• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.25 no.4
• /
• pp.187-195
• /
• 2014

Objectives : The objective of this study was to investigate the relationship between restricted, repetitive behaviors and interests (RRBI) and autistic symptoms in Korean high functioning autism spectrum disorder (ASD) children and to examine the structure of RRBI. Methods : Participants included 147 high functioning ASD subjects and 181 unaffected siblings. ASD subjects were divided into two groups based on the presence of RRBI. The domain scores of the Korean version of Autism Diagnostic Interview-Revised (K-ADI-R), Korean version of Asperger Syndrome Diagnostic Scale and total scores of Korean translated version of Social Responsiveness Scale, Korean version of Social Communication Scale were used for comparison of ASD symptoms between the groups. Eleven items from the RRBI domain of the K-ADI-R were used in principal axis factor analysis (PAF). Results : A statistically lower nonverbal IQ score was observed for ASD with RRBI than for ASD without RRBIs, and more social deficit, communication deficit, and behavioral and emotional problems were observed for ASD with RRBI compared to ASD without RRBI. Using PAF, two distinct factors were identified. 'Resistance to trivial changes in environment', 'Difficulty with minor changes in personal routine & environment', and 'Compulsion/ritual' were included as one factor. Conclusion : Analysis of the data suggests that the presence of RRBI in high functioning ASD is associated with a more severe presentation of autistic disorder. In addition, there appears to be heterogeneity within RRBI in autism except insistence on sameness.

• Clinical and Experimental Pediatrics
• /
• v.54 no.1
• /
• pp.22-28
• /
• 2011

Purpose: To investigate the clinical characteristics of late-onset epilepsy combined with autism spectrum disorder (ASD), and the relationship between certain types of electroencephalography (EEG) abnormalities in ASD and associated neuropsychological problems. Methods: Thirty patients diagnosed with ASD in early childhood and later developed clinical seizures were reviewed retrospectively. First, the clinical characteristics, language and behavioral regression, and EEG findings of these late-onset epilepsy patients with ASD were investigated. The patients were then classified into 2 groups according to the severity of the EEG abnormalities in the background rhythm and paroxysmal discharges. In the severe group, EEG showed persistent asymmetry, slow and disorganized background rhythms, and continuous sharp and slow waves during slow sleep (CSWS). Results: Between the two groups, there was no statistically significant difference in mean age (P=0.259), age of epilepsy diagnosis (P=0.237), associated family history (P=0.074), and positive abnormal magnetic resonance image (MRI) findings (P=0.084). The severe EEG group tended to have more neuropsychological problems (P=0.074). The severe group statistically showed more electrographic seizures in EEG (P=0.000). Rett syndrome was correlated with more severe EEG abnormalities (P=0.002). Although formal cognitive function tests were not performed, the parents reported an improvement in neuropsychological function on the follow up checkup according to a parent's questionnaire. Conclusion: Although some ASD patients with late-onset epilepsy showed severe EEG abnormalities, including CSWS, they generally showed an improvement in EEG and clinical symptoms in the longterm follow up. In addition, severe EEG abnormalities tended to be related to the neuropsychological function.

• Anxiety and mood
• /
• v.14 no.2
• /
• pp.88-98
• /
• 2018

Objective : The purpose of this study was to establish a school-based mental health intervention. The success of which was indexed by its effects on the social anxiety symptoms of the enrolled adolescents. Methods : This program for promoting mental health among adolescents in the community was adopted by three middle schools that volunteered to participate in the project. The program included screening for emotional problems related to social anxiety, depression, suicide, and post-traumatic stress disorder. Case management was provided for groups considered high-risk for depression, suicide, or post-traumatic stress disorder; cognitive-behavior therapy was provided for those at high-risk of developing social anxiety. Additionally, educational programs for the prevention of suicide, a "loving life" module, and mental health promotional campaigns were also included. In total, 1,100 middle school students completed self-report questionnaires. Twenty-five students in the high-risk group for social anxiety participated in a cognitive-behavior therapy program, comprising eight sessions, and conducted by two clinical psychologists. Results : Following the suicide prevention education program, suicide awareness among students increased and coping strategies were improved. In addition, the loving life program was associated with positive self-perceptions by many students. Furthermore, social anxiety symptoms showed a statistically significant difference after the cognitive-behavior therapy program. After the therapy, not only did social anxiety symptoms improve, depressive symptoms and suicidal ideation decreased significantly, while self-esteem and psychological resilience significantly increased. Conclusion : A school-based mental health intervention was successfully implemented in three middle schools and improved the mental health of the participating students. Therefore, this intervention could be widely implemented to promote positive mental health among middle school students.

