• Child Health Nursing Research
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• v.30 no.2
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• pp.87-96
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• 2024

Purpose: The rising prevalence of smartphone overdependence among adolescents and its detrimental impact on mental health have become a growing concern. This study aimed to investigate the association between smartphone overdependence and the mental health of Korean adolescents. Methods: Participants were drawn from the 16th Korea Youth Risk Behavior Web-based Survey conducted in 2020. The dependent variable as smartphone overdependence, while the main exposure of interest was mental health, encompassing generalized anxiety disorder (GAD), perceived stress, sources of perceived stress, perceived loneliness, and perceived depressive symptoms. The study employed the Rao-Scott chi-square test and multiple logistic regression using IBM SPSS version 26.0. Results: The participants comprised 54,948 adolescents aged 13 to 18 years. Among them, 25.1% (n=13,775) were categorized as smartphone overdependence group. Specifically, 20.3% of adolescents who reported GAD ≥10 and 22.5% of those who reported experiencing high levels of perceived loneliness were identified as smartphone overdependent. The GAD increased a risk of smartphone overdependence by 2.61 times (95% confidence interval [95% CI]: 2.46-2.77). Perceived loneliness was associated with 1.98-fold (95% CI: 1.87-2.09) increased risk of smartphone overdependence. Additionally, conflict with peers was found to increase the risk of smartphone overdependence by 4.63-fold (95% CI: 3.89-5.52), followed by conflict with parents (odds ratio [OR]: 4.52, 95% CI: 3.84-5.31), and family environment (OR: 4.52, 95% CI: 3.75-5.46). Conclusion: The findings underscore a significant association between smartphone overdependence and mental health in Korean adolescents. Healthcare services to improve their emotional coping and interpersonal skills are necessary.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.13 no.1
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• pp.15-23
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• 2002

Knowledge regarding the resilience factors and risk factors of the childhood trauma on the developental trajectory is in its infancy due to the lack of prospective follow-up studies in the childhood trauma and limited understanding of the complex reciprocal interactions between childhood trauma, develop-ent and various aspects of children's environment. These difficulties in the conceptual framework and research methods in the childhood trauma are partly reflected in the inconsistencies, even controversies, of the results in the childhood trauma researches. Despite these difficulties, common aspects of the risk factors and resilience of the childhood trauma on the development can be identified from the previous studies. The resilience to the negative outcome on the development by childhood trauma includes：sex female before puberty, male after puberty or infancy), high socioeconomic status, no organic problem, easy temperament, no previous experience with early loss or separation, younger age at the trauma, better problem solving capacity, high self-esteem, internal locus of control, high coping skills, ability to identify interpersonal relationships, ability to play, sense of humor, having capable parents, having a warm relaionship with at least one of the parents, high education and participating in the organized religious activities. These commonalities of the results suggest that risk and resilient factors of the childhood trauma are interdependent, each factor has multiplicity in the impacts on the children's development according to the developmental stage of the child, family and children's other environment, trauma and stressor have diverse effects according to their intensity and risk and resilience factors could have synergistic or antagonistic effects to each other. To develop comprehensive understanding on the relationship between childhood trauma and developmental psychopathology, risk and resilience factors and to develop effective and efficient prevention and intervention, research on the effect of the stress on the neurodevelopment, on the individual differences of the response to the trauma including genetic factors and constitution, and on the brain plasticity should be accompanied in the future.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.8 no.1
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• pp.22-33
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• 1997

