• Title/Summary/Keyword: 아동 정신병리

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ATTACHMENT AND PSYCHOPATHOLOGY (애착과 정신병리)

  • Choi, Jee-Eun;Ahn, Dong-Hyun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.15 no.1
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    • pp.40-60
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    • 2004
  • Introduction:Research on attachment in view point of the developmental perspective which began in the 1940s progressed during several decades. Many investigators focused mother-child separation in early attachment studies, and moved to the relationship with childhood psychopathology. Recently attachment theory and research are moving forward along the intergenerational transmission of attachment patterns, and adolescents and adult mental disorders in the developmental perspectives. Methods:We surveyed the research papers through Medline search, attachment-related monographs, and review or original papers published in Korean journal. Results:Developmental attachment researches have demonstrated convincingly that insecure attachment in infancy is associated with attachment disorder; several childhood psychopatholgy, such as institutional care and adoption, aggression and behavioral problems, childhood anxiety disorders and depressive disorders, gender identity disorder and feeding disorder, and child abuse and maltreatment; peer relationship and social competency, and parental behaviors. Recently the methodological advances including the Adult Attachment Interview that systematically assesses the adults' recollections of the earlier parent-child relationship they experienced could move beyond attachment researcher's initial concern with infancy to consider attachment processes throughout the life span. We could find that the quality of attachment was associated with several mental disorders in adolescents and adults significantly. Conclusion:Attachment theory would have focused on more specific parent-child relationship than general parental behavior. Recent attachment theory underscores its evolutionary origins to promote development of infant and contribute to human survival in psychobiological bases. Advances in attachment research could unite interests in evolutional biology and developmental psychology in understanding early parent-child relationship, and apply to clinical issues concerning mental health throughout the life span.

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Development of the Children's Separation Rating Scale Its Clinical and Research Use (아동분리반응척도의 개발 : 임상 및 연구응용)

  • Kim, Wun-Jung;Hahn, Sung-Up
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.1 no.1
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    • pp.148-160
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    • 1990
  • This paper reports on the development of the Children's Separtion Rating Scale(CSRS), its initial reliability and validity, and clinical/research utility with psychiatrically hospitalized children. The CSRS appears to be a reliable and valid instrument, and useful in distinguishing children's separation reaction from their general psychopathology. It may be also useful in aiding clinicians in differential diagnosis. This study points to the need for further understanding of children's psychiatric hospitalization in relation to their separation reaction and its possible untoward effects. Findings of this pilot study support the notion that inpatient treatment programs should address the developmental needs and abilities of the various age groups and the particular deficits reflected in their psychopathology.

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CHILDHOOD TRAUMA:PSYCHIATRIC OVERVIEW (아동기 외상의 정신과적 개관)

  • Han, Sung-Hee
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.13 no.1
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    • pp.3-14
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    • 2002
  • Childhood psychic trauma appears to be a crucial factor in the development of serious disorders both in childhood and in adulthood. Traumatized children show strong tendency to revisualize or re-feel a traumatic events. Play and behavioral reenactments are frequent manifestations of both the single blow and the long-standing traumas in childhood. Those children who suffer the results of single, intense terror appear to exhibit detailed memory, retrospective reworkings and misperceptions. In long-standing or repetitive trauma, children would show psychic numbing, self-hypnosis, dissociation and rage. Child's brain is undergoing critical and sensitive periods of differentiation. During this time, developing central nervous system is exquisitely sensitive to stress. Stressor-activated neurotransmitters and hormones can play major roles in neurogenesis, migration, synaptogenesis, and neurochemical differentiation. Internal opiate system operates in some trauma and causes the victim to fail to respond, to avoid, to shut off feelings. Evidence is also accumulating in traumatology that dysfuntion of locus coeruleus and ventral tegmental neucleus system leads to catecholamine receptors hypersensitivity. This change result in hypervigilance, increased startle, affective lability, and increased autonomic nervous system hyperreactivity. Another site of action of trauma on the brain is hypothalamic-pituitary-adrenal axis. Individuals with PTSD do not have enough cortisol to halt the alarm reaction. When children are exposed to long-standing extreme events, massive attempts to protect the psyche and to preserve the self are put into gear. These developmental traumas mobilize various kinds of defense mechanisms. Massive denial, dissociation, self anesthesia, identification with aggressor and aggression turned against the self often lead to profound character changes in the youngsters.

