• 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.

• 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.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.4 no.1
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• pp.3-26
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• 1993

Leo Kanner (1943)의 자폐증에 관한 획기적 논문발표 50주년을 맞아, 자폐증의 개념변천, 분류, 의학, 원인설 및 자폐증의 본질을 문헌고찰을 통해 살펴 보았다. 초기에 자폐증을 정신병의 아형으로 보다가 1980년 (DMS-III)을 기점으로 전반적 발달장애로의 개념 변천이 일어났다 원인설도, 초기의 심리${\cdot}$환경설은 지지 받지 못하고 1960년대에는 신경${\cdot}$생물학적 이상이 자폐병리의 기저를 이룸이 분명해 졌고 1970년대에는 지각과 운동, 감각과 인지 통합의 결함, 심각한 언어, 인지의 장해가 일차적인 결함으로 생각 되었다 최근 1980년 후반기 부터 상징적${\cdot}$표상적 인지의 결함, 타인의 감정과 생각의 이해 결함, 사회적${\cdot}$정감적 표현의 결함등 사회${\cdot}$정서발달의 이상이 자폐의 근본적 결함이라는 비교 관찰 연구가 많이 보고되어, 자폐증의 근본적이고 일차적인 결함이 정감적 접촉의 선천적 장애라는 Kanner의 놀라운 임상적 통찰을 증명해 주고 있다. 저자는 이상의 광범위한 문헌 고찰을 통해 자폐장애를 일차성 애착장애로 개념화하고 앞으로 치료, 교육의 방향도 일차적으로 사회${\cdot}$정서발달에 촛점을 두어야 하며, 특히 어머니와의 애착증진 치료가 필요함을 제안하고 있다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.3 no.1
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• pp.3-13
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• 1992

For the purpose of better understanding of RAD children, comparisons were performed about the developmental and psychopathological characteristics between RAD and PDD children. Study subjects were the children between the ages 2 and 6. who visitied SNUCH Child and Adolescent Psychiatry OPD or treated in Day Treatment Center during May, 1989 and Sep., 1991, diagnosed by the child psychiatrist as RAD or PDD according to DSM-III-R diagnostic criteria. A total of 40 children were included in the study. 20 were RAD(18 boys, 2 girls). 20 were PDD(20 boys). PEP was performed to all study subjects, by the raters blind to psychiatric diagnosis of each. And analysis was done about the level of developmental functioning score and psychopathological scores between RAD and PDD children. The results are as follows 'There were retardation on the general developmental functioning in RAD children, and the severity of retardation were lined up as perceptual ability>imitation>gross motor>cogitive language>eye-hand coordination>fine motor. Characteristics of psychopathology in RAD children were lined up by severity as language>play>relationship>affection >sensory. Group differences of the two shows on PDD group rejection score was significantly higher on the perception item. while RAD was superior on the perception emerging response. Differences of the psychopathology between two groups were on such areas as ; Affection, which was significantly higher on 'Absent' in RAD, while significantly higher on 'severe' in PDD children. On the interest for the play and materials. sensory and language areas, RAD children were significantly higher ratings on 'Absent' than PDD children.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.8 no.2
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• pp.287-297
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• 1997

Conduct disorder has been subclassified by the symptom characteristics of socialization, aggression, or age of onset. In ICD-10, ‘Conduct disorder confined to family context’ has been developed as a distinct subtype. Which delineates the conduct problems which take place only in the family and related situation. These authors experienced a case which presents a child who shows aggressive and violent behavior to his parent and brother, severe tamper tantrum and destructiveness only in family. By through history taking, observation and treatment after admission, we could find that insecure and ambivalent attachment between parent and child due to chronic neglect and abuse, and inconsistent parental behavior contribute to many behavioral and emotional problems of this child. We reviewed the relationship between conduct disorder and family pathology and treatment strategy for conduct disorder with family problems.

