Control Study On Characteristics Of Attachment And Family In Children With Tic Disorders

Objective To investigate the characteristics of attachment, family factor, rearing styles of parents, the effect of family threapy in children with tic disorders, and to provide evidence for family intervention.Methods 59 children with tic disorders and 89 normal controls were assessed by attachment security scale, family environment scale-chinese version (FES-CV), family assessment device-chinese version(FAD), family adaptability and cohesion scales, second edition, chinese version (FACESâ…¡-CV) and the egnaminnen av barndomsuppfostran-chinese version (EMBU), to compared attachment relationships and family characteristics. 52 children with tic disorders were also assessed by Yale global tic severity scale (YGTSS), and divided into three treatment groups: drug treatment group, family therapy group, and combined treatment group, to observe the clinical efficacy of different groups and the changes of attachment relationship, family environment, rearing styles of parents in family.Results Father-child attachment and mother-child attachment in attachment security scale of the tic disorders children were all lower than those controls (P<0.01). Cohesion, expressiveness, active-recreational orientation, et al in FES-CV were all lower than those controls (P<0.05/P<0.01), conflict in FES-CV was higher than those controls (P<0.01). General functioning in FAD were higher than those controls (P<0.01). The ratio of the "Disengaged " type of cohesion was higher than that of normal controls(P<0.01), the ratio of the "Rigid" type of adaptability was higher than that of normal controls(P<0.01), the ratio of the "Flexible" type of adaptability was lower than that of normal controls (P<0.05). The score of being cared of parents in EMBU was lower than those controls(P<0.01), the score of being refused, being punished of parents, interference were higher than those controls (P<0.05/P<0.01).In YGTSS: after 4 weeks or 8 weeks of intervention, the score of tic severity were lower than themselves before of three different treatment groups (P<0.01).While there were no significantly difference among three groups.In attachment security scale: after 4 weeks or 8 weeks of intervention, the scores of parental attachment in attachment security scale were higher than themselves before(P<0.01). After 4 weeks, there were no significantly difference of father-child attachment or mother-child attachment among three groups. After 8 weeks, mother-intimacy or mother-child attachment of drug treatment group was the hightest one among three groups (P<0.01).In FES-CV: after 4 weeks of intervention, either family therapy or drug therapy changed scores of the scale. The contradictory results suggested there are some fluctuations in family. After 8 weeks, in drug treatment group, conflict, independence, active-recreational orientation were lower than themselves before (P<0.01). There was no difference of expressiveness after intervention. After 8 weeks, in family therapy group and combined treatment group, cohesion, expressiveness, independence, active-recreational orientation, were higher than themselves before (P<0.01), conflict was lower than itself before (P<0.01).In EMBU: after 4 weeks of intervention, in drug treatment group and combined treatment group, the score of being cared of father were lower than themslves before(P<0.01). In family therapy group, the score of being cared of father was higher than itself before (P<0.01). The scores of being punished, interference in three groups were lower than themslves before(P<0.01). After 8 weeks, the score of being cared of mather in drug treatment group, the score of being cared of father in combined treatment group, and the score of being cared of parents in family therapy group were higher than themslves before(P<0.01). The scores of being punished in three groups were lower than themslves before(P<0.01). The score of interference varied from different groups or different parents.Conclusions Security of attachment in children with tic disorders was lower than the controls. Children with tic disorders suffered from unhealthy family environment and bad rearing styles of parents. Both drug treatment and family therapy could alleviate the symptoms, improve security of attachment. But the effects of systemic family therapy were more related to the improvements of family environment and bad rearing styles of parents. Treatment of drug combined with family therapy was beneficial to disease rehabilitation and healthy in mind and body promotion of children with tic disorders from the biological, psychological and social factors.