Mother–Child Agreement on Behavioral Ratings in Tourette Syndrome: A Controlled Study

Background: In Tourette syndrome (TS), motor and phonic tics are often associated with a spectrum of psychiatric disorders, which can pose considerable diagnostic challenges. Objective: As proxy-report is commonly used to assess children with TS, we investigated the relationship between child and mother ratings of behavioral problems. Methods: Participants were 28 children (25 boys; mean age, 13.9 years) diagnosed with TS according to DSM-IV-TR criteria, and 61 gender and age-matched healthy controls (HC) (55 boys; mean age, 14.7 years). Clinicians completed measures of tic severity, plus a structured psychiatric interview (K-SADS) with both patients with TS and their parents. All children completed the Youth Self-Report (YSR) version of the Child Behavior Checklist (CBCL), while mothers completed the CBCL. Results: Children with TS showed higher scores on most subscales of the CBCL than the HC. In the TS group, YSR scores were significantly lower than mothers’ CBCL scores across the majority of subscales. In contrast, mother and child ratings only differed for HC for the Externalizing behavior subscales. Competence was rated lower by mothers than children for both groups. Conclusion: While the CBCL is a sensitive instrument to behavioral problems in children with TS, we found clinically relevant differences between self and mother ratings of certain behavioral problems (especially affect and somatization). This suggests that the self-report form of this instrument fails to capture the severity of these symptoms. Alternatively, mothers’ may perceive behavioral problems as more stressful and therefore more severe than their children.