Therapeutic Science for Rehabilitation (재활치료과학)

Korean Society of Neurological Occupational Therapy (대한신경계작업치료학회)
권호 표지
DOI QR코드

DOI QR Code

Factor Structure of the Korean-Child Behavior Checklist 1.5-5 Dysregulation Profile in Infants and Toddlers With Mental Disorders and the Difference Among Mental Disorders

정신장애 영유아에 대한 K-CBCL 1.5-5 (Korean-Child Behavior Checklist 1.5-5) 조절곤란 프로파일의 요인구조와 정신장애 간 차이검증

  • Kyung, Hye Min (Dept. of Child Psychotherapy in Child Welfare Studies Major The Graduate School, Sookmyung Women's University) ;
  • Ha, Eun Hye (Dept. of Child Welfare Studies, Sookmyung Women's University)
  • 경혜민 (숙명여자대학교 일반대학원 아동복지학과 아동심리치료전공) ;
  • 하은혜 (숙명여자대학교 생활과학대학 아동복지학부)
  • Received : 2022.07.22
  • Accepted : 2022.09.13
  • Published : 2023.02.28
Download PDF
⟨ Previous Next ⟩

Abstract

Object : This study aimed to identify the factor structure of Korean-Child Behavior Checklist 1.5-5 Dysregulation Profile (K-CBCL 1.5-5 DP) in infants and toddlers with mental disorders and verify differences in K-CBCL 1.5-5 DP among the diagnosis groups. Methods : The participants were 265 mothers of infants and toddlers with mental disorders who completed K-CBCL 1.5-5 DP. The data was analyzed using AMOS 25.0 and SPSS 25.0. Results : First, the bifactor model was the most suitable for the factor structure of the K-CBCL 1.5-5 DP. Second, there were significant differences among the diagnosis groups, such as communication disorders, pervasive developmental disorders, emotional disorders, and developmental delays. It was confirmed that the pervasive developmental disorder and emotional disorder groups showed significantly higher dysregulation compared with the communication disorder group. Conclusion : This study confirmed that infants and toddlers had dysregulation problems. Using the bifactor model, the multidimensional nature of the K-CBCL 1.5-5 DP was assessed. It was also meaningful that dysregulation could contribute to onset and deepening of symptoms of pervasive developmental disorders and emotional disorders in infancy.

목적 : 본 연구의 목적은 정신장애 영유아의 K-CBCL 1.5-5(Korean-Child Behavior Checklist 1.5-5) DP(Dysregulation Profile)의 요인구조를 확인하고, 정신장애 진단 집단 간 차이를 검증하였다. 연구방법 : 서울 소재의 종합병원 소아정신과, 발달장애 클리닉 등에서 2010년에서 2015년까지 수집된 자료를 활용하였다. DSM-IV에 근거하여 정신장애로 진단된 영유아 265명의 어머니에게 실시된 K-CBCL 1.5-5 자료를 최종분석에 사용하였다. 결과 : 정신장애 영유아의 K-CBCL 1.5-5 DP의 요인구조는 이중요인 모형(Bifactor)이 상대적으로 가장 적합하였다(χ2 = 893.722, TLI = .782, CFI = .822, RMSEA = .064). 또한 의사소통장애, 전반적 발달장애, 정서장애, 발달지체 등 영유아의 정신장애 진단 집단 간 차이가 유의하였다(F(3, 259) = 9.780, p < .001). 그 중 전반적 발달장애 집단과 정서장애 집단이 의사소통장애 집단보다 높은 조절곤란을 보이는 것으로 확인되었다. 결론 : 본 연구에서는 정신장애 영유아의 조절곤란 문제의 존재를 확인하였다. 이중요인 모형을 통해 K-CBCL 1.5-5 DP가 불안/우울, 공격행동, 주의집중문제의 특정요인과 특정요인 이상의 일반요인으로 구성된다는 것을 확인하였고, K-CBCL 1.5-5 DP의 다차원성을 규명하였다. 또한 정신장애 집단 간 유의한 차이가 있었고 조절곤란 문제는 영유아기부터 전반적 발달장애와 정서장애의 증상 발현과 심화에 기여하는 것으로 사료된다.

