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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 13, Issue 1 - Dec 2002
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CHILDHOOD TRAUMA：PSYCHIATRIC OVERVIEW
Han, Sung-Hee ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 13, issue 1, 2002, Pages 3~14
Childhood psychic trauma appears to be a crucial factor in the development of serious disorders both in childhood and in adulthood. Traumatized children show strong tendency to revisualize or re-feel a traumatic events. Play and behavioral reenactments are frequent manifestations of both the single blow and the long-standing traumas in childhood. Those children who suffer the results of single, intense terror appear to exhibit detailed memory, retrospective reworkings and misperceptions. In long-standing or repetitive trauma, children would show psychic numbing, self-hypnosis, dissociation and rage. Child's brain is undergoing critical and sensitive periods of differentiation. During this time, developing central nervous system is exquisitely sensitive to stress. Stressor-activated neurotransmitters and hormones can play major roles in neurogenesis, migration, synaptogenesis, and neurochemical differentiation. Internal opiate system operates in some trauma and causes the victim to fail to respond, to avoid, to shut off feelings. Evidence is also accumulating in traumatology that dysfuntion of locus coeruleus and ventral tegmental neucleus system leads to catecholamine receptors hypersensitivity. This change result in hypervigilance, increased startle, affective lability, and increased autonomic nervous system hyperreactivity. Another site of action of trauma on the brain is hypothalamic-pituitary-adrenal axis. Individuals with PTSD do not have enough cortisol to halt the alarm reaction. When children are exposed to long-standing extreme events, massive attempts to protect the psyche and to preserve the self are put into gear. These developmental traumas mobilize various kinds of defense mechanisms. Massive denial, dissociation, self anesthesia, identification with aggressor and aggression turned against the self often lead to profound character changes in the youngsters.
CHILDHOOD TRAUMA：RESILIENCE AND RISK FACTORS ON DEVELOPMENTAL TRAJECTORY
Kim, Young-Shin ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 13, issue 1, 2002, Pages 15~23
Knowledge regarding the resilience factors and risk factors of the childhood trauma on the developental trajectory is in its infancy due to the lack of prospective follow-up studies in the childhood trauma and limited understanding of the complex reciprocal interactions between childhood trauma, develop-ent and various aspects of children's environment. These difficulties in the conceptual framework and research methods in the childhood trauma are partly reflected in the inconsistencies, even controversies, of the results in the childhood trauma researches. Despite these difficulties, common aspects of the risk factors and resilience of the childhood trauma on the development can be identified from the previous studies. The resilience to the negative outcome on the development by childhood trauma includes：sex female before puberty, male after puberty or infancy), high socioeconomic status, no organic problem, easy temperament, no previous experience with early loss or separation, younger age at the trauma, better problem solving capacity, high self-esteem, internal locus of control, high coping skills, ability to identify interpersonal relationships, ability to play, sense of humor, having capable parents, having a warm relaionship with at least one of the parents, high education and participating in the organized religious activities. These commonalities of the results suggest that risk and resilient factors of the childhood trauma are interdependent, each factor has multiplicity in the impacts on the children's development according to the developmental stage of the child, family and children's other environment, trauma and stressor have diverse effects according to their intensity and risk and resilience factors could have synergistic or antagonistic effects to each other. To develop comprehensive understanding on the relationship between childhood trauma and developmental psychopathology, risk and resilience factors and to develop effective and efficient prevention and intervention, research on the effect of the stress on the neurodevelopment, on the individual differences of the response to the trauma including genetic factors and constitution, and on the brain plasticity should be accompanied in the future.
THERAPEUTIC APPROACH FOR CHILD AND ADOLESCENT AFTER DISASTER
Lee, Young-Sik ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 13, issue 1, 2002, Pages 24~29
The social attention about disaster psychiatry was increased after 911 terror in New York. The role of child psychiatrist and specific consideration for the treatment of child victim in disaster were reviewed. The following were main points. 1) The most single determining factor of prognosis is supporting system and parental attitude to their child victim. So family therapy and parental eucation are needed. 2) Cognitive Behavior Therapy is known to the most effective treatment in many literature. 3) Brief group therapy with fellow victim is cost effective preventive methods and screening tool for more serious victim, 4) Eye Movement Desensitization and Reprocessing(EMDR) could be a very amazing method in reducing repetative horrible traumatic image. 5) Many kinds of drug using in adult are considered with caution.
