• Title/Summary/Keyword: 발달장애 청소년

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THE INFLUENCE OF FAMILY ENVIRONMENT AND MORAL DEVELOPMENT TO CONDUCT DISORDER IN ADOLESCENTS (청소년의 가정환경과 도덕발달단계가 행동장애에 미치는 영향)

  • Chin, Tae-Won;Kim, Sa-Jun;Lee, Heung-Pyo;Cho, Soo-Churl
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.8 no.2
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    • pp.163-174
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    • 1997
  • This study was to know the influence of familial environment and moral development on conduct disorder. Subjects were composed of 47 male and female patients with conduct disorder(patients group), 113 general male and female students(normal group), and 173 juvenile prisoners(JP group). The Korean Form of the Family Environment Scale(FES) was used to assess the family environment of the subjects and the Korean Defining Issues Test(DIT) was used to assess the moral development. Conduct disorder was diagnosed with the DSM-III-R criteria for conduct disorder. The influence of familial environment and moral development on conduct disorder was analyzed with ANOVA and the differences among groups were verified with Scheffe test. There was no difference in the socioeconomic status and the physical abuse by the parents among the three groups. But the rates of divorce or separation of the parents were significantly highest in the JP group and higher in the patients group than in the normal group. Especially the subjects of the JP group experienced the divorce or separation of their parents during the preschool or the elementary school periods. In regard to the family environment, there was no difference among the three groups in the Subscales of Expressiveness, Independence, Intellectual-cultural orientation, Moral-religious emphasis, Organization, and Control. ‘Cohesion Subscale’ was significantly higher in the normal group than in the JP group. ‘Conflict Subscale’ was significantly higher in the JP and patients groups than in the normal group. ‘Achievement orientation Subscale’ was significantly lower in the JP group than in the patients and normal groups. ‘Activerecreational orientation’ was significantly lower in the normal group than in the JP and patients groups. In gegard to the moral developmental stage, the lower moral developmental step was higher in the JP and patients groups than in the normal group. The higher steps were significantly higher in the normal group than in the JP group. There was no significant correlation between the degree of ‘Moral-religious emphasis Subscale’ and the moral development. The clinical implication and limitation of present study were listed and discussed.

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A COMPARATIVE STUDY OF PARENTAL REARING BEHAVIORS BETWEEN CONDUCT DISORDER AND NORMAL ADOLESCENTS (청소년 품행장애와 부모양육행동과의 관계에 대한 연구)

  • Kim, Kyung-Bin;Lee, Jong-Il;Jhin, Hea-Kyung
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.9 no.1
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    • pp.67-81
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    • 1998
  • 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.

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STANDARDIZATION OF WORD/NONWORD READING TEST AND LETTER-SYMBOL DISCRIMINATION TASK FOR THE DIAGNOSIS OF DEVELOPMENTAL READING DISABILITY (발달성 읽기 장애 진단을 위한 단어/비단어 읽기 검사와 글자기호감별검사의 표준화 연구)

  • Cho, Soo-Churl;Lee, Jung-Bun;Chungh, Dong-Seon;Shin, Sung-Woong
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.14 no.1
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    • pp.81-94
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    • 2003
  • Objectives:Developmental reading disorder is a condition which manifests significant developmenttal delay in reading ability or persistent errors. About 3-7% of school-age children have this condition. The purpose of the present study was to validate the diagnostic values of Word/Nonword Reading Test and Letter-Symbol Discrimination Task for the purpose of overcoming the caveats of Basic Learning Skills Test. Methods:Sixty-three reading-disordered patients(mean age 10.48 years old) and sex, age-matched 77 normal children(mean age 10.33 years old) were selected by clinical evaluation and DSM-IV criteria. Reading I and II of Basic Learning Skills Test, Word/Nonword Reading Test, and Letter-Symbol Discrimination Task were carried out to them. Word/Nonword Reading Test:One hundred usual highfrequency words and one hundred meaningless nonwords were presented to the subjects within 1.2 and 2.4 seconds, respectively. Through these results, automatized phonological processing ability and conscious letter-sound matching ability were estimated. Letter-Symbol Discrimination Task:mirror image letters which reading-disordered patients are apt to confuse were used. Reliability, concurrent validity, construct validity, and discriminant validity tests were conducted. Results:Word/Nonword Reading Test:the reliability(alpha) was 0.96, and concurrent validity with Basic Learning Skills test was 0.94. The patients with developmental reading disorders differed significantly from normal children in Word/Nonword Reading Test performances. Through discriminant analysis, 83.0% of original cases were correctly classified by this test. Letter-Symbol Discrimination Task:the reliability(alpha) was 0.86, and concurrent validity with Basic Learning Skills test was 0.86. There were significant differences in scores between the patients and normal children. Factor analysis revealed that this test were composed of saccadic mirror image processing, global accuracy, mirror image processing deficit, static image processing, global vigilance deficit, and inattention-impulsivity factors. By discriminant analysis, 87.3% of the patients and normal children were correctly classified. Conclusion:The patients with developmental reading disorders had deficits in automatized visuallexical route, morpheme-phoneme conversion mechanism, and visual information processing. These deficits were reliably and validly evaluated by Word/Nonword Reading Test and Letter-Symbol Discrimination Task.

