Abstract
The purpose of the study was to characterize repetitive phenomena in Williams syndrome (WS). The parents of 60 subjects with WS completed the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) or Children’s Y-BOCS, the Yale Global Tic Severity Scale, the Stereotyped Behavior Scale, and the Spence Children’s Anxiety Scale–Parent Version. Nineteen males and 41 females participated in the study. Six subjects (10%) had obsessions only, six (10%) had compulsions only, and eleven (18%) had at least one obsession and at least one compulsion. None of the subjects had tics. Fifty subjects (83.3%) endorsed at least one stereotypy. Increased anxiety was associated with increased severity of obsessions, but not severity of compulsions or stereotypies.
Similar content being viewed by others
References
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders. (2013) (5th ed.). Arlington, VA: American Psychiatric Association.
Asada, K., & Itakura, S. (2012). Social phenotypes of autism spectrum disorders and Williams syndrome: Similarities and differences. Frontiers in Psychology. https://doi.org/10.3389/fpsyg.2012.00247.
Davies, M., Udwin, O., & Howlin, P. (1998). Adults with Williams syndrome: Preliminary study of social, emotional and behavioural difficulties. British Journal of Psychiatry, 172, 273–276. https://doi.org/10.1192/bjp.172.3.273.
Goodman, W. K., Price, L. H., Rasmussen, S. A., Mazure, C., Delgado, P., Heninger, G. R., & Charney, D. S. (1989a). The Yale-brown obsessive compulsive scale: II. Validity. Archives of General Psychiatry, 46(11), 1012–1016. https://doi.org/10.1001/archpsyc.1989.01810110054008.
Goodman, W. K., Price, L. H., Rasmussen, S. A., Mazure, C., Fleischmann, R. L., Hill, C. L., Heninger, G. R., & Charney, D. S. (1989b). The yale-brown obsessive compulsive scale: I. development, use, and reliability. Archives of General Psychiatry, 46(11), 1006–1011. https://doi.org/10.1001/archpsyc.1989.01810110048007.
Green, T., Avda, S., Dotan, I., Zarchi, O., Basel-Vanagaite, L., Zalsman, G., Weizman, A., & Gothelf, D. (2012). Phenotypic psychiatric characterization of children with Williams syndrome and response of those with ADHD to methylphenidate treatment. American Journal of Medical Genetics, Part B: Neuropsychiatric Genetics,. https://doi.org/10.1002/ajmg.b.31247.
Harris, K. M., Mahone, E. M., & Singer, H. S. (2008). Nonautistic motor stereotypies: Clinical features and longitudinal follow-up. Pediatric Neurology, 38(4), 267–272. https://doi.org/10.1016/j.pediatrneurol.2007.12.008.
Kaufman, A. (2004). KBIT-2 Kaufman Brief Intelligence Test 2nd Edition. (A. Publishing, Ed.) (2nd ed.). Circle Pines, MN. https://www.pearsonassessments.com/store/usassessments/en/Store/Professional-Assessments/Cognition-%26-Neuro/Non-Verbal-Ability/Kaufman-Brief-Intelligence-Test-%7C-Second-Edition/p/100000390.html.
Klein-Tasman, B. P., Mervis, C. B., Lord, C., & Phillips, K. D. (2007). Socio-communicative deficits in young children with Williams syndrome: Performance on the autism diagnostic observation schedule. Child Neuropsychology, 13(5), 444–467. https://doi.org/10.1080/09297040601033680.
Klein, A. J., Armstrong, B. L., Greer, M. K., & Brown, F. R. (1990). Hyperacusis and otitis media in individuals with williams syndrome. Journal of Speech and Hearing Disorders, 55(2), 339–344. https://doi.org/10.1044/jshd.5502.339.
Knight, T., Steeves, T., Day, L., Lowerison, M., Jette, N., & Pringsheim, T. (2012). Prevalence of tic disorders: A systematic review and meta-analysis. Pediatric Neurology, 47(2), 77–90. https://doi.org/10.1016/j.pediatrneurol.2012.05.002.
Leckman, J. F., Riddle, M. A., Hardin, M. T., Ort, S. I., Swartz, K. L., Stevenson, J., & Cohen, D. J. (1989). The yale global tic severity scale: Initial testing of a clinician-rated scale of tic severity. Journal of the American Academy of Child and Adolescent Psychiatry, 28(4), 566–573. https://doi.org/10.1097/00004583-198907000-00015.
Leyfer, O. T., Woodruff-Borden, J., Klein-Tasman, B. P., Fricke, J. S., & Mervis, C. B. (2006). Prevalence of psychiatric disorders in 4 to 16-year-olds with Williams syndrome. American Journal of Medical Genetics Part B, Neuropsychiatric Genetics: The Official Publication of the International Society of Psychiatric Genetics, 141B(6), 615–622. https://doi.org/10.1002/ajmg.b.30344.
Long, J., & Ervin, L. (2000). Using heteroscedasticity consistent standard errors in the linear regression model. The American Statistician, 54, 217–224.
López-Pina, J. A., Sánchez-Meca, J., López-López, J. A., Marín-Martínez, F., Núñez-Núñez, R. M., Rosa-Alcázar, A. I., et al. (2015). The yale-brown obsessive compulsive scale: A reliability generalization meta-analysis. Assessment, 22(5), 619–628. https://doi.org/10.1177/1073191114551954.
March, J. S. (2004). Cognitive-behavior therapy, sertraline, and their combination for children and adolescents with obsessive-compulsive disorder: The pediatric OCD treatment study (POTS) randomized controlled trial. Journal of the American Medical Association, 292(16), 1969–1976. https://doi.org/10.1001/jama.292.16.1969.
