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Hong JS, Choi MJ, Gómez A, Padilla YC, Espelage DL. How receiving welfare assistance could be linked to children's bullying victimization: Exploring the potential pathways. BEHAVIORAL SCIENCES & THE LAW 2024. [PMID: 38741415 DOI: 10.1002/bsl.2663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 04/19/2024] [Accepted: 04/29/2024] [Indexed: 05/16/2024]
Abstract
The study proposes and tests the pathways from receiving welfare assistance to children's bullying victimization. Specifically, the study examines whether children's difficulty making friends and school disconnection mediate the association between welfare assistance receipt to children's bullying victimization. The 2019 National Survey of Children's Health dataset was used, and the sample consisted of 12,230 caregivers of adolescents, aged 12-17 years. A path model was utilized to explore the proposed pathways. Findings suggest that welfare assistance receipt was not significantly associated with children's bullying victimization. It was positively related to children's bullying victimization through the mediating roles of having difficulty making friends and school disconnection. Schools and communities need to create spaces where youth can connect with peers, which is an important part of their development.
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Affiliation(s)
- Jun Sung Hong
- School of Social Work, Wayne State University, Detroit, Michigan, USA
- Department of Social Welfare, Ewha Womans University, Seoul, South Korea
| | - Mi Jin Choi
- School of Social Work, Texas State University, San Marcos, Texas, USA
| | - Anthony Gómez
- School of Social Welfare, University of California Berkeley, Berkeley, California, USA
| | - Yolanda C Padilla
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, Texas, USA
| | - Dorothy L Espelage
- School of Education, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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2
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Pring K, Malli M, Hardy BW, Rapp SR, Storch EA, Mink JW, Martindale JM. Reframing stigma in Tourette syndrome: an updated scoping review. Eur Child Adolesc Psychiatry 2023:10.1007/s00787-023-02332-3. [PMID: 38159134 DOI: 10.1007/s00787-023-02332-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 11/28/2023] [Indexed: 01/03/2024]
Abstract
Persistent tic disorders (PTD) such as Tourette's syndrome (TS) are common childhood-onset neurodevelopmental disorders. Stigmatization of individuals with these disorders remains an ongoing problem. The purpose of this scoping review is to serve as an updated review of the research regarding stigmatization in youth with PTD since the publication of the original systematic review about this topic in 2016. The electronic databases Embase, Web of Science, PubMed, PsycINFO, and CINAHL were searched. Of the 4751 initial articles screened after removing duplications, 47 studies met the inclusion criteria. The studies were examined under the social-ecological stigmatization model, which helps categorize stigmatization into individual, interpersonal, community, and structural levels and serves as a broader definition of stigmatization than the previous systematic review. On the individual level, youth with PTD had lower self-esteem than peers, often leading to fear of future stigmatization, avoidant behaviors, and self-stigmatization. They also experienced higher rates of bullying and other forms of abuse than peers at the interpersonal level. At the community level, youth with PTD faced discriminatory environments in school and work and limited availability of community services and healthcare access. At the structural level, knowledge about PTD was limited in the general population, often about the limited portrayals of PTD in the media. We hope that the broader scope of this review serves to help inform future efforts to decrease the stigmatization faced by this group.
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Affiliation(s)
- Kelly Pring
- Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Melina Malli
- Institute of Population Ageing, University of Oxford, Oxford, UK
| | - Brandy W Hardy
- Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Stephen R Rapp
- Department of Psychology and Behavioral Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Eric A Storch
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | | | - Jaclyn M Martindale
- Department of Neurology, Wake Forest University School of Medicine, North Carolina, Winston-Salem, NC, USA.
