• Title/Summary/Keyword: 정신지체 아동의 부모

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The Study of Psychiatric Problem of the Caregivers of Children with Disability (장애아동 양육자의 정신과적 문제에 관한 연구)

  • Kim, Hee-Jung;Kim, Dong-Hyun
    • The Korean Journal of Health Service Management
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    • v.5 no.4
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    • pp.137-147
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    • 2011
  • 본 연구는 일부지역 장애아동 양육자의 정신과적 문제를 알아보기 위해 우울증 지수를 검사하고 분석함으로서 그 심각성을 확인하고 장애아동 양육자의 정신보건의 필요성을 알리기 위한 기초자료를 제공하는 데 목적이 있다. 본 연구는 2011년 8월부터 9월까지 경주 및 인근지역에서 지적장애아동과 지체장애아동을 둔 전업주부의 정신과적 문제를 알아보기 위해 양육 스트레스로 인한 우울증 정도를 알아보았다. 연구대상자는 3개의 치료기관 및 치료 관련기관에서 지적장애 또는 지체장애 아동을 양육하고 있는 부모 각 20명씩을 대상으로 하였다. 우울증 평가도구는 한국형 우울증 검사(Korean Depression Scale; KDS)를 이용하였다. 결과는 첫째, 지적장애아동과 지체장애아동 양육자 모두 우울증이 있는 것으로 나타났고 각각의 차이 비교에는 유의성이 없었다. 둘째, 지적장애아동과 지체장애아동 양육자의 우울증 세부항목에서는 의욕상실 부분에서만 유의성이 있었다. 셋째, 지적장애아동 양육자의 우울증 세부항목간의 비교에서는 유의성이 있었다. 넷째, 지체장애아동 양육자의 우울증 세부항목간의 비교에서는 유의성이 있었다. 다섯째, 지적장애아동 양육자의 우울증과 세부항목의 상관관계에서는 의욕상실에서 유의한 상관성이 있었다. 여섯째, 지체장애아동 양육자의 우울증과 세부항목의 상관관계에서는 의욕상실에서 유의한 상관성이 있었다. 본 연구에서는 두 장애아동의 양육자간 차이는 없었으며 우울증은 장애유형에 상관없이 모두 나타났다. 그리고 세부항목과 우울증의 상관성에서는 의욕상실에서 유의한 상관성을 보였다. 이것은 장애아동의 양육에서 치료의 지연으로 인한 의욕상실에서 우울증이 많이 유발됨을 알 수 있다.

EFFECTS OF INTERPERSONAL COGNITIVE PROBLEM SOLVING SKILLS TRAINING ON ADOLESCENTS WITH MILD MENTAL RETARDATION (대인관계 인지 문제해결 기술훈련의 효과 - 교육가능 정신지체 청소년을 대상으로 -)

  • Oh, Kyung-Ja;Lee, Mi-Seon
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.6 no.1
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    • pp.100-108
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    • 1995
  • The purpose of the present study was to examine whether Interpersonal Cognitive Problem Solving(ICPS) skill training would enhance interpersonal solving skills and behavioral adjustment of mildly mentally retarded adolescents in the junior and high school. The program used in the present study was shortened and adapted for mildly retarded adolescents from Shure and Spivack(1982) program which was developed to improve the adjustment of children in the intermediate grades 5-6. The subjects were 22 mildly retarded adolescents, and they were assigned to either the experimental(11) or the control group(11). The experimental group were given ICPS training 4 times a week over a period of 8 weeks with a total of 32 sessions in all. The results showed a significant improvement of alternative thinking and consequential thinking in the experimental group compared with the control group. With regard to behavioral ratings by the parents and teachers, there were no significant differences between the groups. The results indicated that the training was effective in increasing the ability to generate alternative solutions and to predict consequences, but the significant improvement of interpersonal cognitive problem solving skills did not lead to noticeable improvement in behavioral adjustment. It was suggested that a longer training period for over-learning, concomitant parent education program, and more behaviorally oriented social skill training combined with the cognitive approach would yield significant training effects, maintenance and transfer.