CHILD AND ADOLESCENT'S TRAUMATIC EXPERIENCES EXPRESSED IN MOVIES
Kim, Jae-Won ; Yoo, Hee-Jeong ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 13, issue 1, 2002, Pages 30~37
The authors reviewed the child and adolescent's traumatic experiences expressed in movies through late 1950s to year 2002. The movies are roughly classified by 3 categories based on the methods that used to express protagonist's experience and to uncover the meaning that is implied, that is, an important motive of growth, a metaphor of socio-political issues, or merely an event to develop a drama. Movie is a product of repetition compulsion and an activity like symbolic play between creator and spectators through screen, which enables a kind of corrective emotional experience. The curative elements in movies were also reviewed. The authors suggest the importance of mutual communications between movie creators and psychiatrists because media images about psychiatric issues can make internal stereotypes in conscious and unconscious mind of spectators.
DISASTER PSYCHIATRY IN CHILDREN & ADOLESCENTS
Lee, So-Young Irene ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 13, issue 1, 2002, Pages 38~46
Disaster psychiatry is a new emerging area of psychiatry, in which psychiatrists help to minimize psychological impact of a disaster and to reduce secondary morbidities. In our society, more children and adolescents are facing disasters nowadays. Thus, the necessity for the disaster psychiatry is increasing. After a trauma, children express various symptoms in relevance to their age, development, and their environmental support. The recovery from the disaster and its long-term effect are also influenced by those factors. Psychiatric intervention in a disaster consists mainly of crises intervention and supportive psychotherapy, which includes counseling the victims, educating and providing information to the public, providing support and consultation to the community, and referring of at-risk or severely impaired individuals for more intensive clinical evaluation and care. In addition to a summarized concept of disaster psychiatry, this article presents the adverse psychological effects of children and adolescents exposed to disaster and issues related to the psychiatric intervention.
CHILD SEXUAL ABUSE - CONCEPT, PATHOPHYSIOLOGY, PSYCHIATRIC SEQUELAE, INTERVENTION -
Kim, Boong-Nyun ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 13, issue 1, 2002, Pages 47~66
Sexual abuse is emerging as one of the major form of child abuse. In the late 1990s, official reports of sexual abuse began to mushroom at a much more rapid rate than reports of other forms of abuse in Korea. In addition, sexual abuse can cause the most serious emotional-cognitive-behavioral sequelae to victims. Although child & adolescent psychiatrists meet many sexual abuse victims who are referred from many types of child protective services, the psychiatrists may not be likely to give them sufficient and appropriate treatment and guideline for victims and their parents. In this article, the historical concepts, pathophysiological processes, shortterm & longterm sequelae of sexual abuse are reviewed and summarized. And I summarize the intervention and outcome studies for sexual abuse victims. In the close future, the active participation of psychiatrists who help the child and adolescents will be expected in the development of nationwide preventive and therapeutic projects for victims and families of sexual abuse.
CHILDREN WITH CHRONIC CONVULSIVE DISORDER AND THEIR FAMILIES
Cho, Soo-Churl ; Kim, Boong-Nyun ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 13, issue 1, 2002, Pages 67~75
Objectives：This study was conducted to investigate the degree of psychopathologies of the family members of children with chronic convulsive disorder and evaluate the structures and dynamics of those families. Methods：The participant patients and family members were recruited from the population attending the outpatient clinic of department of pediatric neurology in Seoul National University Hospital in Korea. All the patients had idiopathic chronic convulsive disorder. Any patient with mental retardation, pervasive developmental disorder and gross brain pathology was excluded. As controls, normal students were chosen and their sex, age, achievement, socioeconomic status were matched to patients. The author interviewed the children and their family members twice and obtained informations about patient-parent relationship, patient-sibling relationship and others. For in-depth evaluation, we used family environment scales(FES), symptom Checklist-90-revised(SCL-90-R), self administered dependency questionnaire for mother(SADQ). Results：After interviewing with the parents of epileptic children, overprotection of parents, hostile feeling of siblings toward index children were higher than controls. The parental conflict was also more expressed than control families. According to results from FES, the scores of the subscales of expression, achievement-orientation, intelligence-orientation and active recreation were significantly lower than control group. The epileptic children showed higher dependency to parents especially in affection, communication and traveling areas of SADQ than control group. Maternal psychopathologies evaluated by SCL-90-R were much higher than the mothers of controls. According to T scores of SCL-90-R, about 40% of mothers with epileptic children had the risk of clinically significant depressive or anxiety disorders. Conclusion：These results suggested that the family members of epileptic children had more relationship problems and psychopathologies than control group and some mothers might have clinically significant depressive or anxiety disorders. so, effective psychiatric family interventions are needed for resolution of conflict and psychopathologies of family members.
