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Journal of the Korean Academy of Child and Adolescent Psychiatry
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Korean Academy of Child and Adolescent Psychiatry
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Volume & Issues
Volume 10, Issue 2 - Dec 1999
Volume 10, Issue 1 - Jun 1999
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STRUCTURAL MODEL OF CAUSES OF CONDUCT PROBLEM - RELATIONSHIP AMONG CONDUCT PROBLEMS, DEPRESSION, ANXIETY, FAMILY ENVIRONMENT, SELF-CONCEPT, AND TODDLER TEMPERAMENT -
Cho, Soo-Churl ; Shin, Min-Sup ; Roh, Myoung-Sun ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 10, issue 1, 1999, Pages 3~14
Objectives：This study was investigated to examine the relationship among conduct problems, anxiety, depression, family environment, self-concept and toddler temperament in general population and to make a structural model of causes of conduct problem that could be applicated for conduct disorder prevention. Methods：477 middle school students in Seoul and Iksan city were assessed using Rating Form for DSM-IV Disruptive Behavior Disorder, Korean Form of the Kovacs' Children's Depression Inventory (CDI), Spielberger's. State-Trait Anxiety Inventory for hildren(STAI), Moos & Moos' Family Environment Scale(FES) and Piers-Harris' Self Concept Scale(PHSCS). Fullard's Toddler Temperament Scale(TTS) was performed by their parents. Conduct problem group was compared with nonconduct problem group on each scales. Results：1) Conduct problem group reported higher level of depression(p<0.01) and state anxiety(p<0.01) than non-conduct problem group. There was no difference in trait anxiety between two groups. 2) Family of conduct problem group showed lower level of cohesion(p<0.05) and organization (p<0.01). 3) Conduct problem group reported lower level of self-concept(p<0.01), esp. behavior(p<0.01), intellectual and school status（p<0.01）, physical appearance and attribute subscale(p<0.05). 4) Assessment of the temperament of conduct problem group by their parents was not different from that of non-conduct problem group, except persistence subscale of TTS(p<0.01). 5) The structural model of causes of conduct disorder - negative family environments induce low self-concept and depression, that make child anxious, and anxiety results conduct problem - was proved(GFI>0.90). Temperament had little effect on this model. Conclusion：Anxiety was suggested for a direct cause of conduct problem. Family environ-mental factors had more influence on conduct problem development than temperament. This suggests anxiety and family environment must be treated more importantly in the preventive and clinical approaches of the children with conduct problems.
EXECUTIVE FUNCTIONS OF ATTENTION DEFICIT/HYPERACITIVITY DISORDER
Kim, Ji-Hae ; Hong, Sung-Do ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 10, issue 1, 1999, Pages 15~20
Objective：This study was designed to investigate the difference between executive function of Attention Deficit/Hyperactivity Disorder(ADHD) group and that of neurotics, and to investigate the developmental aspects of ADHD group's executive function. Method：Executive function between ADHD(N=87) and Neurotics(N=19) was evaluated through their performance on the Wisconsin Card Sorting Test. The results were analyzed by 2-way ANOVA and t-test. Results：The results revealed group difference between ADHD and neurotics in total correct reponses, total error responses, nonperseverative errors, number of categories completed, conceptual level responses. There was no significant difference between the performance of 8-12 aged group and 13-15 aged group. But 7-8 aged group showed significantly poor performance than 8-12 aged in total responses, total error responses, perseverative responses, perseverative error responses, nonperseverative error responses. Conclusions：In comparison to the neurotics group, the children of ADHD group are suggested to be lacking the ability to correct their responses according to the external feedback and they probably respond randomly without self-control. However, as there is no difference between perseverative errors and perseverative responses, the interpretation of this finding warrants caution. It also suggests that the developmental aspects should be considered in the studies of executive functions because there are differences in the performance of executive functions by ages.
