• Title/Summary/Keyword: Externalizing behavior disorder

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A Validation Study of the Korean Child Behavior Checklist 1.5-5 in the Diagnosis of Autism Spectrum Disorder and Non-Autism Spectrum Disorder

  • Cho, Han Nah;Ha, Eun Hye
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.30 no.1
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    • pp.9-16
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    • 2019
  • Objectives: The purpose of this study was to analyze the discriminant validity and the clinical cut off scores of the Child Behavior Checklist 1.5-5 (CBCL 1.5-5) in the diagnosis of autism spectrum disorder (ASD) and non-ASD. Methods: In total, 104 ASD and 441 non-ASD infants were included in the study. T-test, discriminant analysis, receiver operating characteristic (ROC) curve analysis, and odds ratio analysis were performed on the data. Results: The discriminant validity was confirmed by mean differences and discriminant analysis on the subscales of Emotionally reactive, Somatic complaints, Withdrawn, Sleep problems, Attention problems, Aggressive behavior, Internalizing problems, Externalizing problems, and Total problems, along with the Diagnostic and Statistical Manual of Mental Disorders (DSM)-oriented scales between the two groups. ROC analysis showed that the following subscales significantly separated ASD from normal infants: Emotionally reactive, Somatic complaints, Withdrawn, Sleep problems, Attention problems, Aggressive behavior, Internalizing problems, Externalizing problems, Total problems, and DSM pervasive developmental problems. Moreover, the clinical cut off score criteria adopted in the Korean-CBCL 1.5-5 were shown to be valid for the subscales Withdrawn, Internalizing problems, Externalizing problems, Total problems, and DSM pervasive developmental problems. Conclusion: The subscales of Withdrawn, Internalizing problems, Externalizing problems, Total problems, and DSM pervasive developmental problems significantly discriminated infants with ASD.

Discriminant Validity of the Child Behavior Checklist for Ages 1.5-5 in Diagnosis of Autism Spectrum Disorder (자폐스펙트럼장애 진단에서 Child Behavior Checklist 1.5-5 유아 행동평가척도 부모용의 변별력)

  • Lee, Sun Hee;Ha, Eun Hye;Song, Dong-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.26 no.1
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    • pp.30-37
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    • 2015
  • Objectives: The purpose of this study was to verify the validity and clinical cutoff score of the Child Behavior Checklist for ages 1.5-5 (CBCL 1.5-5) for diagnosis of autism spectrum disorder (ASD). Methods: 44 ASD infants and 100 normal infants participated. T-test, discriminant analysis, receiver operating characteristic (ROC) curve analysis, and odds ratio analysis were performed on the data. Results: Discriminant validity was confirmed by mean differences and discriminant analysis on the subscales of Withdrawn, Attention problems, Internalizing problems, Externalizing problems, Total problems, and all Diagnostic and Statistical Manual of Mental Disorders (DSM)-oriented scales between the two groups. ROC curve analysis showed that Withdrawn, Attention problems, Internalizing problems, Externalizing problems, Total problems, DSM pervasive developmental problems, DSM attention deficit/hyperactivity problems, and DSM oppositional defiant problems significantly predicted ASD infants compared to normal infants. In addition, the clinical cutoff score criteria adopted in the Korean CBCL 1.5-5 for subscales of Withdrawn, Attention problems, Internalizing problems, Externalizing problems, Total problems, DSM pervasive developmental problems, DSM attention deficit/hyperactivity problems, and DSM oppositional defiant problems were shown to be valid. Conclusion: The subscales of Withdrawn, Attention problems, Internalizing problems, Externalizing problems, Total problems, DSM pervasive developmental problems, DSM attention deficit/hyperactivity problems, and DSM oppositional defiant problems significantly discriminated for the diagnosis of ASD.

EFFECTS OF CHILDREN'S PROBLEMATIC BEHAVIORS AND INTELLIGENCE ON MATERNAL DEPRESSION (아동의 문제행동과 지능이 어머니의 우울증에 미치는 영향)