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The Lived Experience of Mothers Mentally Handicapped Daughters Having Menarche at Puberty (사춘기 정신지체여아의 초경에 대한 어머니의 경험 연구(Parse의 방법론 적용))

  • 이명숙
    • Journal of Korean Academy of Nursing
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    • v.29 no.3
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    • pp.494-506
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    • 1999
  • The purpose of this study is to understand the structure of mothers of mentally handicapped daughters' lived experience, to apprehend the connectedness of the structure of the experience with concept of Parse's human becoming theory, and to provide a foundation for nursing research and education. Data collection was conducted from October 1995 to April 1996. Research participants were eight mothers of mentally handicapped daughters whose ages ranged from 12 to 18 attending special schools located in either Inchon or Seoul. The researcher had interviews with them over their lived experience conducted tape recorded, and made an analysis according to Parse's “human becoming research methodoloy.” The data were collected using the dialogical engagement process “I and You,” the participant researcher and the participant subject. The data were analyzed using the extraction-synthesis and heuristic interpretation. The structural integration is illustrated in the following : 1) Realizing the mother's role of mentally handicapped daughters and admitting situation. 2) Concealing a part of their relationship with others is interpreted as revealing-concealing. 3) Living a life kept moving between separating and connecting. 4) Their flight back voluntarily to improve the situation is interpreted as powering. The conceptual integration which emerged was the lived experience of mothers is powering through the revealing-concealing and connecting-separating of valuing.

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A CASE OF FALSE ALLEGATION OF CHILD SEXUAL ABUSE (위(僞) 소아성학대 보고 1예)

  • Choi, Bo-Moon
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.5 no.1
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    • pp.194-200
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    • 1994
  • When children exhibit unusually intense or persistent sexual interests or behavior, this is an indication that they have been exposed to more than the expectable amount of sexual experience, Although sexualized behavior and/or statement is a symptom of sexual abuse, it is not necessarily an indication of sexual abuse. The possibility of false allegation needs to be considered, particularly if allegations are coming from the parent rather than a child, if parents are engaged in dispute over custody or visitation, and/or if the child is a preschooler. False allegations may arise in other situations as well, such as the misinterpretation of a child's statement or behavior by relative or caretakers. And children may make false statement in psychiatric evaluations. A case of false allegation of sexual abuse made by mentally retarded 10 year-old girl who has been located in an institute is presented. During her evaluation process, it was clinician's diagnostic impression that she had no been sexually abused but sexually stimulated in some way, and most of what she said was a fantasy lie. Its pathological mechanism is discussed in terms of pseudologia fantastica along with the review of literatures.

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FACTORS OF MENTALLY HANDICAPPED CHILDREN AND THEIR FAMILY ASSOCIATED WITH THE QUALITY OF LIFE AND THE EMOTIONAL WELLBEING OF THEIR MOTHERS (장애 아동의 행동 특성과 가족환경이 어머니의 정서적 안녕감과 삶의 질에 미치는 영향)

  • Lee, Yong-Ho;Chung, Yong-Kyoon;Cho, Soo-Churl;Koo, Young-Jin
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.10 no.1
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    • pp.100-112
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    • 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.

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TEMPERAMENTAL CHARACTERISTICS OF KOREAN CHILDREN WITH COMMUNICATION DISORDERS (한국 의사 소통 장애 아동의 기질 특성)

  • Joung, Yoo-Sook;Hong, Sung-Do;Kim, E-Yong;Lee, Soo-Geun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.10 no.1
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    • pp.43-49
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    • 1999
  • Objectives:One of the most common developmental problems is communication disorder in which a child appears normal in every way but who has failed to begin speaking or speaks very little. A few studies have examined the temperamental characteristics of children with communication disorders. This study was to investigate the temperamental characteristics of Korean children with communication disorders. Methods:The parents of 20 Korean children with communication disorders and the parents of 50 normal control children, the age of both groups ranges from 3 to 7, completed Korean version of Parental Temperamental Questionnaire developed by Thomas and Chess. Children with a pervasive developmental disorder, mental retardation, or speech-motor or sensory deficit were excluded. The scores of each temperamental scale of two groups and the diagnostic clusters of two groups were compared. Results:The children with communication disorders were characterized by lower mood scores and higher intensity of reaction scores than normal controls. The two groups showed no significant correlation in terms of the temperamental diagnostic clusters. Conclusion:This findings suggest the existence of a distinct temperamental profile of the children with communication disorders. Early detection of the profile may be of great value for parents in understanding the developmental characteristics of the children with communication disorders and in providing appropriate parenting approaches.

