• 대한감각통합치료학회지
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• 제17권1호
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• pp.43-53
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• 2019

목적 : 본 연구는 주의력결핍과잉행동장애아동(Attention Deficit Hyperactivity disorder; ADHD)을 대상으로 국내에서 제공되는 중재 방법을 체계적으로 고찰하여 최신의 국내 치료 경향을 제시하고자 하였다. 연구방법 : 2004년 1월부터 2018년 12월까지 최근 15년간 국내 학회지에 게재된 연구를 대상으로 하였다. 누리미디어(DBpia), 스콜라(Scholar), 학술연구정보서비스(RISS), 한국학술정보(KISS)에서 '주의력결핍과잉행동', '아동', '중재'를 키워드로 검색하였다. 연구대상으로 선정된 연구는 총 14개로, 각 연구는 근거의 질적 수준과 방법론적 질적 수준으로 분석한 후 그 결과를 대상자, 중재, 대조, 결과의 순으로 제시하였다. 결과 : 분석 결과 근거기반 실행의 질적 수준은 수준 IV의 연구가 가장 많았고, 방법론적 질적 수준은 '보통'의 연구가 가장 많았다. 중재는 상호작용식 메트로놈 중재(Interactive metronome; IM)의 빈도가 가장 높았고, 측정된 평가도구는 상호작용식 메트로놈 전체형 검사(Long form assessment of IM), 아동 청소년 행동평가척도(Korean behavior child checklist; K-CBCL)의 사용이 높았다. 중재결과 ADHD아동의 집중력, 과잉행동, 과제 수행, 과다언어 사용, 그리고 타이밍 등에서 유의한 효과가 나타났다. 결론 : 국내 ADHD아동을 대상으로 다양한 중재방법이 제공되었고, 그 결과 ADHD증상에서 효과적인 결과가 나타났다. 따라서 본 연구결과는 임상에서 근거기반 실행을 위한 기초자료로 사용할 수 있다. 앞으로 ADHD아동을 대상으로 한 지속적인 연구가 이루어져야 할 것이다.

• 대한한방소아과학회지
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• 제33권2호
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• pp.1-11
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• 2019

Objectives The objectives of this study is to investigate the characteristics of Attention-deficit/hyperactivity disorder (ADHD) pattern identification based on the survey of frequencies of symptoms and signs according to the pediatricians and psychiatrists in Korean Medicine. Methods Eleven pediatricians and fourteen psychiatrists participated in this study. 38 symptoms and signs of 4 ADHD pattern identifications (Kidney yin deficiency and liver yang ascendant hyperactivity 腎虛肝亢, Dual deficiencies in the heart and spleen 心脾兩虛, Phlegm-fire harassing the heart 痰火擾心, Spleen weakness and liver energy preponderance 脾虛肝旺) were used to evaluate the frequencies of ADHD. The differences in frequencies of symptoms and signs amongst ADHD pattern identifications, and the correlations between them were analyzed. Results There were significant differences in the frequencies of symptoms and signs between each pattern identification. Dual Deficiencies in the Heart and Spleen 心脾兩虛 is negatively related with hyperactivity and impulsivity, and positively related with inattention. Phlegm-fire Harassing the Heart 痰火擾心 is positively related with hyperactivity and impulsivity, and negatively related with inattention. Conclusions The results of the characteristics of ADHD pattern identifications from the survey analysis could be used in the clinical practices of ADHD as well as to improve the ADHD pattern identification questionnaire.

• 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.

• 대한간호학회지
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• 제47권3호
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• pp.305-318
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• 2017

Purpose: The aim of this study was to identify the effects of a newly developed instructional coaching program regarding Attention Deficit Hyperactivity Disorder (ADHD) for teachers. Methods: Seventy teachers participated in this study involving a nonequivalent control group and a pretest-posttest design. The instructional coaching program consisted of eight 60-minute sessions. The program was developed through a theoretical development program involving six steps. To evaluate the effects of the program, data were collected through self-report questionnaires including the Knowledge Scale of Attention Deficit Disorder, Attitude Scale of Primary School Teachers Experiencing Students with ADHD, Practice Scale of Educational Intervention Activity, and the Korean ADHD Rating Scale. Data were analyzed with an independent t test, a chi-square test, and an ANCOVA using SPSS WIN version 20. Results: The intervention program consisted of 3 sectors, 8 subjects, and 24 content items. The experimental group showed a significant improvement in attitudes toward ADHD (F=22.83, p<.001). In addition, teacher's knowledge regarding ADHD (F=7.16, p=.010) and the implementation of instructional interventions (F=4.29, p=.043) improved. Further, teachers reported a reduction in children's ADHD-related behavior (F=4.34, p=.041). Results showed that the coaching program made a positive contribution to teaching skills and understanding of school-age children with ADHD. Conclusion: The instructional coaching program was well structured and significantly improved not only teachers'attitudes, knowledge, and teaching skills but also the behavior of children with ADHD in class. Therefore, the program is recommended as a means of facilitating teaching and managing children with ADHD in class.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제28권1호
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• pp.25-30
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• 2017

