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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 8, Issue 2 - Dec 1997
Volume 8, Issue 1 - Jun 1997
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AN EMPIRICAL STUDY ON DREAM, DAYDREAM AND HOPE IN CHILDREN(1)：FROM DEVELOPMENTAL PERSPECTIVE
Kim, Soo-Jeong ; Shin, Min-Sup ; Nam, Min ; Hong, Kang-E ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 8, issue 1, 1997, Pages 3~21
We examined the developmental characteristics of dream, daydream, and hope of elementary school students in their 1st, 3rd, and 5th grades, and studied the correlation between three variables. We summarized the results of this study as follows. 1) The contents of dream developed with the cognitive development and socialization process. In detail, appearance of animals, family members, and known persons gradually decreased, and appearance of self, same-sex peers, and strangers gradually increased. These results are comparable with the previous studies of dream. 2) Daydream, hope, and current state also developed with age. In detail, frequency of daydream increased, and the contents of daydream and hope changed toward more self-centered and more realistic. The changes of current state are thought to reflect the specific situation of Korea. 3) There are some correlation among dream, daydream, and hope. Especially happy mood and fearful mood had positive correlation with the relevant contents of dream, daydream, and hope. Also the contents of dream showed positive correlation with the same contents of daydream. This study is the first trial which investigate the developmental characteristics of dream, daydream, and hope of normal children in Korea. We verified that dream and daydream are on the continuous line of ‘reality-imitation-play-daydream-dream’ Finally, considering the facts that dream developed with age；responded to meaningful emotional experiences；and had the correlation with daydream, hope, and current state, the results of this study support the psychological meaning of dream.
MOTHER-CHILD RELATIONSHIP OF CHILDREN WITH REACTIVE ATTACHMENT DISORDER
Shin, Yee-Jin ; Lee, Kyung-Sook ; Park, Sook-Kyung ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 8, issue 1, 1997, Pages 22~33
The objective of this study is to understand disordered parent-child relationships of Reactive Attachment Disorder(RAD) systematically through the mother’ internal working model of child. In this study, RAD mothers’internal representations of the child were compared with mothers’of control group and association between mothers’ representation classifications and children’ attachment classifications was examined. Also individual differences in mother-child interaction by mothers’representation classifications was observed. The subjects of this study were 40 2-5 year-old children and their mothers, 20 attachment disordered dyads and 20 normal dyads of control group. Mothers were interviewed using the Working Model of the Child(Zeanah, Benoit & Barton 1986) to classify internal representations of child. Children’ attachment patterns were assessed by the Strange Situation Procedure. For observation of motherchild interaction, Each dyad was seen in DPICS devised by Eyberg and Robinson(1983). The results of the study were as follows：1) Among RAD group, 55% of mothers were classified as disengaged and 45% classified as distorted, while all mothers of control group were classified as balanced. In rating scales, there were significant differences in all 3 representation classifications in Intensity of involvement and Coherence. In Intensity of involvement disengaged representations had the lowest score and distorted representations had the lowest score in Coherence. 2) Mothers’representation classifications were related to children’ attachment classifications. All mothers of control group whose children were classified as secure were classified as balanced. Among RAD’ mothers, by contrast, 82% of mothers classified as disengaged had children classified as anxious-avoidant, 56% of mothers classified as distorted had children classified as disorganized / disoriented and 33% of mothers classified as distorted had children classified as anxious-resistant. 3) There were individual differences in mother-child interactions by mothers’representation classifications. In the child-centered play, mothers classified as disengaged used discriptive statement, reflective statement and discriptive-reflective question less than balanced mothers. Mothers classified as distorted used direct command and indirect command more than balanced mothers. In the clean-up task, mothers classified as disengaged and distorted used direct command and indirect command more than balanced mothers. The results of this study suggest that parents’working model of the child is an important factor to understand parent-child attachment relationships and their interactions. The understanding of parents’ working model of the child is thought to enrich our understanding of disordered parent-child relationships and to provide useful informations for specific and successful treatments.
