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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 11, Issue 2 - Dec 2000
Volume 11, Issue 1 - Jun 2000
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MOLECULAR BIOLOGIC ANALYSIS OF FMR-1 GENE TRINUCLEOTIDE REPEATS IN AUTISTIC PATIENTS
Kwak, Ho-Soon ; Chun, Hyo-Jin ; Chang, Eun-Jin ; Kim, Hee-Cheol ; Kim, Jung-Bun ; Park, Young-Nam ; Jung, Chul-Ho ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 11, issue 1, 2000, Pages 3~15
Objectives：There has been a rapid expansion of studies aimed at elucidating the genetic basis of autistic disorder, especially it’ relationship to fragile-X syndrome. The detection of fragile X chromosome(Xq27.3) by cytogenetic analysis has revealed many difficulties in testing. Therefore, to explore the relationship between autistic disorder and fragile X syndrome, this study administered molecular biologic methods which examined an unstable CGG repeat within the fragile X mental retardation-1(FMR-1) gene. Methods：Ninety nine autistic children and eight normal control children were tested. The number of CGG repeats within FMR-1 gene was measured after amplification by PCR, and cytogenetic analysis was also carried out to detect fragile site Xq27.3. Southern blot hybridization, using StB12.3 and/or Pfxa3 probe, was done for the patients showing expansion of more than 50 CGG repeats (premutation). Results：All but two autistic patients had no expansion in CGG repeats by PCR and there was no significant statistical difference in number of CGG repeat in comparison with normal control. Two autistic patients, considered as premutation by PCR analysis, had no full mutation or premutation by Southern blot hybridization. All autistic children tested did not have any abnormal karyotype or fragile site Xq27.3. Conclusions：These results suggest that autistic patients may not have abnormality in FMR-1 gene or abnormal expansion in CGG repeat. In conclusion, fragile X syndrome may not be antecedent of autistic disorder.
FAMILY ENVIRONMENTAL FACTORS AFFECTING TEST ANXIETY IN ADOLESCENT
Sung, Jong-Ho ; Sohn, In-Ki ; Lee, Young-Sik ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 11, issue 1, 2000, Pages 16~26
Objectives：This study was done as a part of investigating individual and socioenvironmental factors affecting test anxiety in adolescent. The focusing of this study was detecting specific family enviromental factors affecting worry and emotionality of test anxiety. Methods：The subjects of this study were 880 middle and high school students in Seoul, Korea. To evaluate test anxiety level, Spielberger's Test Anxiety Inventory was applied and to evaluate familial factor, Moos and Moos' Family Environmental Scale was done. Results：The results were as follows. 1) Total and worry part of test anxiety scores were negatively correlated with cohesion and independence scores. Total, worry, and emotional part of test anxiety scores were positively correlated with achievement orientation and control scores. 2) High test anxiety group showed higher achievement orientation and control scores, and lower cohesion scores than low test anxiety group. 3) The higher socioeducational level of parents were, the higher three subscale (cohesion, independence, and achievement orientation) scores were, except control score. Conclusion：In therapeutic approach of adolescent's test anxiety, the importance of education and treatment of their parents should be emphasized. Parents should set their children's appropriate achievement goal, encourage their children's independency instead of control. Cohesion of familial members are also needed.
