파킨슨병에서 관리기능의 결손: 짝과제를 사용한 검증

김다영,김홍근 한국임상심리학회 2016 Korean Journal of Clinical Psychology Vol.35 No.4

A number of previous studies reported that patients with Parkinson’s disease (PD) perform poorly on executive function tests. However, due to the low specificity of most executive function tests, it is uncertain whether these results reflect deficits in the executive function or some other cognitive functions. Accordingly, the aim of this study was to distinguish between two hypotheses: (1) low performance of PD patients on executive function tests reflects deficits in the executive function and (2) low performance of PD patients on executive function tests is due to impairment in some other cognitive functions. To this end, Cognition Scale for Older Adults was administered to patients with PD (n=30) and matched controls (n=26). They were compared on six sets of paired tasks, in which one strongly demanded the executive function while the other did not. The major findings were as follows. First, relative to the matched controls, PD patients showed significantly greater impairment in word fluency than in information fluency, Rey copy than picture naming, delayed recall than delayed recognition, and Executive Function Index than Basic Function Index, indicating that low performance on word fluency, Rey copy, Delayed recall, and Executive Function Index is associated with impairment in executive function. Second, PD patients showed a large impairment in both the Stroop simple and interference trials, indicating prominent deficit in the psychomotor speed. Third, PD patients and controls were not significantly different with respect to Digit span forward and backward, indicating relative preservation of working memory capacity. Taken together, these results indicate that PD is associated with relatively greater cognitive impairment in the domains of the executive function and psychomotor speed.

Wechsler 지능검사에서 관리기능과 비관리기능의 비교

김홍근 한국임상심리학회 2006 Korean Journal of Clinical Psychology Vol.25 No.1

One of the critical defects of Wechsler scales is its insensitivity to executive functions. However, not all subtests of Wechsler scales are completely insensitive to executive functions, but some subtests are relatively sensitive to executive functions. The goal of the present study was to devise a method to compare executive and non-executive functions using Wechsler scales. A validity study using schizophrenic patients indicated that Block Design and Digit Symbol are relatively sensitive to executive functions, whereas Information and Comprehension are insensitive to executive functions. A normative study was also performed to provide normative data for comparing the average of Block Design and Digit Symbol with the average of Information and Comprehension. Even Wechsler subtests that are relatively sensitive to executive functions were less sensitive to executive functions than specialized executive-function tests. These results indicate that assessment of executive functions based on Wechsler scales is clinically useful but not sufficiently sensitive to executive functions. Thus, use of specialized executive-function tests is essential to properly assess executive functions.

