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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 9, Issue 2 - Dec 1998
Volume 9, Issue 1 - Jun 1998
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PARENT-ADOLESCENT AGREEMENT IN THE ASSESSMENT OF BEHAVIOR PROBLEMS OF ADOLESCENTS：COMPARISON OF FACTOR STRUCTURES OF K-CBCL AND YSR
Ha, Eun-Hye ; Lee, Soo-Jung ; Oh, Kyung-Ja ; Hong, Kang-E ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 9, issue 1, 1998, Pages 3~12
The present study compared the self report and parental report on the behavior problems of adolescents as a way to explore similarities and differences in the ways that adolescents and their parents conceptualize behavior problems of adolescents. Specifically, K-CBCL and YSR data from 3271 adolescents between the ages of 12 and 17 were subjected to factor analyses. Five factors；Depression/Anxiety/Withdrawal, Aggressiveness, Somatic Symptom, Disruptiveness, Attention Getting were obtained from the YSR data with the first factor, Depression/Anxiety/Withdrawal explaining 14.23% of the total variance. K-CBCL data yielded somewhat different factor structure with Aggression/Delinquency as the first factor explaining 14.08% of the total variance, followed by Somatic Symptoms, Social Withdrawal, Disruptiveness, and Depression/Anxiety. Total K-CBCL and YSR score showed a moderate correlation(r=.51), and correlation between pairs of comparable K-CBCL and YSR factor scores were also moderate. Regression analyses of the variables contributing to the total problem score of the K-CBCL and YSR suggested that social competence and academic achievement are two important sources of influence on the evaluation of behavior problems both in self-report and parental report. However, externalizing problems such as aggressiveness/delinquency appeared to be more salient for parents, while adolescents themselves appeared to be more concerned with internalizing problems such as depression/anxiety. Implications of these subtle differences for assessment of adolescent behavior problems were discussed.
PSYCHOPATHOLOGY IN ADOLESCENTS WITH PARENT ABUSE
Kwak, Young-Sook ; Bang, Hyun-Soog ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 9, issue 1, 1998, Pages 13~25
Aim：We think that the most important etiology in parent abuse is the psychodynamic and psychopathology in the family. So, we investigated the adolescents being admitted in SNMH, whose chief complaints were parent abuse. We were trying to explore families psychodynamic and psychopathology, especially mother-child interaction and to differentiate them in according to developmental psychopathology. Method：Our objects were the adolescent patients admitted in SNMH from 1987 to 1997 because they attacked parents verbally and physically. We examined 21 adolescents except those with psychosis, organic mental disorder, autism and mental retardation by means of interview or chart review. Result and Conclusion：The number of male patients was 14 and the number of female patients was 7. The most common diagnosis was conduct disorder and borderline personality disorder. The mean age was in the mid-teens. We observed 4 subgroups that were divided developmentally in object relation. 1) Symbiotic group with mother：(1) They did not separate and remain in symbiotic relationships with their mothers based on insecure attachment. Fathers were abscent emotionally and physically, and their mothers were prominent in close relationships with the patients in their family , where as the patients were the only man in the family. Adolescents entered the second separation-individuation. They expressed anger and internal tension involved with the close attachment with their mothers and also attempted separation from their mothers through physically attacking them. (2) These patients had suffered from physical illness and developmental delay since birth. Therefore the parents overprotected their children. The children had persistent infantile omnipotence and fantasies of power, so they could not deal with unrealistic states, adapt to reality, and depended on their parents overtly. They easily acted out unless their demands were fulfilled. 2) Borderline personality disorder：We observed deficiencies in care taking. Their parents had personality problems and immaturity. They coulden’t help their children to be separated in the rapproachment phase. Their conflict about dependence-independence was revived in the second separation-individuation adolescent period. We understand parent abuse as an attempt to overcome the conflict. 3) Conduct disorder：They did not build up basic attachment with their parents. They think of their parents as only a means of fulfilling their needs. When patients’ need were not fulfilled and remained in a conflicted state, they attacked their parents, unable to control their aggressions and impulses.
