MMPI에 나타나는 Context Effect : 한국판 단축형의 검증 A Study on the Korean Short Form

金重述,李定均 大韓神經精神醫學會 1980 신경정신의학 Vol.19 No.3

The standard booklet form and the short form of the MMPI(383 items) currently in use in Korea were administered to 150 High school first year students for the purpose of comparing the two forms. Group A and B was given the two forms alternatively while to Group C the identical form twice with an interval of one week. The data obtained reveal that (1) significant differences exist between group means in Hs, D and Si scales. (2) Scales L, D, Mf, and Sc differ significantly in its correlations between the two forms. No difference was found among three groups in terms of code-type change between the two sets. Cook-book style interpretations based on the standard MMPI form should be applied cautiously to the profiles from the short form with due consideration of the differences on a few scales. Further confirmation of the results through repetition of the study like this is needed.

臨床的 測定의 樣式

金重述 서울대학교 의과대학 정신과학교실 1982 精神醫學報 Vol.6 No.5

臨床心理學的 硏究方法

金重述 서울대학교 의과대학 정신과학교실 1983 精神醫學報 Vol.7 No.4

MMPI 재검사 신뢰도

金重述 서울대학교 의과대학 정신과학교실 1980 精神醫學報 Vol.4 No.8

躁鬱症 躁期 患者의 MMPI 反應

金重述 大韓神經精神醫學會 1983 신경정신의학 Vol.22 No.1

Too often psychological test responses of the manic patients are found not in accordance with the clinical symptoms or diagnosis. This study is a part of the comprehensive psychometric approach to the methods. MMPI profiles of 13 hospitalized manic patients whose diagnosis was clinically confirmed were reviewed Ma(67T) and Pd(57T) scales proved to be average high-points, making no difference between male(70T for Ma, 58T for Pd) and female(64T for Ma, 57T for Pd) patients. Viewed from the code pattern, Ma was the most frequent(62%) high-point scale among the total patients, but it elevated above 70T for only one-third of them. For more efficient differential diagnosis application of multimodal assessment is needed, preferably using multitrait-multimethod matrix.

분노표현방식과 우울 및 신체화 증상과의 관계

최성일,김중술,신민섭,조맹제 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.3

연구목적 : 우울 및 신체화와 분노 표현 방식 간에 유의한 연관성이 있음이 이전 연구들에 의해 보고된 바 있으며, 분노 억압 이외에 분노 표현이 신체병리의 발생과 관련이 있다는 상반된 연구결과도 제시되어 왔다. 그러나 정신과 환자들은 대상으로 두 요인을 모두 고려하여 이뤄진 연구는 거의 없는 실정이므로, 본 연구에서는 정신과 환자들을 대상으로 상태-특성 분노 및 분노표현방식과 우울 및 신체화 간의 관련성을 알아보고자 하였다. 방 법 : 정신과 환자 53명과 정상인 59명을 대상으로 정신진단 검사(SCL-90-R)의 우울과 신체화 증상을 측정하는 문항 25문항과 한국판 상태-특성 분노 표현 척도를 실시하여 두집단의 차이를 비교하였다. 분노와 우울 및 신체와 간의 관계를 알아보기 위해 각 집단별로 상관 및 회귀 분석을 실시하였다. 결 과 : 본 연구결과는 분노 억제가 우울 및 신체화 증상의 발생에 중요한 요인으로 작용하고 있음을 보이고있으나, 신체화에 비해 우울이 더 높은 관련성을 보이는 바, 이전 연구결과들의 해석에 주의를 요함을 시사한다. 분노 억제와 우울 및 신체화 간의 관계가 심리치료에 중요한 함의를 지닐수 있다. Objectives : In previous studies, significant correlations between depression or somatization and the mode of anger expression were reported. However few studies were done in psychiatric patients, while some evidences were found that anger expression as will as anger suppression were related to development of somatization. This study aimed to investigate the relationship of the state-trait anger and the mode of anger expression to depression and somatization in psychiatiric patients. Methods : The depression and somatization questionnaire of SCL-90-R and Korean Adaptation of the State-Trait Anger expression Inventory were administered to 53 psychiatric patients and 59 normals. The relationship of anger to depression and somatization was analyzed by correlation and regression analyses. Results : In comparison with the normal control group, the psychiatric patient group showed significant differences on trait anger temperament but no significant differences on other anger variables. In regression analysis, the anger-in score was related to depression and somatization. However, the degree of explanatory power was higher in depression than in somatization. In the case of analyzing the state-trait anger, anger-in was significant predictor variable for depression in psychiatric patient group. Conclusion ; These results suggested that anger-in is the important factor in the onset of depression and somatization. Rather than the relationship of anger-in and somatization, the relationship of anger-in and depression is higher ; therefore the caution is necessary in the interpretation of previous studies. The relationship of anger-in to depression and somatization may have important implications for psychotherapy.

