• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제22권4호
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• pp.246-252
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• 2011

Background : The objective of this study was to evaluate the diagnostic efficiency of the Comprehensive Attention Test (CAT) by comparing the results of the continuous performance test (CPT) and the CAT in children and adolescents with attention-deficit hyperactivity disorder (ADHD). Method : A total of 110 children and adolescents with ADHD (mean age : 11.2${\pm}$2.9 years, 76 boys) and 36 children and adolescents without ADHD (mean age : 12.0${\pm}$2.7 years, 25 boys) completed the CAT. We compared the specificity and sensitivity of the CPT and CAT at two different cut-off points via the McNemar test. The areas under the receiver operating characteristic curves (AUC) between the two groups were compared using Medcalc software. Results : The sensitivity and specificity of the CPT were .419 and .806, respectively. The sensitivity of the CAT was .827, which was significantly higher than that of the CPT (p<.001), and the specificity of CAT is .444, which was significantly lower than that of CPT (p<.001). The AUC of the CPT and CAT was .664 and .692, respectively, and there were no significant difference between the two groups on the paired comparison (p=.513). Conclusions : The results of this study suggest that the CAT has moderate specificity and high sensitivity. The CAT can be used as a useful tool to evaluate the neuropsychological function of children and adolescents with ADHD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제20권2호
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• pp.68-75
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• 2009

Objectives: This study was conducted in order to develop and obtain the nonnative data of the computerized Comprehensive Attention Test(CAT) in Korean children and adolescents. It also aimed to evaluate the reliability and validity of the CAT. Methods: We developed the computerized CAT which includes the selective attention task, the sustained attention to response task, the flanker task, the divided attention task, and the spatial working memory task. We investigated the test-retest reliability and the construction validity of this computerized version by using the data from 21 children, and gathered the nonnative data of 9l2 subjects, aged 4 to 15 years, dwelling in the Metropolitan Seoul area in 2008. Results: No statistical differences between means of the tests and retests of the CAT were observed. The mean of the correlation coefficient of the test-retest scores was 0.715. The results from the factor analyses explained 51.7% of the cumulative variance. In addition, the nonnative data for all of the CAT subtests were obtained. Conclusion: The computerized CAT can be used as a reliable and valid tool in both clinical and research settings for Korean children and adolescents with or without neuropsychiatric conditions such as attention deficit.

• 정신신체의학
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• 제25권1호
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• pp.63-72
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• 2017

연구목적 본 연구는 주의력결핍 과잉행동장애(attention-deficit/hyperactivity disorder, ADHD) 환자들을 대상으로 다양한 실행기능과 정량화 뇌파간의 상관성을 알아보고자 하였다. 방법 31명의 소아청소년 ADHD 환자를 대상으로 정량화 뇌파를 측정하였다. 종합주의력검사(Comprehensive Attention Test, CAT), 스트룹 색-단어 추론 검사(Color-Word Inference Test, CWIT), 선추적 검사(Trail Making Test, TMT), 카드분류검사(Card Sorting Test, CST)가 시행되었고 한국어판 주의력결핍 과잉행동장애 평정척도(Korean version of the ADHD Rating Scale, K-ARS)가 측정되었다. 결과 CAT 검사 점수와 알파, 베타 파워가 양적 상관이 있는 반면, 델타 파워와는 부적 상관이 있었다. CWIT 검사에서는 감소된 델타 파워와 증가된 베타 파워가 높은 수행수준과 관련 있었다. 높은 TMT 검사 점수는 증가된 알파 대역 파워와 관련이 있었으며, CST 검사에서 델타 파워는 높은 수행수준과 부적 상관이 있는 반면 알파, 하이 감마파의 파워와는 양적 상관을 보였다. K-ARS 점수는 알파 파워와 부적 상관을 보였다. 결론 정량화 뇌파는 ADHD 환자들의 실행기능과 상관성을 보이며 신경생리학적 지표로서의 유용성이 시사된다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제29권3호
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• pp.129-136
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• 2018

Objectives: This study aimed to evaluate the efficacy of the attention-deficit/hyperactivity disorder (ADHD)-After School Checklist (ASK) by comparing the results of the Comprehensive Attention Test (CAT) and Clinical Global Impression-Severity (CGI-S) Scale and then by calculating the area under the receiver operating characteristic (ROC) curve. Methods: We performed correlation analyses on the ASK and CAT results and then the ASK and CGI-S results. We created a ROC curve and evaluated performance on the ASK as a diagnostic tool. We then analyzed the test results of 1348 subjects (male 56.8%), including 1201 subjects in the general population and 147 ADHD subjects, aged 6-15 years, from kindergarten to middle school in Seoul and Gyeonggi province, South Korea. Results: According to the correlation analyses, ASK scores and the Attention Quotient (AQ) of CAT scores showed a significant correlation of -0.20--0.29 (p<0.05). The t-test between ADHD scores and CGI-S also showed a significant correlation (t=-2.55, p<0.05). The area under the ROC curve was calculated as 0.81, indicating good efficacy of the ASK, and the cut-off score was calculated as 15.5. Conclusion: The ASK can be used as a valid tool not only to evaluate functional impairment of ADHD children and adolescents but also to screen ADHD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제22권4호
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• pp.253-261
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• 2011

