• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.18 no.1
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• pp.10-15
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• 2007

Probably the three most important components to a comprehensive evaluation of patients with attention-deficit hyperactivity disorder (ADHD) are the clinical interview, the medical examination, and the completion and scoring or behavior rating scales. Teachers and other school personnel are often the first to recognize that a child or adolescent might have ADHD, and often play an important role in the help-seeking/referral process. A diagnostic evaluation for ADHD should include questions about ADHD symptoms, other problems including alcohol and drug use, family history of ADHD, prior evaluation and treatment for ADHD. Screening interview or rating scales as well as interviews should be used. When it is feasible, clinicians may wish to supplement these components of the evaluation with objective assessments of the ADHD symptoms, such as psychological tests. These tests are not essential to reaching a diagnosis, however, or to treatment planning, but they may yield further information about the presence and severity of cognitive impairments that could be associated with some cases of ADHD. Screening for intellectual ability and academic achievement skills is also important in determining the presence of comorbid developmental delay or loaming disabilities. The number and type of symptoms required for a diagnosis of ADHD vary depending on the specific subtype. To receive a diagnosis of ADHD, the person must be experiencing significant distress or impairment in daily functioning, and must not meet criteria for other mental disorders which might better account for the observed symptoms such as mental retardation, autism or other pervasive developmental disorders, mood disorders, anxiety disorders. This report aims to suggest a practice guideline of assessment and diagnosis for children and adolescents with ADHD in Korea.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.28 no.2
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• pp.58-69
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• 2017

Attention-deficit hyperactivity disorder (ADHD) is a highly prevalent, impairing, and comorbid disorder that persists into adulthood. ADHD should be diagnosed in the same manner as other common adult mental health disorders. The three most important components in the comprehensive evaluation of patients with ADHD are the clinical interview, medical examination, and completion and scoring of behavior rating scales. The diagnostic evaluation of ADHD should include questions about the symptoms, family history, prior evaluation and treatment of ADHD, as well as other problems including alcohol and drug use. Screening interviews or rating scales, as well as interviews, should be used. When it is feasible, clinicians may wish to supplement these components of the evaluation with the objective assessments of the ADHD symptoms, such as through psychological tests. These tests are not essential to reaching a diagnosis, however, or to treatment planning, but may yield further information about the presence and severity of cognitive impairments that could be associated with some cases of ADHD. As comorbidity is the rule rather than the exception, clinicians should carefully screen for comorbid disorders as part of a comprehensive assessment of ADHD. To receive a diagnosis of ADHD, the person must be experiencing significant distress or impairment in his or her daily functioning, and must not meet the criteria for other mental disorders which might better account for the observed symptoms, such as mental retardation, autism or other pervasive developmental disorders, mood disorders and anxiety disorders. This report aims to suggest practice guidelines for the assessment and diagnosis of children, adolescents and adults with ADHD in Korea.

• Journal of the Korean Society of Child Welfare
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• no.56
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• pp.253-281
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• 2016

The purpose of this study was to verify the clinical utility of th Korea Child Behavior Checklist 16-18(K-CBCL 6-18) in diagnosing ADHD among children with psychological disorders in child welfare institutions. The participants were 509 elementary school children(309 boys and 200 girls) who lived in child welfare institutions. They were assessed using the Korean ADHD Rating Scale(K-ARS) and K-CBCL 6-18. Only five scales of the K-CBCL 6-18 related with attention were used for analysis: syndrom total, externalizing total, aggressive behavior, attention problems and DSM-oriented ADHD scales. The results were as follows. First, K-ARS and K-CBCL 6-18 had significantly positive correlations with all five scales. Second, as a result of a t-test on the ADHD and the non-ADHD groups, which were divided using K-ARS, the mean scores of ADHD group were significantly higher than the non-ADHD group for all five scales of the K-CBCL 6-18. The hit rate of all five scales of the K-CBCL 6-18 was 60 to 70 percent. The syndrom total and externalizing total scales had high sensitivity, whereas the aggressive behavior, attention problems, and the DSM-oriented ADHD scales had high specificity. In addition, all scales had high positive predictive values. Third, as the result of a t-test on the ADHD group and the emotional disorder group, there were significant difference in the mean scores of the attention problems and the DSM-oriented ADHD scales. The attention problems and the DSM-oriented ADHD scales had a similar percentage of hit rate, high specificity and low sensitivity. Especially, the DSM-oriented ADHD scale revealed higher specificity than the attention problems scale. The results of this study suggested that the five scales related to attention of the K-CBCL 6-18 are useful in diagnosing ADHD in child welfare institutions.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.22 no.4
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• pp.307-313
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• 2011