憂鬱 脆弱性 類型과 憂鬱에 對한 對處行動

金銀定,金重述 서울醫大 1990 精神醫學 Vol.15 No.3

만성적인 신체질환 및 장애를 지닌 아동의 심리적 특성:자기개념 및 스트레스에 대한 양상 비교

최승미,신민섭,정진엽,김중술 대한소아청소년정신의학회 2000 소아청소년정신의학 Vol.11 No.2

목적 : 만성 신체 질환 아동의 우울, 자기 개념 및 스트레스에 대한 지각과 대처 양상에 대해 알아보고자 하였다. 방법 : 연구 대상자는 서울대학교 병원 어린이 병원에 입원해 있거나 외래에 다니는 환아 13명과 정상아동 13명으로 구성되었다. 만성 질환 아동군은 Schiffer 등(1963)이 만성 환자군으로 정의한 조작적 정의에 근거하여 최소한 3개월 이상 질환을 앓고 있거나 앓았던 적이 있으며, 현재도 그 질환으로 인해 지속적인 치료를 받고 있는 정형외과, 소아과 아동을 대상으로 하였다. 정상 아동군은 그러한 병력이 없는 아동 13명을 대상으로 하였다. 검사도구는 피어스-해리스 자기 개념 척도, 소아 우울 척도, 투사적 검사(나의 기분을 색으로 표현하기, 다른 사람으로 인한 나의 기분을 색으로 표현하기, 비속의 아이)를 실시하였다. 결과 : 만성 질환 아동군과 정상 아동군을 비교한 결과, 만성 질환 아동군이 소아 우울 척도에서 유의미하게 높은 점수를 보였으며, 자기 개념 척도에서는 보다 유의미하게 낮은 점수를 보였다. 또한 자기 개념 척도의 하위 항목인 '인기도' 및 '학습 상태'에서 유의미하게 점수가 낮았다. 투사 과제의 경우, '색으로 표현하기' 과제에서는 집단간의 유의한 차이를 보이지 않았으나, 스트레스에 대한 지각 및 대처를 평가하는 '비속의 아이'과제에서는 하위 항목(비의 양, 기간, 도구, 효율성) 모두에서 집단간의 차이를 보였다. 비속의 아이 과제와 우울 점수, 자기 개념 점수와의 상관 계수를 구한 결과, '비가 오는 기간'항목이 우울 점수와는 정적 상관을, 자기 개념 점수와는 높은 부적 상관을 보였다. 결론 : 만성 질환 아동군이 정상 아동군 보다 더 우울하며, 자기 개념이 더 부정적이었다. 또한, 이들이 지각하는 스트레스는 상당히 지속적이고 장기적이며, 이에 대해 대처할 수 있는 스스로의 능력이나 전략을 사용하는 데 있어서는 매우 무기력한 것으로 나타났다. 이러한 결과는 만성적인 신체 질환이 아동의 정신 건강 및 심리적 적응에 있어서 위험 요인이 될 수 있음을 시사해 준다. 중심 단어 : 만성 질환 아동ㆍ심리적 특성ㆍ우울ㆍ자기 개념ㆍ스트레스 Objectivity : This study was conducted to examine the depression, self-concept, perception of stress & coping strategy in children with chronic physical illness. Methods : Two groups of participants were recruited for this study, 13 children with chronic illness in outpatient or impatient treatment at Seoul National University Children's Hospital, and 13 nonpatient children. They were assessed using Korean form of the Piers-Harris Self-Concept Scale(PHSCS), Kovacs' Children's Depression Inventory(CDI) and three subscaleds ('color how you feel', 'color how others make you feel', 'A children in the rain') of Children's Self-Report and Projective Inventory(CSRPI). Result : There were significant differences between the chronic ill children and the healthy children in scores of depression and self-concept. The chronicity ill children were more depressive and had very negative self-concept, and obtained significantly lower scores than the healthy children in the subscales of PHSCS, 'intellectual/school status' and 'popularity'. Among three scales of CSRPI, there was no difference in 'color how you feel' and 'color how others make you feel'. But there were significant differences in all items of 'A child in the rain' (quantity of raining, duration of raining, tool, and effectiveness). 'Duration of raining', correlated most negatively with PHSCS scores, and correlated positively with CDI scores. Conclusion : The children with chronic illness are more depressive and have very negative self-concept. And they fuel that the stresses are more permanent, but have no appropriate coping strategy. The results suggest that the chronic illness strongly affects the psychological and emotional adjustment of children(i.e. depression, peer relation, stress coping strategy). KEY WORDS : Children with Chronic illnessㆍPsychological characteristicsㆍSelf-conceptㆍStress.

