• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.26 no.3
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• pp.226-235
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• 2015

Objectives : The purpose of this study was to examine the factor structure of the Adolescent Personality Assessment Inventory (PAI-A) in a standardized adolescent sample using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Methods : For this purpose, three models about factor structure of the PAI-A were explored with EFA in 490 adolescents and then were evaluated with CFA in 268 young offenders. Results : The results showed that the five factor model was considered to be most appropriate for factor structures of the PAI-A in EFA. However, none of the factor models were appropriate for the factor structures of the PAI-A in CFA. Conclusion : These findings suggest that the "five factor model" is thought to explain the PAI-A the best, but further studies are needed.

• Journal of Preventive Medicine and Public Health
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• v.46 no.sup1
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• pp.22-27
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• 2013

The purpose of this study was to examine the beneficial effects of a new cognitive intervention program designed for the care and prevention of dementia, namely Learning Therapy. The training program used systematized basic problems in arithmetic and Japanese language as training tasks. In study 1, 16 individuals in the experimental group and 16 in the control group were recruited from a nursing home. In both groups, all individuals were clinically diagnosed with senile dementia of the Alzheimer type. In study 2, we performed a single-blind, randomized controlled trial in our cognitive intervention program of 124 community-dwelling seniors. In both studies, the daily training program using reading and arithmetic tasks was carried out approximately 5 days a week, for 15 to 20 minutes a day in the intervention groups. Neuropsychological measures were determined simultaneously in the groups both prior to and after six months of the intervention. The results of our investigations indicate that our cognitive intervention using reading and arithmetic problems demonstrated a transfer effect and they provide convincing evidence that cognitive training maintains and improves the cognitive functions of dementia patients and healthy seniors.

• Psychiatry investigation
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• v.15 no.12
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• pp.1168-1173
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• 2018

Objective After the Sewol ferry disaster, bereavement with suicidal ideation was a critical mental health problem that was accompanied by various neuropsychological symptoms. This study examined the frontal alpha asymmetry (FAA), heart rate variability (HRV), and several psychological symptoms in bereaved family members (BFM) after the Sewol ferry disaster. Methods Eighty-three BFM after the Sewol ferry disaster were recruited. We assessed FAA, HRV, and psychological symptoms, including depression, post-traumatic stress, post-traumatic growth factor, anxiety, grief, and positive resources, between BFM with the presence and absence of current suicidal ideation. Results Compared to BFM without suicidal ideation, BFM with suicidal ideation showed a higher FAA with right dominance. Significant differences in psychological symptoms were observed between the groups. In BFM with suicidal ideation, the low: high frequency (LF:HF) ratio correlated with social resources and support. Conclusion The FAA and LF:HF ratio may be biomarkers that represent the pathological conditions of BFM with suicidal ideation. If researched further, they may shed light on the interaction between bereavement with suicidal ideation and social resources for therapeutic intervention.

• Journal of Medicine and Life Science
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• v.15 no.2
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• pp.89-94
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• 2018

Cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is inherited microangiopathy caused by mutations in the Notch3 gene. Typical findings from brain magnetic resonance imaging (MRI) include subcortical lacunes, extensive white matter change and cerebral microbleeds(CMBs). CMBs are indicative of bleeding-prone microangiopathy. Despite some studies investigating the association between lacunes and cognitive dysfunction in CADASIL, few studies have examined the relationship between cognitive dysfunction and CMBs. We sought to assess whether CMBs are associated with cognitive dysfunction in CADASIL. This study enrolled 83 consecutive patients with CADASIL between April 2012 and January 2014. Their degree of cognitive dysfunction was assessed by the Korean version of the CERAD neuropsychological assessment battery, digit span test, and the Stroop test. A 3.0-T MRI was used to obtain T1-weighted, fluid-attenuated inversion recovery, and susceptibility weighted images. In multiple logistic regression analysis, the grade of CMBs influenced tests of memory dysfunction (p=0.003). Three or more lacunes correlated with dysfunction in the executive domain (p=0.013) and attention domain (p=0.005). White matter hyperintensity (WMH) was an independent predictor of executive dysfunction (p=0.001). These findings suggest that in addition to lacunes, CMBs and WMHs may be useful imaging markers to associated with cognitive dysfunction in CADASIL.

