• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제18권1호
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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.

• 대한간호학회지
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• 제23권2호
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• pp.299-315
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• 1993

Koreans are one of the fastest growing immigrant groups in America. Stress responses and stressors among this large cultural minority has been rarely been studied by nursing researchers. Adjusting to life in foreign country produces a great deal of stress. Differences in culture, language, expectations and social behavior can lead to misunderstandings between health care providers and clients. These misunderstandings are not well accounted for in health assessment. This study investigated the relationship between life events or / and daily activities as a stressor and the symptoms of stress among a sample of Korean immigrants in America. The symptoms of stress scale (SOS) was used to identify stress responses and open-ended questions were used to identify life events and daily activities considered by the respondents to be stressful. A simple random sample of 283 subjects was selected from the Directory of the Korean Society of Chicago, New York, Los Angeles, Philadelphia and Seattle. Demographically, the subjects ranged in age from 20 to 69 years, and the percentage of women and men was approximately 50% each. Almost ninety percent of the subjects were highly educated, 17% owners of business, 19% white collar professionals, 14% employed in sales or as skilled /unskilled labor, 27% as housewives and students and 3％ had no occupation. The total group SOS mean was 0.8042 ; the SOS men for man was 0.7371, and for women was 0.8713. The stress response of this subject group was high, -the stress response of women higher than that for men. In an earlier study(June, 1992) with another sample, the total mean SOS score was similar to this one. The main stressful life events or / and daily activities were, in order, economic problems (N=97), interpersonal problems (N=68), children care problems (N=258), health problems (N=49), communication problems (N=42), family problems (N=38), worry about future career (N=36), and religious problems (N=25). There was a significant difference in the SOS means between the group that expressed life events or / and daily activities to be stressful and the group that did not. Interpersonal relationships and economic and family problems were stressors for those who complained about peripheral manifestations. cardiopulmonary symptoms, central-neurological symptoms, gastrointestinal symptoms, muscle ten-sion, habitual patterns, depression, anxiety, emotional irritability and cognitive disorganization. In summary, interpersonal relationships and economic and family problems influenced stress response manifestations. Income, the number of people in the family, the year of immigration. the level of education, and marital status were related to physiological and psychosocial stress responses.

• 농촌지도와개발
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• 제13권1호
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• pp.149-171
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• 2006

This is a pilot study on rural women's psychological trap to define some obstacles to self directed learning. During few decades, according to major crop of each farm household has shifted from rice to other crops like as vegetables, fruits, horticultures, livestock, etc., women's role or labor sharing of women in farming has been also increased. Although women are important human resources, till now, there is no a research or an approach to rural woman on the view of individual human being. Therefore this study will contribute to understand woman's behavior or attitudes based on psychological description at each person's experiences. For this study, the data was collected from 23 women leaders who participated in a training course in 2005, through the scale of Jeffrey E. Young & Janet S. Klosko which was developed to improvement of one's repetitious behavior based on cognitive psychological care. It was categorized into 11types of psychological trap of one person, named as follows; (1) trap of being deserted by someone (2) trap of disbelief and being ill-treated (3) trap of weakness (4) trap of dependence (5) trap of emotional deprivation (6) trap of feelings of alienation among society (7) trap of deficiency (8) trap of anxiety to failure (9) trap of subordination (10) trap of the merciless standard by self-estimation (11) trap of the sense of privilege. From the data, the average age of subjects was 52.8years old, and the educational back of subjects was higher than general rural women. In both of the trap of weakness and the trap of the merciless standard by self-estimation, the ratio of over and 4 point score of 6 points was 71.4% and 76.2%. It means most of subjects have experienced fear of unexpected calamity(trap of weakness), and mental press hard for efforts to meet one's ideal standard(trap of the merciless standard by self-estimation). Especially the trap of the merciless standard by self-estimation may have relation with rural women's over burden from farming and local society activities.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제11권2호
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• pp.240-251
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• 2000

본 연구는 청소년 정신과 환자 중 외톨이 혹은 왕따 특성을 보이는 환자에 대한 예비연구이다. 청소년 정신과 환자 25명에게 외톨이 설문지, 왕따 설문지 등 8개 설문지를 시행하였고, 일반적인 친구 관계를 질문하였다. 외톨이 설문지 및 왕따 설문지의 점수를 근거로 15명의 외톨이-왕따 집단과 10명의 비외톨이 집단으로 나눈 뒤 일반적 친구 관계와 8개 설문지의 점수를 비교하였다. 또한 5명의 외톨이-왕따 환자 사례를 분석하였다. 이때 SCL-90-R의 우울 차원 점수, 불안 차원 점수, 편집 차원 점수, SCL-90-R의 4가지 차원의 총합, 사회 불안 설문지 점수 등에서 두 집단이 유의한 차이를 보였다. 5명의 외톨이-왕따 환자의 사례 분석 결과, 병원을 찾은 청소년 정신과 환자는 언어 발달 및 인지 발달의 지연 등 발달에서의 문제가 동반되는 경우에 외톨이-왕따를 당할 가능성이 높은 경향을 보인다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제28권2호
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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.