• The Journal of Pediatrics of Korean Medicine
• /
• v.32 no.4
• /
• pp.13-23
• /
• 2018

Objectives The Eum-Yang (Yin-Yang in English) temperament was shown to have clinical and structural validity with Sasang Personality Questionnaire (SPQ), however the studies of the association with behavior problems and personality structure in adolescents were not satisfactory. The purpose of this study was to examine the relationships between Eum-Yang temperament and behavior problems in Korean middle school students. Methods 122 first grader of middle school students (68 boys and 54 girls) completed SPQ, Junior version of Temperament and Character Inventory (JTCI), and Youth Self Report (YSR). The correlations between SPQ, JTCI, and YSR subscales were investigated. And, also the differences between SPQ, JTCI, and YSR subscales among Yang (high 30% of SPQ total score) and Eum (low 30% of SPQ total score) temperament groups classified with SPQ total score were examined. Results The SPQ total score were correlated with Novelty-Seeking (r=.321) and Reward-Dependence (r=.392) in boys, and with Novelty-Seeking (r=.427) and Harm-Avoidance (r=-.444) in girls. The SPQ total score were not significantly correlated with Body Mass Index, Ponderal Index and YSR total, however significantly correlated with YSR Internalizing problems and Withdrawal/depressed subscale (r=-.242 and r=-.419) in boys and Withdrawal/depressed subscale (r=-.449) in girls. There were significant differences between Eum and Yang groups in Novelty-Seeking, Harm-Avoidance and Withdrawal/depressed as for boys and girls. Conclusions The biopsychological structure of SPQ was confirmed with middle school students. The behavioral (SPQ-B) and emotional (SPQ-E) perspectives of Eum-Yang were found to be protective and risk factors, and also correlated with Externalizing and Internalizing behavior problems, respectively. The biopsychological characteristics of Eum-Yang temperament and its relation with psychopathological symptoms in late-childhood should be carefully analyzed.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.10 no.1
• /
• pp.100-112
• /
• 1999

Objective：In life-long disabilities like autism and mental retardation, the authors thought that it is important for clinician to consider the quality of life of a primary caregiver for long-term management and prognosis. This study was to investigate the factors of children and family environment affecting the quality of life and depression in mothers with autistic and/or mentally retarded children. Methods：41 autistic and/or mentally retarded children aged 5-12 years with their mothers were surveyed from September, 1998 to January, 1999, with K-CBCL, K-BDI, K-FES, and K-SBQOL scale and compared with data from 35 normal control subjects. Results：1) Total K-BDI and K-SBQOL scores of mothers with mentally handicapped children were significantly poorer than the scores of normal control group. Independence, intellectual/cultural orientation and active recreation subscales of K-FES in mentally handicapped children were significantly decreased than those in normal control group. 2) Total K-BDI score of mothers with mentally handicapped children was correlated with their children’s behavioral problems, especially internalizing and thought symptoms, and with family cohesion, expressiveness, conflict and independence. 3) Totol K-SB quality of life score of mothers with mentally handicapped children was correlated with their children’s behavioral problems, especially attention problem, and with family cohesion, conflict, independence, intellectual/cultural orientation, and moral-religional emphasis. 4) The quality of life of mothers with mentally handicapped children was predicted by attention problem($R^2$=.36, p=.000) and social competence($R^2$=.07, p=.038) in children and family cohesion ($R^2$=.16, p=.001). 5) Depression of mothers with mentally handicapped children was predicted by internalizing symptom ($R^2$=.21, p=.003) and thought disorder($R^2$=.06, p=.048) in children and family cohesion($R^2$=.14, p=.008). Conclusion：Reducing behavioral problems and family therapeutic intervention in autistic and mentally retarded children can improve the quality of life of primary caregivers and long-term prognosis of the children, although those are not curative.

