Abstract
The premonitory urge for tics scale (PUTS) is a common self-report measure of premonitory sensations preceding tics. The present study aimed to examine the internal consistency and concurrent validity of the PUTS by sex and psychiatric comorbidity status; and explored interactions between sex and psychiatric comorbidity in predicting premonitory urge and tic symptom severity. Seventy-four youth and young adults with persistent tic disorders completed the PUTS, while their parents completed the parent tic questionnaire (PTQ) and a demographic measure. Independent samples t-tests revealed no significant sex differences in PUTS items or total score. The PUTS total score also did not significantly differ between participants with and without attention-deficit hyperactivity disorder (ADHD) and/or obsessive–compulsive disorder (OCD) comorbidity. Internal consistency did not significantly differ between females (α = 0.85) and males (α = 0.75), and those with comorbid ADHD and/or OCD (α = 0.83) relative to those without (α = 0.69). With respect to concurrent validity, the PUTS total was significantly correlated with PTQ tic frequency, intensity, number, and severity for males but not for females. Among those with ADHD and/or OCD, the PUTS total score was correlated significantly and strongly with tic number and moderately with tic intensity. Interactions between sex and psychiatric comorbidity performed using 2 × 2 analysis of variance did not significantly predict the PUTS total or PTQ subscale scores. Findings suggest sex and comorbidity status may influence premonitory urge expression. Results have implications for understanding and measurement of the premonitory urge.
Similar content being viewed by others
References
American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Publishing, Arlington
Brandt VC, Beck C, Sajin V, Anders S, Münchau A (2016a) Convergent validity of the PUTS. Front Psychiatry 7:51. https://doi.org/10.3389/fpsyt.2016.00051
Brandt VC, Beck C, Sajin V, Baaske MK, Bäumer T, Beste C, Anders S, Münchau A (2016b) Temporal relationship between premonitory urges and tics in Gilles de la Tourette syndrome. Cortex 77:24–37. https://doi.org/10.1016/j.cortex.2016.01.008
Chang S, Himle MB, Tucker BTP, Piacentini J (2009) Initial psychometric properties of a brief parent-report instrument for assessing tic severity in children with chronic tic disorders. Child Fam Behav Ther 31:181–191. https://doi.org/10.1080/07317100903099100
Cohen J (1988) Statistical power analysis for the behavioral sciences, 2nd edn. Erlbaum, Hillsdale
Cohen AJ, Leckman JF (1992) Sensory phenomena associated with Gilles de la Tourette’s syndrome. J Clin Psychiatry 53:319–323
Crossley E, Cavanna AE (2013) Sensory phenomena: clinical correlates and impact on quality of life in adult patients with Tourette syndrome. Psychiatry Res 209:705–710. https://doi.org/10.1016/j.psychres.2013.04.019
Eddy CM, Cavanna AE (2014) Premonitory urges in adults with complicated and uncomplicated Tourette syndrome. Behav Modif 38:264–275. https://doi.org/10.1177/0145445513504432
Greydanus DE, Kaplan G, Antshel KM (2013) Attention deficit hyperactivity disorder: neuropsychologic and pharmacologic aspects. Int J Child Adolesc Health 6:159–174
Gulisano M, Cali P, Palermo F, Robertson M, Rizzo R (2015) Premonitory urges in patients with Gilles de la Tourette Syndrome: an Italian translation and a 7-year follow-up. J Child Adolesc Psychopharmacol. https://doi.org/10.1089/cap.2014.0154
Houghton DC, Capriotti MR, Scahill LD, Wilhelm S, Peterson AL, Walkup JT, Piacentini J, Woods DW (2017) Investigating habituation to premonitory urges in behavior therapy for tic disorders. Behav Ther 48:834–846. https://doi.org/10.1016/j.beth.2017.08.004
Kano Y, Matsuda N, Nonaka M, Fujio M, Kuwabara H, Kono T (2015) Sensory phenomena related to tics, obsessive-compulsive symptoms, and global functioning in Tourette syndrome. Compr Psychiatry 62:141–146. https://doi.org/10.1016/j.comppsych.2015.07.006
Leckman JF, Walker DE, Cohen DJ (1993) Premonitory urges in Tourette’s syndrome. Am J Psychiatry 150:98–102. https://doi.org/10.1176/ajp.150.1.98
Li Y, Wang F, Liu J, Wen F, Yan C, Zhang J, Lu X, Cui Y (2019) The correlation between the severity of premonitory urges and tic symptoms: a meta-analysis. J Child Adolesc Psychopharmacol 29:652–658. https://doi.org/10.1089/cap.2019.0048
Lichter DG, Finnegan SG (2015) Influence of gender on Tourette syndrome beyond adolescence. Eur Psychiatry 30:334–340. https://doi.org/10.1016/j.eurpsy.2014.07.003