Objectives: The study compared the intelligence test profiles of Tourette's Disorder (TD), attention-deficit hyperactivity disorder (ADHD), and TD with ADHD (TD+ADHD) groups. Methods: The Korean Wechsler Intelligence Scale for Children-third edition (K-WISC-III) and Korean Wechsler Intelligence Scale for Children-fourth edition (K-WISC-IV) were administered to 13 children and adolescents with TD, 17 children and adolescents with ADHD, and 15 children and adolescents with TD+ADHD. Each parameter was compared among the groups using the Kruskal-Wallis test. Results: The mean scores of the freedom from distractibility/working memory index (FD/WMI) and the digit span and arithmetic subtests of the TD+ADHD group were significantly lower than those of the TD group. Conclusion: According to the intelligence test results, the comorbid ADHD+TD group showed a significant decrease in working memory compared to the TD group. These findings are similar to those of previous research on cognitive functions and suggest that the TD+ADHD comorbid and TD alone groups exhibit different endophenotypes. The results also imply that WISC-III and WISC-IV, the most commonly used intelligence tests clinically, are effective in evaluating cognitive functions such as attention. Further research is required to confirm these results.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제27권3호
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• pp.207-215
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• 2016

Objectives: This study aimed to investigate the differences in the facial emotion recognition and discrimination ability between children with attention-deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Methods: Fifty-three children aged 7 to 11 years participated in this study. Among them, 43 were diagnosed with ADHD and 10 with ASD. The parents of the participants completed the Korean version of the Child Behavior Checklist, ADHD Rating Scale and Conner's scale. The participants completed the Korean Wechsler Intelligence Scale for Children-fourth edition and Advanced Test of Attention (ATA), Penn Emotion Recognition Task and Penn Emotion Discrimination Task. The group differences in the facial emotion recognition and discrimination ability were analyzed by using analysis of covariance for the purpose of controlling the visual omission error index of ATA. Results: The children with ADHD showed better recognition of happy and sad faces and less false positive neutral responses than those with ASD. Also, the children with ADHD recognized emotions better than those with ASD on female faces and in extreme facial expressions, but not on male faces or in mild facial expressions. We found no differences in the facial emotion discrimination between the children with ADHD and ASD. Conclusion: Our results suggest that children with ADHD recognize facial emotions better than children with ASD, but they still have deficits. Interventions which consider their different emotion recognition and discrimination abilities are needed.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제29권4호
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• pp.150-160
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• 2018

Objectives: This study investigated the effect of social skills training (SST) on facial emotion recognition and discrimination in children with attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Methods: Twenty-three children aged 7 to 10 years participated in our SST. They included 15 children diagnosed with ADHD and 8 with ASD. The participants' parents completed the Korean version of the Child Behavior Checklist (K-CBCL), the ADHD Rating Scale, and Conner's Scale at baseline and post-treatment. The participants completed the Korean Wechsler Intelligence Scale for Children-IV (K-WISC-IV) and the Advanced Test of Attention at baseline and the Penn Emotion Recognition and Discrimination Task at baseline and post-treatment. Results: No significant changes in facial emotion recognition and discrimination occurred in either group before and after SST. However, when controlling for the processing speed of K-WISC and the social subscale of K-CBCL, the ADHD group showed more improvement in total (p=0.049), female (p=0.039), sad (p=0.002), mild (p=0.015), female extreme (p=0.005), male mild (p=0.038), and Caucasian (p=0.004) facial expressions than did the ASD group. Conclusion: SST improved facial expression recognition for children with ADHD more effectively than it did for children with ASD, in whom additional training to help emotion recognition and discrimination is needed.

