Self-Esteem in Adults with Tourette Syndrome and Chronic Tic Disorders: The Roles of Tic Severity, Treatment, and Comorbidity

Authors

Hilary Weingarden, Harvard Medical School
Lawrence Scahill, Emory University
Susanne Hoeppner, Harvard Medical School
Alan L. Peterson, University of Texas Health Science Center - San AntonioFollow
Douglas W. Woods, Marquette UniversityFollow
John T. Walkup, Northwestern UniversityFollow
John Piacentini, University of California - Los AngelesFollow
Sabine Wilhelm, Harvard Medical School

Document Type

Article

Language

eng

Publication Date

7-2018

Publisher

Elsevier

Source Publication

Comprehensive Psychiatry

Source ISSN

0010-440X

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.

Comments

Accepted version. Comprehensive Psychiatry, Vol. 84 (July 2018): 95-100. DOI. © 2018 Elsevier. Used with permission.

Recommended Citation

Weingarden, Hilary; Scahill, Lawrence; Hoeppner, Susanne; Peterson, Alan L.; Woods, Douglas W.; Walkup, John T.; Piacentini, John; and Wilhelm, Sabine, "Self-Esteem in Adults with Tourette Syndrome and Chronic Tic Disorders: The Roles of Tic Severity, Treatment, and Comorbidity" (2018). Psychology Faculty Research and Publications. 437.
https://epublications.marquette.edu/psych_fac/437