Psychosocial Effects of Turner Syndrome
The psychosocial impact of Turner syndrome can have a significant impact on these women and children making it extremely difficult for them to live a happy healthy life, so there are support groups available for them to help. Patients were asked which symptom(s) has had the biggest impact on their lives. Their answers were (in decreasing order of importance) infertility; short stature; and impaired development of sexual characteristics, most importantly lack of libido.
These symptoms can results in women feeling depressed, low self-esteem, anxiety, and impaired social competence when they are compared to their peers.
Research has been conducted on the behavioral characteristics of girls and women with Turners. This research allows scientists to discover the association between alterations in DNA and both neurocognitive and behavioral development.
There is only an 8-10% occurrence of mental retardation in women with Turner syndrome. The types of impairment women have affect nonverbal perceptual motor and spatial skills. Deficits in visual-spatial organization, social cognition, non-verbal problem solving and psychomotor function have been identified (McCauley, 2006).
Approximately 70% if individuals with Turner syndrome experience these learning disabilities to some degree, but not as extreme in some cases. Individuals experience difficulties with mathematics, directional sense, driving and multitasking as well as related problems in social functioning.
Social and behavioral development across the lifespan
During infancy, it is most common to observe infants having trouble using their motor functions (gross motor 39%, fine motor 59%), language delays (37%), and feeding problems (71%) (Verlinole, 2006). As girls with Turner syndrome transition into elementary school, there are noticeable challenges they face with increased hyperactivity, poor concentration, and immaturity (McCauley, 1995). Girls with Turner syndrome have an increased likelihood of attention deficit hyperactivity disorder (ADHD). These girls struggle with inhibitory control, being distracted easily, planning and short term recall as well as working memory.
During adolescence, inattention, immaturity, social isolation and anxiety appear to be the most common problems. ADHD is more commonly expressed during this stage of life with girls who have Turner syndrome. They can have anxiety problems which are usually expressed as shyness, a preoccupation with keeping things in order and a lack of flexibility in terms of change in routines.
A recent study of 50 young women, with final heights within the normal range, treated with growth hormone during childhood assessed social and behavioral functioning at age 18. The investigators found no evidence of behavioral problems but self-esteem and attitudes about their bodies were less positive among the girls with Turner syndrome than for their peers. Girls with Turner syndrome have a low self-esteem and low attitudes about their bodies when compared to their peers.
Psychological studies of adult women with Turner syndrome have addressed questions about academic and work achievement, interpersonal relationships, emotional difficulties and quality of life. Most adults with Turner syndrome report reasonable levels of satisfaction in employment and social life (Pavlidis, 1995). Survey data from a number of studies of adult women reveal excellent education and occupation achievement but some delays in reaching milestones associated with adult development, such as marriage or living independent of parents (Pavlidis, 1995). Some women are employed at an occupational level below that predicted by education (Pavlidis, 1995). This may reflect the long-term impact of early learning disabilities, some of which do persist into adult life (Ross, 2002). One recent study of quality of life found that problems in school accounted for 25% of the variance in well-being among adult women with Turner syndrome (Boman, 1998).
The behavioral study findings suggest that girls with Turner syndrome show a delay in social and emotional development but that most adult women with Turner syndrome are emotionally stable and living self-sufficient lives as independent productive adults.
Elizabeth McCauley’s Social and behavioral development of girls and women with Turner syndrome.