The Effect of Social Situations on Risky Decision-Making in Individuals With Borderline Personality Tendency

Objective@#This study examined the effect of social situations on risky decision-making in individuals with a borderline personality tendency (BT). @*Methods@#Fifty-eight participants with either high or low levels of BT were included in this study. Those who met the screening criteria were assigned to one of the two social situations (exclusion vs. inclusion) and they played the Cyberball game. Next, the participants were required to play the “Game of Dice” task to measure their decision-making pattern. @*Results@#The results revealed that individuals with high BT (n=28) showed significantly higher risky decision-making, compared with low BT (n=30) in the exclusion condition. However, no significant difference was found in the social inclusion condition. @*Conclusion@#In the social exclusion condition, individuals with high BT made risky decision in response to negative feedback, regardless of the previous decision. These findings can be applied to develop appropriate interventions in psychotherapy for individuals with borderline personality disorder/tendency.

Understanding a Mutually Destructive Relationship Between Individuals With Borderline Personality Disorder and Their Favorite Person

Objective@#Individuals with borderline personality disorder (BPD) commonly have a favorite person (FP), whom they are heavily emotionally attached to and dependent on. This study aims to identify and illustrate the patterns of destructive FP relationships based on actual experiences described by those with BPD. @*Methods@#A data mining process was conducted using raw data collected from online communities, such as blogs and social networks. An in-depth review of the information to better understand the natural course of the FP relationship was also conducted. @*Results@#Individuals with BPD form an intense and insecure attachment toward their FP, from which they enormously suffer. FPs can be their friends, romantic or life partners, or family members. As their feelings go beyond their control, being increasingly obsessed with their FP, they make their FP gradually lose hope in continuing the relationship and want to quit trying to fulfill their needs. The relationship finally ends when the FP stops being responsible for meeting their expectations and eventually drifts away. @*Conclusion@#This study suggests that certain FPs, distinctively named Teddy Bear Person, may behave in a particular manner to increase the likelihood of the FP relationship becoming more destructive. Moreover, the rejection sensitivity model should be discussed to understand their dysfunctional interaction.

Self-Injurious Thoughts and Behaviors Interview-Korean Version: Psychometric Properties

Objective@#There is currently no structured interview tool developed that comprehensively evaluates self-injurious thoughts and behaviors (SITB) in Korea. The Self-injurious Thoughts and Behaviors Interview (SITBI) collectively measures suicidal ideation, plans, gestures, attempts, and non-suicidal self-injuries (NSSI). The SITBI’s reliability and validity have been established with it being widely used in English speaking countries. This study evaluated the psychometric validity of the Korean version of the SITBI (SITBI-K). @*Methods@#The SITBI’s validity as a diagnostic assessment tool for NSSI and suicidal behavior disorder (SBD), as defined by the Diagnostic and Statistical Manual of Mental Disorders-5th edition, was examined. Analyses were performed on 108 university students reporting experiences of suicidal thoughts and behaviors (female 84.26%, mean age=22.10, ±SD 3.33). @*Results@#The SITBI-K displayed excellent interrater reliability, with a credible test-retest reliability at two months. Construct validity examined the correlation between the SITBI-K’s modules and approved the self-report results. Appropriate convergent and discriminant validities were obtained for suicidal ideation, plans, gestures, attempts, and NSSI. @*Conclusion@#The SITBI-K showed excellent psychometric validity at a level comparable to the original. Its clinical utility for both NSSI and SBD diagnoses was confirmed.

