• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.6 no.1
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• pp.74-89
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• 1995

Selective mutism is a childhood condition defined by persisten failure to speak in specific social situation when speaking is expected, dispite preserved ability to comprehend spoken language and speak. Present study is to investigate clinical characteristics, treatment method and outcome of 23 children who were diagnosed as selective mutism by DSM-IV criteria at the child psychiatry ouptatient department of SNUH. The results were as follows : 1) The Sex ratio was 1: 4.8, female dominant Mear age of onset was 33 years old and mean age of first referral was 7.7 years old. 2) 22% of subjects had perinatal problem such as low birth weight, preterm birth, 26% of the subjects have history of delayed language development. There are subjects who had been separated with mam caretaker before 3 years old(26%) and who experienced physical or psychological trauma before 3 years old(26%). A few subjects had enurests(30%) and encoprests(4%). 3) Many subjects(65%) had symbiotic relationship with their mother. These families consist of dominant, verbally aggressive mother and passive father. Parents of 39% of all subjects were judged to have definite psychopathology(social phobic, depression, hysterical trait or alcohol problem) 26% of all subject, were reported physically abused. 4) The personality trait of the subjects were frequently described as follows(in order of frequency) ; Shy(100%), anxious(83%), stubborn(83%)m rigid and tense posture(78%), immature(65%) overdependent(65%), irritable(52%), manipulative(39%), depressive(39%). 5) The mean performance IQ of 16 subjects by KEDI-WISC was 88.3 Among them, the subjects with IQ below 69 were seven and those with IQ above 70 were nine. When comparing these two group(Mental retardation group vs Normal IQ group), we could find some difference in language development, personality trait, family dynamics and treatment outcome. 6) Among several treatment methods for selective mutism, play therapy was the most frequently used method(65%). Other commonly used treatment methods were pharmacotherapy(21%), behavioral therapy(8%), combined therapy(play therapy+pharmacotherapy+family therapy+behavioral therapy)(12%), 7) Regarding the outcome of treatment 8.6% was evaluated as Excellent, 30.4% as Good, 52% as Fair, 8.7% as Poor at the tinic of treatment. At follow up interview 21.7% was evaluated Excellent, 13% as Good, 21.7% as Fair, 34.8% as Poor. 8) We classified all subjects by Havden's 4 subtype. Symbiotic mutism was most common(65%) and other subtypes are Speech phobic mutism(8.6), Reactive mutism(13%) and Passive-aggressive mutism(30%).

• 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.

• 한국노년학
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• v.38 no.3
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• pp.569-592
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• 2018

This study purported to investigate the current state of human rights of older adults residing in rural areas of Korea. The study utilized, as an analytic framework, 4 priority directions (1. "older persons and development", 2. "rural area development", 3. "advancing health and well-being into old age", and 4. "ensuring enabling and supportive environments") with 13 task actions recommended by Madrid International Plan of Action on Ageing (MIPAA). Furthermore, the study examined gender differences in all items included in the analytic framework. Data was collected by the face-to-face survey on 800 subjects aged 65 and over. Statistical analyses were conducted using STATA 13.0 program. The main results were summarized in order of 4 priority directions as follows. First, average working hours per day were 6.2, and men reportedly participated in economic activities and needed job training more than women, while women participated in lifelong education programs more than men. Awareness of fire and disaster prevention facilities was low in both genders. Second, accessibility to the support center for the elderly living alone as well as protective services for the vulnerable elderly was found to be low. IT-based services and networking were used more by men than women, and specifically, IT-based financial transactions and welfare services were least used. Third, medical check-ups and vaccinations were well received, while consistent treatments for chronic illnesses and long-term care services were relatively less given. In addition, accessibility to mental health service centers was considerably low. Fourth, although old house structures and the lack of convenience facilities were found to be circumstantial risk factors for these elders, experiences of receiving housing support services were scarce. The elderly were found to rely more on informal care, and concerns for their care were higher in women than men. Plus, accessibility to elderly abuse services was markedly low. Based on these results, discussed were implications for implementing policies and practical interventions to raise the levels of the human rights for this population.