Objectives : This study aimed to investigate the efficacy and safety of Metadate CD (MCD) when given to Korean children and adolescents with attention-deficit hyperactivity disorder (ADHD). We also explored the effects of the drug on diverse neuro-cognitive functions. Methods : Ninety-one subjects with ADHD (mean age 8.6${\pm}$2.2 years) were recruited at 6 outpatient clinics in Seoul, Korea. We used the ADHD Rating Scale (ARS), Clinical Global Impression (CGI), and comprehensive attention test (CAT) to measure the drug's effects. Results : After 0.92${\pm}$0.32mg/kg/day of MCD were administered for 57.4${\pm}$7.6 days, there was a 48.5% reduction in the mean total ARS scores (p<.001). Fifty-seven subjects (64.8%) showed either much improved or very much improved outcomes on the CGI-Improvement scale. The CGI-Severity scale also decreased from an average of 4.7 to an average of 2.9 (p<.001). Errors and response time standard deviations of the CAT, sustained attention test-to-response tasks, the flanker test, and divided attention test scores decreased after treatment (p<.05). The forward memory span of the spatial working memory test scores increased (p<.05). Thirty-five patients (39.8%) experienced side effects, of which the most common were headache (14.8%), nausea (12.5%), and anorexia (9.1%). Conclusion : This open-label study suggests that MCD is effective and safe in improving the symptoms and neurocognitive functions of Korean children and adolescents with ADHD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제34권4호
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• pp.275-282
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• 2023

Objectives: This study aimed to identify the psychiatric comorbidity status of adult patients diagnosed with attention-deficit hyperactivity disorder (ADHD) and determine the impact of comorbidities on neuropsychological outcomes in ADHD. Methods: The study participants were 124 adult patients with ADHD. Clinical psychiatric assessments were performed by two board-certified psychiatrists in accordance with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. All participants were assessed using the Mini-International Neuropsychiatric Interview Plus version 5.0.0 to evaluate comorbidities. After screening, neuropsychological outcomes were assessed using the Comprehensive Attention Test (CAT) and the Korean version of the Wechsler Adult Intelligence Scale, Fourth Edition (K-WAIS-IV). Results: Mood disorders (38.7%) were the most common comorbidity of ADHD, followed by anxiety (18.5%) and substance use disorders (13.7%). The ADHD with comorbidities group showed worse results on the Perceptual Organization Index and Working Memory Index sections of the K-WAIS than the ADHD-alone group (p=0.015 and p=0.024, respectively). In addition, the presence of comorbidities was associated with worse performance on simple visual commission errors in the CAT tests (p=0.024). Conclusion: These findings suggest that psychiatric comorbidities are associated with poor neuropsychological outcomes in adult patients with ADHD, highlighting the need to identify comorbidities in these patients.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제27권2호
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• pp.109-118
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• 2016

Objectives: The aim of this study was to develop the computerized Comprehensive Learning Test-Reading (CLT-R) to evaluate the cognitive processes and achievements related to their basic reading ability and identify dyslexia in children and adolescents in South Korea. We also obtained the normative data and evaluated the reliability and validity of the test. Methods: We developed the CLT-R, including the word attack/nonword decoding, paragraph reading, sound blending, nonword repetition, rapid automatized naming, letter-sound matching, visual attention, orthography awareness, and digit span tests, for the purpose of diagnosing dyslexia. We investigated the reliability and validity of the tests and gathered the normative data from 399 subjects (male 48.9%), aged 5-14 years, from the last grade in kindergarten to middle school, dwelling in Seoul and Gyeonggi Province, South Korea. Results: No statistical differences were observed between the means of the tests and retests of the CAT. The mean of the correlation coefficient of the test-retest scores was 0.85. According to the construct validity test calculated by principal constant analysis using the oblique rotation method, 4 factors explained 70.0% of the cumulative variances. In addition, the normative data were obtained for all of the CLT-R subtests. Conclusion: The computerized CLT-R can be used as a reliable and valid tool to evaluate the reading achievement and reading related cognitive process in Korean children and adolescents in schools, clinics, and research institutes.

