• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제33권3호
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• pp.67-72
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• 2022

Objectives: This study investigated the reliability and validity of the Korean version of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Level 2 Cross-Cutting Symptom Measure-Patient-Reported Outcomes Measurement Information System (PROMIS)-Depression and the Irritability for parents of children aged 6-17 years. Methods: Participants were 190 children diagnosed with depressive disorder (n=14), anxiety disorder (n=21), attention-deficit/hyperactivity disorder (ADHD; n=111), ADHD with anxious depression (n=13), and tic disorder with somatic symptoms (n=31). Patients were 8-15 years of age. The participants' mothers completed the Korean versions of the DSM-5 Level 2 Cross-Cutting Symptom Measure-PROMIS Depression and Irritability (Affective Reactivity Index, ARI), and the Korean Child Behavior Checklist (K-CBCL). Using these data, we calculated the reliability coefficient and examined the concurrent and discriminant validity of the PROMIS Depression and the Irritability (ARI) scales for assessing depression and irritability in children. Results: The reliability coefficient of the PROMIS Depression scale (Cronbach's α) was 0.93. The correlation coefficient with the K-CBCL DSM emotional problem score was 0.71. The PROMIS Depression scale significantly discriminated children with depressive disorders from those with other conditions. The reliability coefficient of the Irritability (ARI) scale was 0.91, suggesting its high reliability. Conclusion: Our results suggest that the Korean version of the DSM-5 Level 2 Cross-Cutting Symptom Measure for Depression and Irritability Scales for parents of children aged 6-17 years is reliable and valid and may be an efficient alternative to the K-CBCL.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제23권2호
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• pp.49-56
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• 2012

Methylphenidate is a widely used stimulant for treatment of attention-deficit hyperactivity disorder (ADHD). In addition to core symptoms of attention and behavioral symptoms, methylphenidate is even effective for executive functions. However, abuse and misuse of stimulants, including methylphenidate, for the purpose of cognitive enhancement is an issue of concern worldwide. Some prejudices and misunderstandings against methylphenidate are popular ; however, little attention has been given to the neuropsychiatric evidence of methylphenidate for enhancement of cognitive function among healthy populations. In this article, our aim was to conduct a review of previous studies investigating the effect of methylphenidate in healthy populations. Findings from several recent studies have demonstrated the effectiveness of methylphenidate for enhancement of cognitive function in healthy populations. The mechanisms of cognitive enhancement are thought to be associated with motivation and the reward circuit in the brain. However, when considering the risk to benefit, an official discussion of the use of methylphenidate among healthy members of the population would be premature. Instead, investigation of epidemiological studies of the prevalence of misuse of stimulants among healthy members of the population, particularly adolescents and college students, is needed. In addition, based on achievements reported in previous studies, investigation of the effect of an approach using non-pharmacological enhancing motivation, which will in turn result in increased cognitive function would be helpful.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제15권1호
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• pp.82-90
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• 2004

목 적：본 연구에서는 주의력 결핍과잉행동장애 아동을 대상으로 주요 3가지 실행기능 영역인 억제능력, 작업기억, 그리고 계획능력 면에서 정상아동과의 수행차이를 비교 분석하였으며, 실행기능 수행에 영향을 미치는 나이와 지능을 통제하여 고찰하였다. 또한 억제통제능력을 인지억제와 행동억제로 구분하여 수행을 비교연구 하였다. 방 법：대상은 주의력결핍과잉행동장애로 진단된 아동 25명으로 연령범위는 7세에서 12세였고, 비교집단은 동일연령의 정상 아동 25명이였다. 모든 아동들에게 개별적으로 지능검사와 실행기능 검사(고노고, 스트룹 간섭과제, 하노이탑, 숫자검사)를 실시하였으며, 나이와 지능을 공변인으로 한 공변량 분석을 하였다. 결 과：지능에서 ADHD아동과 정상아동간에 유의미한 차이를 보였으며, 나이는 각 실행기능 검사와 유의미한 상관을 보였다. ADHD아동은 정상아동에 비해서 억제능력과 작업기억에서 유의미하게 저조한 수행을 보였다. 하지만, 지능과 나이를 통제했을 경우, 작업기억과 계획능력에서는 수행차이가 없었다. 논 의：ADHD아동은 전반적인 실행기능에서 손상을 보이는 것이 아니라 억제능력(인지억제와 행동억제)에 어려움이 있으며, 억제능력이 ADHD의 주요결함임을 시사해준다. 이와 같은 결론은 치료적 개입시 인지억제 및 행동억제에 중점을 둔 치료방법이 필요함을 시사해준다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제12권1호
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• pp.149-156
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• 2001

