• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제13권1호
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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.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제13권1호
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• pp.139-152
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• 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
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• 제12권1호
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• pp.115-124
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• 2001

Objective：The purpose of this study was to compare the clinical features of children with three subdiagnoses of tic disorder(transient tic disorder(TTD), chronic tic disorder(CTD) and Tourette’s disorder (TD)) and to exam the factors related with illness severity of them. Method：Subjects were 69 children who met DSM-IV criteria for tic disorder and 43 control children. All subjects were investigated demographic and clinical factors related to tic. The severity of tic was assessed with the Yale Global Tic Severity Scale(YGTSS) in tic disorder children. The Child Behavior Checklist(CBCL) was accomplished by parents of all subjects. Results：Children with TTD had not only shorter duration of tic symtoms but also milder tic severity and impairment than those with CTD and TD. They also had significantly lower scores on most CBCL subscales than children with CTD and TD, while they were similar with controls in all the CBCL subcale scores except aggressive behavior. Children with CTD and those with TD were similar to each other in clinical variables except number of tic symptom and scores on CBCL social problem subscale. The interference and intensity of motor tic symptoms and duration of tic symptoms were significant predictors of global impairment score on YGTSS, while the presence of comorbid ADHD was a preictor of the total behavior problem score of CBCL. Conclusion：These findings indicate that duration of tic symptoms and the presence of comorbid ADHD as well as the severity of tic symptoms strongly associated with the illness severity of children with tic disorder. These results also suggest that those clinical factors may be more important for assessing the severity of illness and determining the treatment strategy than the sub-diagnosis itself in children with tic disorder.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제15권1호
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• pp.82-90
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• 2004

Objectives：The study was performed to compare the executive function(EF；Inhibition, Planning and Working memory) between ADHD and normal group, and to controll the effect of age and intelligence. And the function of inhibition was assessed in two dimensions(cognitive inhibition and motor inhibition). Methods：K-WISC III and EF test(Go-No-Go, Stroop test, Tower of Hanoi, Digit) was administered to both 25 children with ADHD and 25 normal control participants, all aged between 7 and 12. The results were analyzed after statistically controlled for age and intelligence. Results：Children in the ADHD group had significantly lower IQ score than those in the control group and consistent relations were found between the child's age and the study's major variables. Once IQ and age were controlled, results indicated that children with ADHD had deficit only cognitive inhibition and motor inhibition. There was no significant difference in planning and working memory. Conclusion：These results suggested that specific deficits in inhibition control rather than general EF deficits are associated with ADHD. So inhibition is the core problem of children with ADHD. Thus, the therapeutic approach focused on cognitive inhibition and motor inhibition is required.

• Journal of Dental Anesthesia and Pain Medicine
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• 제22권3호
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• pp.205-216
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• 2022

Background: People with special needs tend to require diverse behavioral management in dentistry. They may feel anxious or uncomfortable or may not respond to any communication with the dentists. Patients with medical, physical, or psychological disorders may not cooperate and therefore require sedation (SED) or general anesthesia (GA) to receive dental treatment. Using the healthcare big data in Korea, this study aimed to analyze the trends of SED and GA in special needs patients undergoing dental treatment. It is believed that these data can be used as reference material for hospitals and for preparation of guidelines and related policy decisions of associations or governments for special needs patients in dentistry. Methods: The study used selected health information data provided by the Korean National Health Insurance Service. Patients with a record of use of one of the eight selected drugs used in dental SED between January 2007 and September 2019, those with International Classification of Diseases-10 codes for attention deficit hyperactivity disorder (ADHD), phobia, brain disease, cerebral palsy, epilepsy, genetic disease, autism, mental disorder, mental retardation, and dementia were selected. The insurance claims data were analyzed for age, sex, sedative use, GA, year, and institution. Results: The number of special needs patients who received dental treatment under SED or GA from January 2007 to September 2019 was 116,623. Number of SED cases was 136,018, performed on 69,265 patients, and the number of GA cases was 56,308, implemented on 47,257 patients. In 2007, 3100 special needs patients received dental treatment under SED while in 2018 the number of cases increased 6 times to 18,528 SED cases. In dentistry, ADHD was the most common disability for SED cases while phobia was the most common cause of disability for GA. The male-to-female ratio with respect to SED cases was higher for males (M : F = 64.36% : 35.64%). Conclusion: The application of the SED method and GA for patients with special needs in dentistry is increasing rapidly; thus, preparing guidelines and reinforcing the education and system are necessary.