McGuire JF, McBride N, Piacentini J, Johnco C, Lewin AB, Murphy TK, Storch EA (2016) The premonitory urge revisited: an individualized premonitory urge for tics scale. J Psychiatr Res 83:176–183. https://doi.org/10.1016/j.jpsychires.2016.09.007
Nunnally JC, Bernstein IH (1994) Psychometric theory, 3rd edn. McGraw-Hill, New York
Openneer TJC, Tárnok Z, Bognar E et al (2019) The Premonitory Urge for Tics Scale in a large sample of children and adolescents: psychometric properties in a developmental context An EMTICS study. Eur Child Adolesc Psychiatry. https://doi.org/10.1007/s00787-019-01450-1
Raines JM, Edwards KR, Sherman MF, Higginson CI, Winnick JB, Navin K, Gettings JM, Conteh F, Bennett SM, Specht MW (2018) Premonitory urge for tics scale (PUTS): replication and extension of psychometric properties in youth with chronic tic disorders (PTDs). J Neural Transm 125:727–734. https://doi.org/10.1007/s00702-017-1818-4
Reese HE, Scahill L, Peterson AL, Crowe K, Woods DW, Piacentini J, Walkup JT, Wilhelm S (2014) The premonitory urge to tic: Measurement, characteristics and correlates in older adolescents and adults. Behav Ther 45:177–186. https://doi.org/10.1016/j.beth.2013.09.002
Ricketts EJ, Bauer CC (2018) Habit reversal training for tics. In: McGuire JF, Murphy TK, Piacentini J, Storch EA (eds) The clinician’s guide to treatment and management of youth with Tourette syndrome and tic disorders. Academic Press, London, pp 43–70
Ricketts EJ, McGuire JF, Chang S, Bose D, Rasch MM, Woods DW, Specht MW, Walkup JT, Scahill L, Wilhelm S, Peterson AL, Piacentini J (2017) Benchmarking treatment response in Tourette’s disorder: a psychometric evaluation and signal detection analysis of the parent tic questionnaire. Behav Ther 49:46–56. https://doi.org/10.1016/j.beth.2017.05.006
Robertson MM (2014) Tourette syndrome—beyond swearing and sex? Nat Rev Neurol 10:6–8. https://doi.org/10.1038/nrneurol.2013.248
Rosario MC, Prado HS, Borcato S, Diniz JB, Shavitt RG, Hounie AG, Mathis ME, Mastrorosa RS, Velloso P, Perin EA, Fossaluza V, Pereira CA, Geller D, Leckman J, Miguel E (2009) Validation of the University of São Paulo Sensory Phenomena Scale: initial psychometric properties. CNS Spectr 14:315–323. https://doi.org/10.1017/S1092852900020319
Sambrani T, Jakubovski E, Muller-Vahl KR (2016) New insights into clinical characteristics of Gilles de la Tourette Syndrome: findings in 1032 patients from a single German center. Front Neurosci 10:415. https://doi.org/10.3389/fnins.2016.00415
Specht MW, Woods DW, Piacentini J et al (2011) Clinical characteristics of children and adolescents with a primary tic disorder. J Dev Phys Disabil 23:15–31. https://doi.org/10.1007/s10882-010-9223-z
Specht MW, Woods DW, Nicotra CM, Kelly LM, Ricketts EJ, Conelea CA, Grados MA, Ostrander RS, Walkup JT (2013) Effects of tic suppression: ability to suppress, rebound, negative reinforcement, and habituation to the premonitory urge. Behav Res Ther 51:24–30. https://doi.org/10.1016/j.brat.2012.09.009
Steinberg T, Baruch SS, Harush AH, Dar R, Woods D, Piacentini J, Apter A (2010) Tic disorders and the premonitory urge. J Neural Transm 117:277–284. https://doi.org/10.1007/s00702-009-0353-3
Sutherland Owens AN, Miguel EC, Swerdlow NR (2011) Sensory gating scales and premonitory urges in Tourette syndrome. Sci World J 11:736–741. https://doi.org/10.1100/tsw.2011.57
Woods DW, Piacentini J, Himle MB, Chang S (2005) Premonitory urge for tics scale (PUTS): initial psychometric results and examination of the premonitory urge phenomenon in youths with tic disorders. J Dev Behav Pediatr 26:397–403. https://doi.org/10.1007/s00702-009-0353-3
Woods DW, Piancentini J, Chang SW, Deckersbach T, Ginsburg GS, Peterson AL, Scahill LD, Walkup JT, Wilhelm S (2008) Managing Tourette syndrome: a behavioral intervention for children and adults: therapist guide. Oxford University Press, New York
Acknowledgements
The authors would like to express their gratitude to Ms. Ashley Shields for her help with project oversight during data analysis and Dr. Julie Gettings for her help with the results and manuscript preparation.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare no conflicts of interest.
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
Edwards, K.R., Raines, J.M., Winnick, J.B. et al. Sex and psychiatric comorbidity correlates of the premonitory urge for tic scale in youth with persistent tic disorders. J Neural Transm 127, 977–985 (2020). https://doi.org/10.1007/s00702-020-02151-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00702-020-02151-9