Advanced Test of Attention in Children with Attention-Deficit/Hyperactivity Disorder in Japan for Evaluation of Methylphenidate and Atomoxetine Effects

OBJECTIVE: This study was conducted to validate the Advanced Test of Attention (ATA) of the visual attention version of Japanese children with attention deficit/hyperactivity disorder (ADHD) and to evaluate the efficacy of methylphenidate (OROS-MPH) and atomoxetine medications. METHODS: To assess pharmacotherapy efficacy, the visual version of ATA was administered to 42 children with ADHD. Results were assessed using discriminant analysis, ANOVA for indices of ATA before and after medication treatment, and correlation analysis between the improvement of indices of ATA and clinical symptoms during medication treatment. RESULTS: Discriminant analysis showed that 69.0% of ADHD children were assigned correctly. The T score of commission errors increased as the trial progressed on the medication-off condition. T scores of commission errors and standard deviation of response times on medication-on condition were low compared to the medication-off condition. A few significant correlations were found between the improvements of indices of ATA and ADHD-Rating Scale (RS) during treatment. CONCLUSION: The performance of the visual version of ATA on medication-off condition reflected the features of ADHD. Furthermore, the medication treatment effects were confirmed sufficiently. In addition, results suggest that indices of ATA reflected aspects of ADHD symptoms that are difficult to elucidate for ADHD-RS. For assessing symptoms and effects of medical treatment in children with ADHD, ATA might be a useful assessment tool.

Neuropsychological and Behavioral Profiles in Attention-Deficit Hyperactivity Disorder Children of Parents with a History of Mood Disorders: A Pilot Study

OBJECTIVE: We aimed to investigate the neurocognitive and behavioral endophenotypes of premorbid mood disorder. We compared intelligence, neuropsychological functioning, and behavioral problems among three groups: 1) a high-risk group [attention-deficit hyperactivity disorder (ADHD) children of parents with a history of a mood disorder], 2) a low-risk group (ADHD children of parents without a history of a mood disorder), and 3) normal comparison subjects. METHODS: We used the Korean Educational Development Institute Wechsler Intelligence Scale for Children-Revised (KEDI-WISC-R), the Stroop Color Word Interference Test (Stroop), the Wisconsin Card Sorting Test (WCST), and the Rey-Osterrieth Complex Figure Test (RCFT) as neurocognitive measures, and we used the Child Behavior Checklist (CBCL) as a behavioral measure. Performance on these neuropsychological tests and score on the CBCL of 18 high-risk children were compared to those of 20 low-risk children and 24 healthy children. We also assessed the children's current mood state and familial functioning to control for the confounding effects of these variables. RESULTS: Compared to low-risk and healthy children, high-risk children were impaired on the Picture Completion and Stroop Word subtest and showed higher scores on the CBCL subscales representing internalizing symptoms. These significant group differences persisted even after adjustment for the children's current mood state and familial functioning. CONCLUSION: Neuropsychological deficits in the offspring of parents with a mood disorder may be associated with the current mood state rather than with innate characteristics, while their internalizing symptoms may partially stem from innate characteristics that are endophenotypes of a premorbid mood disorder.

The Characteristics of Suicide Attempts and Psychosocial Risk Factors in Correctional Institutions / 신경정신의학

OBJECTIVES: Suicide is one of the most common causes of deaths in correctional institutions. This study aimed to examine the characteristics of suicide attempts and its related psycho-social factors in correctional institutions. METHODS: This study examined the characteristics of 101 suicide attempts from 2006 to 2007 in the two regional correctional headquarters. Thirty-seven male inmates (43 suicide attempts) and 40 matched controls were included in interviews and reviews of personal records. Psychiatric illnesses were examined using the Structured Clinical Interview for DSM-IV and medical outcomes of their suicide attempts with the Lethality Scale of Diagnostic Interview for Genetic Studies. RESULTS: Over a half of suicide attempts occurred in solitary cells and the most common method was hanging. Medically, 70% of the suicide attempts were more than severe. Poor social support, a lifetime history of suicide attempts, and incarceration were associated with suicide attempts. Additionally, psychiatric illnesses were more likely to increase the risk of suicide. CONCLUSION: This study implies that mental health issues and monitoring systems are important to reduce suicides in the correctional system. Regular checks and management of suicide risk and mental illness are crucial to prevent suicide in correctional institutions.

Effects of the Family Environment and the Biogenetic Temperament/Character on the Emotional and Behavioral Aspects of the Filial Piety / 신경정신의학

OBJECTIVE: This study aimed to tap the influence of the childhood and adolescent family environment and biogenetic temperament/character on the filial piety profile, i.e., its behavioral and emotional aspects in Korean college students. METHODS: Ninety-eight college students(male=49, female=49, the main study group) in the Seoul Metropolitan area were selected using multi-stage(randomized) cluster procedures. Their parents(N=174) became the 'generation' comparison group. The Filial Piety Scale was used to evaluate the perception of filial piety, both in 13 individual items and in two factor-analytically- produced behavioral and emotional aspects of filial piety. The Family Environment Scale was used to evaluate the childhood and adolescent family environment. The Temperament and Character Inventory was used to assess biogenetic temperament and character of the study subjects. RESULTS: Parents of college students scored significantly higher on filial piety items of familial harmony, responsibility/obligation, sacrifice, compensation, neighborhood harmony, and family continuity than their offspring did. There were no significant differences between study subjects and their parents in perceiving their family environment. Childhood environment with high moralethical emphasis and high achievement orientation was significantly correlated with the behavioral aspect of filial piety whereas cohesive and expressive family environment was shown to be linked to the emotional aspect of filial piety. Regarding the biogenetic temperament/character-filial piety relationship, low self-directedness was positively correlated with behavioral aspect of filial piety while high cooperativeness was positively correlated with emotional aspect of filial piety. CONCLUSIONS: This study reports distinct patterns of relationship between childhood family environment and the filial piety profile and between biogenetic temperament/character and the filial piety profile in Korean college students.

