• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.29 no.2
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• pp.62-72
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• 2018

Objectives: The molecular mechanisms underlying attention-deficit hyperactivity disorder (ADHD) remain unclear. Therefore, this study aimed to identify the genetic susceptibility loci for ADHD in Korean children with ADHD. We performed a case-control and a family-based genome-wide association study (GWAS), as well as genome-wide quantitative trait locus (QTL) analyses, for two symptom traits. Methods: A total of 135 subjects (71 cases and 64 controls), for the case-control analysis, and 54 subjects (27 probands and 27 unaffected siblings), for the family-based analysis, were included. Results: The genome-wide QTL analysis identified four single nucleotide polymorphisms (SNPs) (rs7684645 near APELA, rs12538843 near YAE1D1 and POU6F2, rs11074258 near MCTP2, and rs34396552 near CIDEA) that were significantly associated with the number of inattention symptoms in ADHD. These SNPs showed possible association with ADHD in the family-based GWAS, and with hyperactivity-impulsivity in genome-wide QTL analyses. Moreover, association signals in the family-based QTL analysis for the number of inattention symptoms were clustered near genes IL10, IL19, SCL5A9, and SKINTL. Conclusion: We have identified four QTLs with genome-wide significance and several promising candidates that could potentially be associated with ADHD (CXCR4, UPF1, SETD5, NALCN-AS1, ERC1, SOX2-OT, FGFR2, ANO4, and TBL1XR1). Further replication studies with larger sample sizes are needed.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.30 no.3
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• pp.116-120
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• 2019

Objectives: This study was conducted to re-validate the clinical efficacy of the Korean Adult Attention-Deficit/Hyperactivity Disorder (ADHD) Rating Scale (K-AARS), which is a self-report scale for ADHD in adults, and to determine the clinical utility and cut-off scores of K-AARS. Methods: The participants were 135 drug naïve adults with ADHD and 144 healthy controls. To diagnose ADHD based on the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, two board-certified pediatric psychiatrists interviewed the participants and completed the Mini International Neuropsychiatric Interview. K-AARS was applied to all participants. K-AARS comprises six clinical subscales, one impairment subscale, and one driving behavior subscale. The receiver operating characteristic analysis was conducted to calculate the cut-off scores of K-AARS. Results: All subscale scores, including six clinical subscale, impairment subscale, and driving behavior subscale scores, were found to be significant in distinguishing adults with ADHD from healthy controls. The sensitivity and specificity of the six clinical subscales were 63.0-77.0% and 66.7-79.9%, respectively. The combined total score of the six clinical subscales, had a sensitivity of 80.0% and specificity of 79.9%. Conclusion: The discriminative power of K-AARS for the diagnosis of ADHD in adults was excellent, and K-AARS and the empirical diagnosis of adults can be useful in diagnosing ADHD in adulthood.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.27 no.1
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• pp.64-71
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• 2016

Objectives: The objective of this study was to examine the effects of osmotic-controlled release oral delivery system methylphenidate on changes in regional cerebral blood flow (rCBF) in children with attention-deficit hyperactivity disorder (ADHD) using single photon emission computed tomography (SPECT). Methods: A total of 26 children with ADHD (21 boys, mean age: $9.2{\pm}2.05$ years old) were recruited. Each ADHD participant was examined for changes in rCBF using technetium-99m-hexamethylpropylene amine oxime brain SPECT before and after 8 weeks methylphenidate medication. Brain SPECT images of pediatric normal controls were selected retrospectively. SPECT images of ADHD children taken before medication were compared with those of pediatric normal controls and those taken after medication using statistical parametric mapping analysis on a voxel-wise basis. Results: Before methylphenidate medication, significantly decreased rCBF in the cerebellum and increased rCBF in the right precuneus, left anterior cingulate, right postcentral gyrus, right inferior parietal lobule and right precentral gyrus were observed in ADHD children compared to pediatric normal controls (p-value<.0005, uncorrected). After medication, we observed significant hypoperfusion in the left thalamus and left cerebellum compared to pediatric normal controls (p-value<.0005, uncorrected). In the comparison between before medication and after medication, there was significant hyperperfusion in the superior frontal gyrus and middle frontal gyrus and significant hypoperfusion in the right insula, right caudate, right middle frontal gyrus, left subcallosal gyrus, left claustrum, and left superior temporal gyrus after methylphenidate medication (p-value<.0005, uncorrected). Conclusion: This study supports dysfunctions of fronto-striatal structures and cerebellum in ADHD. We suggest that methylphenidate may have some effects on the frontal lobe, parietal lobe, and cerebellum in children with ADHD.