COMPUTER GAME PLAYING PATTERNS, PARENTAL REARING PATTERNS AND INDIVIDUAL PSYCHOPATHOLOGY IN ADOLESCENTS
Ryu, Jeoung-Whan ; Kim, Young-Mi ; Jeong, Hong-Kyung ; Jo, A-Ra ; Lee, Jung-Ho ; Choi, Young-Min ; Lee, Gi-Chul ; Jeon, Seong-Ill ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 11, issue 1, 2000, Pages 27~41
Objects：This study was designed for studying of current Korean adolescents computer game playing habits and exploring associations with parental rearing patterns and individual psychopathology. Methods：One hundred twenty four adolescents(age 13-15) who reside in urban area completed self-report questionnaires containing Questionnaires designed by authors, Symptom Checklist-90-Revision of Korean Version(SCL-90-R) and Parental Bonding Instrument(PBI). Results：1) Computer game playing appears to be one of the social and leisure phenomena in these days. Although Adolescents spend a lot of times on computer game, Many of them perceive not problematic. 2) Compared with females, Male play computer games more regularly, more longer, spent more times in gamebang. 3) There was positive relationship between anxiety subscale in SCL-90-R and detrimental effects of computer game. 4) There was positive relationship between game frequency and maternal overprotection. 5) The main reasons for playing are 'for an avoidance of stressful life events', academic burden was the most troublesome issues in korean adolescents. 6) Many adolescents use gamebang as a social place, but they thought that gamebang is not good places to have a good time. Conclusion：This papers shows that computer game playing is a popular social leisure activity in Korean adolescents. And, Most of korean adolescents reported that they are suffered from pressure of academic achievements. They use computer game mainly by means of relieving academic pressures. In a heavy game users who have many conflicts with parents, teacher and who has frequent truancy and social withdrawal show significant anxiety. Maternal overprotection was observed in heavy game users. Authors recommended that clinicians should be careful in examining heavy computer game behaviors. Both underlying affective states and environmental influences, including family situations should be vicariously examined.
EMOTIONAL AND BEHAVIORAL PROBLEMS OF NOCTURNAL ENURESIS CHILDREN IN GENERAL POPULATION
Lee, Young-Sik ; Kim, Eun-Young ; Na, Chul ; Jeon, Chang-Moo ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 11, issue 1, 2000, Pages 42~50
This study was designed to evaluate the emotional and behavioral problems of nocturnal enuresis children(n=72) in general population. And this was compared with normal control children(n=72). The behavioral problems were assessed using a modified child behavior checklist(CBCL) parent form. The results indicated that enuretic children were rated significantly more anxious, fearful, depressed, inattentive, hyperactive, delinquent on the modified CBCL rating when compared to the age-, grade- and sex-matched normal control children. Finally, it was an impressive evidence that there exist many emotional and behavioral problems in children with nocturnal enuresis.
INFLUENCE OF ATTACHMENT RELATIONSHIP WITH PARENTS ON REJECTION SENSITIVITY AND PEERRELATION IN SCHOOL-AGE CHILDREN
Lee, Kyung-Sook ; Suh, Soo-Jeung ; Shin, Yee-Jin ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 11, issue 1, 2000, Pages 51~59
This study aims to reveal whether attachment relationship with parents can differ from children being accepted and rejected in peer relations, and whether children's rejection sensitivity can differ from children having secure and insecure attachment relationship with parents. Subjects were 218 students in fifth and sixth grade of primary school. Inventory of Parent and Peer Attachment(IPPA), Children's Rejection Sensitivity Questionnaire(CRSQ), and peer relation sociometrics were used as measurements. The results showed that children in secure attachment with parents had lower scores on the subscales of CRSQ, such as anxiety, anger, belief, and psychological reaction, than children in insure attachment relationship with parents. And IPPA scores were higher in children being accepted in peer relation than children being rejected. These results can be considered that early attachment relationship with parents may influence children's rejection sensitivity and peer relation.
DEVELOPMENT OF KOREAN FORM OF CHILDREN'S YALE-BROWN OBSESSIVE-COMPULSIVE SCALE(CY-BOCS)：A RELIABILITY AND VALIDITY STUDY
Lee, Jeoung-Seop ; Kang, Yun-Hyong ; Cho, Seong-Jin ; Suh, Dong-Hyuck ; Hong, Kang-E ; Chung, Sung-Ju ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 11, issue 1, 2000, Pages 60~69
Objective：This study was carried out to evaluate the reliability and validity of the Korean form of the Children's Yale-Brown Obsessive Compulsive Scale(CY-BOCS). Method：Forty-two children with obsessive-compulsive disorder(OCD)(31 boys and 11 girls, aged 7 to 18 years) were assessed with CY-BOCS. Interrater agreement was assessed by two raters in subsample(n=20). discriminant and convergent validity were assessed by comparing CY-BOCS scores to Clinical Global Impression-OCD(CGI-OCD), Leyton Obsessional Inventory-Child Version (LOI-CV), State-Trait Anxiety Inventory for Children(STAI-C), and Child Depression Inventory(CDI). Results：Internal consistency was high, measuring 0.86 for the 10 items and total score. The intraclass correlations for the CY-BOCS total, obsession, and compulsion scores were 0.94, 0.94, 0.84, suggesting excellent interrater agreement for subscale and total scores. The CY-BOCS total score showed highest correlation with CGI-OCD(r=0.88), and significant correlation with LOI-CV(r=0.51), Trait Anxiety score(r=0.43), and CDI scores(r=0.49), but it was not correlated with State-Anxiety score(r=0.25). Conclusion：The results of this study indicate that the Korean form of CY-BOCS is a reliable and valid scale for rating obsessive-compulsive symptom severity.