Keywords

References

  1. 권준수 (역) (2015). DSM-5 정신질환의 진단 및 통계 편람. 학지사.
  2. Achenbach, T. M., & Rescorla, L. A. (2000). Manual for the ASEBA preschool forms & profiles. Research Center for Children, Youth, & Families.
  3. Althoff, R. R., Rettew, D. C., Ayer, L. A., & Hudziak, J. J. (2010). Cross-informant agreement of the dysregulation profile of the child behavior checklist. Psychiatry Research, 178(3), 550-555. https://doi.org/10.1016/j.psychres.2010.05.002
  4. Althoff, R. R., Rettew, D. C., Faraone, S. V., Boomsma, D. I., & Hudziak, J. J. (2006). Latent class analysis shows strong heritability of the child behavior checklist-juvenile bipolar phenotype. Biological Psychiatry, 60(9), 903-911. https://doi.org/10.1016/j.biopsych.2006.02.025
  5. Basten, M. M. G. J., Althoff, R. R., Tiemeier, H., Jaddoe, V. W. V., Hofman, A., Hudziak, J. J., Verhulst, F. C., & Van Der Ende, J. (2013). The dysregulation profile in young children: Empirically defined classes in the generation R study. Journal of the American Academy of Child and Adolescent Psychiatry, 52(8), 841-850. https://doi.org/10.1016/j.jaac.2013.05.007
  6. Biyao, W., Andreas, B., Christina, K., Aribert, R., & Henrik, U. S. (2021). Dysregulation profile (DP) as a transdiagnostic psychopathological factor in clinically referred children-comparisons between disorders and latent structure. Nordic Journal of Psychiatry, 76(1), 71-79. https://doi.org/10.1080/08039488.2021.1936167
  7. Calkins, S. D., & Bell, K. L. (1999). Developmental transitions as windows to parental socialization of emotion. Psychological Inquiry, 10(4), 368-372. https://www.jstor.org/stable/1449467
  8. Chung, C. M., Liao, X., Song, H., & Lee, T. (2016). Bifactor approach to modeling multidimensionality of physical self-perception profile. Measurement in Physical Education and Exercise Science, 20(1), 1-15. https://doi.org/10.1080/1091367X.2015.1081594
  9. Deutz, M. H. F., Geeraerts, S. B., Belsky, J., Dekovic, M., Van Baar, A. L., Prinzie, P., & Patalay, P. (2020). General psychopathology and dysregulation profile in a longitudinal community sample: Stability, antecedents and outcomes. Child Psychiatry and Human Development, 51(1), 114-126. https://doi.org/10.1007/s10578-019-00916-2
  10. Deutz, M. H. F., Geeraerts, S. B., Van Baar, A. L., Dekovic, M., & Prinzie, P. (2016). The dysregulation profile in middle childhood and adolescence across reporters: Factor structure, measurement invariance, and links with self-harm and suicidal ideation. European Child & Adolescent Psychiatry, 25(4), 431-442. https://doi.org/10.1007/s00787-015-0745-x
  11. Deutz, M. H. F., Vossen, H. G. M., De Haan, A. D., Dekovic, M., Van Baar, A. L., & Prinzie, P. (2018). Normative development of the child behavior checklist dysregulation profile from early childhood to adolescence: Associations with personality pathology. Development and Psychopathology, 30(2), 437-447. https://doi.org/10.1017/S0954579417000955
  12. Dolitzsch, C., Kolch, M., Fegert, J. M., Schmeck, K., & Schmid, M. (2016). Ability of the child behavior checklist-dysregulation profile and the youth self report-dysregulation profile to identify serious psychopathology and association with correlated problems in high-risk children and adolescents. Journal of Affective Disorders, 205, 327-334. https://doi.org/10.1016/j.jad.2016.08.010