  • Yang Su-Jin;Cheong Seongshim;Noh Kyung-Sun;Lee Helen
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.16 no.2
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    • pp.211-218
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    • 2005
  • Objectives : The purpose of the study was to evaluate the related factors of depression in mothers bringing their offspring for evaluation or treatment of problematic behaviors. Methods : Fifty mothers were recruited through their offspring's evaluation or treatment for offspring's problematic behaviors. Psychological tests battery including Korean Wechsler Adult Intelligence Scale and the Korean Educational Development Institute-Wechsler Intelligence Scale for Children was administered to all mothers and their offspring. Mothers completed Korean version of Child Behavior Checklist (K-CBCL), and teachers completed Teacher's Report Form (TRF). On the basis of the maternal depression, the mothers were divided into two groups. Results : 1) Among the fifty mothers, $42\%$ of the mothers had depressive disorder, $16\%$ had anxiety disorder, and $42\%$ had no psychiatric disorder. 2) Depressed mothers rated significantly higher in aggressive behaviors, externalizing problems of K-CBCL in their children. 3) Children of depressed mothers had lower score in picture arrangement and coding subtests of KEDI-WISC than those of no psychiatric disorder mothers. 4) After controlling for the total problematic behavior scores of TRF, mother's depression is positively correlated with aggressive behaviors, externalizing problems, total problematic behaviors of K-CBCL, and negatively correlated with coding of KEDI-WISC. Conclusion : Children's aggressive behavior, externalizing behavior, total problematic behaviors and low coding score may be associated with mother's depression.

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Comorbid Psychiatric Symptom Associated With Oppositional Defiant Symptom in Community School-Age Children

  • Yong Hun Kim;Duk-Soo Moon;Na Ri Kang
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.34 no.3
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    • pp.169-174
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    • 2023
  • Objectives: Oppositional defiant disorder (ODD) is often comorbid with other psychiatric disorders in childhood. This study aimed to investigate comorbid psychiatric symptoms and associated factors in elementary school children with symptoms of ODD. Methods: The participants consisted of 205 mother-offspring pairs. Psychiatric symptoms were measured using the Diagnostic Predictive Scales and Korean Child Behavior Checklist. Psychiatric comorbid symptoms were compared between children with ODD symptom and those without ODD symptom. Multivariate logistic regression analysis was used to estimate the odds ratio of psychiatric symptom on ODD. Results: ODD group had a significant association with internalizing and externalizing problem (p=0.001, p<0.001, respectively). ODD group were more comorbid with anxiety disorder, depressive disorder, attention-deficit/hyperactivity disorder, and conduct disorder. Among psychiatric disorder, generalized anxiety disorder (GAD) (adjusted odds ratio [AOR]=18.620, p<0.001) and conduct disorder (AOR=9.529, p=0.014) were associated with ODD symptom. Conclusion: These findings suggest that children with ODD symptom had significantly higher rates of comorbid psychiatric symptoms. And GAD and conduct disorder are related to ODD symptom.

The Effect of Social Skills Training for Children with Attention-Deficit Hyperactivity Disorder and Asperger's Disorder : Preliminary Study (주의력결핍 과잉행동장애 아동과 아스퍼거장애 아동에서 사회기술훈련의 효과 비교)

  • Hwang, Ji-Hee;Kwack, Young-Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.24 no.4
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    • pp.199-206
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    • 2013
  • Objectives : Attention-deficit hyperactivity disorder (ADHD) and Asperger's disorder (AD) in children are associated with attentional problems, impulsivity, hyperactivity, and difficulties with social interactions. Pharmacological treatment may alleviate symptoms of ADHD, but seldom solves difficulties with social interactions. Social skills training (SST) may assist in improving their social interactions. We examined the effects of SST on children's social competences, general behavior, and ADHD symptoms. Methods : Thirty four children, aged 7 to 12 years, participated in the cognitive behavioral SST program once a week at the outpatient division of child-adolescent psychiatry. SST was composed of 24 sessions (ninety minutes) for 6 months. Twenty-five children were diagnosed with ADHD, and 9 children were diagnosed with AD. Parents of the children rated Korea-Child Behavior Checklist (K-CBCL), Conner's rating scales, Korean-ADHD Rating Scale (K-ARS), Social Skill Rating System (SSRS), and Matson's Social Skill Rating Scale as an evaluation of the treatment effect, before the first session and after the final session of the training. Results : The ADHD group showed significantly increased scores of social and social competence of CBCL and SSRS. Further, scores of externalizing problems of CBCL, CRS, and ARS were significantly decreased. The Asperger's group showed significantly increased scores of social competence of CBCL, SSRS, and MESS. There was a significant difference of the improvement in CBCL's school and total behavior problem score, CRS between drug change group and no drug change group. Conclusion : The result of this study suggests that SST is effective in improving social skills for children with ADHD and AD. In addition, SST has shown its effectiveness in treating attentional problems for children with ADHD. To prove objective usefulness of SST, further studies with a more structured design and long-term duration along with a sufficient number of AD participants will be necessary.

