• The Journal of Korean Academy of Sensory Integration
• /
• v.9 no.2
• /
• pp.1-13
• /
• 2011

Objective : Purpose of this study is to discuss benefits and implications of the clinical reasoning process and re-evaluation in the OTIPM by introducing a single case that occupational therapy intervention is provided based on the OTIPM. Methods : The case subject is a boy aged 5 years and 10 month who had diagnosed as attachment disorder and anxiety disorder from a pediatric psychiatrist before. The boy is referred to sensory integration therapy clinic and underwent occupational therapy intervention service twice a week for four month. Therapeutic activities for the intervention were consisted of sensory integration activities for restorative model, care-giver education for educational model, and performance skill training for acquisitional model. Measurements used in the initial evaluation are JSI-R, DDST-2, Social Maturity Test, KPPS-R, and observation-based performance task analysis. For the performance task analysis, performance skill items were constructed based on the Occupational Therapy Process Framework (OTPF), and those were assessed by the evaluation system of Assessment of Motor and Process Skill (AMPS) and Evaluation of Social Participation (ESI). Results : The detail process of implementing of the OTIPM in this study is reported by following four phases; 1) establish client-centered performance context; 2) establish baseline and interpret cause (initial evaluation); 3) intervention planning and implementing; and 4) recognize intervention outcome (reevaluation). Conclusion : In this case, occupational therapist could provide the client an occupation-based intervention within comprehensive performance context based on the OTIPM. Therapist could clearly identify the cause of problematic performance skills and behaviors and so provide effective intervention to improve client's occupational performance. Additionally, it was found that client's satisfaction of the intervention can be raised when the concept of 'who is the client' is expanded based on the OTIPM. From this study, it is proposed that OTIPM may be a model educible 'comprehensive' enhancement of 'specific' occupational engagement, as it considers both improvement of occupational performance and satisfaction.

• Journal of Preventive Medicine and Public Health
• /
• v.29 no.2 s.53
• /
• pp.239-254
• /
• 1996

Health services on industrial noisy environment have been provided only for noise-induced hearing loss management until now. But gradually, modem diseases and death have come to be related to stress and mental health deeply, therefore noise-induced mental disorder, like a stress became very important. In this point, the purpose of this study was to analyze the relationship between noise exposure level in worksite and workers' stress symptoms. This study included a survey of 786 manual workers selected from 89 worksites in 21 factories in Puchon. The results were as follows: 1. For demographic characteristics, most of the workers were males(80.8%), the $20\sim29years$ old were 34.5% and those who graduated from high school were 65.3%. The workers whose monthly income ranged from 100,000 to 800,000 won were 37.5% and who have a religion were 47.9%. 2. For occupational characteristics, workers who had worked $1\sim5$ years in the factories were 33.0%. Those who were much for them workload were 43.9% and who worked more than 8 hours a day were 73.9%. Those who were disatisfied with their job and pay were 31.9% and 50.6%. The workers who responsed ventilation condition of their worksites were bad were 51.9% and the dissatisfed with working environment of their worksites were 45.9%. 3. Workers who were suffering from tinnitus were 53.3% and those who perceived hearing loss were 50.1%. Persons who reported they always wore earplugs at work were 35.4%. Those who felt earplugs bigger than their ears were 30.6% and those who experienced eardiseases caused by earplugs were 25.6%. 4. For the noise exposure level in worksite, workers who were exposed to $80\sim90dB$ were 30.3%, $90\sim100dB$ were 26.4% and $50\sim70dB$ were 19.2%. 5. Workers' stress symptoms were significantly related to marital status and their monthly income(p<0.05). Workers who were single and had lower monthly income showed higher PSI (Psychiatric Symptom Index) scores than those who were married and had higher monthly income. Higher PSI scores were also significantly related to $1\sim2$ days hight-work per week, much for them workload, dissatisfaction with their job, and bad relationship with their bosses and coworkers. 6. Higher PSI scores were significantly related to severe tinnitus and perceived hearing losso(p<0.001). Workers who felt the earplugs they use did not fit their ears showed significantly higher PSI scores(p<0.01). Workers who reported that they did not feel they need earplugs showed. significantly higher PSI scores (p<0.05). Increased experience of eardisease caused by earplugs that did not fit were also significantly related to higher PSI scores(p<0.01). 7. The higher noise exposure level in worksite from 80dB was, the more severe stress symptoms including PSI subparts were reported; Anxiety, Anger, Depression, and Cognitive disorder(p<0.001). 5. According to the results of stepwise multiple regression analysis, factors affecting workers' PSI scores were perceived hearing loss$(R^2=0.160)$, noise exposure level in worksite$(R^2=0.110)$, realtionship with coworkers, amount of workload, monthly income and relationship with bosses orderly and the total $R^2$ of this 6 factors was 0.371. 9. The most significant factors that have impact on manual workers' stress symptoms were perceived hearing loss and noise exposure level in worksite, especially noise exposure level in the worksite was the most affective factor on the depression symptom.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.13 no.1
• /
• pp.139-152
• /
• 2002