  13. Gadow, K. D., DeVincent, C. J., Pomeroy, J., & Azizian, A. (2004). Psychiatric symptoms in preschool children with PDD and clinic and comparison samples. Journal of Autism and Developmental Disorders, 34(4), 379-393. https://doi.org/10.1023/B:JADD.0000037415.21458.93
  14. Geeraerts, S. B., Deutz, M. H. F., Dekovic, M., Bunte, T., Schoemaker, K., Espy, K. A., Prinzie, P., Van Baar, A,, & Matthys, W. (2015). The child behavior checklist dysregulation profile in preschool children: A broad dysregulation syndrome. Journal of the American Academy of Child and Adolescent Psychiatry, 54(7), 595-602. https://doi.org/10.1016/j.jaac.2015.04.012
  15. Holtmann, M., Buchmann, A. F., Esser, G., Schmidt, M. H., Banaschewski, T., & Laucht, M. (2011). The child behavior checklist-dysregulation profile predicts substance use, suicidality, and functional impairment: A longitudinal analysis. Journal of Child Psychology and Psychiatry, 52(2), 139-147. https://doi.org/10.1111/j.1469-7610.2010.02309.x
  16. Hong, S. H. (2000). The criteria for selecting appropriate fit indices in structural equation modeling and their rationales. Korean Journal of Clinical Psychology, 19 (1), 161-177.
  17. Hong, S. H., Hwang, S. T., & Kim, Y. R. (2018). Replication of a validation study on the Korean version of the Personality Inventory for DSM-5 (K-PID-5). Korean Journal of Clinical Psychology, 37(4), 558-572. https://doi.org/10.15842/kjcp.2018.37.4.008
  18. Hu, L. T., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6(1), 1-55. https://doi.org/10.1080/107055 19909540118
  19. Joshi, G., Wozniak, J., Fitzgerald, M., Faraone, S., Fried, R., Galdo, M., Furtak, S. L., Conroy, K., Kilcullen, J. R., Belser, A., & Biederman, J. (2018). High risk for severe emotional dysregulation in psychiatrically referred youth with autism spectrum disorder: A controlled study. Journal of Autism and Developmental Disorders, 48(9), 3101-3115. https://doi.org/10.1007/s10803-018-3542-9
  20. Jucksh, V., Salbach-Andrae, H., Lenz, K., Goth, K., Dopfner, M., Poustka, F., Freitag, C. M., Lehmkuhl, G., Lehmkuhl, U., & Holtmann, M. (2011). Severe affective and behavioral dysregulation is associated with significant psychosocial adversity and impairment. Journal of Child Psychology and Psychiatry, 52(6), 686-695. https://doi.org/10.1111/j.1469-7610.2010.02322.x
  21. Kang, H. C. (2013). Discussions on the suitable interpretation of model fit indices and the strategies to fit model in structural equation modeling. Journal of the Korean Data Analysis Society, 15(2), 653-668.
  22. Kang, K. M. (1994). Depression in children-an overview and the developmental perspectives on children in depression. Journal of the Korean Academy of Child & Adolescent Psychiatry, 5(1), 3-11.
  23. Keefer, A., Singh, V., Kalb, L. G., Mazefsky, C. A., & Vasa, R. A. (2020). Investigating the factor structure of the child behavior checklist dysregulation profile in children and adolescents with autism spectrum disorder. Autism Research, 13(3), 436-443. https://doi.org/10.1002/aur.2233
  24. Kim, E. Y., & Ha, E. H. (2020). Characteristics of the factor structure of the child behavior checklist dysregulation profile for school-aged children. The Korean Journal of School Psychology, 17(1), 17-38. https://doi.org/10.16983/kjsp.2020.17.1.17
