Metakognition ermöglicht Einblicke in eigene kognitive Prozesse und beeinflusst menschliches Verhalten in mehreren Bereichen. Die Debatte, ob Metakognition sich domänenallgemein oder domänenspezifisch auswirkt, bleibt unentschieden, wobei die meisten Studien auf sensorische Informationsverarbeitung und Gedächtniseffekte fokussieren. Diese Dissertation unterstreicht die Notwendigkeit, weitere Domänen zu untersuchen, um diese Frage zu klären, und tut dies, indem sie Metakognition im motorischen Bereich erforscht. Diese Arbeit umfasst vier empirische Studien. Studie 1 untersuchte die zugrundeliegenden Strukturen in metakognitiven Domänen und fand keine Beweise, die eine Unterscheidung zwischen intern oder extern generierter Information unterstützen. Studie 2 konzentrierte sich auf motorische Metakognition und verglich die Introspektion direkter und indirekter Bewegungsparameter. Obwohl beide Bewegungsparameter gleichermaßen introspektierbar sind, weisen fehlende Korrelationen zwischen verschiedenen Bewegungsparametern innerhalb einer Domäne auf die Rolle von nicht-domänenspezifischen Merkmalen in der Metakognition hin. In einem datengesteuerten Ansatz zeigte Studie 3, wie die Introspektion verschiedener Aspekte der Bewegung mit motorischer Kontrolle und Metakognition verknüpft ist. In Studie 4 wurde getestet, ob metakognitive Defizite die Vorgefühle bei Tourette-Störung untermauern. Es fanden sich keine Belege für Beeinträchtigungen in taktiler oder visueller Metakognition, was die Rolle der Metakognition in der Pathophysiologie der Störung in Frage stellt. Insgesamt betont die Arbeit die Notwendigkeit, domänenbezogene und aufgabenspezifische Merkmale zu entflechten und Faktoren zu identifizieren, die Allgemeinheit und Spezifität beeinflussen. Sie trägt zum Verständnis der motorischen Metakognition bei, indem sie experimentelle und analytische Ansätze vorantreibt und gleichzeitig Einblicke in die Architektur höherer kognitiver Funktionen und das Bewusstsein bietet. / Metacognition, the ability to introspect into one's cognitive processes, can guide human behaviour across various domains. The debate whether metacognition operates in a more domain-general or a domain-specific fashion remains inconclusive, with most studies focused on sensory and memory domains. This thesis argues that to resolve this question, it is necessary to broaden the scope of domains, and it does so by exploring metacognition in the motor domain. This thesis comprises four empirical studies. Study 1 examined the underlying structures in metacognitive domains, finding no evidence to support a distinction between internally or externally generated information. Study 2 focused on motor metacognition, comparing the monitoring of direct and indirect movement parameters. While both movement parameters can be equally well monitored, the absence of correlations within the same domain but across different monitored parameters highlights the role of non-domain features on metacognition. In a data-driven approach, Study 3 revealed how monitoring different aspects of movement is linked with motor control and metacognitive judgments. Study 4 tested whether metacognitive deficits underpin premonitory urges in Tourette's disorder. No evidence of metacognitive impairment was found in the tactile or visual domains, challenging metacognition's role in the disorder's pathophysiology. Overall, the thesis emphasises the need to disentangle domain-related and task-specific features, advocating for identifying factors that influence generality and specificity. It contributes to the understanding of motor metacognition by advancing experimental and analytical approaches, while providing insights into the architecture of higher cognitive functions and conscious processing.

Summaries in Afrikaans and English / Text in Afrikaans / Tourettesindroom is 'n lewenslange versteuring wat gekenmerk word deur motoriese en vokale trekkings saam met moontlik ook komorbiede simptome soos aandagtekort-hiperaktiwiteitsversteuring, obsessief-kompulsiewe versteuring, aggressie en depressie. Die sindroom kom in hoe mate in Suid-Afrika voor en die pastor kan dus heel moontlik daarmee te doen kry. Die beste behandeling vir die sindroom is medikasie saam met gedrags- en gesinsterapie toegedien deur 'n multidissiplinere span. Die pastor het 'n rol om te vervul in hierdie span probleme het aangesien persone met Tourettesindroom dikwels in hulle verhoudings met God, hulleself en ander mense. Vir effektiewe pastorale berading aan sodanige persone, moet die pastor deeglike kennis he van die sindroom en die simptome daarvan, asook van sy of haar invalshoek as pastor. 'n Moontlike kernmoment van die sindroom wat deur die pastor aangespreek kan word, is die verlies aan beheer wat deur dje lyer ervaar word. Die sindroom kan as 'n verskoning gedrag en gebruik word vir negatiewe en onverantwoordelike die pastor sal die lyer dus moontlik eties moet konfronteer op 'n medemenslike wyse. / Tourette Syndrome is a lifelong disorder. Symptoms are motoric and vocalic tics with possible comorbid symptoms such as attention deficit disorder with hyperactivity, obsessive-compulsive disorder, and depression. It is frequent among South Africans and the pastor will probably be confronted with persons struggling with the syndrome. The best therapy for Tourette Syndrome is medication in conjunction with behaviour and family therapy administered by a multi-disciplinary team. Persons with Tourette Syndrome have problems maintaining relationships with God, themselves and others. The pastor therefore has a definite role to play in the team. Knowledge of the syndrome and its symptoms, and of pastoral care are essential for succesful pastoral counseling. A possible central theme of the syndrome is the loss of control experienced by the person with the syndrome. The syndrome can become an excuse for negative and irresponsible behaviour and ethical confrontation may be necessary. / Philosophy, Practical & Systematic Theology / M. Th. (Praktiese Teologie)