• Therapeutic Science for Rehabilitation
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• 제12권1호
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• pp.7-22
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• 2023

Objective : This study aimed to confirm the research characteristics and quality of single-subject literature among domestic studies that applied interactive metronome (IM) intervention. Methods : Regarding literature search, 11 single-subject studies using IM were selected from an online database from January 2011 to June 2022. Moreover, the general characteristics and quality of the research method were analyzed. Results : The qualitative level of the analyzed literature was above the moderate level. However, intervention blindness and reliability showed low compliance. The ABA design accounted for the largest proportion of methods. Most of the study participants had attention deficit hyperactivity disorder. Attention, balance, bilateral coordination, and timing were checked as dependent variables. The IM-SFT was used most frequently as an evaluation method. The mediation session applied more than 8-10 interventions for 3-11 weeks. The intervention results in all studies indicated functional improvement after intervention. Conclusion : It might be necessary to expand the application of IM interventions to diverse diseases. In addition, there is a need to study the effect on the participants' quality of life and changes in daily life along with dependent variables such as attention and balance

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제12권1호
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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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• 제14권1호
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• pp.3-11
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• 2003

Attention-deficit/Hyperactivity disorder(ADHD) is the most common psychiatric disorder of childhood and among the most prevalent chronic health conditions affecting school-aged children. Children with ADHD experience significant functional problems, such as school difficulties, academic underachievement, troublesome interpersonal relationships with family members and peers, and low self-esteem. The most widely used pharmacological treatments for ADHD are psychostimulants, such as methylphenidate and amphetamine salts. These medications provide clinical efficacy by increasing the availability of catecholamines, primarily dopamine, in the frontal lobe of the brain. immediate-release(IR) formulations of sychostimulants were among the most effective psychotrophic medications in the psychopharmacological treatment. However, there are some limitations of IR formulations：the short half-life and duration of efficacy, which result in the need for multiple daily dosing and the poor compliance. These limitations have led to the development of once-daily, extended-release(ER) formulations of methylphenidate and amphetamine salts. However, these ER formulations may not be as immediately helpful to ADHD children due to delayed onset of action and the acute tolerance which is the failure to sustain the efficacy with the same concentration of drug as the initial stage of medication. OROS-methylphenidate(Concerta$^{\circledR}$) given once a day produces an ascending-pattern plasma drug level generated by the osmotically released, timed drug-delivery system. These new formulations of the psychostimulants have been shown to be a useful alternative to old stimulant medications through the evidence by the clinical trials.

• Journal of Korea Game Society
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• 제10권6호
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• pp.115-124
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• 2010

In the beginning brain waves were used for monkeys to control robot arm with neural activity. In recent years there are research that measured brain waves are used for the control of programs which monitor the progression of dementia or enhance of attention in children diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). Moreover, low-price devices that can be used as a game control interface have become available. One of the problems associated with control using brain waves is that the mean amplitude, mean wavelength, and mean vibrational frequency of the brain waves differ from individual to individual. This paper attempts to propose a method to normalize measured brain waves using normal distribution and calculate the waveforms that can be used in controlling games. For this, a framework in which brain waves are converted in seven stages has been suggested. In addition, the estimation process in each stage has been described. In an experiment the waveforms of two subjects have been compared using the proposed method in the BCI English word learning program. The level of similarity between two subjects' waveforms has been compared with correlation coefficient. When the proposed method was applied, both meditation and concentration increased by 13% and 8%, respectively. Because the proposed regularization method is converted into a waveform fit for control functions by reducing personal characteristics reflected in the brain waves, it is fitting for application programs such as games.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제3권1호
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• pp.84-96
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• 1992

The present study was designed to investigate variables associated with mother-child interaction patterns of Attention Deficit Hyperactivity Disorder(ADHD), and also to evaluate short-term effects of stimulant medication on the behaviors of ADHD children and their mothers during interaction. 15 ADHD boys(ages 5${\sim}$10 years) were treated with metylphenidate(0.5mg/kg per day) for 1 month, and their behaviors as well as their mothers for the 10 minute free play and 20 minute task performance period were videotaped through one-way mirror. The childrens attention was also evaluated using the Continuous Performance Task(CPT) and ratings of their hyperactive behaviors were obtained from their mother prior to the treatment. The videotaped interaction were rated according to the Response Class Matrix developed by Mash, Terdal & Anderson(1973). Results indicated that percentage of behavior of the mother and child during interaction was highly correlated with each other, which, in turn, was highly correlated with the symptom severity of the ADHD child. That is the more severe the cognitive and behavioral symptoms of ADHD, the more negative the interaction behavior pattern was. After 4 weeks of stimulant medication the mothers as well as the ADHD children showed a significant decrease in the percentage of negative-aggressive behavior during the task performance period. The results indicated that negative interaction behavior of the mothers was in large part a response to the negative behavior of their ADHD children.