• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.35 no.1
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• pp.29-38
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• 2024

We conducted a comprehensive review of behavioral and educational interventions for individuals with autism spectrum disorder (ASD). The most prominent type of intervention, Comprehensive Early Intervention, often referred to as Early Intensive Behavioral Intervention (EIBI), has been found to be particularly effective in improving intelligence and adaptive behaviors. The naturalistic developmental behavioral intervention, designed to enhance social and communication abilities, showed effectiveness in improving language, cognitive function, and social initiation. However, more studies are needed to examine its effectiveness. Intensive individualized intervention, which provides a tailored intervention for a specific target behavior, was effective in improving social skills and communication, as well as reducing sleep, eating, and toileting problems. Cognitive behavioral therapy (CBT) is the most effective method for dealing with emotional difficulties, but it has not been widely used because of the shortage of trained experts. Parent-mediated intervention (PMI) involves parents acquiring knowledge and specific skills to improve their child's functioning or reduce challenging behaviors. Speech and language therapy, sensory integration, Treatment and Education of Autistic and related Communications Handicapped Children, developmental approaches, and social stories are frequently used interventions. However, evidence of their effectiveness has yet to be well established. Based on these findings, intervention recommendations for autism include EIBI, Early Start Denver Model, intensive individualized intervention, CBT, and PMI. The choice of intervention should be tailored to the individual's needs and delivered by qualified professionals with expertise in the specific intervention.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.21 no.3
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• pp.161-167
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• 2010

Objectives: In assessing behavioral/emotional problems in school-aged children, the importance of multi-informant reporting has been well documented. However, in clinical settings obtaining multiple informants' opinions has proven difficult. For that reason, we researched the agreement and predictive validity of the Child Problem-Behavior Screening Questionnaire (CPSQ) in order to reveal how accurate parents' assessments reflected teachers'opinions. Methods: We conducted the first screening for second- and third-grade children from 3 elementary schools in Seoul from 2003 to 2007 using the CPSQ. There were 1178 children included in the analysis. We then administered the Korean version of the Child Behavior Checklist (K-CBCL) as a second screening tool and subsequently, the ADHD Diagnostic System (ADS) and the Korean Educational Development Institute version of the Wechsler Intelligence Scale for Children (KEDI-WISC) was administered by a psychiatrist. We examined each item on the CPSQ and the subscale's agreement between parent and teacher as well as the predictive validity of the CPSQ in children diagnosed with emotional/behavioral problems. Results: The agreement rates between parents and teachers appeared high for questions 18 (0.433), 1 (0.385), and 2 (0.325). Among the subscales, a relatively high correlation was found for externalizing problems, attention deficit hyperactivity disorder, and cognitive problems. For all diagnosed children, their parents revealed a higher sensitivity and lower specificity than teachers. Conclusion: From these results, we confirmed that the CPSQ can be useful for sorting out externalizing and cognitive problems. There is a need for further study, however, with a larger sample size.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.24 no.2
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• pp.83-89
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• 2013

Objectives : It is known that children with attention-deficit hyperactivity disorder (ADHD) experience significant difficulty in recognizing facial emotion, which involves processing of emotional facial expressions rather than speech, compared to children without ADHD. This objective of this study is to investigate the differences in facial emotion recognition between children with ADHD and normal children used as control. Methods : The children for our study were recruited from the Suwon Project, a cohort comprising a non-random convenience sample of 117 nine-year-old ethnic Koreans. The parents of the study participants completed study questionnaires such as the Korean version of Child Behavior Checklist, ADHD Rating Scale, Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version. Facial Expression Recognition Test of the Emotion Recognition Test was used for the evaluation of facial emotion recognition and ADHD Rating Scale was used for the assessment of ADHD. Results : ADHD children (N=10) were found to have impaired recognition when it comes to Emotional Differentiation and Contextual Understanding compared with normal controls (N=24). We found no statistically significant difference in the recognition of positive facial emotions (happy and surprise) and negative facial emotions (anger, sadness, disgust and fear) between the children with ADHD and normal children. Conclusion : The results of our study suggested that facial emotion recognition may be closely associated with ADHD, after controlling for covariates, although more research is needed.

• Anxiety and mood
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• v.12 no.1
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• pp.34-41
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• 2016

Objective : Emotional state and emotion regulation strategies are considered to be important factors influencing the pattern and severity of somatic pain. The aim of this study is to investigate the relationship between cognitive emotional regulation strategies and somatic pain in patients with depression and/or anxiety disorders. Methods : A total of 140 outpatients, diagnosed with depression and/or anxiety disorders according to DSM-IV-TR, were evaluated using the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), the Cognitive Emotion Regulation Questionnaire (CERQ), and the Numerical Rating Scale (NRS) for somatic pain. Pearson correlations and independent t-tests were performed to analyze the relationship between somatic pain, the severity of depression and/or anxiety and cognitive emotion regulation strategies. Results : The severity of pain was significantly correlated with depressive symptoms, but not with anxiety. Patients with somatic pain tend to use maladaptive cognitive emotion regulating strategies more frequently, especially rumination and catastrophizing. Conclusion : These findings suggest that somatic pain correlates with maladaptive cognitive emotional regulating strategies. Interventions which modulate these non-productive strategies, especially rumination and catastrophizing, would be a new approach for managing patients with depressive and/or anxiety disorders who are suffering from somatic pain.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.22 no.3
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• pp.182-191
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• 2011

