Cross-Cultural Aspect of Behavior Assessment System for Children-2, Parent Rating Scale-Child: Standardization in Korean Children

PURPOSE: Our study aimed to examine psychometric properties and cross-cultural utility of the Behavior Assessment System for Children-2, Parent Rating Scale-Child (BASC-2 PRS-C) in Korean children. MATERIALS AND METHODS: Two study populations were recruited: a general population sample (n=2115) of 1st to 6th graders from 16 elementary schools and a clinical population (n=219) of 6–12 years old from 5 child psychiatric clinics and an epidemiological sample of autism spectrum disorder. We assessed the validity and reliability of the Korean version of BASC-2 PRS-C (K-BASC-2 PRS-C) and compared subscales with those used for US populations. RESULTS: Our results indicate that the K-BASC-2 PRS-C is a valuable instrument with reliability and validity for measuring developmental psychopathology that is comparable to those in Western population. However, there were some differences noted in the mean scores of BASC-2 PRS-C between Korean and US populations. CONCLUSION: K-BASC-2 PRS-C is an effective and useful instrument with psychometric properties that permits measurement of general developmental psychopathology. Observed Korean-US differences in patterns of parental reports of children's behaviors indicate the importance of the validation, standardization and cultural adaptation for tools assessing psychopathology especially when used in populations different from those for which the instrument was originally created.

Abnormal Activation of the Social Brain Network in Children with Autism Spectrum Disorder: An fMRI Study

OBJECTIVE: The aim of this study is to investigate abnormal findings of social brain network in Korean children with autism spectrum disorder (ASD) compared with typically developing children (TDC). METHODS: Functional magnetic resonance imaging (fMRI) was performed to examine brain activations during the processing of emotional faces (happy, fearful, and neutral) in 17 children with ASD, 24 TDC. RESULTS: When emotional face stimuli were given to children with ASD, various areas of the social brain relevant to social cognition showed reduced activation. Specifically, ASD children exhibited less activation in the right amygdala (AMY), right superior temporal sulcus (STS) and right inferior frontal gyrus (IFG) than TDC group when fearful faces were shown. Activation of left insular cortex and right IFG in response to happy faces was less in the ASD group. Similar findings were also found in left superior insular gyrus and right insula in case of neutral stimulation. CONCLUSION: These findings suggest that children with ASD have different processing of social and emotional experience at the neural level. In other words, the deficit of social cognition in ASD could be explained by the deterioration of the capacity for visual analysis of emotional faces, the subsequent inner imitation through mirror neuron system (MNS), and the ability to transmit it to the limbic system and to process the transmitted emotion.

The Reliability and Validity of Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version- Korean Version (K-SADS-PL-K)

In order to develop a structured and objective diagnostic instrument, authors completed: (1) the translation and back translation of the Korean version of the Kiddie-Schedule for Affective Disorders and Schizophrenia - Present and Lifetime Version (K-SADS-PL) and (2) the examination of its validity and reliability of the K-SADS-PL-Korean version (K-SADS- PL) when used with Korean children. A total of 91 study subjects were recruited from child and adolescent psychiatry outpatient clinics. Clinical diagnoses were used as a gold standard for the examination of validity of K-SADS-PL-K. Consensual validity of threshold and sub-threshold diagnoses were good to excellent for attention-deficit/hyperactivity disorder (ADHD), fair for tic and oppositional defiant disorders, and poor to fair for anxiety and depressive disorders. Inter-rater and test-retest reliabilities were fair to excellent for ADHD and tic disorder. The significant correlations between the K-SADS-PL-K and Korean Child Behavior Checklist (K-CBCL) were found, which provided additional support for the concurrent validity of the K-SADS-PL-K. Sensitivities varied according to the diagnostic categories, but specificities remained high over all diagnoses, suggesting that the K-SADS-PL-K is a desirable confirmatory diagnostic tool. The results of this study suggest that the K-SADS-PL-K is an effective instrument for diagnosing major child psychiatric disorders, including ADHD, behavioral disorders and tic disorders in Korean children. Future studies will examine the validity and reliability of the K-SADS-PL-K in larger samples, including adolescents and community samples on a variety of child and adolescent psychiatric disorders.

Normative Data on the Korean ADHD Rating Scales(K-ARS) for Parents and Teacher / 신경정신의학

OBJECTIVES: Identifying children with Attention-Deficit/Hyperactivity Disorder (ADHD) and providing early therapeutic interventions for them are important to prevent secondary problems in academic achievement and emotional disturbances. The aims of the study is to examine the characteristics of K-ARS for parents and teachers, a screening questionnaire to identify children with ADHD, by age and sex of the children, to examine its clinical validity, and to provide norm data of K-ARS for school-aged children which will facilitate the use of K-ARS in clinical practice and research. METHODS: Randomly selected 1st to 6th graders of the two elementary schools (N=1044) in Anyang City participated in this study. Twenty three children diagnosed with ADHD at the child and adolescent clinic at the Hallym University Sacred Heart Hospital were included in this study for the analysis of validity. Parents and teachers completed K-ARS. Descriptive statistics, t-test and analysis of variance were performed. RESULTS: K-ARS scores showed significant difference according to the gender, with boys having higher scores than girls. There was no significant difference of the scores by ages. Validity analysis showed that K-ARS distinguishes children with ADHD from children without ADHD well. The normative data were presented by age and sex. CONCLUSION: K-ARS for parents and teachers has an excellent clinical validity to discriminate children with ADHD from children without ADHD. Different normative data of K-ARS need to be used due to the gender difference. K-ARS is a useful tool for screening and identifying children with ADHD. Future studies are required to include larger samples with adolescents in various geographic areas.