The objective of this study is to understand disordered parent-child relationships of Reactive Attachment Disorder(RAD) systematically through the mother’ internal working model of child. In this study, RAD mothers’internal representations of the child were compared with mothers’of control group and association between mothers’ representation classifications and children’ attachment classifications was examined. Also individual differences in mother-child interaction by mothers’representation classifications was observed. The subjects of this study were 40 2-5 year-old children and their mothers, 20 attachment disordered dyads and 20 normal dyads of control group. Mothers were interviewed using the Working Model of the Child(Zeanah, Benoit & Barton 1986) to classify internal representations of child. Children’ attachment patterns were assessed by the Strange Situation Procedure. For observation of motherchild interaction, Each dyad was seen in DPICS devised by Eyberg and Robinson(1983). The results of the study were as follows：1) Among RAD group, 55% of mothers were classified as disengaged and 45% classified as distorted, while all mothers of control group were classified as balanced. In rating scales, there were significant differences in all 3 representation classifications in Intensity of involvement and Coherence. In Intensity of involvement disengaged representations had the lowest score and distorted representations had the lowest score in Coherence. 2) Mothers’representation classifications were related to children’ attachment classifications. All mothers of control group whose children were classified as secure were classified as balanced. Among RAD’ mothers, by contrast, 82% of mothers classified as disengaged had children classified as anxious-avoidant, 56% of mothers classified as distorted had children classified as disorganized / disoriented and 33% of mothers classified as distorted had children classified as anxious-resistant. 3) There were individual differences in mother-child interactions by mothers’representation classifications. In the child-centered play, mothers classified as disengaged used discriptive statement, reflective statement and discriptive-reflective question less than balanced mothers. Mothers classified as distorted used direct command and indirect command more than balanced mothers. In the clean-up task, mothers classified as disengaged and distorted used direct command and indirect command more than balanced mothers. The results of this study suggest that parents’working model of the child is an important factor to understand parent-child attachment relationships and their interactions. The understanding of parents’ working model of the child is thought to enrich our understanding of disordered parent-child relationships and to provide useful informations for specific and successful treatments.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.9 no.1
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• pp.82-90
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• 1998

This study is attempted to examine Korean teachers’ perceptions of mental health problems in students and their attitudes towards psychiatric consultations through a questionnaire survey. The results of this study are as follows. 1) Teachers thought that 5.3% of their students had mental health problems, 1.9% of students required psychiatric evaluation, and 1.2% of students were referred or recommended psychiatric evaluation by their teachers. 2) The most frequent mental health problems in students discovered by teachers were distractibility and inattention, lack of academic skills, and language difficulties in elementary schools；distractibility and inattention, conduct problems, and lack of academic skills in middle schools；and conduct problems, distractibility and inattention, physical symptoms, and substance abuse in high schools. 3) Teachers thought the mental health problems in students were caused by the family environment, psychological factors, the educational system, and a lack of mental health services. 4) Teachers desired smaller classes, improvement of the school environment, more time, regular mental health education, a special program for students with mental health problems, and the counseling staffs or consultants for the school mental health. 5) Teachers consulted with other teachers, the parents of the students, the counseling teachers, the health care teachers, the counseling institutes, the psychiatric clinics, and the principals in descending order to handle the hard case problems. The frequent reasons for failing in psychiatric consultations were the prejudice of parents against psychiatric services, the teachers’ sense of superiority in dealing with the problems of students, the prejudice of teachers themselves against psychiatric practice, and inaccessible professional consultation. 6) About 20.4% of teachers reported they had proposed psychiatric consultations or had recommended their students to receive psychiatric evaluations.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.15 no.5
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• pp.2713-2723
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• 2014

This study adopts an ecological perspective to empirically navigate the issues surrounding the impact of parental abuse on the emotional development of adolescents. The data is used from the Korean Children and Youth Panel Survey 2011 (KCYPS 2011), which was conducted by the National Youth Policy Institute (n=2,270). Path models were constructed in which adolescents' environmental mediators (i.e., the relationship with parents, friends, and teachers; and school life) control their negative emotions (i.e., aggressiveness, negative physical symptoms, social weakness and depression); in turn to compare the difference between two groups based on parental abuse by using Structural Equation Modeling (SEM). As with the non-abused group (n=1,644), all the environmental mediators remained significant to control their negative emotion; whereas, the abused group (n=626) showed no significant pathway from their relationship with teachers and school life to negative emotion. This indicates that the abused group have limited number of the mediators to control their negative emotion than those of the non-abused group. For the non-abused group, the mediator with the highest total effect to control their negative emotion was the relationship with their friends; on the other hand, the abused group's mediator that showed the highest total effect to control their negative emotion was the relationship with their parents. Although the relationship with teachers remained significant as a mediator to affect school life for the both groups, teachers were not significant to control the negative emotion of the abused group. These findings suggest that the negative relationship with teachers in the abused group is a factor to threat the school adaptation of adolescents, which also leads to problems that are related to the emotional development of adolescents.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.6 no.1
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• pp.74-89
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• 1995

