위스콘신 카드 분류검사의 발달추세연구-7~11세 아동을 중심으로-

고려원,강연욱,오경자,박미자 한국임상심리학회 2002 Korean Journal of Clinical Psychology Vol.21 No.2

Although the Wisconsin Card Sorting Test (WCST) has been widely used to evaluate the frontal lobe functioning, there is no published data on normal children in Korea which results in limitation of its clinical validity in children. The present study was conducted to investigate developmental trends of normal children`s performance on the WCST. The computerized version of WCST (Heaton, 1991) was administered to 160 elementary school children aged 7 to 11 years. Their Full Scale IQs measured by the Korean version of WISC-R ranged from 80 to 138 (M=111.02, SD=11.77). Children did not differ in FSIQ, VIQ, and PIQ when compared based on age. However, very moderate correlations were found between FSIQ, VIQ, and PIQ scores and the scoring variables. Out of the 10 WCST scoring variables, 9 variables except Failure to Maintain Set showed age effect, but sex difference was not found in any variables. There was also no significant interaction effect between age and sex. Important differences in developmental trends were found among the 10 WCST scoring variables. The nature of these differences was effectively explained by the three factors. From the principal axis analysis with oblique rotation using the 10 WCST scoring variables, three factors with eigenvalue greater than 1 emerged, interpreted as conceptual formation (Factor Ⅰ: accounted for 60.24% of variance), perseveration (Factor Ⅱ: 18.52% of variance), and ability to sustain attention (Factor Ⅲ: 12.12% of variance). The growth curves for the 5 scoring variables constituting Factor Ⅰ(Total Number of Corrects, Nonperseverative Errors, Conceptual level Responses, Number of Categories Completed, and Trials to Complete First Category) showed significant improvement from age 7 to 8, suggesting a developmental spurt during that period. By contrast, Perseveration Errors included in Factor Ⅱ significantly decreased from age 9 to 11, while Failure to Maintain Set included in Factor Ⅲ showed no age effect. These results suggest that the WCST performance requires multiple cognitive functioning with different developmental trends.

신장 초음파 검사에서 연령대에 따른신장 기능 지표와 신장 크기 간의 상관관계 분석

고려원(Ryo-won Go),성열훈(Youl-Hun Seoung) 한국방사선학회 2020 한국방사선학회 논문지 Vol.14 No.7

본 연구에서는 초음파 검사 시 정상인을 대상으로 연령대에 따른 신장 기능 지표와 신장 크기 간의 상관관계를 분석하고자 하였다. 복부 초음파 검사를 실시한 정상인 170명(남:86명, 여:84명)을 20대, 30대, 40대, 50대 이상으로 분류하였다. 피검사자는 옆으로 누운 자세로 좌/우측 신장을 2번씩 신장 길이와 너비 그리고 단면적으로 신장 크기를 측정하였다. 이때 신장 길이는 최대 상극에서 최대 하극까지 측정하고 같은 초음파 영상에서 가장 넓은 너비를 계측하여 단면적을 구하였다. 그 외 관련인자로 체표면적, 혈중크레아티닌, 사구체여과율, MDRD (Modification of diet in renal disease), C-G (Cockcroft-Gault)를 조사하였다. 성별에 따른 연령대별로 관련인자 간의 유의한 차이 비교는 일원배치분산분석으로 실시하였다. 또한 관련인자들 간의 상관관계 분석을 시행했으며 Pearson과 Spearman correlation coefficient를 이용하였다. 이때 p 값이 0.05보다 작을 때 유의성이 있다고 정의하였다. 그 결과, 신장의 길이, 너비, 단면적 등은 사구체 여과율, C-G, MDRD와 상관관계가 있었다. 따라서 신장 초음파 검사 시 신장 길이 하나만을 측정하기보다는 관련 인자를 함께 평가한다면 신장 질환에 진단 정확도를 높일 수 있으리라 기대한다. The purpose of this study was to analysis the correlation between kidneys function indicators and these size in ultrasonography. A total of 170 (male:86, female:84) patients of sex and age groups were examined by abdominal ultrasonography. The patients classified as those in their 20’s, 30’s, 40’s, and over 50’s. We measured the length, width, and cross-sectional height of the kidneys twice. At this time, the length of these were measured from the maximum upper to the maximum lower pole and the widest width in the same ultrasonography was measured to obtain the cross-sectional area. Other relevant indicators included body surface area, serum creatinine, glomerular filtration rate (GFR), MDRD (Modification of diet in renal disease) and C-G (Cockcroft-Gault). Significant comparisons of differences between relevant factors by age groups and sex were conducted with a one-way distribution analysis. Correlation analysis was also performed between relevant factors by using Pearson and Spearman correlation coefficient. It was defined as meaningful when the p-value was less than 0.05. As a result, the length, the width, and the cross-sectional area of kidneys were correlated with GFR, C-G, MDRD. Therefore, it is expected that the accuracy of diagnosis of kidneys disease will be increased if the relevant indicators are evaluated together rather than measuring only length of these in ultrasonography.