THE COMORBIDITY AND EMOTIONAL STATE OF THE ENURETIC CHILDREN
Lee, Kyu-Kwang ; Shin, Yun-O ; Lee, Tae-Yong ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 8, issue 1, 1997, Pages 34~42
Enuresis is repeated involuntary or intentional voiding of urine into bed or clothes over age 5. Though it would be a self-remitting disorder, it could be serious problem in emotional and socio-adaptational aspects. The author reviewed the enuretic patients of Child & Adolescence psychiatric section in Chungnam National University Hospital during past 3 years. 46(4.9%) of 936 patients were diagnosed as enuresis in DSM-Ⅳ. The author evaluated their comorbidity by the data of diagnostic review made in two psychiatrists, and emotional aspects(self-concept, anxiety, depression) through the self-rating scales (Piers-Harris children’ self concept scales, RCMAS, state-trait anxiety inventory for children, child’s depresson inventory). Thirty(65.2%) of the 46 enuretic patients had additional diagnoses such as attention deficit hyperactive disorder, mental retardation, encopresis, oppositional defiant disorder, depression, anxiety disorder, autism, somatoform disorder, tic disorder, obsessive-compulsive disorder, sleep disorder, etc. Sixteen enuretic patients had at least one comorbid disorder. Eleven patients had two, and three patients had more than three. Fourteen of 46 enuretic patients were evaluated through self-rating scales of self-concept, anxiety and depression. But we couldn’t obtain meaningful results. Maybe it was due to the small sample size(N＝14) and the influence of the comorbid disorders. Finally, it was an impressive evidence that there exist many comorbid disorders in enuresis(esp. attention deifict/hyperactive disorder). In emotional aspects, the author thought that further evaluation should be needed for more meaningful results.
RELATIONSHIP BETWEEN TEMPERAMENTAL CHARACTERISTICS AND PHYSICAL GROWTH OF CHILDREN
Choi, Seong-Goo ; Hong, Sung-Do ; Kim, S. Peter ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 8, issue 1, 1997, Pages 43~49
This study was designed to explore whether the temperament of a child influences the physical growth. The Korean version of the Parent Questionnaire for Children developed by Thomas, Chess and Korn was applied to 395 Korean children whose ages ranged from 3 years to 7 years. Simultaneously the height and the weight were measured for each child and converted into percentile scale according to the Growth Curve and the Weight Percentile Table for the Height of Korean children. Statistical analysis was performed among 9 temperamental categories, height and weight percentiles for the age and weight percentiles for the height using the first-order partial correlation analysis, controlling for the familial mean income per month. Results showed that the more temperamentally difficult a child is, the lower weight he has when compared with the children of the same age or the same height. Although there were some differences, the tendency of the above findings was maintained both in male and female children. These results show that the temperament may influence the physical growth as well as the psychological development.
A PRELIMINARY STUDY OF RELATIONSHIP AMONG TEMPERAMENTAL CHARACTERISTICS, FAMILY ENVIRONMENT AND DEVELOPMENTAL HISTORY
Hong, Sung-Do ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 8, issue 1, 1997, Pages 50~56
The objective of this study was to compare the family environment and developmental history of three groups of children classified by their temperament. The parents of 484 Korean children aged between 3 and 7 years completed the Korean version of Parental Temperamental Questionnaire developed by Thomas and Chess and Developmental Questionnaire created by Division of Child and Adolescent Psychiatry, Samsung Medical Center. After clustering these children into 5 temperamental groups according to the method proposed by Fullard et al, 98 Easy, 36 Difficult, and 21 Slow-To-Warm-Up children were included in the analysis. Statistically meaningful differences observed among three groups were as follow：1) Marital conflict of parents was more frequent in Difficult and Slow-To-Warm-Up children than in Easy children. 2) Parentchild conflict was more frequent in Difficult children than in Easy children. 3) Conflict among siblings was more frequent in Difficult children than in Easy children. 4) Average monthly income of family was less in Difficult children than in Easy children. 5) Toilet training was achieved later in Difficult children than in Easy children. 6) Motor development was slower, between 2 and 5 years old, in Slow-To-Warm-Up children than in Easy children. 7) Fear of stranger started earlier in Slow-To-Warm-Up children than in easy children. 8) Physical health was poorer in Difficult and Slow-To-Warm-Up children than in easy children. The findings indicate that Difficult child or Slow-To-Warm-Up child group have unfavorable family environment, different developmental milestone and poorer physical health in comparison with Easy child group.