• 생물정신의학
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• 제27권2호
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• pp.74-83
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• 2020

Objectives Psychological resilience plays a significant role in many aspects of mental health. The aim of this study was to find an association between childhood attention deficit hyperactivity disorder (ADHD) features and adulthood psychological resilience in patients with mood disorders. Methods A total of 213 patients with mood disorders including major depressive disorder or bipolar I, II disorder and 909 healthy controls were included. We assessed childhood ADHD features using the Wender Utah Rating Scale (WURS), adulthood psychological resilience using the Connor-Davidson Resilience Scale (CD-RISC), and current depressive mood using the Beck Depression Inventory (BDI). Pearson's correlation, multiple linear regression and a mediation analyses were performed to examine the relationships between three WURS factor (impulsivity, inattention, and mood instability) scores, the BDI score, and the CD-RISC score. Results The CD-RISC score was negatively correlated with the WURS childhood inattention factor score and current BDI score in patients with mood disorders. BDI score mediated the influence of the inattention factor score on CD-RISC score among patients with mood disorders. The CD-RISC score was significantly lower in patients with mood disorders than in controls even after controlling for age, WURS scores, and the BDI score. Conclusions An evaluation of psychological resilience is important for enhancing recovery and quality of life in patients with mood disorders. When assessing psychological resilience, current depression and ADHD features in childhood, particularly inattention, should be considered.

• Journal of Yeungnam Medical Science
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• 제14권2호
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• pp.415-429
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• 1997

저자는 1989년 McCarney(1989)에 의해 개발되어 신뢰도와 타당도가 입증된 주의력 결핍 장애 평가척도-교사판(ADDES-SV)의 한국형을 개발하여, 신뢰도와 타당도를 검증하고, 한국실정에서 ADHD 환자를 선별할수 있는 평가용 도구로 적합한지 여부와 ADHD를 연구할 도구로 사용 할수 있는지를 알아보고자 본 연구를 시행하게 되었다. 1996년 10-11월사이에 대상은 대구, 경북에 소재한 4개 초등학교 2학년 아동 263명과 1996년 6-10월사이에 ADHD 환자 28명을 대상으로 하였으며, 진단은 DSM-IV의 기준에 근거 하였다. 문항번역은 2명의 신경정신과 전문의와 1명의 사회 사업가와 1명의 아동 심리학자에 의해 이루어졌다. 검사-재검사 신뢰 검증에서 신뢰도 계수는 주의산만 계수 0.88, 충동성 계수 0.80, 과잉운동 계수 0.83, 전체점수 0.83이었고(p<0.05), 내적 일관성에 대한 신뢰도 검증에서 Cronbach의 ${\alpha}$값은 주의산만, 충동성, 과잉운동 소척도에서 각각, 0.98, 0.87, 0.96 (p<0.05)이었고, 반분신뢰도 계수는 주의산만 소척도에서 part 1: 0.96(p<0.05), part 2: 0.95(p<0.05), 충동성 소척도에서 part 1: 0.95(p<0.05), part 2: 0.93(p<0.05), 과잉 운동 소척도에서 part 1: 0.92(p<0.05), part 2: 0.94(p<0.05)이었다. 각 소척도간의 상관은 주의산만 소척도와 충동성 소척도와의 상관계수는0.87(p<0.05), 충동성 소척도와 과잉운동 소척도와의 상관계수는 0.95(p<0.05), 주의산만 소척도와 과잉운동 소척도와의 상관계수는 0.88(p<0.05)로 각 소척도간의 높은 상관관계를 보여주고, 검사자간 신뢰도는 주의산만 소척도 0.92, 충동성 소척도 0.87, 과잉운동 소척도 0.89, 전체점수 0.89였다. 본 교실에서 한국형을 개발하여 신뢰도와 타당도를 입증한 CAP척도와의 공존 타당도 검사에서는 환자군에서 0.85, 대조군에서 0.79의 상관관계를 얻었다. ADHD 환자군과 정상 대조군간의 감별 타당도 검증에서 모두 유의하게 환자군이 높은 점수를 보였다. 판별력 검증에는 정상대조군은 100%에서 정상으로, 환자군은 89.2%에서 환자군으로 판별되어 전체 판별력이 94.6%로 나타났으며, Cmax공식을 적용했을 때 89.2%의 판별력의 개선율을 보였다. 따라서, ADDES-SV척도는 한국인의 ADHD를 평가하기 위한 도구로서 신뢰도와 타당도가 높은 것으로 나타났으며, 향후 ADHD에 대한 선별검사 및 역학 조사 연구에 유용한 도구인 것으로 판단된다.

• 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.