Maternal Depression and Anxiety and Ratings of Behavioral Problems of Child / 신경정신의학

OBJECTIVES: This study was aimed to investigate the relationship between maternal depression and anxiety, and their ratings of child's behavior. METHODS: 769 elementary school students participated in this study. Mothers completed the Korean Conners' Parent Rating Scale (K-CPRS), the Korean Attention-deficit/hyperactivity disorder Rating Scale (K-ARS): Home Version, the Korean Beck Depression Inventory (K-BDI) and the Korean Beck Anxiety Inventory (K-BAI). Teachers completed the Korean Conners' Teacher Rating Scale (K-CTRS) and the K-ARS: School Version. The maternal emotional status was classified into four groups (Normal, Anxious and Not Depressed, Depressed and Not Anxious, Anxious and Depressed) according to BDI and BAI scores. The subscale raw scores of K-CPRS, and K-ARS: Home version were compared among maternal emotional status by the Analysis of Covariance before and after their scores were controlled for the each subscale scores rated by teachers consistent with those rated by parents. RESULTS: All of the subscale scores of parent's form were significantly different according to maternal emotional status after controlled for the scores of teacher's form. After post hoc analysis, the scores of parents' ratings of Anxious and Not Depressed group and Anxious and Depressed group were higher than those of the Normal group. CONCLUSION: The mothers who are depressed and/or anxious tend to report more behavior problems of children than now they actually are.

The Reliability and Validity of Korean Parent and Teacher ADHD Rating Scale / 신경정신의학

OBJECTIVE: It is important to identify and treat ADHD children early to prevent secondary academial and emotional problem. The Purpose of this study is to investigate the reliability and validity of Korean parent and teacher ADHD Rating Scale. METHOD: First to sixth graders in two elementary schools in Anyang City participated in this study. Teachers and parents completed ADHD Rating Scale. Additionally parents completed K-CBCL and Conners scale. Descriptive statistics, correlation, t-test and analysis of variance were performed. RESULT: A total of 1044 students participated in this study. Correlation of rater reliabilities between parent and teacher was significantly close. And Internal consistency by age was high. As correlations among ARS, K-CBCL, Conners scale were high, the ARS scores can be validated. CONCLUSION: Korean parent and teacher ADHD Rating Scale has high reliability and validity. This scale will be a useful tool for ADHD evaluations and diagnosis. A study of comparing clinical groups is suggested.

Development of Korean-Peer Nomination Inventory(K-PNI):An Inventory to Evaluate School Bullying / 신경정신의학

OBJECTIVES: School bullying is known to be related to behavioral, emotional and social problems both in victims and perpetrators. The aims of this study are to develop a Korean-Peer Nomination Inventory(K-PNI), which can identify victims and perpetrators of school bullying in an objective and effective way, and to examine its reliability and validity. METHODS: Fourth to 6 th graders of two elementary schools in An Yang city completed K-PNI, Peer Acceptance Scale and Self-Perception Scale. Varimax Rotation Factor Analysis, Cronbach's Alpha Reliability Analysis and Pearson's Correlational Analysis were performed for statistical analyses. RESULTS: Total of 532 students(male:female=1:1;4 th:5 th:6 th grader=1:1:1.2) participate in this study. Factor analysis showed that K-PNI identified victims and perpetrators of school bullying effectively with excellent reliability(Chrobach's alpha;0.90-0.94). Victims were further divided into two categories;passive bullying including exclusion and verbal abuse, and active bullying including physical abuse and being forced. K-PNI, Peer acceptance scale and Self-perception scale were significantly correlated, reflecting its validity identifying victims and perpetrators of school bullying. CONCLUSION: K-PNI is an effective tool with excellent reliability and validity to identify victims and perpetrators of school bullying. K-PNI is expected to be a useful tool in future studies of school bullying and school violence.

School Bullying and Related Psychopathology in Elementary School Students / 신경정신의학

OBJECTIVE: School bullying, the most prevalent type of school violence, is known to be related to various behavioral, emotional and social problems both in victims and perpetrators. The purpose of the present study is to investigate the prevalence of school bullying and related psychopathology in a community sample of elementary school students. METHOD: Fourth to 6 th graders of two randomly selected classes in two elementary schools in Anyang City participated in a cross-sectional study. Study subjects completed Korean-Peer Nominating Inventory(K-PNI). Parents completed Korean-Child Behavior Checklist(K-CBCL), ADHD Rating Scale(ARS) and Conners Scales for parents, and teachers completed ARS and Conners Scales for teachers. Descriptive statistics, multiple linear and logistic regression were performed. RESULTS: A Total of 532 students participated in this study. Prevalence of victims, perpetrators, and victim-perpetrators were 48%, 45%, and 30% respectively. Extreme victims and perpetrators of school bullying ranged from 2.1-4.1%. Inattention-passivity in teachers' Conners Scale, social immaturity or aggression in K-CBCL were positively associated with victims and victim-perpetrators, and grade was negatively related to school bullying. Conduct problem in Conners Scale for teachers and emotional instability in K-CBCL, and male gender were positively associated with perpetrators. CONCLUSION: School bullying is very common in Korean children of elementary schools. Those who had experienced school bullying, either as victims or as perpetrators, had signifi-cantly more psychopathology than their counterparts. To clarify a causal relationship between psychopathology and school bullying, a longitudinal follow-up study is suggested.