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Example research essay topic: Deficit Hyperactivity Disorder Adhd Obsessive Compulsive Disorder - 1,714 words

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Tourette Syndrome (TS) is an inherited, neurological disorder characterized by repeated and involuntary body movements and uncontrollable vocal sounds. In a minority of cases, the vocalizations can include socially inappropriate words and phrases. These outbursts are neither intentional nor purposeful. Involuntary symptoms can include eye blinking, repeated throat clearing or sniffing, arm thrusting, kicking, shoulder shrugging or jumping. These, and other symptoms, typically appear before the age of 18 and the condition occurs in all ethnic groups with males affected three to four times more often than females. Although symptoms of TS vary from person to person and range from moderate to severe, the majority of cases fall into the mild category.

Associated conditions can include attention problems, impulsiveness, and learning disabilities. However, most people with TS lead productive lives and participate in all professions. Increased public understanding and tolerance of TS symptoms are of paramount importance to people with this still mysterious disorder. Discovery: Tourette Syndrome is also known as Gilles de la Tourette Syndrome after the neurologist who described the disorder in 1885. Until the end of the nineteenth century, movement disorders, referred to as motor incoordinations, were diagnosed as chorea, a Greek word meaning dance.

In 1825, the first description of a patient with Tourette's disorder appeared in a paper by Itard, who described a French woman who displayed not only involuntary tics, but also obscene vocalizations. Since the age of seven, she suffered from involuntary compulsive spasms in her arms and hands. Progressively, her symptoms grew worse. At the time, Itard could only explain the illness as an "idiopathic irritation of the brain." Gilles de la Tourette proposed that the symptoms observed in nine patients, six of whom were his own, constituted a new disease category, which should be separated from chorea.

He called the illness a "nervous affliction characterized by generalized motor incoordination and noises, " accompanied by vocal outbursts. Gilles de la Tourette was the first physician to identify the unique development of this odd disorder. Motor symptoms are the first to appear, most frequently of the face, specifically eye blinking, and spreading to the upper limbs. As the disorder progresses, symptoms become verbal, including incoherent cries. Echolalia, repetition of ones own words, follows and was considered by Gilles de la Tourette to be one of the most persistent symptoms. The third symptom category identified by Gilles de la Tourette was coprolalia, vocalization of obscenities.

Gilles de la Tourette also made reference to the disorders early onset, which usually occurs before puberty, its male predominance, and the progressive nature of symptoms, new ones added to or replacing old ones. The Nature of Involuntary Movements (Tics): The nature and complexity of the tics varies over time, with natural waxing and waning in frequency and severity. Many individuals with TS also develop associated behavioral problems, such as obsessions and compulsions, inattention, hyperactivity, and impulsiveness. As previously mentioned, the onset of symptoms typically occurs during childhood or early adolescence.

Tics are a curious assemblage of abrupt repetitive movements and sounds. Today, clinical investigators have endeavored to characterize both the overt features of tics and the associated mental states. The primary characteristics associated with TS are multiple motor tics and one or more vocal tics. Motor and vocal tics may develop at about the same time or predominate at different times during the course of the disorder. Tics are more easily recognized than defined. Patients initially develop sudden, rapid, recurrent, motor tics, particularly of the head and facial area.

Initially, motor tics usually consist of abrupt, brief, isolated movements known as simple motor tics, such as repeated eye blinking or facial twitching. Less common, motor tics can be more coordinated, with distinct movements involving several muscle groups, such as repetitive squatting, skipping, or hopping. These tics, referred to as complex motor tics, may also include repetitive touching of others, deep knee bending, jumping, smelling of objects, hand gesturing, head shaking, leg kicking, or turning in a circle. In addition to affecting the head and facial area, motor tics also affect other parts of the body, such as the shoulders, torso, and arms and legs. The anatomical locations of motor tics may change over time. The degree of impairment and disruption associated with particular tics varies.

Partly dependent on frequency, intensity, complexity, and duration of specific tics, estimates of impairment also need to include the impact on the patients self-esteem, social acceptance, physical well-being and school achievement. On average, vocal tics begin one or two years after the onset of motor symptoms of TS and are usually simple in character. These phonic tics usually begin as single, simple sounds that may eventually progress to involve more complex phrases and vocalizations. For example, some patients may develop simple vocal tics, including grunting, throat clearing, sighing, barking, hissing, sniffing, tongue clicking, or snorting. Complex vocal tics may involve repeating certain phrases or words out of context, one's own words or sounds (palilalia), or the last words or phrases spoken by others (echolalia).