Cross-Cultural Study on the Development of Self-Image in Korean, Korean-Chinese and Chinese Adolescents / 신경정신의학

OBJECTIVES: In order to investigate the effect of cultural and ethnic differences on the development of self-image, we conducted a cross-cultural study on Korean, Korean-Chinese and Chinese adolescents. METHODS: A total of 1576 Korean middle and high school students in Seoul/Choongju, 665 Korean-Chinese students and 634 Chinese students living in Yunbyun, China participated in this study. The Korean version of the Offer Self-Image Questionnaire was administered to Korean students, and the Chinese version of the questionnaire was administered to Korean-Chinese and Chinese students. The data obtained from all subjects were analyzed according to ethnicity and age variable through ANOVA. RESULTS: A significant difference across ethnicity was found in the 12 subscales and the total self-image score of OSIQ-R. Korean adolescents obtained significantly higher scores in all of the 11 subscales except the sexuality subscale than Korean-Chinese and Chinese adolescents. Korean-Chinese adolescents obtained significantly higher scores on the ethical value, idealism, family functioning, social functioning, impulse control, self-confidence and total self-image scores than Chinese adolescents, whereas Chinese adolescents obtained significantly higher scores in the subscales of emotional tone, sexuality, vocational attitudes, and self-reliance than Korean-Chinese adolescents. CONCLUSION: The results suggest the possibility that the difference in ethnicity(Korean versus Chinese), the tradition associated with each ethnic group, and the cultural-political factor(democracy versus socialism) significantly affects the development of self-image in adolescents. Although Korean-Chinese adolescents seemed to show cultural pluralism between Korean and Chinese cultures, they were similar to Korean adolescents in their tendency to respond in socially desirable ways, which suggests that although raised under the different cultural systems, traditional Korean ethical values were learned and internalized within the family.

A Standardization Study of the Korean Version of Learning Disability Evaluation Scale / 신경정신의학

OBJECTIVES: This study was to develop the Korean version of Learning Disability Evaluation Scale(K-LDES), to examine the reliability and validity of it, and to establish the age norms of the K-LDES for assessing the specific learning disorder. METHODS: The normative group was composed of 720 children between the age of 6 and 12. The clinical group consisted of 27 children with learning disorder and 25 children with attention deficit hyperactivity disorder accompanying learning problem(mean age=108.44month+/-6.60, mean FSIQ=108.61+/-13.47). The K-LDES as administered to teachers of the normative and clinical groups. The KEDI-WISC and the Basic Learning Test(BLT) were administerd to the clinical group. RESULTS: The reliability coefficients(Cronbach's alpha) of the K-LDES were ranged .92-.97 and the correlation coefficients between the K-LDES subscales were moderate to high. The subscales of K-LDES were significantly correlated with the subtests of KEDI-WISC and BLT. Principal component analysis with varimax rotation resulted five factors, which are similar to those of original LDES, strongly supporting the construct validity of the K-LDES. There was significant differences between the normal and the clinical groups on six subscales of K-LDES except arithmetic subscale, implying that the K-LDES is a more valid measure for assesing reading and writing disorders. The discriminant power of each items were calculated, and 71 of the 88 items discriminated significantly between the normal and the clinical groups. In order to establish norms of K-LDES for six age levels, the means and standard deviations of subscale raw scores for normative group were used to calculate subscale standard scores at a given age, and LQ was determined by adding 7 subscale standard scores and being converted standard score with a mean of 100 and a standard deviation of 15. CONCLUSION: K-LDES was found to be a reliable and valid instrument for screening specific learing disorder. The expectation is that K-LDES will be a useful teacher/mother rating measure for identifying learning disorder and providing information which may contribute to diagnosing and developing individualized educational program for identified problem areas.

A Standardization Study of the Korean Version of Offer Self-Image Questionnaire-Revised / 신경정신의학

OBJECTIVES: This study was carried out to develop Korean version of Offer Self-Image Questionnaire-revised(OSIQ-R) designed to assess the self-image in adolescence. METHODS: We applied the translated OSIQ-R to 1,602 Korean middle school and Korean higher school adolescents and conducted retest with 6 weeks' interval. Together with OSIQ-R, Korean form of Symptom Checklist 90-R was applied to all subjects for testing of concurrent validity. We also examined whether this scale discriminates between clinical and normal population in the self-image. RESULTS: Test-retest reliability, internal consistency were very much satisfactory and concurrent validity with other scales. There were significant differences by school, sex and locality in the global self-image. However, comparison of normal and conduct disorder adolescents failed to show significant differences. CONCLUSIONS: In global self-image, reliability and validity of OSIQ-R were sufficient. To get the further validity, more comparative studies of clinical population are required. Additional studies like this, will establish basic normative data and make Korean form of OSIQ-R more useful.

A Clinical Study of Tic Disorder in Korea

No abstract available.