Obsessive-compulsive Problems Research Articles

Predictive associations of executive functions and oppositional defiant problems and obsessive-compulsive problems in preschoolers

ABSTRACT Oppositional defiant problems (ODP) and obsessive-compulsive problems (OCP) may co-occur in children, though the way they interact is not known. The aim of the study was to examine longitudinal associations between executive functions at age 3 and ODP, ODP dimensions, and OCP at age 6. The sample consisted of 622 preschoolers (50% were boys) from the general population. Executive functions were assessed by teachers using the Behavior Rating Inventory of Executive Functioning – Preschool version questionnaire when children were 3 years old, and ODP and OCP were informed by parents and teachers at the age of 6 years. Multiple linear regression analyses indicated that higher Inhibit and Emotional Control and lower Shift deficits were associated with higher ODP reported by teachers, while higher Shift but lower Inhibit deficits were related to higher OCP. Moreover, ODP and OCP shared difficulties on the Flexibility Index, which means that the capacity to modulate emotions and behavior according to contextual and environmental demands is compromised in both disorders. The findings inform etiology and prevention, pointing out not only the executive function specificities related to each problem, but also common cognitive challenges related to Flexibility. Young children could benefit from training and programs designed to improve executive function processes at an early age to prevent later behavioral difficulties.

Transcranial sonography of subcortical structures in tic/tourette disorder

Functional neuroimaging studies demonstrate disinhibition of the cortico-striatal-thalamo-cortical circuit. However, structural imaging studies revealed conflicting results, some suggesting smaller volumes of the caudate nucleus (CN) in children with Gilles de la Tourette syndrome (TS). Here we wanted to find out whether transcranial sonography (TCS) detects alterations of raphe nuclei, substantia nigra, lenticular nucleus (LN), or CN in children with Tic disorder or TS (TIC/TS).The study included 25 treatment-naive children (age: 12.2 ± 2.5 years) with a DSM-V based diagnosis of Tic disorder or TS (10 subjects), without other psychiatric or neurologic diagnosis, and 25 healthy controls (age: 12.17 ± 2.57 years), matched for age and sex. Parental rating of behavioral, emotional abnormalities, somatic complaints and social competencies of the participants were assessed using the Child Behavior Check List (CBCL/4-18R). TCS of deep brain structures was conducted through the preauricular acoustic bone windows using a 2.5-MHz phased-array ultrasound system.Fisher's exact test and Mann-Whitney-U test were used for comparisons between TIC/TS patients and healthy volunteers. The number of participants with hyperechogenic area of left CN in the TIC/TS sample was increased, compared to the healthy control group. TIC/TS patients with hyperechogenic CN showed an increased occurrence of thought- and obsessive-compulsive problems. This TCS study revealed pathologic structural changes in CN, its higher occurrence in TIC/TS compared to healthy controls and the relation to comorbidity of thought problems. Further research should focus on the molecular cause of these alterations, probably the disturbed iron metabolism.

Potential Sociodemographic Predictors of Childhood Anxiety Disorders: A Cross-Sectional Study

Background: Previous studies have shown that the prevalence of anxiety among primary school students in rural areas is relatively high. Also, this stage is a critical developmental stage of academic life. Childhood anxiety disorders lead to significant disruption and interference with other aspects of life, including behavioral, emotional, cognitive, and academic achievement. Aims: This study aimed to find the frequency of 6 subtypes of anxiety disorders and to determine the potential sociodemographic factors of anxiety disorders among primary school students in a rural area of Malaysia. Methods: This was a cross-sectional study in which 411 students answered the Spence Children’s Anxiety Scale-Child version (SCAS-C). Descriptive analyses elucidated at-risk students, and multivariate analysis of variance and multiple linear regression presented potential predictors of anxiety disorders. Results: The most common abnormal level was for social phobia (SP) (n = 109/18.6%), and the least common were panic/agoraphobia (n = 85/14.1%) and physical injury fears (PIF) (n = 82/13.6%). Multivariate analysis of variance revealed that age ( P < .05), gender ( P < .05), father’s employment ( P < .05), and mother’s educational level (EL) P < .05) were predictors of overall anxiety. A Tukey post-hoc test revealed that older children are more likely to suffer from overall anxiety, separation anxiety (SA), SP, and obsessive-compulsive problems. Children of low-income families were less likely to suffer from SA than those of middle-income families. Children of stay-at-home mothers were less likely to suffer from overall anxiety, SA, and SP than mothers who worked more than 8 h per day. Multiple linear regression could predict 6 models of anxiety based on sociodemographic factors. Conclusion: According to our findings in this study, promoting mental health by providing preventive strategies and screening programs is more recommended for students with sociodemographic risk factors for anxiety disorders.