• 감성과학
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• 제20권2호
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• pp.33-44
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• 2017

심리치료의 궁극적인 목표는 특정한 심리적 문제를 유발하는 근본적 원인을 파악하여 이를 수정하고 변화시키는 것이다. 본 연구는 이와 같은 관점에서 최근 사회적 문제로 급부상하고 있는 SNS 중독의 근본 원인을 파악해서 향후 심리치료 프로그램 개발에 도움을 제공하고자 한다. 본 연구는 선행 연구 개관을 통해서 부적응적 자기개념(예: 낮은 자기존중감), 부적응적 성격 특성(예: 강한 자기애), 그리고 강한 부정적 정서 경험(예: 높은 수준의 불안)이라는 SNS 중독의 표면적 원인을 파악하였다. 이후 본 연구는 선행 연구 개관을 기반으로 이들 표면적 원인 기저의 근본적 원인으로 인지적 차원의 초기 부적응 도식과 정서적 차원의 정서조절곤란을 도출하고 '초기 부적응 도식 ${\rightarrow}$ 정서조절곤란 ${\rightarrow}$ SNS 중독'이라는 심리적 부적응 기제를 개념적으로 제안하였다. SNS 중독의 고위험군인 20대를 대상으로 설문조사를 실시한 결과, 20대 여성 집단에서 이와 같은 심리적 부적응 기제가 나타났지만 20대 남성 집단에서는 '초기 부적응 도식 ${\rightarrow}$ SNS 중독'의 관계만 유의미한 것으로 밝혀졌다. 본 연구 결과는 20대 남녀의 초기 부적응 도식에 대한 인지치료나 20대 여성의 정서조절곤란에 대한 정서치료가 SNS 중독 치료에 실질적으로 도움이 될 수 있다는 함의를 제공한다.

• 정신신체의학
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• 제22권1호
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• pp.31-39
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• 2014

연구목적 이 연구는 2년 6개월 동안 일 병원에 입원 중인 HIV감염/AIDS환자에 대한 정신건강의학과 자문 의뢰를 분석하였다. 방법 일 병원에서 2011년 1월 1일부터 2013년 6월 30일까지 자문 의뢰된 97명의 HIV감염/AIDS 환자와 282개의 자문 의뢰를 대상으로 후향적 의무기록 연구를 수행하였다. 결과 97명의 HIV감염/AIDS 환자 중 91명(93.8%)이 남자였으며, 평균연령은 48세, 연구 기간 동안 평균 1인당 자문건수는 2.8건이었다. 주로 호소한 증상으로는 우울 102건(55.3%), 불면 60건(14.0%), 불안감 31건(7.2%) 등이었으며, 최초 자문의뢰 시 진단된 정신과적 질환은 우울장애 37명(37.0%), 인지장애 11명(11.0%), 섬망 9명(9.0%) 등 이었고 투약 권고된 향정신병 약물은 Lorazepam 99건(17.2%), Escitalopram 90건(15.7%), Quetiapine 84건(14.6%) 순이었다. 결론 HIV감염/AIDS 입원 환자들은 '우울감', '불면', '자살사고/시도' 등을 주문제로 정신건강의학과로 자문의뢰 되었고, 자문의뢰 환자의 85명(93.3%)에서 정신장애로 진단을 받았다 그러나 자문의뢰 환자의 16.9%만 퇴원 후 본원 정신건강의학과로 외래 추적 진료가 이루어져, 향후, 정신건강문제가 HIV감염 및 AIDS의 치료 순응도, 예후, 전파에 미치는 영향에 대한 장기적 연구가 필요할 것으로 보인다.

• 한국산학기술학회논문지
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• 제16권1호
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• pp.462-470
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• 2015

본 연구는 사회경제적 차이가 아동의 뇌기능과 문제행동증후에 미치는 영향에 대해서 살펴보았다. 장애, 질병 또는 인지기능에 문제가 없는 저소득층(LIC) 아동 30명, 중산층(MC)아동 30명을 대상으로 2013년 1월부터 4월까지 뇌기능 분석과 K-CBCL을 이용한 아동문제행증후의 데이터를 측정 분석하였다. 연구 결과는 첫째, LIC아동은 MC아동보다 세타파(${\Theta}$), SMR파의 비율과 델타파(${\delta}$), 고베타파(${\beta}h$), 알파파(${\alpha}$):저베타(${\beta}l$)의 비율이 유의미하게 높게 나타났고, MC아동은 LIC아동보다 자기조절지수 주의지수 정서지수 항스트레스지수 브레인 지수의 값에서 더 유의미하게 높다는 것을 보여주었다. 둘째, 아동문제행동증후는신체증상, 우울/불안, 사회적 미성숙, 사고의 문제, 주의집중문제, 공격성, 내재화, 외현화, 총 문제행동, 정서불안정에 있어서 LIC아동이 MC아동에 비해서 더 유의미하게 높았고, MC아동은 사회성, 학업수행능력, 총 사회능력에서 LIC아동보다 유의미하게 높았다. 결론적으로, LIC아동과 MC아동의 사회경제적 차이가 상기 뇌기능과 문제행동증후에 영향을 미치는 것으로 밝혀졌다.

