Theory of mind in neurodevelopmental disorders: beyond autistic spectrum disorder

INTRODUCTION

Theory of mind (ToM) is the human ability to perceive, interpret, and attribute the mental states of other people, and the alteration of this cognitive function is a core symptom of autistic spectrum disorder (ASD). In such other neurodevelopmental disorders as childhood-onset obsessive-compulsive disorder (OCD) and Tourette syndrome (TS) that can present with cognitive dysfunctions, ToM has been less extensively studied, especially in the young population. The aim of the study was to compare advanced ToM between groups of young people diagnosed with OCD, TS, or ASD and a control group.

METHODS

Clinical interviews were conducted with male patients aged between 11 and 17 years with a main diagnosis of OCD (n = 19), TS (n = 14), or ASD (n = 18), and a control group (n = 20). We administered instruments for estimating intelligence quotient and severity of psychiatric symptoms, and tasks to evaluate ToM (the "Stories from everyday life" task and the "Reading the mind in the eyes" test).

RESULTS

Young people with TS and with ASD present similar difficulties in solving advanced ToM tasks, whereas patients with childhood-onset OCD present similar results to controls.

CONCLUSIONS

ToM is altered in other neurodevelopmental disorders beyond ASD, such as TS.

Tic disorders and premonitory urges: validation of the Spanish-language version of the Premonitory Urge for Tics Scale in children and adolescents

INTRODUCTION

Most people with persistent tics report an unpleasant sensation (premonitory urge) before the tic. In recent years, interest in these sensory phenomena has increased due to their important role in behavioural therapy. However, instruments for assessing these sensations remain scarce. Among the available instruments, the Premonitory Urge for Tics Scale (PUTS) is the most widely used.

METHODS

We examined the psychometric properties and factor structure of the Spanish-language version of the PUTS in a sample of 72 children and adolescents with Tourette syndrome or persistent tic disorders. We analysed data from the total sample and by age group (children up to 10 years old and children/adolescents over 10).

RESULTS

The PUTS presented good internal consistency and moderate correlations between items on the scale (except for item 1). Divergent validity was good, test-retest reliability was adequate, and a bifactorial structure was identified (one dimension related to mental phenomena reported in obsessive-compulsive disorder, and another related to the quality and frequency of premonitory urges). These results were replicated in both age groups, with lower divergent validity and test-retest reliability in the younger group.

CONCLUSIONS

The Spanish-language version of the PUTS is a valid, reliable tool for assessing premonitory urges in both children and adolescents, especially after the age of 10.

Theory of mind in neurodevelopmental disorders: Beyond autistic spectrum disorder

INTRODUCTION

Theory of mind (ToM) is the human ability to perceive, interpret, and attribute the mental states of other people, and the alteration of this cognitive function is a core symptom of autistic spectrum disorder (ASD). In such other neurodevelopmental disorders as childhood-onset obsessive-compulsive disorder (OCD) and Tourette syndrome (TS) that can present with cognitive dysfunctions, ToM has been less extensively studied, especially in the young population. The aim of the study was to compare advanced ToM between groups of young people diagnosed with OCD, TS, or ASD and a control group.

METHODS

Clinical interviews were conducted with male patients aged between 11 and 17 years with a main diagnosis of OCD (n=19), TS (n=14), or ASD (n=18), and a control group (n=20). We administered instruments for estimating intelligence quotient and severity of psychiatric symptoms, and tasks to evaluate ToM (the "Stories from everyday life" task and the "Reading the mind in the eyes" test).

RESULTS

Young people with TS and with ASD present similar difficulties in solving advanced ToM tasks, whereas patients with childhood-onset OCD present similar results to controls.

CONCLUSIONS

ToM is altered in other neurodevelopmental disorders beyond ASD, such as TS.

Tic disorders and premonitory urges: validation of the Spanish-language version of the Premonitory Urge for Tics Scale in children and adolescents

INTRODUCTION

Most people with persistent tics report an unpleasant sensation (premonitory urge) before the tic. In recent years, interest in these sensory phenomena has increased due to their important role in behavioural therapy. However, instruments for assessing these sensations remain scarce. Among the available instruments, the Premonitory Urge for Tics Scale (PUTS) is the most widely used.

METHODS

We examined the psychometric properties and factor structure of the Spanish-language version of the PUTS in a sample of 72 children and adolescents with Tourette syndrome or persistent tic disorders. We analysed data from the total sample and by age group (children up to 10 years old and children/adolescents over 10).

RESULTS

The PUTS presented good internal consistency and moderate correlations between items on the scale (except for item one). Divergent validity was good, test-retest reliability was adequate, and a bifactorial structure was identified (one dimension related to mental phenomena reported in obsessive-compulsive disorder, and another related to the quality and frequency of premonitory urges). These results were replicated in both age groups, with lower divergent validity and test-retest reliability in the younger group.

CONCLUSIONS

The Spanish-language version of the PUTS is a valid, reliable tool for assessing premonitory urges in both children and adolescents, especially after the age of 10.

Validation of the Spanish version of the Dimensional Yale-Brown Obsessive-Compulsive Scale (DYBOCS) in children and adolescents

BACKGROUND

Obsessive-compulsive disorder (OCD) is best understood as a complex overlap of obsessive-compulsive (OC) symptom dimensions with specific clinical and etiological characteristics. The Dimensional Yale-Brown Obsessive-Compulsive Scale (DYBOCS) was developed to assess the presence and severity of each of these OC symptom dimensions. Despite showing excellent psychometric properties in adults, the psychometric properties of the DYBOCS have not been widely investigated in children and adolescents.

METHODS

We examined the psychometric properties of the DYBOCS Spanish version in a sample of 97 OCD children and adolescents.

RESULTS

The results of the psychometric analyses were excellent overall. The internal consistency for each OC symptom dimension was high, although somewhat lower than in previous studies with adult samples. The DYBOCS showed overall good convergent and divergent validity. Factors obtained from a principal component analysis corresponded with the five DYBOCS dimensions (aggressive; sexual/religious; contamination; symmetry; and hoarding) and each one accounted for approximately 20% of the variance.

CONCLUSIONS

The DYBOCS is a valid instrument for assessing the frequency and severity of OC symptom dimensions in children and adolescents with OCD. The principal component analysis supported the division of OC symptoms into five dimensions. OCD is a heterogeneous disorder, and a dimensional approach can help to understand its clinical, etiological and treatment response characteristics.