정신분열병 환자의 공격 행동 예측 변인

송현주,민성길,고려원,이남훈,김태경,오경자 대한신경정신의학회 2003 신경정신의학 Vol.42 No.5

Objectives:This study aims to investigate the variables predicting violent behavior in schizophrenic patients. Methods:Subjects were 65 schizophrenic patients diagnosed according to DSM-IV. Schizophrenic symptom and the insight of patients were evaluated with the Postive and Negative Syndrome Scale (PANSS) and the Scale of Unawareness of Mental Disorder (SUMD). Violent behaviors were evaluated with the Modified Overt Aggression Scale (MOAS). The State Trait Anger Expression Inventory (STAXI) and the Symptom Checklist-90-Reversion (SCL-90-R) self-reported measures were used for the evaluation of anger state & trait, and general psychopathology. Statistic method used in analized variables were stepwise multiple regression and discriminant analysis as well as t-test. Results:Anger out style, hostility and trait anger variables were extracted as the significant predictors in stepwise multiple regression (37%). Emotion and attitude factors related to anger were more powerful predictor than symptom factors. These three variables could discriminate between violent group and nonviolent group in 72.4%. Conclusion:Violent behavior of schizophrenic patients could be predicted more accurately by stable factors such as attitude and emotion related to anger than by symptom factors.

부모훈련을 통한 아동행동장애의 행동치료

오경자,박중규,고려원 한국임상심리학회 1999 한국임상심리학회 Workshop Vol.1999 No.3

주의산만을 주소로 소아정신과를 내원한 아동의 인지적 특성 : T.O.V.A. 양상을 중심으로

신의진,이수진,이혜란,고려원 대한소아청소년정신의학회 2000 소아청소년정신의학 Vol.11 No.2

본 연구에서는 주의산만을 주소로 내원하는 아동을 진단 준거에 따라 분류하고 각 진단 집단을 설명할 수 있는 인지적 특성을 T.O.V.A. 양상을 중심으로 설명하였다. 소아정신과를 방문한 65명의 아동을 각각 주의력결핍 과잉행동장애(38명), 틱장애(17명), 그리고 기타 정서장애(10명) 집단으로 분류한 후 주의산만의 정도에 영향을 미칠 수 있는 집단의 연령 및 지능(전체 지능, 동작성 지능, 언어성 지능)을 먼저 파악한 후 T.O.V.A.의 중다구인(누락오류, 오경보오류, 정반응시간, 반응시간 표준편차, 예기반응, 다중반응)을 통해 주의산만의 양상을 살펴보았다. 세 집단 간에 연령에서 집단 간에 유의미한 차이가 나타나 연령 수준의 차이에서 기인한 효과를 배제한 결과, 언어성 지능에서 세 집단 간에 유의미한 차이가 나타났다. 또한, T.O.V.A.의 정반응 시간(전반부, 후반부, 전체)에서 세 집단간에 유의미한 차이가 있는 것으로 나타났다. 주의력결핍 과잉행동장애 집단은 틱장애 및 기타 정서장애 집단보다 T.O.V.A.의 정반응 시간이 길어 정보처리의 지연을 시사해 주었다. 한편 주의산만을 주소로 내원하는 아동의 경우 T.O.V.A. 양상과 더불어 연령과 지능의 효과에 대해 신중히 고려해야 할 필요가 있겠다. 중심 단어 : 인지적 특성ㆍ주의산만ㆍT.O.V.A.ㆍ정반응시간ㆍ주의력결핍 과잉행동장애ㆍ틱장애ㆍ기타 정서장애. Objective : This study aims to investigate the cognitive characteristics of clinically referred children with symptoms of inattention, cash as having ADHD, tic disorder, and emotional disorder. Methods : 65 boys(38 with ADHD, 17 with Tic disorder, and 10 with Emotional disorder) were individually assessed using the KEDI-WISC(FIQ, VIQ, PIQ) and T.O.V.A.(errors of omission, errors of commission, reaction time, variability, anticipatory response, multiple response), and the results of those tests were analyzed. Results : There was significant difference among three diagnostic groups of the VIQ of KEDI-WISC and the reaction time of T.O.V.A. after the correction of the effect of age difference. Conclusion : The finding suggest that the reaction time of T.O.V.A. might be the useful variable to differentiate the ADHD from other psychiatric disorders and the effect of age and IQ difference should be considered carefully to diagnose in clinical setting. KEY WORDS : Cognitive characteristicㆍInattentionㆍT.O.V.A.ㆍReaction time.