兒童行動目錄(CBCL)에 의한 國民學生의 行動問題 調査

홍강의,송혜양,김중술,홍경자,박성수 大韓神經精神醫學會 1988 신경정신의학 Vol.27 No.2

This is an epidemiological study of emotional/behavior problems in Korean elementary school children(total 2,399 : 1.236 boys, 1,163 girls) by empolying Children's Behavior Check List(CBCL) developed by Achenbach and Edelbrock(1983), to which 3 problem items were added for this study. A test-retest reliability of CBCL was was assessed by computing the Spearman-Browm correlation and the average correlation among items was. 72. The interparent agreeement was also assessed and the average correaltion between mother and father was. 62. The study subjects were drawm by stratified sampling from 5 schools in Korea ; 3 schools (A, B, C) from Seoul, one school(D) from a medium size city one school (E) from a rural town. School C is located in upper/middle-upper class residential area, School A and D in middle class, and School B and E in lower-middle/lower class. The present paper reports the prevalence of behavioral/emotional problems in relation to sex, grade, locality and socioeconomic variables. Some of the major findings were as follows ; 1) The mean total problem score excluding 3 additional items was 27.28 and did not differ significanthy according to sex and locality(Seoul vs non-Seoul), However, the mean total problem scores were significanthy different from school to school. The lowest score was observed in children of School C(22.15), higher scores for School B(30.89) and E(30.64) and in-between scores for the School A(27.58) and D(25.47). Father's education also had significant effect on the total problem scores : 31.46 for elementary of less 27.79 for middle and high school and 23.05 for college or more. As for to the grade, mean total score was lowest for the first graders(22.12), increasing up until 4th grade(29.83), then decreasing for 5th graders(26.81) and then relatively high score for the 6th graders(29.81). 2) Examination of each 122 problem items revealed that prevalence rate ranged from 2.1% to 61.7% : less than 5% for 13% items, 5-10% for 18 items, 10-20% for 31 items, 20-30% for 25 items, 30-40% for 15 items, 40-50% for 13 items, more than 50% for 7 items. Although sex did not make any difference in total problem scores, examination of the prevalence of each item revealed that 47 problem items were significanthy different between sexes : 26 items were more prevalent in boys and 21 items in girls. The items more prevalent for boys were externalizing problems such as hyperkinetic, aggressive and other behaviors and 21 items, more prevalent for girls were internalizing problems such as emotional and psychosomatic problems. School grade had significant effect in 47 items, only 3 of which showed lower prevalence in the younger children and the prevalence of 39 items were higher in older children. Significant differences were observed in 83 items, and 94 items, respectively according to school and father's education that could be considered to reflect socioeconomic status and it was reavealed that the lower the status, the higher the prevalence in most items. Items more common in upper class tend to be more anxiety-tension related(internalizing) and items more common in lower class tend to be more aggressive, hyperactive and other behavioval problems(externalizing). 3) Brief cross-cultural comparisons between the current study and other studies reported in the literature revealed major differences in several areas. The total problem score for Korean children was much higher than those of American and Dutch children, but lower than those of Canada and Chile. Although most of other studies reported higher total problem scores for boys, than for girls there was no sex difference in total problem score for Korean children. This was reflected in the finding of an almost equal numbers of items(26 for boys, 21 for girls) being more common than the other sex. Analyses by grade(age) also indicate major differences between Korean and American-Dutch children ; In contrast to the finding that total problem score was higher and larger number of items were more common for younger children in American and Dutch studies, they were higher for older children in Korean study. Socioeconomic variables seems to exert far more significant effect on the total score and the prevalence of each items in Korean study, when compared with American and Dutch studies. Further analyses of the data including a comparison with a clinic sample are deferred to another paper and so are the factor analysis results of 122 items into emotional/behavioral syndromes.