유아의 인지능력, 인지 및 정서실행기능이 정서ㆍ행동 유능성에 미치는 영향

김성현 한국영유아교원교육학회 2019 유아교육학논집 Vol.23 No.4

The purpose of this study was to analyze the relationship among children's emotional and behavioral competence, their cognitive ability, and cognitive(cool) and emotional(hot) executive function and to examine the impact of the cognitive ability and cognitive and emotional executive function on children' emotional and behavioral competence. The participants were 212 children (mean age = 65.12 months) attending kindergartens and preschools in Korea. For data collection, the study utilized the ‘Preschool Behavioral and Emotional Rating Scale’, the ‘Kaufman Assessment Battery for Children-2nd edition’, ‘Cool executive Function task(Stroop like Star-Flower Task, Card Sorting Task)’ and ‘Hot executive Function (a Less is More Task, Sticker Search Task)’. SPSS 21.0 was utilized to analyze the data, and a Pearson correlation and hierarchical multiple regression analysis were employed for the analysis. Findings are as follows. First, there were positive correlations between children’s emotional and behavioral competence and cognitive ability and their cool and hot executive functions. Second, sequential processing and cool executive function predicted variables affecting the young children’s total emotional and behavioral competence. In the sub-scale, sequential processing and cool executive function predicted variables affecting school readiness. Sequential processing and hot executive function predicted variables affecting emotional regulation. Cool executive function uniquely predicted variable concerning family involvement. Lastly, sequential processing, cool and hot executive functions predicted variables related with social confidence. 본 연구는 유아의 정서․행동 유능성과 인지능력 그리고 인지 및 정서실행기능 간의 관계를 밝히고 유아의 정서․행동 유능성에 인지능력과 인지 및 정서실행기능이 미치는 영향을 분석하고자 하였다. 연구대상은 유치원과 어린이집에 재원 중인 만 4-5세 유아 총 212명이었으며, 평균 월령은 65.12개월이었다. ‘유아용 정서․행동 유능성 척도’, ‘K-ABC-2’, ‘인지실행기능 검사(별과 꽃 과제, 카드분류과제) 및 정서실행기능 검사(역보상과제, 스티커 찾기 과제)’ 도구들을 통해 연구자료를 수집하였다. 수집된 자료는 Pearson 적률 상관과 위계적 중다회귀분석을 통해 검증하였다. 1단계에서는 인지능력 변인을 2단계에서는 인지 및 정서실행기능 변인을 투입하였다. 연구결과, 유아의 정서․행동 유능성과 인지능력, 인지 및 정서실행기능 간에 정적상관이 있는 것으로 밝혀졌다. 유아의 순차처리 능력과 인지실행기능이 정서․행동 유능성의 정적 예측 변인으로 나타났다. 또한 하위변인 별로 분석한 결과 학습준비도에는 순차처리와 인지실행기능이 유의미한 예측 변인으로, 정서조절에는 순차처리와 정서실행기능이 유의미한 예측 변인으로, 가족 참여에는 인지실행기능이 유일한 예측변인으로 밝혀졌으며 마지막으로 사회적 자신감에는 순차처리와 인지 및 정서실행기능 모두 유의미한 예측변인으로 나타났다.

Intelligence-Dependent Differential Effects of Media Exposure on Executive Function Changes in Children: A Population-Based Cohort Study With a Longitudinal Design

Oh Yunhye,Baek Ji Hyun,Joung Yoo-Sook 대한의학회 2023 Journal of Korean medical science Vol.38 No.48

Background: Excessive media use is known to be associated with executive dysfunction in children, but it’s unclear whether this exposure can lead to long-term changes of executive function. This study aimed to investigate the association between media exposure and longitudinal changes in executive function within a population-based study, while considering the potential influence of intelligence. Methods: This study used data from 1,209 participants in the Panel Korea Study for Children. The children’s media exposure was measured at ages 7 and 8, and executive function was evaluated annually from ages 7 to 10 using the Executive Function Difficulty Screening Questionnaire. Participants were grouped by media exposure level (low, medium, or high), and longitudinal changes in executive function were analyzed using linear mixed effects models. Subgroup analysis was conducted to investigate how executive function changes varied based on intelligence within each media exposure group. Results: Children with high media exposure (n = 97) had severer executive function difficulties than those with low (n = 141) or medium (n = 971) exposure in all waves. The high exposure group demonstrated persistent higher executive function difficulties up to age 10 after controlling for child gender, intelligence, parental education level and maternal depression. Children with intelligence quotient (IQ) ≤ 100 in the medium to high media exposure group had significantly more severe executive function difficulties than those with IQ > 100. Conclusion: This study provided evidence of a longitudinal negative association between media exposure and executive function. The findings suggest that excessive media exposure may lead to long-term changes in executive function in children and highlight the importance of implementing targeted interventions and educational strategies to mitigate the potential negative effects of excessive media use, particularly for children with lower cognitive abilities.