Objectives：This study was conducted to compare the clinical and neuropsychological characteristics by DSM-IV subtypes of attention deficit hyperactivity disorder(ADHD) patients who did not have comorbid psychiatric disorders. Methods：5-15 year old children with ADHD were recruited at psychiatric outpatient clinic of Yeungnam University hospital and the patients with comorbidity or neurological abnormalities were excluded. Finally, total 404 children with ADHD were selected for this study. There were 234 subjects of ADHD-C(57.9%), 156 subjects of ADHD-I(38.6%) and 14 subjects of ADHD-HI(3.5%), who fulfilled the DSM-IV diagnostic criteria. The mean age of the total subjects was 9.63±2.49 years old. The psychopathology, IQ, behavioral problems, neuropsychological executive function were evaluated before pharmacological treatment. The measures were Korean Personality Inventory of Child(K-PIC) for psychopathology, 4 behavioral check lists(ADDES-HV, ACTeRS, CAP, SNAP) for behavioral symptoms of ADHD, K-ABC and KEDI-WISC for IQ and Conner's CPT, WCST, SST for neuropsychological executive functions. Results：1) The prevalence of subtypes was ADHD-C, ADHD-I, ADHD-HI in decreasing order. There was no sex difference of prevalence among three subtypes. The mean age of ADHD-I was older than other subtypes. 2) There was significant differences of psychopathology among subtypes, the ADHD-C and ADHD-HI had higher than the ADHD-I in the scores of delinquent, hyperactivity and psychosis；the ADHD-C had higher than the ADHD-I in the scores of family relation and autism, the scores of ego resilience were lower than the ADHD-I. However, there was no difference in anxiety, depression and somatization scores among them. 3) The results of behavioral symptom check lists, the ADHD-C had higher the score of inattention, hyperactivity and impulsivity than the ADHD-I. Meanwhile the results of ACTeRs, which rated by the teachers, were different. 4) There were significant differences of sequential processing scale and arithmetics among subtypes in IQ using K-ABC, but there was no significant difference between the ADHD-C and the ADHD-I after excluding the ADHD-HI due to small numbers. 5) There was numerical difference among subtypes but did not reach statistical significance in three neuropsychological executive function tests. Conclusion：In conclusion, our results revealed that there was significant difference in clinical features among three subtypes but, no significant difference in executive functions.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.1 no.1
• /
• pp.117-129
• /
• 1990

