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REFERENCE LINKING PLATFORM OF KOREA S&T JOURNALS
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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 15, Issue 2 - Dec 2004
Volume 15, Issue 1 - Jun 2004
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NEUROBIOLOGY OF ATTACHMENT
Hong, Hyun-Ju ; Oh, Tae-Sung ; Shin, Yee-Jin ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 15, issue 2, 2004, Pages 115~122
It is difficult to think of any behavioral process that is more intrinsically important to human beings than social attachment. Feeding, sleeping and locomotion are all necessary for survival, but humans are 'a social animal' and it is our social attachment that we live for. One of the early pioneers in this area, Harry Harlow, described the different behavioral processes that are involved in the formation of parent-infant, filial and pair(male-female) bonds. Each of these involves multi-sensory processing and complex motor responses. Over the past decades, studies in a range of vertebrates, including humans, have begun to address the neural basis of attachment at a molecular, cellular and systemic level. This review describes some of important insights from these works, involving three different areas：1) Neurobiological research of infant-parent, parent-infant attachment, 2) Animal studies regarding attachment, 3) Neurobehavioral studies of maltreatment/deprivation causing serious breakdown of attachment relationship in humans.
Noh, Kyung-Sun ; Lee, So-Hee ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 15, issue 2, 2004, Pages 123~131
We reviewed four types of Attachment intervention, 1) programs that seek to enhance sensitivity, 2) programs designed to alter parents' representations, 3) programs that provide and enhance social support, and 4) programs designed to enhance maternal mental health and well-being, and Project STEEP(Steps Toward Effective and Enjoyable Parenting). We have learned from the these studies that the emotional sensitivity and responsivity are very important factors for the development and treatment of Attachment relationships and the needs of the parents should also be addressed. Our recommendation for future attachment intervention is to design programs 1) that have the flexibility to meet participants' needs, 2) that involve other important people in the participants' lives, 3) that focus on fostering individual strengths, 4) that begin early, and 5) that are intensive and sufficiently long.
TREATMENT OF REACTIVE ATTACHMENT DISORDER
Lee, He-Len ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 15, issue 2, 2004, Pages 132~142
Most articles of Reactive Attachment Disorder reported Disinhibited Type children adopted from other countries. Reports from only Turkey and Korea focused on Inhibited Type of Reactive Attachment Disorder children whom raised by their own parents and whose symptoms are very similar to Autistic Disorder. Since articles of treatment of Reactive Attachment Disorder, especially for Inhibited Type are very rare, this article informed the author's experiences of treatment for Korean Reactive Attachment Disorder children since 1987. To treat Reactive Attachment Disorder patients and their parents, three important areas must be included : 1) to make a therapeutic environment for a Reactive Attachment Disorder child, 2) to make an attachment between Reactive Attachment Disorder child and his/her mother through individual play therapy, filial therapy, and group therapy with sibling or peer, 3) to catch up developmental delay by speech therapy, cognitive therapy and therapeutic education. This treatment methods can be more easily and more effectively applied to Korean patients than other methods from western countries including USA or England.
