Influence of Stress and Psychiatric Symptoms on Children With Tourette Syndrome

Vanderbilt University Medical Center66 enrolled

Overview

Investigators propose a cross-sectional, observational pilot study to examine the contribution of stress, family dynamics, and peer relationships to quality of life (QOL) in adolescents with Tourette syndrome (TS). Investigators will recruit two groups of participants: 1) adolescents aged 13-17 years of age with TS and 2) adolescents aged 13-17 without any neurologic or psychiatric diagnoses. Participants and one of their parents/caregivers will complete a series of questionnaires screening for and quantifying the extent of stress and mental health symptoms, including anxiety, depression, obsessive compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD). Participants will also complete instruments characterizing family interactions and peer relationships. Adolescents with TS will also undergo a semi-structured interview assessing the severity of their tics.

Tourette syndrome (TS) is a multi-faceted neurodevelopmental disorder with wide-ranging impact on adolescent quality of life (QOL). Comorbid psychiatric and psychological factors exert greater influence on QOL than tics in TS, but the specific role of stress, family dynamics, and peer relationships has been largely overlooked, despite the fact that these factors are known to impact QOL in those with chronic disease. Investigators propose a cross-sectional, observational pilot study to examine the contribution of stress, family dynamics, and peer relationships to QOL in adolescents with TS. The primary goal of this study is to collect sufficient data for hypothesis-generation and power analysis refinement in planning of a larger scale study. Investigators will recruit adolescents aged 13-17 years of age with TS presenting for regular care at the Vanderbilt Pediatric Neurology Clinic. Adolescents without any neurologic or psychiatric diagnoses will be recruited as a control population. Participants and one of their parents/caregivers will complete a series of questionnaires screening for and quantifying the extent of stress and mental health symptoms, including anxiety, depression, obsessive compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD). Participants will also complete instruments characterizing family interactions and peer relationships. The scale battery can be completed by the adolescent and caregiver in parallel and is anticipated to take 60-75 minutes total to complete. Adolescents with TS will also undergo a semi-structured interview assessing the severity of their tics. The study plans to enroll subjects over a 12-month time frame.

Study Type

OBSERVATIONAL

Eligibility

Sex: ALLMin age: 13 YearsMax age: 17 Years

Medical Language ↔ Plain English

Inclusion Criteria for adolescents with TS: * adolescent age 13-17 years of age * adolescent diagnosis of Tourette syndrome (TS) * English-speaking adolescent and caregiver (as validated questionnaires are in English) * adolescent and caregiver willingness and ability to complete relevant questionnaires Exclusion Criteria for adolescents with TS: * cognitive or attentional impairment precluding ability of adolescent or caregiver to complete self-report questionnaires * adolescent diagnosis of genetic conditions besides TS and its known comorbidities * adolescent with severe medical conditions unrelated to TS (e.g. uncontrolled seizures, prominent heart conditions) Inclusion Criteria for adolescents without any neurologic or psychiatric diagnoses: * adolescent age 13-17 years of age * no history of tics * English-speaking adolescent and caregiver * adolescent and caregiver willingness and ability to complete relevant questionnaires Exclusion Criteria for adolescents without any neurologic or psychiatric diagnoses: * cognitive or attentional impairment precluding ability of adolescent or caregiver to complete self-report questionnaires * adolescent with severe medical conditions

Outcomes

Primary Outcomes

Youth Quality of Life Research Version (YQOL-R)

Self-report quality of life scale comprised of 42 items with 10-point Likert scale (raw total score 0-420) and 15 additional items with open-ended and demographic questions. Higher scores indicate better overall quality of life.

Time frame: Baseline

Secondary Outcomes

Cohen's Perceived Stress Scale

Self-report stress scale comprised of 10 items (total score range 0-40). Higher scores indicate greater perceived stress.

Time frame: Baseline

PedsQL - Family Impact Module

Caregiver-report scale comprised of 36 items (total score range 0-100) assessing impact of health condition(s) on family. Higher scores indicate better family functioning in context of health-related condition(s).

Time frame: Baseline

Conners-3 Parent Short QuikScore Forms

Caregiver-report scale comprised of 45 items assessing inattention, hyperactivity, and executive functioning of child. T-scores are generated, with higher scores indicating greater deviation from norms.

Time frame: Baseline

Revised Children's Anxiety and Depression Scale (RCADS) - Parent Report

Caregiver-report scale comprised of 47 items assessing mood symptoms. T-scores are generated, with higher scores indicating greater deviation from norms.

Time frame: Baseline

Revised Children's Anxiety and Depression Scale (RCADS) - Self-Report

Self-report scale comprised of 47 items assessing mood symptoms. T-scores are generated, with higher scores indicating greater deviation from norms.

Time frame: Baseline

Yale Global Tic Severity Scale (YGTSS)

Semi-structured clinician-administered interview assessing tic severity, with total tic score range of 0-50 and functional impairment scale range of 0-50. Higher scores indicate greater tic severity and functional impairment, respectively. This measure will only be administered to adolescents with TS.

Time frame: Baseline

School and Mental Health Services Inventory

Questionnaire assessing educational and functional status of child. No total score generated.

Time frame: Baseline

Rosenberg Self Esteem Scale

Self-report self-esteem scale comprised of 10 items (total score range 10-40). Higher scores indicate higher self-esteem.

Time frame: Baseline

Kearney's Daily Life Stressors Scale

Self-report scale consisting of 30 items (total score range 0-120) assessing degree of stress caused by daily activities. Higher scores indicate greater burden from daily stressors.

Time frame: Baseline

McMaster Family Assessment Device

Self-report scale consisting of 60 items (total score range 0-180) assessing structural, organizational, and interactional aspects of family environment. The scale contains subscales, the scores of which are added to create a composite overall score, with higher scores indicative of more supportive family environment.

Time frame: Baseline

PROMIS Peer Relationships Short Form 8a - Self Report

Self-report scale consisting of 8 items (total score is composite of individual item scores, ranked on Likert scale from 1-5) assessing quality of peer relationships. Total raw scores are converted to a T-score. Higher scores indicate more positive perception of peer relationships.

Time frame: Baseline

PROMIS Peer Relationships Short Form 8a - Proxy-Report

Proxy-report scale consisting of 8 items (total score is composite of individual item scores, ranked on Likert scale from 1-5) assessing quality of child's peer relationships. Total raw scores are converted to a T-score. Higher scores indicate more positive perception of child peer relationships.

Time frame: Baseline

Influence of Stress and Psychiatric Symptoms on Children With Tourette Syndrome

Overview

Conditions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes