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1. Lottery-Based Evaluations of Early Education Programs: Opportunities and Challenges for Building the Next Generation of Evidence

Author

Christina Weiland, Rebecca Unterman, Susan Dynarski, Rachel Abenavoli, Howard Bloom, Breno Braga, Anne-Marie Faria, Erica Greenberg, Brian A. Jacob, Jane Arnold Lincove, Karen Manship, Meghan McCormick, Luke Miratrix, Tomás E. Monarrez, Pamela Morris-Perez, Anna Shapiro, Jon Valant, and Lindsay Weixler

Subjects
Education
Abstract

Lottery-based identification strategies offer potential for generating the next generation of evidence on U.S. early education programs. The authors’ collaborative network of five research teams applying this design in early education settings and methods experts has identified six challenges that need to be carefully considered in this next context: (a) available baseline covariates that may not be very rich; (b) limited data on the counterfactual; (c) limited and inconsistent outcome data; (d) weakened internal validity due to attrition; (e) constrained external validity due to who competes for oversubscribed programs; and (f) difficulties answering site-level questions with child-level randomization. The authors offer potential solutions to these six challenges and concrete recommendations for the design of future lottery-based early education studies.

Published
2024
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2. The Effects of Public Pre-K for 3-Year-Olds on Early Elementary School Outcomes: Evidence from the DC Centralized Lottery. EdWorkingPaper No. 24-1019

Author

Annenberg Institute for School Reform at Brown University, Breno Braga, Justin B. Doromal, Erica Greenberg, Tomas Monarrez, Leonardo Restrepo, and Rachel Lamb

Abstract

This study examines the effects of universal public pre-kindergarten for 3-year-olds (Pre-K3) on later public education outcomes, including enrollment, school mobility, special education status, and in-grade retention from kindergarten through second grade. While universal pre-kindergarten programs typically target 4-year-olds, interest in expanding to 3-year-olds is growing. Using the centralized assignment lottery in the District of Columbia as the basis for a quasi-experimental design, we find that Pre-K3 students are more likely to persist in the public system and remain in the same school. These effects are strongest for residents of low-income neighborhoods and communities of color and for students enrolled in dual language programs. Overall, public Pre-K3 appears to stabilize children's early educational experiences, especially those starting furthest from opportunity.

Published
2024

3. Early Educators' Reflections on the DC Early Childhood Educator Pay Equity Fund. Research Report

Author

Urban Institute, Heather Sandstrom, Eve Mefferd, Laura Jimenez Parra, Victoria Nelson, Justin Doromal, Erica Greenberg, Elli Nikolopoulos, Rachel Lamb, and Alicia Gonzalez

Abstract

Early childhood educators play an essential role in providing child care for families and learning and development supports for young children, yet they have long faced challenges due to low wages. Recognizing this, the District of Columbia (DC) introduced the Early Childhood Pay Equity Fund in 2022. This first-of-its-kind initiative aims to bridge the pay gap between early educators and teachers at public schools, addressing historical inequities and improving recruitment and retention efforts. This report provides an in-depth exploration of early educators' experiences with the Pay Equity Fund during its initial year of implementation. Drawing on data from surveys conducted in May 2023 and follow-up focus groups, the report offers insights into the transition from direct payments to an opt-in payment structure by employers in FY 2024. It covers educators' introduction to the Fund, their application and payment experiences, financial impacts, and perceived benefits for child care programs and the broader early childhood education field.

Published
2024

4. Coaching to Improve Child Care Quality in the District of Columbia: Perspectives of Community Leaders and Coaches. Research Report

Author

Urban Institute, Laura Wagner, Diane Schilder, Rachel Lamb, Erica Greenberg, and Catherine Kuhns

Abstract

To increase quality licensed child care supply, the District of Columbia implemented Capital Quality, a quality rating and improvement system (QRIS) that includes coaching supports. Urban Institute researchers interviewed leaders who oversee coaches working to help child care facilities improve quality and conducted focus groups with coaches in spring 2023. Researchers captured insights on the quality improvement process, promising practices for working with child care providers, methods to improve quality, and challenges faced by coaches and child care facility directors and owners. Prior Urban Institute research reported positive provider experiences with coaching and benefits from participating (such as improved morale and knowledge of quality practices), despite challenges. For the current study, the Urban research team reviewed a summary of the 2020 findings to obtain reactions and reflections about differences in 2023. This report presents findings from data collected in 2023 from the perspectives of leaders and coaches about the current benefits, promising practices, and challenges in quality improvement.

Published
2024

5. Synaptic processes and immune-related pathways implicated in Tourette syndrome

Author

Fotis Tsetsos, Dongmei Yu, Jae Hoon Sul, Alden Y. Huang, Cornelia Illmann, Lisa Osiecki, Sabrina M. Darrow, Matthew E. Hirschtritt, Erica Greenberg, Kirsten R. Muller-Vahl, Manfred Stuhrmann, Yves Dion, Guy A. Rouleau, Harald Aschauer, Mara Stamenkovic, Monika Schlögelhofer, Paul Sandor, Cathy L. Barr, Marco A. Grados, Harvey S. Singer, Markus M. Nöthen, Johannes Hebebrand, Anke Hinney, Robert A. King, Thomas V. Fernandez, Csaba Barta, Zsanett Tarnok, Peter Nagy, Christel Depienne, Yulia Worbe, Andreas Hartmann, Cathy L. Budman, Renata Rizzo, Gholson J. Lyon, William M. McMahon, James R. Batterson, Danielle C. Cath, Irene A. Malaty, Michael S. Okun, Cheston Berlin, Douglas W. Woods, Paul C. Lee, Joseph Jankovic, Mary M. Robertson, Donald L. Gilbert, Lawrence W. Brown, Barbara J. Coffey, Andrea Dietrich, Pieter J. Hoekstra, Samuel Kuperman, Samuel H. Zinner, Michael Wagner, James A. Knowles, A. Jeremy Willsey, Jay A. Tischfield, Gary A. Heiman, Nancy J. Cox, Nelson B. Freimer, Benjamin M. Neale, Lea K. Davis, Giovanni Coppola, Carol A. Mathews, Jeremiah M. Scharf, Peristera Paschou, on behalf of the Tourette Association of America International Consortium for Genetics, Sabrina Darrow, Roger Kurlan, James F. Leckman, Jan H. Smit, the Gilles de la Tourette GWAS Replication Initiative, Harald Aschauer Harald Aschauer, Anastasios Konstantinidis, Kirsten Müller-Vahl, Tomasz Wolanczyk, the Tourette International Collaborative Genetics Study, Lawrence Brown, Keun-Ah Cheon, Blanca Garcia-Delgar, Donald Gilbert, Dorothy E. Grice, Julie Hagstrøm, Tammy Hedderly, Isobel Heyman, Chaim Huyser, Young Key Kim, Young-Shin Kim, Yun-Joo Koh, Sodahm Kook, Bennett L. Leventhal, Marcos Madruga-Garrido, Pablo Mir, Astrid Morer, Alexander Münchau, Kerstin J. Plessen, Veit Roessner, Eun-Young Shin, Dong-Ho Song, Jungeun Song, Samuel Zinner, and the Psychiatric Genomics Consortium Tourette Syndrome Working Group, Thomas Fernandez, Gary Heiman, Pieter Hoekstra, Jay Tischfield, and Douglas Woods

Subjects
Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
Abstract

Abstract Tourette syndrome (TS) is a neuropsychiatric disorder of complex genetic architecture involving multiple interacting genes. Here, we sought to elucidate the pathways that underlie the neurobiology of the disorder through genome-wide analysis. We analyzed genome-wide genotypic data of 3581 individuals with TS and 7682 ancestry-matched controls and investigated associations of TS with sets of genes that are expressed in particular cell types and operate in specific neuronal and glial functions. We employed a self-contained, set-based association method (SBA) as well as a competitive gene set method (MAGMA) using individual-level genotype data to perform a comprehensive investigation of the biological background of TS. Our SBA analysis identified three significant gene sets after Bonferroni correction, implicating ligand-gated ion channel signaling, lymphocytic, and cell adhesion and transsynaptic signaling processes. MAGMA analysis further supported the involvement of the cell adhesion and trans-synaptic signaling gene set. The lymphocytic gene set was driven by variants in FLT3, raising an intriguing hypothesis for the involvement of a neuroinflammatory element in TS pathogenesis. The indications of involvement of ligand-gated ion channel signaling reinforce the role of GABA in TS, while the association of cell adhesion and trans-synaptic signaling gene set provides additional support for the role of adhesion molecules in neuropsychiatric disorders. This study reinforces previous findings but also provides new insights into the neurobiology of TS.

Published
2021
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6. Center Directors View Teacher Wage Supplements as Benefiting the Child Care Field: Reflections on the DC Early Childhood Educator Pay Equity Fund. Fact Sheet

Author

Urban Institute, Elli Nikolopoulos, Justin B. Doromal, Erica Greenberg, Heather Sandstrom, Victoria Nelson, and Eve Mefferd

Abstract

This fact sheet shares survey findings from directors of 157 child development centers in the District of Columbia (DC) in summer 2023. Findings describe directors' perceptions of direct wage supplements provided to early educators through DC's Early Childhood Educator Pay Equity Fund and implications for their facilities and the child care field. Directors reflect on the benefits of the Pay Equity Fund for recruitment, retention, and pay equity between early educators and public school teachers. They also note challenges for nonteaching staff who ineligible for the Pay Equity Fund.