35 children(17 boys, 18 girls) with Recurrent Abdominal pain(RAP) without apparent organic causes, referrd from pediatric department of Seoul National University Children's Hospital were studied during 1988. 7. 1 ${\sim}$ 1989. 2. 28. The aims of this study are to examine clinical characteristics of the patients with RAP, to find possible factors influencing the onset and the course of the disorder, to evaluate the psychological status and the relationship with psychiatric diagnoses. The study subjects were compared with the age and sex matched control subjects on measures of social and school functioning, family-environment, behavior traits by CBCL and parent-environment rating scale. All patients and their mothers were interviewed by a child psychiatrist. The results were as follows ; 1) Abdominal pain was found to be more frequent when with a care taker, and related with traumatic life stresses such as separation from parents, death of family members. 2) Family members of the patients with RAP also had a high rate of a history of gastrointestinal dysfunctions with could not be attributed to organic etiologies. 3) Among 35 patients with RAP, 16 were diagnosed as psychiatric disorders. They were adjustment disorders (4), overanxious disorders (4), depression (2), tic disorders (2), attention deficit disorders (2), separation anxiety disorders (1), enuresis (1). 4) On CBCL, the patients with RAP were more internalized, socially less competent and less active compared with the control subjects. 5) According to the parent-environment rating scale, the patients with RAP had more conflicts with their parents about control issues. Family members of the patients with RAP were socially less competent and less abjustable. The parents of the patients with RAP were more affectionate and spent more time with their children but they were unfair and vague on instruction and discipline.

• Journal of Music and Human Behavior
• /
• v.4 no.2
• /
• pp.1-17
• /
• 2007

Huge growth in developmental level, new accomplishment, and The period of adolescents is not only the transition stage but also improvement of academic level. In this level of stage, adolescents have difficulties in development, so they show psychological abnormality such as stress and depression. They could develop mental disorder such as depression or anxiety if they do not overcome the abnormality. According to the situation of the insufficiency of the decent program for adolescents' mental health in the current society, we are strongly requested to develop the psycho-therapeutic program for them. Therefore, in this study, we examined the effect of the musical activities as blues music structure on the improvement of the Self-Efficacy in the female middle school students who have depressive tendencies as well as what they experienced through the activities. The 3 participants were selected out of 70 students in the first year at the "D" middle school in Seoul by being tested with Child Depression Inventory(CDI) and Self-Efficacy Scale(SES). The musical activities were built with 3 steps. Of which, the first one was the introduction to each other, the formation of rapport, and induction of their interests to the musical activities through blues. The second one was letting participants learn the blues music structure by practice and play assigned music(including improvisation) during later 5 sessions with different difficulties at each session. The third one was giving them opportunities to play a music out of the acquired ones during the session or creative music by their own, which results in maximizing musical activities and an acquired experience. As a result, first of all, the scores of CDI test of 3 participants in 10 time sessions showed slight changes, suggesting the negative correlation between CDI and SES even though changes were not big differences. Secondly, the scores of SES test of 3 subjects in 10 time sessions were all changed and especially preference for tasking was significant. Thirdly, the scores of SES for musical playing test of 3 participants in 10 time sessions were all changed and especially preference for musical tasking was significant shown. Finally, according to answers of 3 participants in 10 time sessions for the after questionnaire on musical activities, participants experienced affirmative self-confidence and positive emotion. Taken together, it was suggested that musical activities using blues music structure could be promising therapeutic intervention method.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.8 no.2
• /
• pp.232-241
• /
• 1997

The psychological problems following the experiences of school-violence could be more important than the physical problems. Victims could suffer from fear, depression, anger, lowered self-esteem, suicidal thought, and personality changes. To study the risk factors for school violence and the psychiatric problems after the experiences to school-violence provide us important informations to prevent and solve the problems of school violence. We examined clinical characteristics and psychosocial backgrounds of 13 adolescents who visited the psychiatric clinic after exposures to school violence from September, 1996 to May, 1997. The clinical data included intensity, motivations, durations, and methods of violence, psychiatric symptoms following exposure, findings of psychological test, and treatment course. The socioeconomic data included developmental characteristics of subjects, family characteristics, school life, and peer relationships. Of the 13 adolescents who experienced exposure to violence, 8 have experienced chronic psychiatric disturbances, 5 experienced transient psychiatric symptoms such as anxiety, depression, suicidal attempt who eventually returned to home and school life. Of the 8 adolescents who experienced chronic psychiatric disturbances, 4 experienced PTSD and depression lasting 3-6 months more, otherwise 4 showed converted features, such as aggressive behavioral disorder or perpetrator by strong compensatory effects after psychological shock. The subjects who have experienced chronic psychiatric disturbance have clinical characteristics such as physical or emotional abuse, physical illness or handicap, defects of ego functionings, and lack of family support. In summary, victims by school-violence manifested serious psychiatric disturbances, and they had clinically significant risk factors and some of them became perpetrators of school-violence.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.15 no.1
• /
• pp.61-74
• /
• 2004