) ADMINISTRATION EFFECT ON ATTENTION AND MEMORY FUNCTION IN TEENAGE ADOLESCENTS
Kim, Byung-Hyo ; Kim, Young-Mi ; Cho, Soo-Churl ; Kim, Boong-Nyun ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 13, issue 1, 2002, Pages 76~84
Objectives：This study was conducted to investigate the effect of oxygen on attention and memory functions in healthy adolescents. Methods：The participant subjects were recruited from local advertisement. All subjects are students attending ordinary middle and high school. Their degree of achievement was average or below average. Before the study, its nature and purpose were fully explained to the patients and their parents, and a written informed consent was obtained from each child's parent and a written assent from each child for entire the procedure. The Ethics Committee and Clinical Research Committee of Gyeongsang National University Hospital approved the protocol. For baseline assessment, all subjects received tests for attention and memory. All tests were conducted by a certified psychologist. Stroop test, continuous performance test and trail making test A and B were used for evaluation of attention. As memory tests, we used memory assessment scale(MAS), standardized memory assessment tools. Ten to fourteen days after initial assessments, same tests was applied to the same subjects after prior 5 minute oxygen inhalation. Results：1) Attention test：Improved performances in trail making part B, and stroop test were found in normobaric oxygen inhalation group compared to air inhalation group. Improved reaction time in those tests seemed to reflect the enhanced executive prefrontal activity. 2) Memory test：More words and digits memorization were found in short-term memory subscale score in MAS in oxygen inhalation group compared to air inhalation group. This finding suggested the improved working memory function after oxygen inhalation. Conclusion：Though interpreted cautiously, these results suggested that normobaric oxygen inhalation could enhance executive function and working memory of prefrontal lobe. Further study, however, should be performed to investigate the mechanism of effects of oxygen on cognitive enhancement.
COMPARISON OF MEMORY FUNCTION BETWEEN ATTENTION DEFICIT/HYPERACTIVITY DISORDER AND LEARNING DISORDER CHILDREN
Kim, Yong-Hee ; Cho, Soo-Churl ; Shin, Min-Sup ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 13, issue 1, 2002, Pages 85~92
Objectives：This study was conducted to compare the memory function among the attention deficit/hyperactivity disorder(ADHD), the learning disorder(LD) and the comorbidity disorder(ADHD+LD) groups. Methods：Thirty-four children(11 ADHD, 5 LD, 9 ADHD+LD, and 8 Psychiatric control) were individually assessed using the KEDI-WISC and Memoty Assessment Scale(MAS), and then the results of those test were analyzed. Results：In memory test, all of three group showed lower performances than control group. The comorbidity, the LD and the ADHD group showed lower scores in almost subtests of MAS respectively. The good performance in memory test was significantly correlated with the types of memory strategy and error response children used during testing. Discussion：The clinical utility of the memory test like MAS was discussed in terms of differential diagnosis for ADHD, LD and ADHD+LD children.
CLINICAL EVALUATION OF CHILDREN WITH INATTENTION AND HYPERACTIVITY IN A PSYCHIATRIC CLINIC
Kweon, Yong-Sil ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 13, issue 1, 2002, Pages 93~103
The aim of this study is to examine the diagnostic profiles and related clinical variables of children with attention and hyperactivity in psychiatric outpatient clinic. Seventy one children with age range of 5 to 14 were diagnosed by DSM-IV, and assessment battery including KEDI-WISC, KPI-C, ADS(ADHD Diagnostic System) were completed. The subjects were divided into 3 diagnostic groups：ADHD only(n=17), ADHD comorbid(n=27), Other diagnosis(n=27). The results were as follows：In ADHD comorbid group, tic disorder, developmental language disorder, borderline intellectual function, oppositional defiant/conduct disorder, and learning disorder were combined in descending order. Other diagnosis group consisted of tic disorder, borderline intellectual function, depression/anxiety, oppositional defiant/conduct disorder, and others. There were significant differences in IQ, PIQ, and VIQ among the three groups, and ADHD only group showed higher scores of IQ and VIQ than ADHD comorbid group. On the KPI-C, there were no significant differences in all subscales among the three groups. On the visual ADS, omission error and sensitivity showed significant differences among the three groups, and ADHD comorbid group represented higher omission error and lower sensitivity than other diagnostic group. The findings indicated that the inattention and hyperactivity symptoms could be diagnosed into diverse psychiatric disorders in child psychiatry, and ADHD children with comorbidity will show more problems in academic performance and school adjustment.
