Abstract
Youth with Tourette syndrome (TS) often exhibit disruptive behaviors. Although improvement data on rating scales support the efficacy of structured psychotherapeutic interventions, there is growing interest in personalized outcome assessments. This report examined parent-nominated target problems (PTPs) as an individualized outcome measure in 48 youth with TS and disruptive behaviors, who participated in one of two randomized psychotherapy trials. At baseline, parents described two primary problems to an independent evaluator who generated a structured narrative for each problem. These narratives were reviewed and updated at endpoint. When rated by five treatment-blind judges, the PTP rating demonstrated excellent reliability and good convergent validity with the Disruptive Behavior Rating Scale (DBRS). The PTP rating exhibited comparable treatment effects to the DBRS, and accounted for additional variance in global treatment outcome. The PTP rating serves a reliable, valid, and sensitive personalized assessment in research trials that provides complementary information to standardized rating scales.
Similar content being viewed by others
References
Scahill L, Dalsgard S, Bradbury K (2013) The prevalence of Tourette syndrome and clinical characteristics in children. In: Martino D, Leckman JF (eds) Tourette sydrome. Oxford, New York, pp 121–136
Lin H, Yeh CB, Peterson BS, Scahill L, Grantz H, Findley DB et al (2002) Assessment of symptom exacerbations in a longitudinal study of children with Tourette’s syndrome or obsessive-compulsive disorder. J Am Acad Child Adolesc Psychiatry 41:1070–1077
Storch EA, Lack CW, Simons LE, Goodman WK, Murphy TK, Geffken GR (2007) A measure of functional impairment in youth with Tourette’s Syndrome. J Pediatr Psychol 32:950–959
Bitsko RH, Danielson M, King M, Visser SN, Scahill L, Perou R (2012) Health care needs of children with Tourette syndrome. J Child Neurol 28:1626–1636
Scahill L, Williams S, Schwab-Stone M, Applegate J, Leckman JF (2006) Disruptive behavior problems in a community sample of children with tic disorders. Adv Neurol 99:184–190
Kraft JT, Dalsgaard S, Obel C, Thomsen PH, Henriksen TB, Scahill L (2012) Prevalence and clinical correlates of tic disorders in a community sample of school-age children. Eur Child Adolesc Psychiatry 21:5–13
Scahill L, Sukhodolsky DG, Bearss K, Findley D, Hamrin V, Carroll DH et al (2006) Randomized trial of parent management training in children with tic disorders and disruptive behavior. J Child Neurol 21:650–656
Barkley RA (1997) Defiane children: a clinician’s manual for assessment and parent training. Guilford Press, New York
Sukhodolsky DG, Scahill L (2012) Cognitive-behavioral therapy for anger and aggression in children. Guilford Press, New York
Sukhodolsky DG, Vitulano LA, Carroll DH, McGuire J, Leckman JF, Scahill L (2009) Randomized trial of anger control training for adolescents with Tourette’s syndrome and disruptive behavior. J Am Acad Child Adolesc Psychiatry 48:413–421
Barkley RA, Edwards G, Laneri M, Fletcher K, Metevia L (2001) The efficacy of problem-solving communication training alone, behavior management training alone, and their combination for parent–adolescent conflict in teenagers with ADHD and ODD. J Consul Clin Psych 69:926–941
Guy W (1976) ECDEU assessment manual for psychopharmacology (publication 76–338). Department of Health, Education and Welfare, Washington
Piacentini J, Woods DW, Scahill L, Wilhelm S, Peterson AL, Chang S et al (2010) Behavior therapy for children with Tourette disorder: a randomized controlled trial. JAMA 303:1929–1937
Scahill L, Leckman JF, Schultz RT, Katsovich L, Peterson BS (2003) A placebo-controlled trial of risperidone in Tourette syndrome. Neurol 60:1130–1135
Insel TR (2009) Translating scientific opportunity into public health impact: a strategic plan for research on mental illness. Arch Gen Psychiatry 66:128–133
United States Food and Drug Administration (August 2011) Strategic plan for regulatory science (2012–2016). Retrieved from http://www.fda.gov/downloads/ScienceResearch/SpecialTopics/RegulatoryScience/UCM268225.pdf
Arnold LE, Wender PH, McCloskey K, Snyder SH (1972) Levoamphetamine and dextroamphetamine: comparative efficacy in the hyperkinetic syndrome. Assessment by target symptoms. Arch Gen Psychiatry 27:816–822
Arnold LE, Vitiello B, McDougle C, Scahill L, Shah B, Gonzalez NM et al (2003) Parent-defined target symptoms respond to risperidone in RUPP autism study: customer approach to clinical trials. J Am Acad Child Adolesc Psychiatry 42:1443–1450
Weisz JR, Chorpita BF, Frye A, Ng MY, Lau N, Bearman SK et al (2011) Youth top problems: using idiographic, consumer-guided assessment to identify treatment needs and to track change during psychotherapy. J Consul Clin Psych 79:369–380
Weisz JR, Chorpita BF, Palinkas LA, Schoenwald SK, Miranda J, Bearman SK et al (2012) Testing standard and modular designs for psychotherapy treating depression, anxiety, and conduct problems in youth: a randomized effectiveness trial. Arch Gen Psychiatry 69:274–282
Kaufman J, Birmaher B, Brent D, Rao U (1997) Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry 36:980–988
Feindler E, Ecton R (1986) Adolescent anger control: cognitive-behavioral techniques. Pergamon Press, New York
Gomez R, Burns GL, Walsh JA (2008) Parent ratings of the oppositional defiant disorder symptoms: item response theory analyses of cross-national and cross-racial invariance. J Psychopathol Behav 30:10–19
Leckman JF, Riddle MA, Hardin MT, Ort SI (1989) The yale global tic severity scale: initial testing of a clinician-rated scale of tic severity. J Am Acad Child Adolesc Psychiatry 28:566–573
Storch EA, Murphy TK, Geffken GR, Sajid M, Allen P, Roberti JW, Goodman WK (2005) Reliability and validity of the yale global tic severity scale. Psychol Assess 17:486–491
Scahill L, Riddle MA, McSwiggin-Hardin M, Ort SI (1997) Children’s yale-brown obsessive compulsive scale: reliability and validity. J Am Acad Child Adolesc Psychiatry 36:844–852
Storch EA, Murphy TK, Geffken GR, Soto O, Sajid M, Allen P, Roberti JW, Killiany EM, Goodman WK (2004) Psychometric evaluation of the children’s Yale–Brown Obsessive-Compulsive Scale. Psychiatry Res 129:91–98
Kaufman A, Kaufman N (1990) Kaufman brief intelligence test: manual. American Guidance Service, Circle Pines
Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174
Costello EJ, Mustillo S, Erkanli A, Keeler G, Angold A (2003) Prevalence and development of psychiatric disorders in childhood and adolescence. Arch Gen Psychiatry 60:837–844
Warnick EM, Bearss K, Weersing VR, Scahill L, Woolston J (2012) Shifting the treatment model: impact on engagement in outpatient therapy. Adm Policy Ment Health 41:93–103
Garland AF, Kruse M, Aarons GA (2003) Clinicians and outcome measurement: what’s the use? J Behav Health Ser Res 30:393–405
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
McGuire, J.F., Sukhodolsky, D.G., Bearss, K. et al. Individualized Assessments in Treatment Research: An Examination of Parent-Nominated Target Problems in the Treatment of Disruptive Behaviors in Youth with Tourette Syndrome. Child Psychiatry Hum Dev 45, 686–694 (2014). https://doi.org/10.1007/s10578-014-0437-7
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10578-014-0437-7