Abstract
The research on Tourette’s disorder (TD), a neuropsychological disorder consisting of motor and phonic tics, has largely focused on individuals with TD and not on the caregivers of children with TD. We investigated the effects of several variables on caregiver strain of caregivers of children with TD, including perceived social support, caregiver characteristics, and characteristics of the child’s disorder. An online survey was completed by 140 caregivers of children with TD between the ages of 6 to 18 years. We performed a path analysis to examine the outcome of caregiver strain in relation to the research variables. Our results indicated that caregiver age, symptom severity of the child’s TD, and perceived social support accounted for variance in caregiver strain, and that perceived social support was a partial mediator of child’s symptom severity and caregiver strain. Symptom severity and caregiver strain were also related to the presence of other comorbid disorders, such as Oppositional Defiant Disorder (ODD), anxiety, or Attention Deficit Hyperactivity Disorder (ADHD) when compared to children either having no other comorbid disorders or other types of disorders.
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References
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: Author.
Baldwin, K., Brown, R. T., & Milan, M. A. (1995). Predictors of stress in caregivers of attention deficit hyperactivity disordered children. The American Journal of Family Therapy, 23, 149–160.
Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173–1182.
Brannan, A. M., & Heflinger, C. A. (1997). The caregiver strain questionnaire: Measuring the impact on the family of living with a child with serious emotional disturbance. Journal of Emotional & Behavioral Disorders, 5, 212–223.
Brehaut, J. C., Kohen, D. E., Raina, P., Walter, S. D., Russell, D. J., Swinton, M. et al. (2004). The health of primary caregivers of children with cerebral palsy: How does it compare with that of other Canadian caregivers? Pediatrics, 114, 182–191.
Carter, A. S., O’Donnell, D. A., Schultz, R. T., Scahill, L., Leckman, J. F., & Pauls, D. L. (2000). Social and emotional adjustment in children affected with Gilles de la Tourette’s syndrome: Associations with ADHD and family functioning. Journal of Child Psychology and Psychiatry, 41, 215–223.
Coffey, B. J., Biederman, J., Geller, D. A., Spencer, T. J., Kim, G. S., Bellordre, C. A. et al. (2000). Distinguishing illness severity from tic severity in children and adolescents with Tourette’s disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 556–561.
Cohen, S., & McKay, G. (1984). Social support, stress, and the buffering hypotheses: A theoretical analysis. In A. Baum, J. E. Singer, & S. E. Taylor (Eds.), Handbook of psychology and health (Vol. 4, pp. 253–267). Hillsdale, NJ: Erlbaum.
Cohen, S., & Wills, T. A. (1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98, 310–357.
Comings, D. E. (1990). Tourette syndrome and human behavior. Duarte, CA: Hope Press.
Cooper, C., Robertson, M. M., & Livingston, G. (2003). Psychological morbidity and caregiver burden in parents of children with Tourette’s disorder and psychiatric comorbidity. Journal of the American Academy of Child and Adolescent Psychiatry, 42(11), 1370–1375.
Early, T. J., Gregoire, T. K., & McDonald, T. P. (2002). Child functioning and caregiver well-being in families of children with emotional disorders. Journal of Family Issues, 23, 374–391.
England, M. (2000). Caregiver strain: Considerations for change. Nursing Diagnosis, 11, 164–175.
Freeman, R. D., Fast, D. K., Burd, L., Kerbeshian, J., Robertson, M. M., & Sandor, P. (2000). An international perspective on Tourette syndrome: Selected findings from 3500 individuals in 22 countries. Developmental Medicine and Child Neurology, 42, 436–447.
Fuller, G. B., & Rankin, R. E. (1994). Differences in levels of parental stress among mothers of learning disabled, emotionally impaired, and regular school children. Perceptual and Motor Skills, 78, 583–592.
Gaffney, G. R., Sieg, K., & Hellings, J. (1994). The MOVES: A self-rating scale for Tourette’s syndrome. Journal of Child and Adolescent Psychopharmacology, 4, 269–280.
Jaccard, J., Turrisi, R., & Wan, C. K. (1990). Interaction effects in multiple regression. Newbury Park, CA: Sage Publications.
Klem, L. (1995). Path analysis. In L. G. Grimm & P. R. Yarnold (Eds.), Reading and understanding multivariate statistics (pp. 65–97). Washington, DC: American Psychological Association.
Lunsky, Y., & Benson, B. A. (2001). Association between perceived social support and strain, and positive and negative outcome for adults with mild intellectual disability. Journal of Intellectual Disability Research, 45, 106–114.
Preacher, K. J., & Leonardelli, G. J. (2003). Calculation for the Sobel Test: An interactive calculation tool for mediation tests. Retrieved May 10, 2004 from University of North Carolina at Chapel Hill Web site: http://www.unc.edu/%7Epreacher/sobel/sobel.htm
Robertson, M. M. (2000). Invited review: Tourette syndrome, associated conditions and the complexities of treatment. Brain, 123, 425–462.
Singer, H. S., & Walkup, J. T. (1991). Tourette syndrome and other tic disorders: Diagnosis, pathophysiology, and treatment. Medicine, 70, 15–32.
Staley, D., Wand, R., & Shady, G. (1997). Tourette disorder: A cross-cultural review. Comprehensive Psychiatry, 38, 6–16.
Wilkinson, B. J., Newman, M. B., Shytle, R. D., Silver, A. A., Sanberg, P. R., & Sheehan, D. (2001). Family impact of Tourette’s syndrome. Journal of Child and Family Studies, 10, 477–482.
Wodrich, D. L., Benjamin, E., & Lachar, D. (1996). Tourette’s syndrome and psychopathology in a child psychiatry setting. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 1618–1624.
Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley, G. K. (1988). The multidimensional scale of perceived social support. Journal of Personality Assessment, 52, 30–41.
Zimet, G. D., Powell, S. S., Farley, G. K., Werkman, S., & Berkoff, K. A. (1990). Psychometric characteristics of the Multidimensional scale of perceived social support. Journal of Personality Assessment, 55, 610–617.
Acknowledgments
We would like to thank the caregivers of children with TD that participated in this study. We would also like to thank Leslie Packer, Ph.D., for her willingness to sponsor a link to our survey on her website: www.tourettesyndrome.net and all the other people that passed along information about participating in this study. This research would not have been possible without their generosity.
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Schoeder, C.E., Remer, R. Perceived Social Support and Caregiver Strain in Caregivers of Children with Tourette’s Disorder. J Child Fam Stud 16, 888–901 (2007). https://doi.org/10.1007/s10826-007-9133-6
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DOI: https://doi.org/10.1007/s10826-007-9133-6