Belief that Tourette’s patients are aggressive is a myth

Tourette's syndrome is known to be associated with impulsive and sometimes problematic behaviour. This unpredictability, coupled with involuntary movements and a tendency to say things which are offensive or out of context has contributed to the belief that People with Tourette's Syndrome are aggressive.

Working at the Vadaskert Child and Adolescent Psychiatric Hospital in Budapest, researchers took 3 groups of participants (all of them males): 87 with Tourette's, 161 with ADHD, and 494 from a general clinical population. They also had data from a healthy control group. All participants underwent a series of tests, which assessed two major aspects of aggression: "cold" (calculated, callous, unemotional aggression) and "hot" (impulsive, explosive aggression).

Some of the findings were unexpected. Patients with Tourette's proved to be less aggressive, regarding both hot and cold aggression, than the general clinical population or patients with ADHD. Their aggressive traits were comparable with those of the healthy control population. The mean of parent-rated aggression scores (ICU questionnaire) was 25.0 in the Tourette's population, and 23.5 among healthy controls, whereas the mean of the same scale was 35.1 in the general child psychiatric population, and even as high as 36.9 among ADHD patients. The mean of self-rated aggression scores (RPA questionnaire) was 9.5, both among Tourette's patients and healthy controls, but child psychiatric patients in general and ADHD patients both scored a lot higher on the scale (14.3 and 14.1, respectively).

Commenting, lead researcher Dr Péter Nagy said: This is the first study to use these standardised methods to look at aggression in Tourette's Syndrome. We found that Tourette's patients were no more aggressive than the general population. Tourette's patients can show motor tics, like grimacing or arm movements, or certain vocal tics, and people may assume that this is an expression of suppressed or overt aggression. This is in fact not the case. The problem is not one of aggression, but of understanding; Tourette's patients need support and acceptance, not rejection or fear.

Dr Josefina Castro-Fornieles (University of Barcelona), member of the ECNP Child and adolescent disorders Scientific Advisory Panel added: "We need to increase the knowledge of families, teachers and primary practitioners on the symptoms of Tourette's syndrome, to improve their understanding of the disorder. This kind of study can help us to break down some of the mistaken ideas that both professionals and society have about this condition. This is especially important if we consider the psychosocial consequences in children and adolescents."