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3
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Lee MY, Wang HS, Chen CJ. Psychosocial experiences in youth with Tourette syndrome: a systematic review and meta-synthesis. Eur Child Adolesc Psychiatry 2023:10.1007/s00787-023-02339-w. [PMID: 38129352 DOI: 10.1007/s00787-023-02339-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 11/28/2023] [Indexed: 12/23/2023]
Abstract
Suffering from Tourette syndrome (TS) disrupts the daily lives and interpersonal relationships of patients. The psychosocial experiences of young people with TS are not yet clear. The aim of the systematic review is to identify and synthesize the psychosocial experiences of young people with TS. A meta-synthesis was conducted. PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature, Web of Science, and Chinese Electronic Periodical Services databases were searched for articles published from their inception to February 2023. This review followed the Joanna Briggs Institute's Guidelines for Systematic Reviews according to a previously developed protocol. We used the confidence of synthesized qualitative findings (ConQual) approach to evaluate the credibility and dependability of the synthesized findings. This review included 12 qualitative studies from Western and Asian countries published between 2005 and 2019, representing 190 young people with TS. We identified five synthesized findings: affliction by intractable TS, TS was negatively perceived in the social and cultural context, self-adjustment in response to social interaction, response to receiving various interventions, and positivity in promoting self-acceptance. The ConQual grade for each generated synthesized finding ranged from low to moderate. The psychosocial experiences of youths living with TS are unique and are influenced by their interpersonal relationships, social context, and cultural framework. The findings recommend that healthcare providers assist young people in developing personalized symptom management strategies and provide guidance and care that meets the needs of each individual.
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Affiliation(s)
- Mei-Yin Lee
- National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
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4
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Shiu C, Chen W, Kim B, Ricketts E, Stiede JT, Espil FM, Specht MW, Woods DW, Piacentini J. The Roles of Lifetime Enacted Stigma in Tic Symptoms among Young Adults with Tourette Syndrome. Mov Disord Clin Pract 2023; 10:1759-1768. [PMID: 38094654 PMCID: PMC10715356 DOI: 10.1002/mdc3.13900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 08/24/2023] [Accepted: 10/04/2023] [Indexed: 02/01/2024] Open
Abstract
Background Although rarely framed as enacted stigma, adults with Tourette syndrome (ATS) have long suffered from discrimination associated with their tic symptoms. Given the high stress levels of enacted stigma that ATS experience, it is expected that their tic symptoms are profoundly impacted. However, the evidence linking enacted stigma to ATS's tic symptoms remains limited. Methods This study used a secondary data-analysis approach to reanalyze the data from the follow-up phase of a multi-centered, randomized controlled trial in which a behavioral intervention was tested for its efficacy in managing tic symptoms. This study first conducted psychometric testing on a list of 16 enacted stigma events across five life stages and identified the underlying factor structure. The Yale Global Tic Severity Scale (YGTSS) was used to assess severity and impairment of current tic symptoms, whereas the Clinical Global Impression of Severity scale (CGI) was used to obtain the gestalt of clinical judgment on tic severity. A series of multivariate linear models were then fitted to test the relationships between different types of lifetime enacted stigma and current tic symptoms. Results The analytic sample included 73 young ATS (average age of 23.2 [standard deviation = 2.5] years). The factor analysis identified three types of enacted stigmas: "traumatic events," "confrontations," and "subtle mistreatments." In multivariate models, traumatic events significantly associated with YGTSS-severity, whereas subtle mistreatments provided additional explanations for CGI. Conclusions Enacted stigma may play important roles in shaping ATS's current tics symptom severity and, therefore, should be carefully considered in future intervention development.