Published
2024

7. Toward Pay Equity: A Case Study of Washington DC’s Wage Boost for Early Childhood Educators

Author

Erica Greenberg, Erica Greenberg, Justin B. Doromal, Victoria Nelson, Eleanor Lauderback, Heather Sandstrom, Soumita Bose, Erica Greenberg, Erica Greenberg, Justin B. Doromal, Victoria Nelson, Eleanor Lauderback, Heather Sandstrom, and Soumita Bose

Abstract

This short report presents findings from interviews—with key informants, including DC early childhood education leaders, advocates, and implementation partners; parents and legal guardians of young children enrolled in licensed DC child care facilities; and child care center directors and home and expanded home providers—on the nation's first early childhood educator wage supplement with dedicated public funding.

Published
2023

8. 'What Language Do You Want to Complete This Application In?': Comparing Spanish and English Applications to DC Public Prekindergarten

Author

Carina Chien, Carina Chien, Breno Braga, Erica Greenberg, Justin B. Doromal, Rachel Lamb, Grace Luetmer, Leonardo Restrepo, Carina Chien, Carina Chien, Breno Braga, Erica Greenberg, Justin B. Doromal, Rachel Lamb, Grace Luetmer, and Leonardo Restrepo

Abstract

Public preschool can help children thrive and can promote equitable outcomes when families have access to it. District of Columbia Public Prekindergarten has enrolled the highest share of 3- and 4-year-old children in America for more than a decade in its full-day, school-year program. Using data from DC Prekindergarten applications from 2015 to 2020, we examined whether the probability of being matched to a ranked school differed across applications submitted in Spanish and English.Our findings suggest that DC Prekindergarten is generally accessible, even after accounting for language of application, with differences in probability of assignment instead based on grade of application. We find that families who applied to PK3 (prekindergarten for 3-year-olds) in Spanish were slightly less likely to be matched to a school, while families who applied to PK4 in Spanish were substantially more likely to be matched than families who applied in English. We also find applications completed in Spanish ranked fewer schools and ranked both more popular and more dual language programs than those completed in English. This study documents the need for continued examination of school offerings, families' needs, language supports, and the application process to ensure access to DC Prekindergarten.

Published
2023

10. Genome-wide Association Study Points to Novel Locus for Gilles de la Tourette Syndrome

Author

Fotis Tsetsos, Apostolia Topaloudi, Pritesh Jain, Zhiyu Yang, Dongmei Yu, Petros Kolovos, Zeynep Tumer, Renata Rizzo, Andreas Hartmann, Christel Depienne, Yulia Worbe, Kirsten R. Müller-Vahl, Danielle C. Cath, Dorret I. Boomsma, Tomasz Wolanczyk, Cezary Zekanowski, Csaba Barta, Zsofia Nemoda, Zsanett Tarnok, Shanmukha S. Padmanabhuni, Joseph D. Buxbaum, Dorothy Grice, Jeffrey Glennon, Hreinn Stefansson, Bastian Hengerer, Evangelia Yannaki, John A. Stamatoyannopoulos, Noa Benaroya-Milshtein, Francesco Cardona, Tammy Hedderly, Isobel Heyman, Chaim Huyser, Pablo Mir, Astrid Morer, Norbert Mueller, Alexander Munchau, Kerstin J. Plessen, Cesare Porcelli, Veit Roessner, Susanne Walitza, Anette Schrag, Davide Martino, Jay A. Tischfield, Gary A. Heiman, A. Jeremy Willsey, Andrea Dietrich, Lea K. Davis, James J. Crowley, Carol A. Mathews, Jeremiah M. Scharf, Marianthi Georgitsi, Pieter J. Hoekstra, Peristera Paschou, Cathy L. Barr, James R. Batterson, Cheston Berlin, Cathy L. Budman, Giovanni Coppola, Nancy J. Cox, Sabrina Darrow, Yves Dion, Nelson B. Freimer, Marco A. Grados, Erica Greenberg, Matthew E. Hirschtritt, Alden Y. Huang, Cornelia Illmann, Robert A. King, Roger Kurlan, James F. Leckman, Gholson J. Lyon, Irene A. Malaty, William M. McMahon, Benjamin M. Neale, Michael S. Okun, Lisa Osiecki, Mary M. Robertson, Guy A. Rouleau, Paul Sandor, Harvey S. Singer, Jan H. Smit, Jae Hoon Sul, Christos Androutsos, Entela Basha, Luca Farkas, Jakub Fichna, Piotr Janik, Mira Kapisyzi, Iordanis Karagiannidis, Anastasia Koumoula, Peter Nagy, Joanna Puchala, Natalia Szejko, Urszula Szymanska, Vaia Tsironi, Alan Apter, Juliane Ball, Benjamin Bodmer, Emese Bognar, Judith Buse, Marta Correa Vela, Carolin Fremer, Blanca Garcia-Delgar, Mariangela Gulisano, Annelieke Hagen, Julie Hagstrøm, Marcos Madruga-Garrido, Alessandra Pellico, Daphna Ruhrman, Jaana Schnell, Paola Rosaria Silvestri, Liselotte Skov, Tamar Steinberg, Friederike Tagwerker Gloor, Victoria L. Turner, Elif Weidinger, John Alexander, Tamas Aranyi, Wim R. Buisman, Jan K. Buitelaar, Nicole Driessen, Petros Drineas, Siyan Fan, Natalie J. Forde, Sarah Gerasch, Odile A. van den Heuvel, Cathrine Jespersgaard, Ahmad S. Kanaan, Harald E. Möller, Muhammad S. Nawaz, Ester Nespoli, Luca Pagliaroli, Geert Poelmans, Petra J.W. Pouwels, Francesca Rizzo, Dick J. Veltman, Ysbrand D. van der Werf, Joanna Widomska, Nuno R. Zilhäo, Lawrence W. Brown, Keun-Ah Cheon, Barbara J. Coffey, Thomas V. Fernandez, Donald L. Gilbert, Hyun Ju Hong, Laura Ibanez-Gomez, Eun-Joo Kim, Young Key Kim, Young-Shin Kim, Yun-Joo Koh, Sodahm Kook, Samuel Kuperman, Bennett L. Leventhal, Athanasios Maras, Tara L. Murphy, Eun-Young Shin, Dong-Ho Song, Jungeun Song, Matthew W. State, Frank Visscher, Sheng Wang, Samuel H. Zinner, Psychiatry, APH - Mental Health, APH - Methodology, Amsterdam Neuroscience - Complex Trait Genetics, Amsterdam Neuroscience - Mood, Anxiety, Psychosis, Stress & Sleep, Anatomy and neurosciences, Amsterdam Neuroscience - Compulsivity, Impulsivity & Attention, Amsterdam Neuroscience - Neurodegeneration, Radiology and nuclear medicine, Amsterdam Neuroscience - Brain Imaging, Amsterdam Neuroscience - Systems & Network Neuroscience, Biological Psychology, and Amsterdam Reproduction & Development

Subjects
meta-analysis, Medizin, GWAS, Biological Psychiatry, NR2F1, Tourette Syndrome
Abstract

Background: Tourette syndrome (TS) is a childhood-onset neurodevelopmental disorder of complex genetic architecture and is characterized by multiple motor tics and at least one vocal tic persisting for more than 1 year. Methods: We performed a genome-wide meta-analysis integrating a novel TS cohort with previously published data, resulting in a sample size of 6133 individuals with TS and 13,565 ancestry-matched control participants. Results: We identified a genome-wide significant locus on chromosome 5q15. Integration of expression quantitative trait locus, Hi-C (high-throughput chromosome conformation capture), and genome-wide association study data implicated the NR2F1 gene and associated long noncoding RNAs within the 5q15 locus. Heritability partitioning identified statistically significant enrichment in brain tissue histone marks, while polygenic risk scoring of brain volume data identified statistically significant associations with right and left thalamus volumes and right putamen volume. Conclusions: Our work presents novel insights into the neurobiology of TS, thereby opening up new directions for future studies.