Selective mutism is a childhood condition defined by persisten failure to speak in specific social situation when speaking is expected, dispite preserved ability to comprehend spoken language and speak. Present study is to investigate clinical characteristics, treatment method and outcome of 23 children who were diagnosed as selective mutism by DSM-IV criteria at the child psychiatry ouptatient department of SNUH. The results were as follows : 1) The Sex ratio was 1: 4.8, female dominant Mear age of onset was 33 years old and mean age of first referral was 7.7 years old. 2) 22% of subjects had perinatal problem such as low birth weight, preterm birth, 26% of the subjects have history of delayed language development. There are subjects who had been separated with mam caretaker before 3 years old(26%) and who experienced physical or psychological trauma before 3 years old(26%). A few subjects had enurests(30%) and encoprests(4%). 3) Many subjects(65%) had symbiotic relationship with their mother. These families consist of dominant, verbally aggressive mother and passive father. Parents of 39% of all subjects were judged to have definite psychopathology(social phobic, depression, hysterical trait or alcohol problem) 26% of all subject, were reported physically abused. 4) The personality trait of the subjects were frequently described as follows(in order of frequency) ; Shy(100%), anxious(83%), stubborn(83%)m rigid and tense posture(78%), immature(65%) overdependent(65%), irritable(52%), manipulative(39%), depressive(39%). 5) The mean performance IQ of 16 subjects by KEDI-WISC was 88.3 Among them, the subjects with IQ below 69 were seven and those with IQ above 70 were nine. When comparing these two group(Mental retardation group vs Normal IQ group), we could find some difference in language development, personality trait, family dynamics and treatment outcome. 6) Among several treatment methods for selective mutism, play therapy was the most frequently used method(65%). Other commonly used treatment methods were pharmacotherapy(21%), behavioral therapy(8%), combined therapy(play therapy+pharmacotherapy+family therapy+behavioral therapy)(12%), 7) Regarding the outcome of treatment 8.6% was evaluated as Excellent, 30.4% as Good, 52% as Fair, 8.7% as Poor at the tinic of treatment. At follow up interview 21.7% was evaluated Excellent, 13% as Good, 21.7% as Fair, 34.8% as Poor. 8) We classified all subjects by Havden's 4 subtype. Symbiotic mutism was most common(65%) and other subtypes are Speech phobic mutism(8.6), Reactive mutism(13%) and Passive-aggressive mutism(30%).

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.11 no.1
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• pp.27-41
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• 2000

Objects：This study was designed for studying of current Korean adolescents computer game playing habits and exploring associations with parental rearing patterns and individual psychopathology. Methods：One hundred twenty four adolescents(age 13-15) who reside in urban area completed self-report questionnaires containing Questionnaires designed by authors, Symptom Checklist-90-Revision of Korean Version(SCL-90-R) and Parental Bonding Instrument(PBI). Results：1) Computer game playing appears to be one of the social and leisure phenomena in these days. Although Adolescents spend a lot of times on computer game, Many of them perceive not problematic. 2) Compared with females, Male play computer games more regularly, more longer, spent more times in gamebang. 3) There was positive relationship between anxiety subscale in SCL-90-R and detrimental effects of computer game. 4) There was positive relationship between game frequency and maternal overprotection. 5) The main reasons for playing are 'for an avoidance of stressful life events', academic burden was the most troublesome issues in korean adolescents. 6) Many adolescents use gamebang as a social place, but they thought that gamebang is not good places to have a good time. Conclusion：This papers shows that computer game playing is a popular social leisure activity in Korean adolescents. And, Most of korean adolescents reported that they are suffered from pressure of academic achievements. They use computer game mainly by means of relieving academic pressures. In a heavy game users who have many conflicts with parents, teacher and who has frequent truancy and social withdrawal show significant anxiety. Maternal overprotection was observed in heavy game users. Authors recommended that clinicians should be careful in examining heavy computer game behaviors. Both underlying affective states and environmental influences, including family situations should be vicariously examined.

