Quality School

Prediction of Functional Impairment and Quality of Life in Youth with Tourette s Syndrome

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Lack1, Storch2, Simons3, Murphy2, Geffken2

Caleb W. Eric A. Laura E. Tanya K. & Gary R. 2 University of Florida

3 Children s Hospital, Boston

Table 3

Introduction Results Results (cont.)

Impairment due to Tics Stepwise Multiple Regression Analyses for Prediction of Parent-reported

Regression Analyses

While development of tics during childhood for a short period of time Quality of Life

There was a wide range of endorsement on particular types of Stepwise multiple regression analyses were used to examine the

is fairly normative (Kurlan, Behr, & Medved, 1988), youth with full-

impairments, but the majority of the sample reported significant relationship between severity of tics, internalizing and externalizing

blown Tourette s Syndrome (TS) experience a wide range of Significance

functional problems in one or more areas (52.1%), with 37.5% of problems, social problems, peer victimization, and degree of Variable Multiple R R Adjusted R F change of F

functional impairments and behavioral difficulties. These typically

the sample reporting significant problems in two or more areas. The impairment due to tics as measured by the CTIM-P (see Table 2).

include school-related problems (Abwender et al., 1996; Erenberg,

areas where parents reported the highest percentage of impairment Step 1 .220 .049 .013 1.35 .267

On Step 1, gender and age were entered on the first step to control

Cruse & Rothner, 1986), difficulty coping with TS (Ernberg, Cruse, & Gender, age

(defined as a rating of pretty much or very much on CTIM-P) due for demographic effects and accounted for 15.9% of the variance.

Rothner, 1987), social interactions (Storch et al., in press), and a

to tics were primarily school related, such as writing during class The Social Problems scale of the CBCL entered on step two, Step 2 .710 .505 .476 47.90

lower overall quality of life than their peers without TS (Elstner, Selai,

(24.6%), doing homework (21.9%), concentrating on work (21.8%), + CBCL Internalizing

accounting for an additional 12.9%, with Phonic scale of the YGTSS

Trimble, & Robertson, 2001). In addition, highly disruptive behavior

and being prepared for class (18.5%), or social activity related, such added on step three and adding 6.8% to the model. On the last

(Sukhodolsky et al., 2003) and anxiety and mood disturbance Step 3 .775 .601 .570 12.33 .001

as being teased by peers (17.5%) and making new friends (15.8%). step, the total of the SPVS was entered, accounting for a total

(Robertson, Banerjee, Eapen, & Fox-Hiley, 2002) are very common in + CBCL Social Problems

There was a wide range of endorsement on particular items, but the adjusted R2 to .408 for the total model (p = .023).

youths with TS. Consequently, there is a high comorbidity between

majority of the sample reported significant problems in one or more Note: CBCL Externalizing, SVPS, YGTSS Motor, YGTSS Phonic and YGTSS Total did not enter into

TS and other psychiatric disorders, including attention- the equation.

areas (52.1%), with 37.5% of the sample reporting significant Two more stepwise multiple regressions were used to examine

deficit/hyperactivity disorder (ADHD; 50-75% of cases; Robertson et

problems in two or more areas. Across broad categories of prediction of quality of life, as reported by both parents and children.

al., 2002) and obsessive-compulsive disorder (OCD; 50% of cases;

impairment, 35.6% of children were reported as having at least one For the first analysis, examining prediction of parent-reported QoL

Robertson, 1995). Little research, however, has been conducted to

significant problem area in school, 23.7% were reported to have at (see Table 3), gender and age were entered on step one and

examine what factors are predictive of current functional impairment Table 4

least one significant problem area at home, and 25.4% were accounted for 1.3% of the variance. The CBCL Internalizing scale

and quality of life in youths with TS. The factors examined in the

reported to have at least one problem area in social activities. Of Stepwise Multiple Regression Analyses for Prediction of Child-reported

entered on step two and accounted for 46.3% of the variance in

current exploratory study are demographic variables, such as age,

those children with significant problems, 10.2% reported at least one Quality of Life

parent-reported QoL. The Social Problems scale of the CBCL entered

gender, and race, current emotional and behavioral difficulties, and

problem area in each domain (school, home, and social activities). on the final step of the model, bringing the total adjusted R2 to .570 Significance

the specific type of TS symptoms possessed.

Variable Multiple R R Adjusted R F change of F

for the model (p = .001).

Behavioral and Emotional Functioning

Step 1 .278 .077 .042 2.21 .119

Table 1 gives the means and standard deviations for the various To predict child-reported quality of life, another analysis was run. As Gender, age

measures of behavioral and emotional functioning in the current before, gender and age were entered on step one to control for

Method study, as well as the Pearson product moment correlations between Step 2 .637 .406 .371 28.74

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