• Korean Journal of Psychosomatic Medicine
• /
• v.10 no.2
• /
• pp.142-153
• /
• 2002

The authors intended to investigate personality characteristics and those influence on the outcome of cognitive behavioral therapy in patients with panic disorder. 167 patients who met DSM-IV criteria for panic disorder were assessed by the PDQ-R(Personality Disorder Questionnaire-Revision) and various self-report tools for assessing symptoms of panic disorder. The effect of therapy was measured by the changes of scores and the end state functioning before and after 12-sessions of CBT. The patients with panic disorder were more likely showed obsessive-compulsive, avoidant and paranoid personality disorder and also Cluster C. If is needed when patients were divided into two groups according to total scores of PDQ-R(high or low personality disorder groups), high personality disorder group showed many evidences for increased psychopathology at the start of treatments, this suggested the close linkage between panic disorder and personality disorder. Interestingly, there were no significant differences between both groups in scores of clinical variables and the end state functioning. In conclusion, although patients with high tendency of personality disorder had more generalized problems at the beginning of treatments, they could improve as much as the patients with low tendency of personality disorder. They can be helped by cognitive behavioral therapy for panic disorder and seem to profit as much as patients with low tendency of personality disorder. If is needed to seek other factors in poor responders for cognitive behavioral therapy.

• The Journal of Pediatrics of Korean Medicine
• /
• v.16 no.1
• /
• pp.105-124
• /
• 2002

With the progress of civilization, the disorders due to the stress, which derived from the social-structural complexity and diversity, are on an increasing trend in our times. Accordingly, the accurate diagnosis and appropriate treatment for them are required. Especially in the current years, children's disorders delivered by the emotional problems keep increasing. In this research, the researcher tried to figure out the cause of the children's stress and its treatment, studied the theories of the stress in the modem medicine and the sever emotions in oriental medicine, and came to the conclusion as follows: 1. The stress can be defined as the combination of the reaction to noxious stimuli and its defense mechanism of the body, In oriental medicine, it is considered as pathological notions which includes seven emotions as the internal factor, six evils as the external factor and other foods, expectoration, ecchymoma as the non-internal/external factors. 2. Children usually get stressed by various reasons in a growth process such as schooling, relationship with friends, the opposite sex of family, or change of surroundings, and these can cause the various disorders. 3. In the study of the children's stress symptoms, it is found that the silent reaction is uncommon. It usually appeared in both reactions: firs, physical reactions such as stomachache, vomiting, headache, neural frequent urination, bronchial asthma or excessive respiration and/or, second, behavioral reactions such as a decline of performance, alimentary disorder, e.g. anorexia nervosa or bulimia, sleep disorder, e.g. nightmare or panic in sleep, anthrophobia, refusal to a school attendance or hyperactiveness. Besides, the peculiar mental disorder such as paroxysm of anger, tic, autism, nocturnal enuresis, lack of attentiveness, impediment in linguistic development, learning difficulty, intellectual decline, etc. can be appeared, and the heavy stress during the babyhood can cause the regression of behavior or the immaturity of formation of character. 4. The appropriate treatments for the children's stress are Osteopathy, Manpulation, Aroma Therapy, Alexander Technique, Autonomic Never Control Treatment, Biofeedback, Chiropractic, Dance Therapy, Feldenkrasis Technique, Gravity Therapy, Homepathy, Aquatherapy, Hypnotherapy, Naturopathy and Meditation.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.25 no.3
• /
• pp.142-155
• /
• 2014

