is that the self-handicapper creates obstacles which impede success or withdrawal effort to maintain self-esteem and competent public and private self-image. Most of the research undertaken regarding the practice of self-handicapping has been conducted in the context of education, work, and sporting activities. However, in other contexts this phenomenon is less explored and loosely defined. With regards to romantic relationships, there is a distinct lack of knowledge to explain why some people, having successfully initiated a relationship, embark upon what appears to be a path to certain dissolution of that engagement. Studies will need to be conducted to provide evidence for this phenomenon and directions for practical approaches in relationship counselling.