Published
2023

11. European Society for the Study of Tourette Syndrome 2022 criteria for clinical diagnosis of functional tic-like behaviours: International consensus from experts in tic disorders

Author

Tamara Pringsheim, Christos Ganos, Christelle Nilles, Andrea E. Cavanna, Donald L. Gilbert, Erica Greenberg, Andreas Hartmann, Tammy Hedderly, Isobel Heyman, Holan Liang, Irene Malaty, Osman Malik, Nanette Mol Debes, Kirsten Muller Vahl, Alexander Munchau, Tara Murphy, Peter Nagy, Tamsin Owen, Renata Rizzo, Liselotte Skov, Jeremy Stern, Natalia Szejko, Yulia Worbe, Davide Martino, Pringsheim, T, Ganos, C, Nilles, C, Cavanna, A, Gilbert, D, Greenburg, E, Hartmann, A, Hedderly, T, Heyman, I, Liang, H, Malaty, I, Malik, O, Debes, N, Vahl, K, Munchau, A, Murphy, T, Nagy, P, Owen, T, Rizzo, R, Skov, L, Stern, J, Szejko, N, Worbe, Y, and Martino, D

Subjects
tic, Neurology, Tourette syndrome, functional neurological disorder, tics, Neurology (clinical)
Abstract

Background and purpose: In 2020, health professionals witnessed a dramatic increase in referrals of young people with rapid onset of severe tic-like behaviours. We assembled a working group to develop criteria for the clinical diagnosis of functional tic-like behaviours (FTLBs) to help neurologists, pediatricians, psychiatrists, and psychologists recognize and diagnose this condition. Methods: We used a formal consensus development process, using a multiround, web-based Delphi survey. The survey was based on an in-person discussion at the European Society for the Study of Tourette Syndrome (ESSTS) meeting in Lausanne in June 2022. Members of an invited group with extensive clinical experience working with patients with Tourette syndrome and FTLBs discussed potential clinical criteria for diagnosis of FTLBs. An initial set of criteria were developed based on common clinical experiences and review of the literature on FTLBs and revised through iterative discussions, resulting in the survey items for voting. Results: In total, 24 members of the working group were invited to participate in the Delphi process. We propose that there are three major criteria and two minor criteria to support the clinical diagnosis of FTLBs. A clinically definite diagnosis of FTLBs can be confirmed by the presence of all three major criteria. A clinically probable diagnosis of FTLBs can be confirmed by the presence of two major criteria and one minor criterion. Conclusions: Distinguishing FTLBs from primary tics is important due to the distinct treatment paths required for these two conditions. A limitation of the ESSTS 2022 criteria is that they lack prospective testing of their sensitivity and specificity.

Published
2023

13. Is Persistent Motor or Vocal Tic Disorder a Milder Form of Tourette Syndrome?

Author

Sang-Wahn Koo, Erica Greenberg, Daniel A. Geller, Matthew E. Hirschtritt, Mary M. Robertson, Benjamin D. Greenberg, Robert A. King, Karla Claudio-Campos, James A. Knowles, Jack Samuels, Mark A. Riddle, Cornelia Illmann, Oscar J. Bienvenu, Lisa Osiecki, Gholson J. Lyon, Gerald Nestadt, Cathy Budman, Sabrina M. Darrow, Jeremiah M. Scharf, Janice Krasnow, Daniel A. Stevens, Marco A. Grados, James T. McCracken, Carol A. Mathews, Danielle C. Cath, Guy A. Rouleau, Paul Sandor, Fernando S. Goes, Franjo Ivankovic, Paul C. Lee, and Alexa Valko

Subjects
0301 basic medicine, Tic disorder, Pediatrics, medicine.medical_specialty, Obsessive-Compulsive Disorder, Movement disorders, Population, severity, Regular Issue Articles, Comorbidity, Tourette syndrome, chronic tics, 03 medical and health sciences, 0302 clinical medicine, mental disorders, medicine, Attention deficit hyperactivity disorder, Humans, Spectrum disorder, education, Research Articles, education.field_of_study, business.industry, Tourette, medicine.disease, meta-analysis, 030104 developmental biology, Mood, Neurology, meta‐analysis, Attention Deficit Disorder with Hyperactivity, Tic Disorders, Tics, Anxiety, Neurology (clinical), medicine.symptom, business, 030217 neurology & neurosurgery, Research Article, Tourette Syndrome
Abstract

Background Persistent motor or vocal tic disorder (PMVT) has been hypothesized to be a forme fruste of Tourette syndrome (TS). Although the primary diagnostic criterion for PMVT (presence of motor or vocal tics, but not both) is clear, less is known about its clinical presentation. Objective The goals of this study were to compare the prevalence and number of comorbid psychiatric disorders, tic severity, age at tic onset, and family history for TS and PMVT. Methods We analyzed data from two independent cohorts using generalized linear equations and confirmed our findings using meta-analyses, incorporating data from previously published literature. Results Rates of obsessive-compulsive disorder (OCD) and attention deficit hyperactivity disorder (ADHD) were lower in PMVT than in TS in all analyses. Other psychiatric comorbidities occurred with similar frequencies in PMVT and TS in both cohorts, although meta-analyses suggested lower rates of most psychiatric disorders in PMVT compared with TS. ADHD and OCD increased the odds of comorbid mood, anxiety, substance use, and disruptive behaviors, and accounted for observed differences between PMVT and TS. Age of tic onset was approximately 2 years later, and tic severity was lower in PMVT than in TS. First-degree relatives had elevated rates of TS, PMVT, OCD, and ADHD compared with population prevalences, with rates of TS equal to or greater than PMVT rates. Conclusions Our findings support the hypothesis that PMVT and TS occur along a clinical spectrum in which TS is a more severe and PMVT a less severe manifestation of a continuous neurodevelopmental tic spectrum disorder. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Published
2021

14. Modified Comprehensive Behavioral Intervention for Tics: Treating Children With Tic Disorders, Co-Occurring ADHD, and Psychosocial Impairment

Author

Erica Greenberg, Caroline Albright, Margaret Hall, Susanne Hoeppner, Sarah Miller, Alyssa Farley, Michelle Silverman, Valerie Braddick, Susan Sprich, and Sabine Wilhelm

Subjects
Clinical Psychology
Abstract

Our objective was to evaluate the feasibility and acceptability, and preliminary efficacy of a modified comprehensive behavioral intervention for tics (MCBIT) therapy for youth with chronic tic disorders (CTDs), co-occurring attention-deficit hyperactivity disorder (ADHD), and associated psychosocial impairment. Seventeen youth ages 10-17 with CTD and co-occurring ADHD were randomly assigned to the MCBIT group (n = 9) or to a control group where they received traditional comprehensive behavioral intervention for tics (CBIT) therapy (n = 8). Both groups received ten 55-minute weekly treatment sessions, and two 55-minute biweekly relapse prevention sessions. Sixteen of the 17 participants completed the study, and acceptability ratings in both treatment groups were high with no significant differences in expectation of improvement. The MCBIT and CBIT groups in combination showed significant improvement in tic severity, ADHD symptom severity, and tic-related impairment. Group differences were not significant. The results indicate that MCBIT treatment is feasible and acceptable for youth with CTD and ADHD, and is similarly well tolerated relative to traditional CBIT. Results were not sufficiently superior to recommend MCBIT over CBIT for this population. However, given the demonstrated benefit of behavioral treatments that target co-occurring conditions concurrently, continuing to examine novel behavioral approaches that can target tics and related conditions simultaneously and successfully is recommended.

Published
2021

15. Diagnosis and Management of Functional Tic-Like Phenomena

Author

Irene A. Malaty, Seonaid Anderson, Shannon M. Bennett, Cathy L. Budman, Barbara J. Coffey, Keith A. Coffman, Erica Greenberg, Joseph F. McGuire, Kirsten R. Müller-Vahl, Michael S. Okun, Julio Quezada, Amy Robichaux-Viehoever, and Kevin J. Black

Subjects
General Medicine
Abstract

Over the past 3 years, a global phenomenon has emerged characterized by the sudden onset and frequently rapid escalation of tics and tic-like movements and phonations. These symptoms have occurred not only in youth known to have tics or Tourette syndrome (TS), but also, and more notably, in youth with no prior history of tics. The Tourette Association of America (TAA) convened an international, multidisciplinary working group to better understand this apparent presentation of functional neurological disorder (FND) and its relationship to TS. Here, we review and summarize the literature relevant to distinguish the two, with recommendations to clinicians for diagnosis and management. Finally, we highlight areas for future emphasis and research.

Published
2022

17. Intrusive-Destructive Behaviors: Novel Behavioral Presentations of Patients With Co-Occurring Tourette Syndrome, Obsessive-Compulsive Disorder, and Attention-Deficit/Hyperactivity Disorder

Author

Theodore A. Stern, Erica Greenberg, and Aldis H. Petriceks

Subjects
medicine.medical_specialty, Obsessive-Compulsive Disorder, Hospitalized patients, business.industry, MEDLINE, General Medicine, Comorbidity, medicine.disease, Tourette syndrome, Psychiatric consultation, Co occurring, Obsessive compulsive, Attention Deficit Disorder with Hyperactivity, medicine, Attention deficit hyperactivity disorder, Humans, General hospital, Psychiatry, business, Tourette Syndrome
Abstract

The Psychiatric Consultation Service at Massachusetts General Hospital sees medical and surgical inpatients with comorbid psychiatric symptoms and conditions. During their twice-weekly rounds, Dr Stern and other members of the Consultation Service discuss diagnosis and management of hospitalized patients with complex medical or surgical problems who also demonstrate psychiatric symptoms or conditions. These discussions have given rise to rounds reports that will prove useful for clinicians practicing at the interface of medicine and psychiatry.