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Clinical Significance of Auditory Brainstem Response(ABR) in Speech/Language Disorders (언어발달장애에 있어서 청성뇌간반응의 임상적 의의)

  • Oh, Ki Won;Park, Woo Saeng;Kwon, Soon Hak;Kim, Jin Kyung;Lee, Jun Hwa
    • Clinical and Experimental Pediatrics
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    • v.45 no.10
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    • pp.1199-1203
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    • 2002
  • Purpose : The study aimed to evaluate the efficacy of auditory brainstem response(ABR) as a screening tool in children with speech and language disorders. Methods : Between January 1, 1999 and December 31, 2001, 139 patients with chief complaints of speech and language delay were recruited from the pediatric neurology clinic, Kyungpook National University Hospital, Daegu, Korea. They had ABR on entry and the clinical data were then analyzed. Results : Fifteen out of 139 cases(10.8%) showed abnormal findings; seven had pervasive developmental disorders, four had developmental language disorders, and four were noted to have other conditions. Among them, seven cases were noted to have conductive hearing loss and eight had sensoryneuronal hearing loss. We also evaluated the normal values in children at the ages of 18 months to seven years. The mean latency of wave I and V were $1.40{\pm}0.13$ and $5.57{\pm}0.26$ respectively. Interpeak latency of I-V was $4.18{\pm}0.24$. Conclusion : Based on these findings, ABR has proved to be a highly sensitive and specific index of hearing impairment. It should be used as a screening tool in children with speech and language disorders.

ATTACHMENT AND PSYCHOPATHOLOGY (애착과 정신병리)

  • Choi, Jee-Eun;Ahn, Dong-Hyun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.15 no.1
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    • pp.40-60
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    • 2004
  • Introduction:Research on attachment in view point of the developmental perspective which began in the 1940s progressed during several decades. Many investigators focused mother-child separation in early attachment studies, and moved to the relationship with childhood psychopathology. Recently attachment theory and research are moving forward along the intergenerational transmission of attachment patterns, and adolescents and adult mental disorders in the developmental perspectives. Methods:We surveyed the research papers through Medline search, attachment-related monographs, and review or original papers published in Korean journal. Results:Developmental attachment researches have demonstrated convincingly that insecure attachment in infancy is associated with attachment disorder; several childhood psychopatholgy, such as institutional care and adoption, aggression and behavioral problems, childhood anxiety disorders and depressive disorders, gender identity disorder and feeding disorder, and child abuse and maltreatment; peer relationship and social competency, and parental behaviors. Recently the methodological advances including the Adult Attachment Interview that systematically assesses the adults' recollections of the earlier parent-child relationship they experienced could move beyond attachment researcher's initial concern with infancy to consider attachment processes throughout the life span. We could find that the quality of attachment was associated with several mental disorders in adolescents and adults significantly. Conclusion:Attachment theory would have focused on more specific parent-child relationship than general parental behavior. Recent attachment theory underscores its evolutionary origins to promote development of infant and contribute to human survival in psychobiological bases. Advances in attachment research could unite interests in evolutional biology and developmental psychology in understanding early parent-child relationship, and apply to clinical issues concerning mental health throughout the life span.

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Relationships Between Premonitory Urge, Tics and Comorbidities in Children and Adolescents With Chronic Tics (만성 틱장애 소아청소년의 전조충동, 틱증상 심각도, 동반질환 간의 관련성)

  • Joo-Han Kwon;Sang-Keun Chung;Jong-Chul Yang;Jong-Il Park;Ha-Min Kim;Tae Won Park
    • Korean Journal of Psychosomatic Medicine
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    • v.31 no.2
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    • pp.142-148
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    • 2023
  • Objectives : The purpose of this study is to investigate the relationships between premonitory urge, tic severity, and comorbidities in children and adolescents with chronic tic disorders. Methods : In this study, scales for tic symptoms, premonitory urge, obsessive-compulsive symptoms, and ADHD symptoms were repeatedly measured twice in 26 children and adolescents aged 10 to 18 years with chronic tic disorders. Correlations between scales were confirmed through repeated measures correlation analysis, and causal relationships between scales were confirmed through regression analysis using a linear mixed model. Results : The degree of premonitory urges showed a significant positive correlation with the severity of tic symptoms, the severity of obsessive-compulsive symptoms, and the severity of ADHD symptoms. The ADHD symptoms showed a significant positive correlation with the severity of tic symptoms. These results were the same even in children and adolescents with tic disorders who were not diagnosed with obsessive-compulsive disorder. Additionally, premonitory urges were found to have a significant positive effect on the severity of tic symptoms. Conclusions : These results may be helpful in treating tic disorders and can be used in future tic disorder research considering developmental trajectory.

