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***choose a mental disorder and refer the assignment about this
and follow up next instructions.
1-Why the name of the disorder / concept or definition.
2-Criteria to be followed in order to be diagnosed with this
specific disorder according to the DSM-5. 3-History
4-Causes
5-Symptoms & Signs
6-Different types
7-Preventions
8-Environmental Causes
9-Treatment plans for short-term goals and long-term goals
10-Prognosis
11-Tips or suggestions on how to overcome the disorder
12-Parenting skills to help the individuals Evidence-based
therapies for specific disorder
Psychology; Study Data from Institute for
Psychology Update Knowledge of Psychology
(Chess databases as a research vehicle in
psychology: Modeling large data)
Publication info: Psychology & Psychiatry Journal ; Atlanta
[Atlanta]09 Sep 2017: 6156.
ProQuest document link
FULL TEXT
2017 SEP 9 (NewsRx) -- By a News Reporter-Staff News Editor
at Psychology &Psychiatry Journal -- Current study
results on Psychology have been published. According to news
reporting originating from Klagenfurt, Austria, by
NewsRx correspondents, research stated, "The game of chess
has often been used for psychological
investigations, particularly in cognitive science. The clear-cut
rules and well-defined environment of chess provide
a model for investigations of basic cognitive processes, such as
perception, memory, and problem solving, while
the precise rating system for the measurement of skill has
enabled investigations of individual differences and
expertise-related effects."
Financial support for this research came from Talent Austria
Grant, Austrian Agency for International Cooperation
in Education and Research.
Our news editors obtained a quote from the research from
Institute for Psychology, "In the present study, we focus
on another appealing feature of chess-namely, the large archive
databases associated with the game. The German
national chess database presented in this study represents a
fruitful ground for the investigation of multiple
longitudinal research questions, since it collects the data of over
130,000 players and spans over 25 years. The
German chess database collects the data of all players,
including hobby players, and all tournaments played. This
results in a rich and complete collection of the skill, age, and
activity of the whole population of chess players in
Germany. The database therefore complements the commonly
used expertise approach in cognitive science by
opening up new possibilities for the investigation of multiple
factors that underlie expertise and skill acquisition.
Since large datasets are not common in psychology, their
introduction also raises the question of optimal and
efficient statistical analysis."
According to the news editors, the research concluded: "We
offer the database for download and illustrate how it
can be used by providing concrete examples and a step-by-step
tutorial using different statistical analyses on a
range of topics, including skill development over the lifetime,
birth cohort effects, effects of activity and inactivity
on skill, and gender differences."
For more information on this research see: Chess databases as a
research vehicle in psychology: Modeling large
data. Behavior Research Methods, 2017;49(4):1227-1240.
Behavior Research Methods can be contacted at:
Springer, 233 Spring St, New York, NY 10013, USA. (Springer
- www.springer.com; Behavior Research Methods -
www.springerlink.com/content/1554-351x/)
The news editors report that additional information may be
obtained by contacting N. Vaci, Univ Klagenfurt, Inst
Psychol, Cognit Psychol, A-9020 Klagenfurt, Austria.
Keywords for this news article include: Klagenfurt, Austria,
Europe, Mental Health, Psychology, Institute for
Psychology.
Our reports deliver fact-based news of research and discoveries
from around the world. Copyright 2017, NewsRx
LLC
https://search.proquest.com/docview/1934567940?accountid=15
8399
https://search.proquest.com/docview/1934567940?accountid=15
8399
DETAILS
Database c
Terms and Conditions Contact ProQuest
Subject: Research methodology; Psychology; Data bases;
Studies
Location: New York United States--US Austria Germany
Identifier / keyword: Klagenfurt Austria Europe Mental Health
Psychology
Publication title: Psychology &Psychiatry Journal; Atlanta
First page: 6156
Publication year: 2017
Publication date: Sep 9, 2017
Publisher: NewsRx
Place of publication: Atlanta
Country of publication: United States, Atlanta
Publication subject: Medical Sciences--Psychiatry And
Neurology, Psychology
ISSN: 1944-2718
Source type: Wire Feeds
Language of publication: English
Document type: News
ProQuest document ID: 1934567940
Document URL:
https://search.proquest.com/docview/1934567940?accountid=15
8399
Copyright: Copyright 2017, NewsRx LLC
Last updated: 2017-09-02
Database: Psychology Database
https://search.proquest.com/docview/1934567940?accountid=15
8399
https://search.proquest.com/info/termsAndConditions
http://www.proquest.com/go/pqissupportcontactPsychology;
Study Data from Institute for Psychology Update Knowledge of
Psychology (Chess databases as a research vehicle in
psychology: Modeling large data)
Running Head: TOURETTE SYNDROME 1
Tourette Syndrome
Enma Tamayo
Florida National University
Human Growth and Development
Prof. Rafael Ramos, M.S.
September 30, 2018
TOURETTE SYNDROME 2
Abstract
The Tourette Syndrome is publicly known in 1885, described by
a French doctor, to whom it
owes its name. It is a neurological disorder of which the causes
are unknown in their entirety, but
its genetic character has been proven. Symptoms are different in
each person and are
characterized by movements called tics; more frequent in boys
than in girls. Tics tend to
disappear in adulthood in most cases. People with this syndrome
have normal expectations of
life. The investigations continue with the purpose of being able
to provide an effective treatment
that improves the quality of life of those people who suffer this
syndrome.
