**6. Related problems in tic disorders along life**

Oftenly, presence of tics are associated with messing conditions that impair the performance at work, familiar and social environments. Prevalence studies should consider these entities because detection is a first step to diagnose and treat them. We illustrate studies of tic disorders and related morbidities in Table 3.

Total population and their parents were asked to fill in a questionnaire covering both motor and vocal tics. A three- stage procedure was used: screening, interview and clinical investigation. SGT were diagnosed according to DMS-IV criteria.

Patients recruited through print advertisement, physician referrals and Tic Disorder Clinics. The assessment consisted of a structured diagnostic interview, including intelligence quotient (IQ), videotape and patient, parent and clinics-reports. Monetary compensation was given to

Retrospective analyses from clinical archives of child neurology outpatients of Hospital General de Santo Antonio,

Students were screened by inquiring

Children indicated as tic-positive by the screening procedure were investigated using semi-structured questionnaires and the Polish version of YGTSS scale. A validity study involved random selection and investigation of 130 non indicated subjects. Screening procedure had high sensitivity (92%) and low positive

their parents and teachers.

predictive value (18%).

Oftenly, presence of tics are associated with messing conditions that impair the performance at work, familiar and social environments. Prevalence studies should consider these entities because detection is a first step to diagnose and treat them. We illustrate studies of tic

Assessment by structured questionnaire, interview and 20 minutes of clinical examination. **(%)** 

**Vocal (%)** 

0,8 0,5 0,6

15,4 10 95,3

NA NA 45,7

NA NA 0,6

63,8 12 19

**SGT (%)** 

**Author Year Population Methodology Motor** 

children.

Spain.

**5.7 Clinical characterization of tics** 

2003 4479 Swedish school children aged 7 to 15 years.

2006 43 children, ages 8 to 17 years

2006 78 Children and teenagers with tics diagnosed based by DSM-IV criterions.

2008 12-15 year old Warsaw schoolchildren attending 24 randomly selected

schools.

2011 346 students of public elementary

**6. Related problems in tic disorders along life** 

school.

Table 4. Clinical characteristics of tics.

disorders and related morbidities in Table 3.

Khalifa N, Knorring ALV78.

Himle, M. B., & Woods, D. W63.

Prior AC, Tavares S, Figueiroa S, Temudo T77.

Stefanoff P, Wolanczyk T, Gawrys A, Swirszcz K, Stefanoff E, Kaminska A, et

Ortiz B, David M, Sánchez Y, Mira J, Sierra JM, Cornejo JW72.

al70.

#### **6.1 Studies of comorbidity in tics**


Table 5. Related disorders in tics.

Epidemiology of Tics 183

correspondence between direct observation scores and YGTSS ratings may be lower for low-

Whether tic frequency is the most important dimension of tic severity (*e.g.* best predicts psychosocial functioning) is an empirical issue that warrants investigation. Studies should evaluate methods capable of quantifying multiple dimensions of tics including overt physical dimensions (*e.g.* frequency, intensity, complexity), social dimensions (*e.g.* social reinforcement and punishment contingencies, functional interference) and the concomitant private dimensions commonly reported to accompany tics (*e.g.* sensory events). The research will likely require novel direct observation techniques used in combination with other measurement methods (*e.g.* functional assessment, self-report, clinician ratings, social acceptability ratings, physiological measures, neuroimaging techniques, etc.) and research strategies (*e.g.* functional analysis, group research designs, inferential statistical analyses). The use of not traditional measurement techniques to complement direct observation is likely to increase in popularity within the broader field of clinical behavior analysis. Clinical researchers are increasingly concerning themselves with the study of behavior that is complex, highly variable and not easily accessible by traditional direct-observation techniques (*e.g.* the private behaviors of individuals who suffer from anxiety and mood disorders). If behavior analysts are to continue to be at the forefront for understanding and treating clinical problems (including tic disorders), they must systematically determine which dimensions of specific target behaviors are socially relevant and must be diligent not to restrict themselves by investigating only those aspects that are easily quantifiable with traditional direct observation methods92. This will require researchers both to refine their current measurement techniques and to incorporate techniques that have not traditionally been employed in behavior-analytic research (*e.g.* clinician ratings, self-report, physiological and neuroimaging techniques, etc). This is not to suggest that clinical behavior analysts abandon direct observation in favor of other measurement techniques. On the contrary, it is a call to behavior analysts to develop, investigate and incorporate new direct and indirect measurement techniques that will enhance scientific investigation of the environment–

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[2] Leckman, J. F.; King, R. A. & Cohen, D. J. (1999). Tics and tic disorders. In: *Tourette's* 

[3] Carr, J. E., Taylor, C. C., Wallander, J. J., & Reiss, M. L. (1996). A functional analytic

[4] Cornejo W, Posada C, Uribe A. (2001). Caracterización clínica de pacientes con trastorno de Gilles de la Tourette. *Acta Neurológica Colombiana*; 17: 97-102, ISSN 0120-8748. [5] Kurlan R, Como PG, Miller B, Palumbo D, Deeley C, Andresen EM, Eapen S, McDermott

Médica Panamericana. ISBN 978-958-4410-19-9. Bogotá.

*Experimental Psychiatry*, 27, 291–297, ISSN 0005-7916.

*Neurology*; 59(3):414-20, ISSN 0028-3878.

*ambulatoria.* Marín A; Jaramillo JC; Gómez JF; Gómez LF. Pp. 151-153. Editorial

*syndrome—Tics, obsessions, compulsions: Developmental psychopathology and clinical care,* J. F. Leckman & D. J. Cohen, pp. 23–42, Wiley, ISBN 0-471-16037-7, New York.

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MP. (2002). "The behavioral spectrum of tic disorders: a community-based study."

frequency tics than for high-frequency tics91.

behavior relations involved in clinical problems.

**8. References**