Childhood Imaginary Companion and Schizotypy in Adolescents and Adults

Objective: This study evaluated the association of Childhood Imaginary Companion (CIC) status and schizotypy levels of adolescents and adults within the framework of the Hierarchical Taxonomy of Psychopathology (HiTOP). Method: The sample included 255 Iranian adolescents and adults, grouped according to their CIC status, who responded mostly via e-questionnaires on a website. Schizotypy dimensions were compared between these two groups. Two measures compatible with the HiTOP model were also evaluated both in relation to the short scale of the Oxford-Liverpool Inventory of Feelings and Experiences (sO-LIFE) schizotypy dimensions and the CIC status of participants; one scale used exclusively with adolescents (i.e., the Achenbach System of Empirically-Based Assessment-Youth Self-Report [ASEBA-YSR]), and another with adults (i.e., the NEO-Five Factor Inventory [NEO-FFI]). Results: Scores on the unusual experiences (UnEx) the impulsive nonconformity (ImpNon) dimensions, and the total score of the sO-LIFE were higher for the CIC group. For adolescents, the UnEx dimension and the Thought Problems subscale of the ASEBA-YSR correlated. Scores on three subscales of the ASEBA-YSR (i.e., Thought Problems, Obsessive-Compulsive Problems, and PTSD Problems) were significantly higher for the CIC group. For adults, the neuroticism domain of the NEO-FFI correlated strongly with total score of the sO-LIFE and the cognitive disorganization (CogDis) dimension. This domain of the NEO-FFI was the only one in which CIC adults scored higher than the NIC group. Conclusion: CIC in adolescents and adults is associated with a set of schizotypy dimensions in line with the concept of the “happy schizotype.”

Gender-Related Clinical Characteristics in Children and Adolescents with ADHD.

Attention Deficit/Hyperactivity Disorder (ADHD) is the most frequently diagnosed neurodevelopmental disorder in school-age children, and it is usually associated with a significant impairment in global functioning. Traditionally, boys with ADHD are more likely to be referred for clinical assessments due to a higher prevalence of externalizing symptoms. However, as regards gender-related differential clinical characteristics between boys and girls with ADHD, further investigation is warranted in light of conflicting results found in currently available literature. In fact, a more precise clinical characterization could help increase appropriate diagnoses and treatment planning. In this context, we carried out a retrospective observational study on 715 children and adolescents diagnosed with ADHD from 2018 to 2020 at our center, in order to describe their gender-related clinical characteristics. Boys displayed higher average IQs, but they were comparable to girls in functional impairments and adaptive skills. Girls displayed higher scores on the Attention Problems subscale of the CBCL 6–18 and on several CPRS-R:L subscales, suggesting higher general ADHD symptom severity. Boys showed higher scores on CBCL 6–18 subscales, such as withdrawn/depressed, internalizing, and obsessive-compulsive problems. In conclusion, girls showed more severe ADHD features and lower IQ in clinically referred settings, while boys showed more internalizing problems and obsessive-compulsive symptoms.

Irritability, Defiant and Obsessive-Compulsive Problems Development from Childhood to Adolescence

Little is known about the coexistence of oppositionality and obsessive-compulsive problems (OCP) in community children and how it affects their development until adolescence to prevent possible dysfunctions. The co-development of oppositional defiant dimensions and OCP is studied in 563 children (49.7% female) from ages 6 to 13 years, assessed yearly with measures answered by parents and teachers. A 4-class model based on Latent Class Growth Analysis for three parallel processes (irritability, defiant, and OCP) was selected, which showed adequate fitting indexes. Class 1 (n = 349, 62.0%) children scored low on all the measures. Class 2 (n = 53, 9.4%) contained children with high OCP and low irritability and defiant. Class 3 (n = 108, 19.2%) clustered children with high irritability and defiant and low OCP. Class 4 (n = 53, 9.4%) clustered comorbid irritability, defiant, and OCP characteristics. The classes showed different clinical characteristics through development. The developmental co-occurrence of irritability and defiant plus obsessive-compulsive behaviors is frequent and adds severity through development regarding comorbidity, peer problems, executive functioning difficulties, and daily functioning. The identification of different classes when combining oppositional problems and OCP may be informative to prevent developmental dysfunctions and to promote good adjustment through development.

