Clinical phenomenology of episodic rage in children with Tourette syndrome.
ABSTRACT Episodic rage of unknown etiology causes significant morbidity in children with Tourette's syndrome (TS). Using modified Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for intermittent explosive disorder (IED), we developed a screen and symptom questionnaire to explore rage attack phenomenology and to preliminarily investigate whether symptom clusters can identify clinical subgroups of TS children with rage attacks.
48 children with TS between ages 7 and 17 years consecutively presenting with rage attacks completed the Rage Attacks Screen and Questionnaire. Data was subjected to factor analysis. Cluster analytic procedures were used to identify clinical subgroups.
Final cluster solution revealed four homogeneous subgroups of TS children with rage who were differentiated by predominant clinical characteristics: specific urge resolution, environmentally secure reactivity, nonspecific urge resolution or labile nonresolving.
Episodic rage in TS has stereotypic features, but diverse and complex etiologies. Identifying particular symptom clusters may facilitate improved treatment strategies.
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ABSTRACT: For children with Tourette syndrome (TS), explosive outbursts (EO) can be more disruptive than tics to the child's functioning. This study evaluated the effectiveness of an innovative cognitive-behavioral intervention for decreasing frequency and intensity of EO. Five boys and one girl ranging in age from 9 to 12 years took part in the study. EO frequency and intensity were measured by systematic observation of events and by questionnaire, while tics and child's psychosocial functioning were measured by questionnaires. The children showed trends towards decreased EO frequency post treatment but no changes in EO intensity. Statistical analysis and questionnaires results revealed no significant change. Qualitative information indicated a benefit to the families following therapy.Pratiques Psychologiques 09/2012; 18(3):221-244. DOI:10.1016/j.prps.2010.07.001 · 0.27 Impact Factor
- When Things Go Wrong - Diseases and Disorders of the Human Brain, 02/2012; , ISBN: 978-953-51-0111-6
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ABSTRACT: Motor and phonic tics are the defining characteristics of Tourette syndrome (TS). However, several comorbidities are frequently associated and the most prevalent in children are Attention Deficit Hyperactivity Disorder (ADHD) and Obsessive Compulsive Disorder. Oppositional and aggressive behaviors are also highly rated for children with TS. Explosive outbursts (EO) have been defined as a disproportionate rage attack, which occurs in a sudden intensity and a recurring way according to a situational profile. EO have been viewed as a result of interplay between various comorbidities, particularly ADHD. This study evaluated the effectiveness of an innovative cognitive-behavioral intervention for decreasing frequency and intensity of EO. A case series of a child (10 years old) who participated in the program and who is showing ADHD comorbid to TS is presented. EO frequency and intensity were measured by systematic observation of events and by questionnaires. The child showed trends towards decreased EO frequency, mostly with the implementation of cognitive-behavioral exercises but no changes in EO intensity.Journal de Thérapie Comportementale et Cognitive 09/2010; 20(3):104-111. DOI:10.1016/j.jtcc.2010.09.007