The Effects of Narrative Therapy for Children with Attention Deficit Hyperactivity Disorder / 신경정신의학

OBJECTIVES: Clinical symptoms and related psychological problems in children with attention deficit hyperactivity disorder (ADHD) are associated with low self-control and problematic interpersonal relationship between family members. A therapeutic narrative treatment based on "Treating Huckleberry Finn" by David Nylund was reported to be effective in reduction of individual or family conflicts. We hypothesized that therapeutic narrative treatment would improve self-control and parent-child relational problems. METHODS: Sixteen children who were diagnosed as ADHD participated in the current study. They were classified according to two groups, narrative treatment group and medication treatment group. The narrative treatment group (NTG) was asked to participate in 6 weeks combined therapy of medication and 11 sessions of narrative therapeutic treatment. The medication group (MG) was asked to participate in 6 weeks combined therapy of medication and education for behavior controls in ADHD children. RESULTS: During the 6-week treatment period, the clinical symptoms in NTG improved at a trend level, compared to MG [F(1,16)=4.32, p=0.054]. During the 6-week treatment period, the sub-scale of respecting for children in parent-child interaction scores [F(1,16)=8.65, p=0.010] and self-control scores [F(1.16)=3.78, p<0.01] in NTG improved significantly, compared to MG. CONCLUSION: Based on the current results, therapeutic narrative treatment can be a complementary trial for improving self-control and parent-child interaction in children with ADHD.

Comparison of Memory Function and MMPI-2 Profile between Post-traumatic Stress Disorder and Adjustment Disorder after a Traffic Accident

OBJECTIVE: Differential diagnosis between post-traumatic stress disorder (PTSD) and adjustment disorder (AD) is rather difficult, but very important to the assignment of appropriate treatment and prognosis. This study investigated methods to differentiate PTSD and AD. METHODS: Twenty-five people with PTSD and 24 people with AD were recruited. Memory tests, the Minnesota Multiphasic Personality Inventory 2 (MMPI-2), and Beck's Depression Inventory were administered. RESULTS: There were significant decreases in immediate verbal recall and delayed verbal recognition in the participants with PTSD. The reduced memory functions of participants with PTSD were significantly influenced by depressive symptoms. Hypochondriasis, hysteria, psychopathic deviate, paranoia, schizophrenia, post-traumatic stress disorder scale of MMPI-2 classified significantly PTSD and AD group. CONCLUSION: Our results suggest that verbal memory assessments and the MMPI-2 could be useful for discriminating between PTSD and AD.

National Evidence-based Collaborating Agency (NECA) Round-table Conference Consensus Statement: multidisciplinary responses to suicide, the first ranked cause of death in adolescents

The National Evidence-based Collaborating Agency (NECA) holds the NECA Round-table Conference that not only disseminates objective and systematic information on topics of social concern in public health care but also organizes discussions on core issues under dispute in the literature through panels composed of multidisciplinary experts. Accordingly, the Round-table Conference was composed of multidisciplinary experts including medical specialists in the areas of psychiatry and preventive medicine, psychiatric and mental health nursing, psychologists, social welfare experts, consultation experts, religious leaders, and government officials from the Ministry of Education, Science and Technology, and Ministry of Health and Welfare. The Round-table Conference, tasked with analysis of the actual status and causes of, and search for solutions for suicide in adolescents, has reached consensus on the current status, trend, risk factors and prevention factors, problems and issues in prevention and coping strategies, effective prevention and coping strategies and areas of research needed for the future. The Round-table Conference commented on the actual status and gravity of suicides in adolescents, and came to the agreement that mental health issues including stress from interpersonal relationships and depression are the key risk factors of suicide. It was further agreed that problems in the measures being implemented for each of the areas include lack of manpower and funding, and inadequate organic association and cooperation among relevant institutions. They also agreed that development of a government-initiated suicide prevention program for adolescents, association among relevant experts, and development, and management of practical guidelines that are of broad and practical use are important. Furthermore, the panels were in agreement that the mass media must comply with the recommended level of coverage in reporting of suicide as adolescents are greatly influenced by provocative mass media reports due to their strong impulsive dispositions.