ATTENTION-DEFICIT HYPERACTIVITY SYMPTOMS IN CHILDHOOD OF ADULT BIPOLAR DISORDER/SCHIZOPHRENIA PATIENTS
Lee, Kye-Seong ; Shin, Jong-Ho ; Ahn, Joung-Sook ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 9, issue 1, 1998, Pages 26~33
Object：The authors compared the attention-deficit hyperactivity(ADH) symptoms in childhood of adult male patients with bipolar disorder, schizophrenia and normal control subjects and attempted to find out whether attention-deficit hyperactivity disorder and bipolar disorder are related each other. Method：The authors compared ADH symptoms in childhood assessed with Wender Utah Rating Scale(WURS), selected 25 items of WURS(WURS-25), and Parent Rating Scale(PRS), and compared them between 26 bipolar, 29 schizophrenic, and 27 normal control subjects. Result：The subjects with bipolar disorder had significantly higher mean score of WURS compared with normal control group(One-way ANOVA, duncan test, WURS：DF=2, F=3.77 p=0.027), and the differences between the mean scores of WURS-25 and PRS of bipolar subjects and the other two groups were also highly significant(One-way ANOVA, Duncan test, WURS-25：DF=2, F=4.24 p=0.0178, PRS：DF=2, F=13.97 p<0.001). The mean scores of WURS, WURS-25, and PRS of schizophrenic subjects were higher than those of normal control group, though not significant. WURS and PRS were correlated for subjects with bipolar disorder(r=0.7495) and the normal control(r=0.5305), and there was no correlation for schizophrenic subjects. Conclusion：The ADH symptoms in childhood were much more evident for adult bipolar subjects than schizophrenic and normal control subjects. And these results are very suggestive that there might be some relationship between bipolar disorder and attention-deficit hyperactivity disorder and these two disorders might have a shared common pathophysiology which needs further study.
A PRELIMINARY STUDY ON THE DEVELOPMENT OF 'PATERNAL PARENTING INVENTORY'
Lee, Jong-Il ; Yoon, Chang-Young ; Song, Su-Kil ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 9, issue 1, 1998, Pages 34~46
This study was designed to develop the scale of paternal parenting attitudes which has become an area of interest in child fostering study recently. Considering various factors extracted from previous Korean and foreign studies, the authors constructed a questionnaire composed of total 57 questions. It was applied to 126 mothers from families with no psychiatric patient in Seoul and Pusan who had at least onechild older than age 12 by random sampling. Then the authors extracted the factors which were able to compose the scale and evaluated the concurrent reliability. Also the authors selected mothers of 47 schizophrenic patients and 29 bipolar I patients diagnosed with the criteria of DSM-IV who have treated in Seoul National Mental Hospital and 46 controls which consisted of randomly selected mothers from normal families for the discriminative validity test. The results were as follows. The authors extracted 5 subscales of active participation, democratic guidance, warmth, hostility, devotion for education and Cronbach’s
value of each subscale which shows its internal consistency was .82, .78, .65, .78, .61 respectively. In the discriminative validity test, all subscales except ‘devotion for education’ subscale significantly discriminated between fathers of schizophrenics and control group. Furthermore ‘active participation’ subscale and ‘warmth’ subscale showed significant difference between fathers of control group and resting both father group of schizophrenics and biopolar I patients.
TREATMENT OF ECHOLALIA IN CHILDREN WITH AUTISM
Chung, Bo-In ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 9, issue 1, 1998, Pages 47~53
The purpose of this study was to investigate the possibility of providing familiar tasks as a treatment option to decrease echolalia. Two comparisons were made：One was to compare ‘conversation condition’ and ‘task performance condition.’ and the other was to compare ‘task performance alone condition’ and ‘task performance along with contingency of reinforcement condition.’ Two echolalic children aged 12 and 13 years participated in the experiment and A-B-A-B-BC-B-BC design was used, in which A was conversation only, B was task performance, and C was task performance along with contingency of reinforcement. In the A condition, the therapist asked easy and short questions to the child；in the B condition the child was given familiar tasks with short instruction, and in BC condition, each child was reinforced for his performance on given tasks, in which immediate echolalia was controlled through his hands being held down for 5 seconds. Delayed echolalia was recorded without any intervention being given. Each child was put into each of the 7 treatment conditions. With a 15 minutes session, each child went through 5 to 6 sessions per day for 2 weeks. The mean echolalia(immediate) rates across the 7 treatment conditions were：For child 1, A(99%)-B(65%)-A(95%)-B(10%)-BC(7%)-B(6%)- BC(7%) and for child 2, A(67%)-B(62%)-A(63%)-B(35%)-BC(8%)-B(4%)-BC(0%). As to the generalization of the treatment effect of immediate echolalia to the untreated delayed echolalia, there was shown a drastic reduction of delayed echolalia in child 2：A(35%)-B(57%)-A(56%)-B(40%)-BC(8%)-B(5%)-BC(9%). Child l’s delayed echolalia was negligible(mean=3%) pre-and post treatments. In conclusion, the results of this study clearly show that providing a task performance setting with familiar tasks can certainly be helpful for minimizing echolalic response, and along with the use of the contingency of reinforcement technique it can further not only correct echolalic behavior to a negligible degree but also help the echolalic child generalize its treatment effect to the child’ overall language improvement.