PSYCHOSOCIAL VULNERABILITIES OF CHILD-ADOLESCENT INTERNET ADDICTS
Kim, Eun-Jung ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 13, issue 1, 2002, Pages 104~116
This study investigated the psychosocial characteristics of children and adolescents who were addicted to internet. 1107 children and adolescents were administered several self-report inventories assessing internet addiction, internet expectancy, self-control, parent-adolescent communication, parent control of internet, peer relation, and loneliness. Results indicated that internet addicted adolescents had more expectancy for internet, less self-control, more dysfunctional communication with parents, and more withdrawn from peers than non-addicted. To determine relative contributions of these variables, multiple regression was conducted. It was demonstrated that internet expectancy, self-control, dysfunctional parentadolescent communication, and parent control of internet explained adolescent internet addiction.
OBSTETRICIAN'S VIEW OF TEENAGE PREGNANCY：PRESENT STATUS, PREVENTION AND PSYCHIATRIC CONSULTATION
Kim, Eun-Young ; Kim, Boong-Nyun ; Hong, Kang-E ; Lee, Young-Sik ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 13, issue 1, 2002, Pages 117~128
Objectives：For the purpose of obtaining the more vivid present status and prevention program of teenage pregnancy, this survey was done by Obstetricians, as study subject, who manage the pregnant teenager in real clinical situation. Methods：Structured survey form about teenage pregnancy was sent to 2,800 obstetricians. That form contained frequency, characteristics, decision making processes, and psychiatric aspects of the teenage pregnancy. 349 obstetricians replied that survey form and we analysed these datas. Results：(1) The trend of teenage pregnancy was mildly increased. (2) The most common cases were unwanted pregnancy by continuing sexual relationship with boyfriends rather than by forced, accidental sexual relationship with multiple partners. (3) The most common reason of labor was loss the time of artificial abotion. (4) Problems of pregnant girls' were conduct behaviors and poor informations about contraception rather than sexual abuse or mental retardation. (5) Most obstetricians percepted the necessity of psychiatric consultation, however psychiatric consultation was rare due to parents refusal and abscense of available psychiatric facility. (6) For the prevention of teenage pregnancy, the most important thing was practical education about contraception. Conclusions：Based on the result of this study, further study using structured interview schedule with pregnant girl is needed for the detecting risk factor of teenage pregnancy and effective systematic approach to pregnant girl.
PRELIMINARY STUDY FOR ADHD TREATMENT GUIDELINE
Kim, Eun-Young ; Ra, Chul ; Lee, Young-Sik ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 13, issue 1, 2002, Pages 129~138
Objectives：In order to treatment guideline of ADHD, present clinical practise of child psychiatrists and their opinion of optimal intervention were evaluated. Methods：Structured questionnaire items about diagnostic workup, drug choice of 5 different situations according to different co-morbid disorders, and non - pharmacological treatment were applied to 32 child psychiatrists working at university and general hospital. we compared the data with Texas Algorithm Project guideline. Results：(1) Intelligence Test, Sentence Completion Test, sustained attention test, and Conner's questionnaire were the basic routine test that must be performed. (2) Main trend of medication in this study was not different from TAP guideline. (3) In case of co-morbid tic disorder, first recommending drug is still psychostimulant in the TAP guideline. But in this study initial psychostimulant prescription was not main trend. (4) In case of MPH non-response co-morbid disruptive behavior disorder, MPH medication combined with other drug were more common than switching to other drug as suggested the TAP guidelines. (5) In non-pharmacological treatment, most child psychiatrists reported the importance of parent management. Conclusion：There were some difference in medication trend in this study compared with TAP guideline. Further study and conference are needed for experts consensus in Korea.