  25. Kim, E. Y., & Ha, E. H. (2021). Factor structure of general psychopathology and CBCL-dysregulation profile: A focus on children with mental disorder(s) in child welfare facilities. Korean Journal of Clinical Psychology, 40(1), 43-59. https://doi.org/10.15842/kjcp.2021.40.1.004
  26. Kim, G. S. (2007). The structural equation modeling. Hannarae.
  27. Kim, J., Carlson, G. A., Meyer, S. E., Buffered, S. J., Dougherty, L. R., Dyson, M. W., Laptook, R. S., Olino, T. M., & Klein, D. N. (2012). Correlates of the CBCL-dysregulation profile in preschool-aged children. Journal of Child Psychology and Psychiatry, 53(9), 918-926. https://doi.org/10.1111/j.1469-7610.2012.02546.x
  28. Kim, Y. A., Lee, J., Moon, S. J., Kim, Y. J., & Oh, K. J. (2009). Standardization study for the Korean version of the child behavior checklist for ages 1.5-5. The Korean Journal of Clinical Psychology, 28(1), 117-136. https://doi.org/10.15842/kjcp.2009.28.1.007
  29. Masi, G., Pisano, S., Milone, A., & Muratori, P. (2015). Child behavior checklist dysregulation profile in children with disruptive behavior disorders: A longitudinal study. Journal of Affective Disorders, 186, 249-253. https://doi.org/10.1016/j.jad.2015.05.069
  30. McCracken, J. T., McGough, J., Shah, B., Cronin, P., Hong, D., Aman, M. G., Arnold, E., Lindsay, R., Nash, P., Hollway, J., McDougle, C. J., Posey, D., Swiezy, N., Kohn, A., Scahill, L., Martin, A., Koenig, K., Volkmar, F., Carroll, D., ... McMahon, D. (2002). Risperidone in children with autism and serious behavioral problems. New England Journal of Medicine, 347(5), 314-321. https://doi.org/10.1056/NEJMoa013171
  31. Meyer, S. E., Carlson, G. A., Youngstorm, E., Ronsaville, D. S., Martinez, P. E., Gold, P. W., Hakak, R., & Radke-Yarrow, M. (2009). Long-term outcomes of youth who manifested the CBCL-pediatric bipolar disorder phenotype during childhood and/or adolescence. Journal of Affective Disorders, 113(3), 227-235. https://doi.org/10.1016/j.jad.2008.05.024
  32. Oh, K. J., & Kim, Y. J. (2009). Child behavior checklist for age 1.5-5: CBCL 1.5-5. Huno.
  33. Patel, S., Day, T. N., Jones, N., & Mazefsky, C. A. (2017). Association between anger rumination and autism symptom severity, depression symptoms, aggression, and general dysregulation in adolescents with autism spectrum disorder. Autism, 21(2), 181-189. https://doi.org/10.1177/1362361316633566
  34. Uljarevic, M., Hedley, D., Nevill, R., Evans, D. W., Cai, R. Y., Butter, E., & Mulick, J. A. (2018). Brief report: Poor self-regulation as a predictor of individual differences in adaptive functioning in young children with autism spectrum disorder. Autism Research, 11(8), 1157-1165. https://doi.org/10.1002/aur.1953
  35. Wang, B., Brueni, L. G., Isensee, C., Meyer, T., Bock, N., Ravens-Sieberer, U., Klasen, F., Schlack, R., Becker, A., & Rothenberger, A. (2018). Predictive value of dysregulation profile trajectories in childhood for symptoms of ADHD, anxiety and depression in late adolescence. European Child and Adolescent Psychiatry, 27(6), 767-774. https://doi.org/10.1007/s00787-017-1059-y
  36. Wicks-Nelson, R., & Israel, A. C. (2000). Behavior disorders of childhood. Prentice Hall.
  37. Winsper, C., & Wolke, D. (2014). Infant and toddler crying, sleeping and feeding problems and trajectories of dysregulated behavior across childhood. Journal of Abnormal Child Psychology, 42(5), 831-843. https://doi.org/10.1007/s10802-013-9813-1