THE PRELIMINARY STUDY FOR THE DEVELOPMENT OF KOREAN VERSION PARENTING STRESS INDEX
Youm, Hyun-Kyung ; Shin, Yun-O ; Lee, Kyung-Sook ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 11, issue 1, 2000, Pages 70~78
This study was to develop Korean version of Parenting Stress Scale. Primary research was processed thru Abidin's PSI(Parenting Stress Index) scale. For the pilot primary study, distri-buted questionnaire to the mothers who have three to twelve age children and tried factor analysis with 382 data sheets. At the result, 29 items and 5 factors among the 47 items of child domain, 28 items and 5 factors among the items of parent domain were extracted. At the secondary pilot study survey, reanalyzed the 57 items extracted by primary pilot survey with the 392 data collected from three to six age children's parents. For the item discrimination analysis, calculated item-total correlation and deleted the items under r=.20. For the validity test, reviewed content validity and construct validity. For the verification of construct validity, tried factor analysis. At the result, in child domain area, the four factors, 'Reinforces Parent's, 'Accep-tability', 'Attention Distractiveness', 'Demandingness' and 24 items were extracted. Among the common variance of child domain, 'explained common variance' was 82.05%. In parent domain area, the five factors, 'Restriction of Role', 'Depression', 'Social Isolation', 'Parent Health', 'Spouse Relationship' and 24 items were extracted. Among the common variance of parent domain, 'explained common dominator' was 82.40%. For the verification of reliability, Cronbach's
coefficient was calculated and in child domain, .69, .70, .67, .66 were produced by each item, respectively and total reliability coefficient was
=.81. Reliability coefficient of parent domain was .73, .70, .70, .55, .73 by each item, respectively and total reliability coefficient was
=.83. This study was processed as a primary research to develop the Korean version of parent stress scale which is originally from U.S.A. version of PSI and apply it to proper Korean culture. Therefore, the necessity of continuous study was discussed with more localized items and factors.
DEVELOPMENT OF SCALE FOR MEASURING DELINQUENT BEHAVIOR
Kim, Hyun-Sil ; Kim, Hun-Soo ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 11, issue 1, 2000, Pages 79~90
Objective：This study was performed in order to develop a measuring instrument for assessing and predicting delinquent behavior of the adolescents in Korea. Methods：This study was methodological research for developing a questionnaire for measuring delinquent behavior. Through the relevant literature review and personal interview using open-ended question with 12 adolescents in schools, outpatient basis and the juvenile corrective institutions, the author developed a pre-questionnaire with 31 items for assessing delinquent behavior among delinquentprone adolescents. Statistical method employed were test-retest reliability and Cronbach's alpha coefficient for testing reliability and factor analysis for testing validity of this questionnaire, and t-test for mean difference between student adolescents and delinquent adolescents, using SAS program. Subject served for this study consisted of 2,177 adolescents including 1,206 students and 971 delinquent adolescents by proportional stratified random sampling method. Results：1) Three stable factors were emerged and these contributed 52.2% of the variance in the total score. All 31 items loaded above .40 on each factor. 2) Factor I was named as antisocial delinquent behavior(17 items), factor II was named as aggressive delinquent behavior(8 items), and factor III was named as psychopathic delinquent behavior(6 items). 3) Comparison of these 3 factors between student adolescents and delinquent adolescents showed that there was a significant difference in factor Ⅰ(t=-42.91(student), -41.71(delinquent), p=.0001), factor II(t=-34.10(student), -35.72(delinquent), p=.0001), factor III(t=-14.24(student), -14.26 (delinquent), p=.0000), and total score(t=37.02(student), -36.38(delinquent), p=.0001). 4) Internal consistency reliability was tested by Cronbach's
was .952 for total 31 items and .950, .866 and .721 for each 3 factors related to delinquent behavior. Conclusions：The author confirmed that this scale can use for measuring delinquent behavior, and hope to make a contribution to screening test and prevention of juvenile delinquency in Korea.