CLINICAL AND NEUROPSYCHOLOGICAL CHARACTERISTICS OF DSM-IV SUBTYPES OF ATTENTION DEFICIT HYPERACTIVITY DISORDER
Cheung, Seung-Deuk ; Lee, Jong-Bum ; Kim, Jin-Sung ; Seo, Wan-Seok ; Bai, Dai-Seg ; Chun, Eun-Jin ; Suh, Hae-Sook ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 13, issue 1, 2002, Pages 139~152
Objectives：This study was conducted to compare the clinical and neuropsychological characteristics by DSM-IV subtypes of attention deficit hyperactivity disorder(ADHD) patients who did not have comorbid psychiatric disorders. Methods：5-15 year old children with ADHD were recruited at psychiatric outpatient clinic of Yeungnam University hospital and the patients with comorbidity or neurological abnormalities were excluded. Finally, total 404 children with ADHD were selected for this study. There were 234 subjects of ADHD-C(57.9%), 156 subjects of ADHD-I(38.6%) and 14 subjects of ADHD-HI(3.5%), who fulfilled the DSM-IV diagnostic criteria. The mean age of the total subjects was 9.63±2.49 years old. The psychopathology, IQ, behavioral problems, neuropsychological executive function were evaluated before pharmacological treatment. The measures were Korean Personality Inventory of Child(K-PIC) for psychopathology, 4 behavioral check lists(ADDES-HV, ACTeRS, CAP, SNAP) for behavioral symptoms of ADHD, K-ABC and KEDI-WISC for IQ and Conner's CPT, WCST, SST for neuropsychological executive functions. Results：1) The prevalence of subtypes was ADHD-C, ADHD-I, ADHD-HI in decreasing order. There was no sex difference of prevalence among three subtypes. The mean age of ADHD-I was older than other subtypes. 2) There was significant differences of psychopathology among subtypes, the ADHD-C and ADHD-HI had higher than the ADHD-I in the scores of delinquent, hyperactivity and psychosis；the ADHD-C had higher than the ADHD-I in the scores of family relation and autism, the scores of ego resilience were lower than the ADHD-I. However, there was no difference in anxiety, depression and somatization scores among them. 3) The results of behavioral symptom check lists, the ADHD-C had higher the score of inattention, hyperactivity and impulsivity than the ADHD-I. Meanwhile the results of ACTeRs, which rated by the teachers, were different. 4) There were significant differences of sequential processing scale and arithmetics among subtypes in IQ using K-ABC, but there was no significant difference between the ADHD-C and the ADHD-I after excluding the ADHD-HI due to small numbers. 5) There was numerical difference among subtypes but did not reach statistical significance in three neuropsychological executive function tests. Conclusion：In conclusion, our results revealed that there was significant difference in clinical features among three subtypes but, no significant difference in executive functions.
THE EFFECT OF ADHD CHILD MOTHER'S DEPRESSIVE MOOD, PARENTING STRESS, AND PARENTING RELATED ATTITUDE ON PARENTING BEHAVIOR
Choi, Yoon-Young ; Cho, Sun-Mi ; Hong, Sung-Do ; Oh, Eun-Young ; Kim, Ji-Hae ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 13, issue 1, 2002, Pages 153~162
Summary：This study was designed to examine the effect of mother's depressive mood and parenting related attitude on parenting behavior, focusing on the cases having an ADHD child. Method：A total of 82 parents, 31 parents having children with ADHD and 51 normal, were involved in this study. The children of ADHD and normal group were 6-11 years old. ADHD group were diagnosed as attention-deficit hyperactivity disorder by psychiatric doctor and psychological evaluations using DSMIV criteria and the normal group were excluded by using Diagnostic Rating Scale-Parent, Teacher Form. The mothers of both group completed a series of questionnaire about mother's depressive mood and parenting-related attitude. To investigate the relationships between each variables, Student's t-test, correlation, stepwise regression, and hierarchical regression analysis were performed. Result：In correlation analysis, Mothers with an ADHD child were likely to report more coercive parenting behavior, more negative parenting-related attitudes, and depressive mood than normal group. In regression analysis, mother's parenting stress, dysfunctional thoughts, parenting competence, and depressive mood predicted coercive parenting behavior significantly, total explaining 50% of its variance, and especially depressive mood explained 29% of their coercive parenting behavior. These Results indicated that mother's depressive mood accounted for a substantial portion of coercive parenting behavior. Conclusion：These findings suggested that it is significantly important to reduce Mother's depressive mood through dealing with parenting sense of competence and dysfunctional thoughts, so, both parent education program and cognitive-behavioral therapeutic approach are needed to change parent's coercive parenting behavior. Finally, limitation of the present study and suggestions were discussed for further studies.
