Children and adolescents with Tourette syndrome: Towards a better understanding of rage reactions
The purpose of this study was to explore and better understand the phenomenon of rage attacks in children and adolescents with Tourette's Syndrome (TS) with the goal of identifying potential subgroups within this population. The Rage Attacks Screen and Questionnaire, was developed for gathering descriptive data on the phenomenology of explosive rage in children and adolescents with TS (Budman, 1998). This measure is based on DSM-IV diagnostic criteria for Intermittent Explosive Disorder (IED) and was administered along with other standardized measures of tic severity and comorbid disorders to 47 subjects with TS between the ages of 5 and 17 who presented with clinically significant explosive rage. ^ Factor analysis was performed on the Rage Attacks Screen and Questionnaire and a six-factor model was obtained. These six factors were labeled as “non-interpersonal urges,” “situational control,” “dysregulation,” “contextual state for rage,” “post-rage activity/irritability,” and “control of tics and rage.” The six factors were then subjected to cluster analytic procedures. ^ The final cluster solution classified 47 children into 4 homogeneous subgroups. Subgroup 1 was classified as “goal-oriented reactivity.” Subgroup 2 was classified as “situationally reactive.” Subgroup 3 was classified as “disinhibited.” Subgroup 4 was classified as “diffuse regulatory dysfunction.” Subgroups were also compared on a number of external variables. ^ Subgroups were found to display significant differences with respect to age, grade, negative mood, interpersonal problems, social anxiety, oppositional defiant disorder, obsessions and compulsions, internalizing and externalizing disorders, and planning and attention measures. ^ Findings from the present study suggest that children and adolescents with TS who suffer from explosive rage attacks represent a heterogeneous group in which different etiologies may contribute to rage symptoms. These findings emphasize that distinct, more specific treatment strategies should be devised based on subtypes of behavioral symptom clusters. ^
Lori Michelle Rockmore,
"Children and adolescents with Tourette syndrome: Towards a better understanding of rage reactions"
(January 1, 2001).
ETD Collection for Pace University.