The research, on which this account is based, took place within the context of Blooming Acres, my home, and the learning community that I co-founded with my wife Sherri-Ann. In the first chapters, I tell the story of how I came to home-educate learners with complex special needs at my farm north of Toronto, Canada. I describe the neurological disorders that the children in my care are diagnosed with and map out the main literature that guides how I think about and practice education. The aim of this section is to paint a picture of the context in which the research takes place and describe my role in this community. The second section consists of my research with two of the children who lived and learned at Blooming Acres. This includes their stories as told by them, their parent(s), and the educators at Blooming Acres. As I juxtaposed the life experiences of these learners with each other, and wove together aspects of these stories, significant themes emerged relating to their academic and medical histories, as well as their social, extracurricular, and family life, and finally, their experience at Blooming Acres. I employed a life history methodology; one that honours the meaning and knowledge that exists in the storied lives of individuals. As I applied this methodology and engaged in the storied lives of these learners I learned more about what it is like to live and learn with neurological disorders. Four major themes emerged. The first, Pathology for Support / Support for Pathology, relates to learning issues, referral, assessment, diagnosis, medications and “school battles”. Second, Parent Stress includes behavioural issues, judgment, stressful calls from teachers and principals and school failure. Third, Oasis Teachers / Mentors is an expression of care, support, social competence, self-esteem and relationships. Finally, Strengths and Coping is a culmination of issues such as advocacy for support, strategies for success, identifying and coping with stress, understanding diagnosis and becoming well. These emergent themes are articulated within the context of neurology and school failure (risk) and the context of transformation and getting well (resilience). This work contributes to parenting, education, social work, disabilities, medical and risk / resiliency literature.

The research, on which this account is based, took place within the context of Blooming Acres, my home, and the learning community that I co-founded with my wife Sherri-Ann. In the first chapters, I tell the story of how I came to home-educate learners with complex special needs at my farm north of Toronto, Canada. I describe the neurological disorders that the children in my care are diagnosed with and map out the main literature that guides how I think about and practice education. The aim of this section is to paint a picture of the context in which the research takes place and describe my role in this community. The second section consists of my research with two of the children who lived and learned at Blooming Acres. This includes their stories as told by them, their parent(s), and the educators at Blooming Acres. As I juxtaposed the life experiences of these learners with each other, and wove together aspects of these stories, significant themes emerged relating to their academic and medical histories, as well as their social, extracurricular, and family life, and finally, their experience at Blooming Acres. I employed a life history methodology; one that honours the meaning and knowledge that exists in the storied lives of individuals. As I applied this methodology and engaged in the storied lives of these learners I learned more about what it is like to live and learn with neurological disorders. Four major themes emerged. The first, Pathology for Support / Support for Pathology, relates to learning issues, referral, assessment, diagnosis, medications and “school battles”. Second, Parent Stress includes behavioural issues, judgment, stressful calls from teachers and principals and school failure. Third, Oasis Teachers / Mentors is an expression of care, support, social competence, self-esteem and relationships. Finally, Strengths and Coping is a culmination of issues such as advocacy for support, strategies for success, identifying and coping with stress, understanding diagnosis and becoming well. These emergent themes are articulated within the context of neurology and school failure (risk) and the context of transformation and getting well (resilience). This work contributes to parenting, education, social work, disabilities, medical and risk / resiliency literature.