Development of a Cognitive Rehabilitation Program for Patients with Schizophrena / 신경정신의학

OBJECTS: The purpose of this study was to investigate the effects of cognitive differentiation training program-Korean version(a training program of attention and conceptual abilities) on cognitive function, psychopathology and problem solving skills in patients with schizophrenia. METHODS: A total of patients diagnosed as schizophrenia using DSM-IV were randomly assigned to 2 groups. The training group went through a total of 22 sessions of cognitive differentiation training (60min/sessionX2sessions/wkX11wks). The attention-placebo control group received psychoeducation program during the same period. Arithmetic, vocabulary, similarities, picture completion of Wechsler Adult Intelligence Scale-Korean version, Positive and Negative Syndrome Scale, and Social Problem Solving Scales were administered to all patients, both before and after the training program. RESULTS: In the arithmetic scores(F=6.35, af=1, p=0.018) of Wechsler Adult Intelligence Scale-Korean version, and total scores(F=6.35, af=1, p=0.018) and problem solving skill scale scores (F=4.88, af=1, p=0.036) of social problem solving scale, interaction effects of training was significant. CONCLUSION: Our findings suggest that cognitive differentiation training program-Korean version is effective on improving auditory attention and problem solving skills in patients with schizophrenia.

Effects of Cognitive Differentiation Training of Intergrated Psychological Therapy to the Basic Cognitive Functions in Schizophrenic Patients / 신경정신의학

OBJECTIVES: The purpose of this study was to investigate the effects of cognitive differentation training of Integrated Psychological Therapy(a training program of executive function,concept formation,language,and abstraction) on micro-level cognitive function such as attention,memory and reaction time in patients with schizophrenia. METHODS: Twenty-four inpatients diagnosed as schizophrenia using DSM-lV were randomly assigned to 2 group. The training group went through a total of 12 sessions of cognitive differentiation training for 4 weeks. The control group received psychoeducation Timer of Vienna Test System were administered to all patients, both before and after the training program. RESULTS: 1) In the attention and concentration scores of Wechsler Memory Scale-Revised, between group, within group and interaction effects of training were not significant. 2) In the short-term memory scores of Wechsler Memory Scale-Revised, within group effect of training was significant(F(1,24)=15.09,p<0.05), but the between group and interaction effects did not reach significance. 3) In the long-term memory scores of Wechsler Memory Scale-Revised, within group effect of training was significant(F(1,24)=15.09,p<0.05), but the between group and interaction effects did not reach significance. 4) In the reaction time scores of Decision-Reaction Timer,interaction effect of training was significant(F(1,24)=5.18,p<0.05). 5) In the motor time scores of Decision-Reaction Timer,between group,within group and interaction effects of training were not significant. 6) In the decision time scores of Decision-Reaction Timer,interaction effect of training was significant(F(1,24)=6.00,p<0.05). CONCLUSION: Our findings suggest that cognitive differentiation training of Integrated Psychological Therapy is partly effective on improving micro-level cognitive functions such as reaction time(especially,decision time)in patients with schizophrenia.

Predictability of Neurocognitive Functions on the Treatment Effect in Schizophrenia / 신경정신의학

OBJECTIVES: This study was to investigate a wider range of neurocognitive function tests to find out how accurately each subtest could predict the outcomes of treatment in schizophrenics. METHODS: The subjects were 33 inpatients diagnosed as schizophrenia according to DSM-IV. Each subject had a drug wash-out period of at least 1 week, and had been given K-WAIS, WMS-R, and Signal Detection, Decision Reaction Timer, and Motor Performance Series in Vienna Test System just before drug administration. Treatment response was evaluated with BPRS and CGI scales before and 8 weeks after drug treatment. We divided the subjects into responders and non-responders according to the outcomes of the above clinical scales in week 8. The responder group was defined with having 20% increase in BPRS score and a CGI score of less than 3. Then we compared the neuropsychological test results between the two groups. RESULTS: Significantly different results between responders and non-responders were Verbal IQ and Full Scale IQ in K-WAIS, the number of correct responses in Signal Detection and Decision Reaction Timer in Vienna Test System. In discrimination analysis of the two groups using these subtests as variables, we could predict the responders with 66.7% accuracy, even though statistically non-significant. CONCLUSION: Although discriminating between responders and non-responders using neurocognitive function tests were proven to be statistically non-significant, the possibility that neurocognitive function tests can be utilized to predict the treatment outcome in schizophrenia cannot be completely ruled out.