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Affiliation(s)
- Chengshi Shiu
- Department of Social Work and Taiwan Social Resilient Research CenterNational Taiwan UniversityTaipeiTaiwan
- School of NursingUniversity of CaliforniaLos AngelesCaliforniaUSA
| | - Wei‐Ti Chen
- School of NursingUniversity of CaliforniaLos AngelesCaliforniaUSA
| | - Boram Kim
- School of NursingUniversity of CaliforniaLos AngelesCaliforniaUSA
| | - Emily Ricketts
- Department of PsychologyMarquette UniversityMilwaukeeWisconsinUSA
| | - Jordan T. Stiede
- Department of Psychiatry and Behavioral SciencesBaylor College of MedicineHoustonTexasUSA
- Department of Psychiatry and Biobehavioral SciencesUniversity of CaliforniaLos AngelesCaliforniaUSA
| | - Flint M. Espil
- Department of Psychiatry and Behavioral SciencesStanford UniversityStanfordCaliforniaUSA
| | | | - Douglas W. Woods
- Department of Psychiatry and Behavioral SciencesBaylor College of MedicineHoustonTexasUSA
| | - John Piacentini
- Department of PsychologyMarquette UniversityMilwaukeeWisconsinUSA
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5
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Haegele JA, Zhu X. Prevalence of Bullying Victimization and Perpetration Among Youth with Chronic Health Conditions in the United States. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:881-888. [PMID: 38045843 PMCID: PMC10689641 DOI: 10.1007/s40653-023-00569-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/17/2023] [Indexed: 12/05/2023]
Abstract
Background Bullying perpetration and victimization have gained widespread recognition as major public health issues. However, few studies focused on exploring prevalence rates across impairments or chronic health conditions exist in the literature. The primary purpose of this analysis was to provide current estimates of bullying victimization and perpetration among US youth with 24 chronic health conditions. A secondary purpose was to examine associations between the number of chronic health conditions and bullying victimization and perpetration. Methods Data from the 2019-2020 National Survey of Children's Health, nationally representative cross-sectional probability sample of noninstitutionalized youth, were used. This study focused on 29,285 adolescents (aged 12-17 years), including 14,203 with a chronic condition. Pearson's χ2 tests were used to examine proportional equivalence on bullying perpetration and victimization, and logistic regression analyses were used to explore associations between the number of chronic conditions and bullying behaviors. Results A significantly higher proportion of adolescents with chronic health conditions engaged in bullying perpetration and victimization compared to those without a chronic health condition. Those with autism spectrum disorder, developmental delay, and depression were noted as having elevated proportions of bullying victimization, whereas those with behavioral or conduct problems, blood disorders, and depression had higher rates of perpetration. Conclusions This analysis helps to identify several groups of adolescents in need of targeted interventions to help reduce bullying rates. Those experiencing more than one chronic health condition were 3.56 and 2.97 times as likely to engage in bullying victimization and perpetration, respectively, compared to those with no condition.
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Affiliation(s)
- Justin A. Haegele
- Old Dominion University, Norfolk, USA
- Center for Movement, Health & Disability, Department of Human Movement Sciences, Old Dominion University, Norfolk, USA
- Department of Human Movement Sciences, Old Dominion University, Norfolk, USA
| | - Xihe Zhu
- Old Dominion University, Norfolk, USA
- Center for Movement, Health & Disability, Department of Human Movement Sciences, Old Dominion University, Norfolk, USA
- Department of Human Movement Sciences, Old Dominion University, Norfolk, USA
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Hartmann A, Andrén P, Atkinson-Clément C, Czernecki V, Delorme C, Monique Debes NM, Müller-Vahl K, Paschou P, Szejko N, Topaloudi A, Ueda K, Black KJ. Tourette syndrome research highlights from 2022. F1000Res 2023; 12:826. [PMID: 37691732 PMCID: PMC10483181 DOI: 10.12688/f1000research.135702.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/18/2023] [Indexed: 09/12/2023] Open
Abstract
This is the ninth yearly article in the Tourette Syndrome Research Highlights series, summarizing selected research reports from 2022 relevant to Tourette syndrome. The authors briefly summarize reports they consider most important or interesting.