Forgiveness in the Modulation of Responsibility in a Sample of Italian Adolescents with a Tendency towards Conduct or Obsessive-Compulsive Problems.

Although obsessive–compulsive disorder (OCD) and the conduct disorders (CD) express a contrasting symptomatology, they could represent different answers to a common matrix about morality. In the literature, some theoretical models describe people with OCD as individuals who experience high levels of responsibility and guilt. On the other hand, adolescents with a CD are described as if they do not feel guilty at all or consider anti-social purposes as more important than existing moral purposes. The aims of this study were to investigate the role of forgiveness in responsibility and guilt levels and to test whether this putative relation was influenced by tendencies towards obsessive–compulsive problems (OCP) or conduct problems (CP). In total, 231 adolescents aged between 16 and 18 years were self-assessed using a Youth Self-Report, Child Responsibility Attitudes Questionnaire, Heartland Forgiveness Scale, and Test Of Self-Conscious Affect. The results show that self-forgiveness predicted responsibility levels, while guilt was predicted by self-forgiveness and situation-forgiveness. Moreover, mediation analyses revealed that the effects of OCP on responsibility and guilt were mediated by self-forgiveness and situation-forgiveness. Regarding CP, no mediated effects were found. In conclusion, lower proneness to forgive increases responsibility and guilt, and this is particularly evident in subjects with higher levels of OCP.

1.2 Construct Validity of the Schwartz Outcome Scale-10 for Adolescents: Comparisons With the Youth Self-Report in an Outpatient Setting

The Schwartz Outcome Scale-10 (SOS-10) was initially developed to assess adult patients’ overall psychological health across a wide range of populations and pathologies. The primary purpose of the scale is to assess change over a patient’s treatment course, translating to overall treatment outcome. The SOS-10 was shown to be a valid measure of psychological health and well-being in both adult and adolescent inpatients. This study looks to extend the research with the SOS-10 by assessing its validity with an outpatient sample of adolescents and young adults utilizing a well-established questionnaire, the Youth Self-Report (YSR). This is essential for the growing need for determining the efficacy of treatments in real-time to further efficiency in the current climate of increasing demand yet continued scarcity of child and adolescent psychiatry resources. A total of 121 adolescent and young adult outpatients, and their parents when applicable, were consented. This sample consisted of 55% females with an average age of 18.77 years (SD = 3.2) and ethnicities of 35.3% White, 31.9% African American, 23.3% Hispanic, 2.6% Asian, and 6.9% identified as other. Diagnostically, 55% had a mood disorder, 19.3% ADHD, 8.3% conduct disorder/ODD, 8.3% PTSD, 0.9% psychosis, and 8.3% other. Of these 121 outpatients, 53 completed both the SOS-10 and the YSR as part of a larger intake battery of assessments. Higher scores on the SOS-10 are indicative of better psychological health. The SOS-10 was negatively correlated with YSR’s depressive problems (r = –0.54), anxiety problems (r = –0.33), somatic problems (r = –0.27), obsessive compulsive problems (r = –0.31), and stress problems (r = –0.42). Consistent with the study’s hypothesis, results demonstrate the SOS-10 as a valid tool for assessing psychological health and well-being in the adolescent and young adult outpatient population. The SOS-10 is easy to self-administer, is short in duration, and is applicable across various mental health disorders, therefore making it a feasible objective method of continually assessing patient progress in an outpatient setting. In doing so, treatment can potentially be tailored to patients’ levels of distress and psychological well-being.

4.3 Construct Validity of the Schwartz Outcome Scale-10 for Adolescents: Comparisons With the Youth Self-Report (YSR) in an Inpatient Setting