A STUDY OF THE DEVELOPMENT AND STANDARDIZATION OF ADHD DIAGNOSTIC SYSTEM
Cho, Sung-Zoon ; Chun, Sun-Young ; Hong, Kang-E ; Shin, Min-Sup ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 11, issue 1, 2000, Pages 91~99
Objectives：Present study developed the computerized ADHD Diagnostic System(ADS) in order to diagnose ADHD and evaluate treatment effect of it, and conducted a standardization study for ADS. Methods：The normative group was composed of 847 children and adolescents between the age of 5 and 15(boy 429, girl 418) living in the areas of Seoul, Kyunggi-do, and Kangwon-do. 30 ADHD children with age ranged 7 to 9 years were participated present study to evaluate the validity of ADS. To establish the norms for diagnosing ADHD, the means and standard deviations of normative group were used to calculate T-scores for each age group. Results：The reliability coefficient of ADS(Cronbach's
) was .85. There were significant differences in the measures of ADS except commission error between the normal and the ADHD groups. Three factors were extracted through factor analysis of ADS, which were labelled 'inattention', 'slow information processing' and 'impulsivity'. Discriminant analysis showed that ADS significantly discriminate the normal and the ADHD groups. Percentage of correct classification by ADS variables was 96.7%. Conclusion：These results put together strongly support the reliability and validity of ADS as a diagnostic instrument for ADHD.
THE TREATMENT RESULTS OF A DAY TREATMENT PROGRAM FOR CHILDREN WITH DEVELOPMENTAL DISORDERS
Kwak, Young-Sook ; Kang, Gyung-Mi ; Lee, Hae-Sook ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 11, issue 1, 2000, Pages 100~109
Objective：This was conduced to evaluate the effect of early intervention to promote the development of children with developmental disorders. Methods：49 children(31 in PDD group and 18 in DLD group) participated in a one year day treatment program conduced from 1996 to 1999. They were performed PEP, CARS, and SMS. They were grouped by diagnosis, comorbidity, chronological age and CARS score at the beginning of the program and the treatment effect was compared. Results：The children who participated in the day treatment program showed significant increase in their PEP, SMS score, and decrease trend in their CARS score. When children were grouped by diagnosis, comorbidity, chronological age, and severity in CARS score we did not find out significant difference between groups. Conclusion：Our data suggest that the day treatment program which emphasis on development is effective in treating children with developmental disorders.
MUSIC THERAPY FOR ADOLESCENTS WITH CONDUCT DISORDER
Jhin, Hea-Kyung ; Kwon, Hea-Kyung ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 11, issue 1, 2000, Pages 110~123
The short-term music therapy was performed for adolescents with conduct disorder admitted to Seoul National Mental Hospital for 3 months from Jun to September, 1998. This case study focused mainly on two female patients who participated regularly in the group music therapy. The music therapy process was divided into three phases；beginning, opening up, and closing. This music therapy session consisted of three parts；hello song as beginning, various musical activities, and sound & movement activity as closing. Free musical improvisation, song discussion, musical monodrama, and sound & movement were the mainly applied techniques. Free improvisation was used to enhance, motivate, identify and contain the adolescents' feelings and ideas. Song discussion was used to convey their thoughts and to support each other. Musical monodrama was used to make them have insights into interpersonal relationships. Sound & movement was used to enhance spontaneity. It made them explore their body and voice as an expressive medium. Throughout three months period of music therapy, patient A's communication skill, socialization, and behavior areas were assessed with improvement. She could use music as a symbolic form and was able to share her feelings about herself and her family. Patient B's self-expression and cognitive areas were assessed with improvement. She became more spontaneous and could verbalize her emotions during the group session. Music as a non-verbal and therefore often a non-threatening medium wherein so much can be expressed provided two female patients an atmosphere where a sense of trust may be regained.
