청소년정서행동발달검사 표준화연구 자료를 활용한 학교폭력 피해 전국유병률 및 관련요인 조사

방수영(Soo-young Bhang),유한익(Hanik K. Yoo),김지훈(Ji-Hoon Kim),김봉석(Bongseog Kim),이영식(Young Sik Lee),안동현(Donghyun Ahn),서동수(Dong-Su Suh),조수철(Soo-Churl Cho),황준원(Jun-Won Hwang),반건호(Geon Ho Bahn) 대한소아청소년정신의학회 2012 소아청소년정신의학 Vol.23 No.1

Objectives:This study was conducted to investigate the prevalence of victims of bullying and the demographic characteristics of victims, and their related psychopathology, in a Korean nationwide sample of youths in middle and high school over a one month period. Methods:During the autumn of 2009, students in the 7th to 12th grades at 23 secondary schools participated in a nationwide, cross-sectional study. The study subjects completed the Adolescent Mental Health and Problem Behavior Screening Questionnaire-II (AMPQ-II) and Symptom Checklist-90-Revision (SCL-90-R). Based on the data acquired, descriptive statistics, correlation coefficients and multiple logistic regression analysis were performed. Results:Among the 3364 participants, 2272 (67.54%) completed the questionnaire. The prevalence of victimization was 28.9%. Male gender was positively associated with victimization, and grade level was negatively related to victimization. The AMPQ-II bullying score (Factor 4) was significantly (p<.001) and positively correlated to the AMPQ-II student total score (r=0.50), Worry and thought (Factor 1 ; r=0.38), Mood and suicide (Factor 2 ; r=0.31), Academic and Internet-related problems (Factor 3 ; r=0.24), Rule violations (Factor 5 ; r=0.23), and AMPQ-II teacher total score (r=0.11). Somatization (r=0.23), Obsessive-compulsive behavior (r=0.24), Interpersonal sensitivity (r=0.30), Depression (r=0.33), Anxiety (r=0.26), Hostility (r=0.30), Phobic anxiety (r=0.22), Paranoid ideation (r=0.36), and Psychoticism (r=0.31) results from the SCL-90-R were also found to be positively related to the AMPQ-II bullying score, and remained significant after adjusting for age and gender. A total of 26% of the victims reported suicidal ideations as compared to 9% of non-victims over the month prior to the evaluation (χ2=119.595, df=1, p<.001). The multiple logistic regression analysis indicated that the AMPQ-II bullying score significantly increased the risk of suicidal ideation [Exp(b)=1.55, df=1, p<.001] after adjusting for age and gender. Conclusion:School bullying was highly prevalent among Korean middle and high school students. This study provided strong evidence that suicidal ideation and psychopathology were serious problems among the victims of bullying.

청소년용 정신건강 선별검사 개정 연구

방수영(Soo-Young Bhang),유한익(Hanik K. Yoo),김지훈(Ji-Hoon Kim),김봉석(Bongseog Kim),반건호(Geon Ho Bahn),안동현(Donghyun Ahn),서동수(Dong-Su Suh),조수철(Soo-Churl Cho),황준원(Jun-Won Hwang),이영식(Young Sik Lee) 대한소아청소년정신의학회 2011 소아청소년정신의학 Vol.22 No.4

Objectives:The purposes of this study were to develop a mental health screening questionnaire and the practical intervention programs or guidelines which can be used in middle and high schools by students and teachers. Methods:The Adolescent Mental health & Problem behavior Screening Questionnaire II (AMPQ-II) was developed and was tested for reliability and validity using nationwide data from 2,180 middle and high school students and 2,145 teachers. Results:The AMPQ-II was measured by both students and teachers. The correlation coefficient of the test-retest test was 0.567 and internal consistency was high (Cronbach?s alpha=0.878). Five factors such as worry and thought, mood and suicide, academic and Internet-related problems, peer problems, and rule violations were proposed. We also developed a practical guideline and manuals which can be easily used by secondary school teachers to screen for and manage mental health problems at school. Conclusion:The AMPQ-II can be a useful and reliable tool to screen for mental health problems in middle and high schools in South Korea.