Effects of Integrated Psychological Therapy for Schizophrenic Patients / 신경정신의학

OBJECTIVES: This study, as a preliminary one attempting to develop the Korean version of Integrated Therapy for the rehabilitation of schizophrenic patients, was designed to investigate the results of Integrated Psychological Therapy(IPT) and review the problems during the program application. METHODS: Cognitive Differentiation Scale, Problem-Solving Scale, and PANSS(Positive And Negative Syndrome Scale) were administered to schizophrenic inpatients before and after IPT incorporating cognitive differentiation, social perception, verbal communication, social skill and interpersonal problem-solving skill subprograms. The therapy groups were offered activities three times per week during the 12-week program. The control groups were attention-placebo groups for control ling factors such as group interaction and social attention, and were offered psychoeducation. RESULTS: The 12-week IPT groups, compared with the control groups, demonstrated significant improvements in the general psychopathology and the total symptoms of PANSS, but did not in cognitive functions and problem-solving skill. Significant improvements in cognitive functions were found only after cognitive differentiation subprogram and social skill subprogram had limited effects on social skills. But within 12-week IPT groups significant improvements in the positive symptoms, negative symptoms and general psychopathology were found. CONCLUSION: These findings support some effectiveness of IPT, but do not address the unique contribution by cognitive components. Applied to schizophrenic patients in this country, this modality had the problems such as differences in sociocultural and lingual background, duration of treatment, homogeneity in the level of the functioning among group members, management of emotions in activities, and the therapists' skill in the training of cognitive components. So the modification of this modality will be required.

The Study of the Signal Detection Test of the Traffic Accident Patients with and without Brain Lesions / 신경정신의학

OBJECTIVES: The purpose of this study was to investigate the differences of signal detection between the traffic accident patients with and without brain lesions in neuroimaging techniques. METHODS: Subjects were 48 traffic accident patients. All subjects were asked to detect the signals in Signal Detection test of Vienna Test System. RESULTS: The number of correct response and the stimulus sensitivity were significantly higher in group without lesion than group with lesion, but the number of false alarm and the response criterion were not. CONCLUSIONS: These results suggest that a cause of lower signal detection of the patients with brain lesions was not motivational and emotional impairment but cognitive impairment.

The Effect of Attention Training Using Computer-Aided Cognitive Rehabilitation Program(REHACOM) in Chronic Schizophrenics / 신경정신의학

OBJECTIVE: The authors study evaluated the effect of a cognitive rehabilitation program designed to enhance the attention skill of chronic schizophrenics. METHODS: Dependent variables included measures of perceptual sensitivity and response criterion derived from the Vigilance test of Vienna test system. Each of 10 subjects received 10 sessions of repeated training with computer-aided cognitive rehabilitation program(REHACOM). Eleven subjects were assigned to a control group. All subject were rated on measures of positive and negative symptoms before training. RESULTS: Significant changes on the outcome measures were observed following attention training. CONCLUSION: It is suggested that cognitive rehabilitation with chronic schizophrenics should stress the possibility of remediating deficiencies in basic abilities, such as attention.

Statistical Classification of Alcohol Dependence by MMPI / 신경정신의학

OBJECTS AND METHODS: The authors tried to classify 75 male patients with alcohol dependence by using cluster analysis of their MMFI data, to Identify the characteristics of each subtype classified through that process and to evaluate the discriminant validity of the classification. RESULTS: The subjects were divided into 3 subtypes by K-means cluster analysis of MMPI scores: a psychotic subtype of 6(Fa)-7(Ft)-8(Sc) profile(21.4%), a neurotic subtype of 2(D)-3(Hy)-1(Hs) profile(49.3%), a normal subtype(29.3%). But, there were no statistically significant differences of age, educational level, marital status, admission history due to alcoholic problems, number of drinking day per week, average amount of ethanol consumed per drinking occasion, age at onset of drinking and family history of alcoholism among these three subtypes. CONCLUSION: It seems that the subjects with alcohol dependence could be classified into three subtypes with statistical significance, but this statistical classification does not constitute any evidence of discriminant validity.