Published
2020

18. TOURETTE’S DISORDER: PATHWAYS TO RESILIENCE

Author

Barbara J. Coffey and Erica Greenberg

Subjects
Psychiatry and Mental health, Developmental and Educational Psychology, Resilience (network), Psychology, Developmental psychology
Published
2021

19. Predictors of comorbid eating disorders and association with other obsessive-compulsive spectrum disorders in trichotillomania

Author

Erin E. Curley, Jeremiah M. Scharf, Douglas W. Woods, Jon E. Grant, Christine Lochner, Erica Greenberg, Dan J. Stein, Esther S. Tung, Sarah A. Redden, and Nancy J. Keuthen

Subjects
Adult, Obsessive-Compulsive Disorder, medicine.medical_specialty, Adolescent, lcsh:RC435-571, Compulsive Personality Disorder, Substance-Related Disorders, Population, Comorbidity, Feeding and Eating Disorders, Trichotillomania, South Africa, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, lcsh:Psychiatry, mental disorders, medicine, Humans, Obsessive compulsive scale, Psychiatry, Association (psychology), education, education.field_of_study, Obsessive–compulsive spectrum, Middle Aged, medicine.disease, Anxiety Disorders, United States, 030227 psychiatry, Diagnostic and Statistical Manual of Mental Disorders, Psychiatry and Mental health, Clinical Psychology, Eating disorders, Increased risk, Attention Deficit Disorder with Hyperactivity, Female, Psychology, 030217 neurology & neurosurgery, Anxiety disorder, Clinical psychology
Abstract

Trichotillomania (TTM) and eating disorders (ED) share many phenomenological similarities, including ritualized compulsive behaviors. Given this, and that comorbid EDs may represent additional functional burden to hair pullers, we sought to identify factors that predict diagnosis of an ED in a TTM population. Subjects included 555 adult females (age range 18–65) with DSM-IV-TR TTM or chronic hair pullers recruited from multiple sites. 7.2% (N = 40) of our TTM subjects met criteria for an ED in their lifetime. In univariable regression analysis, obsessive-compulsive disorder (OCD), Yale-Brown Obsessive Compulsive Scale (Y-BOCS) worst-ever compulsion and total scores, certain obsessive-compulsive spectrum disorders, anxiety disorder, attention-deficit/hyperactivity disorder (ADHD), and substance disorder all met the pre-specified criteria for inclusion in the multivariable analysis. In the final multivariable model, diagnosis of OCD (OR: 5.68, 95% CI: 2.2–15.0) and diagnosis of an additional body-focused repetitive behavior disorder (BFRB) (OR: 2.69, 95% CI: 1.1–6.8) were both associated with increased risk of ED in TTM. Overall, our results provide further support of the relatedness between ED and TTM. This finding highlights the importance of assessing for comorbid OCD and additional BFRBs in those with TTM. Future research is needed to identify additional predictors of comorbid disorders and to better understand the complex relationships between BFRBs, OCD and EDs.

