• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제28권2호
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• pp.115-122
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• 2017

Objectives: Executive dysfunctions including working memory deficit have been suggested to be one of the major neuropsychological etiologies of attention-deficit hyperactivity disorder (ADHD). The purpose of this study was to investigate the augmentative effects of working memory training on the behavioral problems, quality of life, and parental stress of medicated children with ADHD. Methods: Twenty-five children with ADHD, aged 9 to 19 years, who were being treated with ADHD medication, were included. The participants were trained with a commercially available and computerized working memory program ($Cogmed^{(R)}$) for 5 weeks without any alteration of their medication. The Child Behavior Checklist (CBCL), KIDSCREEN-52 quality of life measure, and Parenting Stress Index-Short Form (PSI-SF) were administered before training, and 4 weeks and 7 months after training, respectively. Results: After completing the training, the anxiety/depression, social problems, thought problems, attention problems, aggressive behavior, and externalizing problems scores in the CBCL were significantly reduced. The score on the Parent-child dysfunctional interaction in the PSI-SF was also decreased. However, the scores related to the quality of life were not changed. These changes were still observed 7 months after the training. Conclusion: Cogmed working memory training can be a promising training option for the additional improvement of behavioral problems and parental stress in medicated children with ADHD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제21권2호
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• pp.80-86
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• 2010

Objectives : The purpose of this study was to compare levels of parenting stress and efficacy in mothers of children suffering from attention-deficit hyperactivity disorder (ADHD) and internet addiction disorder (IAD), mothers of children with ADHD alone only, and those with normal children. Methods : Participants were composed of 25 mothers of children with ADHD and IAD, 35 mothers of children with ADHD alone, and 50 mothers of normal children. They completed the Parenting Stress Index (PSI) and Parenting Sense of Competence (PSOC). Results : In comparison with the mothers of normal children, the mothers of children with ADHD and IAD and the mothers of children with ADHD alone showed significantly higher levels of parenting stress and lower parenting efficacy. However, a comparison of mothers of children with ADHD and IAD with those of children with ADHD alone did not show any significant differences in their levels of parenting stress or efficacy. Conclusion : Mothers of children with ADHD, regardless of the presence of IAD exhibited a higher level of parenting stress and a lower level of parenting efficacy than mothers of normal children.

• Clinical and Experimental Pediatrics
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• 제51권9호
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• pp.935-943
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• 2008

Attention deficit hyperactivity disorder (ADHD) is a neurobehavioral developmental disorder characterized by a persistent pattern of inattention and/or hyperactivity, as well as forgetfulness, poor impulse control or impulsivity, and distractibility. The recommended evaluation includes documenting the type and severity of ADHD symptoms, verifying the presence of normal vision and hearing, screening for comorbid psychological conditions, reviewing the child's developmental history and school performance, and applying objective measures of cognitive function. Prevailing opinion characterizes ADHD as a disorder of executive function attributable to abnormal dopamine transmission in the frontal lobes and frontostriatal circuitry. A clearly defined etiology remains unknown, but studies suggest a strong genetic link. The aim of treatment is to decrease symptoms, enhance functionality, and improve well-being for the child and his or her close contacts. Stimulants remain the pharmacological agents of first choice for the management of ADHD, and psychosocial, behavioral and educational strategies that enhance specific behaviors may improve educational and social functioning in children with ADHD.

• 재활치료과학
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• 제6권1호
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• pp.45-54
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• 2017

목적 : 본 연구는 주의력결핍 과잉행동장애(ADHD) 아동들의 집중력 향상과 충동성 조절에 상호작용식 메트로놈(IM) 훈련이 효과가 있는지 알아보고자 한다. 연구방법 : ADHD 아동 1명을 대상으로 2016년 5월부터 7월까지 개별 실험 연구(single-subject experimental research design) 중 ABA'디자인을 적용하여 실시하였다. 총 21회기로 기초선 3회기, 중재기 15회기, 추적기 3회기를 시행하였다. 중재는 IM 훈련이었으며 매 회기마다 IM의 SFA(Short Form Assessment)와 집중력 측정과제를 수행하였다. 또한 기초선, 중재기, 추적기 때 각 한번씩 IM의 LFA(Long Form Assessment)와 자기통제력 검사(SCRS) 평가를 진행하였다. 매회기 SFA와 집중력 측정과제의 결과를 시각적 그래프로 나타내었으며 LFA와 SCRS의 값은 표로 제시하였다. 결과 : 기초선과 비교하여 IM 훈련 중재 후에 대상자의 집중력은 향상되었으며 충동성은 감소하였다. 중재가 끝나고 한 달 후인 추적기에도 그 효과가 유지되거나 향상됨을 확인 할 수 있었다. 결론 : 본 연구는 IM이 ADHD 아동의 집중력 향상과 충동성 조절에 긍정적인 영향을 미친다는 것을 확인하였고 ADHD 아동의 중재방법으로써 임상적 근거를 제공하는데 의의가 있다.