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Affiliation(s)
- Andreas Hartmann
- Department of Neurology, Pitié-Salpêtrière Hospital, Assistance Publique - Hopitaux de Paris, Paris, Île-de-France, 75013, France
| | - Per Andrén
- Department of Psychology, University of Lund, Lund, Sweden, Sweden
| | | | - Virginie Czernecki
- Department of Neurology, Pitié-Salpêtrière Hospital, Assistance Publique - Hopitaux de Paris, Paris, Île-de-France, 75013, France
| | - Cécile Delorme
- Department of Neurology, Pitié-Salpêtrière Hospital, Assistance Publique - Hopitaux de Paris, Paris, Île-de-France, 75013, France
| | | | | | | | - Natalia Szejko
- Department of Neurology, University of Calgary, Calgary, Alberta, Canada
| | | | - Keisuke Ueda
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, Missouri, 63110-1010, USA
| | - Kevin J. Black
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, Missouri, 63110-1010, USA
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Ricketts EJ, Wolicki SB, Holbrook JR, Rozenman M, McGuire JF, Charania SN, Piacentini J, Mink JW, Walkup JT, Woods DW, Claussen AH. Clinical Characteristics of Children With Tourette Syndrome With and Without Sleep Disorder. Pediatr Neurol 2023; 141:18-24. [PMID: 36736236 PMCID: PMC10590926 DOI: 10.1016/j.pediatrneurol.2022.12.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 11/22/2022] [Accepted: 12/22/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND Sleep problems are common in children with Tourette Syndrome (TS). However, research regarding their demographic and clinical profile is limited. METHODS We examined characteristics of 114 children aged five to 17 years with a lifetime diagnosis of TS and compared children with sleep disorder (n = 32) and without sleep disorder (n = 82). Parent report from the 2014 National Survey of the Diagnosis and Treatment of ADHD and Tourette Syndrome provided demographics and clinical information, other diagnosed disorders, medication use, TS severity, and impairment. RESULTS More children with TS with sleep disorder were from households with lower parental education (P < 0.01) and poverty (P = 0.04); had other diagnoses (P = 0.03), including obsessive-compulsive disorder (P < 0.01), oppositional defiant disorder or conduct disorder (P < 0.01), attention-deficit/hyperactivity disorder (ADHD) (P = 0.02), and autism (P = 0.03); and had ever used TS medication (P = 0.01) than children with TS without sleep disorder. More children with TS with sleep disorder had severe TS symptoms (P <0.01), tic-related impairment (P<0.01), and severe ADHD symptoms (P < 0.01) compared with children with TS without sleep disorder. CONCLUSIONS Findings suggest greater parent-reported impact and tic-related interference in children with TS with sleep disorder compared with TS without sleep disorder. Results underscore the importance of monitoring and intervention for TS exacerbations, other diagnosed disorders, and medication use, and consideration of socioeconomic context in sleep disorder management and prevention in children with TS.
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Affiliation(s)
- Emily J Ricketts
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California.
| | - Sara Beth Wolicki
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Joseph R Holbrook
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Joseph F McGuire
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Sana N Charania
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - John Piacentini
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California
| | - Jonathan W Mink
- Department of Neurology, University of Rochester Medical Center, Rochester, New York
| | - John T Walkup
- Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois; Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Douglas W Woods
- Department of Psychology, Marquette University, Milwaukee, Wisconsin
| | - Angelika H Claussen
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Resztak JA, Choe J, Nirmalan S, Wei J, Bruinsma J, Houpt R, Alazizi A, Mair-Meijers HE, Wen X, Slatcher RB, Zilioli S, Pique-Regi R, Luca F. Analysis of transcriptional changes in the immune system associated with pubertal development in a longitudinal cohort of children with asthma. Nat Commun 2023; 14:230. [PMID: 36646693 PMCID: PMC9842661 DOI: 10.1038/s41467-022-35742-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 12/21/2022] [Indexed: 01/18/2023] Open
Abstract
Puberty is an important developmental period marked by hormonal, metabolic and immune changes. Puberty also marks a shift in sex differences in susceptibility to asthma. Yet, little is known about the gene expression changes in immune cells that occur during pubertal development. Here we assess pubertal development and leukocyte gene expression in a longitudinal cohort of 251 children with asthma. We identify substantial gene expression changes associated with age and pubertal development. Gene expression changes between pre- and post-menarcheal females suggest a shift from predominantly innate to adaptive immunity. We show that genetic effects on gene expression change dynamically during pubertal development. Gene expression changes during puberty are correlated with gene expression changes associated with asthma and may explain sex differences in prevalence. Our results show that molecular data used to study the genetics of early onset diseases should consider pubertal development as an important factor that modifies the transcriptome.
