도시지역 초등학생에서 주의력결핍 과잉운동장애의 유병율

표경식,박상학,김상훈,조용래,김학렬,문경래 조선대학교 2001 The Medical Journal of Chosun University Vol.26 No.2

Background and Objectives : To study the prevalence of ADHD in urban elementary school children using the Korean version of the disruptive behavior disorders parent rating scale. Materials and methods : 6,372 students from seven urban elementary schools were targeted using the parent rating scale. Results : (1)The total ADHD prevalence was 6.1%. It can be broken down as follows: 4.1% was the Inattentive type, 1.0% was the Hyperactive-impulsive type and 1.1% was the Combined type. 8.3% occurred in male students and 3.9% occurred in female students. The prevalence in boys was significantly higher. (2) The prevalence of Conduct Disorder(CD) was 0.3%: 0.2% for male students and 0.3% for female students. There was no significant difference between girls and boys. (3) The prevalence of Oppositional Defiant Disorder(ODD) was 4.4%: 5.0% for boys and 3.9% for girls. The value for boys was significantly higher. (4) A statistically significant difference between grades was found with ADHD, but no significant difference between grades was found with CD and ODD. (5) In the results of the comorbidity research, ADHD accompanied by CD was 2.3%. ADHD accompanied by ODD was 25.5%. ADHD accompanied by both CD and ODD was 4.1%. (6) Mild forms of ADHD, CD and ODD were found four times more often than that observed in typical cases. Conclusion : Prevalence of ADHD in urban elementary schools is high and CD or ODD is accompanied more frequently. In the future, the school mental health project should be focused mainly on ADHD. From the beginning of urban elementary schools, ADHD should be screened for. Intervention is required depending on whether or not there are accompanying diseases.

