Assessing the relationships of emotion regulation and parenting behaviors with internalizing psychopathology in adolescents with Tourette syndrome

About This Grant

PROJECT SUMMARY Tourette syndrome (TS) is a complex neurodevelopmental disorder, primarily characterized by the presence of motor and vocal tics, which places affected individuals at significantly heightened risk for internalizing symptoms and disorders. While comorbid internalizing symptoms have been shown to be a stronger predictor of quality of life and long-term clinical outcomes than tic severity, current behavioral interventions for TS predominantly focus on tic management and fail to comprehensively address the psychological burden of TS. Adolescence is a particularly sensitive developmental period in TS during which tic severity tends to peak and internalizing psychopathology often emerges. As such, there is an urgent clinical need to identify modifiable risk factors for internalizing psychopathology in adolescents with TS to inform interventions and improve clinical outcomes. This study aims to examine difficulties with emotion regulation (ER) and insensitive parenting behaviors as risk factors for internalizing symptoms in adolescents with TS. In this highly innovative proposal, I will collect neurophysiological and self-report data to assess adolescent implicit and explicit ER and leverage coding of behavioral observations to assess insensitive parenting behaviors from 100 families of adolescents with (n=50) and without (n=50) TS. I hypothesize that, compared to adolescents without TS, adolescents with TS will (1) display greater late positive potential amplitude, an event-related potential component derived from the electroencephalogram (EEG), indicating greater difficulty with implicit ER, and (2) self-report greater use of maladaptive ER strategies, indicating greater difficulty with explicit ER. Further, I hypothesize that parents of adolescents with TS will be observed to display greater insensitive parenting behaviors than parents of adolescents without TS. Lastly, I will test a structural equation model examining the unique contributions of difficulties with ER and insensitive parenting as latent constructs to the self-reported internalizing symptoms of adolescents with TS only. Importantly, this project addresses a critical gap in TS by revealing both how these potential risk factors may present differently in TS and how they may uniquely impact the psychological well-being of adolescents with TS, a particularly vulnerable neurodevelopmental population. By identifying the potential influences of ER and parenting behaviors on internalizing symptomology in TS, the findings of this work have the potential to inform longitudinal research and clinical interventions in TS. Throughout this predoctoral training project, I will develop valuable expertise in EEG methodology, assessment of parenting behaviors, advanced quantitative methods, and research dissemination skills. This training will position me to excel in a competitive postdoctoral research position and help launch my career as an independent clinical scientist with rigorous methods expertise.