In hierdie studie is daar gefokus op Tourettesindroomlyers se leefwereldstigting, met spesifieke verwysing na hulle kognitiewe funksionering. Tourettesindroom is 'n neuropsigiatriese versteuring wat gewoonlik tydens die kinderjare 'n aanvang neem en wat deur motoriese en/of vokale tics gekenmerk word. Tourettesindroomlyers kan 'n verskeidenheid aanverwante versteurings manifesteer, byvoorbeeld Obsessief-kompulsiewe Versteuring, Aandaggebrekversteuring, met of sander hiperaktiwiteit, fobies en ander affektiewe afwykings. Aangesien die werklike oorsake van T ourettesindroom steeds 'n onbekende faktor is, is die behandeling van hierdie chroniese toestand nie 'n gewaarborgde sukses nie. Dit wil voorkom asof die insidensie van Tourettesindroom, wat heelwat hoer onder manlikes as vroulikes is, hoer is as wat aanvanklik vermoed is. Al ses die fasette van menswees kan deur Tourettesindroomlyers negatief beleef word. Op fisiese gebied toon navorsing verskillende abnormaliteite in die brein, byvoorbeeld by die afskeiding van die neurosenders soos dopamien en serotonien, 'n reduksie in die volume van die basale ganglia, 'n kleiner linker globus pallidus en versteurings in die frontale lobbe, die corpus callosum en die basale ganglia se senuweebane. Hulle konatiewe faset kan oorheers word deur hulle ongemotiveerdheid op kognitiewe gebied. Die normatiewe faset word dikwels weens verslawende gedrag belemmer. Die Tourettesindroomlyers se sosialisering kan swak wees weens hulle gedragsprobleme. Hierdie navorsing bevestig vorige ondersoeke wereldwyd wat toon dat depressie, slaapprobleme, angsversteurings en die onvermoe om stres te hanteer by sommige Tourettesindroomlyers kan bydra tot uitputting wat hulle kognitiewe funksionering belemmer. Tourettesindroomlyers presteer op kognitiewe gebied 6f uitstekend 6f uiters swak. Groot uiteenlopendhede word in die neuropsigologiese gedrag van Tourettesindroomlyers gemanifesteer, met 'n vermindering in hulle uitvoerende kognitiewe funksionering weens tekorte in hulle kognitiewe prosesseringsvermoens. Dit het verarmende gevolge vir hulle kognitiewe inhoud, struktuur en uiteindelik kognitiewe produkte. Algemene en spesifieke leerprobleme is die gevolg. Dit is dus te begrype dat Tourettesindroomlyers se betrokkenheid, belewing en betekenisgewing by die skoolsituasie en leerstof negatief beleef kan word. Saam met hulle vernederende simptome, fluktuasie van hulle punte en belemmerde leefwereldstigting, is die logiese gevolg ontwrigte selfbeelde. Tourettesindroomlyers benodig daadwerklike ondersteuning in hulle selfaktualisering ten einde waardevolle mensepotensiaal vir SuidAfrika te behou. / The focus of this study is the life-world formation of Tourette syndrome sufferers, with specific reference to their cognitive functioning. Tourette syndrome is a neuropsychological disorder which usually has its inception during childhood and is characterised by motor and/or vocal tics. Tourette syndrome sufferers may also exhibit a variety of related disorders, for example Obsessive Compulsive Disorder, Attention Deficit Disorder, with or without hyperactivity, phobias and various affective disorders. The cause of Tourette syndrome is still unknown, therefore treatment cannot be guaranteed to be successful. The incidence of Tcurette syndrome is higher than was initially suspected and is more prevalent among men. Tourette syndrome sufferers can negatively experience all six facets of humanity. In the physical area research indicates various abnormalities in the brain, for example the secretion of neurotransmitters, a reduction in the volume of the basal ganglia, a smaller left globus pallidus and disorders in the frontal lobes, the corpus callosum and the nerve circuitry of the basal ganglia. The conative facet may be dominated by their lack of motivation in the cognitive area. The normative facet is often hampered due to addictive behaviour. Socialisation can be poor due to behaviour problems. This research confirms previous investigations world-wide which indicated that depression, sleep and anxiety disorders and the inability to handle stress contributes to exhaustion, which impedes cognitive functioning. In the cognitive area Tourette syndrome sufferers perform either extremely well or extremely poorly. There are great discrepancies in the neuropsychological behaviour of Tourette syndrome sufferers and a reduction in their executive cognitive functioning due to shortages in their cognitive processing abilities. This has impoverishing consequences for their cognitive content, structure and eventually cognitive products resulting in general and specific learning disabilities. It is therefore understandable that Tourette syndrorne sufferers' involvement with, experiences of and attribution of meaning to the school situation and study material are negatively influenced. Add their humiliating symptoms, fluctuation of marks and hampered life-world formation and the logical result is disrupted self-images. Tourette syndrome sufferers need crucial support in their self-actualisation in order to be able to offer South Africa worthy human potential. / Psychology of Education / D. Ed.(Sielkundige Opvoedkunde)