• Dementia and Neurocognitive Disorders
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• v.22 no.4
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• pp.158-168
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• 2023

Background and Purpose: Facial emotion recognition deficits impact the daily life, particularly of Alzheimer's disease patients. We aimed to assess these deficits in the following three groups: subjective cognitive decline (SCD), mild cognitive impairment (MCI), and mild Alzheimer's dementia (AD). Additionally, we explored the associations between facial emotion recognition and cognitive performance. Methods: We used the Korean version of the Florida Facial Affect Battery (K-FAB) in 72 SCD, 76 MCI, and 76 mild AD subjects. The comparison was conducted using the analysis of covariance (ANCOVA), with adjustments being made for age and sex. The Mini-Mental State Examination (MMSE) was utilized to gauge the overall cognitive status, while the Seoul Neuropsychological Screening Battery (SNSB) was employed to evaluate the performance in the following five cognitive domains: attention, language, visuospatial abilities, memory, and frontal executive functions. Results: The ANCOVA results showed significant differences in K-FAB subtests 3, 4, and 5 (p=0.001, p=0.003, and p=0.004, respectively), especially for anger and fearful emotions. Recognition of 'anger' in the FAB subtest 5 declined from SCD to MCI to mild AD. Correlations were observed with age and education, and after controlling for these factors, MMSE and frontal executive function were associated with FAB tests, particularly in the FAB subtest 5 (r=0.507, p<0.001 and r=-0.288, p=0.026, respectively). Conclusions: Emotion recognition deficits worsened from SCD to MCI to mild AD, especially for negative emotions. Complex tasks, such as matching, selection, and naming, showed greater deficits, with a connection to cognitive impairment, especially frontal executive dysfunction.

• Dementia and Neurocognitive Disorders
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• v.23 no.1
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• pp.11-21
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• 2024

Background and Purpose: Although dementia with Lewy bodies (DLB) is the second most common cause of neurodegenerative dementia, its clinical prevalence is low. We developed a short and easy-to-complete DLB screening questionnaire (DLBSQ) to raise diagnostic sensitivity in routine clinical settings. Methods: A total of 501 participants were retrospectively enrolled, including 71 controls, 184 patients without DLB, and 246 patients with probable DLB. All patients underwent clinical evaluation, including core features of DLB, the DLBSQ, brain magnetic resonance imaging, and detailed neuropsychological assessments. The diagnostic performance of the DLBSQ for probable DLB was investigated using a receiver operating characteristic curve analysis. Results: Total DLBSQ score was associated with visuospatial and frontal/executive dysfunction and the diagnosis of probable DLB. The area under the receiver operating characteristic curve for total DLBSQ score was 0.727. Youden's method revealed an optimal cutoff value of 3. The sensitivity and specificity of the DLBSQ were 68.7% and 62.4%, respectively. Its discriminating performance improved when cognitive test profiles were additionally considered (area under the curve: 0.822, sensitivity: 80.6%, and specificity: 70.4%). Conclusions: The DLBSQ might be a useful screening tool for DLB in routine clinical practice with good sensitivity and specificity.

• Dementia and Neurocognitive Disorders
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• v.21 no.1
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• pp.17-29
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• 2022

Background and Purpose: Verbal and nonverbal fluency tests are the conventional methods for examining executive function in the elderly population. However, differences in impairments result in fluency tests in patients with mild cognitive impairments (MCIs) and Alzheimer's disease (AD) and in neural correlates underlying the tests still necessitate concrete evidence. Methods: We compared the test performances in 27 normal controls, 28 patients with MCI, and 20 with AD, and investigated morphological changes in association with the test performances using structural magnetic imaging. Results: Patients with AD performed poorly across all the fluency tests, and a receiver operating characteristics curve analysis revealed that only category fluency test discriminated all the 3 groups. Association, category, and design fluency tests involved temporal and frontal regions, while letter fluency involved the cerebellum and caudate. Conclusions: Category fluency is a reliable measure for screening patients with AD and MCI, and this efficacy might be related to morphological correlates that underlie semantic and executive processing.