McDougle, C. J., Kresch, L. E., Goodman, W. K., Naylor, S. T., Volkmar, F. R., Cohen, D. J., & Price, L. H. (1995). A case-controlled study of repetitive thoughts and behavior in adults with autistic disorder and obsessive-compulsive disorder. American Journal of Psychiatry, 152(5), 772–777. https://doi.org/10.1176/ajp.152.5.772.
McDougle, C., Kresch, L., & Posey, D. (2000). Repetitive thoughts and behavior in pervasive developmental disorders: treatment with serotonin reuptake inhibitors. Journal of autism and developmental disorders, 30(5), 427–435. https://doi.org/10.1023/a:1005551523657.
Nauta, M. H., Scholing, A., Rapee, R. M., Abbott, M., Spence, S. H., & Waters, A. (2004). A parent-report measure of children’s anxiety: Psychometric properties and comparison with child-report in a clinic and normal sample. Behaviour Research and Therapy, 42(7), 813–839. https://doi.org/10.1016/S0005-7967(03)00200-6.
Nicita, F., Garone, G., Spalice, A., Savasta, S., Striano, P., Pantaleoni, C., et al. (2016). Epilepsy is a possible feature in Williams-Beuren syndrome patients harboring typical deletions of the 7q1123 critical region. American Journal of Medical Genetics, Part A, 170(1), 148–155. https://doi.org/10.1002/ajmg.a.37410.
Péter, Z., Oliphant, M. E., & Fernandez, T. V. (2017). Motor stereotypies: A pathophysiological review. Frontiers in Neuroscience. https://doi.org/10.3389/fnins.2017.00171.
Pober, B. R. (2010). Williams-Beuren syndrome. The New England Journal of Medicine, 362(3), 239–252. https://doi.org/10.1056/NEJMra0903074.
Rojahn, J., Matlock, S. T., & Tassé, M. J. (2000). The stereotyped behavior scale: Psychometric properties and norms. Research in Developmental Disabilities, 21(6), 437–454. https://doi.org/10.1016/S0891-4222(00)00057-3.
Royston, R., Howlin, P., Waite, J., & Oliver, C. (2017). Anxiety disorders in Williams Syndrome contrasted with intellectual disability and the general population: A systematic review and meta-analysis. Journal of Autism and Developmental Disorders, 47(12), 3765–3777. https://doi.org/10.1007/s10803-016-2909-z.
Royston, R., Oliver, C., Moss, J., Adams, D., Berg, K., Burbidge, C., Howlin, P., Nelson, L., Stinton, C., & Waite, J. (2018). Brief report: repetitive behaviour profiles in Williams syndrome: cross syndrome comparisons with Prader-Willi and down syndromes. Journal of Autism and Developmental Disorders, 48(1), 326–331. https://doi.org/10.1007/s10803-017-3319-6.
Scahill, L., Riddle, M. A., McSwiggin-Hardin, M., Ort, S. I., King, R. A., Goodman, W. K., Cicchetti, D., & Leckman, J. F. (1997). Children’s yale-brown obsessive compulsive scale: Reliability and validity. Journal of the American Academy of Child and Adolescent Psychiatry, 36(6), 844–852. https://doi.org/10.1097/00004583-199706000-00023.
Singer, H. S. (2009). Motor stereotypies. Seminars in Pediatric Neurology, 16(2), 77–81. https://doi.org/10.1016/j.spen.2009.03.008.
Smith, V., Preisser, J., Neelon, B., & Maciejewski, M. (2014). A marginalized two-part model for semicontinuous data. Statistics in Medicine, 33(28), 4891–4903.
Spence, S. H. (1998). A measure of anxiety symptoms among children. Behaviour Research and Therapy, 36(5), 545–566. https://doi.org/10.1016/S0005-7967(98)00034-5.
Storch, E. A., De Nadai, A. S., Rosário, C. D. M., Shavitt, R. G., Torres, A. R., Ferrão, Y. A., Miguel, C. E., Lewin, A. B., & Fontenelle, L. F. (2015). Defining clinical severity in adults with obsessive-compulsive disorder. Comprehensive Psychiatry, 63, 30–35. https://doi.org/10.1016/j.comppsych.2015.08.007.
Thom, R. P., & McDougle, C. J. (2021). A comprehensive review of the assessment and differential diagnosis of repetitive thoughts and behaviors in autism spectrum and other neuropsychiatric disorders. Review Journal of Autism and Developmental Disorders. Submitted.
Woodruff-Borden, J., Kistler, D. J., Henderson, D. R., Crawford, N. A., & Mervis, C. B. (2010). Longitudinal course of anxiety in children and adolescents with Williams syndrome. American Journal of Medical Genetics Part C: Seminars in Medical Genetics, 154C(2), 277–290. https://doi.org/10.1002/ajmg.c.30259.
Zainal, H., Magiati, I., Tan, J. W. L., Sung, M., Fung, D. S. S., & Howlin, P. (2014). A preliminary investigation of the Spence children’s anxiety parent scale as a screening tool for anxiety in young people with autism spectrum disorders. Journal of Autism and Developmental Disorders, 44(8), 1982–1994. https://doi.org/10.1007/s10803-014-2075-0.
Acknowledgment
The authors thank the individuals with Williams syndrome and their families for their participation.
Funding
This work was funded, in part, by the Nancy Lurie Marks Family Foundation.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors have no conflicts of interest to disclose.
Research involving human/animal participants
The research involved human participants whose legal guardians provided informed consent. The research participants provided informed assent. The research did not involve animals.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Huston, J.C., Thom, R.P., Ravichandran, C.T. et al. Repetitive Thoughts and Repetitive Behaviors in Williams Syndrome. J Autism Dev Disord 52, 852–862 (2022). https://doi.org/10.1007/s10803-021-04979-w
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10803-021-04979-w