기초학습부진으로 의뢰된 일 광역시의 일반학급 초등학생의 심리, 정신과적 평가 및 부모의 특성

방수영(Soo-Young Bhang),박정환(Jung-Whan Park),임재인(Jae-In Lim) 대한소아청소년정신의학회 2011 소아청소년정신의학 Vol.22 No.1

Objectives:This study examined the prevalence of psychiatric problems in children with scholastic difficulties who had been referred for mental health services from the Office of Education in Ulsan Metropolitan City. Methods:Child psychiatrists evaluated the referred children using the DSM-IV. Evaluation tools included the Wechsler Intelligence Scale for Children-III, the Children’s Depression Inventory, the Korean form of the State-trait anxiety Inventory for children, the ADHD rating. Results:Seventy-six children consisting of 64 boys (84.2%) and 12 girls (15.8%) participated in the study. The average age was 10.3 (SD=0.93) years old. Approximately 74% of the children referred for scholastic difficulties were diagnosed with mental retardation. The Axis I diagnosis among these children were ADHD (86.8%), depression (21.1%), learning disorder (9.2%), communication disorder (4.8%), pervasive developmental disorder (3.6%), internet addiction (1.3%), and mood disorder (1.3%). Their overall measure according to the Child Depression Inventory was 22.7 (SD=16.8), that for the State-Trait Anxiety Inventory for Children was 33.3 (SD=7.9)/32.4 (SD=9.5), and that for the ADHD rating scale was 18.9 (SD=10.9). Conclusion:These results suggest that many children with scholastic difficulties have both complex psychiatric and educational problems.

소년원생들의 우울증 예측에 기계학습을 적용한 예비연구

손동훈(Dong Hun Son),장진구(Jhin Goo Chang),송후림(Hoo Rim Song),이수영(Su Young Lee),이승훈(Seung Hoon Lee),방수영(Soo-Young Bhang),이미선(Mi-Sun Lee),김현수(Hyun-Soo Kim),홍민하(Minha Hong) 대한사회정신의학회 2021 사회정신의학 Vol.26 No.2

연구목적 : 청소년 범죄에서 정신건강의 문제와 범죄가 관련성이 높다는 것은 잘 알려져 있지만 국내에서는 아동청소년 범죄자들의 정신건강에 관한 연구가 거의 없다. 뿐만 아니라 아동청소년정신건강 영역에서 기계학습을 적용한 연구는 아직 초기단계이다. 본 예비연구에 서는 여자청소년 재소자들에서 정신건강 문제 중 우울증의 예측에 기계학습 알고리즘을 적용하여 적합한 지를 알아보고자 한다. 방 법 : 대상자는 청주소년원에 재소중인 87명의 여자청소년을 대상으로 하였다. 대상자들에게 설문지 패키지 (인구학적 정보, 범죄관련 정보, 자기보고척도 설문지(아동기부정적경험 설문지, 벡우울척도)를 배부하여 정보를 수집하였다. 기계학습 기법을 이용하여 수집된 재소자들의 기본 정보를 바탕으로 우울증을 예측할 수 있는 6개의 모델(Logistic regression, Random forest, Supportive vector machine, Decision tree, Nearest neighbor, Adaboost)을 생성하여 각 모델간의 예측 성능을 비교해 보았다. 결 과 : 대상자를 벡우울척도(절단점 13)로 군을 분류한 결과 정상군 18명(21%)과 우울증군 69명(79%)이었다. 6개 모델의 우울증 예측 정확도는 Logistic regression 81.8%, Random forest 81.8%, Supportive vector machine 68.18%, Decision tree 72.7%, Nearest neighbor 77.3%, Adaboost 63.6%였다. 그중에서 Random forest 모델의 AUC score는 0.75로 다른 모델들과 비교하여 가장 높았다. 결 론 : 본 연구는 재소청소년의 정신건강에 중점을 두어 현황을 파악하고,우울증의 예측에 기계학습 기법을 적용을 하여 높은 정확도를 확인하였다는 점에서 의의가 있다. 또한 취약계층의 정신건강 영역에 기계학습 기법을 적용하여 관리 및 감시에 적용 가능성에 대한 근거를 제공하였다. Objectives : It is well known that mental health problems and crime are highly related to youth crime, but there is little research on the mental health of young offenders in Korea. Furthermore, research on the application of machine learning in the mental health of children and adolescents is still novel. This preliminary study aims to investigate whether it is appropriate to apply machine learning algorithms to predict depression among female adolescent inmates. Methods : The subjects were 87 young females in Cheongju Juvenile Center. A questionnaire was distributed to the subjects to gather their demographic information and crime-related information, as well as their adverse childhood experiences and Beck depression inventory scores using self-reported scale questionnaires. Based on the collected information, six models (logistic regression, random forest, supportive vector machine, decision tree, nearest neighbor, Adaboost) that can predict depression were created to compare the predictive performance between models using machine learning techniques. Results : Results showed that 29 victims (25.7%) met the criteria of PTSD and 19 victims (16.8%) met the rigid criteria of PTSD. But, according to the subscales, 41 victims (36.3%) were diagnosed as PTSD. Victims with PTSD had more serious depression, anxiety, sleep disturbance, anger, social withdrawal and life stresses. Conclusion : This study identified the current mental health status of female inmates with high accuracy by applying machine learn-ing techniques to predict depression. The applicability of machine learning techniques to the management and surveillance of mental health in vulnerable groups was also highlighted.