TOURETTE SYNDROME 3
History about this disease:
The Syndrome of Gilles de la Tourette is a neurological
disorder that induces the
individual to perform involuntary movements or sounds out of
the ordinary called tics. Appears
in childhood with severe or moderate tics, which persist for
more than a year and can be for life.
In many cases they tend to improve or even disappear during the
last stage of adolescence or in
adulthood. It is a hereditary disorder of autosomal dominant
form, behaving as a pattern of
complex inheritance. The gene carriers do not necessarily need
to develop the symptoms of this
syndrome. Also, the gender has a determining influence.
This syndrome owes its name to Dr. George Gilles de la
Tourette who lived from 1859 to
1904. In 1885 he described for the first time the disorders of
this disease with the study of 9
cases that presented involuntary reflexes; and diagnosed the
disease in an 86-year-old French
noblewoman. Currently there are many investigations that are
being conducted proving that the
symptoms appear in childhood, beginning between 5 and 10
years of age regardless of ethnic
groups.
Research has also shown that the chances of males being more
affected than females is 4
times higher. Sometimes, girls can only develop compulsive
obsessive symptoms.
In the United States, approximately 200,000 people suffer from
the most severe form of this
disease, and an average of 3.8% of children from 5 to 18 years
of age can suffer from it.
Symptoms and Sings
The symptoms can vary from mild to very severe, but in most
cases, they develop
moderately. This syndrome can be persistent chronic throughout
life, but usually in the first years
of adolescence the most severe stage is suffered. Later it may or
may not improve and even
TOURETTE SYNDROME 4
disappear in adulthood. The first symptoms appear in the head
and neck; they can progress
involving more muscles of the body either of the trunk or the
extremities. The symptoms of the
disease may be associated with the existence of other
neurological or psychiatric conditions.
Generally, this disease is evidenced by repetitive movements or
unwanted sounds, which
cannot be controlled like constant blinking, the use of coarse
words and movements of different
parts of the body. Coupled with this are compulsive behaviors,
impulsivity, lack of self-control,
hyperactivity, repetition of incoherent words or phrases,
meaningless words, chronic coughing,
involuntary eyelid spasms, stuttering, muscle contractions,
increased muscle activity, difficulty
moving any limb of the body or the body in general and
involuntary movements. All this coupled
with a growing state of anxiety, depression and fear.
Causes
Despite the studies that are carried out, the causes of this
condition are unknown. Researchers
link their causes to abnormalities in some regions of the brain
such as basal ganglia, frontal lobes
and cerebral cortex. It is also related to problems in the circuits
that make the connection
between these regions and neurotransmitters such as serotonin,
dopamine and norepinephrine
that facilitate communication between neurons.
Diagnosis
The diagnosis of this disease is made clinically, as a result of
persistent motor or vocal
tics in the patient for one year or longer. Many cases find
improvements in late adolescence or at
the beginning of adulthood. Only in 10% of those affected does
the disease persist until they
reach the age of majority. The diagnosis can be established in a
better way when the symptoms
are related to other conditions. Blood tests or laboratories are
not needed to detect this syndrome,
but studies such as Nuclear Magnetic Resonance, Computed
Tomography and
TOURETTE SYNDROME 5
Electroencephalogram are used for its diagnosis. Many patients
are slow to be diagnosed because
when presenting simple or moderate tics, they and their
relatives consider it secondary and
associate it with another disease. Example of this, they
associate repetitive blinking with vision
problems or sounds of throat and cough with allergies. On the
other hand, once patients and
relatives already have previous knowledge about the disease can
perform a self-diagnosis.
According to the Diagnostic and Statistical Manual of
Mental Disorders (DSM-5) tics are
divided into three categories:
- Motor and vocal tics present in the patient for more than one
year (Tourette Syndrome)
- Motor and vocal tics showing one of them or both at the same
time (Persistent Disorder)
-Motor or vocal tics that are presented separately or joined in
less than one year (Provisional tics
disorders)
The inclusion in one of these 3 groups is done considering that
the behavior of the patient
has not been modified by any drug or associated with another
disease. These motor and vocal tics
are classified as we have already seen in simple ones like
blinking, grimacing, cephalic jerking
without social sense and in complexes like grunts or barks and
sniffing. There is also the
classification of sensory and cognitive tics. Sensory tics are
those involuntary recurrent sensations
such as tingling, cold, heat, heaviness, lightness and
strangeness. Cognitive tics are defined as
repetitive thoughts with aggressive content.
Medical terminologies have been created to describe some
symptoms of this syndrome, such as
Coprolalia which is used to describe one of the most confused
and attacked symptoms. Patients
with this symptom express obscene words, derogatory
comments, and refer to the genital areas,
excrement and sexual act. We can also find Echolalia which
refer to patients who repeat what is
expressed by other people, they cannot communicate correctly
because they are not able to
TOURETTE SYNDROME 6
express their own thoughts. In addition to Palilalia who are
patients that repeat syllables or
words, then we can have Echopraxia which refer to patients that
repeat the movements that other
people make, and finally, we have Copropraxia which refer to
patients who perform obscene or
forbidden involuntary gestures and obsessive behavior.
