• Genes and Genomics
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• v.40 no.12
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• pp.1309-1317
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• 2018

It is well known that dopaminergic genes affect the development of attention deficit hyperactivity disorder (ADHD) in various populations. Many studies have shown that variable number tandem repeats (VNTRs) located within the 3′-untranslated region of DAT1 and in exon 3 of DRD4 are associated with ADHD development; however, these results were inconsistent. Therefore, we investigated the genetic association between two VNTRs and ADHD in Korean children. We determined the VNTRs using PCR. We examined genotype and allele frequency differences between the experimental and control groups, along with the odds ratios, using Chi square and exact tests. We observed a significant association between the children with ADHD and the control group in the 10R/10R genotype of DAT1 VNTRs (p=0.025). In addition, the 11R allele of DAT1 VNTRs showed a higher frequency in the control group than in the ADHD group (p=0.023). Also, the short repeat (without 11R) and long repeat alleles (including 11R) were associated with ADHD (p<0.05). The analysis of DRD4 VNTRs revealed that the 2R allele is associated with ADHD (p=0.025). A significant result was also observed in long and short repeats (p<0.05). Additionally, ADHD subtypes showed that the DRD4 VNTRs are associated with combined and hyperactive-impulsive subtype groups (p<0.05). Therefore, our results suggest that DAT1 VNTRs and DRD4 VNTRs play a role in the genetic etiology of ADHD in Korean children.

• Journal of Digital Convergence
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• v.17 no.8
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• pp.1-13
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• 2019

This study examined the effect of digital technologies on adolescent mental health; attention deficit, aggression, depression. Furthermore, we investigated the role of parenting style and peer attachment as they might have effects on digital technologies. Using two-wave longitudinal data, we conducted longitudinal analysis from the Korean Children and Youth Panel Survey done in 2015 and 2016. Results showed that computer and internet usage for learning purpose has a positive effect on mental health, while computer games and social media have negative effects. Also, the positive effects of learning on depression indicated stronger in adolescents who felt less affection from their parents. On the other hand, the negative effects of computer games and social media could be moderated by both parenting style and peer attachment. Implications of these results and directions for future research are discussed.

• Journal of Digital Convergence
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• v.17 no.10
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• pp.497-507
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• 2019

The purpose of this study was to examine the effects of music intervention programs for children with ADHD in Korea through systematic review and meta-analysis. For this, nine researches of 1,856 articles published from 2000 to 2019 were reviewed which are experimental studies with the control groups in accordance with selection criteria. As the result of systematic review on four criteria, two or more in each of musical activities, intervention goals, and evaluation tools were employed in most of the nine studies, and there were frequently found studies on sociality and attentiveness. As the result of meta-analysis, there were shown that the overall effect scored medium effect size, and attention deficit and sociality marked low, while problem behavior did medium effect size. It is meaningful that this study showed the importance of using standardized evaluation tools in music intervention for children with ADHD, and it could be used as basic data to develop music intervention programs for them,

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.33 no.3
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• pp.67-72
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• 2022

Objectives: This study investigated the reliability and validity of the Korean version of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Level 2 Cross-Cutting Symptom Measure-Patient-Reported Outcomes Measurement Information System (PROMIS)-Depression and the Irritability for parents of children aged 6-17 years. Methods: Participants were 190 children diagnosed with depressive disorder (n=14), anxiety disorder (n=21), attention-deficit/hyperactivity disorder (ADHD; n=111), ADHD with anxious depression (n=13), and tic disorder with somatic symptoms (n=31). Patients were 8-15 years of age. The participants' mothers completed the Korean versions of the DSM-5 Level 2 Cross-Cutting Symptom Measure-PROMIS Depression and Irritability (Affective Reactivity Index, ARI), and the Korean Child Behavior Checklist (K-CBCL). Using these data, we calculated the reliability coefficient and examined the concurrent and discriminant validity of the PROMIS Depression and the Irritability (ARI) scales for assessing depression and irritability in children. Results: The reliability coefficient of the PROMIS Depression scale (Cronbach's α) was 0.93. The correlation coefficient with the K-CBCL DSM emotional problem score was 0.71. The PROMIS Depression scale significantly discriminated children with depressive disorders from those with other conditions. The reliability coefficient of the Irritability (ARI) scale was 0.91, suggesting its high reliability. Conclusion: Our results suggest that the Korean version of the DSM-5 Level 2 Cross-Cutting Symptom Measure for Depression and Irritability Scales for parents of children aged 6-17 years is reliable and valid and may be an efficient alternative to the K-CBCL.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.9 no.2
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• pp.154-164
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• 1998