Summaries in Afrikaans and English / Text in Afrikaans / Tourettesindroom is 'n lewenslange versteuring wat gekenmerk word deur motoriese en vokale trekkings saam met moontlik ook komorbiede simptome soos aandagtekort-hiperaktiwiteitsversteuring, obsessief-kompulsiewe versteuring, aggressie en depressie. Die sindroom kom in hoe mate in Suid-Afrika voor en die pastor kan dus heel moontlik daarmee te doen kry. Die beste behandeling vir die sindroom is medikasie saam met gedrags- en gesinsterapie toegedien deur 'n multidissiplinere span. Die pastor het 'n rol om te vervul in hierdie span probleme het aangesien persone met Tourettesindroom dikwels in hulle verhoudings met God, hulleself en ander mense. Vir effektiewe pastorale berading aan sodanige persone, moet die pastor deeglike kennis he van die sindroom en die simptome daarvan, asook van sy of haar invalshoek as pastor. 'n Moontlike kernmoment van die sindroom wat deur die pastor aangespreek kan word, is die verlies aan beheer wat deur dje lyer ervaar word. Die sindroom kan as 'n verskoning gedrag en gebruik word vir negatiewe en onverantwoordelike die pastor sal die lyer dus moontlik eties moet konfronteer op 'n medemenslike wyse. / Tourette Syndrome is a lifelong disorder. Symptoms are motoric and vocalic tics with possible comorbid symptoms such as attention deficit disorder with hyperactivity, obsessive-compulsive disorder, and depression. It is frequent among South Africans and the pastor will probably be confronted with persons struggling with the syndrome. The best therapy for Tourette Syndrome is medication in conjunction with behaviour and family therapy administered by a multi-disciplinary team. Persons with Tourette Syndrome have problems maintaining relationships with God, themselves and others. The pastor therefore has a definite role to play in the team. Knowledge of the syndrome and its symptoms, and of pastoral care are essential for succesful pastoral counseling. A possible central theme of the syndrome is the loss of control experienced by the person with the syndrome. The syndrome can become an excuse for negative and irresponsible behaviour and ethical confrontation may be necessary. / Philosophy, Practical and Systematic Theology / M. Th. (Praktiese Teologie)

D.Phil. (Psychology) / Please refer to full text to view abstract

Abstract: Tourettes syndrom är en neuropsykiatrisk funktionsnedsättning som kännetecknas av motoriska och vokala tics. Sedan covid- 19 pandemin har Tourettes syndrom spridits sig på sociala medier som en trend bland ungdomar och detta har uppmärksammats av forskare som nu försöker ta reda på vad spridningen bero på.    Syftet med denna litteraturstudie har varit att kartlägga vad tidigare forskning beskriver om Tourettes syndroms samband i sociala medier.    Metoden som används var en litteraturstudie med hjälp av scoping metoden som följer Arksey & O´Malleys (2005) sexstegsmodell. Sökresulteten gav oss 13 artiklar som hittades i databasen libsearch.    Resultaten visar på att man har sätt ett samband mellan sociala medier användningen och Tourettes syndrom. Resultatet visar även på att det tics liknande beteendet kan ha med MSI (mass socogenic illness) att göra. Slutligen visar resultatet också på att spridningen av tic liknande beteende har ökat sedan covid- 19 pandemin till följd av restriktionerna och förhållningsreglerna kring den sociala distansen. / Abstract: Tourette's syndrome is a neuropsychiatric disability characterized by its motor and vocal tics. Since the covid-19 pandemic, Tourette syndrome has spread on social media as a trend among young people. This trend has been noticed by researchers who are now trying to find out what caused the spread. The purpose of this scoping study has been to map what previous research describes about Tourette syndrome's connection to social media. The method used was a literature study using the metod scoping study that follows Arksey & O'Malley's (2005) six-step model. The search result gave us 13 articles that were found in the database libsearch. The results show that a connection is made between social media use and Tourette's syndrome. The result also shows that the tick-like behavior can be related to MSI (mass socogenic illness). Finally, the results show that the spread of similar behavior has increased since the covid-19 pandemic.