THE CHARACTERISTICS OF THEIR FAMILY ENVIRONMENT AND CHARACTER TRAIT AMONG DELINQUENT ADOLESCENTS IN KOREA
Kim, Hun-Soo ; Kim, Hyun-Sil ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 8, issue 1, 1997, Pages 57~69
Objective：At the present time in Korea, for a considerable proportion of children and adolescent, delinquent behavior and violence has become as a way of life in their lives and a major social problem issue as well. The contributing factors to this problem were assumed to be the negative interaction between family environment and character of adolescent. The purpose of this study is to search the relationship between these constructs and juvenile delinquency. Method：Data were collected through questionnaire survey over a period of 2 months. Subjects served for this study consisted of 1,863 adolescents including 657 delinquent adolescents and 1,206 student adolescents in Korea, sampled from Korean student population and delinquent adolescent population confined in juvenile corrective institutions, using proportional stratified random sampling method. Their age ranged between 12 and 18 years. Data were analysed by IBM PC using SAS program. Statistical methods employed were Chi-square and principal component analysis. Results：The results of this study were as follows：Inconsistency by parental child rearing patterns tended to affect delinquent behavior among delinquent adolescents. On the other hand, adolescent students were consistently reared by their parent with democratic, flexible, trusting their children and reward-oriented attitudes. In comparison of both parents in the degree of influence on their children, it was revealed that paternal child rearing pattern was more influential on their children’s behaviors than maternal’s. The psychological instability of family, disharmonious parent-child relationships tended to be contributing to delinquent behavior among delinquent adolescents. Especially, It was an interesting finding that student’s mother is the higher employed than delinquent’s mother. However working mother was more prevalent in the student’ adolescents than in student adolescents in previous studies. The delinquent adolescents have more depressive trend, more complaints of psychosomatic symptoms, the higher degree of need frustration, the more maladaptive and antisocial personality pattern than student adolescents. Conclusion：Recently, many studies on association between family factor, character of adolescent and juvenile delinquent behavior have produced relatively consistent results. This study showed that family environment and character trait of adolescent also were linked with delinquent behavior such as smoking, drinking, runaway and physical assaults etc. The results of this survey may provide impetus for future speculation and study of correlation or reciprocal interaction between family factor, character trait of adolescent and delinquent behavior during adolescence and beyond.
CHARACTERISTICS OF UNRULY & DELINQUENT ADOLESCENTS ADMITTED TO A PSYCHIATRIC INPATIENT UNIT
Lee, Young-Sik ; Kim, Wun-Jung ; Carey, Michael ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 8, issue 1, 1997, Pages 70~82
Objective：This study was performed to identify and understand the characteristics of adolescents who had a history of police arrest and/or were adjudicated unruly/delinquent by the juvenile court. Method：The study employed a retrospective reivew of coumputer-recorded data set on 210 consecutive admissions to an adolescent psychiatric inpatient unit. Three groups(No Police Contact, N=115；Police Contact Only, N=60；Adjudicated, N=35) were compared on the areas of a) cognitive and educational performance b) emotion：anxiety, depression, suicidality c) personality d) family and life experiences. Standardized assessments were administered to all subjects using WISC-Ⅲ, Kaufman Test of Educational Achievement, Millon Adolescent Personality Inventory, Reynolds Adolescent Depression Scale, Revised-Chilren’s Manifest Anxiety Scale, Suicide Ideation Questionnarie, Suicide Behavior Interive, Life Events Checklist, and Family Environmental Scale. A subgroup of the subjects, 60 cases also received a standardized interview by Child Assessment Schedule. Results：The characteristic findings of the delinquent group(the police contact only and adjudicated subjects combined) included (1) a high rate of adoption, sexual promiscuity, out of home placement, and repeated psychiatric hospitalization, (2) low verbal IQ scores and educational achievements, (3) high impulsivity, low social conformity, and high forcefulness in personality inventory, (4) low activityrecreation orientation and low moral religious emphasis in family environment, (5)a high frequency of adverse life experiences, (6) among 3 groups, the Police Contact Only group showed the lowest depression, anxiety and suicidal ideation scores, (7) a high diagnostic frequency of conduct disorder, ODD, and ADHD. Conclusions：The adolescent psychiatric inpatients with a delinquent history presented with a certain clinical, family, psychometric characteristics that warrant specific clinical intervention strategies for their cognitive deficits, an impulsive personality style, family dysfunction with adverse life experiences and disruptive behavioral disorders, different from the rest of adolescent psychiatric inpatients.
