Carter A S, Pauls D L, Leckman J F, Cohen D J
Department of Psychology, Yale University, New Haven, CT 06510.
J Am Acad Child Adolesc Psychiatry. 1994 Mar-Apr;33(3):377-85. doi: 10.1097/00004583-199403000-00012.
The goals of this study were to estimate the frequency of Gilles de la Tourette's syndrome (TS), tics, and other behavioral disorders among children at risk for TS and to examine the association of family functioning with children's diagnostic status and social-emotional functioning.
A prospective longitudinal design was used. Young children who were not displaying any tic behaviors but who had a first-degree relative with TS were recruited. Children's diagnostic status, social-emotional functioning, and family functioning were assessed with the Schedule for Tourette and Other Behavioral Syndromes, Vineland Adaptive Behavior Scales, Child Behavior Checklist, the Harter Self Perception Profile, and Family Environment Scale.
Increased rates of tic disorders, obsessional and anxiety symptoms, and attentional and speech difficulties were observed. Family functioning, independent of parental psychopathology, was associated with attention-deficit and anxiety disorders, decreased adaptive and increased maladaptive behaviors, and lower self-esteem but not tic spectrum or learning disorders.
The observed rates of tic disorders add support for an autosomal dominant mode of transmission. Family functioning appears to play an important role in non-tic disorders as well as adaptive and maladaptive behaviors. Family, cognitive-behavioral, and interpersonal therapies should be considered to address the social-emotional difficulties that often accompany TS.
本研究的目的是估计患抽动秽语综合征（TS）风险儿童中TS、抽动及其他行为障碍的发生率，并探讨家庭功能与儿童诊断状况及社会情感功能之间的关联。
采用前瞻性纵向设计。招募未表现出任何抽动行为但有一位患TS的一级亲属的幼儿。使用抽动秽语及其他行为综合征量表、文兰适应行为量表、儿童行为清单、哈特自我认知量表和家庭环境量表对儿童的诊断状况、社会情感功能和家庭功能进行评估。
观察到抽动障碍、强迫和焦虑症状以及注意力和言语困难的发生率增加。独立于父母精神病理学的家庭功能与注意力缺陷和焦虑障碍、适应性行为减少和适应不良行为增加以及自尊降低相关，但与抽动谱系或学习障碍无关。
观察到的抽动障碍发生率为常染色体显性遗传模式提供了支持。家庭功能似乎在非抽动障碍以及适应性和适应不良行为中发挥重要作用。应考虑采用家庭、认知行为和人际治疗来解决TS常伴随的社会情感困难。
