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      Metakognitionen und interozeptive Sensibilität bei der Wahrnehmung des Vorgefühls bei Tic-Störungen über die Lebensspanne Translated title: Metacognitions and interoceptive sensibility in the perception of premonitory urges in tic disorders across the lifespan

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          Abstract

          Zusammenfassung. Fragestellung: Menschen mit Tic-Störungen (TS) berichten im Kindesalter selten, im Erwachsenenalter mehrheitlich von Vorgefühlen vor Ausführen eines Tics. Die Vorgefühle sind situationsabhängig und variieren sowohl intra- als auch interindividuell. Bei Jugendlichen wurden Zusammenhänge des Vorgefühls mit metakognitiven Überzeugungen gefunden, bei altersgemischten Stichproben Auffälligkeiten in interozeptiver Sensibilität. Wir untersuchten unter Berücksichtigung des Tic-Schweregrads den Zusammenhang von Vorgefühlen, Metakognitionen und interozeptiver Sensibilität über die Lebensspanne hinweg. Methodik: 59 TS-Betroffene nahmen an einer Online-Fragebogenstudie teil. Vorgefühle wurden über die Premonitory Urge for Tics Scale (PUTS) erfasst, der Tic-Schweregrad über den Selbstbeurteilungsbogen TIC (DISYPS-III: SBB-TIC), die interozeptive Bewusstheit über eine Kurzform der Bewusstheitsskala des Body Perception Questionnaire (BPQ-A) und metakognitive Überzeugungen in Bezug auf Tics über die Belief About Tics Scale (BATS). Ergebnisse: Erwachsene berichten höhere PUTS-Werte. Bei Kindern steigt die interozeptive Sensibilität mit zunehmendem Alter. Interozeptive Sensibilität korreliert mit der PUTS. BATS und BPQ sagen PUTS vorher, auch wenn für Tics und Alter kontrolliert wird. Schlussfolgerungen: Es ist davon auszugehen, dass die gefundenen altersabhängigen Entwicklungen des Vorgefühls im Jugendalter auf hirnphysiologische Reifungsprozesse zurückzuführen sind. Negative Metakognitionen und Interozeptionsfähigkeit sind jedoch ebenfalls von Bedeutung bei der Entstehung und Aufrechterhaltung von Vorgefühlen und könnten therapeutisch genutzt werden.

          Metacognitions and interoceptive sensibility in the perception of premonitory urges in tic disorders across the lifespan

          Abstract. Objective: Depending on contextual factors, the prevalence of premonitory urges (PU) in patients with tic disorders (TD) increases with age and varies both intra- and interindividually. In youth, PUs correlate with metacognitions. In both youth and adults, interoceptive sensibility is altered compared to healthy controls. We examined the relationship between PUs, tics, metacognitions, and interoceptive sensibility across the lifespan regarding tic severity. Method: In an online survey, 53 participants reported their PUs on the Premonitory Urge for Tics Scale (PUTS) and tic severity on the Symptom Checklist for Tic Disorders (SBB-TIC). We assessed interoceptive sensibility via the Body Perception Questionnaire (BPQ-A) and metacognitions regarding tics with the Belief About Tics Scale (BATS). Results: Adults scored higher on the PUTS than youth. In youth, interoceptive sensibility increased with age; interoceptive sensibility correlated with PUTS. Metacognitions and interoceptive sensibility explained a significant amount of variance in premonitory urges, even after controlling for tic severity and age. Conclusions: The presumed cause of age-dependent development of PUs in youth lies in their neurophysiological maturing processes. However, negative metacognitions and interoceptive abilities also play an important role in the development and maintenance of PU and might be of therapeutic use in the treatment of TD.

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          Knowing your own heart: distinguishing interoceptive accuracy from interoceptive awareness.

