Premonitory urges pu in ts can be assessed with the university of sao paulo sensory phenomena scale uspsps and the premonitory urge for tics scale puts. Mar 17, 2020 some tics are preceded by an urge or sensation in the affected muscle group, commonly called a premonitory urge. Premonitory urge for tics scale puts, the clinical global impression of changetourette syndrome cgitsimprovement scale, and the clinical global impression of tics cgi tics severity scale as secondary efficacy variables. Investigating a therapistguided, parentassisted remote. Disease specific quality of life was assessed with the gtsquality of life scale gtsqol. Timepoints it is recommended that measures are applied 1 before the start of the treatment, 2 after the end of the treatment, 3 three months after the end of treatment. The premonitory urge for tics scale in a large sample of children and adolescents.
Studies investigating the psychometric properties of. Each item is rated using a 4point ordinal scale, ranging from 1 to 4 1 not at all true, 2 a little true, 3 pretty much true, 4 very much true. Scores 31 and above indicate extremely high intensity with probable severe impairment. Once the tic is performed, the urge goes away either partially or completely. The premonitory urge is a feeling of tension or discomfort that comes before the visible tic. Others are preceded by a subtle urge that is difficult to describe some liken it to the urge to scratch an itch. Although some studies have used the premonitory urge for tics scale puts 58 to evaluate tic related premonitory urges, 42,59 this tool does not assess tics. Severity scale secondary rush video scale premonitory urge for tics scale 25 adolescent dose 1 n15 children dose 1 n15 twoweek offdrug followup. Motor and vocal tics are relatively common motor manifestations identified as the core features of tourettes syndrome ts. Tics are relatively common symptoms of hyperkinetic movement disorders and are defined as involuntary, sudden, rapid, recurrent, nonrhythmic movements motor tics or vocalizations vocalphonic tics. The first aim of the present study was to explore the psychometric properties of a standardized selfreport. The primary outcome is reduction in tic severity as measured on the yale global tic severity scale total tic severity score. Neurobiology of the premonitory urge in tourette syndrome.
The puts is a selfreport instrument that measures premonitory urges in tic disorders. The most popular abbreviation for premonitory urge for tics scale is. The premonitory urge for tics scale is recommended for clinical use in the assessment of premonitory urges, but it has also been repeatedly used to measure premonitory urge intensity in brain. Some with ts will describe a need to complete a tic in a certain way or a certain number of times in order to relieve the urge or decrease the sensation. Are premonitory urges a prerequisite of tic inhibition in. This is a 10item clinicianrating instrument that provides an evaluation of the number, frequency, intensity, complexity, and interference of motor and phonic tics. Evidence supports the effectiveness of psychosocial treatments for tourette syndrome ts and tic disorders. The majority of those with tics experience them as somewhat voluntary. Simple vs complex tics motor movement vs vocal noise producing waxingwaning course exacerbating factors anxiety, stress fatigue premonitory urgesensory phenomena 90% 0f adults, 37% young children suppressible suggestible. After they tend to reduce in a fluctuating manner. The puts is a brief selfreport of the frequency of specific pretic related sensory symptoms, while the uspsps assesses the frequency and severity of sensory phenomena. Validation of the university of sao paulo sensory phenomena. Other tics, particularly simple tics such as eye blinking, just happen without warn. Premonitory urges, reported by 75%80% of persons with chronic tic disorders ctds and tourettes leckman et al.
Sensory and sensorimotor gating deficits characterize both tourette syndrome ts and schizophrenia. Tics waxandwane over time and move around to different parts of the body. This is a 10item clinicianrating instrument that provides an evaluation of the number, frequency, zacks investment research. Woods and colleagues developed a brief selfreport scale called the premonitory urge for tics scale puts that assessed tic premonitory urges across 9 items woods et al. Participants will be followed up midtreatment, and 3, 6, 12 and 18 months post randomisation. Habit reversal training hrt, a behavioral intervention, is the best researched psychosocial treatment for ts and tic disorders, and is now considered a wellestablished treatment for reducing tic symptoms. Woods, piacentini, himle, and chang 2005, however, recently developed and published a brief, selfreport scale, the premonitory urge for tics scale puts, for assessing the presence and intensity of premonitory urges to tic in a dimensional manner. If the tic is delayed, the urge tends to go up, increasing discomfort. Many tics are preceded by a premonitory urge to make the tic, in much the same way people experience an urge before a sneeze. Initial psychometric results and examination of the premonitory urge phenomenon in youths with tic disorders. Journal of developmental and behavioral pediatrics, volume 26, number 6, december 2005 pp397403. Advantages of a modified scoring method for the rush video. University of groningen the premonitory urge for tics scale in a large sample of children and adolescents emtics collaborative grp. Each item is scored from 1 not at all true to 4 very much true.
