title: Factors impacting the quality of peer relationships of youth with Tourette's syndrome.
abstract: BACKGROUND
  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. All research was conducted from the parental perspective.
  
  
  METHODS
  The 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.
  
  
  RESULTS
  Results 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.
  
  
  CONCLUSIONS
  Our 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.
  
  
  CONCLUSIONS
  The 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.
authors.affiliation: Department of Psychology, College of Healthcare Sciences, James Cook University, Queensland, Australia.
authors.forename: Deirdre
authors.initials: D
authors.lastname: O'Hare
authors.affiliation: School of Psychiatry, University of New South Wales, Sydney, Australia. v.eapen@unsw.edu.au.
authors.forename: Valsamma
authors.initials: V
authors.lastname: Eapen
authors.affiliation: Department of Psychology, College of Healthcare Sciences, James Cook University, Queensland, Australia.
authors.forename: Edward
authors.initials: E
authors.lastname: Helmes
authors.affiliation: Department of Psychology, College of Healthcare Sciences, James Cook University, Queensland, Australia.
authors.forename: Kerry
authors.initials: K
authors.lastname: McBain
authors.affiliation: School of Psychological Sciences. Australian College of Applied Psychology, Melbourne, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Reece
authors.affiliation: School of Psychiatry, University of New South Wales, Sydney, Australia.
authors.forename: Rachel
authors.initials: R
authors.lastname: Grove
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D010290:Parents; D010379:Peer Group; D010551:Personality; D012917:Social Adjustment; D012919:Social Behavior; D011795:Surveys and Questionnaires; D005879:Tourette Syndrome / Q000150:complications / Q000523:psychology*