• Child Health Nursing Research
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• v.17 no.2
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• pp.136-144
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• 2011

Purpose: The purpose of this study was to analyze teaching status and knowledge about children with Attention Deficit Hyperactivity Disorder (ADHD) in elementary school teachers. Methods: The participants of this study were 204 elementary school teachers in Busan. From July to September 2010, the researchers collected data by using self-report questionnaires consisted of questions about their teachers' characteristics and teaching status and KADDS (36 items) developed by Sciutto, Terjesen and Frank. Frequency, percentage, arithmetic mean, standard deviation, t-test and ANOVA were used to analyze the data using SPSS WIN 16.0 program. Results: Less than 50% of the participants had previous education on ADHD. According to this experience, there were significant differences in participants' knowledge about children with ADHD (t=4.703, p<.001). For the 36 items, participants had an average of $19.19{\pm}4.58$ points out of a possible 36. Moreover, lack of knowledge about teaching children with ADHD and communication problems with the parents of these children were considered to be the most disturbing factors. Conclusion: These results suggest that networks among teachers, parents and medical care professionals should be established. The results also indicate that educational programs for elementary school teachers should be developed in order to identify and teach children with ADHD appropriately.

• Journal of East-West Nursing Research
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• v.29 no.2
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• pp.150-160
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• 2023

This study aimed to identify the actor and partner effects of parenting efficacy, spousal support on parenting stress and depression in couples with children with attention deficit hyperactivity disorder (ADHD). Methods: A cross-sectional survey design was used. Participants were 103 couples (103 husbands, 103 wives) with children with ADHD visiting child adolescent psychiatry clinic or community mental health center in Seoul, Gyeonggi-do, South Korea. Data were analyzed by SPSS 20.0 and AMOS 20.0 program. Results: The parenting efficacy of husbands and wives had direct actor effect (β=-.69, p=.004; β=-.60, p=.004) and partner effect (β=-.22, p=.007; β=-.18, p=.026) on their parenting stress. In addition, husbands and wives's parenting efficacy had a direct actor effect (β=-.25, p=.031; β=-.21, p=.025) on their depression and indirect actor effect (β=-.25, p=.004; β=-.34, p=.004) through parenting stress on their depression. However, parenting stress did not show a partner effect on depression. Husband and wife's parenting efficacy had a direct effect (β=.46, p=.004; β=.25, p=.009) on perceived spousal support. The effects of husbands and wives were the same in actor effect size (χ² differences=0.74, p=.390) and partner effect size (χ² differences=0.20, p=.652) of parenting efficacy on parenting stress. In addition, the effect sizes of husbands and wives were the same in actor effect size (χ² differences=0.93, p=.334) and partner effect size (χ² differences=0.15, p=.704) for parenting stress and depression. Conclusion: The results of this study may provide the foundation for developing a nursing intervention program that can maximize interaction between couples with ADHD children.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.19 no.3
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• pp.175-181
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• 2008