Objectives：This study was performed to introduce a psychoeducational family therapy model for the families of schizophrenic patient and to investigate the effect of this model on the changes in coping style and depressive symptoms of the family members, and in perception of emotional support by families and depressive symptoms of patients. Methods：Nine preschool children, 3-5 years old, experiencing physical injuries caused by attack from a psychotic patient at kindergarten, were evaluated for psychological assessments；Intelligence test, MSSB(MacArthur Story-Stem Battery), H-T-P test(House-Tree-Person test). And their parents completed rating scale, KPI-C(Korean Personality Inventory for Children about children’s psychological conditions). Results：With respects to the contents and emotional reactions of MSSB, 9 preschool children showed generally high levels of anxiety, depression, avoidance, aggression, probably related to the traumatic experiences. Even though children couldn't verbally report directly about their traumatic experiences, in both MSSB, structured play narrative assessment tool, and HPT, free drawing and association test, they demonstrated psychiatric problems through reenactment plays, regardless of clinical diagnoses. Conclusion：Present study allowed us the chance to see beyond the outer pathological behaviors of PTSD in preschool children, through deeper evaluations of their mental representation. These preliminary data suggest deep understanding of internal representation would be of help for thorough evaluations and treatment plan for preschool children, experiencing severe trauma.

• Journal of agricultural medicine and community health
• /
• v.28 no.2
• /
• pp.1-14
• /
• 2003

Objectives: This paper introduces need and supply level of rural mental health care service and especially focuses on the evaluation for the community mental health programs of Public Health Centers(PHCs) in rural areas as the facilities for primary mental health care. Methods: We defined the need as prevalance rate and service utilization rate, for which reviewed the results of the epidemiological study of mental disorders using Korean Composite International Diagnostic Interview surveyed on a nationwide scale in 2001. Supply was appraised in terms of psychiatric beds and primary mental heath care facilities such as private psychiatric clinics, facilities for social rehabilitation, PHCs running community mental health programs. For this, we reveiwed a variety of annual reports related mental health published by Ministry of Health and Welfare. To evaluate the community mental health programs of PHCs in rural areas, we selected. randomly samples out of the 3rd community health plans including the contents of community mental health programs, which submitted by 89 rural counties and 44 cities mixed with rural areas, and used the program's guideline established by central government as a standard. Results: Prevalence rates of major psychiatric diseases such as schizophrenia, alcoholism, major depression, anxiety disorder were higher in rural area than in urban area and 8.9% of psychiatric patients in both areas stayed at homes contacted with mental health manpower more than one time during the last year. Psychiatric beds were sufficiently supplied, but urban area had less beds than rural area contrary to general health care service. Psychiatric clinics were supplied very insufficiently in rural areas and PHCs bridged the gap instead. However rural PHCs got less financial support for community mental health programs from higher positioned agencies than urban PHCs. Rural community health programs not supported hardly worked out. Conclusions: Central government should consider a special policy for rural primary mental health care, because private psychiatric clinics can't be introduced in rural areas due to demand-deficiency and the financial independence of rural counties was very vulnerable.