MENTAL REPRESENTATION OF PRESCHOOL CHILDREN：ASSOCIATION WITH PARENTAL MENTAL REPRESENTATION
Lee, Kyung-Sook ; Lee, Hae-Ran ; Shin, Yee-Jin ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 10, issue 1, 1999, Pages 21~33
The clinical assessment for preschool children who are known to have problems in selfreporting tends to be dependent on outsiders' reporting. Thus, the direct assessment of children's inner experience, thoughts and feelings is difficult. MacArthur Story-Stem Battery(MSSB) developed to learn more about preschool children's mental representation in play is used in this study to help assess clinical preschool children through developmental study of normal children's mental representation. Fifty five children(32boys and 23girls) who performed MSSB, IQ Test, Peabody Picture Vocabulary Test-Revised(PPVT) were videotaped and were analyzed. The results of this study were as follows：1) Children frequently displayed negative mental representation such as atypical negative response, reparation/guilt, punishment, personal injury and so on during emotionally laden play situation. 2) Mental representation of parent appeared positive, disciplinary, and negative in respective. 3) As a result of factor analysis of MSSB content themes, aggressive, prosocial, and oppositional content theme composites were generated. Aggressive content included atypical negative response, aggression, personal injury, and exclusion. Prosocial content included affection, affiliation, and reparation/guilt. Oppositional content included punishment and non-compliance. 4) Mental representation of parent and content themes showed significant correlation. Positive, negative, and disciplinary representation were significantly correlated for prosocial(r=0.40), aggressive (r=0.52), and oppositional(r=0.75) content theme respectively. 5) Among the correlations between parental mental representations and emotional responses, positive parental representation and anxiety showed significant negative correlation(r=-0.43). 6) Among the correlations between content themes and emotional responses, there were significant positive correlations between aggressive(r=0.28) and oppositional content themes(r=0.29) and distress, and were significant negative correlations between prosocial content theme and concern(r=-0.29) and anxiety(r=-0.43). According to the above results, preschool children frequently displayed negative mental representation in emotionally conflictual play situation. Children with more prosocial themes in their stories exhibit more positive parental mental representation. Also, children with more aggressive themes tend to display more negative parental representation and negative emotional responses.
A STUDY ON CORMORBID PSYCHOPATHOLOGY AND PARENTING ATTITUDE IN CHILDREN AND ADOLESCENTS WITH ATOPIC DERMATITIS
Jung, Jae-Suk ; Kim, Kyu-Han ; Hong, Kang-E ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 10, issue 1, 1999, Pages 34~42
The purpose of this study was to examine the nature of psychopathology and psychosocial environments of children with Atopic Dermatitis(AD) and their relationship to skin symptoms. Seventy outpatients with AD(mean age 9.94, range 4-15 years) and their mothers were subjected to psychiatric interview and parent- and self-report questionnaire(CBCL, MBRI, CDI, Spielberger's State-Trait Anxiety Inventory for Children(STAI), Family Impact questionnaire). Disease severity was assessed in three dimensions(skin extent, disease activity, and subjective symptom) by SCORAD index. Sixteen(22.9%) of our sample were suspected to have behavioral-emotional problems and they were different from non-problem group on depression, trait-anxiety, maternal controlling attitude and negative appraisal of children. While skin inflammation activity was correlated with only trait-anxiety and depression, subjective skin symptoms were correlated with many psychosocial factors such as depression, state-and traitanxiety, family-impact, social competence, internalized and externalized behavioral problem, sexual problem, and mother's positive appraisal of children). We concluded that children with AD are highrisk group for behavioral-emotional problems, and these problems along with maternal negative parenting attitude can affect their subjective symptom experience.