IMPACT OF PARENTAL PSYCHIATRIC DISORDER ON OFFSPRING'S DEPRESSION, ANXIETY, SELF CONCEPT AND PERCEPTION OF FAMILIAL RELATIONSHIP
Lee, Jung-Bum ; Cho, Soo-Churl ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 9, issue 1, 1998, Pages 54~66
Objectives：This study was to investigate the impact of parental psychiatric disorder on offspring's depression, anxiety, self concept, perception of familial relationship compared with offspring of normal control. In offsprings of parents with psychiatric disorder, this study explored whether their psychopathology, self concept, and perception of familial relationship were influenced by parent’s sex, onset time of parent’s psychiatric disorder and parent’s psychiatric diagnosis. Methods：52 offsprings aged 10-18 years of 39 psychiatric outpatient were surveyed from June, 1997 to April, 1998 and completed several questionnaaire, including Korean from of the Family Environment Scale, Korean form of the State-Trait Anxiety Inventory for Children, Korean form of Kovac’s Children’s Depression Inventory, and Korean form of Piers-Harris Children’s Self-Concept Scale. Their score was compared with offsprings’ of normals. In offsprings of parents with psychiatric disorder, they were compared according to parent’s sex, onset time of parent's psychiatric disorder and parent’s psychiatric diagnosis. Results：The results were as follows：1) Offsprings of parents with psychiatric disorder reported higher level of state anxiety and lower level of the FES expressive subscale than offsprings of normals(p<0.05). But they reported higher level of PHCSCS intellectual & school status subscale and popularity subscale than normals(p<0.05). 2) There were no differences in anxiety, depression, self concept, and perception of familial relationship between patient’s sex. 3) Offsprings less than 3 years old when parent’s psychiatric disorder had developed showed higher level of trait anxiety and lower level of FES control subscale than offsprings more than 3 years old (p<0.05). 4) There were no diferences in anxiety, depression, self concept, and perception of familial relationship between patient’ diagnostic groups(schizophrenia spectrum disorder-mood disoderneurosis). Conclusion：The finding indicated that self reported scale of anxiety and depression showed no significant difference between offsprings of psychiatric patients and offsprings of normals. In offsprings of parents with psychiatric disorder, parent’s sex and psychiatiric diagnosis had no influence on offspring’s psychopathology. But the offspring’s age(before 3 years old) when the parent’s psychiatriric disorder developed had influence on higher level of offspring’s trait anxiety. For further high risk group study, direct interview and evaluation of parent-child agreement or teacher-child agreement will be needed in longitudinal study.
A COMPARATIVE STUDY OF PARENTAL REARING BEHAVIORS BETWEEN CONDUCT DISORDER AND NORMAL ADOLESCENTS
Kim, Kyung-Bin ; Lee, Jong-Il ; Jhin, Hea-Kyung ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 9, issue 1, 1998, Pages 67~81
Objective：There is increasing interest in the developmental relationship of parental psychopathology and parenting behavior and conduct disorder in adolescence. The object of this study is to investigate the role of parental rearing behaviors in influencing conduct disorder in adolescence comparing with normal adolescents. Methods：The author assessed 52 conduct disorder who met the DSM-Ⅳ criteria, and 144 normal control subjects using self-report questionnaires, 'The Parental Rearing Behavior Scale'. Results：The results of study were as follows：1) There is significant correlation between the conduct disorder group and the control group in the father’s anxious emotion subscale, not mother’s. 2) There is no significant correlation between the conduct Disorder group and the control group in other subscales such as affection, hostility, rational guideline and consistent limitation subscales. Conclusion：The results suggest that father’s psychopathology including overanxious parenting style will predispose a risk factor for conduct disorder than mother’s psychopathology.
