An initial study of family accommodation in children and adolescents with chronic tic disorders.
This initial study examined the nature, incidence, and clinical correlates of family accommodation in youth with tic disorders, and validated a brief self-report measure of tic-related family accommodation, the Tic Family Accommodation Scale (TFAS). Seventy-five youth aged 6-18 who were diagnosed with a tic disorder and their parent completed a diagnostic clinical interview, and clinician and parent-report measures of tic severity, depressive symptoms, anxiety symptoms, behavioral problems, family accommodation and impairment. An exploratory factor analysis of the TFAS showed a two-factor structure, with good internal consistency for the Total score, Modification of Child Environment and Modification of Parent Environment subscales (α = 0.88, 0.86, and 0.81, respectively). Family accommodation was not associated with tic severity. Family accommodation was associated with increased anxiety and depressive symptoms, higher externalizing, rule breaking, aggressive behaviors and social problems, and with greater tic-related functional impairment. Anxiety and externalizing problems (but not depressive symptoms) predicted family accommodation when controlling for tic severity. Family accommodation predicted high levels of functional impairment over and above the effect of tic severity, anxiety, depression and externalizing problems. Family accommodation is a common phenomenon for youth with tic disorders, with modifications typically encompassing changes to the child and/or parent environments. Accommodation was not associated with tic severity, but was related to higher levels of anxiety, depressive symptoms, externalizing symptoms, aggression, and rule breaking behaviors. Results suggest that other emotional symptoms are more likely to drive accommodation practices than the tic symptoms per se.
Department of Pediatrics, University of South Florida, Box 7523, 880 6th Street South, St. Petersburg, FL, 33701, USA. estorch@health.usf.edu.|Department of Health Policy and Management, University of South Florida, Tampa, USA. estorch@health.usf.edu.|Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, USA. estorch@health.usf.edu.|Department of Psychology, University of South Florida, Tampa, USA. estorch@health.usf.edu.|Rogers Behavioral Health, Tampa Bay, Tampa, USA. estorch@health.usf.edu.|All Children's Hospital, Johns Hopkins Medicine, St. Petersburg, USA. estorch@health.usf.edu.
Eric A
EA
Storch
Department of Pediatrics, University of South Florida, Box 7523, 880 6th Street South, St. Petersburg, FL, 33701, USA.
Carly
C
Johnco
Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, USA.
Joseph F
JF
McGuire
Department of Pediatrics, University of South Florida, Box 7523, 880 6th Street South, St. Petersburg, FL, 33701, USA.|Department of Psychology, University of South Florida, Tampa, USA.
Monica S
MS
Wu
Department of Pediatrics, University of South Florida, Box 7523, 880 6th Street South, St. Petersburg, FL, 33701, USA.
Nicole M
NM
McBride
Department of Pediatrics, University of South Florida, Box 7523, 880 6th Street South, St. Petersburg, FL, 33701, USA.|Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, USA.|Department of Psychology, University of South Florida, Tampa, USA.
Adam B
AB
Lewin
Department of Pediatrics, University of South Florida, Box 7523, 880 6th Street South, St. Petersburg, FL, 33701, USA.|Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, USA.|All Children's Hospital, Johns Hopkins Medicine, St. Petersburg, USA.
Tanya K
TK
Murphy
D000293:Adolescent; D001007:Anxiety / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D002648:Child; D003863:Depression / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D005195:Family Relations / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology; D013981:Tic Disorders / Q000453:epidemiology* / Q000523:psychology* / Q000628:therapy
Assessment; Family accommodation; Tourette’s syndrome; Treatment; Youth