Consider a particular diagnostic category such as Tourette's Syndrome as it is described in the DSM-5 -TR (APA, 2022)

Other diagnostic notes (Jafari et al., 2022; Sukhodolsky et al. 2017):

• Tends to emerge around age 6 (range: 4-8 years old).

• Peak severity between 10-12 years old; often fades in late adolescence or adulthood.

• Males > Females at a 2 to 4:1 ratio.

• Prevalence: Once thought to be very rare, recent estimates among children and adolescents range from about 0.7% (that is, 7 in 1,000) to 1.4% (14 in 1,000). The DSM-5-TR (2022) has a slightly lower estimate.

• Though no cause has yet been identified, Tourette's appears much more frequently in families, i.e., a strong genetic component.

• “There are no racial, ethnic, or cultural differences in the clinical characteristics, processes, or etiology of Tourette’s” (Jafari et al. 2022, p. 15)

• Complex tics may include: sexual or obscene gestures, imitation of others' movements or words, unacceptable language including obscenities, or ethnic-racial-religious slurs.

• Comorbidity: often seen with ADHD or obsessive-compulsive disorders; if ADHD, may be disruptive, socially immature, or have learning difficulties; sometimes other disorders like depressive, bipolar or substance use disorders.
  

What does Tourette's look like in an actual individual?

Twenty-five years ago, NPR's "Radio Diaries" -- hosted by its executive producer, Joe Richman -- presented the recorded segment found below which we will listen to ourselves: It uses cassette tape recordings made over a period of time by Josh Cutler, a 16-year-old in New York City, the son of a mother-professor and father-lawyer. He was a high school junior at St. Ann's School in Brooklyn, a place he had attended from the 1st grade. Here is his "Radio Diary" from 1996 on National Public Radio. It runs about 15 min. Listen to what he has to say and note what you learn about Josh that you'd not know from the DSM-5 description.

Radio Diaries: Josh's Diary

• What strikes you most about what Josh records in this "radio diary"?

• Does Josh seem like an average teenager?

• How does Josh act when he is with his classmates and with his mother?

• What does Josh think about himself?

• What is Josh doing in this "diary"

• Is there a story or are there stories that this radio diary conveys? What is/are they?
  

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Approaches to research in narrative: The Big vs. Small Story Contrast

"Big Stories"

"Small" or "Little Stories"

Life story Autobiography Memoirs Episodes that were "life determining" or "life threatening" Focus on identity more broadly conceived Searching for "meaning" in what we do or will do Occurs in specific kinds of settings that require personal reflection &/or elicitation by another Often makes use of culturally-supplied schemes, categories or genres Redemptive lives (McAdams) Contaminated lives (McAdams) Tragic hero, romantic hero, spiritual quest, etc. Rarely told by individuals at any length and, thus, may be considered unusual (or even artificial) One has to "step out" of life to fashion a life story

Short in length Told in everyday life Told in interaction with others Often about everyday, mundane events of life Told by individuals who assume roles in the telling Spontaneous Positioning of self vis-à-vis others Linked to "socio-linguistic" analysis

References

American Psychiatric Association [APA]. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text revision). Washington, DC: APA.

Jafari, F., Abbasi, P., et al .(2022). Systematic review and meta-analysis of Tourette syndrome prevalence; 1986 to 2022. Pediatric Neurology, 137, 6-16. https://doi.org/10.1016/j.pediatrneurol.2022.08.010  

Sukhodolsky, D. G., Gladstone, T. R., Kaushal, S. A. et al. (2017) Tics and Tourette syndrome. In J. L. Mason (Ed.), Handbook of childhood psychopathology and developmental disabilities treatment (pp. 241-256). Cham, Switzerland, Springer. https://doi.org/10.1007/978-3-319-71210-9_14