The Premonitory Urge for Tics Scale in a large sample of children and adolescents: psychometric properties in a developm
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ORIGINAL CONTRIBUTION
The Premonitory Urge for Tics Scale in a large sample of children and adolescents: psychometric properties in a developmental context. An EMTICS study Thaïra J. C. Openneer1 · Zsanett Tárnok2 · Emese Bognar2 · Noa Benaroya‑Milshtein3 · Blanca Garcia‑Delgar4 · Astrid Morer4,5,6 · Tamar Steinberg3 · Pieter J. Hoekstra1 · Andrea Dietrich1 · and the EMTICS collaborative group Received: 18 April 2019 / Accepted: 22 November 2019 © The Author(s) 2019
Abstract Premonitory urges are uncomfortable physical sensations preceding tics that occur in most individuals with a chronic tic disorder. The Premonitory Urge for Tics Scale (PUTS) is the most frequently used self-report measure to assess the severity of premonitory urges. We aimed to evaluate the psychometric properties of the PUTS in the largest sample size to date (n = 656), in children aged 3–16 years, from the baseline measurement of the longitudinal European Multicenter Tics in Children Study (EMTICS). Our psychometric evaluation was done in three age-groups: children aged 3–7 years (n = 103), children between 8 and 10 years (n = 253), and children aged 11–16 years (n = 300). The PUTS exhibited good internal reliability in children and adolescents, also under the age of 10, which is younger than previously thought. We observed significant but small correlations between the severity of urges and severity of tics and obsessive–compulsive symptoms, and between severity of urges and ratings of attention-deficit/hyperactivity disorder and internalizing and externalizing behaviors, however, only in children of 8–10 years. Consistent with previous results, the 10th item of the PUTS correlated less with the rest of the scale compared to the other items and, therefore, should not be used as part of the questionnaire. We found a two-factor structure of the PUTS in children of 11 years and older, distinguishing between sensory phenomena related to tics, and mental phenomena as often found in obsessive–compulsive disorder. The age-related differences observed in this study may indicate the need for the development of an age-specific questionnaire to assess premonitory urges. Keywords Tourette syndrome · Premonitory urges · Premonitory Urge for Tics Scale (PUTS) · Psychometric properties · Obsessive–compulsive symptoms
Pieter J. Hoekstra and Andrea Dietrich contributed equally to this work. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00787-019-01450-1) contains supplementary material, which is available to authorized users. * Thaïra J. C. Openneer [email protected] 1
Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Hanzeplein 1 XA10, 9713 GZ Groningen, The Netherlands
2
Vadaskert Child and Adolescent Psychiatric Hospital, Budapest, Hungary
3
Child and Adolescent Psychiatry Department, Affiliated to Sackler Faculty of Medicine, Schneider Children’s Medical Center of Israel, Tel Aviv University, Petah‑Tikva, Israel
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