TEMPERAMENTAL CHARACTERISTICS OF KOREAN CHILDREN WITH COMMUNICATION DISORDERS
Joung, Yoo-Sook ; Hong, Sung-Do ; Kim, E-Yong ; Lee, Soo-Geun ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 10, issue 1, 1999, Pages 43~49
Objectives：One of the most common developmental problems is communication disorder in which a child appears normal in every way but who has failed to begin speaking or speaks very little. A few studies have examined the temperamental characteristics of children with communication disorders. This study was to investigate the temperamental characteristics of Korean children with communication disorders. Methods：The parents of 20 Korean children with communication disorders and the parents of 50 normal control children, the age of both groups ranges from 3 to 7, completed Korean version of Parental Temperamental Questionnaire developed by Thomas and Chess. Children with a pervasive developmental disorder, mental retardation, or speech-motor or sensory deficit were excluded. The scores of each temperamental scale of two groups and the diagnostic clusters of two groups were compared. Results：The children with communication disorders were characterized by lower mood scores and higher intensity of reaction scores than normal controls. The two groups showed no significant correlation in terms of the temperamental diagnostic clusters. Conclusion：This findings suggest the existence of a distinct temperamental profile of the children with communication disorders. Early detection of the profile may be of great value for parents in understanding the developmental characteristics of the children with communication disorders and in providing appropriate parenting approaches.
A STUDY ON THE STRUCTURAL RELATIONSHIP AMONG TEST ANXIETY, PSYCHOPATHOLOGY, TEMPERAMENT & FAMILY ENVIRONMENT
Cho, Soo-Churl ; Yoo, Tae-Ik ; Shin, Min-Sup ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 10, issue 1, 1999, Pages 50~63
Introduction：Test anxiety is a pervasive problem among high school students in Korea. While anxiety in test situations may actually facilitate the performance of some students, more often it is disruptive and leads to performance decrements. Over the past years, many child psychiatrists have become concerned with understanding the nature of test anxiety, but it is not clearly understood yet. In order to understand the nature of test anxiety, the relationship between test anxiety and depression, state anxiety, trait anxiety, temperament and family environment were examined. Methods：The Test Anxiety Inventory, Chidlren's Depression Inventory, State-Trait Anxiety Inventory, Temperamnet and Family Environment Scale Scale were administered to 576 high school students in Seoul. The relationships between test anxiety and other measures were tested using Pearson correlation coefficients and to test the causal relationship among the variables, regression analysis was performed. Results：The correlation coefficients between test anxiety and depression, state anxiety, trait anxiety, temperament and family environment scale were 0.42(p<0.01), 0.34(p<0.05), 0.38(p<0.05), 0.36(p<0.05) and -0.23(p<0.01), respectively. Regression analysis showed that only state and trait anxiety had direct causal relationship with test anxiety. Depression, temperament and family environment were indirecly related with test anxiety. Conclusions：This study indicates that the level of state and trait anxiety are directly related with test anxiety, and other variables such as temperament, family environment and depression are indirectly related with test anxiety. Thus, in order to develop the effective methods for treatment, these psychopathological characteristics should be kept in mind and the most important factors are the levels of state and trait anxiety.
A STUDY ON COMORBID DISORDERS AND ASSOCIATED SYMPTOMS OF PERVASIVE DEVELOPMENTAL DISORDER CHILDREN
Kwak, Young-Sook ; Kang, Kyung-Mee ; Cho, Seong-Jin ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 10, issue 1, 1999, Pages 64~75
Objective：The purpose of this study was to investigate the prevalence and characteristics of comorbid disorders and associated symptoms in pervasive developmental disorder(PDD) and to examine the correlation between associated symptoms and developmental characteristics in PDD children. Method：The sample consisted of 209 cases of PDD and 143 cases of developmental language disorder(DLD)(control group) who were treated at the Seoul National Mental Hospital from Jan. 1996 to Mar. 1999. The diagnostic work based on DSM-IV criteria was performed by one or two child psychiatrists, while the clinical feature was evaluated by doctors’s notes, occupational/speech therapy reports, and results of social maturity scale(SMS), childhood autism rating scale(CARS), and psycho-educational profile(PEP). Two groups were compared on a wide range of measures including comorbid disorders, associated symptoms, treatment drugs, and PEP. The relation between associated symptom & PEP was investigated in total(106 cases) and in each dignostic group. Sixty-four cases of PDD were divided into three groups by CARS and then compared on associated symptoms. Result：The prevalence of comorbid disorder was 19.6% in PDD, 41.2% in DLD. The rate of manifestation of 13 associated symptoms was 31.47% in PDD, 22.13% in DLD on the average. Associated symptoms significantly high in PDD were preoccupation, obsession, self-mutilation, stereotypy, sleep problems, and odd response. In total patient group, associated symptoms that significantly influenced PEP were preoccupation, self-stimulation, stereotypy, inappropriate affect, sleep problems, and odd response. But, in each diagnostic group, no associated symptom influenced PEP. Associated symptoms significantly different between the 3 groups of CARS were stereotypy, anxiety, and sleep problems. Conclusion：These preliminary results suggest that developmental characteristics may influence associated symptoms in PDD children and a realistic approach considering minute diagnosis by associated symptoms and comorbid disorders is required.
