Dataset Information

Revisiting the structure of the Yale Global Tic Severity Scale (YGTSS) in a sample of Chinese children with tic disorders.

ABSTRACT:

Background

To the best of our knowledge, although the Chinese version of the Yale Global Tic Severity Scale (YGTSS) is widely used in child psychiatry departments in China, there is very little evidence focusing on the psychometric characteristics of the Chinese version of YGTSS. In this present study, we aim to re-examine the structure of the Chinese version of YGTSS and investigate its reliability and validity.

Methods

A total of 367 children and adolescents with tic disorders aged 5-16 years old participated in the study. The Cronbach's alpha, test-retest reliability and concurrent validity will be calculated. Confirmatory Factor Analysis (CFA) also will be performed to assess the structure of YGTSS.

Results

The Cronbach's alpha of the motor tic subscale of YGTSS was 0.84, for the phonic tic subscale of YGTSS, it was 0.90, but for the whole scale, it was 0.58. The test-retest reliability of YGTSS was 0.84. For the results of CFA, the Comparative Fit Index (CFI) of YGTSS based on the Two-Factor Model and Three-Factor Model was 0.97 and 0.96 respectively. The measurement invariance analysis suggested that the Two-Factor model of YGTSS across different age and sex groups was at the accepted level (≥0.90).

Conclusion

Overall, according to the results of this research, it suggested that the Chinese version of YGTSS showed good psychometric properties. It can be used in the assessment of tic disorders in the Chinese population. In the future, more comprehensive tools for assessing tics need to be further developed, which can cover the symptoms of premonitory urge and tic related obsessive-compulsive symptoms.

SUBMITTER: Wen F

PROVIDER: S-EPMC8351146 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:The Yale Global Tic Severity Scale (YGTSS) is a clinician-rated instrument considered as the gold standard for assessing tics in patients with Tourette's Syndrome and other tic disorders. Previous psychometric investigations of the YGTSS exhibit different limitations such as small sample sizes and insufficient methods. To overcome these shortcomings, we used a subsample of the large-scale "European Multicentre Tics in Children Study" (EMTICS) including 706 children and adolescents with a chronic tic disorder and investigated convergent, discriminant and factorial validity, as well as internal consistency of the YGTSS. Our results confirm acceptable convergent and good to very good discriminant validity, respectively, indicated by a sufficiently high correlation of the YGTSS total tic score with the Clinical Global Impression Scale for tics (r s = 0.65) and only low to medium correlations with clinical severity ratings of attention deficit/hyperactivity symptoms (r s = 0.24), obsessive-compulsive symptoms (r s = 27) as well as internalizing symptoms (r s = 0.27). Internal consistency was found to be acceptable (Ω = 0.58 for YGTSS total tic score). A confirmatory factor analysis supports the concept of the two factors "motor tics" and "phonic tics," but still demonstrated just a marginal model fit (root mean square error of approximation = 0.09 [0.08; 0.10], comparative fit index = 0.90, and Tucker Lewis index = 0.87). A subsequent analysis of local misspecifications revealed correlated measurement errors, suggesting opportunities for improvement regarding the item wording. In conclusion, our results indicate acceptable psychometric quality of the YGTSS. However, taking the wide use and importance of the YGTSS into account, our results suggest the need for further investigations and improvements of the YGTSS. In addition, our results show limitations of the global severity score as a sum score indicating that the separate use of the total tic score and the impairment rating is more beneficial.

Project description:Objective Patients with tic disorders (TDs) usually also have obsessive–compulsive disorder (OCD). The severity of obsessive–compulsive symptoms (OCSs) in TD is widely evaluated using the Children’s Yale–Brown Obsessive–Compulsive Scale (CY-BOCS). However, there is no survey on the severity of OCSs in patients with TD based on a Chinese sample, and the reliability and validity of the CY-BOCS in patients with TD have not been well established in China. This study examined the severity of OCSs in TDs and the psychometric properties of the CY-BOCS in Chinese pediatric patients with TD. Methods A total of 367 patients who were diagnosed with TD [152 with Tourette syndrome (TS)] were enrolled in the Department of Psychiatry at Beijing Children’s Hospital in China. The mean age of the patients was 9.21 ± 2.06 years (range: 5–16 years). The Yale Global Tic Severity Scale (YGTSS) and CY-BOCS were used as screening tools. The psychometric properties of the CY-BOCS were assessed using Cronbach’s alpha, test-retest reliability, and construct validity. Results The OCSs in TDs were 3.93 ± 5.15 based on the CY-BOCS in the whole sample. The older adolescent group showed higher scores than the young adolescent groups (Z = −3.37, p = 0.001). However, the young adolescent group showed a higher incidence rate of OCSs than the older adolescent group (p < 0.01). Men with TDs also showed a higher incidence rate of OCSs than women (p = 0.03). The reliability and validity analyses of the CY-BOCS showed Cronbach’s alpha and test-retest reliability values of 0.81 and 0.82, respectively. The CY-BOCS showed an acceptable level in the two-factor structure (obsession and compulsive) in patients with TD. The comparative fit index (CFI) was 0.84 for TD, 0.86 for Tourette, 0.94 for the younger adolescent group, and 0.74 for the older adolescent group. Conclusion More OCSs were identified in the TS group and the older adolescent group with TDs. The CY-BOCS showed good psychometric properties in children and adolescents with TD, especially in younger patients with TD. OCSs might be associated with age and functional impairment of TD.