뇌졸중 노인에서 전두엽-관리기능의 차별적 결손

추은진,김홍근 한국심리학회 2009 한국심리학회지 일반 Vol.28 No.1

The goal of the present study was to investigate whether elderly stroke patients show differential deficit in executive function relative to other cognitive functions. To this end, we compared cognitive functions of 31 elderly stroke patients and 31 normal elderly subjects. The stroke patients were sampled from nursing hospitals for elderly persons and the normal older adults were sampled from the local community. Cognition Scale for Older Adults(CSOA) was used to measure executive and other cognitive functions. The study yielded three main findings. First, the stroke patients showed greater deficits in Executive IQ than in Basic IQ. Second, the stroke patients performed more poorly on tasks that demand executive processing than on tasks that do not demand executive processing. This differential performance was confirmed in cognitive tasks of attention, working memory, language, and visuospatial function. Third, the stroke patients were classified into normal, mild cognitive impairment, and dementia subgroups, based on their MMSE-KI scores. Each subgroup showed greater deficits in Executive IQ than in Basic IQ. Diagnostic indices indicated that only 10% of the stroke patients have normal executive function. These results indicate that most stroke patients have more severe deficits in executive function relative to other cognitive functions. High prevalence of executive dysfunction among stroke patients may reflect high incidence of subcortical small-vessel infarcts. 본 연구의 목적은 뇌졸중 노인에서 다른 인지기능에 비해 관리기능에 보다 심한 결손이 있다는 가설을 검증하는 것이었다. 이를 위해 뇌졸중 노인 31명과 일반 노인 31명을 대상으로 인지기능을 비교하였다. 뇌졸중 노인은 요양병원에 입원 중인 환자들에서 모집하였으며, 일반 노인은 뇌졸중 노인과 연령 및 학력이 균등하도록 표집 하였다. 연구 도구로는 ‘노인용 인지검사’(Cognition Scale for Older Adults)를 사용하였다. 주요 결과는 다음 세 가지였다. 첫째, 통제군에 비해 뇌졸중군이 낮은 정도는 Basic IQ에 비해 Executive IQ에서 보다 현저하였다. 둘째, 관리기능 의존도가 높은 과제와 낮은 과제의 환산점수를 짝지워 비교한 결과, 통제군은 차이가 없었지만 뇌졸중군은 관리기능 의존도가 높은 과제가 유의하게 낮았다. 이러한 차이는 주의, 작업 기억, 언어, 시공간기능 영역에서 공통적이었다. 셋째, 뇌졸중군을 세분한 무인지장애군, 경도인지장애군, 치매군 각각에서 Basic IQ에 비해 Executive IQ가 유의하게 낮았다. 관리기능과 관련된 진단적 지표에서 ‘정상’이라고 평가되는 뇌졸중 환자는 전체의 10%에 불과하였다. 이 결과들은 뇌졸중 환자에서 다른 인지기능에 비해 관리기능의 결손이 보다 현저함을 제시한다. 뇌졸중 환자에서 관리기능 결손이 특징적인 것은 다수의 환자들이 피질하 부위에 소혈관 경색이 있는 것과 관련될 수 있다.

The Relationship of Executive Function and Sentence Comprehension Ability in Children with High-Function Autism

고아라(A Ra Kho),임동선(Dongsun Yim) 한국언어청각임상학회 2013 Communication Sciences and Disorders Vol.18 No.3