Published
2017

21. Genomic Relationships, Novel Loci, and Pleiotropic Mechanisms across Eight Psychiatric Disorders

Author

Laura M. Thornton, Paul Lichtenstein, Verneri Anttila, Diego Albani, Josep Antoni Ramos-Quiroga, Roger A.H. Adan, Monika Schlögelhofer, Stephen Sanders, Enrique Castelao, Klaus Berger, Nina Dalkner, Urs Heilbronner, Engilbert Sigurdsson, Pablo Mir, Fuquan Zhang, James T.R. Walters, Patrick F. Sullivan, Fragiskos Gonidakis, F. Kyle Satterstrom, Sara Marsal, Per Hoffmann, Amy Perry, Valentina Ciullo, Beate Herpertz-Dahlmann, Catharina Lavebratt, Kieran C. Murphy, Tammy Hedderly, Hyun Ju Hong, Evald Saemundsen, Sascha B. Fischer, Hailiang Huang, Andrew D. Grotzinger, Nienke Vulink, Murray B. Stein, Mark A. Frye, Laura J. Scott, David Curtis, Todd Lencz, Janiece E. DeSocio, Richard A. Belliveau, Eduard Vieta, Andrea Dietrich, Wade H. Berrettini, Kenneth S. Kendler, Marquis P. Vawter, Paul S. Nestadt, Michael E. Talkowski, Manuel Mattheisen, Ingrid Agartz, Elisa Docampo, Bernhard T. Baune, Stefan Ehrlich, Jolanta Lissowska, Felecia Cerrato, Terje Nærland, Robin M. Murray, Jennifer Reichert, Annette M. Hartmann, Hannelore Ehrenreich, Howard J. Edenberg, Katherine A. Halmi, Qingqin S. Li, Peristera Paschou, Marie Bækvad-Hansen, Esther Walton, Alessio Maria Monteleone, Ted Reichborn-Kjennerud, Frank Bellivier, Jungeun Song, D. Blake Woodside, Young Shin Kim, Jochen Seitz, Jacques Pantel, Palmiero Monteleone, Erika L. Nurmi, Rodney J. Scott, Kang Sim, Ekaterina A. Khramtsova, Udo Dannlowski, Rolf Adolfsson, Danielle Posthuma, Melissa J. Green, Laura Ibanez-Gomez, Jakob Grove, Elvira Bramon, Gregory L. Hanna, Cynthia M. Bulik, Yiran Guo, Stephan Ripke, Mary M. Robertson, Harald N. Aschauer, Adebayo Anjorin, Joanna Martin, Bertram Müller-Myhsok, Deborah Kaminská, Jose Guzman-Parra, Benedetta Nacmias, Erik G. Jönsson, Jonathan R. I. Coleman, Douglas F. Levinson, Hamdi Mbarek, Gun Peggy Knudsen, Karin Egberts, Mette Nyegaard, Patrik K. E. Magnusson, Mark Adams, Douglas Blackwood, Elisabeth B. Binder, Marcus Ising, Anna R. 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Leventhal, Giovanni Gambaro, Christos Androutsos, Jennifer Tübing, Marion Roberts, Annelie Nordin Adolfsson, Hakon Hakonarson, Dorothy E. Grice, Vaughan J. Carr, Konstantinos Tziouvas, Stephanie Zerwas, Cathy L. Barr, Michael Conlon O'Donovan, Per Qvist, Beate St Pourcain, Samuel Kuperman, Leila Karhunen, Jack Samuels, Markus M. Nöthen, Martien J H Kas, Alfonso Tortorella, Mikael Landén, Jennifer Crosbie, Marco A. Grados, Joanna M. Biernacka, Paul D. Arnold, Irene A. Malaty, Jurjen J. Luykx, Nicholas Bass, Naomi R. Wray, Catharina A. Hartman, Christina M. Hultman, Michael S. Okun, Brandon Wormley, Michael Bauer, Daniel J. Smith, Ian Jones, Kathryn Roeder, Brien P. Riley, Caroline M. Nievergelt, Katrin Gade, Sarah Kittel-Schneider, Roy H. Perlis, James R. Mitchell, Ziarih Hawi, James Lee, Liz Forty, William E. Bunney, Thomas Damm Als, Catherine Schaefer, Digby Quested, Matteo Cassina, Anna C. Koller, Patrick Turley, Agnes A. Steixner, Anu Raevuori, Assen Jablensky, Peter Holmans, Dong-Ho Song, S. Evelyn Stewart, Jan K. Buitelaar, Fernando S. Goes, Alexander Münchau, Ayman H. Fanous, Nicolas Ramoz, James B. Potash, Monica Gratacos Mayora, Tobias Banaschewski, Céline S. Reinbold, Renata Rizzo, Arianna Di Florio, Lenka Foretova, Gianfranco Spalletta, Aarno Palotie, Eleftheria Zeggini, Lawrence W. Brown, Julie K. O'Toole, Lynn E. DeLisi, Ulrich Schall, Mary Roberson, Barbara J. Coffey, Bryan J. Mowry, Murray J. Cairns, Dan J. Stein, Glyn Lewis, Marta Ribasés, C. Robert Cloninger, Bettina Konte, John B. Vincent, Duncan S. Palmer, Radhika Kandaswamy, Christine Ladd-Acosta, Lars Alfredsson, Frank Visscher, Ulrike Schmidt, Aiden Corvin, Susan L. Santangelo, Brenda W.J.H. Penninx, David J. Porteous, Tetsuya Ando, Arne E. Vaaler, Bru Cormand, Laura Carlberg, Claire Churchhouse, Manfred Stuhrmann, Niamh Mullins, Christine Søholm Hansen, Cathy L. Budman, Hartmut Imgart, Dan E. Arking, James J. McGough, Michael Gill, Christel Depienne, Roland Burghardt, Antonio Julià, Anders M. Dale, Sven Sandin, Katharina Domschke, Maria Grigoroiu-Serbanescu, Susana Jiménez-Murcia, Marianne Giørtz Pedersen, Zsanett Tarnok, Gisli Baldursson, Michele T. Pato, David M. Hougaard, Thorgeir E. Thorgeirsson, Katharina Bey, Kerstin J. Plessen, Margaret A. Richter, Ole A. Andreassen, Claudine Laurent-Levinson, Leonid Padyukov, Jacques Mallet, Daniela Degortes, John R. Kelsoe, Robert D. Levitan, Andreas Reif, Chaim Huyser, Derek W. Morris, Sina Wanderer, William Byerley, Edna Grünblatt, E.J.C. de Geus, Hyejung Won, Josephine Elia, Rudolf Uher, Jay A. Tischfield, Andreas Karwautz, Gustavo Turecki, Pieter J. Hoekstra, Dorret I. Boomsma, Jacob Rosenthal, Daniele Cusi, Michael C. Neale, Sara Mostafavi, Gwyneth Zai, F. Anthony O'Neill, Gary Donohoe, Karola Rehnström, Harry Brandt, Helena Gaspar, Francis J. McMahon, H-Erich Wichmann, Andrew W. Bergen, Giovanni Coppola, Lea K. 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H., Anttila, V., Won, H., Feng, Y. -C. A., Rosenthal, J., Zhu, Z., Tucker-Drob, E. M., Nivard, M. G., Grotzinger, A. D., Posthuma, D., Wang, M. M. -J., Yu, D., Stahl, E. A., Walters, R. K., Anney, R. J. L., Duncan, L. E., Ge, T., Adolfsson, R., Banaschewski, T., Belangero, S., Cook, E. H., Coppola, G., Derks, E. M., Hoekstra, P. J., Kaprio, J., Keski-Rahkonen, A., Kirov, G., Kranzler, H. R., Luykx, J. J., Rohde, L. A., Zai, C. C., Agerbo, E., Arranz, M. J., Asherson, P., Baekvad-Hansen, M., Baldursson, G., Bellgrove, M., Belliveau, R. A., Buitelaar, J., Burton, C. L., Bybjerg-Grauholm, J., Casas, M., Cerrato, F., Chambert, K., Churchhouse, C., Cormand, B., Crosbie, J., Dalsgaard, S., Demontis, D., Doyle, A. E., Dumont, A., Elia, J., Grove, J., Gudmundsson, O. O., Haavik, J., Hakonarson, H., Hansen, C. S., Hartman, C. A., Hawi, Z., Hervas, A., Hougaard, D. M., Howrigan, D. P., Huang, H., Kuntsi, J., Langley, K., Lesch, K. -P., Leung, P. W. L., Loo, S. K., Martin, J., Martin, A. R., Mcgough, J. J., Medland, S. E., Moran, J. L., Mors, O., Mortensen, P. B., Oades, R. D., Palmer, D. S., Pedersen, C. B., Pedersen, M. G., Peters, T., Poterba, T., Poulsen, J. B., Ramos-Quiroga, J. A., Reif, A., Ribases, M., Rothenberger, A., Rovira, P., Sanchez-Mora, C., Satterstrom, F. K., Schachar, R., Artigas, M. S., Steinberg, S., Stefansson, H., Turley, P., Walters, G. B., Werge, T., Zayats, T., Arking, D. E., Bettella, F., Buxbaum, J. D., Christensen, J. H., Collins, R. L., Coon, H., De Rubeis, S., Delorme, R., Grice, D. E., Hansen, T. F., Holmans, P. A., Hope, S., Hultman, C. M., Klei, L., Ladd-Acosta, C., Magnusson, P., Naerland, T., Nyegaard, M., Pinto, D., Qvist, P., Rehnstrom, K., Reichenberg, A., Reichert, J., Roeder, K., Rouleau, G. A., Saemundsen, E., Sanders, S. J., Sandin, S., St Pourcain, B., Stefansson, K., Sutcliffe, J. S., Talkowski, M. E., Weiss, L. A., Willsey, A. J., Agartz, I., Akil, H., Albani, D., Alda, M., Als, T. D., Anjorin, A., Backlund, L., Bass, N., Bauer, M., Baune, B. T., Bellivier, F., Bergen, S. E., Berrettini, W. H., Biernacka, J. M., Blackwood, D. H. R., Boen, E., Budde, M., Bunney, W., Burmeister, M., Byerley, W., Byrne, E. M., Cichon, S., Clarke, T. -K., Coleman, J. R. I., Craddock, N., Curtis, D., Czerski, P. M., Dale, A. M., Dalkner, N., Dannlowski, U., Degenhardt, F., Di Florio, A., Elvsashagen, T., Etain, B., Fischer, S. B., Forstner, A. J., Forty, L., Frank, J., Frye, M., Fullerton, J. M., Gade, K., Gaspar, H. A., Gershon, E. S., Gill, M., Goes, F. S., Gordon, S. D., Gordon-Smith, K., Green, M. J., Greenwood, T. A., Grigoroiu-Serbanescu, M., Guzman-Parra, J., Hauser, J., Hautzinger, M., Heilbronner, U., Herms, S., Hoffmann, P., Holland, D., Jamain, S., Jones, I., Jones, L. A., Kandaswamy, R., Kelsoe, J. R., Kennedy, J. L., Joachim, O. K., Kittel-Schneider, S., Kogevinas, M., Koller, A. C., Lavebratt, C., Lewis, C. M., Li, Q. S., Lissowska, J., Loohuis, L. M. O., Lucae, S., Maaser, A., Malt, U. F., Martin, N. G., Martinsson, L., Mcelroy, S. L., Mcmahon, F. J., Mcquillin, A., Melle, I., Metspalu, A., Millischer, V., Mitchell, P. B., Montgomery, G. W., Morken, G., Morris, D. W., Muller-Myhsok, B., Mullins, N., Myers, R. M., Nievergelt, C. M., Nordentoft, M., Adolfsson, A. N., Nothen, M. M., Ophoff, R. A., Owen, M. J., Paciga, S. A., Pato, C. N., Pato, M. T., Perlis, R. H., Perry, A., Potash, J. B., Reinbold, C. S., Rietschel, M., Rivera, M., Roberson, M., Schalling, M., Schofield, P. R., Schulze, T. G., Scott, L. J., Serretti, A., Sigurdsson, E., Smeland, O. B., Stordal, E., Streit, F., Strohmaier, J., Thorgeirsson, T. E., Treutlein, J., Turecki, G., Vaaler, A. E., Vieta, E., Vincent, J. B., Wang, Y., Witt, S. H., Zandi, P., Adan, R. A. H., Alfredsson, L., Ando, T., Aschauer, H., Baker, J. H., Bencko, V., Bergen, A. W., Birgegard, A., Perica, V. B., Brandt, H., Burghardt, R., Carlberg, L., Cassina, M., Clementi, M., Courtet, P., Crawford, S., Crow, S., Crowley, J. J., Danner, U. N., Davis, O. S. P., Degortes, D., Desocio, J. E., Dick, D. M., Dina, C., Docampo, E., Egberts, K., Ehrlich, S., Espeseth, T., Fernandez-Aranda, F., Fichter, M. M., Foretova, L., Forzan, M., Gambaro, G., Giegling, I., Gonidakis, F., Gorwood, P., Mayora, M. G., Guo, Y., Halmi, K. A., Hatzikotoulas, K., Hebebrand, J., Helder, S. G., Herpertz-Dahlmann, B., Herzog, W., Hinney, A., Imgart, H., Jimenez-Murcia, S., Johnson, C., Jordan, J., Julia, A., Kaminska, D., Karhunen, L., Karwautz, A., Kas, M. J. H., Kaye, W. H., Kennedy, M. A., Kim, Y. -R., Klareskog, L., Klump, K. L., Knudsen, G. P. S., Landen, M., Le Hellard, S., Levitan, R. D., Li, D., Lichtenstein, P., Maj, M., Marsal, S., Mcdevitt, S., Mitchell, J., Monteleone, P., Monteleone, A. M., Munn-Chernoff, M. A., Nacmias, B., Navratilova, M., O'Toole, J. K., Padyukov, L., Pantel, J., Papezova, H., Rabionet, R., Raevuori, A., Ramoz, N., Reichborn-Kjennerud, T., Ricca, V., Roberts, M., Rujescu, D., Rybakowski, F., Scherag, A., Schmidt, U., Seitz, J., Slachtova, L., Slof-Op't Landt, M. C. T., Slopien, A., Sorbi, S., Southam, L., Strober, M., Tortorella, A., Tozzi, F., Treasure, J., Tziouvas, K., van Elburg, A. A., Wade, T. D., Wagner, G., Walton, E., Watson, H. J., Wichmann, H. -E., Woodside, D. B., Zeggini, E., Zerwas, S., Zipfel, S., Adams, M. J., Andlauer, T. F. M., Berger, K., Binder, E. B., Boomsma, D. I., Castelao, E., Colodro-Conde, L., Direk, N., Docherty, A. R., Domenici, E., Domschke, K., Dunn, E. C., Foo, J. C., D, e. Geus E. J. C., Grabe, H. J., Hamilton, S. P., Horn, C., Hottenga, J. -J., Howard, D., Ising, M., Kloiber, S., Levinson, D. F., Lewis, G., Magnusson, P. K. E., Mbarek, H., Middeldorp, C. M., Mostafavi, S., Nyholt, D. R., Penninx, B. W., Peterson, R. E., Pistis, G., Porteous, D. J., Preisig, M., Quiroz, J. A., Schaefer, C., Schulte, E. C., Shi, J., Smith, D. J., Thomson, P. A., Tiemeier, H., Uher, R., van der Auwera, S., Weissman, M. M., Alexander, M., Begemann, M., Bramon, E., Buccola, N. G., Cairns, M. J., Campion, D., Carr, V. J., Cloninger, C. R., Cohen, D., Collier, D. A., Corvin, A., Delisi, L. E., Donohoe, G., Dudbridge, F., Duan, J., Freedman, R., Gejman, P. V., Golimbet, V., Godard, S., Ehrenreich, H., Hartmann, A. M., Henskens, F. A., Ikeda, M., Iwata, N., Jablensky, A. V., Joa, I., Jonsson, E. G., Kelly, B. J., Knight, J., Konte, B., Laurent-Levinson, C., Lee, J., Lencz, T., Lerer, B., Loughland, C. M., Malhotra, A. K., Mallet, J., Mcdonald, C., Mitjans, M., Mowry, B. J., Murphy, K. C., Murray, R. M., O'Neill, F. A., Oh, S. -Y., Palotie, A., Pantelis, C., Pulver, A. E., Petryshen, T. L., Quested, D. J., Riley, B., Sanders, A. R., Schall, U., Schwab, S. G., Scott, R. J., Sham, P. C., Silverman, J. M., Sim, K., Steixner, A. A., Tooney, P. A., van Os, J., Vawter, M. P., Walsh, D., Weiser, M., Wildenauer, D. B., Williams, N. M., Wormley, B. K., Zhang, F., Androutsos, C., Arnold, P. D., Barr, C. L., Barta, C., Bey, K., Bienvenu, O. J., Black, D. W., Brown, L. W., Budman, C., Cath, D., Cheon, K. -A., Ciullo, V., Coffey, B. J., Cusi, D., Davis, L. K., Denys, D., Depienne, C., Dietrich, A., Eapen, V., Falkai, P., Fernandez, T. V., Garcia-Delgar, B., Geller, D. A., Gilbert, D. L., Grados, M. A., Greenberg, E., Grunblatt, E., Hagstrom, J., Hanna, G. L., Hartmann, A., Hedderly, T., Heiman, G. A., Heyman, I., Hong, H. J., Huang, A., Huyser, C., Ibanez-Gomez, L., Khramtsova, E. A., Kim, Y. K., Kim, Y. -S., King, R. A., Koh, Y. -J., Konstantinidis, A., Kook, S., Kuperman, S., Leventhal, B. L., Lochner, C., Ludolph, A. G., Madruga-Garrido, M., Malaty, I., Maras, A., Mccracken, J. T., Meijer, I. A., Mir, P., Morer, A., Muller-Vahl, K. R., Munchau, A., Murphy, T. L., Naarden, A., Nagy, P., Nestadt, G., Nestadt, P. S., Nicolini, H., Nurmi, E. L., Okun, M. S., Paschou, P., Piras, F., Pittenger, C., Plessen, K. J., Richter, M. A., Rizzo, R., Robertson, M., Roessner, V., Ruhrmann, S., Samuels, J. F., Sandor, P., Schlogelhofer, M., Shin, E. -Y., Singer, H., Song, D. -H., Song, J., Spalletta, G., Stein, D. J., Stewart, S. E., Storch, E. A., Stranger, B., Stuhrmann, M., Tarnok, Z., Tischfield, J. A., Tubing, J., Visscher, F., Vulink, N., Wagner, M., Walitza, S., Wanderer, S., Woods, M., Worbe, Y., Zai, G., Zinner, S. H., Sullivan, P. F., Franke, B., Daly, M. J., Bulik, C. M., Mcintosh, A. M., O'Donovan, M. C., Zheutlin, A., Andreassen, O. A., Borglum, A. D., Breen, G., Edenberg, H. J., Fanous, A. H., Faraone, S. V., Gelernter, J., Mathews, C. A., Mattheisen, M., Mitchell, K. S., Neale, M. C., Nurnberger, J. I., Ripke, S., Santangelo, S. L., Scharf, J. M., Stein, M. B., Thornton, L. M., Walters, J. T. R., Wray, N. R., Geschwind, D. H., Neale, B. M., Kendler, K. S., and Smoller, J. W.