The Schwartz Outcome Scale-10 (SOS-10) measures psychological well-being through the use of a 10-item questionnaire. With an administration time of less than 5 minutes, the survey results can be obtained with relative ease, reducing burden on both patients as well as clinical staff. Initial research shows the survey to be well validated in adult populations. In comparison, the Youth Self-Report (YSR) consists of a 112-item survey that assesses behavioral and emotional problems. The YSR has been extensively studied, and is a well-validated measurement commonly used in adolescent populations. The purpose of this study is to further assess the construct validity of the SOS-10 using a sample of adolescent patients. This sample included 62 adolescent patients who were being treated at a large northeast teaching hospital’s adolescent inpatient unit. Patients were consented and completed an admission assessment packet that included the SOS-10 and the YSR upon admission to the unit. The average age of the patients was 15.7 years (SD = 1.1), and 52% were male. Regarding race, 59.2% were White, 31% were African American, 2.8% were Asian, and 7% were listed as “Other.” The primary diagnosis was 65% mood disorders, 30% conduct disorder/ODD, 3% PTSD, and 2% psychosis. The average length of stay for the patients was 10.8 days (SD = 5.22; range 2-32). The SOS-10 was negatively correlated with the YSR’s depressive problems (r = –0.66), anxiety problems (r = –0.42), somatic problems (r = –0.51), sluggish cognitive tempo (r = –0.46), obsessive-compulsive problems (r = –0.53), and stress problems (r = –0.58). These results demonstrate the relationship between a well-validated assessment in the YSR and a more easily implemented SOS-10. Study results enhance current validity research on SOS-10, a promising tool for use in outcome measurement in adolescent psychiatry.

Gender Differences in Anxiety, Depression, and Self-Esteem among Children of Alcoholics

Background: Children growing up in families with alcohol abuse are at high risk for anxiety, depression, and low self-esteem. The published studies mainly focused on the gender difference in behavioral problems among normal children, but only limited studies are focused on gender difference in anxiety, depression, and self-esteem among children of alcoholics (COAs). Materials and Methods: A cross-sectional descriptive survey research design was adopted for the present study. The study was conducted at selected government high school located in Bangalore South. The simple random sampling technique was used to select the participants for the study. COA screening test (modified) and pediatric symptom checklist were used for identifying COAs and behavioral problems. Spence Children's Anxiety Scale, Center for Epidemiological Studies Depression Scale for Children, and Rosenberg Self-Esteem Scale were used to assess anxiety, depression, and self-esteem, respectively. Data were analyzed using Statistical Package for the Social Sciences software package (Version 23). Results: The results showed that there is no statistically significant difference in mean scores of anxiety, depression, self-esteem, separation anxiety, social phobia, obsessive–compulsive problems, and physical injury between boys and girls COAs. Mean scores of generalized anxiety are high in boys compared to girls COAs. Conclusion: The study concluded that there is no gender difference in anxiety, depression, and self-esteem among COAs.

Anxiety, depression, self-esteem among children of alcoholic and nonalcoholic parents.

Context:Children of alcoholics (COAs) face risks of behavioral problems during childhood and mental health problems in adult life. Identifying these problems at the earliest can significantly reduce the problems in future.Aims:To compare the anxiety, depression, and self-esteem between COA and non-COA parents.Settings and Design:A cross-sectional comparative survey research design was adopted for the present study. The study was conducted at selected government high school located in Bangalore urban.Subjects and Methods:The simple random sampling technique was used. A total of 200 children comprising 100 children of each alcoholic parents and nonalcoholic were recruited for the study. A screening test (modified) was used for identifying COA. Spence Children's Anxiety Scale, Center for Epidemiological Studies Depression Scale for Children (CES-DC), and Rosenberg Self-Esteem Scale were used to assess anxiety, depression, and self-esteem, respectively.Statistical Analysis Used:Data were analyzed using Statistical Package for the Social Sciences software package (version 23).Results:The results show that there is statistically significant difference between COA and non-COA group with regard to anxiety, depression, self-esteem, separation anxiety, social phobia, obsessive compulsive problems, and physical injury.Conclusion:The study concludes that COAs are having higher rate of anxiety, depression, and low self-esteem compared with children of nonalcoholics.

Knots and black holes: why we’re all prone to madness and what we can do about it

AbstractPeople from all walks of life can suffer from mental health problems such as low mood, anxiety, obsessive-compulsive problems, even hearing voices. In extreme circumstances, people can begin to fear that other people are plotting to harm them, and some of us even take our own lives. While it is overwhelmingly true that traumatic experiences or on-going deprivation or abuse are possible factors that contribute to psychological problems, there remains an apparent capriciousness to mental health problems. Some people seem to rise above trauma; other people are plagued by great misery without obvious external causes. There is a tendency to explain these differences as reflecting personal, even biological, vulnerabilities. This article is published as part of a collection entitled “On balance: lifestyle, mental health and wellbeing”.

