NRNP6665 Week 8 Assignment Paper

NRNP6665 Week 8 Assignment Paper

NRNP6665 Week 8 Assignment Paper

Study Guide: Tic Disorder

Tic Disorder is a neurodevelopmental disorder affecting about 1.4 million people in the US, primarily in males and children (Tinker et al. 1). It involves involuntary motor and vocal tics, which can impact daily functioning and quality of life. The disorder is caused by genetics, neurobiological, and environmental factors. Motor tics involve sudden muscle movements, while vocal tics involve involuntary vocalizations. The exact cause is yet to be fully understood, but factors such as family history, Tourette’s syndrome, and motor control brain regions are linked (“Quick Guide to Chronic Motor or Vocal Tic Disorder”). Environmental factors like prenatal complications, infections, and toxins are also potential risk factors.

Signs and Symptoms according to DSM-5-TR A. Criteria

Tic Disorder diagnosis requires an individual to have motor and/or vocal tics at some point during the illness, persist for at least several months, start before 18 years old, and not be attributed to other conditions. The tics should not be caused by substances or medical conditions, and should not be better explained by other neurodevelopmental or movement disorders (Nussbaum 76).

Motor Tic Symptoms

1. Eye blinking
2. Shoulder shrugging
3. Head jerking or nodding
4. Facial grimacing or twitching
5. Twisting or contorting body postures
6. Touching or tapping objects
7. Complex movements involving multiple muscle groups

Vocal Tic Symptoms

1. Throat clearing
2. Coughing
3. Grunting or growling sounds
4. Sniffing
5. Repeating one’s own words (palilalia)
6. Uttering words or phrases involuntarily (echolalia)
7. Making involuntary throat noises

Onset, Duration, and Frequency of Tics

Tic symptoms usually begin in childhood, with a common onset between 5-10 years. Chronic tics persist for over a year, with waxing and waning patterns. Frequency varies, from a few times per day to multiple times per minute, and may be exacerbated during stress or fatigue (Nussbaum 76).

Severity and Impairment Levels

Tic Disorder severity varies among individuals, with mild tics impacting daily functioning and severe tics causing distress and impairment in physical, emotional, and social aspects, potentially affecting academic performance, self-esteem, and relationships (“Quick Guide”).

Differential Diagnoses of Tic Disorder

Accurate differential diagnosis is essential because Tic Disorder shares some similarities with other disorders.

1. Tourette’s Syndrome
2. Chronic Motor Tic Disorder
3. Chronic Vocal Tic Disorder
4. Stereotypic Movement Disorder
5. Obsessive-Compulsive Disorder (OCD)
6. Attention-Deficit/Hyperactivity Disorder (ADHD)
7. Autism Spectrum Disorder (ASD)
8. Anxiety disorders,
9. Learning disabilities may impact academic performance.

Incidence and Prevalence of Tic Disorder

Tic Disorder prevalence and incidence rates vary across populations and geographical regions.

1. Age and Gender Distribution: The most common age of onset is between 5 and 10 years, with males being more affected than females. The male-to-female ratio is around 3:1, with hormonal and genetic factors possibly playing a role (Stocco para 1).
2. Geographical variations: Tic Disorder is globally reported and does not show significant variations in occurrence based on geographic location. Cultural and environmental factors, such as attitudes, healthcare access, and outbreaks, can influence the expression and reporting of tic symptoms. Clusters and outbreaks are rare and require thorough investigation to understand underlying factors (“Quick Guide”).

Development and Course of Tic Disorder

Tic Disorder typically begins in childhood and progresses into adolescence and adulthood. Symptoms increase in severity during early childhood, peaking around 10-12 years, and can be variable. They negatively impact a child’s academic performance, social interactions, and emotional well-being, leading to feelings of isolation and distress (“Quick Guide”). Symptomatology changes over time due to waxing and waning nature, tic suppression, tic subtypes, stress, and fatigue. Tics may exhibit fluctuating frequency and intensity, and can improve or worsen without intervention.

Prognosis of Tic Disorder

Tic Disorder is a chronic condition with varying prognosis influenced by factors such as tic severity, comorbid conditions, family history, age of onset, supportive environment, and access to treatment. While some individuals may experience a favorable prognosis, others may face social, academic, emotional, and medication side effects, and co-occurring conditions that complicate treatment and management (McGuire 12). The long-term outcome can be favorable for many individuals, with some cases experiencing spontaneous remission, stable course, or chronic presentation. Factors influencing the long-term prognosis include tic severity, family history, age of onset, supportive environment, and access to appropriate interventions.

