Impact of Perceived Stress, Anxiety-Depression and Social Support on Coping Strategies of Parents Having A Child With Gilles de la Tourette Syndrome Véronique Goussé a, ⁎, Virginie Czernecki b , Pierre Denis a , Jean-Louis Stilgenbauer c , Emmanuelle Deniau b , Andreas Hartmann b a Aix-Marseille Université, LPS EA 849, Aix-en-Provence, France b Centre de Référence National Maladie Rare « Syndrome Gilles de la Tourette », Pôle des Maladies du Système Nerveux, Groupe Hospitalier Pitié-Salpêtrière, 47–83 Boulevard de l'Hôpital, 75651 Paris Cedex 13, France c EA 4004 CHART (Paris-Reasoning) Université Paris 8 et EPHE, Paris, France abstract Purpose: Previous reports have indicated that raising a child with Gilles de la Tourette syndrome (GTS) could be considered a stressful experience. Thus our study aimed to assess the impact of perceived stress (i.e. parental cognitive perception of their child's disorder) and social support (number of people surrounding the subject providing support) on coping strategies—defined as processes of restoring balance between excessive demands and inadequate resources—of parents having a child with GTS. Methods: Twenty-eight parents of 21 patients with GTS (aged 6 to 16 years) completed questionnaires on perceived stress (ALE Scale), social support (SSQ6), coping strategies (WCC-R) and anxiety–depression (HAD). Results: Principal component analysis showed a negative correlation between social support on one side and perceived stress and anxiety/depression on the other. Problem- and emotion-focused coping both correlated with social support, all of them being independent from perceived stress and anxiety/depression. Hierarchical ascendant classification showed three clusters of individuals in our parents' groups: i) those having high scores in perceived stress and anxiety–depression; ii) those having high scores in social support associated with low scores in perceived stress; iii) parents having lower than average scores on both problem- and emotion- focused coping and social support. Conclusion: Our results reinforce the need for developing training programs for parents with GTS children to better understand and tolerate the disorder to decrease their stress. © 2015 Elsevier Inc. All rights reserved. Gilles de la Tourette syndrome (GTS) is a chronic neurodevelopmental disorder characterized by multiple motor and one or more vocal/phonic tics. Recent studies suggest that the prevalence of GTS is around 0.8% in school-age children (Knight et al., 2012). Comorbidity occurs in approxi- mately 90% of GTS patients, with attention-deficit/hyperactivity disorder (ADHD) and obsessive–compulsive disorder (OCD) being the most common (Cavanna, Servo, Monaco, & Robertson, 2009). There has been growing evidence demonstrating that as a complex chronic condition, the quality of life in young people with GTS is reduced when compared with healthy control populations (Cavanna, David, Orth, & Robertson, 2012). It also appears that GTS can have a significant effect on relatives of the patients, especially parents, as raising a child with a developmental disorder is considered a stressful experience (Evans, Wittkowski, Butler, Hedderly, & Bunton, 2015; Lee, Chen, Wang, & Chen, 2007). Several studies have been conducted on parental stress as well as adjustment and coping strategies in families having a child with special needs such as a chronic illness or psychiatric disorders (Crnic & Greenberg, 1990; Hanson & Hanline, 1990; Willingham-Storr, 2014). However, very few studies have been conducted on the psychological impact of having a child with GTS. Angold et al. (1998) have shown that the severity of the child's symptomatology and functional impairment has the most effect on parental perceived difficulties. Cooper, Robertson, and Livingston (2003) reported that parents of a child with GTS experience higher levels of perceived negative impacts than parents having a child with asthma. Thus, it appears—at least based on this example—that for parents of children with GTS the burden can be heavier than for parents of children with chronic illness. The psychiatric component is most likely responsible. Indeed, parenting a child with GTS can be more complicated due to a higher occurrence of comorbid disorders (Piacentini et al., 2010). For instance, parents may be more concerned about their children's disruptive behaviors than their tics (Ginsburg, Kingery, Drake, & Grados, 2008). Also, one major problem for these parents seems to be the uncertainty about which behavior their child can control or not. Archives of Psychiatric Nursing 30 (2016) 109–113 Competing Interests: The authors have declared that no competing interests exist. ⁎ Corresponding Author: Véronique Goussé, PhD, Aix-Marseille Université, LPS EA 849, 13621, Aix-en-Provence, France. E-mail address: veronique.gousse@unimes.fr (V. Goussé). http://dx.doi.org/10.1016/j.apnu.2015.08.017 0883-9417/© 2015 Elsevier Inc. All rights reserved. Contents lists available at ScienceDirect Archives of Psychiatric Nursing journal homepage: www.elsevier.com/locate/apnu