ADHD Prevalence in Spanish Preschoolers: Comorbidity, Socio-Demographic Factors, and Functional Consequences

Objective: The object was to examine the prevalence of ADHD among preschoolers, analyzing comorbidity, and the association with socio-demographic factors. Method: We conducted a two-phase epidemiological study of 1,104 preschoolers aged 3 to 6 years in Catalonia, Spain. The Early Childhood Inventory–4 (ECI-4) was administered to parents and teachers. Children at risk of ADHD were assessed using open-ended face-to-face interviews and were observed in a school setting. ADHD diagnoses were based on Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) criteria. Results: The prevalence of ADHD diagnosis was 5.4%. Male sex and first-born status were risk factors for ADHD. Parents reported more symptoms (12.9%) than teachers (8.7%). Behavioral problems (odds ratio [OR] = 12, p = .001), autism spectrum disorder problems (OR = 9.5, p = .001), and obsessive-compulsive problems and tics (OR = 5.9, p = .001) were specifically related to ADHD diagnosis. Mother’s health status and school achievement were lower in ADHD children. Conclusion: Even at early stages of development, ADHD has high rates of comorbidity and a significant impact on school performance and family health.

Sex moderates the association between symptoms of anxiety, but not obsessive compulsive disorder, and error-monitoring brain activity: A meta-analytic review.

Sex differences in cognition and emotion are particularly active areas of research. Much of this work, however, focuses on mean-level differences between the sexes on cognitive and/or emotional variables in isolation. In this article, we are primarily concerned with how sex affects associations between cognition and emotion, or cognition-emotion interactions. Specifically, the purpose of this paper is to shed light on a gap in our understanding of how sex affects the relationship between error monitoring, a core component of cognitive control, and anxiety. Using meta-analysis, we show that the relationship between symptoms of anxiety and a neurophysiological marker of error monitoring-the error-related negativity (ERN)-is significantly greater in women than men such that women, but not men, with higher levels of anxiety show a larger ERN. This sex difference held true across studies of anxiety-specific symptoms but not studies of obsessive-compulsive symptoms. These findings underscore the need to consider sex in studies of anxiety and the ERN as well as support growing evidence indicating that obsessive-compulsive problems are distinguishable from other anxiety-specific problems across multiple levels of analysis. Overall, we conclude that ignoring sex in studies of cognition-emotion interactions is unacceptable. Rather, future research that continues to tackle questions related to sex differences in associations between cognition and emotion will more likely lead to advancements in basic and applied sciences of relevance to health and human behavior.

18 Effect of different blanket weights on surface temperature of horses in cold environments

Some of the most frustrating behavior problems a horse can exhibit are stereotypies. These repetitive, useless behaviors significantly reduce a horse’s value and can affect their overall health. Cribbing is the best study of the stereotypies and has proven to be extremely complex. There are several other oral or head repetitive motions like head shaking and lip flapping. Additionally, locomotor stereotypies like circling and weaving are significant. Most relate to stress, especially that associated with various management practices. Stereotypies become obsessive-compulsive problems when they occur dissociated from the stressor. All forms of these problem vices are complicated to treat, usually involving medications to reduce their frequency. Other neurologic problems are expressed as behavior changes too.

15 The effects of interval versus continuous conditioning on physiological and kinematic parameters of equine fitness

Some of the most frustrating behavior problems a horse can exhibit are stereotypies. These repetitive, useless behaviors significantly reduce a horse’s value and can affect their overall health. Cribbing is the best study of the stereotypies and has proven to be extremely complex. There are several other oral or head repetitive motions like head shaking and lip flapping. Additionally, locomotor stereotypies like circling and weaving are significant. Most relate to stress, especially that associated with various management practices. Stereotypies become obsessive-compulsive problems when they occur dissociated from the stressor. All forms of these problem vices are complicated to treat, usually involving medications to reduce their frequency. Other neurologic problems are expressed as behavior changes too.

Sniffing around oxytocin: review and meta-analyses of trials in healthy and clinical groups with implications for pharmacotherapy

The popularity of oxytocin (OT) has grown exponentially during the past decade, and so has the number of OT trials in healthy and clinical groups. We take stock of the evidence from these studies to explore potentials and limitations of pharmacotherapeutic applications. In healthy participants, intranasally administered OT leads to better emotion recognition and more trust in conspecifics, but the effects appear to be moderated by context (perceived threat of the ‘out-group'), personality and childhood experiences. In individuals with untoward childhood experiences, positive behavioral or neurobiological effects seem lowered or absent. In 19 clinical trials, covering autism, social anxiety, postnatal depression, obsessive-compulsive problems, schizophrenia, borderline personality disorder and post-traumatic stress, the effects of OT administration were tested, with doses ranging from 15 IU to more than 7000 IU. The combined effect size was d=0.32 (N=304; 95% confidence interval (CI): 0.18–0.47; P<0.01). However, of all disorders, only studies on autism spectrum disorder showed a significant combined effect size (d=0.57; N=68; 95% CI: 0.15–0.99; P<0.01). We hypothesize that for some of the other disorders, etiological factors rooted in negative childhood experiences may also have a role in the diminished effectiveness of treatment with OT.