학동기 아토피피부염 환자의 삶의 질 및 정신과적 증상

성준영 ( Jun Young Seong ),이지호 ( Ji Ho Lee ),방수영 ( Soo Young Bhang ),최유성 ( Yu Sung Choi ),서호석 ( Ho Seok Suh ) 대한피부과학회 2015 대한피부과학회지 Vol.53 No.9

Background: Atopic dermatitis (AD) in school-aged children may affect their daily activities and psychological well-being. It can also have a negative impact on the child’s behavior. Little is known about the quality of life (QOL) and psychiatric symptoms in school-aged children and their relationship to disease severity. Objective: The purpose of this study was to document the impact of AD on QOL and psychiatric symptoms in school-aged children by disease severity. Methods: Seventy-eight AD patients aged 7∼19 years were included in this study. Participants completed the Children’s Dermatology Life Quality Index (CDLQI), Kovacs’ Children’s Depression Inventory (CDI), and the Korean Attention-Deficit Hyperactivity Disorder Rating Scale (K-ARS). Disease severity was evaluated using the SCORAD (SCORing Atopic Dermatitis) index. Results: The SCORAD was 28.95±17.92 (mean±SD), and the CDLQI was 8.04±6.29. The CDLQI was significantly correlated with the SCORAD. Psychiatric symptoms (CDI and K-ARS) did not show a correlation with the SCORAD, but they worsened with increasing CDLQI score. There was no statistically significant difference among the different age groups. Conclusion: We demonstrated that AD had an impact on school-aged children’s QOL and psychological well-being. Severity of AD correlated with QOL decrements, indicating greater QOL impact with greater disease severity. Psychiatric symptoms were more related to subjective impairment of QOL than objective disease severity. (Korean J Dermatol 2015;53(9):671∼676)

청소년의 인터넷 게임 사용에 대한 코로나19 영향과 보호 및 촉발요인 인식 연구

윤지영(Ji-Young Yoon),조관형(Kwanhyung Cho),방수영(Soo-Young Bhang) 한국중독정신의학회 2022 중독정신의학 Vol.26 No.1