Environmental Causes
Although the causes are unknown in their totality, studies have
shown that in addition to a
strong and complex genetic disorder, there are environmental
risks that can contribute to the
suffering of this disease. Among these environmental risks are
complications during pregnancy,
smoking during the same, the consumption of toxic substances,
low birth weight, fetal distress
caused by incorrect medical practices or negligence of the
pregnant woman, infections caused by
bacteria and other germs and emotional variability.
Treatment Plans
When tics do not produce disability, the patient usually does not
require medical
treatment. Patients who are affected by their daily activities in a
severe way due to the disease
are treated with drugs from the group of neuroleptics.
Haloperidol and Pimozide have been very
effective in delaying the onset and duration of tics. All these
treatments bring with them side
effects, which are treated from the beginning of the treatment
and personalized with each patient,
assessing tolerance in the doses. Among the most common side
effects are drowsiness, weight
gain, cognitive dullness, shuddering and dystonic reactions.
When these drugs are used for long
periods, to suppress them they must be of gradual form, to avoid
the effect of rebound in the tics
or the dyskinesia that is a movement disorder not associated
with the Tourette Syndrome. For
this reason, neuroleptics are used in low doses for short periods.
Other symptoms presented by
TOURETTE SYNDROME 7
patients such as attention deficit hyperactivity disorder or
obsessive-compulsive symptoms are
treated with inhibitors, which have been shown to be effective.
A medication that by itself is effective in the treatment of tics
has not yet been found, but
it does help patients in their daily lives. There are other types of
treatments without the use of
drugs when possible or using both. Behavioral Therapies are an
example of them through this,
patients learn different ways to control the tics; helping to
reduce the number of appearances, the
seriousness of them and the personal and social impact. Another
example is the technique of
Inversion of habit or counterconditioning, this practice requires
a lot of study from both
specialists in charge and patients; has two main stages: Training
in awareness, where each tick is
identified aloud; and incompatible or substitute response
training: where you learn a new
behavior that cannot happen at the same time as the tics.
Example: If the person has a tic that
causes him to touch his head, a new behavior would be to put
his hands on his knee, so as not to
touch his head.
Another of the alternative treatments are therapies of
Comprehensive Behavioral
Interventions for Tics (CBIT) this therapy is based on the
inversion of habits, education on tics
and relaxation techniques. This technique is developed in
practice involving therapists, family
members, among others. Although this therapy has been very
helpful, unfortunately the staff able
to perform it is not very numerous. Training therapies for the
family are very useful for both
family members and patients, as it helps them to better
understand the problems and the use in
each case of positive reinforcement and discipline to follow.
Tourette Syndrome does not affect the life expectancy of the
patient and does not
diminish the intelligence capacity. Not all patients need medical
treatment, but it is very frequent
that many patients begin to suffer from neuro-behavior
disorders such as depression, panic
TOURETTE SYNDROME 8
attacks, obsessive disorder and antisocial behavior that leads to
isolation. All these associated
conditions can severely affect the patient even when the initial
symptoms of the syndrome have
improved or disappeared. The ages vary greatly both in the
appearance of the first symptoms and
in the complexity of their development. The disease in most
cases is improving in the late stage
of adolescence especially after 20 years, behaving free of
symptoms. Many patients can stop
taking medications to reduce tics, and even if this happens, it is
not a neglected disease. It is
encouraging that only in 10% of patients do symptoms remain
severe until they reach the age of
majority.
Considering the age of the onset of this disease, behavior and
development; We can
understand that it gives children many emotional problems, a
great physical loss and little social
integration. Coupled with this, we know that the environmental
conditions that surround patients
cause an increase in tics because when they are more concerned
about controlling them, less they
get them. That is why it is so important that people go to the
doctor to have an adequate
diagnosis and therefore receive the right help, where they can
learn techniques to stay calm and
learn to live with their situation.
Suggestion on how to overcome the disorder
For all parents, raising children becomes a great responsibility
and more when your child
suffers from a condition like Tourette's Syndrome. It can
generate a stressful environment, so
something fundamental is the knowledge about the disease,
learn about the behaviors to continue
to help your child to the social insertion and the most important
thing to make the child feel in a
safe environment.
Offer understanding and help whenever the child needs it. Never
ask him to control his
tics since they are uncontrollable. Parents must collaborate in
schools to achieve special and
TOURETTE SYNDROME 9
personalized attention to their child. In many cases both
children and youth are victims of
bullying by their peers, for this reason should talk with them
and teach them to be prepared to
lead with the harmful comments. It is very useful to disseminate
the characteristics of this
disease at a social level, especially in the schools and work
centers where those affected are
located. We must create favorable conditions for each person
with this syndrome, so that they
can develop their activities in a pleasant way. Help and support
your child in establishing
personal relationships, participating in activities and not
isolating himself. This will help him
meet new people, make new friends and develop social skills.