Rarely, there may be involuntary, explosive cursing or compulsive utterance of obscene words or phrases (coprolalia). Stereotypically the benchmark of TS, coprolalia develops in approximately 60 % of TS patients and later disappears in one-third. Most individuals with TS gradually develop a combination of different motor and phonic tics. These tics may occur a few or many times during the day, often in clusters. Symptoms typically follow a waxing and waning course, periodically decreasing or increasing in frequency and intensity. One of the foremost problems in assessing tics is the measurement of severity.

Tics often subside during absorbing activities such as reading or working, decline during sleep, worsen with stress or fatigue, and may be voluntarily suppressed for brief periods. Although TS is considered a lifelong, some patients may go weeks or even years without symptoms. Tic frequency and severity often significantly diminish in adulthood. It is only in 0. 03 % of TS patients that there is a lifetime prevalence of the disorder.

The Natural History of Tourette Syndrome: Clinicians have documented a characteristic progression of tic symptom severity over the first two decades of life for individuals with Tourette Syndrome. The mean age of onset is currently seven years old, followed by a progressive pattern of tic worsening. However, the range of onset age is two through fifteen. On average, the most severe period of tic severity occurs at ten years of age. In 25 % of all cases, the frequency and forcefulness of the tics during the worst-ever period is such that functioning in school is impossible or in serious jeopardy. In most cases, this period is followed by a steady decline in severity.

Thus, by age eighteen, half of all TS patients are nearly tic-free. Most patients, or their parents, recall an eye tic as the first symptom of TS. Most commonly, this consists of eye-blinking. After the initial tic, others will appear over a period of weeks to months, either to replace the original ones or to be added to them. Vocal tics are found by most clinicians to have a later mean age onset than motor tics.

This is particularly true of coprolalia, which begins at a mean age ranging from four to eight years after the onset of the motor tics. TS is such a complex disorder that it does not progress in only one or two ways. Each patients symptom ology is quite unique. This presents challenges to doctors, teachers, and parents in their pursuit of helping children cope with Tourette Syndrome. Co-morbid Conditions: In addition to motor and vocal tics, TS has been reported to be associated with a variety of psychopathological symptoms, including Obsessive-Compulsive Disorder (OCD), Attention Deficit Hyperactivity Disorder (ADHD), and anxiety and mood disorders.

Obsessive compulsions may include touching particular objects in a predetermined sequence, repeatedly counting, or engaging in repetitive hand washing. As many as 50 % of children being treated for TS may also have symptoms of ADHD. ADHD is characterized by over-activity as well as difficulty maintaining attention. Affected children have also been described as "emotionally labile, irritable, or having a short-fuse, resulting in sudden, explosive temper outbursts. Obsessive-Compulsive Disorder (OCD): The symptoms used to define OCD are diverse, and include various intrusive thoughts and preoccupations, rituals, and compulsions.

Two individuals with OCD may have totally different non-overlapping symptom patterns. Studies indicate that more than 40 % of individuals with TS experience recurrent obsessive-compulsive symptoms. There is mounting evidence that obsessive-compulsive's symptoms may be genetically linked to TS and other chronic tic disorders. While there is some disagreement on the prevalence of OCD in TS patients, most agree that the incidence is significantly higher than in the general population.

As a rule in TS patients, obsessive-compulsive symptoms begin somewhat later than tic symptoms and continue to progress at least into early adulthood. Therefore, cross-sectional studies of young children may underestimate the association between OCD and TS. Furthermore, in TS patients with OCD, it may be difficult to determine whether the source of impairment or distress is due to tics or the obsessive-compulsive condition. Thus, treatment becomes a great challenge. Attention Deficit Hyperactivity Disorder (ADHD): ADHD is a major clinical and public health problem because of its associated morbidity and disability in children, adolescents, and adults. Cognitive deficits, particularly impairments in attention and executive functions, have been hypothesized to be a core part of ADHD.

Children with ADHD exhibit sub-average performance on various tasks of sustained attention, motor inhibition, verbal learning, and memory. The reported frequency of co-morbid ADHD in patients with TS has ranged from 35 - 90 %, according to various studies. It is reported that the average age at onset of tic disorders is significantly later than the average age at onset of ADHD. Despite the correlation, the relationship between TS and ADHD is controversial. Irrespective of the debates over genetics, it is clear that ADHD is highly prevalent among TS patients and that ADHD often represents the main clinical and educational concerns and principal source of dysfunction and disability. Psychopathological Symptoms: Recently, there has been increased interest in what has been described as "rage attacks" in children with TS.

Rages are characterized by an apparent absence of situational triggers, a subjective sense of loss of control, and tension preceding the outburst, followed by relief. Ironically...


Free research essays on topics related to: attention deficit hyperactivity disorder, obsessive compulsive disorder, deficit hyperactivity disorder adhd, tourette syndrome, de la

Research essay sample on Deficit Hyperactivity Disorder Adhd Obsessive Compulsive Disorder

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