Purpose: The purpose of this study was to show how the ongoing COVID-19 affects Internet gaming use in adolescents and recognizes triggering and protective factors associated with Internet gaming addiction. Methods: Focus group interviews were conducted with 16 adolescents age 14-21 living in Seoul, and a qualitative analysis based on Thematic analysis was used. Results: As a result of the analysis, four themes consisting of 10 categories and 32 subcategories were derived. In short, a change in the environment caused by a pandemic promotes the use of Internet gaming, and in some situations, friends and parents are not only protective factors but also trigger factors. The protective factor has much to do with harmful experiences of gaming, certain short-term goals, future plans and worries, and effects associated with a brief return to daily life during a pandemic. The main triggers are related to fun and fulfillment through games, managing negative emotions, and marketing by game companies and users engaging in games on YouTube. Conclusion : We propose implications and intervention strategies at the school, community and game provider levels to prevent the risk of Internet gaming addiction among adolescents due to COVID-19 and to enhance the protection of parents and friends.

인터넷게임중독의 단계적, 맞춤형 조절력 향상 치료개입 프로그램의 개발

김현수(Hyun-Soo Kim),최삼욱(Sam-Wook Choi),이보혜(Bo-Hye Lee),김나리(Na Ri Kim),이형초(Hyungcho Lee),황석현(Suk-Hyun Hwang),방수영(Soo-Young Bhang),임숙희(Sookhee Im),이해국(Hae Kook Lee) 한국중독정신의학회 2014 중독정신의학 Vol.18 No.2

Internet gaming disorder (IGD) is a complicated behavioral and mental disorder. IGD is suggested as a one of the addictive dis-orders, also, it has unique characteristic features. Because of the bio-psycho-social model of addiction, IGD is part of a wide spectrum of comorbid psychiatric conditions and sociocultural contexts. Based on previous qualitative studies, we can define the intervention strategy based on the severity of the client’s addiction and characteristics of the problem. Therefore, we developed a multidimensional assessment protocol entitled K-PPC (Korean Patient Placement Criteria) for IGD and a tailored individual intervention approach entitled STEP (Stepped Tailored Empowerment Program) based on the concept proposed by the ASAM PPC (American Society of Addiction Medicine) model designed to help those who abuse alcohol and the Stepped model for ad-diction disorders. The K-PPC Assessment protocol is composed of 4 domains; internet game use behaviors, concurrent psychiatric problems, motivation, and the environmental factors affect-ing recovery and relapse. The STEP intervention matrix was composed of the severity of the addiction (basic and intensive) and concurrent psychiatric problems (introversion and extroversion). The treatment program was developed using information taken from evidence-based programs like cognitive behavioral treatment and motivational interviewing. The periods of the basic and intensive intervention are 8 weeks and 16 weeks, respectively. Because of the tailored approach of STEP, it is hypothesized that outcomes will be better compared to those in people treated with the current standard of care.

청소년의 인터넷게임 및 스마트폰 중독과 부모의 개입 정도의 관계

강윤석(Yoonsuk Kang),방수영(Soo-Young Bhang),윤지영(Ji-Young Yoon),한새롬(Saerom Han),최재원(Jaewon Choi) 한국중독정신의학회 2021 중독정신의학 Vol.25 No.1

Objectives : The purpose of this study was to evaluate the relationship between Internet-gaming/smartphone addiction and parental involvement. Methods : From March 2018 to October 2018, a total of 2,701 students in elementary school (n=1,382), middle school (n=798), and high school (n=521) were surveyed in a district in Seoul. The questionnaire included the degree of parental involvement in Internet gaming and smartphone usage and addictive symptoms on these media. The parental attitude was graded as ‘1=completely restrictive/2=mostly restrictive and partially permissive/3=mostly permissive and partially restrictive/4= completely permissive’. Results : Parent group 4 for Internetgaming and parent group 3 for smartphone usage were significantly related to addictive conditions in each media usage. Parent group 1 for smartphone usage was related to less addictive conditions in students. Conclusion : Parental strategy to prevent adolescent s addiction for Internet-gaming and smartphone would differ according to the media type used. Further study would be helpful to reveal the relationship and prevent the addictive problem in this issue. This issue should not be limited to the areas of parental role and responsibility, but more social interest and systemic efforts should be put in place.