Psychiatric Characteristics of Adolescents with Minor Offenses and Follow-Up after a 6-Month Protective Disposition (1, 2호 보호 처분 청소년의 정신의학적 특성 및 6개월 보호처분 후 추적조사)

  • Chung, Un-Sun;Seo, Sang-Soo;Lee, Seung-Jae;Jeong, Sung-Hoon
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.21 no.2
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    • pp.95-102
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    • 2010
  • Objectives : This study investigated the differences between the psychiatric characteristics of minor juvenile offenders and normal adolescents as well as differences in psychiatric symptoms after a six month protective disposition. Further, the current study aimed at determining psychiatric screening methods for evaluating delinquent adolescents. Methods : The Latent Delinquency Questionnaire (LDQ), the Revised Children's Manifest Anxiety Scale (RCMAS), the Children’s Depression Inventory (CDI), the Reynolds Suicidal Ideation Questionnaire (SIQ), the Piers-Harris Children's Self Concept Inventory (SCI), and the Korean Youth Self Report (K-YSR) were administered to 134 normal adolescents (114 males) and 109 minor offenders (97 males) aged 12 to 16 years. After six months, 46 offenders (all males) completed the RCMAS, CDI, SIQ, and SCI again. Results : Adolescents with minor offenses had more delinquent, aggressive behavior and externalizing behavior problems, but were significantly less depressive, anxious, or suicidal than normal controls. Further, recidivists had more anxiety, depression, and delinquent behavior than non-recidivists. Minor offenders reported that their anxiety and depressive mood decreased after six months of protective disposition. Conclusion : Adolescents with minor offenses had more delinquent, aggressive behavior and externalizing behavior problems suggesting that psychiatric screening tools for minor offenders should measure disruptive behavior disorder.

Agreement between Parents and Teachers on School Children's Emotional/Behavioral Problems (학령기 아동 정서.행동문제에 대한 부모-교사 평가 일치도)

  • Park, Hyo-In;Kim, Jin-Mi;Park, Yong-Chon;Kim, Seok-Hyeon;Ahn, Dong-Hyun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.21 no.3
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    • pp.161-167
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    • 2010
  • Objectives: In assessing behavioral/emotional problems in school-aged children, the importance of multi-informant reporting has been well documented. However, in clinical settings obtaining multiple informants' opinions has proven difficult. For that reason, we researched the agreement and predictive validity of the Child Problem-Behavior Screening Questionnaire (CPSQ) in order to reveal how accurate parents' assessments reflected teachers'opinions. Methods: We conducted the first screening for second- and third-grade children from 3 elementary schools in Seoul from 2003 to 2007 using the CPSQ. There were 1178 children included in the analysis. We then administered the Korean version of the Child Behavior Checklist (K-CBCL) as a second screening tool and subsequently, the ADHD Diagnostic System (ADS) and the Korean Educational Development Institute version of the Wechsler Intelligence Scale for Children (KEDI-WISC) was administered by a psychiatrist. We examined each item on the CPSQ and the subscale's agreement between parent and teacher as well as the predictive validity of the CPSQ in children diagnosed with emotional/behavioral problems. Results: The agreement rates between parents and teachers appeared high for questions 18 (0.433), 1 (0.385), and 2 (0.325). Among the subscales, a relatively high correlation was found for externalizing problems, attention deficit hyperactivity disorder, and cognitive problems. For all diagnosed children, their parents revealed a higher sensitivity and lower specificity than teachers. Conclusion: From these results, we confirmed that the CPSQ can be useful for sorting out externalizing and cognitive problems. There is a need for further study, however, with a larger sample size.

THE RELATIONSHIP AMONG CHILD'S BEHAVIOR PROBLEMS, MATERNAL DEPRESSION, AND PARENTING STRESS (아동의 정서 및 행동 문제와 어머니의 우울증, 양육 스트레스간의 관계)