          Interoception refers to the sensing of internal bodily changes. Interoception interacts with cognition and emotion, making measurement of individual differences in interoceptive ability broadly relevant to neuropsychology. However, inconsistency in how interoception is defined and quantified led to a three-dimensional model. Here, we provide empirical support for dissociation between dimensions of: (1) interoceptive accuracy (performance on objective behavioural tests of heartbeat detection), (2) interoceptive sensibility (self-evaluated assessment of subjective interoception, gauged using interviews/questionnaires) and (3) interoceptive awareness (metacognitive awareness of interoceptive accuracy, e.g. confidence-accuracy correspondence). In a normative sample (N=80), all three dimensions were distinct and dissociable. Interoceptive accuracy was only partly predicted by interoceptive awareness and interoceptive sensibility. Significant correspondence between dimensions emerged only within the sub-group of individuals with greatest interoceptive accuracy. These findings set the context for defining how the relative balance of accuracy, sensibility and awareness dimensions explain cognitive, emotional and clinical associations of interoceptive ability.
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            Neural correlates of tic generation in Tourette syndrome: an event-related functional MRI study.

            Little is known about the neural correlates of tics and associated urges. In the present study, we aimed to explore the neural basis of tics in patients with Tourette syndrome by using event-related functional MRI (fMRI). Ten patients (6 women, 4 men; age: mean +/- SD = 31 +/- 11.2) were studied while spontaneously exhibiting a variety of motor and vocal tics. On the basis of synchronized video/audio recordings, fMRI activities were analysed 2 s before and at tic onset irrespective of the clinical phenomenology. We identified a brain network of paralimbic areas such as anterior cingulate and insular cortex, supplementary motor area (SMA) and parietal operculum (PO) predominantly activated before tic onset (P < 0.05, corrected for multiple comparisons). In contrast, at the beginning of tic action, significant fMRI activities were found in sensorimotor areas including superior parietal lobule bilaterally and cerebellum. The results of this study indicate that paralimbic and sensory association areas are critically implicated in tic generation, similar to movements triggered internally by unpleasant sensations, as has been shown for pain or itching.
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              Premonitory sensory phenomenon in Tourette's syndrome.

              We administered a questionnaire designed to probe for premonitory sensations associated with motor tics to 50 patients with Tourette's syndrome (TS). Premonitory sensations were reported by 46 (92%) patients, and the most common sensation was an urge to move and an impulse to tic ("had to do it"). Intensification of premonitory sensations, if prevented from performing a motor tic, was reported also in 37 patients (74%), 36 patients (72%) reported relief of premonitory sensations after performing the tic, and 27 of 40 (68%) described a motor tic as a voluntary motor response to an involuntary sensation, rather than a completely involuntary movement. The "just right" sensation correlated with the presence of co-morbid obsessive-compulsive disorder. We conclude that premonitory sensations are an important aspect of motor tics and some patients perceive motor tics as a voluntary movement in response to an involuntary sensation. Copyright 2003 Movement Disorder Society
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                Author and article information

                Contributors
                Journal
                kij
                Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie
                Hogrefe AG, Bern
                1422-4917
                1664-2880
                18. November 2022
                Affiliations
                [ 1 ]Lehrstuhl für Klinische Psychologie und Psychotherapie, Universität zu Köln, Deutschland
                Author notes
                Christina Schütteler, M.Sc., Lehrstuhl für Klinische Psychologie und Psychotherapie, Universität zu Köln, Pohligstr. 1, 50969 Köln, Deutschland c.schuetteler@ 123456uni-koeln.de
                Author information
                https://orcid.org/0000-0003-4196-4503
                https://orcid.org/0000-0001-6794-5349
                Article
                kij_a000910_-1_1
                10.1024/1422-4917/a000910
                cd0ed764-c645-46a2-9fcc-d8552a788b49
                Distributed as a Hogrefe OpenMind article under the license CC BY-NC 4.0 ( http://creativecommons.org/licenses/by-nc/4.0)

                Distributed as a Hogrefe OpenMind article under the license CC BY-NC 4.0 ( http://creativecommons.org/licenses/by-nc/4.0)

                History
                : 20. Januar 2022
                : 13. Oktober 2022
                Funding
                Förderung: Open-Access-Veröffentlichung ermöglicht durch die Universität zu Köln .
                Categories
                Originalarbeit

                Pediatrics,Psychology,Family & Child studies,Development studies,Clinical Psychology & Psychiatry
                lifespan,interoception,interozeptive Sensibilität,tics,Metakognition,metacognition,Vorgefühl,Tics,interoceptive sensibility,Interozeption,premonitory urge

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