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Affiliation(s)
- Justyna A Resztak
- Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI, USA
| | - Jane Choe
- Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI, USA
| | - Shreya Nirmalan
- Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI, USA
| | - Julong Wei
- Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI, USA
| | - Julian Bruinsma
- Department of Psychology, Wayne State University, Detroit, MI, USA
| | - Russell Houpt
- Department of Psychology, Wayne State University, Detroit, MI, USA
| | - Adnan Alazizi
- Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI, USA
| | | | - Xiaoquan Wen
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | | | - Samuele Zilioli
- Department of Psychology, Wayne State University, Detroit, MI, USA
- Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI, USA
| | - Roger Pique-Regi
- Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI, USA.
- Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI, USA.
| | - Francesca Luca
- Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI, USA.
- Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI, USA.
- Department of Biology, University of Rome Tor Vergata, Rome, Italy.
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Systematic Review and Meta-Analysis of Tourette Syndrome Prevalence; 1986 to 2022. Pediatr Neurol 2022; 137:6-16. [PMID: 36182698 DOI: 10.1016/j.pediatrneurol.2022.08.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 08/23/2022] [Accepted: 08/25/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Tourette syndrome (TS) is a disorder characterized by a history of multiple motor tics and the emergence of at least one vocal tic during a period of the disorder. The current investigation sought to clarify the prevalence statistics for TS using a systematic review and meta-analysis. METHODS This systematic review and meta-analysis covered the period between 1986 and 2022. Embase, Scopus, PubMed, Web of Science, and Google Scholar were searched to locate articles pertinent to the study topic. The I2 index was used to examine the heterogeneity of the studies, and a comprehensive meta-analysis was employed to analyze the data. RESULTS Ultimately, 30 studies (39 outcomes) were included in the meta-analysis and systematic review. The results showed the global prevalence of TS to be 0.5% (95% confidence interval [CI], 0.3% to 0.8%), with the highest rate of spread observed in the Americas at 0.6% (95% CI, 0.2% to 1.6 %). Analyzing the subgroups of the sample revealed that the highest prevalence was associated with the population of children and adolescents at 0.7% (95% CI, 0.4% to 1.4%) and males at 0.5% (95% CI, 0.2% to 1.0%). CONCLUSIONS This comprehensive review and meta-analysis revealed that the prevalence of TS worldwide is sufficiently high, such that attention of medical specialists and health policy makers is warranted.
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Tinker SC, Bitsko RH, Danielson ML, Newsome K, Kaminski JW. Estimating the number of people with Tourette syndrome and persistent tic disorder in the United States. Psychiatry Res 2022; 314:114684. [PMID: 35724469 PMCID: PMC10645081 DOI: 10.1016/j.psychres.2022.114684] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 06/02/2022] [Accepted: 06/13/2022] [Indexed: 11/21/2022]
Abstract
Estimates of the number of people in the U.S. with Tourette syndrome or other persistent tic disorders can inform service provision planning. Based on available prevalence estimates applied to 2020 population data from the U.S. Census, we estimated that 350,000-450,000 U.S. children and adults have Tourette syndrome and about one million have other persistent tic disorders. Variation across studies makes estimating the total number of people in the United States affected by these disorders challenging. More precise measurement could ensure that prevalence estimates accurately reflect all who are impacted by these disorders and who could benefit from evidence-based services.