• Child Health Nursing Research
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• 제17권2호
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• pp.136-144
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• 2011

Purpose: The purpose of this study was to analyze teaching status and knowledge about children with Attention Deficit Hyperactivity Disorder (ADHD) in elementary school teachers. Methods: The participants of this study were 204 elementary school teachers in Busan. From July to September 2010, the researchers collected data by using self-report questionnaires consisted of questions about their teachers' characteristics and teaching status and KADDS (36 items) developed by Sciutto, Terjesen and Frank. Frequency, percentage, arithmetic mean, standard deviation, t-test and ANOVA were used to analyze the data using SPSS WIN 16.0 program. Results: Less than 50% of the participants had previous education on ADHD. According to this experience, there were significant differences in participants' knowledge about children with ADHD (t=4.703, p<.001). For the 36 items, participants had an average of $19.19{\pm}4.58$ points out of a possible 36. Moreover, lack of knowledge about teaching children with ADHD and communication problems with the parents of these children were considered to be the most disturbing factors. Conclusion: These results suggest that networks among teachers, parents and medical care professionals should be established. The results also indicate that educational programs for elementary school teachers should be developed in order to identify and teach children with ADHD appropriately.

• 정신신체의학
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• 제27권2호
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• pp.147-154
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• 2019

연구목적 우울증 환자들에게서는 부주의를 포함한 인지기능 저하는 흔히 동반된다. 우울증 환자들에게서 나타나는 부주의 증상은 주의력결핍/과잉행동장애(Attention Deficit/Hyperactivity Disorder, ADHD)에게서 나타나는 증상과 유사한 양상을 보인다. 부주의 증상의 원인에 따라 치료가 달라지므로 두 질환을 정확히 진단하는 것이 중요하다. 본 연구에서는 우울감을 주소로 내원한 환자들에서 ADHD 증상의 공존율과 증상 별 상관관계를 알아보고자 한다. 방 법 2015년 3월~2018년 7월까지 우울감을 주소로 순천향대학교 부속 서울병원 정신건강의학과 외래에 내원한 158명의 환자를 대상으로 하였다. 모든 대상자들은 사회인구학적 특성(연령, 성별, 학력, 직업), 한국판 역학연구센터 우울척도(The Center for epidemiological Studies-Depression Scale, CES-D), 성인 주의력결핍과잉 행동장애 자기보고척도(Adult Attention Deficit/Hyperactivity Disorder self-report scale-V 1.1, ASRS-V 1.1), 한국판 코너스 성인 ADHD 평정척도(Korean-Conners' Adult ADHD Rating Scale, K-CAARS)를 수행하였다. 우리는 우울증군과 비우울증군을 CES-D점수로 분류하였으며, 자료처리는 기술통계분석, 교차분석, t-tests, 피어슨 상관분석을 실시하였다. 결 과 성인 ADHD 증상 공존율은 우울증군에게서 36.7%로 높았다(p-value<0.001). K-CAARS에서 ADHD 증상 정도는 우울증군(Inattention=1.80, Hyperactivity=1.92, Impulsivity=1.56, Self-concept=2.06)이 비우울증군(Inattention=1.28, Hyperactivity=1.25, Impulsivity=1.09, Self-concept=1.42) 보다 높게 나타났다(p-value<0.001). 결 론 본 연구에서는 ADHD 증상이 우울군에서 공존한다는 것을 확인하였다. 우울감을 호소하는 환자의 증상을 평가할 때, ADHD 증상의 공존 여부와 ADHD 진단 가능성에 관심을 가지고 정확하게 진단하고 적절한 치료를 병행해 나가야 한다고 제안한다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제28권2호
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• pp.123-131
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• 2017