배경 및 목적: 본 연구는 고기능 자폐아동과 일반아동의 집행기능과 화용 및 구문의미 영역을 중심으로 문장 이해 능력의 차이를 분석하여, 집행기능과 문장 이해 능력과의 상관관계를 알아보고자 하였다. 방법: 서울 및 경기지역에 거주하는 만 7-11세의 고기능 자폐아동 16명, 일반아동 16명, 총 32명을 대상으로 집행기능과 문장이해검사를 실시하였다. 집행기능은 '아동용 Kims 전두엽-관리기능 신경심리검사(김홍근, 2005)'를, 문장 이해 능력 중 화용영역에서의 문장 이해 능력은'은유 이해 검사'를, 구문의미영역에서의 문장 이해 능력은'구문의미이해력검사(배소영ㆍ임선숙ㆍ이지희ㆍ장혜성, 2004)'를 통해 평가되었다. 결과는 일요인분산분석과 이원혼합측정분산분석, 상관분석을 실시하였다. 결과: 집행기능 검사에서 집단 간 수행력에 유의미한 차이를 보였으며, 은유 이해 검사에서 개념적 특성 및 문장 구조에 따른 수행력도 집단 간 유의미한 차이를 보였다. 또한 구문의미이해력 검사에서도 집단 간 유의미한 차이를 보였다. 일반아동 집단은 집행기능과 은유 이해력 간, 생활연령과 구문의미이해력 간 유의미한 상관을 나타내었고, 집행기능과 구문의미이해력 간에는 유의미하지는 않았지만 정적 상관관계를 나타내었다. 고기능 자폐아동 집단은 집행기능과 문장 이해 능력 간의 유의미한 상관이 나타나지 않았다. 논의 및 결론: 고기능 자폐아동은 일반아동에 비해 집행기능과 다양한 언어 영역에서의 문장 이해 능력(은유 및 구문의미 이해)에 어려움을 보였으며, 일반아동과 비교하였을 때 집행기능을 효율적으로 사용하는데 결함이 있음을 알 수 있다. 이러한 결함이 아동의 화용ㆍ구문의미 영역에서의 문장 이해 능력과 관련이 있음을 알 수 있다. Objectives: The present study investigated how children with high-functioning autism (HFA) perform on the executive function task and sentence comprehension task (pragmatic comprehension ability, syntactic/semantic comprehension ability) compared to normal children, and how sentence comprehension ability correlates with executive function. Methods: Sixteen children with HFA and sixteen typically developing peers who were matched on chronological age (7–11 years) participated in the present study. Executive function was assessed using a standardized test 'Kim's frontal executive neuropsychological test for children.' The ability of pragmatic comprehension was measured by a metaphor comprehension task. The ability of syntactic/semantic comprehension was measured by the Korea sentence comprehension test (KOSECT). Two way-mixed ANOVA and Pearson correlation were used to analyze the data. Results: The results were as follows: there was a significant difference between the two groups on the executive function task, showing that children with HFA performed significantly lower than normal children. There was a significant difference between the two groups on metaphor comprehension scores and KOSECT scores, showing that children with HFA performed significantly lower than normal children. Significant correlations among executive function scores and metaphor comprehension scores, age, and KOSECT scores were found in typically developing children. However, there was no significant correlation among executive function scores and metaphor comprehension scores and KOSECT scores in children with HFA. Conclusion: The results of this study showed that children with HFA have more difficulty in executive function and sentence comprehension ability than normal children. Additionally, children with HFA have difficulty in effectively using executive function when they perform on language comprehension tasks.