  • Lee, Young-Joon;Song, Won-Young;Choi, Yui-Gyum;Shin, Yee-Jin
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.14 no.2
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    • pp.218-228
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    • 2003
  • Objectives:This study investigated the relationship among child's behavior problems, maternal depression, and parenting stress in children with psychiatric diagnoses and their mothers, and the effect of these variables to the mothers' parenting stress. Methods:Seventy-three children(31 externalizing, 24 internalizing, 18 mixed) and their mothers were involved in this study. The mothers of three groups completed MMPI, KPI-C(Korean Personality Inventory for Children), and PSI(Parenting Stress Index). To investigate the relationships among each variables, ANOVA, Pearson correlation, stepwise regression analysis were performed. Results:There was no significant difference in maternal depression among three groups of children. In 2-Way ANOVA, main effect of maternal depression was statistically significant on depression, parent health, and relationship with spouse subfactor in parent domain, parent domain total, and overall parenting stress. But the main effect of child group was statistically significant on distractability/hyperactivity subfactor in child domain only. In regression analysis, maternal depression explained the parent domain of parenting stress most effectively, and child's hyperactivity and anxiety explained the child domain of parenting stress significantly. Conclusion:These findings suggest that it is important to intervene maternal depression to reduce the parenting stress, along with the treatment of the child's behavior problems.

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Suicidal Behavior, Violent Behavior, and Neurocognitive Function in Child and Adolescent Mood Disorder Patients (기분 장애 소아 청소년 환자에서 자살 행동, 공격 행동과 인지기능과의 관계)

  • Yoon, Hee Joon;Oh, Yunhye;Joung, Yoo Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.27 no.1
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    • pp.39-47
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    • 2016
  • Objectives: The aim of this study was to examine the association between current suicidal or violent behavior and deficits of specific neurocognitive variables in child and adolescent inpatient samples diagnosed with mood disorder. Methods: A retrospective review of the charts of mood disorder patients hospitalized at Samsung Medical Center between April 2004 and April 2015 was conducted. Child and adolescent patients aged between 10 and 18 years old and those who finished neurocognitive function testing during their hospitalization were included. Among them patients whose full scale IQ was between 85 and 115 were selected (N=111). Participants were first divided into two age-groups-group Y ($10{\leq}age{\leq}15$, N=54) and group O ($16{\leq}age{\leq}18$, N=57)-because neurocognitive function test tools were different according to age [Wechsler Intelligence Scale for Children (WISC) for 10 to 15-year-old patients, Wechsler Adult Intelligence Scale (WAIS) for 16 to 18-year-old patients]. They were then divided according to their suicidal or violent behavior-non suicidal/violent group (NG), suicidal group (SG), violent group (VG), and both suicidal/violent group (BG). The Child Behavior Checklist (CBCL) was checked for measurement of participants' behavior and the Gordon Diagnostic System was checked for measurement of their attention efficiency. Kruskal-Wallis Test and Tukey test was used to determine the differences in neurocognitive function between groups. Results: O-SG patients showed lower scores on the comprehension subscale of WAIS-III than O-NG patients (${\chi}^2=8.454$, p=.015). O-VG patients showed lower scores on the block design subscales of WAIS than O-SG patients (${\chi}^2=7.496$, p=.024). Y-VG patients showed higher scores in aggressive behavior, externalizing problems, and total problems scores of CBCL. Conclusion: This study showed relationship between specific neurocognitive deficits and suicidal or violent behavior. These relationships were significant in relatively older adolescents.

Behavioral and intelligence outcome in 8- to 16-year-old born small for gestational age

  • Yi, Kyung Hee;Yi, Yoon Young;Hwang, Il Tae
    • Clinical and Experimental Pediatrics
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    • v.59 no.10
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    • pp.414-420
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    • 2016
  • Purpose: We investigated behavioral problems, attention problems, and cognitive function in children and adolescents born small for gestational age (SGA). Methods: Forty-six SGA children born at term and 46 appropriate for gestational age (AGA) children born at term were compared. Psychiatric symptoms were examined with reference to the Korean-Child Behavior Checklist, Korean-Youth Self Report, and Attention Deficit Hyperactivity Disorder Rating Scale (ADHD-RS). Cognitive function was estimated using the Wechsler Intelligence Scale. Sociodemographic data were recorded from interviews. Results: SGA children had high scores on delinquent behavior, aggressive behavior, and the externalizing scale, and they also showed a propensity for anxiety and depression. The SGA group had a higher mean ADHD-RS score than the AGA group ($10.52{\pm}8.10$ vs.$9.93{\pm}7.23$), but the difference was not significant. The SGA group had a significantly lower verbal intelligence quotient (IQ) than the AGA group, but the mean scores of both groups were within normal limits. Conclusion: This study indicates marked behavioral problems, such as delinquency, aggressiveness, and anxiety and depression, as well as low verbal IQ in the SGA group than in the AGA group. Even in cases in which these symptoms are not severe, early detection and proper treatment can help these children adapt to society.