Medication is widely accepted as an effective method to reduce the problem of attention deficit, hyperactivity, impulsivity, resistance and violence of ADHD children. However, it does not provide us with the solution on the conflicting routinized behavioral patterns to gain a high level of self-control and acceptable behavior. As a way of replacing medication, this study applies the social skills training program for ADHD children and measures the level of improvement of social skills and the change of the behavioral patterns. The experiment is carried out on 16 children ranged from 6 to 13 years of age for 10 weeks. The patients are divided into three groups：a pure ADHD group, an ADHD group with conduct disorder, an ADHD group with mental retardation and other symptoms. The change of symptoms and the change of social skills are measured by the Child Behavior Checklist(CBCL), the ADD-H Comprehensive Teacher’s Rating Scale(ACTeRS) and the Social Skills Rating Scale(SSRS), and finally Mastson Evaluation of Social Skills for Youth(MESSY). Wilcoxon signed ranks test is used to evaluate the effect of the treatment, and Kruskal-Wallis test is also used to measure the change after the treatment in each of the three groups. In the ADHD group with conduct disorder, the examination of the effect of the treatment shows a significant reduction of violence in the area of behavior(p<.05), and a significant difference of activity and social skills in the area of social competent(p<.001). In the ADHD group with mental retardation and other symptoms, a significant rise of social skills is found in the area of social skills evaluation (p<.05). However, there is no significant difference of effect by the treatment among the three groups. In addition, the current examination shows that the social skills training program does not make a statistically significant contribution to the social skills of the ADHD children. On the other hand, the training helps some children, when it is suitable for the characteristics and accompanying symptoms of the children：it reduces the level of violence in the ADHD group with conduct disorder, and it raises the social skills in the ADHD group with mental retardation. In other words, the social skills training program will reduce the conduct disorder and helps peer relation for ADHD children.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.13 no.1
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• pp.153-162
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• 2002

Summary：This study was designed to examine the effect of mother's depressive mood and parenting related attitude on parenting behavior, focusing on the cases having an ADHD child. Method：A total of 82 parents, 31 parents having children with ADHD and 51 normal, were involved in this study. The children of ADHD and normal group were 6-11 years old. ADHD group were diagnosed as attention-deficit hyperactivity disorder by psychiatric doctor and psychological evaluations using DSMIV criteria and the normal group were excluded by using Diagnostic Rating Scale-Parent, Teacher Form. The mothers of both group completed a series of questionnaire about mother's depressive mood and parenting-related attitude. To investigate the relationships between each variables, Student's t-test, correlation, stepwise regression, and hierarchical regression analysis were performed. Result：In correlation analysis, Mothers with an ADHD child were likely to report more coercive parenting behavior, more negative parenting-related attitudes, and depressive mood than normal group. In regression analysis, mother's parenting stress, dysfunctional thoughts, parenting competence, and depressive mood predicted coercive parenting behavior significantly, total explaining 50% of its variance, and especially depressive mood explained 29% of their coercive parenting behavior. These Results indicated that mother's depressive mood accounted for a substantial portion of coercive parenting behavior. Conclusion：These findings suggested that it is significantly important to reduce Mother's depressive mood through dealing with parenting sense of competence and dysfunctional thoughts, so, both parent education program and cognitive-behavioral therapeutic approach are needed to change parent's coercive parenting behavior. Finally, limitation of the present study and suggestions were discussed for further studies.