Objectives : This study explored the clinical differences in attention-deficit hyperactivity disorder (ADHD) patients with and without developmental coordination disorder (DCD). Methods : Participants were 49 children and adolescents with ages between 6 and 18 years. These subjects were placed into 2 groups: ADHD without DCD (24) and ADHD with DCD (25). We used several evaluation tools on both groups: the Affective Disorders and Schizophrenia-Present and Lifetime Version- Korean Version (K-SADS-PL), Wechsler Intelligence Scale for Children-III (WISC-IIII), Child Behavior Check List (CBCL), Korean Personality Rating Scale for Children (K-PRC), and Bruininks-Osretsky Test of Motor (BOT-2). Results : Patients with both ADHD and DCD had a lower performance intelligence quotient and more internal and external behavioral symptoms than patients with ADHD but not DCD. It is possible that patients with ADHD and motor coordination problems should be noticed earlier and given intensive treatment.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.34 no.3
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• pp.169-174
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• 2023

Objectives: Oppositional defiant disorder (ODD) is often comorbid with other psychiatric disorders in childhood. This study aimed to investigate comorbid psychiatric symptoms and associated factors in elementary school children with symptoms of ODD. Methods: The participants consisted of 205 mother-offspring pairs. Psychiatric symptoms were measured using the Diagnostic Predictive Scales and Korean Child Behavior Checklist. Psychiatric comorbid symptoms were compared between children with ODD symptom and those without ODD symptom. Multivariate logistic regression analysis was used to estimate the odds ratio of psychiatric symptom on ODD. Results: ODD group had a significant association with internalizing and externalizing problem (p=0.001, p<0.001, respectively). ODD group were more comorbid with anxiety disorder, depressive disorder, attention-deficit/hyperactivity disorder, and conduct disorder. Among psychiatric disorder, generalized anxiety disorder (GAD) (adjusted odds ratio [AOR]=18.620, p<0.001) and conduct disorder (AOR=9.529, p=0.014) were associated with ODD symptom. Conclusion: These findings suggest that children with ODD symptom had significantly higher rates of comorbid psychiatric symptoms. And GAD and conduct disorder are related to ODD symptom.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.1 no.1
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• pp.117-129
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• 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 the Korean Academy of Child and Adolescent Psychiatry
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• v.15 no.1
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• pp.40-60
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• 2004

Introduction：Research on attachment in view point of the developmental perspective which began in the 1940s progressed during several decades. Many investigators focused mother-child separation in early attachment studies, and moved to the relationship with childhood psychopathology. Recently attachment theory and research are moving forward along the intergenerational transmission of attachment patterns, and adolescents and adult mental disorders in the developmental perspectives. Methods：We surveyed the research papers through Medline search, attachment-related monographs, and review or original papers published in Korean journal. Results：Developmental attachment researches have demonstrated convincingly that insecure attachment in infancy is associated with attachment disorder; several childhood psychopatholgy, such as institutional care and adoption, aggression and behavioral problems, childhood anxiety disorders and depressive disorders, gender identity disorder and feeding disorder, and child abuse and maltreatment; peer relationship and social competency, and parental behaviors. Recently the methodological advances including the Adult Attachment Interview that systematically assesses the adults' recollections of the earlier parent-child relationship they experienced could move beyond attachment researcher's initial concern with infancy to consider attachment processes throughout the life span. We could find that the quality of attachment was associated with several mental disorders in adolescents and adults significantly. Conclusion：Attachment theory would have focused on more specific parent-child relationship than general parental behavior. Recent attachment theory underscores its evolutionary origins to promote development of infant and contribute to human survival in psychobiological bases. Advances in attachment research could unite interests in evolutional biology and developmental psychology in understanding early parent-child relationship, and apply to clinical issues concerning mental health throughout the life span.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.26 no.3
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• pp.149-158
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• 2015