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Affiliation(s)
- Sarah C Tinker
- Child Development and Disability Branch, Division of Human Development and Disability, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Rebecca H Bitsko
- Child Development and Disability Branch, Division of Human Development and Disability, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Melissa L Danielson
- Child Development and Disability Branch, Division of Human Development and Disability, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kimberly Newsome
- Child Development and Disability Branch, Division of Human Development and Disability, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jennifer W Kaminski
- Child Development and Disability Branch, Division of Human Development and Disability, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Mataix-Cols D, Virtanen S, Sidorchuk A, Fernández de la Cruz L, Larsson H, Lichtenstein P, Latvala A. Association of Tourette Syndrome and Chronic Tic Disorder With Violent Assault and Criminal Convictions. JAMA Neurol 2022; 79:459-467. [PMID: 35311941 PMCID: PMC8938899 DOI: 10.1001/jamaneurol.2022.0167] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Importance Tic disorders are associated with multiple social adversities, but little is known about the experience of violent assault (including sexual assault) and criminality in this group. Objective To establish if Tourette syndrome (TS) and chronic tic disorder (CTD) are associated with an increased risk of experiencing violent assault and criminal convictions. Design, Setting, and Participants In this cohort study, all individuals living in Sweden at any time between January 1, 1973, and December 31, 2013, were identified from Swedish nationwide health and administrative registers. Cox proportional hazards regression models were used to estimate the risk of violent assault and criminal convictions among people with TS or CTD, compared with the general population and unaffected full siblings. Data analyses were conducted between September 1 and October 22, 2021. Exposures The Swedish version of the International Classification of Diseases, Eighth Revision (ICD-8), ICD-9, and ICD-10 diagnoses of TS or CTD in the Swedish National Patient Register. Main Outcomes and Measures Records of sexual and nonsexual violent assault and death due to violent assaults were obtained from the National Patient Register and the Cause of Death Register, respectively. Convictions for violent and nonviolent criminal offenses were obtained from the Crime Register. Covariates included sex and birth year. Results The study cohort included 13 819 284 individuals living in Sweden between 1973 and 2013. A total of 7791 individuals with TS or CTD were identified (median [IQR] age at first diagnosis, 13.4 [10.0-21.8] years; 5944 [76%] male). Compared with unaffected individuals from the general population, people with TS or CTD had a 2-fold increased risk of experiencing any violent assault (sexual and nonsexual) (adjusted hazard ratio [aHR], 2.21; 95% CI, 2.00-2.43), a 3-fold increased risk of violent convictions (aHR, 3.13; 95% CI, 2.92-3.36), and a 1.6-fold increased risk of nonviolent crime convictions (aHR, 1.62; 95% CI, 1.54-1.71). Among people with TS or CTD, 37.0% (114 of 308; 95% CI, 31.6%-42.4%) of individuals who had experienced violent assault also had a violent crime conviction, compared with 17.9% (16 067 of 89 920; 95% CI, 17.6%-18.1%) in the general population. Exclusion of individuals with attention-deficit/hyperactivity disorder and substance use disorders partially attenuated the associations. Similarly, within-sibling models attenuated but did not eliminate the associations (any violent assault: aHR, 1.32; 95% CI, 1.08-1.61; violent crime: aHR, 2.23; 95% CI, 1.86-2.67; nonviolent crime: aHR, 1.34; 95% CI, 1.20-1.50). Conclusions and Relevance Results of this cohort study suggest that most individuals with TS or CTD are not assaulted nor are perpetrators of crime. However, individuals with TS or CTD diagnosed in specialist settings were more likely to both experience violent assault and be perpetrators of violence compared with the general population. The risk was highest in individuals with comorbid attention-deficit/hyperactivity disorder and substance use disorders. The increased risk found in specialty clinics will need to be better understood in the general population.
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Affiliation(s)
- David Mataix-Cols
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Suvi Virtanen
- Institute of Criminology and Legal Policy, University of Helsinki, Helsinki, Finland.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Anna Sidorchuk
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Lorena Fernández de la Cruz
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Antti Latvala
- Institute of Criminology and Legal Policy, University of Helsinki, Helsinki, Finland.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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