In hierdie studie is daar gefokus op Tourettesindroomlyers se leefwereldstigting, met spesifieke verwysing na hulle kognitiewe funksionering. Tourettesindroom is 'n neuropsigiatriese versteuring wat gewoonlik tydens die kinderjare 'n aanvang neem en wat deur motoriese en/of vokale tics gekenmerk word. Tourettesindroomlyers kan 'n verskeidenheid aanverwante versteurings manifesteer, byvoorbeeld Obsessief-kompulsiewe Versteuring, Aandaggebrekversteuring, met of sander hiperaktiwiteit, fobies en ander affektiewe afwykings. Aangesien die werklike oorsake van T ourettesindroom steeds 'n onbekende faktor is, is die behandeling van hierdie chroniese toestand nie 'n gewaarborgde sukses nie. Dit wil voorkom asof die insidensie van Tourettesindroom, wat heelwat hoer onder manlikes as vroulikes is, hoer is as wat aanvanklik vermoed is. Al ses die fasette van menswees kan deur Tourettesindroomlyers negatief beleef word. Op fisiese gebied toon navorsing verskillende abnormaliteite in die brein, byvoorbeeld by die afskeiding van die neurosenders soos dopamien en serotonien, 'n reduksie in die volume van die basale ganglia, 'n kleiner linker globus pallidus en versteurings in die frontale lobbe, die corpus callosum en die basale ganglia se senuweebane. Hulle konatiewe faset kan oorheers word deur hulle ongemotiveerdheid op kognitiewe gebied. Die normatiewe faset word dikwels weens verslawende gedrag belemmer. Die Tourettesindroomlyers se sosialisering kan swak wees weens hulle gedragsprobleme. Hierdie navorsing bevestig vorige ondersoeke wereldwyd wat toon dat depressie, slaapprobleme, angsversteurings en die onvermoe om stres te hanteer by sommige Tourettesindroomlyers kan bydra tot uitputting wat hulle kognitiewe funksionering belemmer. Tourettesindroomlyers presteer op kognitiewe gebied 6f uitstekend 6f uiters swak. Groot uiteenlopendhede word in die neuropsigologiese gedrag van Tourettesindroomlyers gemanifesteer, met 'n vermindering in hulle uitvoerende kognitiewe funksionering weens tekorte in hulle kognitiewe prosesseringsvermoens. Dit het verarmende gevolge vir hulle kognitiewe inhoud, struktuur en uiteindelik kognitiewe produkte. Algemene en spesifieke leerprobleme is die gevolg. Dit is dus te begrype dat Tourettesindroomlyers se betrokkenheid, belewing en betekenisgewing by die skoolsituasie en leerstof negatief beleef kan word. Saam met hulle vernederende simptome, fluktuasie van hulle punte en belemmerde leefwereldstigting, is die logiese gevolg ontwrigte selfbeelde. Tourettesindroomlyers benodig daadwerklike ondersteuning in hulle selfaktualisering ten einde waardevolle mensepotensiaal vir SuidAfrika te behou. / The focus of this study is the life-world formation of Tourette syndrome sufferers, with specific reference to their cognitive functioning. Tourette syndrome is a neuropsychological disorder which usually has its inception during childhood and is characterised by motor and/or vocal tics. Tourette syndrome sufferers may also exhibit a variety of related disorders, for example Obsessive Compulsive Disorder, Attention Deficit Disorder, with or without hyperactivity, phobias and various affective disorders. The cause of Tourette syndrome is still unknown, therefore treatment cannot be guaranteed to be successful. The incidence of Tcurette syndrome is higher than was initially suspected and is more prevalent among men. Tourette syndrome sufferers can negatively experience all six facets of humanity. In the physical area research indicates various abnormalities in the brain, for example the secretion of neurotransmitters, a reduction in the volume of the basal ganglia, a smaller left globus pallidus and disorders in the frontal lobes, the corpus callosum and the nerve circuitry of the basal ganglia. The conative facet may be dominated by their lack of motivation in the cognitive area. The normative facet is often hampered due to addictive behaviour. Socialisation can be poor due to behaviour problems. This research confirms previous investigations world-wide which indicated that depression, sleep and anxiety disorders and the inability to handle stress contributes to exhaustion, which impedes cognitive functioning. In the cognitive area Tourette syndrome sufferers perform either extremely well or extremely poorly. There are great discrepancies in the neuropsychological behaviour of Tourette syndrome sufferers and a reduction in their executive cognitive functioning due to shortages in their cognitive processing abilities. This has impoverishing consequences for their cognitive content, structure and eventually cognitive products resulting in general and specific learning disabilities. It is therefore understandable that Tourette syndrorne sufferers' involvement with, experiences of and attribution of meaning to the school situation and study material are negatively influenced. Add their humiliating symptoms, fluctuation of marks and hampered life-world formation and the logical result is disrupted self-images. Tourette syndrome sufferers need crucial support in their self-actualisation in order to be able to offer South Africa worthy human potential. / Psychology of Education / D. Ed.(Sielkundige Opvoedkunde)