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COMPARISON OF DEVELOPMENTAL AND PSYCHOPATHOLOGlCAL CHARACTERISTICS FOR RAD AND PDD CHILDREN (반응성 애착장애 아동과 전반적 발달장애 아동의 발달 및 정신병리학적 특징의 비교연구)

  • Yoon, Hyun-Sook;Choi, Jin-Sook;Kim, Tae-Ryeon;Hong, Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.3 no.1
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    • pp.3-13
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    • 1992
  • For the purpose of better understanding of RAD children, comparisons were performed about the developmental and psychopathological characteristics between RAD and PDD children. Study subjects were the children between the ages 2 and 6. who visitied SNUCH Child and Adolescent Psychiatry OPD or treated in Day Treatment Center during May, 1989 and Sep., 1991, diagnosed by the child psychiatrist as RAD or PDD according to DSM-III-R diagnostic criteria. A total of 40 children were included in the study. 20 were RAD(18 boys, 2 girls). 20 were PDD(20 boys). PEP was performed to all study subjects, by the raters blind to psychiatric diagnosis of each. And analysis was done about the level of developmental functioning score and psychopathological scores between RAD and PDD children. The results are as follows 'There were retardation on the general developmental functioning in RAD children, and the severity of retardation were lined up as perceptual ability>imitation>gross motor>cogitive language>eye-hand coordination>fine motor. Characteristics of psychopathology in RAD children were lined up by severity as language>play>relationship>affection >sensory. Group differences of the two shows on PDD group rejection score was significantly higher on the perception item. while RAD was superior on the perception emerging response. Differences of the psychopathology between two groups were on such areas as ; Affection, which was significantly higher on 'Absent' in RAD, while significantly higher on 'severe' in PDD children. On the interest for the play and materials. sensory and language areas, RAD children were significantly higher ratings on 'Absent' than PDD children.

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A Clinical Usefulness of Korean Version of Strengths and Difficulties Questionnaire (강점.난점설문지의(SDQ-Kr)의 임상 활용도)

  • Shin, Jong-Soo;Ahn, Joung-Sook;Choi, Young-Hun;Kim, Hae-Ji
    • Korean Journal of Psychosomatic Medicine
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    • v.17 no.2
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    • pp.75-81
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    • 2009
  • Objectives : This study aimed to evaluate the clinical usefulness of Korean version of Strengths and Difficulties Questionnaire(SDQ-Kr) by comparing with Korean version of Childhood Behavior Checklist (K-CBCL). Methods : The parent version of SDQ-Kr and K-CBCL were administered to parents of 313 children in psychiatric clinic, 91 children referred for psychiatric consultation from pediatric clinic and 93 control children in pediatric clinic. All children aged 4-11 years old. Children in psychiatric clinic were diagnosed with one of followings;ADHD, emotional disorders and oppositional/conduct disorder. Mean scores were compared among three groups by gender. Coefficients were calculated for corresponding problem scales and total scores of both questionnaires. ROC analysis was performed for discriminant validity to distinguish psychiatry and pediatrics samples, and also to distinguish diagnostic groups of psychiatry sample. Results : The psychiatry sample showed highest means of problem scales and total scores, followed by consultation and control sample of pediatrics. SDQ-Kr and K-CBCL were significantly correlated, and equally able to distinguish those samples with SDQ-Kr showing better results. Within the psychiatry sample, SDQ-Kr had higher predictive power for all diagnostic groups. Conclusion : This study supports clinical usefulness of SDQ-Kr. We suggest that SDQ-Kr could be used not only as a diagnostic tool for children in psychiatric clinic but also as an effective and efficient screening instrument for children in need for psychiatric evaluation in pediatric clinic.

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Self-Differentiation and Family Function in Parents of Children with Psychopathology (정신병리아동 부모의 자아분화, 가족기능 관한 연구)

  • Hwang, Kyu Sun;Choi, Youn Shil
    • Korean Journal of Child Studies
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    • v.23 no.6
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    • pp.65-79
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    • 2002
  • The present study surveyed both the parents of 130 children with psychopathology and the parents of 240 normal children. children were between 2 and 12 years of age. No differences were found between parents in self-differentiation or in family function by type of disorder. Parents of children with psychopathology were lower than parents of normal children in self-differentiation; this was particularly evident in cognitive function-emotional function, and emotional cut-off. Patents of children with psychopathology were lower than parents of normal children in terms of family function. Multiple regression analyses indicated that parent's self-differentiation, children's psychopathology, and parent's education level had a significant influence on family function. The regression model explained 52% of the variance.

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MALADAPTIVE COGNITIONS ACCORDING TO DEPRESSION, ANXIETY, AND AGE OF CHILDREN WITH ADHD - FOCUS ON COGNITIVE ERROR AND ATTRIBUTIONAL BIAS - (ADHD 아동의 우울, 불안, 공격성과 연령에 따른 부적응적 인지 특성 - 인지 오류와 귀인 편파를 중심으로 -)

  • Kim, Young-Mi;Choi, Eun-Ju
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.12 no.2
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    • pp.275-281
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    • 2001
  • This study examined the relationship between psychopathology(depression, anxiety, aggression), maladaptive cognitions(negative cognitive errors, attributional biases), and age of children with ADHD. 40 ADHD children and their mother completed questionnaires assessing depression, anxiety, aggression level and maladaptive cognitions of children. The results showed that maladaptive cognitions of children with ADHD was not significantly associated with their depression, anxiety, aggression level. Age was negatively related to internal stable attributions for negative events that was characteristic in depression, and had significantly effect on internal stable attributions for negative events. As age of ADHD children increased, their internal attribution for negative events reduced. It seems that their depression and anxiety level is associated with current stress event rather than maladaptive cognitions. Suggestions and limitations of this study, and the directions for future study were discussed.