청소년정서행동발달검사 표준화 연구 자료를 활용한 교사의 학교폭력 피해자 인지도

황준원(Jun-Won Hwang),방수영(Soo-Young Bhang),유한익(Hanik K. Yoo),김지훈(Ji-Hoon Kim),김봉석(Bongseog Kim),안동현(Donghyun Ahn),서동수(Dong-Su Suh),조수철(Soo-Churl Cho),반건호(Geon Ho Bahn),이영식(Young Sik Lee) 대한소아청소년정신의학회 2012 소아청소년정신의학 Vol.23 No.2

Objectives:The current study was conducted in order to investigate teachers’recognition of school bullying using a nationwide database of adolescents in middle and high school in Korea. Methods:Students in the 7th to 12th grades at 23 secondary schools participated in the current study during the fall of 2009. Subjects completed the self-report form of the Adolescent Mental Health and Problem Behavior Screening Questionnaire-II (AMPQII) and Symptom Checklist-90 Revised (SCL-90-R). In addition, relevant teachers used the teachers’ rating scale of the AMPQ-II to report their students’ status. Differences in the number of bullied students between teachers’ recognition and students’ report were explored. Results:A total of 2270 subjects provided relevant responses to the questionnaire. While the one-month prevalence of victimization according to students’ self-reports was 28.9%, the recognized prevalence by teachers was only 10.6%. For prediction of the presence of school bullying according to students’ self reports on the AMPQ-II, item 7 of the teachers’ report on the AMPQ-II showed a sensitivity of 16%, a specificity of 92%, a positive predictability of 44%, a negative predictability of 72%, a false positive rate of 8%, a false negative rate of 84%, and an accuracy of 69%, respectively. No significant differences in subscores of students’ self reports of the AMPQ-II and SCL-90-R were observed between bullied students who were recognized by teachers and those who were not recognized. In stepwise discriminant analysis, classification of teachers’ item 2 and item 7 on the AMPQ-II with respect to school bullying according to students’ reports showed an accuracy of 63.4%. Using this model, 75.2% of non-victimized subjects were classified correctly, while only 35.2% of victimized subjects were classified correctly. Conclusion:Despite the high prevalence in Korea, teachers’ recognition of school violence among their students remains low. Pre-professional and continuing education to improve teachers’ understanding of school bullying and knowledge of effective classroom-based prevention activities should be encouraged.

정신건강의학과 안정병동 내 병원학교교실 참여자의 학교복귀율과 만족도

이미경(Mi-Kyeong Lee),방수영(Soo-Young Bhang),안준호(Joon-Ho Ahn),박장호(Jang-Ho Park),최현경(Hyun-kyoung Choi) 대한소아청소년정신의학회 2013 소아청소년정신의학 Vol.24 No.3

Objectives:The objective of this report is to identify the utilization of hospital school service during hospitalization among patients in their childhood and adolescence with psychiatric disorders. Methods:We retrospectively reviewed the medical record of child and adolescent psychiatric who were hospitalized during March 2009 through October 2012. We compared the one-year successful schooling and outpatient follow up rate between users and nonusers of the inpatient hospital school service. The hospital schooling experiences of the users were investigated upon follow-up visits to the outpatient clinic. Results:Sixty-three students received hospital school service during hospitalization among total 122 child and adolescent inpatients. Hospital school participants showed a significantly higher school reentry rate (61.9%) than non-participants (40.7%). However, there was no difference on follow up rate between the two groups. More than 60% of the 22 interviewed participants expressed an above-average level of satisfaction about hospital school service. Conclusion:Many patients with mental illness experience difficulty in receiving school education during treatment. That induces deterioration in disease, academic failure, poor social skills, low self-esteem, economic difficulties, and future job opportunities. The results of this study emphasize the importance of hospital school service and offer useful guidance for hospital school operation.