No description available.

In hierdie studie is Tourettesindroom as neuro-genetiese toestand aangespreek en die wyse waarop dit in verskillende leer-, gedrags- en emosionele problema by begaafde Tourettesindroomlyers manifesteer. Begaafde Tourettesindroomlyers se relasievorming en leefwereldstigting word gekonstitueer met hul kognitiewe en affektiewe vermoans asook genetiese potensiaal, wat vir beida hul Tourettesindroom en begaafdheid verantwoordelik is. Die verwarring tussen begaafde Tourettesindroomlyers se superieure intellek en hul emosionele onvolwassenheid is die oorsaak van hul relasieprobleme. Negatiewe betekenisgewing en betrokkenheid by hulle relasievorminge bel"nvloed elke faset van hul menswees en gee aanleiding tot die degradering van hul siening van hul eie waarde. Gebrekkige kennis oor begaafdheid en Tourettesindroom veroorsaak dat waardevolle potensiaal en talente vir Suid-Afrika verlore gaan. Daarom moet daar daadwerklike pogings aangewend word om kennis oor begaafde Tourettesindroomlyers aan ouers, skole en universiteite, beskikbaar te stel met 'n konstruktiewe plan van aksie ter ondersteuning van die betrokkenes en tot voordeel van Suid-Afrika. / This study addresses Tourette syndrome as a neuro-genetic condition and the manner whereby it manifests itself in various learning, behavioural and emotional problems experienced by gifted Tourette syndrome sufferers. Their relationship-formation and life world are constituted by their cognitive, emotive and genetic capacity which manifests itself in Tourette syndrome and giftedness. The emotional immaturity which accompanies their superior intellect causes disorientation which results in problems in their relationships. Negative connotations and involvement in their relationship-formation influences each facet of their being and gives rise to the lowering of their perception of their self worth. In South Africa, valuable potential and talent is lost because of an inadequate knowledge of giftedness and Tourette syndrome. Efforts must be directed towards making information about gifted Tourette syndrome sufferers available to parents, schools and universities. A constructive plan of action is necessary that will support gifted Tourette syndrome sufferers to the benefit of South Africa. / Psychology of Education / M. Ed. (Sielkundige Opvoedkunde)