• 한국산림과학회지
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• 제104권4호
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• pp.657-667
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• 2015

본 연구에서는 인터넷중독 위험 청소년들에 대한 '산림치유(Forest Therapy)'의 생물학적, 신경인지적 및 심리사회적 영역에서의 효과를 살펴보았다. 청소년 인터넷중독 위험군을 대상으로 2박 3일 혹은 3박 4일 형태의 산림치유 캠프를 진행했고, 캠프 전-후로 참가자들의 혈청 뇌유래신경영양인자(BDNF), 종합주의력 검사(CAT) 그리고 우울(CDI) 및 상태 불안(STAI)을 포함한 다양한 심리사회적 변인들을 측정했다. 그 결과, 산림치유 캠프에 참가한 이후에 참가자들의 혈청 BDNF 수치 및 CAT의 수행점수가 증가했고, 인터넷/게임 욕구가 감소했으며, 회복탄력성 및 대인관계가 긍정적인 방향으로 변화하였다. 또한, 산림치유 캠프 노출량에 따라 집단을 구분하여 분석한 결과, 집단내에서 일부 불안 완화를 보고하기도 하였다. 전반적으로 인터넷중독 위험 청소년의 증상 개선 및 적응력 증가를 위한 산림치유의 적용가능성을 확인하였다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제22권4호
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• pp.236-245
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• 2011

Objectives : The objective of this study was to evaluate the relationship of the parenting stress with their children's characteristics for typically developing preschool children. Methods : Parents of 38 preschool children (mean age : 4.4${\pm}$0.7 years, 22 boys) completed the Korean Parenting Stress Index, the Korean Child Behavior Checklist, the Conners Parent and Teacher Rating Scale-Abbreviated form (CPRS and CTRS), the Junior Temperament and Character Inventory, the Children's Sleep Habit Questionnaire and the Social Responsiveness Scale. All 38 children performed the Comprehensive Attention Test (CAT). Results : The children's inattentive and hyperactive problems, as measured by the CBCL, CPRS and CAT, had positive correlation with parenting stress. Both internalizing and externalizing behavioral problems were associated with parenting stress. Of the child's temperament dimensions, Novelty Seeking and Harm Avoidance were positively correlated with parenting stress, but Persistence and Cooperativeness were negatively correlated with parenting stress. Sleep anxiety and other sleep characteristics showed a correlation with parenting stress. Social Motivation and Communication were also positively related to parenting stress. Conclusion : Our results suggest that parenting stress could be related to the children's cognition, emotion, behavioral characteristics, sleep habits and social development. These results could assist in the development of interventions to improve the parental well-being in typically developing preschool children.

• 한국산학기술학회논문지
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• 제17권4호
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• pp.351-360
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• 2016

본 연구의 목적은 표준화된 종합주의력검사(CAT)의 소검사인 시공간 작업기억력 검사를 통해 얻어진 실험대상자의 안정상태 뇌파 활성차이로 시공간 작업기억력 수행능력을 예측할 수 있는 지를 알아보고자 하는 것이다. 실험 대상자는 2014년 12월 1개월 동안 학업 성취도와 무관한 31명의 일반적인 중학생 중 시공간 작업기억력 검사 후 순방향과 역방향 공간폭 결과에서 표준편차를 벗어난 7명과 6명이 선별되었고, 선별된 대상자를 각각 작업기억력 우수 집단(EWM)과 저하 집단(PWM)으로 구성하였다. 뇌파 측정과 뇌파 밴드별 상호 연관성을 통한 뇌기능 지수의 하위요소를 알아보기 위해 뇌기능분석 프로그램을 사용하였고 집단 간 차이 검증을 위한 통계 처리는 Mann-Whitney Test로 하였다. 연구 결과는 첫째, 순방향 작업 기억력 검사 결과 EWM과 PWM 집단 간 고베타파 활성도에서 좌뇌와 우뇌 모두 유의미한 차이를 보였고 저베타파 활성도에서는 우뇌에서만 유의미한 차이가 나타났다. 둘째, 세타파와 알파파 활성도는 통계적 유의수준에는 도달하지 못했다. 결론적으로 시공간 작업기억 수행능력과 안정 상태시 고베타파와 저베타파 활성도와 상관관계가 있음을 보여주며 특히 시공간 작업기억 수행능력과 우뇌의 정신적 활동 및 사고능력과는 상관관계를 보여 주었다. 시공간 작업기억 수행능력을 안정 상태에서도 베타파의 활성도를 통해 예측할 수 있다는 점이 본 연구가 갖는 의의이다. 향후 뇌파의 활성도가 작업기억력 평가 도구와 근거자료로써 활용될 수 있기를 기대한다.