Parents should not limit the daily
activities of their children, the children should try to learn and
perform all their activities if they
are sure that they have the capacity to develop them, otherwise
the children could experience
frustration. When children and their families manage to
understand and live with the disease, life
is not so difficult.
TOURETTE SYNDROME 10
Conclusions
The Gilles de la Tourette Syndrome, despite having been
discovered since the 19th
century, continues being an enigma. It is a chronic behavioral
neurological disorder; whose
symptoms appear in childhood or adolescence. Significant
aspect because children and young
people begin to live from an early age with this condition,
whose assimilation can be difficult
and contradictory. This syndrome is not only motor and vocal
tics; it goes much further. The
rejection produced by social ignorance generates stress to the
patients who suffer it. That is why
knowledge about the disease at the social level becomes one of
the most important aspects to
achieve the assessment and attention of the educational and
social needs of these patients. We
must achieve a tolerant and understanding environment that
encourages them to develop their
capacities and that be flexible to be adapted to the demands of
these people.
TOURETTE SYNDROME 11
References
Basal ganglia diseases; new Tourette Syndrome findings from
St. George's hospital
outlined (are there distinct subtypes in Tourette Syndrome?
Pure-Tourette syndrome versus
Tourette Syndrome-Plus, and simple versus complex tics).
(2015, Jul 11). Psychology &
Psychiatry Journal Retrieved from
https://search.proquest.com/docview/1692762483?accountid=15
8399.
Deng, H., Gao, K., & Jankovic, J. (2012). The genetics of
Tourette Syndrome. Nature
Reviews.Neurology, 8(4), 203-213.
doi:http://dx.doi.org/10.1038/nrneurol.2012.26
Tourette Syndrome https://my.clevelandclinic.org<article
Kronenbuerger, M., Belenghi, P., Ilgner, J., Freiherr, J.,
Hummel, T., & Neuner, I. (2018).
Olfactory functioning in adults with Tourette Syndrome. PLoS
One, 13(6)
doi:http://dx.doi.org/10.1371/journal.pone.0197598
https://search.proquest.com/docview/1692762483?accountid=15
8399
TOURETTE SYNDROME 12
TOURETTE SYNDROME 13
Category
Exceeds Standards
Meets Standards
Nearly Meets standards
Does Not Meet Standards
No
Evidence
Score
Title Page
Assigned Title, Your Full Name, School Name, Professor’s
Name and credentials, and Date of submission. In addition to
the Capitalized Running head and Page number. No errors.
Evidence of five aspects or more
Evidence of four to three aspects
Evidence of two aspects or less
Absent.
0-10
Abstract Page
Clearly and concisely states the paper’s purpose. The abstract
content is engaging, states the main topic and previews the
structure of the paper.
The introduction states the main topic and previews the
structure of the paper.
The introduction states the main topic but does not adequately
preview the structure of the paper.
There is no clear introduction or main topic and the structure of
the paper is missing.
Absent or no evidence.
0-10
Content pages:
(60 points)
(Developing Body Pages)
Content pages have thoughtful supporting detail sentences that
develop the main idea of the topic.
Content pages have sufficient supporting detail sentences that
develop the main of the topic.
Content pages lacks supporting detail sentences of the topic.
Content pages fail to develop the main idea of the topic.
Not applicable
0-10
Organization of structural development of the research paper
topic.
Student demonstrates logical sequencing of ideas through well-
developed paragraphs, relevant info and details about the topic.
Used DSM-5 criteria and database information to support your
paper.
Paragraph development present but not perfected.
Logical organization; organization of ideas not fully developed.
No evidence of structure or organization.
Not applicable
0-20
Mechanics
No errors in punctuation, capitalization and spelling.
Almost no errors in punctuation, capitalization and spelling
Many errors in punctuation, capitalization and spelling.
Numerous and distracting errors in punctuation, capitalization
and spelling.
Not applicable
0-10
Usage
No errors sentence structure and word usage.
Almost no errors in sentence structure and word usage.
Many errors in sentence structure and word usage.
Numerous and distracting errors in sentence structure and word
usage.
Not applicable.
0-10
Citation
All cited works, both text and visual, are done in the correct
format with no errors.
Some cited works, both text and visual, are done in the correct
format. Inconsistencies evident.
Few cited works, both text and visual, are done in the correct
format.
Absent
Not applicable.
0-10
Conclusion Page
The conclusion is engaging and restates the main points from
the research a topic as well as the use of statistics and/or
percentages.
The conclusion restates the fairly the main point of the research
paper topic.
The conclusion does not adequately restate the paper topic.
Incomplete and/or unfocused.
Absent or no evidence.
0-10
Reference Page
Done in the correct format with no errors. Includes three (3) or
more professional journals from FNU database and any other
reliable source of information to support your paper topic.
Wikipedia is Not a reliable source of information. Please, Do
NOT use it!!!
Done in the correct format with a few errors. Includes three (3)
or more professional journals from FNU database and five (5)
references (e.g. science journal articles, books, but no more
than five internet sites. Periodicals available on-line are not
considered internet sites)
Done in the correct format with some errors. Includes only two
(2) of the professional journals from the FNU database and
three to four (3-4) major references (e.g. science journal
articles, books, but no more than two internet sites. Periodicals
available on-line are not considered internet).