RELATIONSHIP BETWEEN DEPRESSION/ANXIETY AND PARENTAL REARING PATTERNS IN ADOLESCENTS WITH CONDUCT DISORDER
Han, Sung-Hee ; Choe, Kyoung-Min ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 8, issue 1, 1997, Pages 83~91
Objects：This study investigated whether depression, anxiety and perceived parental rearing patterns of the conduct disorder patients are different from those of the normal control group. The correlations were also assessed between perceived parenting style and depression, anxiety, severity of conduct problems and age at onset of conduct disorder in adolescents with conduct disorder. Methods：Thirty hospitalzed patients who met the DSM-Ⅳ criteria of conduct disorder, and 30 normal control subjects completed self-report questionnaires containing the Children’s Depression Inventory(CDI), the State-Trait Anxiety Inventory for Children(STAIC) and the Parental Bonding Instrument(PBI). Results：In the conduct disorder group, the results were as follows：1) The mean scores of CDI and STAIC-T(Trait) were not significantly different from those of the control group, but STAIC-S (State) showed significantly higher scores. 2) Parenting style was perceved to be less caring and more overprotective than in the control subjects. 3) There were negative correlations between maternal care and CDI and between maternal care and severity of conduct problems. 4) There were positive correlations between maternal overprotection and STAIC-T(Trait). 5) There were no correlations between paternal rearing patterns and depression, anxiety, severity of conduct problems, or age at onset of conduct disorder. Conclusion：We failed to identify depression and anxiety as common comorbid disorders in conduct disorder. Parental rearing patterns are thought to be significantly negativistic in conduct disorder group. It is guessed that less caring and more overprotective rearing style of parents, especially of mothers, could have much influence on depression and anxiety, more severe conduct problems and earlier age at onset of conduct disorder in the adolescents with conduct disorder.
A CLINICAL STUDY ON TOURETTE'S DISORDER
Min, Sung-Kil ; Noh, Kyung S. ; Shin, Dong-Won ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 8, issue 1, 1997, Pages 92~100
Objective：The objective of this study is to examine the clinical characteristics and behavioral comorbidity of patients with Tourette’s disorder. Method：Subjects consisted of 157 patients with Tourette’ disorder diagnosed by DSM-IIIR, who were examined and diagnosed from Jan. 1988 to May 1994 at the Tourette’s Clinic of Yonsei University Medical Center. Characteristics and behavioral comorbidity of Patients were assessed by a semi-structured interview schedule. Behavioral problems like hyperactivity, obsession-compulsion, self destructiveness, enuresis, sleep problem were assessed by global clinical impression. Results：The mean age of patients was 14.49(
) years. Patients consisted of 138 males (87.9%) and 19 females(12.1%). The sex ratio was 7：1, showing a male preponderance. The number of right-handers was 133(84.7%), and the number of non-right handers was 24(15.3%). Mean age of onset was 8.85(
) years, ranging from 2-to-16 years. More than half of the patients had their age of onset at 6-10 years. Bimodal peak in age of onset was observed；the first peak was around 6 and the second peak was around 10 years. There was no sex difference in bimodal age of onset. The most common initial symptom was eye blinking. More than 55% of patients reported eye blinking as their first symptom. The second common initial symptom was head turning and the third was vocal tic. The most common symptoms that patients reported on their first visit since onset were eye blinking(82.2%), head turning or nodding(57.9%), shoulder shrugging(52.7%) and forearm movement(32.6%). Of 157 cases, 101(64.3%) patients showed downward progression of symptoms, and 25(15.9%) showed upward progression of symptoms. Nineteen fathers(12%) of patients had a past history of obsessive-compulsive disorder(OCD). Seventeen fathers(10.6%) had a history of tic disorder. SSevenmothers(4.5%) had OCD, 4 mothers (2.5%) had tic disorder. One hundred and eighteen patients(75.1%) had comorbid hyperactivity, 95 patients(60.5%) had obsession, 55 patiens(35.0%) had self destructiveness, 46 patients(29.3%) had impulsivity, and 35 patients(22.3%) had enuresis. Age of onset had a significant positive correlation with age, duration, and the global severity of obsession；and a negative correlation with the severity of hyperactivity. Hyperactivity had a significant positive correlation with impulsivity, obsession-compulsion, enuresis, and self destructiveness. Obsession-compulsion had a significant positive correlation with hyperactivity, sleep problems, and self destructiveness. Conclusion：These data suggest that clinical characteristcs and behavioral comorbidity of patients with Tourette’ disorder in this study are similar to previous research findings in Korea and other contries. The younger the age of onset was, the more severe hyperactivity was, and the less severe obsession-compulsion was. And severity of hyperactivity had a positive correlation with the severity of obsession-compulsion, impulsivity, enuresis, and self destructiveness.