한국판 학습장애 평가척도의 개발 및 표준화 연구

신민섭,홍강의,김중술,조수철 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.6

목적: 학습장애 평가척도(Loaming Disability Evaluation Scale)를 우리나라 언어와 교육실정에 맞게 번안, 수정하여 한국판 학습장애 평가척도(K-LDES)를 개발한 후, 초등학교에 재학중인 정상 아동(규준 집단)과 임상 아동 집단을 대상으로 K-LDES가 학습장애를 진단하는데 신뢰롭고 타당한 검사인지를 알아 보았고, 정상 규준집단을 대상으로 각 연령별 한국 규준(norm)을 확립하는 표준화 연구를 수행하였다. 방 법 : 서울과 대구에 거주하는 6∼12세 연령범위의 정상 아동 720명이 규준 집단으로 본 연구에 참여하였고, 임상 집단으로는 서울대학병원 소아정신과에서 소아정신과 의사와 임상심리전문가에 의해 DSM-IV에 입각하여 특수 학습장애로 진단받은 아동 27명 (읽기. 쓰기 장애).학습문제가 수반된 주의력결핍/과잉운동장애 아동 25명을 포함한 총 52명의 아동이 참여하였다(평균연령=108.44개월±6.60. 평균지능=108.61±13.47). 정상집단의 아동들에게는 담임교사가 각.아동별로 K-LDES를 평가하였고, 임상 집단의 아동들에서는 모와 담임교사가 평가하였다. 결 과 : K-LDES의 각 하위척도별 신뢰도계수α는 92∼97 범위로 상당히 높은 편이었고,7개 하위척도들간 기능검사의 "읽기 1, ll 척도"의 상관계수도 .66, .47로 유의미하였다. 요인 분석 결과. 5개 요인이 산출되었는데, 요인 1은 '듣기와 말하기' . 요인 2는 '읽기, 쓰기와 철자' . 요인 3은 '수학적 연산' . 요인 4는 "사고력" , 요인 5는 "수학적 추론" 요인인 것으로 나타났으며. 이는 미국의 결과와 일치하는 요인구조로 K-LDBS의 구성타당도를 입증해주는 결과이다. 임상집단과 정상집단간에 수학 척도를 제외한 6개척도 에서 유의미한 차이가 있었고, 88문항중 71문항이 정상 집단과 임상집단을 변별하는데 유의미한 것으로 나타났다. 규준산출을 위해 정상집단 아동들의 자료에 입각하여 6개 연령집단별로 평균과 표준편차를 이용하여 각 하위척도별 평가치 (표준점수)를 산출하였고. 7개 하위척도 평가치를 합산한 점수를 표준점수로 전환하여Learning Quotient(LQ)를 산출하였다. 결론 K-LDES가 학습 장애를 진단하는데 매우 신뢰롭고 타당한 검사인 것으로 나타났다 K-LDES는 교사나 모가 평가하는 척도이므로 아동의 학습문제를 조기에 발견하여, 조속한 치료적 도움을 받도록 하는데 유용하게 사용될 수 있으며, 학습장애 아동의 진단이나 연구를 위한 피험자 선발시 screening검사로써 유용하게 활용될 수 있으리라 생각된다 Objectives : This study was to develop the Korean version of loaming 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 α) 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 KEDl-WISC and BLT. principal component analysis with varimax rotation resulted five factors, which are similar to those of original LDES, strongly supporting the construct vapidity 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 earth 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 tearing 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.