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REARING PATTERN OF SCHIZOPHRENIC MOTHERS AND THEIR CHILDREN'S BEHAVIOUR PROBLEMS (정신분열병이 있는 어머니의 양육태도와 자녀의 행동문제)

  • Kang, Kyung-Mi;Kwack, Young-Sook;Lee, Sung-Hun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.9 no.2
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    • pp.180-189
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    • 1998
  • Objects:This study is investigated to compare psychopathology and their perceived parental rearing pattern of the children of schizophrenic mother with those of normal control group. The correlation were also assessed between perceived parenting style and problem behaviour Method:Thirty children(age 12-18) of schizophrenic mother and normal control subjects completed self-report questionnaires containing child·adolescent behaviour problem check list(K-CBCL) and Parental bonding instrument(PBI). Result:The result were as follow in the children of schizophrenic mother:1) the mean score of problem behaviour significantly higher than normal control group. 2) Parenting style was perceived to be less caring and more overprotective than in the control subject. 3) there was positive correlation between maternal overprotection and problem behaviour and negative correlation between maternal care and problem behaviour. Conclusion:We succeed in identify that the children of schizophrenic mother have more problems in social adjustment than normal control subjects. Parental rearing style are thought to be significantly negativistic in the children of schizophrenic mother. It is guessed that less caring and more overprotective rearing style of schizophrenic mother could have influence on problem behaviours of their children.

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MMPI PROFILE TYPES OF MOTHERS WITH PSYCHIATRIC DISORDERED CHILDREN (정신 장애 아동들의 어머니의 MMPI 유형 분석)

  • Shin, Min-Sup;Oh, Kyung-Ja;Hong, Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.3 no.1
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    • pp.97-105
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    • 1992
  • Present study investigated the relationship between children's psychiatric disorders and their mothers' psychological problems. Ninety-one psychiatric outpatients from a children's hospital were classified into three diagnostic groups - internalizing symptom group(n=35), externalizing symptom group(n=35), and developmental disorder group(n=21) - based on their psychiatric problems. A normal control group was formed by matching on the age and education of mothers. Mothers' MMPI profiles which were classified into five types - normal, depression, anxiety disorder, somatization disorder, and personality disorder - were examined in relation with children's diagnoses. The profiles of the mothers in the normal control group were mostly normal, while depressive profiles were dominant among those of the clinical groups regardless of the children's diagnoses. Therefore, the data implied association between children's psychiatric problems and their mothers' psychological problems. A possibility of negative reciprocal interactions between children and their mothers was discussed. It was also suggested that further research need to examine the specific effects of children's psychiatric problems on the psychological adjustment of their mothers, as well as the effects of parental psychiatric problems on the adjustment of their offsprings.

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PARENTAL ATTACHMENT STYLES AND PSYCHIATRIC MANIFESTATIONS IN THEIR $4^{th}\;TO\;6^{th}$ GRADE ELEMENTARY SCHOOL CHILDREN (부모의 애착 유형과 초등학교 고학년 아동의 정신병리와의 상관 관계)

  • Yoo Han Ik;Hwang Jun Won;Kim Boong-Nyun;Shin Min Sup;Hong Kang-E;Cho Soo Churl
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.16 no.1
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    • pp.47-53
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    • 2005
  • Objectives : Few studies have examined the relation between the attachment styles of the primary caregivers and the behavioral problems of their children. This study was performed to identify the impact of the insecure parental attachment patterns on the development of their higher grades elementary school children's psychiatric manifestations and disorders. Methods : 504 higher elementary pupils and their primary caretakers were included in our study. Relationship Questionnaire, Kovacs Children's Depression Inventory, Spielberger's State-Trait Anxiety Inventory for children, and Korean Child Behavior Checklist were applied to them. Results : The grade-school children of the parents who belonged to preoccupied attachment type revealed higher Withdrawn, Anxious/depressed, Social Problems, Attention Problems, Delinquent Problems, Aggressive Problems, Internalizing Problems, Externalizing Problems, Total Behavioral Problems scores than ones of securely attached parents (p<0.01). Internalizing Problems score of preoccupied parents' children was highest, and one of avoidant and secure typed parents' kids followed in order (p=0.004) . More youngsters revealed Total Behavior Problem score high enough to clinically meaningful level in insecure parental attachment style than in secure one (p=0.038). Higher CDI score in insecure parental group was reported than in secure one (p=0.040). Conclusion : Parental insecure attachment can be associated with the development of the behavioral problems and psychiatric illness of their children.

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