TEACHERS' PERCEPTIONS OF MENTAL HEALTH PROBLEMS IN STUDENTS AND PSYCHIATRIC CONSULTATIONS
Kwak, Young-Sook ; Chun, Ja-Sung ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 9, issue 1, 1998, Pages 82~90
This study is attempted to examine Korean teachers’ perceptions of mental health problems in students and their attitudes towards psychiatric consultations through a questionnaire survey. The results of this study are as follows. 1) Teachers thought that 5.3% of their students had mental health problems, 1.9% of students required psychiatric evaluation, and 1.2% of students were referred or recommended psychiatric evaluation by their teachers. 2) The most frequent mental health problems in students discovered by teachers were distractibility and inattention, lack of academic skills, and language difficulties in elementary schools；distractibility and inattention, conduct problems, and lack of academic skills in middle schools；and conduct problems, distractibility and inattention, physical symptoms, and substance abuse in high schools. 3) Teachers thought the mental health problems in students were caused by the family environment, psychological factors, the educational system, and a lack of mental health services. 4) Teachers desired smaller classes, improvement of the school environment, more time, regular mental health education, a special program for students with mental health problems, and the counseling staffs or consultants for the school mental health. 5) Teachers consulted with other teachers, the parents of the students, the counseling teachers, the health care teachers, the counseling institutes, the psychiatric clinics, and the principals in descending order to handle the hard case problems. The frequent reasons for failing in psychiatric consultations were the prejudice of parents against psychiatric services, the teachers’ sense of superiority in dealing with the problems of students, the prejudice of teachers themselves against psychiatric practice, and inaccessible professional consultation. 6) About 20.4% of teachers reported they had proposed psychiatric consultations or had recommended their students to receive psychiatric evaluations.
RELIABILITY TESTING OF EATING ATTITUDE TEST FOR KOREAN ADOLESCENTS
Choi, Joon-Ho ; Nam, Jung-Hyun ; Cho, Yun-Gyoo ; Choi, Bo-Yeul ; Ahn, Dong-Hyun ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 9, issue 1, 1998, Pages 91~97
Objectives：This study was designed for testing of Eating Attitude Test for Korean adolescents (EAT-26KA) on internal reliability and test-retest reliability and evaluation of each items through factor analysis. Methods：Total 1,160 middle and high school students were surveyed on June 1996. The questionnaire had been delivered by school teachers two weeks earlier before survey started. Among the 1,160 students, 114 students were selected by random. And then they were retested with same questionnaire on July 1996, four weeks later Result：Internal consistency of EAT-26KA was relatively good(Cronbach’s
=.83). There was statistically significance on test-retest reliability(r=.63 p<.01). But two items showed negative correlations(item No. 9, 17). and 5 items had low level correlation(p>.05, item No. 2, 6, 12, 21, 24). We performed factor analysis on whole items except No. 25 item. Result of factor analysis showed that the factor structure of EAT-26KA were different from that of EAT-26. Conclusion：The EAT-26KA is useful for the survey of the eating behavior and problems in Korean adolescents.
A CASE OF TREATMENT-RESISTANT CHILDHOOD-ONSET SCHIZOPHRENIA WITH LONG-TERM TRIAL OF CLOZAPINE
Jang, Soon-Ah ; Kim, Kyung-Hee ; Lee, Hong-Shick ; Song, Dong-Ho ;
Journal of the Korean Academy of Child and Adolescent Psychiatry, volume 9, issue 1, 1998, Pages 98~104
A 12-year-old girl with a 6 year history of childhood-onset schizophrenia required 2 hospitalizations and long-term clozapine trial due to inadequate responses to combinations of typical neuroleptics and traditional treatments of schizophrenic disorder. On admission, she had continuous auditory and visual hallucinations, persecutory delusion, emotional instability, regression of behaviors including temper tantrums as well as specific developmental delays in learning, language, and motor coordination. The clozapine trial significantly reduced most of the positive symptoms, and facilitated in successful discharge from the hospital. During the 4 year clozapine treatment, no significant adverse reactions were noted, and she returned to a structured school setting with minimal degrees of schizophrenic symptoms. From this clinical experience, we suggest that clozapine might be safe and effective in treating treatment-refractory schizophrenic children.