학습장애아의 실행기능에 관한 교육적 탐색: 이론적 특성 및 개별교수적 접근을 중심으로

송찬원 한국학습장애학회 2010 학습장애연구 Vol.7 No.3

The purpose of This study is to examine the Educational research on executive function of the children with learning disorders. especially, This aims to examine the theoretical basis and property of the executive function for effective teaching for children with learning disorders and to research an appropriate teaching strategy based on the property of the executive function. For its methodology, this study collected the precedent domestic and overseas studies regarding the executive function and then carried ut the documentary analysis and examination. According to the results of the study, First, the executive function is a high-level perceptional function, and a defect of this executive function has been pointed out as a main factor in learning disorders. In other words, it is a perceptional factor which may bring about learning defects and behavioral problems and then cause a negative effect on learning achievement. Second, In sub-type of executive function of learning disability, there are obvious difference of function of attention, function of verbal, function of memorial, function of sight-space. Until now, a study and approach on the executive function of children with learning disorders has been rarely carried out. Specially, it is very important to understand the executive function for effective teaching for children with learning disorders, and it is required to approach a individualized teaching strategy considering the sub-type of executive function. 본 연구는 학습장애아의 실행기능에 관한 교육적 탐색을 시도하였다. 구체적으로 실행기능에 관한 전반적인 이론적 근거와 실행기능의 하위요소 특성을 간략히 살펴보았고, 마지막으로 실행기능의 강화를 위해 개별교수적 측면에서의 적용 가능성을 탐색하는 데에 연구의 목적을 두었다. 연구방법은 실행기능 관련 국내외의 선행 연구들을 중심으로 간략히 연구 추이를 살펴보았다. 연구 결과에 의하면 실행기능은 상위인지기능이며, 실행기능의 결함은 학습장애의 주요 원인으로 지적되었다. 실행기능은 학습결함과 행동문제를 수반하여 학업성취도에 부정적 결과를 초래하는 인지요인으로 밝혀졌다. 또한 학습장애아의 실행기능은 주의기능, 언어기능, 시공간기능, 기억기능의 4가지 하위요소별 특성이 각기 차이가 있었다. 그리고 현재 우리나라에서 학습장애아의 실행기능에 관한 연구와 접근은 매우 초기단계이며, 향후 학습장애아의 효과적인 학습지도를 위해서 실행기능의 특성에 적합한 개별교수적 접근의 필요성이 제기되었다. 특히 정확교수의 경우 주의기능, 직접교수의 경우 언어기능과 시공간기능, 임상교수의 경우 언어기능, 시공간기능, 기억기능, 정보처리 접근법의 경우 주의기능, 시공간기능, 기억기능, 인지-행동 접근법의 경우 주의기능, 언어기능, 시공간기능, 기억기능의 강화에 효과적인 개별교수가 될 수 있다는 가능성이 제기되었다.

어머니의 인지적 공감능력이 유아의 실행기능에 미치는 영향: 유아 배려행동과 행복감의 매개효과

공영숙,임지영,안선정,이윤정,Kong, Youngsook,Lim, Jiyoung,An, Sunjung,Lee, Yoonjeong 대한가정학회 2022 Human Ecology Research(HER) Vol.60 No.1

This study examined the effect of maternal cognitive empathy on children's executive function focusing on mediating effects of preschooler's caring behavior and happiness. The subject of this study was 460 five-year-old preschooler-their mother dyads in Korea. Data were collected by Korean Version of Questionnaire of Cognitive and Affective Empathy(K-QCAE), Caring Behaviors Scale for Young Children, Happiness Scale for Young Children and Behavior Rating Inventory of Executive Function-Preschool Version(BRIEF-P). Data were analyzed using descriptive statistics, independent samples t-test, Pearson correlation analysis, structural equation model and bootstrapping test with SPSS 25.0 and AMOS 23.0 program. The major results were as follows. 1) Maternal cognitive empathy had a positive influence on preschooler's caring behavior. 2) Preschooler's caring behavior had a positive influence on happiness and executive function. 3) Preschooler's happiness had a positive influence on executive function. 4) The effect of maternal cognitive empathy on preschooler's executive function was mediated by preschooler's caring behavior. 5) The effect of maternal cognitive empathy on preschooler's executive function was sequentially mediated by preschooler's caring behavior and happiness. This study revealed that maternal cognitive empathy, preschooler's caring behavior, and happiness have an important role in preschooler's executive function. Most of all, we suggest that maternal cognitive empathy should be improved to promote preschooler's executive function. The findings of this study will contribute to designing intervention programs to improve preschooler's executive function as well as maternal empathy.