A COMPARATIVE ANALYSIS OF MOTHER-CHILD PLAY BETWEEN AUTISTIC AND NORMAL GROUPS FOR PROMOTING THE AUTISTIC CHILDREN'S SYNCHRONIZED BEHAVIORS
Im, Sook-Bin ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 10, issue 1, 1999, Pages 76~90
This study was performed 1) to compare the nature of the synchronized behaviors in mother-child plays between autistic and normal groups quantitatively and qualitatively and 2) to identify the behavioral data to improve synchrony. The subjects were consisted of 20 mother-child pairs, 10 for each autistic group(AG) and normal group(NG). The developmental age of two groups was under 24 months old and equally matched. Data were collected by video-taped mother-child free play and analyzed with Wilcoxon Rank Sign(Sum) Test, Spearman Correlation Coefficient, Scheffe's Test, and Content Analysis. The score on synchronized behaviors of AG was significantly lower than that of NG(p<.05). As time progressed, the difference was much higher between the 2 groups. And the structure of motherchild plays in AG was poor and most of the interactions were discontinued as 1 or 2 episodes. On the other hand, mother-child plays in NG were enriched and became somewhat like game or play. The score of mother's growth-fostering nurturing behaviors showed positive relation to synchrony and much highly related to the group of 16 months-old or above. Mother's laughing and patting responses and pausing to get the child's initiative were especially related highly to synchronized behaviors. In conclusion, these mother's growth-fostering nurturing behaviors should be stressed at the mother-child interactions and also well structured therapeutic play with considering in children's developmental level should be given.
COMPARISON BETWEEN ATTENTION DEFICIT HYPERACTIVITY DISORDER AND MANIA IN CHILDREN AND ADOLESCENTS
Sung, Yang-Sook ; Hong, Kang-E ; Cho, Soo-Churl ; Nam, Min ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 10, issue 1, 1999, Pages 91~99
Objects：It is difficult to differentiate between attention deficit hyperactivity disorder(ADHD) and mania because of similar symptoms and atypical symptoms of mania in children and adolescents. The purpose of this study is to identify the characteristics and to clarify the relationship by comparing the clinical features and comorbidities of ADHD and manic patients. Methods：The subjects consisted of 35 patients with ADHD and 19 manic patients. To Compare the characteristic symptoms between the two disorders, we selected 29 patients with ADHD and 14 patients with manic disorders. 6 ADHD patients who had manic disorders as comorbid disorder, and 5 manic patients who had ADHD as comorbid disorders were manic disorders were excluded. Results：1) There were significant differences in ages of onset and state anxiety scale scores, birth weights, numbers of perinatal problem, gestational ages, school behavioral problems between ADHD patients and manic patients(p<0.01). 2) There were significant differences in loses things(p<0.05) of ADHD-symptoms and grandiosity(p<0.01), decrease in sleep(p<0.05), delusions(p<0.01), hallucinations(p<0.05) of mania-symptoms between ADHD patients and manic patients. 3) The comorbid disorders of ADHD patients are significantly high(p<.05) than that of manic patients in major depression. 4) The familial loading of manic patients are significantly high(p<.05) than that of ADHD patients in mood disorder. Conclusions：The above results suggest that ADHD and mania are different disorders, considering the significant differences of clinical features and characteristics, familial loadings of the two disorders.
