Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Nov 3;10(12):1759-1768.
doi: 10.1002/mdc3.13900. eCollection 2023 Dec.

The Roles of Lifetime Enacted Stigma in Tic Symptoms among Young Adults with Tourette Syndrome

Chengshi Shiu  1   2 , Wei-Ti Chen  2 , Boram Kim  2 , Emily Ricketts  3 , Jordan T Stiede  4   5 , Flint M Espil  6 , Matthew W Specht  7 , Douglas W Woods  4 , John Piacentini  3
Affiliations

The Roles of Lifetime Enacted Stigma in Tic Symptoms among Young Adults with Tourette Syndrome

Chengshi Shiu et al. Mov Disord Clin Pract. .

Abstract

Background: Although rarely framed as enacted stigma, adults with Tourette syndrome (ATS) have long suffered from discrimination associated with their tic symptoms. Given the high stress levels of enacted stigma that ATS experience, it is expected that their tic symptoms are profoundly impacted. However, the evidence linking enacted stigma to ATS's tic symptoms remains limited.

Methods: This study used a secondary data-analysis approach to reanalyze the data from the follow-up phase of a multi-centered, randomized controlled trial in which a behavioral intervention was tested for its efficacy in managing tic symptoms. This study first conducted psychometric testing on a list of 16 enacted stigma events across five life stages and identified the underlying factor structure. The Yale Global Tic Severity Scale (YGTSS) was used to assess severity and impairment of current tic symptoms, whereas the Clinical Global Impression of Severity scale (CGI) was used to obtain the gestalt of clinical judgment on tic severity. A series of multivariate linear models were then fitted to test the relationships between different types of lifetime enacted stigma and current tic symptoms.

Results: The analytic sample included 73 young ATS (average age of 23.2 [standard deviation = 2.5] years). The factor analysis identified three types of enacted stigmas: "traumatic events," "confrontations," and "subtle mistreatments." In multivariate models, traumatic events significantly associated with YGTSS-severity, whereas subtle mistreatments provided additional explanations for CGI.

Conclusions: Enacted stigma may play important roles in shaping ATS's current tics symptom severity and, therefore, should be carefully considered in future intervention development.

Keywords: Tourette syndrome; enacted stigma; secondary data analysis; tic symptoms; young adults.

PubMed Disclaimer

References

    1. Levine JLS, Szejko N, Bloch MH. Meta‐analysis: adulthood prevalence of Tourette syndrome. ProgNeuro‐Psychoy Biol Psyc 2019;95:109675. 10.1016/j.pnpbp.2019.109675. - DOI - PubMed
    1. Scharf JM, Miller LL, Gauvin CA, Alabiso J, Mathews CA, Ben‐Shlomo Y. Population prevalence of Tourette syndrome: a systematic review and meta‐analysis. Mov Disorders 2015;30(2):221–228. 10.1002/mds.26089. - DOI - PubMed
    1. TAoA . Connections that Make a Difference; 2014. Accessed October 11, 2021. https://tourette.org/.
    1. Lichter DG, Finnegan SG. Influence of gender on Tourette syndrome beyond adolescence. Eur Psychiatry 2015;30(2):334–340. 10.1016/j.eurpsy.2014.07.003. - DOI - PubMed
    1. Rizzo R, Gulisano M, Cali PV, Curatolo P. Tourette syndrome and comorbid ADHD: current pharmacological treatment options. Eur J Paediatr Neurol 2013;17(5):421–428. 10.1016/j.ejpn.2013.01.005. - DOI - PubMed

LinkOut - more resources