Subjects
Netherlands Twin Register (NTR), cross-disorder genetics, Medizin, Genome-wide association study, Tourette syndrome, functional genomics, gene expression, genetic architecture, genetic correlation, GWAS, neurodevelopment, pleiotropy, psychiatric disorders, Psychiatric genetics, 0302 clinical medicine, Pleiotropy, functional genomic, WIDE ASSOCIATION, cross-disorder genetic, 0303 health sciences, Mental Disorders, Genetic Pleiotropy, HUMAN BRAIN, INSIGHTS, Autism spectrum disorder, Schizophrenia, DISEASES, GENETIC CORRELATIONS, medicine.medical_specialty, Neurogenesis, Quantitative Trait Loci, BF, Biology, GENOTYPE IMPUTATION, Psychiatric geneticscross-disorder geneticspsychiatric disorderspleiotropyneurodevelopmentGWASgenetic correlationgene expressiongenetic architecturefunctional genomics, Article, General Biochemistry, Genetics and Molecular Biology, psychiatric disorder, 03 medical and health sciences, SDG 3 - Good Health and Well-being, medicine, Humans, Genetic Predisposition to Disease, Bipolar disorder, TRANSCRIPTOME, Psychiatry, 030304 developmental biology, Gwas, Psychiatric Genetics, Cross-disorder Genetics, Functional Genomics, Gene Expression, Genetic Architecture, Genetic Correlation, Neurodevelopment, Psychiatric Disorders, Neurodevelopmental disorders Donders Center for Medical Neuroscience [Radboudumc 7], IDENTIFICATION, MUTATIONS, medicine.disease, Genetic architecture, DEMETHYLASE, RC0321, 1182 Biochemistry, cell and molecular biology, 030217 neurology & neurosurgery, Genome-Wide Association Study
Abstract

Genetic influences on psychiatric disorders transcend diagnostic boundaries, suggesting substantial pleiotropy of contributing loci. However, the nature and mechanisms of these pleiotropic effects remain unclear. We performed analyses of 232,964 cases and 494,162 controls from genome-wide studies of anorexia nervosa, attention-deficit/hyper-activity disorder, autism spectrum disorder, bipolar disorder, major depression, obsessive-compulsive disorder, schizophrenia, and Tourette syndrome. Genetic correlation analyses revealed a meaningful structure within the eight disorders, identifying three groups of inter-related disorders. Meta-analysis across these eight disorders detected 109 loci associated with at least two psychiatric disorders, including 23 loci with pleiotropic effects on four or more disorders and 11 loci with antagonistic effects on multiple disorders. The pleiotropic loci are located within genes that show heightened expression in the brain throughout the lifespan, beginning prenatally in the second trimester, and play prominent roles in neurodevelopmental processes. These findings have important implications for psychiatric nosology, drug development, and risk prediction.

Published
2019

25. Assessment and treatment of trichotillomania (hair pulling disorder) and excoriation (skin picking) disorder

Author

Grant Jones, Nancy J. Keuthen, and Erica Greenberg

Subjects
medicine.medical_specialty, Obsessive-Compulsive Disorder, Adolescent, medicine.medical_treatment, Excoriation, Habit reversal training, Dermatology, Acceptance and commitment therapy, Trichotillomania, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Medicine, Humans, Skin-picking, Trichotillomania (hair-pulling disorder), Skin, Cognitive Behavioral Therapy, business.industry, Free Radical Scavengers, medicine.disease, Dialectical behavior therapy, 030227 psychiatry, Acetylcysteine, Cognitive behavioral therapy, Physical therapy, Wounds and Injuries, Female, business, Stimulus control, Self-Injurious Behavior, 030217 neurology & neurosurgery, Selective Serotonin Reuptake Inhibitors, Antipsychotic Agents
Abstract

Recommendations are provided for the assessment and treatment of trichotillomania (hair pulling disorder, or HPD) and excoriation disorder (skin picking disorder, or SPD), two body-focused repetitive behavior (BFRB) disorders, based on their severity, comorbidities, and behavioral style. Habit reversal training (HRT) and stimulus control are first-line behavioral treatments that can be used in cases of all severity levels and may be particularly helpful when pulling or picking is performed with lowered awareness/intention. Acceptance and commitment therapy (ACT) and dialectical behavior therapy (DBT) are behavioral treatments that can be employed to augment HRT/stimulus control, especially when negative emotions trigger the pulling or picking. There are currently no FDA-approved pharmacologic treatments for HPD or SPD, though certain medications/supplements have shown varying degrees of efficacy in trials. N-acetylcysteine (NAC) should be considered for all severity levels and styles given its moderate gain/low side effect profile. Other pharmacologic interventions, including selective serotonin reuptake inhibitors (SSRIs), should be considered in cases with significant comorbidities or previous behavioral/NAC treatment failure.

Published
2018

26. Tricky 'Ticcy' Case: Tics/Tourette Syndrome with Co-occurring OCD

Author

Angela Essa, Erica Greenberg, and Jeremiah M. Scharf

Subjects
medicine.medical_specialty, Tics, business.industry, medicine.medical_treatment, Habit reversal training, Psychological intervention, medicine.disease, Tourette syndrome, Cognitive behavioral therapy, Natural history, Co occurring, medicine, Attention deficit hyperactivity disorder, Psychiatry, business
Abstract

Tourette syndrome and related tic disorders are complex, neuropsychiatric conditions that likely arise from fronto-subcortical circuit dysfunction. Individuals with these disorders often have additional neuropsychiatric comorbidities such as obsessive compulsive disorder and attention deficit hyperactivity disorder. Given their presumed overlapping genetic and neurodevelopmental origins, it is common for individuals to struggle with symptoms that overlap these diagnostic categories. As a result, careful attention must be paid to complete a thorough evaluation inclusive of these and other neuropsychiatric comorbidities, the presence of which helps to guide appropriate treatment, which includes specific psychotherapeutic and pharmacotherapeutic interventions for each of these disorders. This case of a young man exemplifies the complex and evolving experience of individuals struggling with Tourette syndrome and related disorders. His and his family’s stories provide a lesson in the natural history and diagnostic process of these neuropsychiatric conditions and serve as a starting point for discussion of neuropathological correlates and an in-depth discussion of pharmaco- and psychotherapeutic management.