A STUDY ON THE TEMPERAMENTAL CHARACTERISTICS OF KOREAN CHILDREN USING TODDLER TEMPERAMENT SCALE
Choi, Sung-Ku ; Hong, Sung-Do ; Son, Jung-Woo ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 13, issue 1, 2002, Pages 163~176
Objectives：This study was designed to investigate the temperamental characteristics and the differences of temperamental characteristics in Korean children according to the sociodemographic and family environment factors using Toddler Temperament Scale(TTS). Methods：The samples consisted of 1,175 children who were attending twenty-five Samsung Child Care Centers nationwide. Both Korean version of TTS and child developmental questionnaire(designed by the Department of Psychiatry, Samsung Medical Center) were distributed to the parents of these children. Score of 9 temperamental categories was determined using the result of TTS, and determination of 5 temperamental clusters was conducted by the Fullard's criteria. Statistical analyses were performed according to the sex, birth order, existence of siblings, residential city, residential province, marital state of child's parents, and parental relationship to compare the scores of temperamental categories and the distribution of temperamental clusters. Results：The distribution of temperamental clusters was as follows；Easy 35.8%, Intermediate Low (IL) 33.1%, Intermediate High(IH) 11.1%, Slow-To-Warm-Up 6.3%, and Difficult 13.6%. Some of 9 temperamental categories were statistically different according to the sex, birth order, existence of siblings, residential city, residental province, marital state of child's parents, and parental relationship. From the viewpoint of 5 temperamental clusters, there were statistically more Easy and less Difficult children in good relation between each parent(p=.022). In spite of no statistical significance, the children in conditions of first-born, non-existence of siblings, middle or small residential city, Chung-Cheong province, married state of parent had a tendency to be easier to care. Conclusions：The toddler temperamental characteristics of Korean children showed some differences in several sociodemographic and family environment factors. We could confirm that the 'Goodness of Fit' was very important in child temperament.
THE DIFFERENCE OF THE BEHAVIORAL PROBLEM AND MATERNAL REARING PATTERN BETWEEN ADOLESCENT PSYCHIATRIC PATIENTS IN PEER NEGLECT OR REJECT AND THOSE IN NON-NEGLECT - A PRELIMINARY STUDY -
Son, Jung-Woo ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 13, issue 1, 2002, Pages 177~188
Objectives：The major goal of this study was to investigate and compare the behavior problems and mothers' rearing pattern between adolescent psychiatric patients either neglected or rejected by peer and those who were neither neglected nor rejected by peer. Methods：Adolescent psychiatric patients(N=25) performed peer neglect scale, peer reject scale. And their mothers performed the part of Child Behavior Checklist(CBCL), Maternal Behavior Research Instrument(MBRI), the scale for the maternal concern about the social life of their own patients, and the scale for maternal concern about the friendship of their own patients. According to the score of the peer neglect scale and the peer reject scale, we divided the patients into 'peer neglect-reject' group(n=15) and ‘on-loneliness’ group(n=10), and compared the scores of other scales between each group. Also, we investigated the correlation among all scales. Results：1) The scores of the part of CBCL(p<.05), depressed/anxious subscale of CBCL(p<.05) and thought problem subscale of CBCL(p<.01) in peer neglect-reject group were significantly higher than those in non-neglect group. The score of peer neglect scale was significantly correlated with that of the part of CBCL(r=.516), depressed/anxious subscale of CBCL(r=.483), thought problem subscale of CBCL (r=.651), social problem subscale of CBCL(r=.517). And the score of peer reject scale was significantly correlated with that of attention subscale of CBCL(r=.414), thought problem subscale of CBCL(r=.446), social problem subscale of CBCL(r=.531). 2) But, each group was not significantly different on the scores of MBRI, the scale for the maternal concern about the social life of their own patients, and the scale for maternal concern about the friendship of their own patients. And there were no significant correlation between the scores of peer neglect / peer reject scale and those of scales for maternal rearing pattern. Conclusion：The thought problem and depression/anxiety problem of adolescent psychiatric patients neglected or rejected by peer were estimated more higher than those of adolescent psychiatric patients neither neglected nor rejected by peer. But, from the view of maternal rearing pattern, each 2 groups seemed not to be different. Further research using more subjects will be needed.