• The Journal of Korean Medicine
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• v.25 no.4
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• pp.129-138
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• 2004

Objective : Treatments for patients with mental retardation and pervasive developmental disorders are not curative, and are designed to help those with disabilities adjust to their environments and daily demands. As clinicians, the present authors tried to find agents with potentially curative properties. Among the numerous herbal formulations available, we chose and assessed Gami-jiwhang-tang (GJT) in the hope that it would improve cognitive development of children. Methods : Subjects were typically-developing healthy, 7- to 8-year-old boys and girls living in Seoul, Korea. The experimental group took GJT for six weeks and was followed up six weeks after discontinuation of GJT. The control group was assessed at the same intervals but did not receive placebos. To measure the effects of GJT, neuropsychological tests and intelligence test were taken before commencing GJT and twelve weeks later. Resulets and Conclusion : For all of the ANOVAs, the treatment by time interaction terms was not significant. However, the experimental group showed the tendency to be progressed in most subscales compared with the control group, especially on performance intelligence, visual organization, and verbal fluency. Conclusion : Although GJT failed to reveal significant improvement in cognition, we remain hopeful about the compound and believe that it should be evaluated by a double-blind, placebo-controlled trial in the future.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.16 no.2
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• pp.160-172
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• 2005

Attention-Deficit/Hyperactivity Disorder(ADHD) is the most common neurodevelopmental disorder in child psychiatry. The etiology or ADHD is not completely understood, but involved in genetical and/or neurocognitive deficits. This article reviews the current state of the literature pertaining to the neurodevelopmental aspects of ADHD. Although the neurodevelopment of ADHD remains unclear, emerging evidence documents its genetic and neurobiologic underpinnings. A pathophysiology of ADHD has not been fully characterized, although genetic, neurobiologic, neuroimaging, and neuropsychological studies of ADHD consistently implicates dysfunction in the fronto-subcortical network and abnormality in the dopaminergic and noradnergic systems. Furthermore some suggests that the timing of aberrant brain development in ADHD could be in early gestation and genetic and/or early environmental influences on brain development in ADHD are fixed, nonprogressive. Although many studies provide evidences for the important or psychosocial or environmental adversities in ADHD, they may be not specific predictors of ADHD but nonspecific triggers of an underlying predisposition or modifiers of the course of disorder.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.28 no.2
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• pp.115-122
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• 2017

Objectives: Executive dysfunctions including working memory deficit have been suggested to be one of the major neuropsychological etiologies of attention-deficit hyperactivity disorder (ADHD). The purpose of this study was to investigate the augmentative effects of working memory training on the behavioral problems, quality of life, and parental stress of medicated children with ADHD. Methods: Twenty-five children with ADHD, aged 9 to 19 years, who were being treated with ADHD medication, were included. The participants were trained with a commercially available and computerized working memory program ($Cogmed^{(R)}$) for 5 weeks without any alteration of their medication. The Child Behavior Checklist (CBCL), KIDSCREEN-52 quality of life measure, and Parenting Stress Index-Short Form (PSI-SF) were administered before training, and 4 weeks and 7 months after training, respectively. Results: After completing the training, the anxiety/depression, social problems, thought problems, attention problems, aggressive behavior, and externalizing problems scores in the CBCL were significantly reduced. The score on the Parent-child dysfunctional interaction in the PSI-SF was also decreased. However, the scores related to the quality of life were not changed. These changes were still observed 7 months after the training. Conclusion: Cogmed working memory training can be a promising training option for the additional improvement of behavioral problems and parental stress in medicated children with ADHD.