title: Development of the Yale Children's Global Stress Index (YCGSI) and its application in children and adolescents ith Tourette's syndrome and obsessive-compulsive disorder.
abstract: OBJECTIVE
  The Yale Children's Global Stress Index (YCGSI) is a new clinical rating instrument designed to provide objective global clinician ratings of psychosocial stress in studies of children and adolescents. This study was designed to evaluate the psychometric properties of the YCGSI.
  
  
  METHODS
  Independent ratings of clinical severity and psychosocial stress were obtained at two time points separated by 4 months from 33 subjects with Tourette's syndrome (TS) and/or early-onset obsessive-compulsive disorder (OCD), aged 7 to 17 years, and 25 age-matched control subjects. Parents and children were interviewed separately. Multiple measures of stress were obtained including the YCGSI and the Daily Life Stressors Scale (DLSS).
  
  
  RESULTS
  Data support the interrater reliability and convergent and divergent validity of the YCGSI. At both time points, children and adolescents with TS and OCD had, on average, experienced significantly more psychosocial stress than did the controls. Cross-sectional ratings of tic and obsessive-compulsive symptom severity did not correlate with the YCGSI, but did correlate with self-report ratings of stress on the DLSS. In contrast, ratings on the YCGSI were associated with clinician ratings of depression.
  
  
  CONCLUSIONS
  The YCGSI has acceptable psychometric properties. Children and adolescents with TS and OCD appear to be at increased risk of experiencing higher levels of psychosocial stress and adversities compared with their peers in the community. Future studies need to examine the possible differential contributions of distinctive forms of stress on the intramorbid course of these disorders.
authors.affiliation: Child Study Center, Yale University School of Medicine, 230 South Frontage Road, New Haven, CT 06520-7900, USA. James.Leckman@yale.edu
authors.forename: Diane B
authors.initials: DB
authors.lastname: Findley
authors.forename: James F
authors.initials: JF
authors.lastname: Leckman
authors.forename: Liliya
authors.initials: L
authors.lastname: Katsovich
authors.forename: Haiqun
authors.initials: H
authors.lastname: Lin
authors.forename: Heping
authors.initials: H
authors.lastname: Zhang
authors.forename: Heidi
authors.initials: H
authors.lastname: Grantz
authors.forename: Jessica
authors.initials: J
authors.lastname: Otka
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Lombroso
authors.forename: Robert A
authors.initials: RA
authors.lastname: King
mesh_terms: D000293:Adolescent; D002648:Child; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis*; D011446:Prospective Studies; D011594:Psychometrics; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D005879:Tourette Syndrome / Q000175:diagnosis*