A STUDY OF RELIABILITY & VALIDITY FOR THE KOREAN VERSION OF ASPERGER SYNDROME DIAGNOSTIC SCALE (한국판 아스퍼거 증후군 진단척도(The Korean version of Asperger Syndrome Diagnostic Scale : K-ASDS) 의 신뢰도 및 타당도 연구)

  • Kim, Joo-Hyun;Shin, Min-Sup
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.16 no.1
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    • pp.98-105
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    • 2005
  • Objectives : The purpose of this study was to examine the reliability and validity of the Korean version of Asperger Syndrome Diagnostic Scale as a tool to diagnose Asperger disorder. Methods : Subjects consisted of 15 Asperger disorder, 20 PDD & PDD NOS, 20 Communication disorder children who visited the department of child psychiatric outpatient clinic. The age range of the children was between 5 years 1 month and 15 years 6 month. The K-ASDS, the Korean version of Asperger disorder inventory (K-ADI), and K-CARS were administered to mothers of all children by clinical psychologists. Results The internal consistency of the ASDS was high (Chronbach's $\alpha=0.88$) and the range internal consistencies of each subscales of K-ASDS were from .83 to 66. Correlation coefficients between K-ASDS and KADI was significant. Discriminant analysis showed that the Korean version of ASDS significantly discriminate Asperger disorder from PDD and Communication disorder, and the percentage of correct classification were $71\%$. Conclusion : The results of this study proved that the Korean version of ASDS was a reliable and valid measure for Asperger disorder.

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BORDERLINE DISORDER OF CHILDHOOD : 8 CASES (아동기 경계선 장애 : 8증례)

  • Hong, Kang-E;Lee, Jeong-Seop;Shin, Min-Sup
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.6 no.1
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    • pp.3-17
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    • 1995
  • The so-called borderline children are characterised by disturbances in the sense of reality and interpersonal relationships, lack of control, fluctuation of functioning, uneven development and excessive anxiety. But the concept of borderline disorder of childhood is very difficult to define and diagnose in current classification system. The present study adapted the consensus symptoms in borderline children by Bemporad and Vera eight cases aged 7-11 were examined in 37 variables. Results are as follows 1) All subjects are boys and girl hardly be diagnosis n current diagnostic system and have many concurrent diagnoses. Common chief complaints in the sense of reality. 2) In KEDI-WISC test, the borderline children showed average intelligence, but performance IQ tends to be higher than verbal IQ. In Rorscharch test, they showed high thought disorder index, emotional instabilities and aggressive impulses. The results of TOVA suggested attentional deficit in half of the subjects. The organicity is not prominent. 3) Many of the borderline children were unwanted baby. Although primary care takers of all the subjects were their mothers there were moderate problems in caring attitude of their children and marital relationship with their husband. Sccioeconomic status was generally below middle class. Most of all subjects have delayed language development, but have overcome subsequently. Many subjects were rejected by peers because of their aggression. 4) The first visit of the subjects was about 6 years of age. Average duration of treatment was 2 years. All of them were treated in the outpatient basis except one. The effect of pharmacotherapy was doubtful and the necessity of long term play therapy was suggested. Although there were many limitations of method in present study, it was suggested that further research is needed for diagnostic criteria, epidemiology and treatment.

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TREATMENT OF REACTIVE ATTACHMENT DISORDER (반응성 애착 장애의 치료)

  • Lee, He-Len
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.15 no.2
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    • pp.132-142
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    • 2004
  • 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.

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PSYCHIATRIC CONSULTATION IN A CHILDREN'S HOSPITAL (소아병원에서의 정신과 자문)

  • Lee, Young-Sik;Hong, Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.1 no.1
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    • pp.108-116
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    • 1990
  • Child Psychiatric consultations on 92 patients hospitalized at the Seoul National Childrens Hospistal were analyzed retrospectively. The main referral sources were Pedictrics(77.2%), Neurosurgery(8.91%) and Orthopedics(3.96%) Consultation rate was 0.81% for the Hospital, 1.41% for Department of Pediatrics, 3.54% for Neurosurgery and 0.3% for the other department were made for the differential diagnosis raher than for the treatment or intervention. The diagnosis of referred patients were somatoform disorder(25%), organic mental disorder(18.5%), developmental disorder(14.1), conduct disorder(6.5%), anxiety disorder(6.5%).

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