Done in the correct format with many errors. It did not include
any professional journals from the FNU database and one to two
(1-2) major references (e.g. science journal articles, books, but
no more than two internet sites. Periodicals available on-line
are not considered internet sites.)
Absent or the only sites are internet sites.
0-10
Research Paper Rubric for Florida National University.
Prof. Rafael Ramos, M.S.
3

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choose a mental disorder and refer the assignment about this an.docx

  • 1. ***choose a mental disorder and refer the assignment about this and follow up next instructions. 1-Why the name of the disorder / concept or definition. 2-Criteria to be followed in order to be diagnosed with this specific disorder according to the DSM-5. 3-History 4-Causes 5-Symptoms & Signs 6-Different types 7-Preventions 8-Environmental Causes 9-Treatment plans for short-term goals and long-term goals 10-Prognosis 11-Tips or suggestions on how to overcome the disorder 12-Parenting skills to help the individuals Evidence-based therapies for specific disorder Psychology; Study Data from Institute for Psychology Update Knowledge of Psychology (Chess databases as a research vehicle in psychology: Modeling large data) Publication info: Psychology & Psychiatry Journal ; Atlanta [Atlanta]09 Sep 2017: 6156. ProQuest document link FULL TEXT
  • 2. 2017 SEP 9 (NewsRx) -- By a News Reporter-Staff News Editor at Psychology &Psychiatry Journal -- Current study results on Psychology have been published. According to news reporting originating from Klagenfurt, Austria, by NewsRx correspondents, research stated, "The game of chess has often been used for psychological investigations, particularly in cognitive science. The clear-cut rules and well-defined environment of chess provide a model for investigations of basic cognitive processes, such as perception, memory, and problem solving, while the precise rating system for the measurement of skill has enabled investigations of individual differences and expertise-related effects." Financial support for this research came from Talent Austria Grant, Austrian Agency for International Cooperation in Education and Research. Our news editors obtained a quote from the research from Institute for Psychology, "In the present study, we focus on another appealing feature of chess-namely, the large archive databases associated with the game. The German national chess database presented in this study represents a fruitful ground for the investigation of multiple longitudinal research questions, since it collects the data of over 130,000 players and spans over 25 years. The
  • 3. German chess database collects the data of all players, including hobby players, and all tournaments played. This results in a rich and complete collection of the skill, age, and activity of the whole population of chess players in Germany. The database therefore complements the commonly used expertise approach in cognitive science by opening up new possibilities for the investigation of multiple factors that underlie expertise and skill acquisition. Since large datasets are not common in psychology, their introduction also raises the question of optimal and efficient statistical analysis." According to the news editors, the research concluded: "We offer the database for download and illustrate how it can be used by providing concrete examples and a step-by-step tutorial using different statistical analyses on a range of topics, including skill development over the lifetime, birth cohort effects, effects of activity and inactivity on skill, and gender differences." For more information on this research see: Chess databases as a research vehicle in psychology: Modeling large data. Behavior Research Methods, 2017;49(4):1227-1240. Behavior Research Methods can be contacted at: Springer, 233 Spring St, New York, NY 10013, USA. (Springer
  • 4. - www.springer.com; Behavior Research Methods - www.springerlink.com/content/1554-351x/) The news editors report that additional information may be obtained by contacting N. Vaci, Univ Klagenfurt, Inst Psychol, Cognit Psychol, A-9020 Klagenfurt, Austria. Keywords for this news article include: Klagenfurt, Austria, Europe, Mental Health, Psychology, Institute for Psychology. Our reports deliver fact-based news of research and discoveries from around the world. Copyright 2017, NewsRx LLC https://search.proquest.com/docview/1934567940?accountid=15 8399 https://search.proquest.com/docview/1934567940?accountid=15 8399 DETAILS Database c Terms and Conditions Contact ProQuest Subject: Research methodology; Psychology; Data bases;
  • 5. Studies Location: New York United States--US Austria Germany Identifier / keyword: Klagenfurt Austria Europe Mental Health Psychology Publication title: Psychology &Psychiatry Journal; Atlanta First page: 6156 Publication year: 2017 Publication date: Sep 9, 2017 Publisher: NewsRx Place of publication: Atlanta Country of publication: United States, Atlanta Publication subject: Medical Sciences--Psychiatry And Neurology, Psychology ISSN: 1944-2718 Source type: Wire Feeds Language of publication: English Document type: News ProQuest document ID: 1934567940 Document URL: https://search.proquest.com/docview/1934567940?accountid=15
  • 6. 8399 Copyright: Copyright 2017, NewsRx LLC Last updated: 2017-09-02 Database: Psychology Database https://search.proquest.com/docview/1934567940?accountid=15 8399 https://search.proquest.com/info/termsAndConditions http://www.proquest.com/go/pqissupportcontactPsychology; Study Data from Institute for Psychology Update Knowledge of Psychology (Chess databases as a research vehicle in psychology: Modeling large data) Running Head: TOURETTE SYNDROME 1 Tourette Syndrome Enma Tamayo Florida National University Human Growth and Development Prof. Rafael Ramos, M.S.