베타 용혈성 A군 연구균(group A beta-hemolytic streptococcus)에 의한 류마치스성 열 이후에 Sydenham 무도병이 발현되는 환자 군에서 강박 증상 또는 틱 증상이 나타난다는 보고가 있은 후, A군 연구균 감염과 강박 장애 또는 틱 장애 사이의 관계가 주목받게 되었다. A군 연구균 감염 후에 강박 증상 또는 틱 증상이 유발되는 환자들은 갑작스런 발병과 극적인 증상 악화를 보이고 사춘기 이전에 발병하며 무도병 모양의 운동 및 독특한 양상의 운동 과잉 등의 신경학적 이상을 보이고 또 그 경과가 악화 및 완화를 반복하는 양상을 보인다. 이런 임상적 특징을 보이는 소아 환자 군을 PANDAS(pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections)라고 부르게 되었다. 이후 현재까지 강박 장애와 틱 장애뿐 아니라 주의력 결핍/과잉운동 장애, 신경성 식욕부전증, 신체이형장애 환자들이 PANDAS 범주에 속한다는 보고들이 있어 왔다. 본 증례는 7세까지 정상적인 발달을 보이다가 A군 연구균 감염 수개월 후부터, 인지 기능, 사회성, 언어 및 의사소통에 장애를 보이고 틱 증상과 함께 얼굴과 손발에 이상 운동을 보이는 환자를 기술하였다. 이에 저자들은 본 증례가 소아기 붕괴성 장애의 양상을 보이는 PANDAS 증례라고 생각되어 이를 문헌 고찰과 함께 보고함으로써, PANDAS가 틱 장애, 강박 장애, 주의력 결핍/과잉운동 장애, 신경성 식욕부전증, 그리고 신체이형장애 등의 양상을 보일 뿐 아니라 소아기 붕괴성 장애의 양상을 보일 수 있다는 사실을 보고하고자 한다.

• Biomolecules & Therapeutics
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• 제20권2호
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• pp.226-233
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• 2012

Ethanol exposure during gestational period is related to growth retardation, morphological abnormality, and even in neurological abnormalities including attention deficit/hyperactivity disorder (ADHD)-like behaviors on offspring. However, relatively little is known about the effects of maternal ethanol consumption prior to conception on their offspring. In this study, we investigated whether maternal ethanol administration during preconceptional phase produces ADHD-like behaviors in the rat offspring. Sprague-Dawley (SD) female rats were administrated ethanol via intragastric intubation with dosing regimen of 6 g/kg daily for 10 consecutive days and treated female rats then mated with non-treated male SD rats after 8 weeks. Another group subjected to the same procedure as those conducted on ethanol treated group except the saline administration instead of ethanol. Offspring was tested for their ADHD-like behaviors using open field test, Y maze test and impulsivity test that is performed in the aversive electronic foot shock paradigm. Offspring of preconceptional ethanol treated (EtOH) group showed hyperlocomotive activity, attention deficit and impulsivity. And reduction of striatal dopamine transporter (DAT) level was observed by Western blot in the EtOH group, compared to control (Con) group, while the immunohistochemical analysis exhibited increased expression of norepinephrine transporter (NET) in the frontal cortex. These results suggest that maternal ethanol consumption in the preconceptional phase induces ADHD-like behaviors in offspring that might be related to the abnormal expression of DAT and NET in rat.