Objectives: The aim of this study was to investigate the sleep patterns of South Korean elementary school children and whether the differences in sleep patterns were related to behavior, emotional problems, attention and academic performance. Method: This study included a community sample of 268 boys and girls from fourth-, fifth- and sixth-grade classes in a South Korean metropolitan city from November to December 2010. The primary caregivers completed a questionnaire that included information on demographic characteristics, as well as the Child's Sleep Habit Questionnaire (CSHQ), the Korean version of Child Behavior Checklist (K-CBCL), the Korean version of the Learning Disability Evaluation Scale (K-LDES), the Korean version of ADHD Rating Scale (K-ARS) and the Disruptive Behavior Disorder Scale (DBDS). We conducted analyses on the CSHQ individual items, between the subscales, on the total scores and on the K-CBCL, the K-LEDS, the K-ARS and the DBDS. Results: Based on the findings from the CHSQ, the subjects had significantly higher scores for bedtime resistance ($9.18{\pm}2.17$), delayed sleep onset ($1.32{\pm}0.62$), the sleep duration ($4.19{\pm}1.52$) and daytime sleepiness ($14.10{\pm}3.55$) than the scores from the previous reports on children from western countries. The total CHSQ score showed positive correlations to all subscales of the K-CBCL : withdrawn (r=0.24, p<.005), somatic complaint (r=0.24, p<.005) and anxious/depressive (r=0.38, p<.005). Bedtime resistance was associated with oppositional defiant disorder (r=0.15, p<.05) and a positive correlation was demonstrated between sleep anxiety and the oppositional defiant disorder score (r=0.13, p<.05), night waking and the conduct disorder score (r=0.16, p<.05). Delayed sleep onset was related with low performance on the K-LDES with respect to thinking (r=-0.17, p<.05) and mathematical calculation (r=-0.17, p<.05). Conclusion: The results of this study reconfirm Korean children's problematic sleep patterns. Taken together the results provide that the reduced sleep duration and disruption of sleep pattern can have a significant impact on emotion, behavior, performance of learning in children. Further studies concerning more diverse psychosocial factors affecting sleep pattern will be helpful to understanding of the sleep health in Korean children.

• Korean Journal of Psychosomatic Medicine
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• v.7 no.2
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• pp.203-212
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• 1999

Objectives : "Alexithymia" mean literally "no word for mood(or emotion)". It is not only a marked constriction in emotional functioning but a deficit in their cognitive processing. We designed this study to investigate the level of alexithymia, psychopathology and personality factors of patients with somatoform disorder and with diabetes mellitus. Methods : The subjects were consisted of patients with somatoform disorder(N=20), patients with diabetes mellitus(N=20), and normal control(N=20). The level of alexithymia, psychopathology and personality factors were assessed by the Toronto Alexithymia Scale(TAS), the Symptom Checklist 90-Revision(SCL 90-R), and the Sixteen Personality Factor Questionnaire(16-PF). And we compared demographic characteristics, psychopathology and personality factors among three groups, and assessed the relationship between alexithymia and psychopathology, and between alexithymia and personality factors. Results : The results were as follows. 1) Patients with somatoform disorder showed significantly higher TAS scores compared to patients with diabetes mellitus and the normal control group. 2) Patients With somatoform disorder showed significantly higher scores of somatization, anxiety scales than patients with diabetes mellitus and the normal control group, and showed significantly higher scores of obsessive-compulsive, depression, phobic anxiety, psychoticism scales than the normal control group by the SCL-90-R. 3) The normal control group showed high intelligence scores only as compared to patients with somatoform disorder by the 16-PF. 4) A significant relationship was found between TAS scores and psychopathology in patients with somatoform disorder. 5) All three groups did not shown any correlation between TAS and 16-PF. Conclusion : Patients with somatoform disorder showed higher TAS scores and more multiple psychopathology than patients with diabetes mellitus and the normal controls. A significant relationship was found between TAS scores and psychopathology in patients with somatoform disorder. We suggest that the therapeutic approach to patients with somatoform disorder to express emotions and manage psychopathology, and that the treatment methods of patients with diabetes mellitus aims to improve firstly physical conditions are more helpful.