L'impulsivité, un trait multidimensionnel, détermine la sévérité d'affections comportant des désordres compulsifs (syndrome de Gilles de la Tourette, maladie de Parkinson, troubles obsessionnels compulsifs), mais la nature de la relation impulsivité / compulsivité reste méconnue. L'intérêt du présent travail est d'identifier les substrats neurobiologiques de la balance impulsivité / compulsivité, dans une approche transnosographique, en s'aidant au plan préclinique, de manipulations causales et au plan clinique, d'une approche corrélationnelle. Ainsi, nous démontrons pour la première fois en dehors du champ de l'addiction, non seulement que l'impulsivité motrice, endophénotype de vulnérabilité à la compulsivité, prédit, sous l'influence de la transmission noradrénergique, la transition vers la compulsivité, mais aussi que (dans le modèle de la maladie de Parkinson) la dénervation de la voie nigrostriée et les traitements substitutifs dopaminergiques amplifient l'état impulsif. D'où l'interaction complexe entre le trait impulsif, les traitements et le processus dégénératif. Enfin, nous démontrons le bénéfice thérapeutique de la stimulation de la portion antérieure du pallidum interne dans les formes sévères de tics et suggérons dans un modèle préclinique d'une grande valeur heuristique, que le trait impulsif prédit l'efficacité de la stimulation du core du noyau accumbens. Nos résultats démontrent l'intérêt de mieux caractériser le trait impulsif des patients présentant des désordres compulsifs (syndrome de Gilles de la Tourette, maladie de Parkinson) et ouvrent ainsi de nouvelles perspectives thérapeutiques, tant pour la prévention de la transition de l'impulsivité à la compulsivité, que dans le traitement de ceux-ci. / Impulsivity, a multidimensional trait, determines the severity of compulsive disorders (Tourette's syndrome, Parkinson's disease, obsessive compulsive disorders), but the impulsive / compulsive relation remains unclear. The aim of this work is to identify the neurobiological substrates of impulsive / compulsive balance, using causal manipulations in rats and correlational studies in patients. The results demonstrate - for the first time beside the field of addiction - that, not only high impulsive trait is a transnosological endophenotype of increased vulnerability to develop compulsive disorders, but also that the transition from impulsivity toward compulsivity depends upon the noradrenergic transmission. Furthermore, we also show that, in a Parkinson's disease preclinical model, both the nigrostriatal denervation and dopaminergic treatments increase impulsive state, thereby indicating the contribution of a complex interaction between impulsive trait, medications and neurodegenerative process to the impulsive/compulsive balance. Finally, we show the therapeutic benefit of anterior globus pallidus interna in severe forms of tics and suggest in a preclinical model, with great heuristic value, that impulsive trait predicts the efficacy of nucleus accumbens core stimulation. Together, our results demonstrate the need to address the impulsive/compulsive balance in compulsive disorders and show promise for developing new pathophysiological-based therapeutic strategies that will treat both impulsivity and compulsivity.

A web-based survey was conducted that included 97 practicing school psychologists in California. The results from the survey indicated that the majority (88%) of respondents were knowledgeable about Tourette Syndrome. Many respondents (28%) had never worked with a student with Tourette’s, 20% had at least one case, and 52% indicated that they had worked with more than two cases in their careers as school psychologists. The majority of respondents indicated that their school psychology program did not adequately train them to assess or counsel students with Tourette’s. The majority of participants also did not feel confident to work with students with Tourette’s. As found in the study, school psychologists are in need of training to better serve children with Tourette Syndrome. Children, whether diagnosed with Tourette Syndrome or not, may exhibit difficulties making academic progress because of tic related issues, as well as comorbid disorders such as Attention Deficit Hyperactivity Disorder (ADHD) and Obsessive Compulsive Disorder (OCD). Schools typically are where students spend many hours of their day, and where those who are knowledgeable about Tourette’s can identify and provide needed supports depending on the student’s needs. Therefore, school psychologists play a key role in facilitating proper education regarding Tourette’s to students, teachers, staff, and families, as well as providing academic, behavioral, emotional, and social support a student may need.

<p>A total population of 4,479 children (7-15 years of age) attended school in Ludvika & Smedjebacken in 2000. All the school children and their parents were asked to fill in a questionnaire concerning different tics A three-stage procedure was used: tic identification, interview, and clinical assessment.</p><p>Tourette syndrome, according to DSM IV criteria was found in 25 (0.6%) of the children, another 34 (0.8%) suffered from chronic motor tics (CMT), 24 (0.4%) from chronic vocal tics (CVT) and 214 (4.8%) children had had transient tics (TT) during the last year. Altogether 297 (6.6%) children had or had had some tic disorder. </p><p>Twenty-five controls without tics and 25 children with TT of the same age, sex and school as the TS children were randomly chosen. They were together with the 34 children with CMT and the 24 children with CVT examined with use of a broad battery of instruments. </p><p>The mean age of the first symptoms of TS was significantly lower than the onset of chronic motor/vocal tics. A younger age of onset of TS indicated more severe tics. Eighty per cent had a first-degree relative with a psychiatric disorder such as tic disorder, obsessive-compulsive behaviour, attentiondeficit/hyperactivity disorder (ADHD), or depression. A non-significant increase with regard to reduced optimality score in the pre-, peri-, or neonatal periods was found in children with TS compared to controls. No differences were found concerning socio-economic status. Psychiatric comorbid disorders were found in 92% of the children with TS. ADHD was most common. Patterns of psychiatric comorbidity were similar in children with TS and CVT. Children with TS perform poorer than the population in general with respect to cognitive functioning and self-perception.</p><p>The results are discussed as they relate to the need for case identification, diagnosis, intervention, and treatment. </p>