• The Journal of Korean Society for School & Community Health Education
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• v.9 no.1
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• pp.47-61
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• 2008

Objectives: This study examined to explain the practical health behaviour and health-related quality of life, and their influencing factors in high school students. Methods: Total of 718 high school students from 1 school in Seoul were assessed with a self-administered questionnaire regarding general characteristics, health related characteristics, obesity index(Height and weight calculated by using the relative weight law: obesity group>20%, overweight group $10{\sim}20%$, normal weight group $-10{\sim}10%$, under weight group <-10%), health behaviour in school-aged children(eating, exercise and weight control) and health-related quality of life(PedsQLTM4.0 Generic Core Scale: physical health, emotional functioning, social functioning, school functioning). Results: Major results were as follows. 1. The rate of obesity by obesity index was 5.3% of high school students. Obesity incidence in adolescents was mainly associated with gender and parents whether obesity. 2. Perceived health status was lower in obese adolescents than in normal adolescents. 3. The rate of miss a breakfast was 37.9%, and obesity group than normal weight group were fruits, vegetables and milk intake at least, a lot of fastfood intake. During the past week, followed by intense physical activity, and overweight consumed a lot of time for TV and the Internet. Overall, under weight group and normal weight group belong to the students evaluated fatter than themselves. Weight control for weight loss, gain and maintain was grater in obesity group than in normal weight group. Weight loss showed highest scores in overweight group which appeared significant difference. 4. Obese adolescents compared with other groups, reported lower total QOL score and all QOL in domain, and especially social functioning showed significant differences. 5. Factors influencing the adolescents's QOL were found to be gender, perceived health status and exercise. Conclusions: High school girls were aware of their bad health status and likely to improve the QOL by practicing health behaviour. But obese adolescents were likely to degrade the quality of life by reducing the practice of health behaviors. So further school-based education about proper practical health behaviors and obesity prevention is necessary.

• Sleep Medicine and Psychophysiology
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• v.20 no.1
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• pp.22-30
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• 2013

Objectives: Sleep problems has been consistently reported as a suicidal risk factor in adults and, recently, also in adolescents. In this study, dividing study subjects by the previous suicidal behaviors (suicidal vs non-suicidal), we compared the group differences of suicidal risk factors, and examined the possibility of sleep as a suicidal risk factor. Methods: Study subjects were 561 (271 boys and 290 girls) from a community sample of high school students. Suicidal Risk Behavior Checklist, Center for Epidemiological Study-Depression (CES-D), Symptom Checklist-90-Revision (SCL-90-R) Anxiety and Aggression subscale, Pittsburg Sleep Quality Index (PSQI) were done. Results: Forty six students (8.1%) reported previous actual self-harm behavior as a suicidal attempt, 181 students (32.4%) reported having suicidal thought only. Three hundred thirty four students (59.5%) reported no previous suicidal behavior (thought and attempt, both). Suicidal behavior group showed higher score on risk behaviors such as school violence, substance use and internet addiction. CES-D, SCL-90-R, PSQI showed significant group difference. Logistic regression analysis showed suicidal risk were significantly associated with depression, stress in suicidal risk factors and sleep latency, daytime dysfunction in PSQI. Analysis of variance (ANOVA) shows the most prolonged sleep latency and increased index of all PSQI components except sleep efficiency in suicidal attempt group. Conclusions: Sleep Problems had a strong association with the suicidal risk behavior in adolescents. Sleep problems, especially, prolonged sleep latency, daytime dysfunction might be important markers for suicidal behavior. Screening for sleep problems in adolescents are encouraged for the parents, school teachers, and related medical physicians.

• Korean Journal of Psychosomatic Medicine
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• v.14 no.2
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• pp.88-93
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• 2006

Objective : The aim of this study was to examine the relationship between IgE-mediated atopic dermatitis and attention deficit hyperactivity disorder(ADHD) in Korean children. Method : This case-control study included 69 patients with atopic dermatitis and 42 normal students. Diagnoses of atopic dermatitis and assessments of its severity were made by the dermatologist. The MAST tests were administered to atopic dermatitis patients. The parents of all of the subjects completed the parent versions of the ADHD Rating Scale-IV(ARS). Results: Compared to the normal control group, the atopic dermatitis group scored significantly higher in the total, inattention, and hyperactivity/impulsivity profiles of the ARS(t=3.35, p<0.01 : t=6.41, p<0.01 ; t=3.93, p<0.01, respectively), The atopic dermatitis patients with ADHD hyperactivity/impulsivity subtype showed more severe symptoms of atopic dermatitis than those with ADHD inattentive subtype. The MAST-positive atopic dermatitis patients showed significantly increased incidence of ADHD symptoms than the MAST-negative counterparts. Conclusion : The results of this study suggest the possibility of an association between IgE-mediated atopic responsiveness and ADHD symptomatology.