The quality of life of children with Tourette Syndrome, a neurodevelopmental condition characterised by chronic tics, is impacted greatly by both the symptoms themselves and their social consequences. Habit Reversal Therapy, a behavioural therapy for tic management, has substantial empirical support in its individual form, but this approach has never been investigated in a group format. Group based delivery of Habit Reversal Therapy could increase access to therapy, improve the cost-effectiveness of treatments and potentially offer additional therapeutic benefits. This randomised controlled pilot study evaluated the feasibility and preliminary efficacy of Habit Reversal Therapy compared to psycho-educational groups for 33 children aged 9 to 13 years with Tourette Syndrome and Chronic Tic Disorders. Outcomes of the groups were evaluated in terms of reductions in tic severity and improvements in quality of life. Good attendance rates in both groups suggested feasibility and acceptability of the interventions. Improvements in tic severity and quality of life were found in both groups, although to a lesser extent compared to previous studies of individual behavioural therapy for tics. Motor tic severity showed greater improvements in the Habit Reversal Therapy group on the main outcome measure (Yale Global Tic Severity Scale) but not on a direct observational measure of tic frequency. Given the potential for such groups to provide additional treatment options for families, further research is warranted. Clinical implications and suggestions for improvements to the current design for a larger study are outlined as well as indications for wider reaching future research.

The Family Quality Of Life (FQOL) of families who have a child with Tourette Syndrome (TS) has not yet been investigated globally. The purpose of this study was to gather data and listen to the voices and opinions of families of children with TS in order to examine the extent to which the existence of a child with TS, in the family, affected their FQOL. The research was conducted according to the mixed methods approach, combining quantitative and qualitative methods. Data was collected concerning the research population that included all the families who have a child with TS living at home, and registered at the Tourette Syndrome Organisation in Israel. Additionally, semi-structured interviews were conducted with 10 of these 25 families of children with TS. The questionnaire was analysed statistically and the interviews were analysed using a content analysis method. Conclusions derived from the research findings allowed the emergence of the ACEIST model, including five new sub-domains of FQOL that reflect the experiences of the studied families: Advocacy, cooperation, explanation, information, and severity of TS. This is a new way to view FQOL of families having a child with TS, very precise and operative and specific to those families. This ACEIST model fills the gap in knowledge identified in this field, contributing to knowledge regarding FQOL of families who have a child with TS. The new model has practical implications for the education, social and health policies in Israel regarding families who have a child with TS.

Gilles de la Tourette syndrome (GTS) is a chronic neuropsychiatric disorder characterized by multiple motor and vocal tics, affecting approximately 1% of the population. The precise neuropathology of GTS has not yet been delineated, but current models implicate subcortical and cortical areas - the cortico-striato-thalamo-cortical (CSTC) circuit. The majority of studies in the literature have either dealt with GTS with comorbid conditions and/or children with GTS. As these factors are known to affect brain structure and function, it unknown what the neurobiological underpinnings of pure adult GTS are. The objective of this body of work was to use functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) to characterize differences in brain function and structure in pure adult GTS patients versus age- and sex-matched controls. I employed a series of three distinct analyses for this purpose, based upon current models of CSTC circuit-related dysfunction in GTS. In the first, GTS patients and control participants executed three finger-tapping paradigms that varied in both complexity and memory requirements. These finger-tapping tasks were modeled after previous studies that showed CSTC circuit-related activity in healthy individuals. Using a multivariate statistical technique to assess task-related patterns of activation across the whole brain, I found that, while there was much overlap in brain activation patterns between groups, sensorimotor cortical regions were differentially recruited by GTS patients compared to controls. In the second fMRI analysis, I measured low-frequency spontaneous fluctuations of the blood oxygen level dependent signal during rest, and found that GTS patients exhibited greater resting state functional connectivity with the left putamen compared to controls. In the final analysis, DTI was used to provide a whole-brain assessment of regional diffusion anisotropy in GTS patients and healthy volunteers and to investigate the fractional anisotropy in predetermined ROIs. This analysis found no differences between GTS patients and controls. Overall, my findings indicated that several CSTC-related regions shown to be atypical in GTS patients previously, are also atypical in pure adult GTS, and that sensorimotor cortical regions and the putamen may be regions of functional disturbance in pure adult GTS.