Objectives: Executive dysfunction including working memory deficit has been suggested to be one of the major neuropsychological etiologies of attention-deficit hyperactivity disorder (ADHD). The purpose of this study was to investigate the augmentative effects of Cogmed working memory training on the symptoms and neurocognitive functions in medicated children and adolescents with ADHD. Methods: Twenty-five children with ADHD, aged 7 to 19 years, taking ADHD medication participated in this study. The participants were trained for 5 weeks with a commercially available and computerized working memory program ($Cogmed^{(R)}$) without any changes to their medication. The Korean version of the ADHD Rating Scale, Clinical Global Impression Scale, and Comprehensive Attention Test were administered before training and 4 weeks and 7 months after training, respectively. Results: After completing the training, the clinical symptoms and function, rated by the parents and clinician, were improved. In addition, the level of commission errors was significantly reduced in the selective attention (visual/auditory) task, sustained attention to response task, and flanker task. The untrained visuospatial short-term memory and working memory were also improved. These effects were still observed 7 months after the training. Conclusion: Cogmed working memory training can be a promising training option for the additional improvement of the symptoms and deficits in working memory and response inhibition in medicated children with ADHD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제22권1호
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• pp.10-15
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• 2011

In this review, we have provided an overview of the environmental risk factors for attention deficit hyperactivity disorder (ADHD), focusing on the major environmental toxicants related to the disorder. Researchers have indicated that since the characteristics of ADHD are complex, the disorder’s etiology involves multiple genes of moderate effect interacting with environmental factors. The possible roles of prenatal and perinatal exposure have been the main focus of research on environmental risk factors for ADHD. Among environmental toxicants, we reviewed the potential effects on the development of ADHD of exposure to lead, nicotine, alcohol, polychlorinated biphenyls (PCBs), and dioxin. Further, for the each neurotoxicant, clinical prevention or intervention strategies aimed at reducing a child’s risk from environmental toxic insults have been presented.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제19권1호
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• pp.19-27
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• 2008

Objectives : The aim of this study was to examine the association of attention-deficit hyperactivity disorder (ADHD) in Korean populations with functional polymorphisms of six genes dopamine receptors (Ser311/Cys311 polymorphism, Taq1 A polymorphism, and Taq1 B polymorphism in DRD2, BalI polymorphism in DRD3, and promoter -521 C/T polymorphism and exon III 48 bp repeat polymorphism in DRD4) and one gene in dopamine transporter (DAT1). Methods : Participants were 58 children with ADHD and 110 control children. The genotypes were determined by PCR. Results : There was a statistically significant difference in genotype frequency of -521 C/T polymorphism within the promoter region of the DRD4 between two groups. Furthermore, in the male group, both genotype and allele frequencies showed statistically significant differences. Conclusion : Findings of the study indicate that -521 C/T polymorphism in promoter region of DRD4 appears to be a possible candidate gene for ADHD in Korean population.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제20권2호
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• pp.90-96
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• 2009

Objectives: This study examined clinical characteristics associated with bullying in children with attention-deficit/hyperactivity disorder(ADHD). Methods.: Children and their parents were asked to fill out a structured self-report form regarding bullying incidents. To evaluate the characteristics of the children, the results of the ADHD Rating Scale, the Korean version of the Child Behavior Checklist, the ADHD Diagnostic system and the Emotional Recognition Test were used. The agreement of bullying data between each child and their mother and father was measured using Cohen's kappa. The association between victim and perpetrator was analyzed by calculating a contingency coefficient based on chi-square. To compare the characteristics of victimized children and didn't, an independent sample T-test was performed. Results: When children were victims of bullying incidents there was significant agreement between children and parents on the information provided on the self-reports. However, more children reported themselves as a perpetrator of bullying than their parents did. Victimization, that is, the tendency towards being a perpetrator, is associated with the higher level of parental reports of aggressiveness. Conclusion: Victimization of bullying is associated with aggression in children with ADHD. This study suggests that victimized children with ADHD warrant careful evaluation, in particular with regard to the credence placed on parental reports of aggressiveness, and management for aggression.