農村指導와 奉仕活動

表景湜 明知大學 學徒護國團 1975 明大 Vol.6 No.-

성취관련 자기 불일치와 평가위협 스트레스가 수행불안에 미치는 효과

표경식,조용래,이무석,김학렬,박상학,김상훈 대한신경정신의학회 1998 신경정신의학 Vol.37 No.6

연구목적: 취약성-스트레스 모델에 입각하여 과제수행중의 불안수준(정서적, 인지적 및 행동적 측정치)이 성취관련 자기 불일치(=심리적 취약성 변인)와 평가위협 스트레스(=스트레스 유발인)의 상호작용에 의해 영향을 받 는 지를 알아보고자 하였다. 이를 토대로, 수행불안의 발생기전을 밝히며, 더 나아가서는 수행불안을 효과적 으로 감소시키고 적절하게 예방하기 위한 심리학적 대책을 제안하고자 하였다. 방 법: 자기 불일치 고 집단과 저 집단에 속하는 대학생을 각각 40명씩 선발하여 각 집단별로 절반씩 평가위협 조건과 중성적인 조건에 무선 할당한 후 지적 능력 과제(언어추리검사와 바꿔쓰기검사)를 실시하였다. 결 과: 평가위협 조건에서 자기 불일치 고 집단이 저 집단에 비해 과제 수행동안의 상태불안수준이 유의하게 높 았을 뿐만 아니라, 자기 불일치 고 집단의 경우 중성적인 조건에 비해 평가위협 조건에서 상태불안수준이 더 높았으며, 이러한 차이는 통계적으로 유의한 경향성을 보였다. 그 반면에, 중성적 조건에서 두 집단간 차이와, 자기 불일치 저 집단에서 스트레스 수준간의 차이는 모두 유의하지 않았다. 또한 자기 불일치 고 집단이 저 집단에 비해 스트레스 수준에 상관없이 과제를 수행하는 동안 인지적 방해를 더 많이 받았다. 자기 불일치 고 집단이 저 집단에 비해 스트레스 수준에 상관없이 바꿔쓰기검사에서 더 낮은 수행을 보이는 경향이 있었 으나, 언어추리검사에서는 어떤 효과도 유의하지 않았다. 결 론: 수행불안은 성취관련 자기 불일치와 평가위협 스트레스에 의해 영향을 받으며, 이 두 가지 변인의 상호작 용에 의하여 발생할 것이라는 가설은 수행불안의 정서적 측정치에서 비교적 강하게 지지되었다. 뿐만 아니라, 이러한 가설은 수행불안의 인지적 및 행동적 측정치에서도 역시 부분적으로 지지되었다. 이러한 결과들로 보 아 수행불안의 발생과정을 이해하고 이런 불안을 효과적으로 예방하거나 감소시키기 위해서는 성취관련 자 기 불일치 변인과 평가위협 스트레스를 함께 고려하는 것이 중요하다고 결론 내릴 수 있다. Objectives:The purpose of this study to examine if the levels of anxiety(emotional, cognitive, and behavioral measures) during performance are influenced by interaction of both achievement related self discrepancy(=psychological vulnerability variable) and evaluative threat stress(=stressor) based on vulnerabilitystress model in order to identify the mechanism of development of performance anxiety and furthermore to suggest psychological intervention strategies to reduce and prevent it effectively. Method:High and low self discrepancy subjects consisted of students from the upper(n=40) and lower 15%(n=40) on achievement related self discrepancy scale, respectively. They were randomly assigned to either evaluative threat condition or neutral condition, and then all subjects took intellective task(verbal reasoning test and digit symbol test). Results:The results were as follows; 1) High self discrepancy subjects under evaluative threat reported significantly higher level of state anxiety during performance than low self discrepancy subjects under any condition and also experienced higher degreee of state anxiety with marginal significance than high self discrepancy subjects under neutral condition, whereas there were no significant effects on the anxiety level of group variable under neutral condition or of stress variable in low self discrepancy subjects. 2) High self discrepancy subjects reported more cognitive interference during performance than low self discrepancy subjects regardless of the level of stress. 3) High self discrepancy subjects performed marginally significantly more poorly in digit symbol test than low self discrepancy subjects regardless of the level of stress, whereas there were no significant effects on verbal reasoning test. Conclusion:The hypothesis that performance anxiety could be affected by achievement related self discrepancy and stress, and specially by interaction between self discrepancy and stress was relatively strongly supported by the results on emotional measure of performance anxiety. In addition, this hypothesis received partial support by the results on cognitive and behavioral measures. We might conclude that it is important to consider achievement-related self discrepancy and evaluative threat stress together to understand the mechanism of development of performance anxiety and to reduce or prevent this anxiety effectively.

신경증적 증상 환자들의 자기- 불일치와 정신병리의 관계 : 자기-불일치 이론의 임상적 적용가능성에 관한 탐색적 연구 An Exploratory Study on the Clinical Applicability of Self-Discrepancy Theory