Objectives: This study was conducted to compare the mothers' rearing attitude of ADHD children and that of children with depressive disorder. Methods: The participant consisted of 58 school-aged children diagnosed as ADHD, 14 children diagnosed as depressive disorder based on DSM-IV criteria. Normal control group consisted of 34 school-aged children who are free of any diagnosis of psychiatric disorders. Parental Acceptance-Rejection Questionnaire, Parenting Style Questionnaire, Children's Depression Inventory, Marital Satisfaction Scale, Beck's Depression Inventory were administered to all children and their mothers. Results: The parents of ADHD children showed more aggressive/hostile, neglecting/indifferent and less warm/affectionate parenting styles to their children than those of the depression and control groups. The depressive group perceived their parents as more rejecting than the control groups. Conclusion: The externalizing symptoms of ADHD might provoke parental distress and make it difficult for the parents to show positive rearing attitude toward their children. The depressive children might be more sensitive and perceptive to the negative sign of their parents' rearing attitude.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.28 no.2
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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.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.10 no.1
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• pp.91-99
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• 1999

Objects：It is difficult to differentiate between attention deficit hyperactivity disorder(ADHD) and mania because of similar symptoms and atypical symptoms of mania in children and adolescents. The purpose of this study is to identify the characteristics and to clarify the relationship by comparing the clinical features and comorbidities of ADHD and manic patients. Methods：The subjects consisted of 35 patients with ADHD and 19 manic patients. To Compare the characteristic symptoms between the two disorders, we selected 29 patients with ADHD and 14 patients with manic disorders. 6 ADHD patients who had manic disorders as comorbid disorder, and 5 manic patients who had ADHD as comorbid disorders were manic disorders were excluded. Results：1) There were significant differences in ages of onset and state anxiety scale scores, birth weights, numbers of perinatal problem, gestational ages, school behavioral problems between ADHD patients and manic patients(p<0.01). 2) There were significant differences in loses things(p<0.05) of ADHD-symptoms and grandiosity(p<0.01), decrease in sleep(p<0.05), delusions(p<0.01), hallucinations(p<0.05) of mania-symptoms between ADHD patients and manic patients. 3) The comorbid disorders of ADHD patients are significantly high(p<.05) than that of manic patients in major depression. 4) The familial loading of manic patients are significantly high(p<.05) than that of ADHD patients in mood disorder. Conclusions：The above results suggest that ADHD and mania are different disorders, considering the significant differences of clinical features and characteristics, familial loadings of the two disorders.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.8 no.2
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• pp.242-255
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• 1997

Characteristics of attention deficit of attention-deficit hyperactivity disorder(ADHD) were investigated by administering six computerized attention tests of Vienna Test System and four neuropsychological tests to children aged 6-12, with ADHD(n=21) and age-matched normal control children(n=22). The findings indicated that ADHD children show lower level of vigilance, more decline of performance in vigilance task on time, and impaired preparedness to response. They also have selective attention deficit on monitoring tasks, but did not have sustained attention deficit compared with normal control children. On the tasks wich overload their information processing capacity, ADHD children show more impulsive response pattern than normal control children. The performance of ADHD was worse than control on the neuropsychological tests sensitive to frontal lobe dysfunction. The presense 'These' attention deficits supports the theory that the defect of ADHD is due to the dysfunction of more than one brain region, including brain stem reticular formation and frontal lobe.

• Psychiatry investigation
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• v.15 no.12
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• pp.1144-1153
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• 2018

Objective One of the areas of social cognition is Theory of Mind (ToM) is defined as the capacity to interpret, infer and explain mental states underlying the behavior of others. When social cognition studies on neurodevelopmental disorders are examined, it can be seen that this skill has not been studied sufficiently in children with Specific Learning Disorder (SLD). Methods In this study, social cognition skills in children diagnosed with attention deficit hyperactivity disorder (ADHD), SLD or Autism Spectrum Disorder (ASD) evaluated before puberty and compared with controls. To evaluate the ToM skills, the first and second-order false belief tasks, the Hinting Task, the Faux Pas Test and the Reading the Mind in the Eyes Task were used. Results We found that children with neurodevelopmental disorders as ADHD, ASD, and SLD had ToM deficits independent of intelligence and language development. There was a significant correlation between social cognition deficits and problems experienced in many areas such as social communication and interaction, attention, behavior, and learning. Conclusion Social cognition is an important area of impairment in SLD and there is a strong relationship between clinical symptoms and impaired functionality.