• The Journal of Korean Academy of Sensory Integration
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• v.13 no.1
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• pp.13-22
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• 2015

Objective : The aim of this study is to verify validity of Long Form Assessment, which is an Interactive Metronome $measure^{(R)}$(LFA-IM), as a measurement of praxis of children. Methods : The study was implemented from March 2015 to July 2015. Twenty-five children with Attention Deficit Hyperactivity Disorder (ADHD) and those without ADHD (age of 6~11) were selected from a local university hospital and community in Gyeoung-Nam province and Busan for this study. In order to examine discriminative validity of LFA-IM, Bruininks-Oseretsky Test of Motor Proficiency, second edition (BOT-2) was used to compare the difference of results with LFA-IM for both children with- and without ADHD. For concurrent validity, correlation between LFA-IM and BOT-2 was investigated using spearman correlation coefficients. Results : For the comparison between children with ADHD and children without ADHD, there were significant differences in the total scores of LFA-IM (p<.05). Regarding the concurrent validity, there was a strong negative correlation between the total scores of LFA-IM and BOT-2 (p<.05). In addition, there was high correlation between LFA-IM and BOT-2 for the area of hand control (rs=-.532), and high negative correlation for the area of fine-motor accuracy (rs=-.447), hand dexterity (rs=-.532), and balance control (rs=-.623) (p<.05). Conclusion : This study identified validities of LFA-IM as an assessment of praxis of children. The results showed that it is appropriate to evaluate praxis of children with the total score of LFA-IM and, thus, it is believed that LFA-IM has a potential clinical utility. However, there should be more researches with large number of subjects.

• Journal of Preventive Medicine and Public Health
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• v.26 no.4 s.44
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• pp.628-649
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• 1993

This study was conducted to investigate the factors related to the poor school performance of the elementary school children. Two schools in Taegu, one in the affluent area and the other in the poor area, were selected and a total of 175 children whose school performance was within low 10 percentile (poor performers) and 97 children whose school performance were within high 5 percentile (good performers) in each class of 2nd, 4th and 6th grades were tested for the physical health, behavioral problem and family background. Each child had gone through a battery of tests including visual and hearing acuity, anthropometry (body weight, height, head circumference), intelligence (Kodae Stanford-Binet test), test anxiety (TAI-K), neurologic examination by a developmental pediatrician and heavy metal content (Pb, Cd, Zn) in hair by atomic absorption spectrophotometry. A questionnaire was administered to the mothers for prenatal and prenatal courses of the child, family environment, child's developmental history, and child's behavioral and learning problems. Another questionnaire was administered to the teachers of the children for the child's family background, arithmatic & language abilities and behavioral problem. The poor school performance had a significant correlation with male gender, high birth order, broken home, low educational and occupational levels of parents, visual problem, high test anxiety score, attention deficit hyperactivity disorder (ADHD), poor physical growth (weight, height, head circumference) and low I.Q. score. The factors that had a significant correlation with the poor school performance in multiple logistic regression analysis were child's birth order (odds ratio=2.06), male gender(odds ratio=5.91), broken home(odds ratio=9.29), test anxiety score(odds ratio=1.07), ADHD (odds ratio=9.67), I.Q. score (odds ratio=0.85) and height less than Korean standard mean-1S.D.(odds ratio=11.12). The heavy metal contents in hair did not show any significant correlation with poor school performance. However the lead and cadmium contents were high in males than in females. The lead content was negatively correlated with child's grade(P<0.05) and zinc was positively correlated with grade (P<0.05). among the factors that showed a significant correlation with the poor school performance, high birth order, short stature and ADHD may be modified by a good family planning, good feeding practice for infant and child, and early detection and treatment of ADHD. Also, teacher and parents should restrain themselves from inducing excessive test anxiety by forcing the child to study and over-expecting beyond the child's intellectual capability.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.12 no.1
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• pp.25-50
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• 2001