FACTORS OF MENTALLY HANDICAPPED CHILDREN AND THEIR FAMILY ASSOCIATED WITH THE QUALITY OF LIFE AND THE EMOTIONAL WELLBEING OF THEIR MOTHERS
Lee, Yong-Ho ; Chung, Yong-Kyoon ; Cho, Soo-Churl ; Koo, Young-Jin ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 10, issue 1, 1999, Pages 100~112
Objective：In life-long disabilities like autism and mental retardation, the authors thought that it is important for clinician to consider the quality of life of a primary caregiver for long-term management and prognosis. This study was to investigate the factors of children and family environment affecting the quality of life and depression in mothers with autistic and/or mentally retarded children. Methods：41 autistic and/or mentally retarded children aged 5-12 years with their mothers were surveyed from September, 1998 to January, 1999, with K-CBCL, K-BDI, K-FES, and K-SBQOL scale and compared with data from 35 normal control subjects. Results：1) Total K-BDI and K-SBQOL scores of mothers with mentally handicapped children were significantly poorer than the scores of normal control group. Independence, intellectual/cultural orientation and active recreation subscales of K-FES in mentally handicapped children were significantly decreased than those in normal control group. 2) Total K-BDI score of mothers with mentally handicapped children was correlated with their children’s behavioral problems, especially internalizing and thought symptoms, and with family cohesion, expressiveness, conflict and independence. 3) Totol K-SB quality of life score of mothers with mentally handicapped children was correlated with their children’s behavioral problems, especially attention problem, and with family cohesion, conflict, independence, intellectual/cultural orientation, and moral-religional emphasis. 4) The quality of life of mothers with mentally handicapped children was predicted by attention problem(
=.36, p=.000) and social competence(
=.07, p=.038) in children and family cohesion (
=.16, p=.001). 5) Depression of mothers with mentally handicapped children was predicted by internalizing symptom (
=.21, p=.003) and thought disorder(
=.06, p=.048) in children and family cohesion(
=.14, p=.008). Conclusion：Reducing behavioral problems and family therapeutic intervention in autistic and mentally retarded children can improve the quality of life of primary caregivers and long-term prognosis of the children, although those are not curative.
A STUDY OF MIDDLE SCHOOL BOY'S REPORT ON THE FACTORS THAT AFFECT THEIR RELATIONSHIPS WITH FATHERS
Cho, Sun-Mi ; Noh, Kyung-Sun ; Lee, Ho-Young ; Kim, Hyun-Soo ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 10, issue 1, 1999, Pages 113~120
Our aims is a exploration for relationship between father and male-adolescence. For this purpose, we have employed several self-reported questionnaires, including BDI, Rosenberg self-esteem scale, Attitude for father etc. Our hypothesis is that the perception, the attachment, age and alcohol drinking, accademic career of father influences male-adolescent's self-esteem, mood, sex-role, academic accomplishment, satisfying of school life. We have surveyed questionnaire at one middle school, at Suwon city. We have get 196 samples. We have categorized subjective answers and analyzed relations. The result is that a positive relation is self-esteem, sex-role, and attachment, a neagtive relation is mood and no relation is age, academic career, alcohol drinking. Also, father's overprotection attribute on negative influences. We have many limitations. First limitation is a small number. Second is few previous study. Third is a relative analysis, not cause-effect analysis.
A CASE OF LETHAL CATATONIA IN A 11-YEAR-OLD BOY
Cho, In-Hee ; Hong, Sung-Do ; Joung, Yoo-Sook ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 10, issue 1, 1999, Pages 121~133
Lethal catatonia is one of catatonic spectrum, but it differentiates itself to a separate entity as a syndrome because of its severity and lethality. The prevalence of this disorder may have declined worldwide, coinciding with the advent of modern psychopharmacologic agents and other advances in medical treatment. The patient reported here was an 11-year old boy, showing catatonic excitement and stuporous condition with high fever, autonomic dysfunction and several catatonic symptoms. This is a case of successful treatment by using intensive medical monitoring and conservative treatment in an intensive care unit, combined with pharmacological treatment and electroconvulsive therapy during the early phase of lethal catatonia with mild symptoms.