THE CHARACTERISTICS OF CHILD AND ADOLESCENT INPATIENTS WITH SEVERE OBSESSIVE-COMPULSIVE DISORDER
Hwang, Jun-Won ; You, So-Young ; Chang, Jun-Hwan ; Shin, Min-Sup ; Cho, Soo-Churl ; Hong, Kang-E ; Kim, Boong-Nyun ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 15, issue 2, 2004, Pages 143~151
Objectives : Child and adolescent onset obsessive compulsive disorder(C-OCD) is known to be associated with poor drug response, high comorbid rate and strong genetic tendencies. Till now studies for C-OCD have been very rare in Korea. We conducted this study to investigate the informations about clinical features, familial psychiatric loading, treatment profiles and course of server C-OCD from the retrospective analysis of inpatient data of Seoul National University Children's Hospital. Method : Retrospective chart review and data analysis was performed. Twenty(male 16 : female 4) patients with final C-OCD diagnosis by DSM-IV at discharge from 1994 to 2002 were found and their medical chart, psychological data, family interview data and nursing reports were collected and analyzed. Results : 1) The sex ratio of C-OCD was male dominant(4:1). 2) Phenomenological, most common obsession was pathologic doubt, contamination fear, followed by aggressive obsession, need for symmetry, sexual obsession, most common compulsion was checking and washing, followed by breathing, movement, symmetry, repetitive asking, hoarding, mental compulsion. 3) Most common comorbid diagnosis was depression. Other axis-I diagnosis associated OCD were anxiety disorder, tic disorder, conduct and oppositional defiant disorder and psychosis. 4) Regarding psychiatric familial loadings, 17 patients(85%) had relatives with psychiatric disorders, OC-spectrum disorders(OCD or OCPD) were found in 9 patients(45%). 5) The majority of patients(75%) have received SSRI and antipsychotics treatment. The response rate above 'moderate improved" by CGI was 75%. 6) During follow-up period in outpatient clinic, five patients(25%) showed continuous complete remission, 10 patients (50%) did residual symptoms with chronic course. Conclusion : This seems to be the first systemic investigation of severe pediatric OCD patients in Korea. The children & adolescents with severe OCD in inpatient-setting showed the high comorbid rate, familial psychiatric loading, and combined pharmacotherapy with antipsychotics, As for symptoms, high rate of aggressive-sexual obsession and atypical compulsions like breathing and moving was reported in this study. Severe pediatric OCD patients, however, responded well to the combined SSRI and antipsychotics regimen.
COGNITIVE BIASES IN INTERPRETATION, EXPECTATION AND JUDGEMENT OF SOCIALLY ANXIOUS CHILDREN
Yang, Yoon-Ran ; Oh, Kyung-Ja ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 15, issue 2, 2004, Pages 152~159
Objective : The present study investigated the interpretation bias and expectation and judgemental bias of performance in socially anxious children. Method : Children with high social anxiety (n=18) and low social anxiety (n=16) were recruited through self-report and peer nomination, Participants performed three tasks to assess for cognitive bias. The first task measured interpretation of ambiguous social situations. The second task measured expectations regarding performance in a three minute impromptu speech. The third task assessed for judgemental bias via comparison between post-speech self rating and observer rating. Result : Children with high social anxiety did not differ significantly from low social anxiety children on the dependent measures assessing bias in interpretation, expectation and judgement. However, a significant difference was found in the judges' rating of children's performances on the speech task, with high social anxiety children obtaining significantly lower scores compared to low social anxiety children. Conclusion : The role of cognitive biases in the development and maintenance of social anxiety in children was discussed.
COMPLIANCE STUDY OF METHYLPHENIDATE IR IN THE TREATMENT OF ADHD
Hwang, Jun-Wan ; Cho, Soo-Churl ; Kim, Boong-Nyun ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 15, issue 2, 2004, Pages 160~167
Objectives : There have been very few studies on the compliance of methylphenidate-immediate releasing form(MPH-IR), which is the most frequently used drug in Korea, in Attention Deficit Hyperactivity Disorder(ADHD). This study was conducted to investigate the compliance rate and the related factors in the one year pharmacotherapy process via OPD for children with ADHD. Method : Total 100 ADHD patients were selected randomly among patients who have been treated with MPH-IR from September in 2002 to December in 2002. All the selected patients were diagnosed with DSM-IV-ADHD criteria and fulfilled the inclusion criteria. In March, 2003(at the time of 6 month treatment), all the patients and parents received the questionnaire for the compliance and satisfaction for MPH-IR treatment. In October 2003(at time of 1 year treatment), we, investigators evaluated the socio-demographic variables, developmental data, medical data, family data, comorbid disorders, treatment variables, and compliance rate. Through these very comprehensive data, The compliance rate at the time of mean 1 year treatment and the related factors were investigated. Result : 1) In the questionnaire for compliance and satisfaction for MPND treatment, the 60% of respondents(parents) reported more than moderate degree of satisfaction in the effectiveness of MPND. Their compliance rate for the morning prescription was 81%, but the rate of afternoon prescription was 43%. 2) In the evaluation at the time of 1 year treatment(October 2003), the 38% of parents were dropped out from the OPD treatment. The mean compliance rate for the 1 year treatment was 62%. the 38% of parents were dropped out from the OPD treatment. The mean compliance rate for the 1year treatment was 62%. 3) Compared with the noncompliant group(drop-out group), compliant group showed higher total, verbal and performance IQ scores. In the treatment variables, higher reposponder rate(clinician rating), higher medication dosage and more compliance rate in afternoon prescription were found in the compliant group compared with the noncompliant group. There were no statistical differences in the demographic variables(age, sex, SES, parental education level), medical data, developmental profiles and academic function. Conclusion : To our knowledge, this is the first report about the compliance rate of the MPH-IR treatment for the children with ADHD. The compliance rate at the time of mean 1year treatment was 62%, which was comparable with other studies performed in foreign countries, especially States. In this study, the compliance related factors were IQ score, clinical treatment response, dosage of MPH-IR, and early compliance for the afternoon prescription. These results suggest that clinician plan the strategies for the promotion of the early compliance for the after prescription and enhancement of overall treatment response.