  • 7. September 30, 2018 TOURETTE SYNDROME 2 Abstract The Tourette Syndrome is publicly known in 1885, described by a French doctor, to whom it owes its name. It is a neurological disorder of which the causes are unknown in their entirety, but its genetic character has been proven. Symptoms are different in each person and are characterized by movements called tics; more frequent in boys than in girls. Tics tend to disappear in adulthood in most cases. People with this syndrome have normal expectations of life. The investigations continue with the purpose of being able to provide an effective treatment that improves the quality of life of those people who suffer this syndrome.
  • 8. TOURETTE SYNDROME 3 History about this disease: The Syndrome of Gilles de la Tourette is a neurological disorder that induces the individual to perform involuntary movements or sounds out of the ordinary called tics. Appears in childhood with severe or moderate tics, which persist for more than a year and can be for life. In many cases they tend to improve or even disappear during the last stage of adolescence or in adulthood. It is a hereditary disorder of autosomal dominant form, behaving as a pattern of complex inheritance. The gene carriers do not necessarily need to develop the symptoms of this
  • 9. syndrome. Also, the gender has a determining influence. This syndrome owes its name to Dr. George Gilles de la Tourette who lived from 1859 to 1904. In 1885 he described for the first time the disorders of this disease with the study of 9 cases that presented involuntary reflexes; and diagnosed the disease in an 86-year-old French noblewoman. Currently there are many investigations that are being conducted proving that the symptoms appear in childhood, beginning between 5 and 10 years of age regardless of ethnic groups. Research has also shown that the chances of males being more affected than females is 4 times higher. Sometimes, girls can only develop compulsive obsessive symptoms. In the United States, approximately 200,000 people suffer from the most severe form of this disease, and an average of 3.8% of children from 5 to 18 years of age can suffer from it. Symptoms and Sings The symptoms can vary from mild to very severe, but in most cases, they develop
  • 10. moderately. This syndrome can be persistent chronic throughout life, but usually in the first years of adolescence the most severe stage is suffered. Later it may or may not improve and even TOURETTE SYNDROME 4 disappear in adulthood. The first symptoms appear in the head and neck; they can progress involving more muscles of the body either of the trunk or the extremities. The symptoms of the disease may be associated with the existence of other neurological or psychiatric conditions. Generally, this disease is evidenced by repetitive movements or unwanted sounds, which cannot be controlled like constant blinking, the use of coarse words and movements of different parts of the body. Coupled with this are compulsive behaviors, impulsivity, lack of self-control, hyperactivity, repetition of incoherent words or phrases, meaningless words, chronic coughing, involuntary eyelid spasms, stuttering, muscle contractions, increased muscle activity, difficulty moving any limb of the body or the body in general and involuntary movements. All this coupled
  • 11. with a growing state of anxiety, depression and fear. Causes Despite the studies that are carried out, the causes of this condition are unknown. Researchers link their causes to abnormalities in some regions of the brain such as basal ganglia, frontal lobes and cerebral cortex. It is also related to problems in the circuits that make the connection between these regions and neurotransmitters such as serotonin, dopamine and norepinephrine that facilitate communication between neurons. Diagnosis The diagnosis of this disease is made clinically, as a result of persistent motor or vocal tics in the patient for one year or longer. Many cases find improvements in late adolescence or at the beginning of adulthood. Only in 10% of those affected does the disease persist until they reach the age of majority. The diagnosis can be established in a better way when the symptoms are related to other conditions. Blood tests or laboratories are not needed to detect this syndrome,
  • 12. but studies such as Nuclear Magnetic Resonance, Computed Tomography and TOURETTE SYNDROME 5 Electroencephalogram are used for its diagnosis. Many patients are slow to be diagnosed because when presenting simple or moderate tics, they and their relatives consider it secondary and associate it with another disease. Example of this, they associate repetitive blinking with vision problems or sounds of throat and cough with allergies. On the other hand, once patients and relatives already have previous knowledge about the disease can perform a self-diagnosis. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) tics are divided into three categories: - Motor and vocal tics present in the patient for more than one year (Tourette Syndrome) - Motor and vocal tics showing one of them or both at the same time (Persistent Disorder) -Motor or vocal tics that are presented separately or joined in less than one year (Provisional tics
  • 13. disorders) The inclusion in one of these 3 groups is done considering that the behavior of the patient has not been modified by any drug or associated with another disease. These motor and vocal tics are classified as we have already seen in simple ones like blinking, grimacing, cephalic jerking without social sense and in complexes like grunts or barks and sniffing. There is also the classification of sensory and cognitive tics. Sensory tics are those involuntary recurrent sensations such as tingling, cold, heat, heaviness, lightness and strangeness. Cognitive tics are defined as repetitive thoughts with aggressive content. Medical terminologies have been created to describe some symptoms of this syndrome, such as Coprolalia which is used to describe one of the most confused and attacked symptoms. Patients with this symptom express obscene words, derogatory comments, and refer to the genital areas, excrement and sexual act. We can also find Echolalia which refer to patients who repeat what is expressed by other people, they cannot communicate correctly because they are not able to
