Abstract
BackgroundTourette’s syndrome (TS) is a poorly understood neurodevelopmental disorder consistently associated with impaired peer relationships. This research aimed to investigate the relationship between TS and the ability of diagnosed youth to form secure attachment relationships with peers. A quantitative study examined differences between youth with TS and typically developing peers in social functioning, relationship problems and attachment security. Qualitative studies sought to identify factors that enhanced or impeded the ability to form secure peer relationships, including the impact of tic severity, comorbidity and personality traits. All research was conducted from the parental perspective.MethodsThe research consisted of a controlled, survey-based qualitative and quantitative study (Study One) of parents of youth with TS (n = 86) and control group peers (n = 108), and a qualitative telephone interview-based study of TS group parents (Study Two, n = 22). Quantitative assessment of social functioning, peer problems and peer attachment security was conducted using the Paediatric Quality of Life inventory, the Strengths and Difficulties Questionnaire and the Attachment Questionnaire for Children. Qualitative data relating to personality was classified using the Five Factor Model.ResultsResults revealed significantly higher rates of insecure peer attachment, problems in peer relationships, difficulty making friends, stigmatisation and lower levels of social functioning for the TS group. Significant between-group differences in number and type of factors impacting peer relationships were also determined with ‘personality’ emerging as the most prevalent factor. Whilst Extraversion and Agreeableness facilitated friendships for both groups, higher rates of Neuroticism were barriers to friendship for individuals with TS. The TS group also identified multiple ‘non-personality’ factors impacting peer relationships, including TS and comorbid symptom severity, the child’s psychological and behavioural adjustment to their disorder, coping strategies and the behaviour and attitudes of peers.DiscussionOur findings suggest that, whilst Extraversion and Agreeableness facilitated friendships for both groups, higher rates of Neuroticism were barriers to friendship for individuals with TS. Notwithstanding the fact that these findings are based on parental report and not the perceptions of youth themselves, this study may help clinicians to identify youth at increased risk of developing insecure peer relationships and guide the development of targeted supports.ConclusionsThe findings from the study may help clinicians, parents and individuals with TS to better understand and cope with the difficulties experienced in interactions with peers.Electronic supplementary materialThe online version of this article (doi:10.1186/s40359-015-0090-3) contains supplementary material, which is available to authorized users.
Highlights
Tourette’s syndrome (TS) is a poorly understood neurodevelopmental disorder consistently associated with impaired peer relationships
Tourette’s syndrome (TS) is a complex neurodevelopmental disorder characterised by the presence of multiple motor and vocal tics occurring for a period of at least one year [1]
The majority of participants in Study One were the biological mothers of the child or adolescent TS group = 91 %, Controls = 89 %), resided in metropolitan areas (TS group = 59 %, Controls = 62 %), were married (TS Group = 84 %, Controls = 82 %) and reported an average or above level of income (TS Group = 67 %, Controls = 70 %)
Summary
Tourette’s syndrome (TS) is a poorly understood neurodevelopmental disorder consistently associated with impaired peer relationships. This research aimed to investigate the relationship between TS and the ability of diagnosed youth to form secure attachment relationships with peers. A quantitative study examined differences between youth with TS and typically developing peers in social functioning, relationship problems and attachment security. Qualitative studies sought to identify factors that enhanced or impeded the ability to form secure peer relationships, including the impact of tic severity, comorbidity and personality traits. Tourette’s syndrome (TS) is a complex neurodevelopmental disorder characterised by the presence of multiple motor and vocal tics occurring for a period of at least one year [1]. Recent quality of life studies (QoL) on paediatric TS populations have revealed strong relationships between the disorder and decreased QoL, with the highest level of impairment evident in psychosocial functioning [4,5,6,7,8,9,10,11]. Prior research has found that youth with TS experience an increased incidence of bullying, teasing, peer victimisation and social rejection [11], have difficulty making and maintaining friends, have lower quality and numbers of close friends [12, 13] and are more likely to be negatively evaluated by peers [14, 15]
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