Objectives : The aim of this study was to develop an assessment tool for measurement of children's functioning in the mental health service. We conducted a preliminary study to develop a sensitive and inclusive scale focused on the functional changes of children rather than just focusing on their symptoms or screening. Methods : The Child and Adolescent Functional Assessment Scale and the Korean-Child Behavior Checklist (K-CBCL) were both administered to 134 parents of children with emotional or behavioral problems who participated in the Aizone program and also to 186 parents of elementary school children in the Seoul metropolitan area as a control group. SPSS version 12.0 was used for statistical analysis. Results : Most of the reliability coefficients were over 0.70 except those of the conduct behavior items, which showed relatively high internal consistency. The corrected item-total correlations ranged from .411 to 758, except those of conduct behavior items and special measure items. In a concurrent validity test with K-CBCL, the total behavior problem score of K-CBCL was highly correlated with the total score of the Child and Adolescent Functional Assesment Scale (r=.610). For the construct validity, confirmatory factor analysis was performed for each of four areas, including behavior (at home/school), achievement, peer relationship, and emotion. Conclusion : The results showed that the scale was statistically reliable and valid, except for conduct behavior items. This study was conducted only for parents with elementary children. An adolescents group should be included in future studies.

• Biomolecules & Therapeutics
• /
• v.30 no.3
• /
• pp.232-237
• /
• 2022

Autism spectrum disorder (ASD) having core characteristics of social interaction problems and repetitive behaviors and interests affects individuals at varying degrees and comorbidities, making it difficult to determine the precise etiology underlying the symptoms. Given its heterogeneity, ASD is difficult to treat and the development of therapeutics is slow due to the scarcity of animal models that are easy to produce and screen with. Based on the theory of excitation/inhibition imbalance in the brain with ASD which involves glutamatergic and/or GABAergic neurotransmission, a pharmacologic agent to modulate these receptors might be a good starting point for modeling. N-methyl-D-aspartic acid (NMDA) is an amino acid derivative acting as a specific agonist at the NMDA receptor and therefore imitates the action of the neurotransmitter glutamate on that receptor. In contrast to glutamate, NMDA selectively binds to and regulates the NMDA receptor, but not other glutamate receptors such as AMPA and kainite receptors. Given this role, we aimed to determine whether NMDA administration could result in autistic-like behavior in adolescent mice. Both male and female mice were treated with saline or NMDA (50 and 75 mg/kg) and were tested on various behavior experiments. Interestingly, acute NMDA-treated mice showed social deficits and repetitive behavior similar to ASD phenotypes. These results support the excitation/inhibition imbalance theory of ASD and that NMDA injection can be used as a pharmacologic model of ASD-like behaviors.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.12 no.1
• /
• pp.294-300
• /
• 2011

This study was performed to examine the presence of dysphagia and analyze characteristics of the symptoms in cerebrovascular accident(CVA) patients without awareness of dysphagia. A questionnaire for this study was given to CVA patients who had visited P rehabilitation medical center in Busan. Eleven patients (4 males and 7 females) who answered no awareness of dysphasia were given to VFSS, functional dysphasia scale, and NCSE. Descriptive statistics and Pearson correlation analysis were performed by SPSS 12.0. All of subjects without awareness of dysphasia showed characteristics of dysphasia symptoms. Prominent dysfunctions were problems in oral phase and delay of swallowing reflex in pharyngeal phase. For the aspect of cognition, they showed lower score in construction, memory, and similarity than other NCSE items. There was highly significant correlation between orientation, judgment and delay of swallowing reflex. Verbal comprehension and residual materials in oral cavity showed closed correlation. CVA patients without awareness had dysphagia with high probability. The early evaluation of dysphagia should be performed in CVA patients in order to prevent complications due to CVA, so it is necessary to increase the effectiveness of rehabilitation therapy.