Cultural, Gender, and Age-related factors

Cultural factors, gender, and age play a significant role in tic disorder.

Culture: Cultural beliefs and norms influencing symptom expression and treatment-seeking behavior. Stigma and acceptance can hinder access to appropriate healthcare, and traditional healing practices or community support systems may be preferred over formal medical interventions (McGuire 5). Language barriers may affect communication and understanding between healthcare providers and patients, potentially impacting diagnosis and treatment recommendations.

Gender factors: Tic Disorder is more commonly diagnosed in males, with motor and vocal tics more common in both genders.

Age: The age of onset may differ between genders, and females may have a higher likelihood of experiencing comorbid conditions. Age-related variations in symptom severity and coping mechanisms may occur in early childhood, adolescence, adulthood, and later life. Coping strategies may evolve with age, with older individuals developing more adaptive ways to manage tics and associated challenges (McGuire 17).

Pharmacological Treatments

First-line medications for tic disorder typically include alpha-2 adrenergic agonists like clonidine and guanfacine, which act on brain alpha-2 adrenergic receptors to reduce norepinephrine release. Atypical antipsychotics, like risperidone and aripiprazole, have been shown to reduce tic frequency and severity by modulating dopamine receptors. These medications work by stimulating alpha-2 adrenergic receptors, reducing norepinephrine release, and regulating brain circuits involved in tic development (“Quick Guide”). Commonly prescribed medications include clonidine, guanfacine, risperidone, and aripiprazole.

side effects

Alpha-2 adrenergic agonists may cause sedation, dizziness, dry mouth, and constipation. Management involves adjusting dose, taking medication at bedtime, and monitoring blood pressure regularly (“Quick Guide”).

Atypical antipsychotics may cause weight gain, sedation, increased appetite, and metabolic changes; monitoring weight and metabolic parameters is crucial for effective management.

Nonpharmacological Treatments for Tic Disorder

Nonpharmacological treatments for tic disorders include behavioral interventions, such as Habit Reversal Training (HRT), Comprehensive Behavioral Intervention for Tics (CBIT), Cognitive-Behavioral Therapy (CBT), Psychoeducation and Support for Patients and Families, Support Groups, and Deep Brain Stimulation (DBS) (Nussbaum 76). These treatments aim to empower individuals with Tic Disorder to gain better control over their tics and improve their overall quality of life (Jones et al., para 11). Psychoeducation and support play a crucial role in reducing stigma and helping patients and families navigate the challenges associated with Tic Disorder. It is essential to consider the individual’s unique needs and preferences when selecting and implementing nonpharmacological treatments.

Diagnostics and Labs

Tic Disorder diagnosis involves a comprehensive physical examination and medical history to rule out potential medical conditions or neurological issues. Imaging and laboratory tests are not necessary for diagnosing Tic Disorder, but blood tests may be conducted to rule out potential medical issues. Assessment tools for tic severity and impairment include the YGTSS, Clinical Global Impression (CGI), Premonitory Urge for Tics Scale (PUTS), and the Parent Tic Questionnaire (PTQ) (Nussbaum 76). The diagnosis is primarily clinical, based on the presence of characteristic motor and vocal tics, duration, and age of onset, as outlined in the DSM-5-TR criteria. Standardized assessment tools ensure consistency and accuracy in evaluating tics’ impact on daily functioning and intervention effectiveness (“Quick Guide”).

Comorbidities

Tic Disorder often co-occurs with Common Co-occurring Conditions such as ADHD and OCD, impacting treatment and prognosis. Addressing tic symptoms and co-occurring conditions is crucial for improving outcomes and quality of life. A multidisciplinary approach, including behavioral, pharmacological, and support, is essential for better long-term prognosis and symptom management.

Legal and Ethical Considerations

Legal and ethical considerations are crucial for safeguarding rights and promoting equitable access to education, work, and healthcare for individuals with tics. Individuals with Tic Disorder may require accommodations in educational and work settings, including extended exams, preferential seating, and flexible deadlines. Ethical considerations are crucial in research and treatment for Tic Disorder, ensuring participant safety, informed consent, and respecting patient autonomy in decision-making (Tinker et al. 9). Informed consent and patient autonomy are crucial in research and clinical settings, ensuring comprehensive information about risks, benefits, and treatments for individuals with Tic Disorder and their families.