Using Fourier transformation and wavelet analysis, we compared the auditory event-related potentials of the patients with attention deficit-hyperactivity disorders(abbr. ADHD, 13 boys) and normal control children(8 boys). Amplitudes of the event-related potentials which were calculated via Fourier transformation were compared between the groups and between conditions(non-target versus target) in each group. To the non-target stimuli, the patients with ADHD showed significantly greater amplitudes across almost all of the electrode sites and frequencies. To the target stimuli, the incidents which ADHD patients showed much higher amplitudes than normal controls significantly decreased, while those of the reverse results increased significantly. These results were consistent with the comparison results about negative difference wave(abbr. Nd wave) using Fourier transformation. In summary, it was proved that non-target stimulus which should be ignored elicited more robust electrical response from the patients with ADHD than normal children, but the target stimulus which reguired active processing did much less electrical activity in the patients. For the patients, they showed much inhibited electrical response to the target stimuli in some electrodes and frequency ranges. Normal children were more strongly stimulated by the target stimuli in almost all electrodes and frequency ranges than the patients, but less in prefrontal leads and frontal leads. Wavelet analysis results proved that early responses(0-300msec) to the nontarget stimuli of the patients were significantly greater than the normal controls in prefrontal, anterior frontal, some parts of temporal, and occipital lobes and that late response(300-370msec) were significantly lesser than normal children in parietal and central electrodes. Target stimuli elicited significantly higher electrical activity in both group than non-target stimuli did. Prefrontal and frontal lobes showed stronger responses in the patients than normal children irrespective of stimulus condition, but parietal and temporal lobes did higher activities in normal children than the patients only to the target stimuli. In conclusion, the patients with ADHD showed much greater responses to the stimuli which should be ignored, but failed to activated the necessary processes to the target stimuli. Also, we found that the frequency-dimension analysis and wavelet analysis were useful for the signal processing such as event related potentials.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.22 no.1
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• pp.25-37
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• 2011

Objectives：This study was conducted to develop a Korean algorithm of pharmacological and non-pharmacological treatment strategies in attention-deficit hyperactivity disorder (ADHD) and its specific comorbid disorders (e.g. tic disorder, depressive disorder, anxiety disorder, bipolar disorder, and oppositional defiant disorder/conduct disorder). Methods：Based on a literature review and expert consensus, both paper- and web-based survey tools were developed with respect to a comprehensive range of questions. Most options were scored using a 9-point scale for rating the appropriateness of medical decisions. For the other options, the surveyed experts were asked to provide answers (e.g., duration of treatment, aver-age dosage) or check boxes to indicate their preferred answers. The survey was performed on-line in a self-administered manner. Ultimately, 49 Korean child & adolescent psychiatrists, who had been considered experts in the treatment of ADHD, vol untarily completed the questionnaire. In analyzing the responses to items rated using the 9-point scale, consensus on each option was defined as a non-random distribution of scores as determined by a chi-square test. We assigned a categorical rank (first line/preferred choice, second line/alternate choice, third line/usually inappropriate) to each option based on the 95% confidence interval around the mean rating score. Results：Specific medication strategies for key clinical situations in ADHD and its comorbid disorders were indicated and described. We organized the suggested algorithms of ADHD treatment mainly on the basis of the opinions of the Korean experts. The suggested algorithm was constructed according to the templates of the Texas Child & Adolescent medication algorithm Project (CMAP). Conclusion：We have proposed a Korean treatment algorithm for ADHD, both with and without comorbid disorders through expert consensus and a broad literature review. As the tools available for ADHD treatment evolve, this algorithm could be reorganized and modified as required to suit updated scientific and clinical research findings.