Tics

Tics are defined as sudden rapid recurrent non-rhythmic stereotyped movements, gestures, or utterances, which may affect any part of the body, and typically mimic some aspects or fragments of normal behaviour. They vary greatly in nature, location, number, intensity, forcefulness, and frequency.

Tics may be simple or complex. Simple motor tics are fast, darting, and meaningless muscular events, while complex motor tics are slower and resemble purposeful actions. Comings and Comings(10) have studied the nature and frequency of motor and phonic tics in 250 subjects with Tourette's disorder: the most common simple motor tics were neck jerking (63 per cent), eye blinking (56 per cent), elevation of shoulders (32 per cent), mouth movements (38 per cent); the most common vocal tics were throat clearing (56 per cent) and sniffing (21 per cent). Other simple vocal tics may involve sucking air, grunting, snorting, humming, barking. Frequent complex motor tics include facial movements, jumping, gyrating, touching, kicking, grooming behaviours, and echokinesis. In a small fraction of cases, the complex motor tics are self-injuring behaviours, which may be potentially dangerous. Complex vocal tics are coprolalia (explosive utterance of dirty words), echolalia (repeating the last sound heard), palilalia (repeating one's own words or sounds), or repeating phrases out of context.

Initially, tics have been decribed as irresistible, but they can actually be suppressed for varying lengths of time (some children can suppress their tics at school or during specific activities); however, this suppression usually produces a secondary exacerbation of tics (at home or when the child is alone). Tics are markedly diminished during sleep. They are classically exacerbated by stress and tiredness, and attenuated during absorbing activities such as reading or counting.

Many young children are completely oblivious of their tics or experience them as wholly involuntary movements or sounds. By the age of 10 years, most are aware of premonitory urges, which may be experienced as a sensory perception or a mental awareness in a specific region of the body where the tic is about to occur; this unpleasant phenomenon is momentarily relieved by the performance of the tic. (l1>

Children and adolescents with tic disorders may present a broad array of behavioural difficulties including obsessive-compulsive symptoms, disinhibited speech or conduct, impulsivity, distractiblity, and motor hyperactivity.(11.) The presence of motor and/or phonic tics is associated with difficulties in self-esteem, self-definition, family life, peer acceptance and relationships, and sometimes school performance.

Break Free From Passive Aggression

Break Free From Passive Aggression

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