Published
2018

27. Public Preferences for Targeted and Universal Preschool

Author

Erica Greenberg

Subjects
business.industry, 05 social sciences, Self-concept, 050301 education, Survey research, Public relations, Public opinion, Experimental research, Education, Politics, 0502 economics and business, Developmental and Educational Psychology, Sociology, Early childhood, 050207 economics, business, Public education, lcsh:L, 0503 education, Universal preschool, Social Sciences (miscellaneous), lcsh:Education
Abstract

For the past half century, debate over income-targeted and universal approaches to American preschool policy has divided advocates, policymakers, and practitioners. This is the first paper to inform the debate with evidence from public opinion. It begins with the design and fielding of a nationally representative poll of preferences for targeted and universal preschool (N = 1,000). This poll yields rich data with which to assess the causes and correlates of support for each approach. Results indicate that preschool preferences are conditioned by financial self-interest and egalitarian values and that a savvy policymaker should not necessarily endorse universal over targeted preschool. In fact, Americans facing the possibility of tax increases to fund public preschool and those who prioritize equality of opportunity prefer a targeted approach.

Published
2018

28. Prevalence and predictors of hair pulling disorder and excoriation disorder in Tourette syndrome

Author

Carol A. Mathews, Paul Sandor, Nancy J. Keuthen, Erin E. Curley, Gholson J. Lyon, Marco A. Grados, Erica Greenberg, David L. Pauls, Cathy L. Budman, Robert A. King, Yves Dion, Esther S. Tung, Angela Essa, Jeremiah M. Scharf, Matthew E. Hirschtritt, Kelly G. Yang, Lisa Osiecki, Sabrina M. Darrow, Caitlin Gauvin, and Cornelia Illmann

Subjects
Male, Obsessive-Compulsive Disorder, Excoriation, Prevalence, Comorbidity, Neurodegenerative, Obsessive–compulsive disorder, Tourette syndrome, Excoriation disorder/skin picking disorder, Body-focused repetitive behaviors, Trichotillomania, 0302 clinical medicine, Hair-pulling, Surveys and Questionnaires, Developmental and Educational Psychology, Child and adolescent psychiatry, Psychology, Child, Trichotillomania (hair-pulling disorder), Female sex, General Medicine, Serious Mental Illness, Anxiety Disorders, Psychiatry and Mental health, Mental Health, Female, Tourette Association of America International Consortium for Genetics, medicine.medical_specialty, Clinical Sciences, Developmental & Child Psychology, Article, 03 medical and health sciences, Clinical Research, Internal medicine, mental disorders, medicine, Genetic predisposition, Humans, Trichotillomania/hair pulling disorder, Psychiatry, business.industry, medicine.disease, Brain Disorders, 030227 psychiatry, Pediatrics, Perinatology and Child Health, business, Self-Injurious Behavior, 030217 neurology & neurosurgery, Tourette Syndrome
Abstract

OBJECTIVE: Trichotillomania/hair pulling disorder (HPD) and excoriation/skin picking disorder (SPD) are childhood-onset, body-focused repetitive behaviors that are thought to share genetic susceptibility and underlying pathophysiology with obsessive-compulsive disorder (OCD) and Tourette syndrome (TS). We sought to determine the prevalence of DSM-5 HPD and SPD in TS patients, and to identify clinical factors most associated with their co-morbidity with TS. METHOD: Participants included 811 TS patients recruited from TS specialty clinics for a multi-center genetic study. Patients were assessed using standardized, validated semi-structured interviews. HPD and SPD diagnoses were determined using a validated self-report questionnaire. HPD/SPD prevalence rates were calculated, and clinical predictors were evaluated using regression modeling. RESULTS: 3.8% and 13.0% of TS patients met DSM-5 criteria for HPD and SPD, respectively. In univariable analyses, female sex, OCD, and both tic and obsessive-compulsive severity were among those associated with HPD and/or SPD. In multivariable analyses, only lifetime worst-ever motor tic severity remained significantly associated with HPD. Female sex, co-occurring OCD, ADHD and motor tic severity remained independently associated with SPD. CONCLUSION: This is the first study to examine HPD and SPD prevalence in a TS sample using semi-structured diagnostic instruments. The prevalence of HPD and SPD in TS patients, and their association with increased tic severity and co-occurring OCD, suggests that clinicians should screen children with TS and related disorders for HPD/SPD, particularly in females and in those with co-occurring OCD. This study also helps set a foundation for subsequent research regarding HPD/SPD risk factors, pathophysiology, and treatment models.

Published
2017

29. Predictors of comorbid obsessive-compulsive disorder and skin-picking disorder in trichotillomania

Author

Nancy J, Keuthen, Erin E, Curley, Jeremiah M, Scharf, Douglas W, Woods, Christine, Lochner, Dan J, Stein, Esther S, Tung, Erica, Greenberg, S Evelyn, Stewart, Sarah A, Redden, and Jon E, Grant

Subjects
Adult, Trichotillomania, Obsessive-Compulsive Disorder, Surveys and Questionnaires, Humans, Family, Female, Comorbidity, Body Dysmorphic Disorders
Abstract

Trichotillomania (TTM), obsessive-compulsive disorder (OCD), and skin-picking disorder (SPD) frequently occur together and share overlapping phenomenology, pathophysiology, and possible genetic underpinnings. This study sought to identify factors that predict OCD and SPD in hair pullers.Five hundred fifty-five adult female hair pullers were recruited from specialty clinics and assessed using standardized, semi-structured interviews and self-reports. Clinical predictors and multivariate models were evaluated using logistic regression modeling.Hair pullers met criteria for OCD (18.9%), SPD (19.5%), or chronic skin picking (CSP) (5%), or both comorbid diagnoses, respectively. In the final multivariate model for OCD, family history of OCD and an eating disorder diagnosis were associated with an increased risk of OCD in TTM. A nail-biting diagnosis was associated with a decreased risk of OCD in TTM. In the final multivariate model for SPD/CSP, only family history of OCD was associated with an increased risk of SPD/CSP in TTM.Identification of factors predicting OCD and SPD in TTM provides evidence for the relatedness of these disorders and supports their collective classification as obsessive-compulsive and related disorders (OCRDs) in DSM-5. The findings of this study further underscore the importance of assessing for comorbid OCRDs and family histories of OCRDs in clinical practice.

Published
2016

35. Identification of two heritable cross-disorder endophenotypes for Tourette Syndrome

Author

Cornelia Illmann, Dongmei Yu, Danielle C. Cath, Jeremiah M. Scharf, Robert A. King, Yves Dion, Carol A. Mathews, Marco Grados, William M. McMahon, Gholson J. Lyon, Cathy L. Budman, Paul C. Lee, Sabrina M. Darrow, Matthew E. Hirschtritt, Erica Greenberg, Kevin L. Delucchi, David L. Pauls, Lisa Osiecki, Paul Sandor, Lauren M. McGrath, and Lea K. Davis

Subjects
Adult, Male, medicine.medical_specialty, Multifactorial Inheritance, Obsessive-Compulsive Disorder, Adolescent, Endophenotypes, Mothers, Comorbidity, Tourette syndrome, Risk Assessment, Article, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Child of Impaired Parents, mental disorders, medicine, Attention deficit hyperactivity disorder, Humans, Genetic Predisposition to Disease, Adhd symptoms, Psychiatry, Child, Genetic heterogeneity, Heritability, Middle Aged, medicine.disease, 030227 psychiatry, Psychiatry and Mental health, Phenotype, Attention Deficit Disorder with Hyperactivity, Endophenotype, Child, Preschool, Female, Psychology, 030217 neurology & neurosurgery, Genome-Wide Association Study, Tourette Syndrome
Abstract

Phenotypic heterogeneity in Tourette syndrome is partly due to complex genetic relationships among Tourette syndrome, obsessive-compulsive disorder (OCD), and attention deficit hyperactivity disorder (ADHD). Identifying symptom-based endophenotypes across diagnoses may aid gene-finding efforts.Assessments for Tourette syndrome, OCD, and ADHD symptoms were conducted in a discovery sample of 3,494 individuals recruited for genetic studies. Symptom-level factor and latent class analyses were conducted in Tourette syndrome families and replicated in an independent sample of 882 individuals. Classes were characterized by comorbidity rates and proportion of parents included. Heritability and polygenic load associated with Tourette syndrome, OCD, and ADHD were estimated.The authors identified two cross-disorder symptom-based phenotypes across analyses: symmetry (symmetry, evening up, checking obsessions; ordering, arranging, counting, writing-rewriting compulsions, repetitive writing tics) and disinhibition (uttering syllables/words, echolalia/palilalia, coprolalia/copropraxia, and obsessive urges to offend/mutilate/be destructive). Heritability estimates for both endophenotypes were high and statistically significant (disinhibition factor=0.35, SE=0.03; symmetry factor=0.39, SE=0.03; symmetry class=0.38, SE=0.10). Mothers of Tourette syndrome probands had high rates of symmetry (49%) but not disinhibition (5%). Polygenic risk scores derived from a Tourette syndrome genome-wide association study (GWAS) were significantly associated with symmetry, while risk scores derived from an OCD GWAS were not. OCD polygenic risk scores were significantly associated with disinhibition, while Tourette syndrome and ADHD risk scores were not.The analyses identified two heritable endophenotypes related to Tourette syndrome that cross traditional diagnostic boundaries. The symmetry phenotype correlated with Tourette syndrome polygenic load and was present in otherwise Tourette-unaffected mothers, suggesting that this phenotype may reflect additional Tourette syndrome (rather than OCD) genetic liability that is not captured by traditional DSM-based diagnoses.