Pertinent Patient Education Considerations

Teaching coping mechanisms improves the efficiency of managing stress and tic-related problems. Comprehensive Tic Disorder information helps patients understand symptoms, treatment options, and diagnosis (Jones et al., para 14). Setting realistic expectations for treatment outcomes helps patients understand gradual, cyclical treatment management. It also encourages self-advocacy and coping strategies for individuals with Tic Disorder to communicate their needs effectively.

Conclusions

The study guide on Tic Disorder offers valuable insights into this neurodevelopmental condition, affecting individuals from an early age. Early diagnosis and timely interventions are crucial for effective management. Addressing comorbidities and ethical considerations is essential for patient-centered care. Patient education is crucial for understanding Tic Disorder, managing expectations, and developing coping skills. This guide is valuable for healthcare professionals and individuals seeking to improve their quality of life and overall well-being.

References

Jones, K. S., Saylam, E., and Ramphul, K. “Tourette Syndrome and Other Tic Disorders.” StatPearls, updated 8 May 2023, StatPearls Publishing, 2023, Jan-. https://www.ncbi.nlm.nih.gov/books/NBK499958/.

McGuire, Joseph F., et al., eds. The Clinician’s guide to treatment and management of youth with Tourette syndrome and tic disorders. Academic Press, 2018.

Nussbaum, Abraham M. The Pocket Guide to the DSM-5-TR™ Diagnostic Exam. United States, American Psychiatric Association Publishing, 2022.

“Quick Guide to Chronic Motor or Vocal Tic Disorder.” Child Mind Institute, 23 Feb. 2023, childmind.org/guide/what-is-chronic-motor-or-vocal-tic-disorder/.

Stocco, Amber. “Tics and Kids: When Should I Seek Care?” Texas Children’s Hospital, 2023. https://www.texaschildrens.org/blog/2014/01/tics-and-kids-when-should-i-seek-care#:~:text=A%20parent%20might%20first%20notice,female%20ratio%20of%203%3A1.

Tinker, Sarah C., et al. “Estimating the number of people with Tourette syndrome and persistent tic disorder in the United States.” Psychiatry Research 314 (2022): 114684. https://doi.org/10.1016/j.psychres.2022.114684

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STUDY GUIDE FORUM

Abnormal brain development or damage at an early age can lead to neurodevelopmental disorders. Within this group of disorders, some are resolvable with appropriate and timely interventions, either pharmacological or nonpharmacological, while other disorders are chronic and need to be managed throughout the lifespan.

For this Assignment, you will develop a study guide for an assigned disorder and share it with your colleagues. In sum, these study guides will be a powerful tool in preparing for your certification exam.

RESOURCES

Be sure to review the Learning Resources before completing this activity.

Click the weekly resources link to access the resources.

WEEKLY RESOURCES

TO PREPARE

Your Instructor will assign you to a specific neurodevelopmental disorder from the DSM-5-TR.

Research your assigned disorder using the Walden Library. Then, develop an organizational scheme for the important information about the disorder.

my disorder is Tic Disorder

THE ASSIGNMENT

Create a study guide for your assigned disorder. Your study guide should be in the form of an outline with references, and you should incorporate visual elements such as concept maps, charts, diagrams, images, color coding, mnemonics, and/or flashcards. Be creative! It should not be in the format of an APA paper. Your guide should be informed by the DSM-5-TR but also supported by at least three other scholarly resources.

Areas of importance you should address, but are not limited to, are:

Signs and symptoms according to the DSM-5-TR

Differential diagnoses

Incidence

Development and course

Prognosis

Considerations related to culture, gender, age

Pharmacological treatments, including any side effects

Nonpharmacological treatments

Diagnostics and labs

Comorbidities

Legal and ethical considerations

Pertinent patient education considerations

BY DAY 7 OF WEEK 8

You will need to submit your Assignment to two places: the Week 8 Study Guide discussion forum as an attachment and the Week 8 Assignment submission link. Although no responses are required in the discussion forum, collegial discussion is welcome. You are encouraged to utilize your peers’ submitted guides on their assigned neurodevelopmental disorders for study.

Access the Study Guide Forum (or click the Next button).

SUBMISSION INFORMATION

Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.

To submit your completed assignment, save your Assignment as WK8Assgn+last name+first initial.

Then, click on Start Assignment near the top of the page.

Next, click on Upload File and select Submit Assignment for review.

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