Objectives : The objective of this study was to identify the risky behavior subtypes in adolescents with depression, and the relationship between those subtypes and suicide attempt. Methods : Ninety adolescents who met the Diagnostic and Statistical Manual of Mental Disorders-4th edition criteria for major depressive disorder, dysthymia, or depressive disorder not otherwise specified participated in the study. Participants were interviewed about suicidal attempts, non-suicidal self-injuries. Smoking, drinking behaviors, and searching for the word "suicide" on the internet, negative life events including bulling-bullied experiences, and history of abuse were also included with questionnaires. Results : The results of cluster analysis showed that four risky behaviors were divided into three clusters : non-risky type, characterized by few risky behaviors ; delinquency type, which was characterized by smoking and drinking ; non-suicidal self-injury type. In non-suicidal self-injury type, percentage of girls was higher and clinical symptoms were more severe than delinquency type. In addition, delinquency type members could be a bully, while non-suicidal self-injury type members could be abused by a family member. Logistic regression analysis showed that both risky behavior subtypes were significant predictors of suicide attempt. Conclusion : These results suggest that two types of risky behaviors of depressed adolescents have an effect on the suicide attempts independently. Then, the implications and limitations of the study were discussed and directions for future studies were suggested.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.16 no.1
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• pp.47-53
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• 2005

Objectives : Few studies have examined the relation between the attachment styles of the primary caregivers and the behavioral problems of their children. This study was performed to identify the impact of the insecure parental attachment patterns on the development of their higher grades elementary school children's psychiatric manifestations and disorders. Methods : 504 higher elementary pupils and their primary caretakers were included in our study. Relationship Questionnaire, Kovacs Children's Depression Inventory, Spielberger's State-Trait Anxiety Inventory for children, and Korean Child Behavior Checklist were applied to them. Results : The grade-school children of the parents who belonged to preoccupied attachment type revealed higher Withdrawn, Anxious/depressed, Social Problems, Attention Problems, Delinquent Problems, Aggressive Problems, Internalizing Problems, Externalizing Problems, Total Behavioral Problems scores than ones of securely attached parents (p<0.01). Internalizing Problems score of preoccupied parents' children was highest, and one of avoidant and secure typed parents' kids followed in order (p=0.004) . More youngsters revealed Total Behavior Problem score high enough to clinically meaningful level in insecure parental attachment style than in secure one (p=0.038). Higher CDI score in insecure parental group was reported than in secure one (p=0.040). Conclusion : Parental insecure attachment can be associated with the development of the behavioral problems and psychiatric illness of their children.

• Therapeutic Science for Rehabilitation
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• v.13 no.2
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• pp.9-25
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• 2024

Objective : Children with autism spectrum disorder (ASD) commonly suffer from feeding disorders. Major feeding problems include mealtime behavior problems, picky eating, and a lack of food variety can lead to nutritional problems, developmental and social limitations, and stress for the caregivers. A review of the latest literature was conducted to gain an in-depth understanding of assessment tools for feeding disorders in children with ASD. Method : This study analyzed assessments to identify feeding problems in ASD based on previous studies searched through keywords such as ASD, ASD feeding problem, and ASD feeding evaluation. Results : The ASD feeding disorder assessment was divided into direct and indirect assessments. Indirect assessment, in which caregivers measure a child's situation using questionnaires, is mainly used. The assessment of feeding disorders in children with ASD was divided into 1) mealtime behavior, 2) sensory processing, 3) food consumption, and 4) others. Conclusion : As the main feeding disorder characteristics of children with ASD are very diverse, a comprehensive evaluation is necessary but is still limited. Swallowing rehabilitation experts, such as occupational therapists, should apply comprehensive assessment tools based on a basic understanding of the feeding problems, behaviors, and sensations in ASD.