How Common Are Self-Harming Behaviors In People With Tourette Syndrome?

What you need to know

• About 35% of people with Tourette syndrome engage in some form of self-injurious behavior
• Self-harming behaviors are more common in people who also have obsessive-compulsive symptoms
• The severity and types of self-injury can vary greatly between individuals
• Having multiple behavioral conditions along with Tourette’s increases the risk of self-injury

Understanding Tourette Syndrome

Tourette syndrome is a condition that begins in childhood and causes people to make involuntary movements and sounds called tics. These might include eye blinking, facial grimacing, shoulder shrugging, or making vocal sounds like grunting or throat clearing. About 0.3-1% of the population has Tourette syndrome, and it’s more common in males than females.

What is Self-Injurious Behavior?

Self-injurious behavior (SIB) refers to deliberately harming oneself without intending suicide. In Tourette syndrome, this can take many forms:

• Mild behaviors like skin picking or teeth grinding
• Moderate behaviors such as self-hitting or biting
• Severe behaviors like head banging or deliberately causing serious injury

It’s important to understand that these behaviors are not attempts at suicide, but rather compulsive or impulsive actions that are part of the condition.

How Common is Self-Injury in Tourette Syndrome?

Research combining data from multiple studies shows that about 35% of people with Tourette syndrome engage in some form of self-injurious behavior. This rate varies considerably between different studies, from as low as 11% to as high as 78%. This wide range may be due to differences in how researchers define and measure self-injury.

Risk Factors

The research reveals several factors that may increase the likelihood of self-injurious behavior in people with Tourette syndrome:

Obsessive-Compulsive Symptoms

People with both Tourette syndrome and obsessive-compulsive symptoms are more likely to engage in self-injury. These behaviors may be related to compulsive urges rather than the tics themselves.

Multiple Behavioral Conditions

Having multiple behavioral conditions along with Tourette’s (like ADHD, anxiety, or depression) increases the risk of self-injury. One large study found that people with additional conditions were nearly four times more likely to engage in self-injury compared to those with Tourette’s alone.

Tic Severity

Some studies suggest that people with more severe tics may be more likely to engage in self-injury, though this relationship needs more research to confirm.

Types of Self-Injury

Common forms of self-injury reported in the research include:

• Head banging
• Self-hitting, especially to the head area
• Tongue or lip biting
• Skin picking or scratching
• Body punching
• Poking objects into the body

Understanding Severity Levels

Self-injurious behaviors can range from mild to severe:

• Mild/Moderate: These behaviors may cause minor injury but generally don’t require medical attention. They’re often associated with obsessive-compulsive symptoms.

• Severe: These behaviors can cause serious injury and may require medical intervention. They appear to be more related to problems with impulse control.

Conclusions

• Self-injurious behavior is relatively common in Tourette syndrome, affecting about one-third of patients
• Having obsessive-compulsive symptoms along with Tourette’s increases the risk of self-injury
• The presence of multiple behavioral conditions also increases the risk
• Healthcare providers should screen for self-injury in Tourette syndrome patients, especially those with additional behavioral conditions