Self-esteem in adults with Tourette syndrome and chronic tic disorders

The roles of tic severity, treatment, and comorbidity

Hilary Weingarden*, Lawrence Scahill, Susanne Hoeppner, Alan L. Peterson, Douglas W. Woods, John Timothy Walkup, John Piacentini, Sabine Wilhelm

*Corresponding author for this work

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Tourette syndrome (TS) and chronic tic disorders (CTD) are stigmatizing disorders that may significantly impact self-esteem. Alternatively, comorbid psychiatric illnesses may affect self-esteem more than tics themselves. Extant research on self-esteem in TS/CTD is limited, has inconsistently examined the effect of comorbidities on self-esteem, and yields mixed findings. Method: This study aimed to clarify the roles of tics versus comorbid diagnoses on self-esteem in a large, carefully diagnosed sample of adults with TS/CTD (N = 122) receiving 10 weeks of Comprehensive Behavioral Intervention for Tics (CBIT) or Psychoeducation and Supportive Therapy (PST). Results: Baseline self-esteem did not differ between adults with TS/CTD only and normative means, whereas self-esteem was significantly lower among adults with TS/CTD with a comorbid psychiatric illness. In a multiple regression testing the baseline association between tic severity, presence of comorbid psychiatric illness, and depression severity with self-esteem, comorbidity and depression severity were significantly associated with self-esteem, whereas tic severity was not. Finally, using a generalized linear model, we tested the effects of treatment assignment, comorbidity, and their interaction on changes in self-esteem across treatment, controlling for baseline depression severity. Results showed that for those with a comorbid illness, self-esteem improved significantly more with CBIT than with PST. Conclusions: Comorbid illnesses appear to affect self-esteem more so than tics among adults with TS/CTD. Therapeutic attention should be paid to treating comorbid diagnoses alongside tics when treating TS/CTD.

Original languageEnglish (US)
Pages (from-to)95-100
Number of pages6
JournalComprehensive Psychiatry
Volume84
DOIs
StatePublished - Jul 1 2018

Fingerprint

Tic Disorders
Tics
Tourette Syndrome
Self Concept
Comorbidity
Psychiatry
Depression

Keywords

  • Chronic tic disorder
  • Comorbidity
  • Comprehensive Behavioral Intervention for Tics
  • Self-esteem
  • Tourette syndrome

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

Cite this

Weingarden, Hilary ; Scahill, Lawrence ; Hoeppner, Susanne ; Peterson, Alan L. ; Woods, Douglas W. ; Walkup, John Timothy ; Piacentini, John ; Wilhelm, Sabine. / Self-esteem in adults with Tourette syndrome and chronic tic disorders : The roles of tic severity, treatment, and comorbidity. In: Comprehensive Psychiatry. 2018 ; Vol. 84. pp. 95-100.
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abstract = "Background: Tourette syndrome (TS) and chronic tic disorders (CTD) are stigmatizing disorders that may significantly impact self-esteem. Alternatively, comorbid psychiatric illnesses may affect self-esteem more than tics themselves. Extant research on self-esteem in TS/CTD is limited, has inconsistently examined the effect of comorbidities on self-esteem, and yields mixed findings. Method: This study aimed to clarify the roles of tics versus comorbid diagnoses on self-esteem in a large, carefully diagnosed sample of adults with TS/CTD (N = 122) receiving 10 weeks of Comprehensive Behavioral Intervention for Tics (CBIT) or Psychoeducation and Supportive Therapy (PST). Results: Baseline self-esteem did not differ between adults with TS/CTD only and normative means, whereas self-esteem was significantly lower among adults with TS/CTD with a comorbid psychiatric illness. In a multiple regression testing the baseline association between tic severity, presence of comorbid psychiatric illness, and depression severity with self-esteem, comorbidity and depression severity were significantly associated with self-esteem, whereas tic severity was not. Finally, using a generalized linear model, we tested the effects of treatment assignment, comorbidity, and their interaction on changes in self-esteem across treatment, controlling for baseline depression severity. Results showed that for those with a comorbid illness, self-esteem improved significantly more with CBIT than with PST. Conclusions: Comorbid illnesses appear to affect self-esteem more so than tics among adults with TS/CTD. Therapeutic attention should be paid to treating comorbid diagnoses alongside tics when treating TS/CTD.",
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Self-esteem in adults with Tourette syndrome and chronic tic disorders : The roles of tic severity, treatment, and comorbidity. / Weingarden, Hilary; Scahill, Lawrence; Hoeppner, Susanne; Peterson, Alan L.; Woods, Douglas W.; Walkup, John Timothy; Piacentini, John; Wilhelm, Sabine.

In: Comprehensive Psychiatry, Vol. 84, 01.07.2018, p. 95-100.

Research output: Contribution to journalArticle

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AU - Weingarden, Hilary

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AU - Peterson, Alan L.

AU - Woods, Douglas W.

AU - Walkup, John Timothy

AU - Piacentini, John

AU - Wilhelm, Sabine

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N2 - Background: Tourette syndrome (TS) and chronic tic disorders (CTD) are stigmatizing disorders that may significantly impact self-esteem. Alternatively, comorbid psychiatric illnesses may affect self-esteem more than tics themselves. Extant research on self-esteem in TS/CTD is limited, has inconsistently examined the effect of comorbidities on self-esteem, and yields mixed findings. Method: This study aimed to clarify the roles of tics versus comorbid diagnoses on self-esteem in a large, carefully diagnosed sample of adults with TS/CTD (N = 122) receiving 10 weeks of Comprehensive Behavioral Intervention for Tics (CBIT) or Psychoeducation and Supportive Therapy (PST). Results: Baseline self-esteem did not differ between adults with TS/CTD only and normative means, whereas self-esteem was significantly lower among adults with TS/CTD with a comorbid psychiatric illness. In a multiple regression testing the baseline association between tic severity, presence of comorbid psychiatric illness, and depression severity with self-esteem, comorbidity and depression severity were significantly associated with self-esteem, whereas tic severity was not. Finally, using a generalized linear model, we tested the effects of treatment assignment, comorbidity, and their interaction on changes in self-esteem across treatment, controlling for baseline depression severity. Results showed that for those with a comorbid illness, self-esteem improved significantly more with CBIT than with PST. Conclusions: Comorbid illnesses appear to affect self-esteem more so than tics among adults with TS/CTD. Therapeutic attention should be paid to treating comorbid diagnoses alongside tics when treating TS/CTD.

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