Gilles de la Tourette syndrome (GTS) is a chronic neuropsychiatric disorder characterized by multiple motor and vocal tics, affecting approximately 1% of the population. The precise neuropathology of GTS has not yet been delineated, but current models implicate subcortical and cortical areas - the cortico-striato-thalamo-cortical (CSTC) circuit. The majority of studies in the literature have either dealt with GTS with comorbid conditions and/or children with GTS. As these factors are known to affect brain structure and function, it unknown what the neurobiological underpinnings of pure adult GTS are. The objective of this body of work was to use functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) to characterize differences in brain function and structure in pure adult GTS patients versus age- and sex-matched controls. I employed a series of three distinct analyses for this purpose, based upon current models of CSTC circuit-related dysfunction in GTS. In the first, GTS patients and control participants executed three finger-tapping paradigms that varied in both complexity and memory requirements. These finger-tapping tasks were modeled after previous studies that showed CSTC circuit-related activity in healthy individuals. Using a multivariate statistical technique to assess task-related patterns of activation across the whole brain, I found that, while there was much overlap in brain activation patterns between groups, sensorimotor cortical regions were differentially recruited by GTS patients compared to controls. In the second fMRI analysis, I measured low-frequency spontaneous fluctuations of the blood oxygen level dependent signal during rest, and found that GTS patients exhibited greater resting state functional connectivity with the left putamen compared to controls. In the final analysis, DTI was used to provide a whole-brain assessment of regional diffusion anisotropy in GTS patients and healthy volunteers and to investigate the fractional anisotropy in predetermined ROIs. This analysis found no differences between GTS patients and controls. Overall, my findings indicated that several CSTC-related regions shown to be atypical in GTS patients previously, are also atypical in pure adult GTS, and that sensorimotor cortical regions and the putamen may be regions of functional disturbance in pure adult GTS.

The purpose of the present study was to investigate the differences among the human figure drawings (HFDs) of individuals diagnosed with Obsessive-Compulsive Disorder (OCD), Tourette Syndrome (TS), Attention Deficit Hyperactivity Disorder (ADHD), and Normal Controls. Males and females (N=161), ranging in age from 7.0 to 58.9 years, diagnosed with OCD, TS, ADHD, and individuals with no diagnosis were administered the Draw-A-Person (DAP; Machover, 1949), a human figure drawing task. Analyses were conducted to evaluate relationships between several variables: sex of participant, age, detail, emotional indicators, symptom severity, and sex of figure drawn. Results provided support for the hypothesis that males would draw a same sex figure more often than females, and that males would include more anxiety indicators than females. Results also provided support for the hypothesis that younger participants would include more unusual characteristics in HFDs, although the variance explained was minimal. The hypothesis that symptom severity would influence HFD characteristics was not supported, nor was the hypothesis that sex of participant would influence inclusion of detail. Several of the regression analyses of the smaller clinical groups were statistically significant, yet these results should be interpreted with caution due to the small number of cases used for the analysis.

The neuropathology of Tourette Syndrome (TS) is poorly characterized. This thesis provides the first quantitative stereologic immunohistochemical study of the basal ganglia in TS. TS is a childhood neuropsychiatric disorder characterized by motor and vocal tics. Previous imaging studies found alterations in caudate (Cd) and putamen (Pt) volumes. To investigate possible alterations in cell populations, postmortem basal ganglia tissue from individuals with TS and normal controls (NC) was analyzed using unbiased stereological techniques. A markedly higher (>160% of control) total neuron number and density was found in the internal segment of the globus pallidus (GPi) of TS (p<0.025). An increased number (>220% of control) and proportion of these GPi neurons were positive for the calcium-binding protein parvalbumin (PV) in the tissue from TS subjects (p<0.025). In contrast, a lower number (<60% of control) of neurons was observed in the external segment (GPe) (p<0.025). In addition, there was a lower density of PV-positive interneurons in both Cd (<50% of control) and Pt (<65% of control) (p>0.025). The imbalance in striatal and GPi inhibitory neuron distribution suggests that the functional dynamics of cortico-striato-thalamic circuitry are fundamentally altered in severe, persistent TS.