A SURVEY OF THE PSYCHOSIS AMONG SCHOOL VIOLENCE VICTIMS
Kwon, Seok-Woo ; Shin, Min-Sup ; Cho, Soo-Churl ; Shin, Sung-Woong ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 11, issue 1, 2000, Pages 124~143
Objectives：The primary purpose of this study is to understand the psychopathology of the victims of school violence in terms of early psychosis. By doing this, the early detection of psychosis among the victims is possible, and early detection may lead to early intervention. Methods：Two-thousand and nine-hundred seventy two students from 16 middle schools in Seoul were asked to fill out questionnaire comprised of popularity and intellectual and school status of Piers-Harris Children's Self Concept Inventory, Symptom Check List-90-Revised, and Ostracism Scale. The subjects whose scores upon Ostracism Scale were higher than average by two standard deviation were labeled as ‘Repelled and Isolated group', and subjects whose scores on popularity were significantly lower than average and whose scores on psychoticism of SCL-90-R were higher than average were defined as 'tentative early psychosis group'. Odds ratios were calculated from the numbers of subjects with and without high psychoticism scores and high ostracism scores. On the subjects of 'tentative early psychotic group', we examined every clinical characteristic and conducted correlation analysis and regression analysis in order to find out the risk factors and to construct theoretical model that explains the psychoticism scores. Results：The results were as follows：1) Total 157(5.3%) subjects were rated significantly higher on ostracism scale, and among them, 47 subjects(29.9%) were rated significantly higher than average on psychoticism scale, while only 50 subjects among 2,135 students who were rated within normal range showed significantly higher score on psychoticism scale. Odds ratio for psychotic group of isolated group were 17.82 and it was statistically significant. 2) Forty-seven subjects(31 boys, 16 girls) who were rated as they were unpopular and rejected from peers had significantly higher psychoticism scores. They were not significantly different from simply high psychoticism subjects in anxiety, social anhedonia scale, magical thinking, obsessivecompulsive symptoms, phobic anxiety, psychoticism, somatization, but showed higher ostracism scores and paranoid tendencies. Among school violence victims, who rated themselves unpopular and showed higher psychoticism scores, the psychoticism scores were mainly explained by anxiety, depression, hostility, interpersonal sensitivity, obsessive-compulsive symptoms, paranoid tendency, somatization scales(
). Conclusion：Thus, it can be concluded that the subjects with higher ostracism score have the substantially high risk for psychosis development. By these results, we propose that school violence victims with anxiety, depression, hostility, interpersonal sensitivity, obsessive-compulsive symptoms, paranoid tendency, somatization should be tested individually considering school adjustment, attentional deficit, concept formation problems.
A CASE OF 11-YEAR-OLD GIRL WITH PSYCHOGENIC SEIZURE
Noh, Kyung-Sun ; Sohn, Seok-Han ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 11, issue 1, 2000, Pages 144~149
A psychogenic seizure is a disorder which is occasionally met by neurologists and psychiatrists. The most important thing that clinicians should do is differential diagnosis with true epileptic seizures. Especially psychiatrists are expected to be able to diagnose psychogenic seizures through a thorough history taking and an observation of clinical features to some degree before the confirmatory diagnoses. We experienced a case of 11-year-old girl with psychogenic seizure which was characterized by obvious psychological and environmental stress, clinical features, and good outcome by prompt a loboratoy examination and psychiatric intervention. To diagnose and treat childhood psychogenic seizures, we suggest that it is very important to examine the familial background and take a thorough history, and perform psychoeducational intervention in addition to electroencephalogram.