A Six‐year Prospective Study on Children of Mothers with Eating Disorders: The Role of Paternal Psychological Profiles

Several studies have suggested that maternal eating disorders (EDs) represent a significant risk factor for children's affective and behavioral development. Yet, little emphasis has been placed on the paternal role. The present longitudinal study aimed to clarify the role of maternal EDs and the influence of paternal psychological profiles on children's emotional development. Our sample was composed of N = 64 families with firstborn children selected through preschools, primary schools, and outpatient clinics in central Italy. Parents and children participated in a 6-year longitudinal protocol that included a diagnostic interview conducted by clinicians (Structured Clinical Interview for DSM-IV Axis I Disorders [SCID-I]), a self-report (Symptom Checklist-90-Revised [SCL-90-R]), and a parental report-form questionnaire (Child Behavior Checklist [CBCL]). The influence of mothers' EDs on their children's emotional development was confirmed. Moreover, fathers' anxiety and obsessive-compulsive problems in association with mothers' EDs and depressive symptoms influenced the onset of both internalizing and externalizing difficulties in their children over time. Our results suggest that fathers' psychopathological risk affects the development of emotional problems in children with mothers who have EDs.

Second-Order Factor Structure of the Vancouver Obsessive Compulsive Inventory (VOCI) in a Non-Clinical Sample

The Vancouver Obsessive Compulsive Inventory (VOCI) is a self-report measure of the severity of obsessive-compulsive problems such as contamination, checking, obsessions, hoarding, needing things to be just right, and indecisiveness. In the seminal paper a six-correlated-factor structure was found in a sample of OC patients, but the issue of the factor structure of the VOCI in non-clinical populations was not addressed. This study assesses the psychometric properties and the factor structure of the Italian version of the VOCI in a non-clinical sample. The VOCI was administered to a large community sample (n = 445). Some participants also completed a battery including measures of OC behaviour, worry, anxiety and depression (n = 89) and were administered the VOCI twice at an 8-week interval (n = 46). Confirmatory factor analyses replicated the six-correlated-factor structure originally found in a patient sample, but a more parsimonious, second-order-factor model showed a statistically higher fit, suggesting that VOCI subscales can be considered as facets of a higher-order OCD factor. The whole item pool and each of the subscales showed good internal consistency, unidimensionality, test-retest reliability and convergent construct validity. As in the original version, limited support for discriminant validity was found. Scores were weakly associated with age, gender and education. Although some key issues still need to be investigated (e.g. sensitivity to change), the VOCI seems to be a psychometrically sound instrument for the assessment of OCD-related behaviours and thoughts and can be used in cultural contexts different from the original.

Fetal Alcohol Syndrome, Tourette Syndrome, and Hyperactivity in Nine Adopted Children

Much attention has been paid in recent years to the role of prenatal exposure to alcohol. Fetal alcohol syndrome is one of the most severe afflictions resulting from such exposure. The present report documents the cases of adopted children diagnosed with fetal alcohol syndrome who developed both Tourette syndrome and attention deficit-hyperactivity disorder. Out of a population of 138 adopted children with behavior issues whose clinical histories were reviewed retrospectively, 9 children (6.5%) presented this constellation. Epidemiologic data, clinical data, neurologic examination findings, complementary testing, and developmental data were recorded. All nine patients studied had initial psychomotor retardation, despite the frequent case of subsequent intelligence quotient normalization. From a behavioral perspective, half of the cases presented obsessive-compulsive disorder and problems with social relations. Aggressive behavior was common. These cases also presented a high degree of severity of both tics and hyperactivity. The most common drug treatment was methylphenidate. This constellation of fetal alcohol syndrome, Tourette syndrome, and attention deficit-hyperactivity disorder is scantly reported in the literature and is likely underdiagnosed. This particular constellation poses its own prognosis and requires its own treatment.