• Science of Emotion and Sensibility
• /
• v.10 no.3
• /
• pp.411-418
• /
• 2007

Exposure to low frequency noise(LFN) can lead to vibroacoustic diseases(VADs), which include a systemic disease with lesions in a broad spectrum of organs and a psychiatric condition. It is known that VAD is an established risk factor for the development of many psychological conditions in humans and rodents, including major depression and anxiety disorder. The present study investigated the effects of LFN on neuronal stress responses in the rat brain. The neuronal expression of the proto-oncogene c-fos in the paraventricular nucleus(PVN) of the hypothalamus and tyrosine hydroxylase(TH) in the LC was observed. The immunocytochemical detection of the Fos protein and TH has been used as a marker of neuronal activation in response to stress. In addition, corticosterone concentration was evaluated by using an enzyme-linked immunosorbent assay(ELISA). The LFN groups were exposed to 32.5Hz and 125Hz of noise(4hr/day for 2days). The numbers of c-fos and TH-immunoreactive cells in the PVN and LC were significantly increased in the LFN groups(32.5Hz and 125Hz) compared to the normal group. Corticosterone concentration in plasma was also increased in LFN groups. The present results demonstrated that exposure with LFN produced a pronounced increase in expression of c-Fos and TH in stress-relevant brain areas. These results suggest that the neural characteristics involved in LFN are similar to those activated by typical processive stressors. These results also suggest that the central and peripheral activations by LFN may be related to LFN-related negative behavioral dysfunctions such as VADs.

• The Journal of Korean Medicine
• /
• v.19 no.2
• /
• pp.5-16
• /
• 1998

Hwabyung is a common emotional disorder which has symptoms expressed like firt's explosion in middle-aged after long period of emotional suppression among Koreans. It is similar in its characteristics such as neurosis, anxiety, panic attacks in Western Medicine, though the treatment method was not effective. So we have done a clinical research on Oriental Medical Method, especially on Acupuncture Therapy, and obtained following results. 1. Patients with Hwabyung complained of pressure pain around the Chunjung(?中, CV-17) point distinctively. About 70% of those were located on the CV-17 point, 25% were 1cm upper than the CV-17 point and 5% of those were 1cm lower point than the CV-17 point. 2. Degrees of pressure pain were divided into 5 grades from ade 1(feeling pain with slight pressure) to grade 5(feeling no pain with severe pressure), respectively. 3. Patients with Hwabyung showed various symptoms compared to fire's explosion such as anger, chest discomfort, difficulty in breathing. tachycardia. and feeling of epigasfric mass etc., and the degrees were divided into 5 grades according to the severities from grade 1(can't keep their usual living) to grade 5(no complaints with heavy stresses), respectively. 4. For the treatment of Hwabyung in this study, we had given Acupuncture therapy on some points such as Chunjung:?中:CV-17, Jungwan:中脘:CV-12) and Chunchu:天樞:S-25, etc. for 15 minutes a time twice a week. And Bunshimkiumgmnihang(分心氣飮加味方) was administered 3 times a day. 5. About 40% of the patients took treatment for more than 2 months, 29% of those took 1 to 2 months and 31% of those took less than 1 month. In this study, we excluded those who stopped treatment within a month without any expected effects. 6. We evaluated the changes of severity of pain according to the following categories such as - for no change, + for 1 grade, ++ for 2 grades, +++ for 3 grades, and ++++ for 4 grades of improvements. Among the patients taken 1 to 2 months of treatment. 48% of the those showed +, 7% of those showed ++, 3% of those showed +++ and 41% of those showed no change. Among the patients taken less than 2 months of treatment, 20%of those showed +, 40% of those showed ++, 28% of those showed +++ and 13% of those showed no change. 7. We evaluate the changes of symptoms according to the following categories such as - for no change, + for 1 grade, ++ for 2 grades, +++ for 3 grades and +++ for 4 grades of improvements. Among the patients taken 1 to 2 months of treatment, 34% of those showed +, 14% of those showed ++ and 52% of those showed no change. Among the patients taken more than 2 months of treatment, 20% of those showed +, 43% of those showed 20% of those showed +++, 3% of those showed +++ and 15% of those showed no change. 8. When we compare the changes of pain and symptoms according to the periods of treatment, the changes in quantity of pain in 1 to 2 months group was $0.72{\pm}0.75$, in more than 2 months group was $1.83{\pm}0.98$, and the changes in quantity of symptoms in 1 to 2 months group was $0.62{\pm}0.73$, in more than 2 months group was $1.75{\pm}1.03$. According to the above results, we have concluded that more than 2 months of treatment is more beneficial than 1 to 2 months of treatment.