관리기능(executive function)의 빠른 노화: 짝과제를 사용한 검증

김홍근,김용숙 한국심리학회 2015 한국심리학회지 일반 Vol.34 No.2

This study is conducted to verify the hypothesis stating the executive function of a human brain loses its efficiency relatively faster than other cognitive functions in accordance with the body age. In this analysis, 736 healthy participants between age 16 to 69 were recruited and three paired tasks were performed depending the subjects' independency level of their executive functions. The three paired tasks were Stroop Interference Trial vs. Stroop Simple Trial, Verbal Fluency vs. Information, and Design Fluency vs. Picture Completion. The data for each paired task were subject to analysis of covariance in which “age” was the independent variable and “years of education” and “gender” were two covariants. The result shows that there is a statistically significant relationship between the paired tasks and the age of participants. In this interaction, the decreasing rate of participant age-considered performance is greater in the tasks demanding a higher level of executive function. Thus, the age-related performance decline was faster in Stroop Interference Trial relative to Stroop Simple Trial, Verbal Fluency relative to Information, and Design Fluency relative to Picture Completion. In terms of erroneous responses, it showed age-related increases in errors on Stroop Interference Trial and perseverative responses in Verbal and Design Fluency. These results are consistent with the executive decline hypothesis of cognitive aging. The previous studies have provided the evidence that the executive function matures more slowly than nonexecutive cognitive functions. Considering this evidence, this study results lead to a conclusion that the cognitive functions that mature slowly are also age faster, or more succinctly expressed, it is a “Last in, first out”. 본 연구의 목적은 관리기능(executive function)이 다른 인지기능보다 빨리 노화한다는 가설을 검증하는 것이었다. 이를 위해 연령이 16-69세인 736명의 건강한 일반인에게 관리기능 의존도의 강약에 따라 구성한 세 개의 짝과제를 실시하였다. 세 짝과제는 스트룹간섭시행과 단순시행, 단어유창성과 상식, 도안유창성과 빠진곳찾기였다. 분석으로는 연령이 독립변인이고 교육년수와 성별이 공변인인 반복측정 공변량분석을 짝과제별로 시행하였다. 결과를 보면, 세 짝과제 모두에서 짝과제와 연령 간의 상호작용이 통계적으로 유의하였다. 이 상호작용은 연령에 따른 저하가 관리기능 의존도가 높은 과제에서 더 빠름을 나타내었다. 그러므로 스트룹단순시행보다는 간섭시행, 상식보다는 단어유창성, 빠진곳찾기보다는 도안유창성에서 연령에 따른 저하가 더 빨랐다. 오류반응을 보면 스트룹검사의 간섭오류, 단어유창성의 반복반응, 도안유창성의 반복반응이 연령에 따라 유의하게 증가하였다. 이 결과들은 관리기능이 차별적으로 빨리 노화한다는 가설을 지지한다. 선행 연구들은 관리기능의 성숙이 다른 인지기능에 비해 늦은 연령까지 계속됨을 보고하였다. 이런 보고와 본 연구의 결과를 종합하면, “Last in, first out”, 즉 가장 늦게 성숙한 인지기능이 가장 먼저 쇠퇴한다고 결론할 수 있다.

Gender-Specific Relationship Between Executive Function and Self-Rated Health

정미숙,Kyoung Suk Lee,Mijung Kim,Hyeri Yun 질병관리본부 2019 Osong Public Health and Research Persptectives Vol.10 No.2

Objectives: Self-rated health is a comprehensive measure of health. As gender difference in self-rated health is found, identifying gender-specific factors related to self-rated health is important. Poor executive functioning negatively affects an individual’s independence and healthy lifestyle, but it is unknown relationships between executive function and self-rated health and gender differences in these relationships. Therefore, gender differences were examined in the relationship between executive function and self-rated health in the community. Methods: Individuals completed questionnaires about their health status and subjective decline in executive function. Neuropsychological tests were also performed to assess objective executive functioning. Two separate multivariable linear regression analyses were conducted by gender. Results: Better objective executive function was related to greater self-rated health scores (better selfrated health) in men alone (βs = 0.341), while better subjective executive function was significantly associated with greater self-rated health scores in both men and women (βs = 0.385 and 0.443, respectively). Conclusion: Gender differences are important when reporting perceived health status, in particular the different effects of subjective and objective executive function on self-rated health across genders. Clinicians need to be aware of the potential value of subjective executive function complaints when evaluating health status.