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CLINICAL CHARACTERISTICS AND TREATMENT COURSES OF THE CHILDREN WITH SELECTIVE MUTISM (선택적 함구증 아동의 임상특성 및 치료경과)

  • Chung, Sun-Ju;Hong, Kang-E
    • 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%).

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A STUDY ON THE PARENTAL MARITAL RELATIONSHIP OF CHILD PSYCHIATRIC PATIENTS (소아정신과 환아 부모의 부부관계에 대한 연구)

  • Lim, Ke-Won;Hong, Kang-E;Rhee, Kun-Hoo
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.2 no.1
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    • pp.160-175
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    • 1991
  • The purpose of this study is to investigate the parental marital relationships and the parent-child relationships of child psychiatric parents and its control group. This study was carried out two questionnaire instruments ; The marital satisfaction inventory(MSI) and the dyadic adjustment scale(DAS). The subjects are parents of the child psychiatric patients. A matched control group and parents of child psychiatric parents in Seoul area which were collected from July 1987 to September 1987, and classified into five subgroups : 1 Psychiatric disorder 2) Neurotic disorder 3) Tic disorder 4) Autistic disorder 5) Mental retardation. The results are as following ; 1) M.S.I scale scores of parents of patients group are lower than that of control group. 2) D.A.S scale score of parents of patients group is significantly lower than that of the control group(P<0.01). 3) The global distress scale(GDS) of the M.S.I. was most positively correlated with affective communication(AFC) and problem-sloving communication(PSC). 4) Female shoed more modern concept of role identification than male but tend to have heavier role assignment especially in child rearing practices which could be characterized by maternal domination. 5) Affective communication and sexual relationship between married couple and child rearing practices are influenced by their own family history of distress. 6) The marital global distress scale(GDS) score was highest in the parents of psychosis, the next in the parents of neurosis, autism, mental retardation, and tic disorder in descending order of severity. 7) The dyadic maladjustment score was highest in the parents of psychosis, the next in the parents of neurosis, tic, autism and mental retardation in descending order of severity. 8) Conflict in child rearing and parenting problems were particularly prominent in parents of the tic patients, and their marital relationship was not significantly disturbed. The above finding suggested that couple adjustment and marital dissatisfaction were closely related with child rearing problems and the children's disorder. So marital dissatisfaction and marital maladjustment seem to play a significant role in the genesis of psychosis and neurosis not much in autism and mental retardation.

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DIFFERENCES IN THE PATTERNS OF PARENTAL REARING BETWEEN DEPRESSION AND DEPRESSIVE CONDUCT DISORDER IN ADOLESCENCE (청소년의 우울증과 우울 행동 장애에서의 부모 양육 태도에 관한 연구)

  • Jeon, Seong-Il;Lee, Jung-Ho;Lee, Gi-Chul;Choi, Young-Min
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.7 no.1
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    • pp.34-43
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    • 1996
  • In adolescence, the symptoms of depression are more various and different from those of adult. Conduct behaviours are frequently represented in adolescent's depression. The patients who have the depression and conduct disorder are defined as depressive condor disorder in ICD-10. We hypothesized that there might be different parental rearing patterns between the patients with depression alone and the depressive conduct disorder. We applied children's depression inventory (CDI), parental rating form for conduct disorder based on DSM-III-R, and parental bonding instrument (PBI) to patients and normal control adolescent group. The results were as follows : 1) There were no significant differences in severity of depressive symptoms, maternal care, maternal overprotection, and paternal care. 2) Paternal overprotection showed significant higher scores in depressive conduct disorder group than depression group and normal control group. 3) There were positive correlations in the severity of depressive symptoms and behavior problems in all subjects. 4) There were no correlations in maternal care and overprotecion with conduct problems, but with depressive symptoms in all subject. 4) There were no correlations in paternal care with conduct problems and depressive symptoms in all subjects. 5) There were significant correlations in patienral overprotective, intrusive attitudes with conduct problems, not with depressive symptoms in all subjects.

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