• 대한한의진단학회지
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• 제11권2호
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• pp.13-26
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• 2007

Background: Neurofeedback is an electroencephalographic biofeedback technique for training individuals to alter their brain activity via operant conditioning. Also neurofeedback is a form of behavioural training aimed at developing skills for brain activity. Within the past decade, several neurofeedback studies have been published that tend to overcome the methodological shortcomings of earlier studies. This research describes the methodical basis of neurofeedback and reviews the evidence base for its clinical efficacy and effectiveness in attention-deficit hyperactivity disorder (ADHD). Methods: In neurofeedback training, self-regulation of specific aspects of electrical brain activity is acquired by means of immediate feedback and positive reinforcement. In frequency training, activity in different EEG frequency bands has to be decreased or increased. Slow cortical potentials (SCPs) training is focused on the regulation of cortical excitability. Results: Neurofeedback studies revealed training-specific effects on, for example, attention and memory processes and performance improvements in real-life conditions, in healthy subjects as well as in patients. In several studies it was shown that ADHD symptomatology was reduced after frequency training or SCP(Slow cortical potentials) training. Moreover a decrease of impulsivity errors and an increase of the contingent negative variation. Conclusions: This research provides evidence for both positive behavioural and specific neurophysiological effects of neurofeedback training. Also there is growing evidence for neurofeedback as a valuable module in neuropsychiatric disorders. Further, controlled studies are warranted.

• 대한감각통합치료학회지
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• 제13권1호
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• pp.13-22
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• 2015

목적 : 본 연구의 목적은 상호작용식 메트로놈(Interactive $Metronome^{(R)}$: IM)의 평가인 Long Form Assessment(LFA)의 구별타당도와 동시타당도를 알아보고자 하였다. 연구방법 : 연구대상은 경남과 부산지역에 거주하는 만 6세~만11세의 Attention Deficit Hyperactivity Disorder(ADHD) 아동 25명과 일반 아동 25명을 대상으로 하였다. IM의 LFA에 대한 구별타당도를 알아보기 위하여 ADHD 아동과 일반 아동의 LFA 수행의 차이를 비교하였고, 동시타당도를 알아보기 위해 ADHD 아동을 대상으로 LFA와 Bruininks-Oseretsky Test of Motor Proficiency, second edition(BOT-2)와의 상관관계를 알아보았다. 결과 : 일반아동과 ADHD아동에서 IM의 LFA 과제수행을 비교한 결과 총점에서 유의한 차이가 있었다(p<.05). 둘째, ADHD 아동에서 IM의 LFA와 BOT-2의 상관관계를 분석한 결과 LFA의 총점과 BOT-2의 총점에서 비교적 높은 음의 상관관계를 보였다(p<.05). 또한 LFA의 총점과 BOT-2의 손의조절(rs=-.525) 영역에서 높은 상관관계를 보였으며, 미세운동 정확성(rs=-.447), 손의 기민성(rs=-.532)과 균형(rs=-.623) 하위항목에서 높은 음의 상관관계를 보였다(p<.05). 결론 : 연구결과를 통하여 IM의 LFA는 아동의 운동기능을 판별할 수 있는 도구로서 타당도를 확인하였다. IM의 LFA는 총점으로 운동 실행기능을 평가하는 것이 적절하며, 아동의 운동기능 평가를 위해 임상적으로 사용할 수 있으리라 생각된다.