A USEFULNESS OF KEDI-INDIVIDUAL BASIC LEARNING SKILLS TEST AS A DIAGNOSTIC TOOL OF LEARNING DISORDERS
Kim, Ji-Hae ; Lee, Myoung-Ju ; Hong, Sung-Do ; Kim, Seung-Tai ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 8, issue 1, 1997, Pages 101~112
The purpose of this study was to examine usefulness of KEDI-Individual Basic Learning Skills Test as a diagnostic tool of learning disorders(LD). Learning disorder group consisted of two subgroups, verbal learning disorder group(VLD, n＝34) and nonverbal learning disorder group(NVLD, n＝14). Comparison group consisted of Dysthymia Disorder subgroup(n＝11) and Normal subgroup(n＝20). Performance of intelligence test and achievement test was examined in all 4 subgroups. In KEDI-WISC, VLD subgroup revealed primary problems in vocabulary, information and verbal-auditory attention test. NVLD group revealed primary problems in almost all performance tests such as visual acuity, psycho-motor coordination speed and visual-spatial organizations ability subtest. In KEDI-Individual Basic Learning Test, VLD group revealed primary problems in phonological coding process, word recognition and mathematics. For successful classification of LD children, the importance of achievement test and intelligence test was discussed by discriminant analysis and factor analysis. The results indicate that KEDI-Individual Basic Learning Skills is of considerable usefulness in diagnosing LD, but must be used in subtests, and additional tests must be conducted for thorough exploration of LD.
MAGNETIC RESONANCE IMAGING FINDINGS OF THE BRAIN IN AUTISTIC CHILDREN
Park, Pil-Sang ; Jung, Chul-Ho ; Choi, Sang-Yong ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 8, issue 1, 1997, Pages 113~122
The purpose of this study was to examine brain structural abnormalities in autistic children. Magnetic resonance imaging(MRI) findings in 22 male children with a DSM-Ⅲ-R diagnosis of autistic disorder and 17 non-autistic male control children were investigated. The ratio measures by lineometry was used to examine the cerebrum, midbrain, cerebellum, brain stem and ventricular system. The left to right ratio of the lateral ventricle was larger in autistic children than in controls. The pons was significantly larger in autistic children than in controls, and the cerebellum was smaller in autistic children. There were no significant differences between autistic children and controls in the symmetricity of the fontral lobe, parietal lobe, occipital lobe and temporal lobe, and in the size of the midbrain and 4th ventricle. These findings suggest that autistic disorder may be related to structural impairment of the brain.
THE CURRENT TRENDS OF BRITISH MUSIC THERAPY & TWO CASE STUDIES OF AUTISTIC CHILDREN
Kim, Jin-Ah ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 8, issue 1, 1997, Pages 123~132
The purpose of this paper is to introduce the current trends of British Music Therapy and its effectiveness as a therapeutic intervention for the autistic children. This paper consists of two parts；Part one will provide a general picture of music therapy by looking at its fundamental concepts and therories. Part II(two case studies) will illustrate the actual processes of music therapy which can engender a therapeutic relationship between the therapist and the autistic child. Through the first case study of Charlie, a 3 year and 9 month non-verbal autistic boy, we shall see how music therapy facilitates both non-verbal and verbal communication and a form of pretend play. The second case of Mark, a 10 year old autistic boy with complex emotional, behavioural and learning difficulties who had been sexually abused in the past, presents how the therapist’ acceptance of the child’ being and the shared experience of music therapy enable the child to express his difficulties and to develop the awareness of self and others. By exploring both musical and interpersonal aspects of music therapy, this gives an in depth examination of therapeutic processes. In order to clarify clinical procedure, this paper is viewed in musical, developmental and psychodynamic perspectives. To ensure confidentiality, the clients will be referred to by alter-native forenames.
A CASE OF PRADER-WILLI SYNDROME TREATED WITH FLUOXETINE
Shin, Dong-Won ; Song, Dong-Ho ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 8, issue 1, 1997, Pages 133~138
Prader Willi Syndrome(PWS) was first recognized and reported by Prader-Willi. The etiology of the syndrome is not fully understood, but 50-70% of the patients show small deletion in chromosome 15. Manifested symtoms vary according to developmental age. In early life, hypotonia, areflexia, feeding difficulties, hypothermia, microgenitalia, hypoplastic scrotum, cryptochordism were observed. But in several years, hypotonia disappears, and polyphagia, decreased satiety, psychomotor retardation, obesity, hypogonadism and short stature become main problems. Behavioural problems including temper and aggressive outbursts, stealing food, hoarding food, and self excoriating skin picking, trichotillomania are more prominent during adolescence and young adulthood. Also, irritable, depressed mood are described. Lots of psychological and behavioural problems explain the reason why psychiatrists have managed and reported this syndrome. However, there has been no official report of PWS in our country. So authors report the clinical characteristics and issues in management of a patient with PWS.