DEVELOPMENT OF KOREAN ADOLESCENT FORM OF SUICIDAL IDEATION QUESTIONNAIRE
Suh, Dong-Soo ; Yang, Suk-Hoon ; Lee, Kil-Hong ; Lee, Young-Sik ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 15, issue 2, 2004, Pages 168~177
Objectives : This study was done to develop Korean form of Reynolds' SIQ-JR(Suicidal Ideational Questionnaire-Junior). Through this study we evaluated reliability and validity of Korean form SIQ-JR. Methods : Subjects were 1,160 middle and high school students and 114 adolescent psychiatric patients. SIQ-JR and 8 self-reporting scales highly related with suicidal ideation and suicide behaviors were applied to them. Results : In reliability aspect of Korean form of SIQ-JR, internal consistency, test-retest reliability and item-total correlation were statistically significant results. In factor analysis, concerning about other person was extracted as a indepenedent factor. This results reflect our cultural characteristics. There were statistical differences of SIQ-JR scores in groups by sex and age. Clinical group showed significantly(P<0.01) higher scores than general population. Among the 8 suicidal relating scales, depression(r=0.42), aggression(r=0.36), trait anxiety(r=0.35), and anger-in(r=0.31) were highly related with suicidal ideation but impulsivity and hopelessness were not significantly related with suicidal ideation. Conclusion : Korean form of SIQ-JR was useful instrument in reliability and validity. We hope that this instrument widely used in school mental health, community psychiatry and clinical setting for screening tool.
ASSOCIATION BETWEEN TOURETTE DISORDER AND CATECHOL-O-METHYL TRANSFERASE(COMT) GENE IN KOREAN SUBJECTS
Kim, Boong-Nyun ; Lim, Jae-In ; Cho, Soo-Churl ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 15, issue 2, 2004, Pages 178~184
Objectives : This study was conducted to investigate the association of the COMT polymorphism with the TD in Korean sample of families with TD probands. The relationship between risk alleles and specific clinical features (tic severity, comorbidity, drug response) was also explored. Method : Patients were recruited from the Tic Disorder clinic at the Child & Adolescent Psychiatric Division of Seoul National University Hospital and assessed through 2 stage evaluation. Firstly, all the patients and parents received semistructured interview using Korean version of K-SADS-PL. Secondly all the patients received clinical interview and tic severity assessment with Korean version of YGTSS. The subjects in control group were recruited from the health promotion center in out hospital and were evaluated by SCL-90 and SCID-IV. Through these process, total of 42 children and adolescents with TD, their 84 parents and 86 control subjects were finally recruited. Genotyping for The Val158Met polymorphism of the COMT gene was done by standardized method. After collection of genetic data of all the patients, parents and control subjects, case-control comparison and tranmission dysequilibrium test was executed by SPSS version 11. Result : From the case-control comparison, the frequency of L-allele and LL genotype was significantly higher in TD group. However, no differences were found from the TDT. No significant differences were found in in family history of tic, ADHD, OCD, drug response and comorbid conditions among the three different genotypes in patients with TD. Conclusion : Though this study results should be interpreted cautiously due to small sample size and negative finding in TDT test, this study is the first report that there is positive association between the functional polymorphism of COMT gene the TD.