  • 14. TOURETTE SYNDROME 6 express their own thoughts. In addition to Palilalia who are patients that repeat syllables or words, then we can have Echopraxia which refer to patients that repeat the movements that other people make, and finally, we have Copropraxia which refer to patients who perform obscene or forbidden involuntary gestures and obsessive behavior. Environmental Causes Although the causes are unknown in their totality, studies have shown that in addition to a strong and complex genetic disorder, there are environmental risks that can contribute to the suffering of this disease. Among these environmental risks are complications during pregnancy, smoking during the same, the consumption of toxic substances, low birth weight, fetal distress caused by incorrect medical practices or negligence of the pregnant woman, infections caused by bacteria and other germs and emotional variability. Treatment Plans
  • 15. When tics do not produce disability, the patient usually does not require medical treatment. Patients who are affected by their daily activities in a severe way due to the disease are treated with drugs from the group of neuroleptics. Haloperidol and Pimozide have been very effective in delaying the onset and duration of tics. All these treatments bring with them side effects, which are treated from the beginning of the treatment and personalized with each patient, assessing tolerance in the doses. Among the most common side effects are drowsiness, weight gain, cognitive dullness, shuddering and dystonic reactions. When these drugs are used for long periods, to suppress them they must be of gradual form, to avoid the effect of rebound in the tics or the dyskinesia that is a movement disorder not associated with the Tourette Syndrome. For this reason, neuroleptics are used in low doses for short periods. Other symptoms presented by TOURETTE SYNDROME 7
  • 16. patients such as attention deficit hyperactivity disorder or obsessive-compulsive symptoms are treated with inhibitors, which have been shown to be effective. A medication that by itself is effective in the treatment of tics has not yet been found, but it does help patients in their daily lives. There are other types of treatments without the use of drugs when possible or using both. Behavioral Therapies are an example of them through this, patients learn different ways to control the tics; helping to reduce the number of appearances, the seriousness of them and the personal and social impact. Another example is the technique of Inversion of habit or counterconditioning, this practice requires a lot of study from both specialists in charge and patients; has two main stages: Training in awareness, where each tick is identified aloud; and incompatible or substitute response training: where you learn a new behavior that cannot happen at the same time as the tics. Example: If the person has a tic that causes him to touch his head, a new behavior would be to put his hands on his knee, so as not to touch his head.
  • 17. Another of the alternative treatments are therapies of Comprehensive Behavioral Interventions for Tics (CBIT) this therapy is based on the inversion of habits, education on tics and relaxation techniques. This technique is developed in practice involving therapists, family members, among others. Although this therapy has been very helpful, unfortunately the staff able to perform it is not very numerous. Training therapies for the family are very useful for both family members and patients, as it helps them to better understand the problems and the use in each case of positive reinforcement and discipline to follow. Tourette Syndrome does not affect the life expectancy of the patient and does not diminish the intelligence capacity. Not all patients need medical treatment, but it is very frequent that many patients begin to suffer from neuro-behavior disorders such as depression, panic TOURETTE SYNDROME 8 attacks, obsessive disorder and antisocial behavior that leads to
  • 18. isolation. All these associated conditions can severely affect the patient even when the initial symptoms of the syndrome have improved or disappeared. The ages vary greatly both in the appearance of the first symptoms and in the complexity of their development. The disease in most cases is improving in the late stage of adolescence especially after 20 years, behaving free of symptoms. Many patients can stop taking medications to reduce tics, and even if this happens, it is not a neglected disease. It is encouraging that only in 10% of patients do symptoms remain severe until they reach the age of majority. Considering the age of the onset of this disease, behavior and development; We can understand that it gives children many emotional problems, a great physical loss and little social integration. Coupled with this, we know that the environmental conditions that surround patients cause an increase in tics because when they are more concerned about controlling them, less they get them. That is why it is so important that people go to the doctor to have an adequate
  • 19. diagnosis and therefore receive the right help, where they can learn techniques to stay calm and learn to live with their situation. Suggestion on how to overcome the disorder For all parents, raising children becomes a great responsibility and more when your child suffers from a condition like Tourette's Syndrome. It can generate a stressful environment, so something fundamental is the knowledge about the disease, learn about the behaviors to continue to help your child to the social insertion and the most important thing to make the child feel in a safe environment. Offer understanding and help whenever the child needs it. Never ask him to control his tics since they are uncontrollable. Parents must collaborate in schools to achieve special and TOURETTE SYNDROME 9 personalized attention to their child. In many cases both children and youth are victims of bullying by their peers, for this reason should talk with them
  • 20. and teach them to be prepared to lead with the harmful comments. It is very useful to disseminate the characteristics of this disease at a social level, especially in the schools and work centers where those affected are located. We must create favorable conditions for each person with this syndrome, so that they can develop their activities in a pleasant way. Help and support your child in establishing personal relationships, participating in activities and not isolating himself. This will help him meet new people, make new friends and develop social skills. Parents should not limit the daily activities of their children, the children should try to learn and perform all their activities if they are sure that they have the capacity to develop them, otherwise the children could experience frustration. When children and their families manage to understand and live with the disease, life is not so difficult.