Published
2016

36. Within- and Between-Sector Quality Differences in Early Childhood Education and Care

Author

Maria D. Fitzpatrick, Daphna Bassok, Erica Greenberg, and Susanna Loeb

Subjects
Early childhood education, Male, media_common.quotation_subject, MEDLINE, Informal education, Education, Developmental psychology, Child Development, Developmental and Educational Psychology, Early Intervention, Educational, Humans, 0501 psychology and cognitive sciences, Quality (business), Early childhood, Child Care, Set (psychology), media_common, 05 social sciences, 050301 education, Mathematical Concepts, Child development, Reading, Head start, Child, Preschool, Pediatrics, Perinatology and Child Health, Female, Psychology, 0503 education, 050104 developmental & child psychology
Abstract

This study leverages nationally representative data (N ≈ 6,000) to examine the magnitude of quality differences between (a) formal and informal early childhood education and care providers; (b) Head Start, prekindergarten, and other center-based care; and (c) programs serving toddlers and those serving preschoolers. It then documents differences in children's reading and math skills at age 5 between those who had enrolled in formal and informal settings. Cross-sector differences are substantially reduced when accounting for a set of quality measures, though these measures do less to explain more modest differences in outcomes within the formal sector. Results inform current efforts aimed at improving the quality of early childhood settings by highlighting the large quality differences across sectors and their relationship with child development.

Published
2016

37. Brown Fades: The End of Court-Ordered School Desegregation and the Resegregation of American Public Schools

Author

Elena Tej Grewal, Sean F. Reardon, Erica Greenberg, and Demetra Kalogrides

Subjects
Public Administration, Sociology and Political Science, Injury control, Desegregation, education, Poison control, Human factors and ergonomics, social sciences, Public administration, General Business, Management and Accounting, Suicide prevention, humanities, Occupational safety and health, Political science, Injury prevention, Court order, health care economics and organizations
Abstract

In this paper, we investigate whether the school desegregation produced by court-ordered desegregation plans persists when school districts are released from court oversight. Over 200 medium-sized and large districts were released from desegregation court orders from 1991 to 2009. We find that racial school segregation in these districts increased gradually following release from court order, relative to the trends in segregation in districts remaining under court order. These increases are more pronounced in the South, in elementary grades, and in districts where prerelease school segregation levels were low. These results suggest that court-ordered desegregation plans are effective in reducing racial school segregation, but that their effects fade over time in the absence of continued court oversight. Language: en

Published
2012

38. 896. Genetic and Phenotypic Overlap of Specific Obsessive-Compulsive Subtypes with Tourette Syndrome

Author

Lauren M. McGrath, Robert A. King, Cornelia Illmann, Erica Greenberg, David L. Pauls, Paul C. Lee, Dongmei Yu, Danielle C. Cath, Kevin L. Delucchi, Matthew E. Hirschtritt, Marco A. Grados, Yves Dion, Paul Sandor, Gholson J. Lyon, Carol A. Mathews, Jeremiah M. Scharf, Cathy L. Budman, Sabrina M. Darrow, William M. McMahon, and Lisa Osiecki

Subjects
Proband, medicine.medical_specialty, Hoarding, Cognition, medicine.disease, behavioral disciplines and activities, Tourette syndrome, humanities, Mood, Obsessive compulsive, mental disorders, medicine, Anxiety, Adhd symptoms, medicine.symptom, Psychology, Psychiatry, Biological Psychiatry, Clinical psychology
Abstract

Background The unique phenotypic and genetic aspects of obsessive-compulsive (OCD) and attention-deficit/hyperactivity disorder (ADHD) among individuals with Tourette syndrome (TS) have not been well characterized. Methods OCD and ADHD symptom patterns were identified among patients with TS and their family members (N=3494) using exploratory factor and latent class analyses; clinical associations and heritability of these factors were examined. Results Factor analyses yielded 2- and 8-factor models for ADHD and OCD, respectively. Both ADHD factors (inattention and hyperactivity/impulsiveness) were genetically related to TS, ADHD, and OCD; all OCD factors (related to symmetry/contamination, unusual thoughts, aggressive urges, and hoarding) were genetically related to OCD. The OCD aggressive urges factor was genetically associated with TS and ADHD, the symmetry/exactness and fear of harm factors were associated with TS, and the hoarding factor was associated with ADHD. Latent classes based on OCD and ADHD factor sum scores to examine the relationships between OCD and ADHD symptoms in probands and family members revealed a three-class solution: ADHD; OCD+ADHD; and asymmetry/exactness, hoarding, and ADHD. The majority of participants with TS, ADHD, mood, and anxiety disorders, as well as mothers, fathers, and probands, were classified in the ADHD class. In contrast, the largest percentage of participants with OCD and disruptive behavior disorders were classified in the asymmetry/exactness, hoarding, and ADHD class. Conclusions Symmetry/exactness, aggressive urges, fear of harm, and hoarding show complex genetic relationships with TS, OCD, and ADHD, and transcend diagnostic boundaries, perhaps representing a failure of top-down cognitive control common to all three disorders.

Published
2017

39. Untangling OCD and Tics: A Focus on 'Tic-Related OCD'

Author

Barbara J. Coffey and Erica Greenberg

Subjects
Psychiatry and Mental health, Focus (computing), Psychotherapist, Tics, Developmental and Educational Psychology, medicine, Psychology, medicine.disease
Published
2018

40. 33.1 Comorbidity in Trichotillomania

Author

Erica Greenberg

Subjects
Psychiatry and Mental health, medicine.medical_specialty, business.industry, Developmental and Educational Psychology, Medicine, business, medicine.disease, Psychiatry, Comorbidity
Published
2018

41. Pyridoxine supplementation for the treatment of levetiracetam-induced behavior side effects in children: Preliminary results

Author

Alisa Khan, Philippe Major, Erica Greenberg, and Elizabeth A. Thiele

Subjects
Male, Vitamin b, Pediatrics, medicine.medical_specialty, Levetiracetam, Adolescent, Behavioral Symptoms, Irritability, Young Adult, Behavioral Neuroscience, Epilepsy, medicine, Humans, Young adult, Child, Retrospective Studies, business.industry, Pyridoxine, Retrospective cohort study, medicine.disease, Piracetam, Clinical trial, Neurology, Child, Preschool, Vitamin B Complex, Anticonvulsants, Female, Neurology (clinical), medicine.symptom, business, medicine.drug
Abstract

Behavioral side effects related to the use of levetiracetam (LEV) in epilepsy are increasingly being recognized. Patients followed in our center have reported improvement of these side effects after starting pyridoxine (vitamin B(6)) supplements. Using mailed questionnaires, retrospective chart reviews, and phone call follow-ups, we analyzed 42 pediatric patients who had been treated with LEV and pyridoxine. Twenty-two patients started pyridoxine after being on LEV, and significant behavioral improvement was observed in nine (41%), no effect in eight (36%), deterioration in four (18%), and an uncertain effect in one. The effects of pyridoxine supplementation were observed during the first week. The remaining patients (20) were already on pyridoxine before LEV was started, started pyridoxine and LEV at the same time, or took pyridoxine intermittently. Pyridoxine is an easily available, inexpensive, and safe therapeutic option. Given these preliminary results, we plan to conduct a placebo-controlled cross-over study to better characterize these observations.

Published
2008

43. Distinct clinical characteristics of Tuberous Sclerosis Complex patients with no mutation identified

Author

David J. Kwiatkowski, Elizabeth A. Thiele, S. Camposano, and Erica Greenberg

Subjects
Oncology, Adult, Male, medicine.medical_specialty, congenital, hereditary, and neonatal diseases and abnormalities, Angiomyolipoma, Adolescent, Disease, medicine.disease_cause, Article, Tuberous Sclerosis Complex 1 Protein, Tuberous sclerosis, Young Adult, Tuberous Sclerosis, Internal medicine, Tuberous Sclerosis Complex 2 Protein, Genetics, medicine, Humans, Child, Genetics (clinical), Aged, Retrospective Studies, Mutation, business.industry, Tumor Suppressor Proteins, Infant, Retrospective cohort study, Middle Aged, medicine.disease, nervous system diseases, Endocrinology, medicine.anatomical_structure, Child, Preschool, Lymphangioleiomyomatosis, Female, TSC1, TSC2, business
Abstract

Tuberous Sclerosis Complex (TSC) is a multi-system disorder that is highly variable in its clinical presentation. Current molecular diagnostic methods permit identification of mutations in either TSC1 or TSC2 in 75–85% of TSC patients. Here we examine the clinical characteristics of those TSC patients who have no mutation identified (NMI). A retrospective review of our patient population that had comprehensive testing for mutations in TSC1/TSC2 identified 23/157 (15 %) that were NMI. NMI patients had a lower incidence of brain findings on imaging studies, neurological features, and renal findings than those with TSC2 mutations. In contrast, NMI patients had a lower incidence of seizures than TSC patients with TSC1 mutations, but had a higher incidence of both renal angiomyolipomas and pulmonary lymphangioleiomyomatosis. This distinct constellation of findings suggest that NMI patients may have a unique molecular pathogenesis, different from that seen in TSC patients with the usual mutations in TSC1 and TSC2. We suggest that the mechanisms of disease in these patients include both mosaicism for a TSC2 mutation, and unusual non-coding region mutations in TSC2.

Published
2008

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