• Journal of the Korea Convergence Society
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• v.8 no.7
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• pp.305-313
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• 2017

The purpose of this study is to investigate the effect of the level of participation in sports for the disabled on the community attachment. The subjects of this study were 227 persons with physical disabilities in D city. The analysis method was analyzed by factor analysis, frequency analysis, independent t-test, one-way ANOVA and multiple regression analysis using SPSS 21.0 program. The results of this study are as follows: First, there is a high level of community attachment to male(sex), 40's and 50's(by age group) and 1st and 2nd grade(by disability grade). Second, in the degree of participation, the duration of exercise and duration of exercise, duration of exercise in dependency, and duration of exercise and intensity of exercise were found to have a positive effect on identity. As a result, it affected the consciousness of local community. In future research, it is necessary to study the psychological effect connected with community.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.17 no.2
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• pp.91-97
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• 2006

The effects of the Attachment Promotion Therapy (APT) program for the autistic children were reviewed by 8 papers. The program was consisted with play activity centered mother-child interaction, educational activity for parents, lecture, video-feedback, and support. APT program was effective to improve the attachment behaviors and attachment security. And the mother's behaviors to her child became more child-centered, positively responsive, expressive supportively. Ninety six point seven percent of the mothers were satisfied with the APT program. They described that it was helpful to understand their children's developmental limitation and strength, to learn how to play with their children, to make supportive social network among the mothers, to minimize familial conflicts, and to make them much more comfortable with their children. They thought the APT Program was to be a steppingstone of the further educational program. APT program is an effective early intervention to promote social development and decrease autistic problems.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.17 no.2
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• pp.79-90
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• 2006

Social deficits are the most critical and core deficits of the children with Autistic Spectrum Disorder(ASD) and they are qualitatively as well as qualitatively different from typically developing children. It is proposed that the attachment between the mother and the autistic child should be promoted foremost and early as possible, to improve social deficits, just like early social developments in normal children depend largely on interactions between the mother and the child who are attached to each other we have developed an interventional program, 'Attachment Promotion Therapy', largely based on the attachment theory. The Attachment promotion Therapy mandates the participation of both the mother and the autistic child, and consists of mutually enjoying play activities, close physical contacts and parental training on intense mother-child interactions, focusing on improving maternal sensitivity, responsiveness, and nurturing behaviors during their interactions. The program was found to be effective in improving attachment behaviors, attachment security and acquiring joint attention skills. Attachment Promotion Therapy is therefore proposed here as the important earliest intervention method for children with ASD and could become the base for many other educational and therapeutic interventions.

• Journal of Korean Academy of Nursing
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• v.30 no.5
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• pp.1133-1144
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• 2000

This study was conducted to evaluate the effects of the program for the autistic children which was designed to promote mother-child attachment. The subjects of this study were consisted of 11 pairs of mother and child( 7 for participant group:PG, 4 for non-participant group: NPG), who were diagnosed as Pervasive Developmental Disorder. The intervention was consisted with play activity centered mother-child interaction, educational activity for mothers, lecture, video-feedback, and supports. The main data were collected by video-taping and analyzed by Wilcoxon Rank Sign Test, and Content Analysis. The results obtained were as follows, 1. Before the program, there were no significant group differences on the children's and the mother's characteristics. After the program, total score on the attachment of PG was higher than that of NPG, but not significant. Only proximity-seeking behaviors and contact-maintaining behaviors were higher significantly(p<.05). Then the characteristics on contact- maintaining behaviors of PG were lasting longer and reciprocal than those of NPG. 2. After the program, the score on mother's nurturing behavior of PG was significantly more increased. The mother's behaviors to her child of PG became more child- centered, positively responsive, expressive supportively. But there were pretty big individual difference. It can be concluded that Mother-child Attachment Promotion Program is effective. Thus it can be recommended to be a early intervention model for autistic children.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.8 no.1
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• pp.22-33
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• 1997

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.