Individuals with chronic tic disorders ctds frequently describe aversive subjective sensory sensations that precede their tics. Dec 23, 2009 the premonitory urges for tics scale puts was developed to assess the severity of the premonitory urge in children with tic disorders woods et al. Unfortunately for individuals with ts the urge, along with the discomfort, keeps coming back and the. The scale includes nine items designed to measure both sensory and mental phenomena and shows a high internal consistency, especially in children older than 10 years. Nov 28, 2017 individuals with chronic tic disorders ctds frequently describe aversive subjective sensory sensations that precede their tics. Severity scale ygtss and the premonitory urge for tics scale puts. Premonitory urges in tourette syndrome are a feeling of. Although traditional descriptions have focused on objective phenomenological observations, such as anatomical location, number and frequency of tics, patients firstperson accounts have consistently reported characteristic subjective correlates. The puts has demonstrated good psychometric properties to assess an individuals urge to tic across samples mcguire et al.
Most people with ts will experience cooccurring conditions also such as obsessive compulsive disorder ocd, attention deficit hyperactivity disorder adhd and anxiety. The same tics seem to recur in bouts during the day and are worse during periods of fatigue andor stress. Termed a premonitory urge, this pattern of tension buildup and release is similar to the relationship between obsessions and compulsions in. Sensory gating scales and premonitory urges in tourette syndrome. New tics emerge and some old ones disappear but this does not indicate that the condition is getting worse, rather is the natural course of the condition. Tourette syndrome fact sheet national institute of. The snapiv is a behavioural rating scale that includes the core symptoms of adhd and oppositionaldefiant disorder odd. Results showed that the premonitory urge for tics scale puts was internally consistent alpha. Open access protocol investigating a therapistguided, parent. In addition, many individuals with tics describe a distinct aversive sensation or a buildup of tension that is relieved by tic expression. May 18, 2018 premonitory urge for tics scale puts the puts woods et al. The total score is computed by summing the 9 items.
Initial psychometric properties volume 14 issue 6 maria conceicao rosario, helena silva prado, sonia borcato, juliana belo diniz, roseli gedanki shavitt, ana gabriela hounie, maria eugenia mathis, rosana savio mastrorosa, patricia velloso, eduardo alliende perin, victor fossaluza, carlos alberto pereira, daniel geller. Tourette syndrome ts, also known as tourettes disorder, is a neurodevelopmental disorder characterized by multiple motor tics and at least one vocal tic present for greater than one year. Tics are usually at their peak between ages 10 and. Neurobiology of the premonitory urge in tourettes syndrome. Canadian guidelines for the evidencebased treatment of syndrome.
Pdf sensory gating scales and premonitory urges in. University of birmingham healthrelated quality of life in. Validation of the university of sao paulo sensory phenomena scale. In adolescence and early adulthood, there is a decline in tic severity in the majority of people who tic. The instrument includes a visual analogue scale used to express the extent of selfsatisfaction about life higher scores indicate higher satisfaction. Because tics are somewhat suppressible, when people with ts are aware of the premonitory urge that precedes a tic, they can be trained to develop a response to the urge that competes with the tic.
The premonitory urge for tics scale puts 12 is the most frequently used selfreport measure to assess the severity of premonitory urges. The premonitory urge for tics scale in a large sample of. Premonitory urge for tics scale puts 6 the puts is a 10item selfreport scale that assesses premonitory. Premonitory urge for tics scale puts variables produced total score reflecting the presence and frequency of pretic urges variable calculations each item is rated on a 14 scale, from not true at all to very much true. In order to assess the characteristics of premonitory urges, woods et al. Inte alls lite ganska valdigt sant sant sant sant 1. The original scale has met psychometric criteria for interrater reliability, temporal stability, and validity. Many tics occur without warning and may not even be noticed by the person doing them. The first aim of the present study was to explore the psychometric properties of a standardized selfreport measure to assess premonitory urges in ctds, the premonitory urge for tics scale puts, by replicating the analyses of woods et al. The puts demonstrates good internal consistency and testretest reliability, as well as good construct and concurrent validity reese et al. Tic severity tends to peak at 10 to 12 years of age. Sensory gating scales and premonitory urges in tourette. However, despite its proven effectiveness, practitioners seldom use it to.