Date of Award

Spring 2020

Document Type


Degree Name

Master of Science (MS)


Clinical Psychology

First Advisor

Woods, Douglas

Second Advisor

Torres, Lucas

Third Advisor

Kaugars, Astrida


The present study used parent-report data of clinical characteristics, tic severity, and reactions to tics to explore cross-cultural similarities and differences in 223 children with Tourette’s disorder (TD) from the United States, United Kingdom, and Netherlands/Norway. First, the clinical characteristics of age at onset, male to female ratio, and comorbidities of individuals from the three groups of countries were explored. Parents from the United Kingdom reported a significantly later age at onset for their children than parents from the United States. There were no differences in the other clinical characteristics among the participants from the different countries. Second, psychometric properties of the TARS-PR and PTQ were examined in participants from the three groups of countries, and results indicated that both measures are suitable for examining consequences of tics and tic severity, respectively, in the United Kingdom and Netherlands/Norway. Further, results demonstrated no differences in parent-reported tic severity scores among the three groups of countries after controlling for lifetime tic medication status. However, parents of children with TD from the United Kingdom reported significantly more reactions to their child’s tics than parents from the United States and Netherlands/Norway. This finding suggests that therapists may need to consider spending more time managing contextual factors if clients are from the United Kingdom. Additional exploratory analyses examined the strength of the relationship between reaction to tics and tic severity, and results indicated that the relationship between parent-reported reactions to tics and parent-reported tic severity was significantly stronger for participants from the Netherlands/Norway than those from the United States. This suggests that managing reactions to tics in the Netherlands/Norway may have stronger influence on tic expression than in individuals from some other countries. Future research should focus on broadening these findings to more countries and examining if different races/ethnicities within the same country vary in their reactions to tics.

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Psychology Commons