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Tourette Syndrome and Human Behavior

By: David E. Comings, M.D.



Tourette syndrome is a common, hereditary behavioral disorder that provides enormous insight into how we and our children behave and misbehave, why some of us can't read, learn, or pay attention, compulsively do things including over eating and abusing drugs, alcohol, spouses and children, are angry, short-tempered, anxious, afraid, depressed, or feel different and all alone. This book is written for both the general reader and the health or education professional as a guide to the exciting world of the genetics and chemistry of behavior.

This 828 page book is packed with information on all aspects of Tourette syndrome, the diagnosis; chapters on ADHD, obsessive-compulsive behaviors, conduct disorder, learning disorders and dyslexia, sexual problems, phobias, anxiety attacks, depression, mood swings, addictive behaviors (alcoholism, drug abuse, compulsive eating with obesity), sleep and other problems; genetics; structure and chemistry of the brain, role of dopamine and serotonin in behavior; detailed chapters on all the medications used and their side effects; psychological treatment and school problems.

Dr. Comings suggests that the critical factor is not only the number of children individuals have, but the age at which they have them. He first reviews the evidence that a wide range of these behavioral problems have increased in frequency over the latter part of the 20th century, and that these behaviors are caused, in part, by genetic factors. He then shows that regardless of the behavior, individuals who have the problem tend to have children earlier than those who do not, and that this can provide a powerful selective force for the genes involved. The dramatic differences in age at the birth of the first child is largely driven by the number of years of education. This factor has become significant only in the latter part of this century.

This important new theory has broad implications for public policy - as well as the future of the human species.

Table of Content


PART I - INTRODUCTION

  1. The Spectrum of Tourette Syndrome
  2. Gilles de la Tourette
  3. The Diagnosis

  1. The Motor Tics
  2. The Vocal Tics
  3. The Swearing
  4. Characteristics of the Tics

PART II - GENETICS

  1. A Very Brief Course in Genetics
  2. Pedigrees
  3. Types of Inheritance

  1. The Genetics of Tourette Syndrome
  2. Are Girls Smarter than Boys?
  3. Linkage and DNA Markers

PART III - BEHAVIOR

  1. What's Wrong with My Son?
  2. A Controlled Study of Tourette Syndrome
  3. Attention Deficit Disorder
  4. The Genetics of Attention Deficit Disorder
  5. ADHD Children Grown Up
  6. ADHD in Adults
  7. ADHD in Tourette Syndrome
  8. Learning Disorders and Dyslexia
  9. Obsessions, Compulsions, and Repetitive Actions
  10. Conduct - A Mother's Story
  11. Conduct
  12. The Genetics of Bad Conduct
  13. Sex and Exhibitionism
  14. Phobias
  15. Panic attacks
  16. Depression
  17. Mania and Manic Depressive Disorder

  1. Schizoid Behaviors
  2. The Symptoms and Genetics of Schizophrenia
  3. Autism
  4. Borderline Personality - Life on the Edge of Sanity
  5. Alcoholism - Born to Drink?
  6. Obesity - Born to Eat?
  7. Pathological Gambling
  8. Periodic Behaviors in Tourette Syndrome
  9. Bedwetting and Soiling - Enuresis and Encopresis
  10. Sleep Problems
  11. Excesive Drinking of Fluids - Polydipsia
  12. ADHD Secondary to a TS Gene
  13. Physical and Sexual Abuse
  14. Homozygotes, Selective Bias and Gene Selection
  15. Miscellaneous Features
  16. The Positive Features of Tourette Syndrome

PART IV - THE CAUSE

  1. The Anatomy of the Brain
  2. Communication between Nerves-The Neurotransmitters
  3. The Limbic System
  4. Memory and Learning
  5. The Prefrontal Cortex and Frontal Lobe Syndromes
  6. Dopamine - The Regulator of Motor Activity
  7. Dopamine Receptors
  8. Dopamine and Human Behavior
  9. Dopamine and Animal Behavior
  10. Dopamine and the Frontal Lobes
  11. Dopamine and Tourette Syndrome
  12. Norepinephrine - The Modulator
  1. Serotonin - The Great Inhibitor
  2. Serotonin Receptors
  3. Serotonin and Human Behavior
  4. Serotonin and Animal Behavior
  5. Serotonin and Tourette Syndrome
  6. Is Tryptophan the Key?
  7. GABA - Another Great Inhibitor
  8. Opium, Opiates, and Endorphins
  9. Autism Again - Causes
  10. The Dance of the Neurotransmitters
  11. 69. The Semidominant Inheritance of Tourette Syndrome
  12. Personality
  13. Pleasure and Addiction

PART V - TREATMENT

  1. Why Drugs?
  2. Some General Principles about Medications
  3. Haloperidol
  4. Pimozide
  5. Other Phenothiazines
  6. Tardive Dyskinesia
  7. Clonidine
  8. Treatment of ADHD

  1. Ritalin and Dexadrine
  2. The Use of Stimulants in Tourette Syndrome
  3. Imipramine
  4. Other Medications
  5. Non-prescription treatments
  6. Psychotherapy
  7. School

PART VI - CONCLUSIONS

  1. Pedigrees
  2. How Common is Tourette Syndrome?
  3. The Natural History of Tourette Syndrome
  4. Some Sample Pedigrees
  5. Chaos and Human Behavior
  6. Controlled Family Studies
  7. Why is the Diagnosis of Tourette Syndrome Often Missed?

  1. Will My Child Have Tourette Syndrome?
  2. Genetic versus Psychological Causes
  3. The Cortex and the Subcortex. The Superego and the Id
  4. Ethical Issues
  5. The Cloning of Tryptophan Oxygenase
  6. Closing the Logic Loop
  • PART VII - SUMMARY
  • PART VIII - GLOSSARY
  • PART IX - BIBLIOGRAPHY
  • PART X - APPENDIX
  • PART XI - INDEX
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What Reviewers Have Said

"The excitment of Tourette Syndrome and Human Behavior is a result not only of its insights into Tourette syndrome but of their relevance to our understanding human behavior and neuropsychiatric disturbance. The implications for the behavioral sciences and the practice of adult and child psychiatry are profound. This voume is highly recommended for all students of human behavior."
--Jeffrey Sverd, M.D. Director, Inpatient Psychiatry, Sagamore Children's Hosptal, Sagamore, N.Y.

"This book is remarkable in its scope and most importantly, well written and easily readable. It will be very useful to a wide variety of professionals including physicians, nurses, special educators, psychologists, patients and parents. I highly recommend it to persons interested in learning more about Tourette syndrome and human behavior in general.
-- Larry Burd, Ph.D. Medical Center Rehabilitation Hospital, University of North Dakota

"A masterful production that should be read by every professional engaged in medical practice, psychiatry, nursing or special education....invaluable for patients and their families."
-- Health and Nutrition Review

"Best Healthbook of the Year"
-- North American Book Dealers Exchange

"A masterbook"
-- J. Lejuene Annuals Genetique

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