• Journal of Yeungnam Medical Science
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• 제12권1호
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• pp.56-74
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• 1995

저자들은 1994년 3월부터 5월 사이에 대구지역에 소재한 3개 국민학교 2학년 아동 538명을 대상으로 부모 평가용 ADDES-HV 척도를 이용하여 주의력 결핍 과잉 운동 장애에 대한 선별검사를 실시하여 다음과 같은 결론을 얻었다. 1. 학교별 학생간에는 주의력 결핍 과잉 운동장애 점수간에 차이가 없었다. 2. 세 학교 학생들의 남녀간 비교에서 남자가 ADDES-HV 소척도 및 전체 점수 모두에서 여자보다 유의하게 높았다(p<0.05). 3. ADHD 환아군 및 정상 대조군에서 남녀간의 ADDES-HV 척도의 점수에는 유의한 차이가 없었다. 4. 검사-재검사 신뢰도 검증에서 신뢰도 계수는 주의 산만이 0.80, 충동성이 0.69, 과잉 운동이 0.63, 전체 점수 0.82로 모두 만족할 만큼 높았다. 5. 내적일관성에 의한 신뢰도 검증에서 환아군은 Cronbach a값이 0.85(p<0.05), 정상대조군은 0.84(p<0.05)였다. 6. ADDES-HV 척도와 DSM-III-R 척도와의 공존타당도는 ADHD 환아군에서 0.57(p<0.05), 정상대조군에서 0.84(p<0.05)였다. 7. ADHD 환아군과 정상대조군간의 감별 타당도 검증에서 모두 유의하게 환아군이 높은 점수를 보였다(p<0.05). 8. ADDES-HV 척도의 환자군에 대한 판별력을 평가하기 위한 판별 분석에서 전체 판별력은 94.44%였다. 9. 정상적인 접수의 상한선인 절단점을 표준편차 1.5로 볼때 국민학교 2학년 남학생은 80점, 여학생은 69점이었다. 따라서 ADDES-HV 척도를 한국인에 적용한 결과 신뢰롭고 타당함이 입증되었고 환자를 판별하는 능력이 우수하여 향후 ADHD에 대한 선별검사 및 조사 연구에 유용한 도구임이 입증되었다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제31권3호
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• pp.146-153
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• 2020

Objectives: This study aimed to evaluate the reliability and validity of the Korean Form of the Premonitory Urge for Tics Scale (K-PUTS). Methods: Thirty-eight patients with Tourette's disorder who visited Jeonbuk National University Hospital were assessed with the K-PUTS. Together with the PUTS, the Yale Global Tic Severity Scale (YGTSS), the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS), the attention-deficit/hyperactivity disorder (ADHD) rating scale (ARS), and the Adult ADHD Self-Report Scale (ASRS) were implemented to evaluate concurrent and discriminant validity. Results: The internal consistency of items on the PUTS was high, with a Cronbach's α of 0.79. The test-retest reliability of the PUTS, which was administered at 2 weeks to 2 months intervals, showed high reliability with a Pearson correlation coefficient of 0.60. There was a significant positive correlation between the overall PUTS score and the YGTSS score, showing concurrent validity. There was no correlation between the PUTS, CY-BOCS, and ASRS scores, demonstrating the discriminant validity of the PUTS. Factor analysis for construct validity revealed three factors: "presumed functional relationship between the tic and the urge to tic," "the quality of the premonitory urge," and "just right phenomena." Conclusion: The results of this study indicate that the K-PUTS is a reliable and valid scale for rating premonitory urge of tics.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제25권3호
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• pp.136-141
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• 2014

Objectives : The aim of this study was to examine the relationship between internet game addiction and psychiatric symptoms. Methods : A total of 447 adolescents who were recruited from a child and adolescent psychiatric clinic of university hospital completed a self-report questionnaire consisting of Korean Internet Addiction Self-scale (K-scale), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Korean-Attention-Deficit Hyperactivity Disorder Rating Scale (K-ARS), and Adolescent Happiness Index (AHI). They were classified into three internet user groups, non-addicted group (below or equal to 94), potential risk group (95 to 107) and high risk group (above or equal to 108) according to K-scale total score. Results : Significant mean differences in BDI, BAI, K-ARS, and AHI scores were observed among the three groups. The BDI, BAI and K-ARS scores showed positive correlation with K-score. The AHI score showed negative correlation with K-score. Conclusion : Findings of this study suggest that depression, anxiety, inattention, hyperactivity/impulsivity, and happiness are associated with internet game addiction.