  • 21. TOURETTE SYNDROME 10 Conclusions The Gilles de la Tourette Syndrome, despite having been discovered since the 19th century, continues being an enigma. It is a chronic behavioral neurological disorder; whose symptoms appear in childhood or adolescence. Significant aspect because children and young people begin to live from an early age with this condition, whose assimilation can be difficult and contradictory. This syndrome is not only motor and vocal tics; it goes much further. The rejection produced by social ignorance generates stress to the patients who suffer it. That is why knowledge about the disease at the social level becomes one of the most important aspects to achieve the assessment and attention of the educational and social needs of these patients. We must achieve a tolerant and understanding environment that encourages them to develop their capacities and that be flexible to be adapted to the demands of these people.
  • 22. TOURETTE SYNDROME 11 References Basal ganglia diseases; new Tourette Syndrome findings from St. George's hospital outlined (are there distinct subtypes in Tourette Syndrome? Pure-Tourette syndrome versus Tourette Syndrome-Plus, and simple versus complex tics). (2015, Jul 11). Psychology & Psychiatry Journal Retrieved from https://search.proquest.com/docview/1692762483?accountid=15 8399. Deng, H., Gao, K., & Jankovic, J. (2012). The genetics of Tourette Syndrome. Nature Reviews.Neurology, 8(4), 203-213. doi:http://dx.doi.org/10.1038/nrneurol.2012.26 Tourette Syndrome https://my.clevelandclinic.org<article
  • 23. Kronenbuerger, M., Belenghi, P., Ilgner, J., Freiherr, J., Hummel, T., & Neuner, I. (2018). Olfactory functioning in adults with Tourette Syndrome. PLoS One, 13(6) doi:http://dx.doi.org/10.1371/journal.pone.0197598 https://search.proquest.com/docview/1692762483?accountid=15 8399 TOURETTE SYNDROME 12 TOURETTE SYNDROME 13 Category Exceeds Standards Meets Standards
  • 24. Nearly Meets standards Does Not Meet Standards No Evidence Score Title Page Assigned Title, Your Full Name, School Name, Professor’s Name and credentials, and Date of submission. In addition to the Capitalized Running head and Page number. No errors. Evidence of five aspects or more Evidence of four to three aspects Evidence of two aspects or less Absent. 0-10 Abstract Page Clearly and concisely states the paper’s purpose. The abstract content is engaging, states the main topic and previews the structure of the paper. The introduction states the main topic and previews the structure of the paper.
  • 25. The introduction states the main topic but does not adequately preview the structure of the paper. There is no clear introduction or main topic and the structure of the paper is missing. Absent or no evidence. 0-10 Content pages: (60 points) (Developing Body Pages) Content pages have thoughtful supporting detail sentences that develop the main idea of the topic. Content pages have sufficient supporting detail sentences that develop the main of the topic. Content pages lacks supporting detail sentences of the topic. Content pages fail to develop the main idea of the topic. Not applicable 0-10 Organization of structural development of the research paper topic.
  • 26. Student demonstrates logical sequencing of ideas through well- developed paragraphs, relevant info and details about the topic. Used DSM-5 criteria and database information to support your paper. Paragraph development present but not perfected. Logical organization; organization of ideas not fully developed. No evidence of structure or organization. Not applicable 0-20 Mechanics No errors in punctuation, capitalization and spelling. Almost no errors in punctuation, capitalization and spelling Many errors in punctuation, capitalization and spelling. Numerous and distracting errors in punctuation, capitalization and spelling. Not applicable
  • 27. 0-10 Usage No errors sentence structure and word usage. Almost no errors in sentence structure and word usage. Many errors in sentence structure and word usage. Numerous and distracting errors in sentence structure and word usage. Not applicable. 0-10 Citation All cited works, both text and visual, are done in the correct format with no errors. Some cited works, both text and visual, are done in the correct format. Inconsistencies evident. Few cited works, both text and visual, are done in the correct format. Absent Not applicable.
  • 28. 0-10 Conclusion Page The conclusion is engaging and restates the main points from the research a topic as well as the use of statistics and/or percentages. The conclusion restates the fairly the main point of the research paper topic. The conclusion does not adequately restate the paper topic. Incomplete and/or unfocused. Absent or no evidence. 0-10 Reference Page Done in the correct format with no errors. Includes three (3) or more professional journals from FNU database and any other reliable source of information to support your paper topic. Wikipedia is Not a reliable source of information. Please, Do NOT use it!!! Done in the correct format with a few errors. Includes three (3) or more professional journals from FNU database and five (5) references (e.g. science journal articles, books, but no more than five internet sites. Periodicals available on-line are not considered internet sites)
  • 29. Done in the correct format with some errors. Includes only two (2) of the professional journals from the FNU database and three to four (3-4) major references (e.g. science journal articles, books, but no more than two internet sites. Periodicals available on-line are not considered internet). Done in the correct format with many errors. It did not include any professional journals from the FNU database and one to two (1-2) major references (e.g. science journal articles, books, but no more than two internet sites. Periodicals available on-line are not considered internet sites.) Absent or the only sites are internet sites. 0-10 Research Paper Rubric for Florida National University. Prof. Rafael Ramos, M.S. 3