Reliability And Validity Test Of Chinese Version Of The Individualized Premonitory Urge For Tics Scale And Its Clinical Analysis

Objective:1.According to the cross-cultural adjustment procedure of the scale,the English version of the Premonitory Urge for Tics Scale(I-PUTS)was translated and revised,and the reliability and validity was tested.Combined with our cultural and medical background,Chinese version of I-PUTS(C-IPUTS)was formed for children and adolescents with Tic disorder(TD).2.The Chinese version of Premonitory Urge for Tics Scale(C-PUTS)and CIPUTS were used to evaluate the premonitory urges(PUs)from various aspects,and to explore the relationship between PUs,TD and its comorbidities.This work aims to provide a new perspective and breakthrough point for TD diagnosis and treatment.Methods:1.First,the use of IPUTS was authorized by Professor Mc Guire JF,the original author of the I-PUTS scale.According to the requirements of the cross-cultural research adaptation and validation guide,translation and revision of I-PUTS was carried out,and the Chinese description of the English scale was modified and supplemented with interpretation based on literature and expert’s opinion.The culturally adjusted scale items are more appropriate for Chinese language and cultural habits,which helps clinical workers to understand the contents of items more accurately and forms a preliminary C-IPUTS.2.A total of 123 children and adolescents who met the inclusion and exclusion criteria were recruited from clinic of the Department of Developmental Pediatrics of a Class A tertiary hospital in Jilin Province from October 2021 to October 2022 by convenience sampling.SPSS 26.0 software was used for data analysis after data verification.Cronbach’s α coefficient and test-retest reliability were used to analyze the reliability of the I-PUTS scale;exploratory factor analysis was used to statistically describe the construct validity.3.In this study,the sociodemographic data of the children and adolescents were obtained through the questionnaire.The Yale Global Tic Severity Scale(YGTSS)was used to quantify the severity and specific nature,including number,frequency,intensity,complexity,and interference,of motor and vocal tics.Yale-Brown ObsessiveCompulsive Scale(Y-BOCS)was applied to assess the severity of OCD symptoms.The Swanson Nolan and Pelham scale,Version IV(SNAP-Ⅳ)were used to assess attention deficit hyperactivity disorder(ADHD).Achenbach Child Behavior Checklist(CBCL)was applied for social ability and behavioral problems.Self-Rating Scale for Depressive Disorder in Childhood Anxiety-Related Disorder(SCARED)and Depressive Self-Rating Scale for Children(DSRS)were used to evaluate the comorbidities of anxiety and depression.The Spearman rank correlation coefficient was used to evaluate the correlation between PUs and TD and comorbidities.Finally,this research used R software and Cytoscape to estimate networks and describe correlations.Results:1.Through the translation,qualitative interview and cultural debugging of the scale,the initial version of C-IPUTS was formed.The Cronbach’s α coefficient of CIPUTS was 0.899 and the retest reliability was 0.910,indicating that the scale has good reliability.According to project analysis and exploratory factor analysis,a total of 47 items were included in C-IPUTS.The analysis results showed that when one common factor was extracted,the common factor eigenvalue,the contribution rate,and the cumulative total variance interpretation rate was 2.822,94.082%,and 94.082%,respectively indicating good scale structural validity.2.For PUs symptoms,there was a good correlation between the C-IPUTS and CPUTS.The number,frequency and intensity scores of PUs in C-IPUTS were associated with OCD,anxiety and depression.However,the C-PUTS correlated well with OCD,anxiety and ADHD.3.The results of this study indicate that PUs mainly occurs in the head/eyes,neck/throat and arm areas among Chinese children and adolescents.The number,frequency and intensity of PUs were positively correlated with the overall tic severity,the vocal tic subscale and the impairment(r=0.215～0.483,P<0.05).PUs was associated with anxiety(r=0.189～0.239,P<0.05),depression(r=0.203～0.221,P<0.05),obsessive compulsive disorder(OCD)(r=0.288～0.411,P<0.05)and attention deficit hyperactivity disorder(ADHD)(r=0.274,P<0.05),but not with behavioral problems..Conclusions:1.C-IPUTS has good reliability and validity in the Chinese context,which can be used to evaluate PUs reliably and effectively,and can provide supplementary information for C-PUTS from different dimensions of PUs.2.PUs relate to OCD,anxiety/depression,and ADHD in children and adolescents with TD.C-IPUTS and C-PUTS correlate well with symptoms of TD and comorbidities.Accordingly,PUs evaluation using the C-IPUTS combined with the C-PUTS might provide useful information for clinical diagnosis and future therapies for TD to achieve greater tic reduction.