학교정신보건사업의 두 가지 모델 : 서대문구 학교정신보건사업과 오산시 초등학교 보건사업의 비교

오경자,하은혜,배주미,김영아,고려원 연세대학교 교육대학원 1999 연세교육과학 Vol.47 No.-

Two models of mental health service programs for elementary school children were reviewed. The Sudaemoonkoo School Mental Health Project which was designed to Provide basic mental heatlh services for children in two elementary schools in Sudaemo7nk7o with special emphasis on early identification and treatment of children with mental health problems consisted of the following components ; comprehensive assessment programs for children identified to be at risk for behavior disorders at the initial screening process, telephone consultation service open to parents, mental health education for teachers and parents, bimonthly mental health consultation sessions for teachers, social skills training for children with mild school adjustment problems, and monthly newsletters with information on child mental health. A university-based school mental health team consisting of psychiatrists, clinical psychologists and college student volunteers provided services in the Sudaemoonkoo project. The Osansee Public Health Center Elementary School Mental Health Program included registration of children with mental health problem, mental health education for teachers and parents as well as the campaign for children's mental health via mass media, and crisis intervention program. A nurse at the public health center with a consulting psychiatrist provided services for the Osansee Elementary School Mental Health Program. Evaluation of the two programs suggested that university-based model such as Sudaemoonkoo Project is more appropriate where the option is available and the participating school is ready for more intensive programs, while public health center model is more approapriate where professional manpower is limited and motivation for school mental health program in the community is not high. It was suggested that institutional support and professional manpower within the school system are important conditions for success of school mental health programs.

전두엽 인지기능에 따른 정신분열병 하위유형 연구

이남훈,민성길,오경자,송현주,변경민,고려원,김태경,장지흠 대한신경정신의학회 2003 신경정신의학 Vol.42 No.5

Objectives:This study was designed to identify frontal lobe dysfunctions of schizophrenic group and to classify into subtypes accordingly. Methods:Four neuropsychological tests (Wisconsin Card Sorting Test (WCST), Word Fluency Test, Ruff Figural Fluency Test and Grooved Pegboard Test) were administered to 93 schizophrenia or schizophreniform patients diagnosed with the Korean version of SCID. Ten measures (WCST Total Number of Errors, WCST Number of Categories Completed, WCST Conceptual Level Responses, WCST Trials to Complete First Category, WCST Perseverative Responses, GPT Dominant Hand RT, GPT Nondominant Hand RT, Letter Fluency raw score, Category Fluency raw score, RFFT Total Unique Designs) from the four tests were selected by statistical procedure. Latent factors embedded in the frontal lobe function of schizophrenic patients were extracted from the factor analysis, and hierarchical and K-means clustering procedures were used to identify subtypes. To examine the differences among the subtypes, demographic variables, K-WAIS and PANSS were used. Results:① The subjects in this study showed significant impairments in the four neuropsychological tests. ② Through factor analysis, three factors were extracted: Conceptualization, Motor and Fluency. ③ Three cluster solution was considered optimal by cluster analysis. The preserved cluster (n=42) comprised of patients who showed relatively high function in all three factors. This group showed relatively higher function than the other two clusters. However, even the performance of the preserved cluster was 1SD below the norm of the normal people. The conceptualization deficit cluster (n=25) comprised of patients with deficit in conceptualization function. This group was characterized by the clinical symptoms of poor impulse control and active social avoidance suggesting a deficit in the ability to actively organize stimuli utilizing the feedback from the external environment. And finally, the fluency deficit cluster (n=19) showed impairment in fluency. This group was characterized by impairments in the use of abstract-symbolic thinking and the ability to pay attention to relevant stimuli suggesting a severe deficit in the efficiency and flexibility of information withdrawal. These three subtypes didn’t differ significantly in age, duration of illness and current dosage of antipsychotics. However, the three groups differed significantly in years of education, IQ and on five items of PANSS. Conclusion:This study shows that schizophrenia can be characterized by frontal lobe dysfunctions and divided into three subtypes according to the profile of the frontal lobe dysfunctions. These neurocognitive heterogeneity of schizophrenia, not related to age, duration of illness and dosage of antipsychotic, suggest that different strategies need to be developed in diagnosing and planning rehabilitation programs for schizophrenc patients