• 한국콘텐츠학회논문지
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• 제18권4호
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• pp.636-652
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• 2018

본 연구는 심리적 트라우마를 경험한 후 일상에 적응하지 못하는 현상에 대한 비정신병리적 접근으로의 도덕적 손상이라는 개념을 탈북여성의 경험을 재해석하고 이해하는데 적용시키고자 실시되었다. 이를 위해 데이터베이스 KISS와 DBpia를 이용하여 2017년 8월 13일까지 국내 학술지에 출판된 질적 연구물 중 '탈북여성' '새터민 여성' '북한이탈 여성'이라는 주제어를 포함하는 연구물을 검색 했다. 최종 선정된 총 51개의 질적 연구물의 내용분석을 실시한 결과는 다음과 같다. 첫째, 연구주제로는 적응경험, 어머니로서의 경험, 북한 체제와 전쟁에 대한 경험, 일/직업/고용 경험, 정신적인 충격에 대한 극복 및 성장과 회복탄력성의 경험, 중국에서의 삶에 관한 경험, 트라우마나 심리적인 경험, 심리적 불안함을 치료하는 과정과 효과에 대한 순으로 많이 나타났다. 둘째, 도덕적 손상으로 인해 나타날 수 있는 부정적 감정에 관한 단어는 총 260회, 존재론적 믿음에 미치는 영향과 관련된 단어는 총 82회, 인지의 변화와 관련 단어들이 총 71회, 그리고 행동의 변화와 관련 표현이 총 21회 나타났다. 셋째, 도덕적 손상의 현상을 일으키는 맥락으로 크게 '정체성 부정'과 '가족 해체'가 드러났다. 그리고 도덕적 손상을 일으킬 만한 맥락을 경험했음에도 불구하고 도덕적 손상의 흔적이 발견되지 않았던 정 반대되는 사례들 속에서 '정체성 재구성'이라는 맥락을 공통적으로 발견했다. 이러한 연구결과를 통해 탈북여성이 도덕적 손상으로부터 예방 되는, 혹은 도덕적 손상으로부터의 회복에 필요한 실천적 함의를 제언하였다.

• 정신신체의학
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• 제6권2호
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• pp.104-119
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• 1998

This study was conducted to determine the important factors in the illness behavior of panic disorder patients. And then, find the best ways to lead the patients who have recurrent panic attacks to the adequate therapeutic situations. We studied 53 patients diagnosed as panic disorder according to DSM-IV among the outpatients who had been followed up at Bong Seng Memorial Hospital for 6 Ms, from May 1997 to October 1997. To evaluate the illness behaviors, we designed a checklist including socio-demographic data, degree of subjective distress from medical and psychiatric treatment, panic symptoms, life events, places of help-seeking, Anxiety Sensitivity Index. Using the checklist, we had semistructured interviews with the panic disorder patients to elucidate their help-seeking behaviors from first panic attack to diagnosing as panic disorder. The results were as follows ; 1) After first panic attack, the patients initially sought help at 1) Emergency room 40%, 2) Rest &/or Personal emergency care 35%, 3) Pharmacy 10%, 4) Outpatient care at hospital 10%, 5) Oriental medicine 5%. 2) Considering the panic symptoms, derealization, paresthesia and the severity of panic symptoms were the most important factors affecting the patient's help-seeking behaviors who had experienced the first panic attack. 3) Most of all the patients (80%) were apt to visit the hospitals within 15 days after experiencing about 3 panic attacks. 4) Before diagnosed as panic disorder, the patients had visited 3-5 health care centers during about 1 year. 5) Primary care physicaians(for example, emergency care physicians, family doctors and internists) had the most important roles in treating or guiding the patients to the adequate therapeutic situations. From the above results, the authors propose that non-psychiatric physicians have to know the panic disorder or attacks exactly. When patients complaint sudden onset physical symptoms e.g. palpitation, dyspnea, dizziness or the cognitive symptoms like the fear of death or insanity, physicians should consider the possibility of panic attack and encourage the patients to be evaluated for psychiatric illness.