• Korean Journal of Psychosomatic Medicine
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• v.5 no.1
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• pp.52-62
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• 1997

This study was designed to determine the frequency of premenstrual dysphoric disorder in gynecological outpatients, and also attempted to compare premenstrual change characteristics, functional impairment due to premenstrual changes and frequency of risk factors reported by women with confirmed premenstrual changes$(PMC^+)$(n=17) and those without confirmed premenstrual changes$(PMC^-)$(n=23). Forty gynecological outpatients who complained of premenstrual discomforts were asked to complete questionnaires on menstrual history, obstetric-gynecological history, and premenstrual change and functional impairment. The women were also asked to complete a daily rating form based on DSM-IV diagnostic criteria for one menstrual cycle. Absolute severity method, effect size method and percent change method were used to assess changes between follicular phase and luteal phase. The results of the study were as follows: 1) The frequency of premenstrual dysphoric disorder according to each of the three methods was 5% for the absolute severity method, 15% for the effect size method, and 27.5% for the percent change method. 2) The frequently reported symptoms were as follow: physical symptoms(64.7%) : lethargy, easy fatigability, or marked lack of energy(41.2%) : decreased interest in usual activities(29.4%) ; and marked affective lability(23.5%). 3) There were no significant differences in onset ages of premenstrual changes, regularities of premenstrual changes and changes of severity and duration of premenstrual symptoms over time between women with and without confirmed premenstrual changes. However, women with confirmed premenstrual changes reported both physical and emotional symptoms as earliest symptoms most frequently, while women without confirmed premenstrual changes reported only physical symptoms most frequently. 4) functional impairment was significantly higher in women with confirmed premenstrual changes than those without confirmed premenstrual changes, but impairment was not severe. 5) No differences were found between women with and without confirmed premenstrual changes in risk factors including demographic data, menstrual and obstetric and gynecological history. These results suggest that the prevalence of premenstrual dysphoric disorder varies with scoring methods. The women with confirmed premenstrual changes reported physical symptoms most frequently(64.7%). functional impairment was significantly higher in women with confirmed premenstrual changes, but impairment was not severe.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.14 no.1
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• pp.123-127
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• 2003

Cornelia de Lange syndrome is a dysmorphogenic disorder characterized by multiple congenital abnormalities, mental retardation, growth retardation and neurodevelopmental abnormalities. Diagnosis for the Cornelia de Lange syndrome is dependent on the clinical observation because neither definite biological marker nor definite chromosomal abnormality have been investigated. Clinical observation is important for the diagnosis, so we report a case of Corenelia de Lange syndrome with mental retardation and autistic disorder. The patient is a 6-year old girl. Her motor development and language development have been delayed. She could say no meaningful word and understood simple command partially. She showed poor eye contact and poor emotional interaction. Social interaction was impaired and she Showed stereotypic behaviors. Thus we diagnosed her as mental retardation with autistic disorder. She had vesicoureteral reflux, frequent upper respiratory infection and pneumonia. She had experienced febrile convulsions 4 times. She had short stature, confluent eyebrows, long eyelashes, and upturned nose with anteverted nostrils. She also showed low hairline and hypertrichosis in body and extremities. Her finger was short. In this case, we diagnosed Cornelia de Lange syndrome by her characteristic face, hypertrichosis and medical and behavioral problems that were frequently showed in this syndrome.

• Sleep Medicine and Psychophysiology
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• v.16 no.1
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• pp.10-15
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• 2009

Sleep problems and disorders are common in patients with cancer. Sleep of the cancer patients is affected by various factors, including thermoregulatory changes associated with chemotherapy and radiotherapy, cancer related symptoms, such as pain, fatigue, and emotional difficulties. As one of the most common symptoms in cancer patients, fatigue is positively correlated with sleep difficulties. Cytokine is also frequently associated with chemotherapy and radiotherapy. It provokes excessive daytime sleepiness and hypersomnia. Medications for controlling pain, depression, and anxiety can affect sleep of the cancer patients. Medications as well as behavior therapy are reported to be effective for controlling sleep problems, and the physicians need to be accustomed to use the modalities appropriately. This paper reviews causative factors, evaluation, and management of sleep problems and disorders, experienced by cancer patients.

• Korean Journal of Biological Psychiatry
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• v.2 no.1
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• pp.28-37
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• 1995

Clinical neuropsychology which belongs to the necuroscience field is concerned with relationship between human behaviors and the brain structure. Clinical neuropsychology has grown to be a specialized separate field within psychology over the last twenty years. Clinical neuropsychology offers an objective methodology to consider the mind-body interaction and evaluate the behavioral consequences and functional deficits associated with brain lesions. Clinical neuropsychological assessment is composed of cognitive, perceptual, motor and emotional function through various neuropsychological examinations such as Halsted-Reitan and Luria-Nebraska batteries, and computerized neuropsychological test such as PCIS Vienna Test System and Stim. The goals of neuropsychological evaluation are to identify of neuropsychological dysfuncitions, to develop execute and monitor treatment plans, and to make rehabilitation programs. Recently, the neuropsychiatric patients are increasing in number and 15-20% of acute psychiatric patients suffer from organic mental problems. Moreover, clinical neuropsychology has an increasingly important role in both neurobehavioral foundation and clinical application. So, psychiatrists must play a major role in the development of clinical neuropsychology in psychiatry.