Tic disorders (TD), which are neurodevelopmental issues that cause physical tics, are commonly found in children who also have another psychological challenge. “The majority of individuals with TD (up to 90%) have at least one comorbid psychiatric disorder, with attention-deficit/hyperactivity disorder (ADHD) being the most frequent co-occurring condition,” said Ellen Greimel of the Department of Child and Adolescent Psychiatry at the University Hospital of the RWTH Aachen in Germany. “ADHD has been shown to substantially account for impairments in social, cognitive and school functioning in individuals comorbid with TD and ADHD.” To date, research on the relationship between ADHD and TD has been mixed. “A number of studies that have investigated attentional functions in subjects with co-occurring TD and ADHD have revealed unexpected results as they have shown superior performance in participants comorbid with both disorders compared to participants with ‘ADHD only’ in selective or sustained attention tasks.”
To clarify the cloudy evidence that already exists, Greimel and her colleagues assessed the cognitive and social impact of TD, ADHD and TD and ADHD together in 96 adolescents of mixed diagnoses. What they discovered supported their hypothesis. “In sum, as expected, we found that the diagnosis of ADHD was associated with impaired attentional functions: regardless of a diagnosis of TD, participants with ADHD were found to perform worse in tasks related to the supervisory attentional system, the selectivity domain and the intensity domain of attention,” said Greimel. “Also in line with our hypothesis, a diagnosis of TD had no negative impact on attentional task parameters; participants with TD even outperformed individuals without a diagnosis of TD in the set shifting task.” Greimel added, “Our results add to previous findings showing that in TD, comorbid disorders often are far more impairing than the tics themselves with regard to functioning in several areas, including general cognitive, academic and social skills.” She believes that children with both TD and ADHD should receive treatment for the problem that most disrupts their ability to function adequately.
Greimel, Ellen, Sina Wanderer, Aribert Rothenberger, Beatte Herpertz-Dahlmann, Kerstin Konrad, and Veitt Roessner. “Attentional Performance in Children and Adolescents with Tic Disorder and Co-Occurring Attention-Deficit/Hyperactivity Disorder: New Insights from a 2×2 Factorial Design Study.” Journal of Abnormal Child Psychology 39 (2011): 819-28. Print.
© Copyright 2011 by By John Smith, therapist in Bellingham, Washington. All Rights Reserved. Permission to publish granted to GoodTherapy.org.