Reframing Stigma in Tourette Syndrome: An Updated Scoping Review

Authors

Kelly Pring
Melina Malli
Brandy W Hardy
Stephen R Rapp
Eric A Storch
Jonathan W Mink
Jaclyn M Martindale

Publication Date

1-1-2025

Journal

European Child & Adolescent Psychiatry

DOI

10.1007/s00787-023-02332-3

PMID

38159134

PMCID

PMC11805784

PubMedCentral® Posted Date

12-30-2023

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

Humans, Tourette Syndrome, Social Stigma, Adolescent, Child, Self Concept, Stereotyping, Stigma, Tourette syndrome, Social–ecological, Discrimination, Tic, Scoping review

Abstract

Persistent tic disorders (PTD) such as Tourette's syndrome (TS) are common childhood-onset neurodevelopmental disorders. Stigmatization of individuals with these disorders remains an ongoing problem. The purpose of this scoping review is to serve as an updated review of the research regarding stigmatization in youth with PTD since the publication of the original systematic review about this topic in 2016. The electronic databases Embase, Web of Science, PubMed, PsycINFO, and CINAHL were searched. Of the 4751 initial articles screened after removing duplications, 47 studies met the inclusion criteria. The studies were examined under the social-ecological stigmatization model, which helps categorize stigmatization into individual, interpersonal, community, and structural levels and serves as a broader definition of stigmatization than the previous systematic review. On the individual level, youth with PTD had lower self-esteem than peers, often leading to fear of future stigmatization, avoidant behaviors, and self-stigmatization. They also experienced higher rates of bullying and other forms of abuse than peers at the interpersonal level. At the community level, youth with PTD faced discriminatory environments in school and work and limited availability of community services and healthcare access. At the structural level, knowledge about PTD was limited in the general population, often about the limited portrayals of PTD in the media. We hope that the broader scope of this review serves to help inform future efforts to decrease the stigmatization faced by this group.