조용래,김선태,표경식 大韓神經精神醫學會 1996 신경정신의학 Vol.35 No.3

본 연구는 우리나라 임상장면에서 Higgins(1987)의 자기-불일치 이론의 적용가능성을 탐색하기 위하여 신경증적 증상 환자들의 자기-불일치와 정신병리의 관계를 경험적으로 알아보고자 하는 것이 주목적이다. DSM-Ⅳ의 기분부전장애, 불안장애, 신체형 장애, 적응장애, 섭식장애의 진단기준에 부합되는 환자 총 71명(남:45명, 여:26명)을 연구대상으로 자기 질문지로 자기개념을 측정한 후 Higgins(1987)의 방법에 따라 각 종류별 자기-불일치 점수를 채점하였으며, 정신병리는 Beck의 우울척도(BDI), Beck의 불안척도(BAI) 및 간이 정신진단 검사(SCL-90-R)의 하위척도 등으로 측정하여 다음과 같은 결과를 얻었다. 1) 네가지 유형의 자기-불일치 모두에서 채점자간 일치도가 매우 높았으며(r=0.96∼0.98), 자기-불일치 유형들간의 상관계수(r)의 범위는 0.41∼0.59로서 모두 유의하였다. 2) 전체 자기-불일치는 대부분의 정신병리와 유의상관(r=0.24∼0.40)이 있었으므로, 전체 자기-불일치와 정신병리 전반의 관계에 대한 일반성 가설이 지지되었다. 3) 단순상관 분석에서, 실제적-이상적 불일치는 일반적인 불안과는 유의한 상관을 보이지 않았으나, 우울 외에 대인불안 및 강박증상과도 유의한 상관이 있었으며, 실제적-이상적/자신 및 타인 불일치의 경우에도 거의 비슷한 양상을 보였다. 그러나, 편상관 분석에서는 실제적-이상적 불일치의 어떤 유형도 특정한 정신병리와 유의한 상관을 보이지 않았으므로, 실제적-이상적 불일치와 우울의 관계에 대한 특정성 가설은 부분적으로 지지되었다고 하겠다. 4) 실제적-의무적/자신 불일치의 경우 우울과는 유의한 편상관을 보이지 않았으나, 일반적인 불안 및 대인 불안과는 유의한 편상관이 있었다. 하지만 실제적-의무적 불일치 및 실제적-의무적/타인 불일치 양자 모두 공포불안을 제외하고는 거의 모든 유형의 정신병리와 유의한 편상관을 보였다. 따라서 실제적-의무적 불일치와 불안의 관계에 대한 특정성 가설은 각 유형에 따라 혼합되게 지지되었다고 할 수 있겠다. 결론적으로, 본 연구의 결과들은 자기-불일치 이론을 대체로 지자하고 있으며, 우리나라 신경증적 증상 환자들의 정신병리를 이해하고 치료적으로 도와주는데 있어 자기-불일치 이론의 임상적 적용가능성을 시사한다고 하겠다. Objectives : The main purpose of this study is to investigate the relationship between self-discrepancy and psychopathology in patients with neurotic symptoms in order to explore th clinical applicability of Higgins'(1987) self-discrepancy theory. Methods : Subjects were 71(male : 45, female : 26) patients with dysthymic disorder, anxiety disorder, somatoform disorder, adjustment disorder, or eating disorder diagnosed with DSM-Ⅳ. After all the subjects' different self-cocepts were measured with the Selves questionnaire, their different kinds of self-discrepancy scores were scored according to the method of Higgins'(1987), and their various psychiatric symptom dimensions(psychopathology) were measured with BAI, BDI, and SCL-90-R. Results : 1) All of the interscorer agreements for four different kinds of self-discrepancies were very high, and the intercorrelations among these were all significant. 2) Total self-discrepancy was significantly associated with most of psychiatric symptom dimensions, and thus this result supports the generality hypothesis about the relationship between total self-discrepancy and psychopathology. 3) In simple correlation analysis, whereas overall actual-ideal discrepancy was not significantly related to anxiety, it was significantly related to interpersonal anxiety and obsessive-compulsive symptom dimension as well as depression. These patterns of correlations were also identified in both actual-ideal/own discrepancy and actual-ideal/other discrepancy, but partial correlations between all of the actual-ideal self-discrepancies and psychopathology were not significant. Therefore, these results partly support the specificity hypothesis about the relationship between actual-ideal discrepancy and depression. 4) In partial correlation analyses, actual-ought/own discrepancy was significantly associated with both general and interpersonal anxiety, but was not associated with depression. However, both overall actual-ought discrepancy and actual-ought/other discrepancy were significantly associated with most of psychiatric symptom dimensions except phobic anxiety. Thus, these results provide mixed support for the specificity hypothesis about the relationship between actual-ought discrepancy and anxiety. Conclusion : The results of this study provide general support for self-discrepancy theory, and provide suggestions for its clinical applicability in understanding and treating patients with neurotic symptoms.

성취관련 자기 불일치와 평가위험 스트레스가 수행불안에 미치는 효과

표경식,조용래,이무석,김학렬,박상학,김상훈 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.6

목적: . 취약성 -스트레스 모델에 입각하여 과제수행중의 불안수준(정서적. 인지적 및 행동적 측정치)이 성취관련 자기 불일치(=심리적 취약성 변인)와 평가위협 스트레스(=스트레스 유발인)의 상호작용에 의해 영향을 받는 지를 알아보고자 하였다 이를 토대로, 수행불안의 발생기전을 밝히며. 더 나아가서는 수행 불안을 효과적으로 감소시키고 적절하게 예방하기 위한 심리학적 대책을 제안하고자 하였다. 방 법 : 자기 불일치 고 집단과 저 집단에 속하는 대학생을 각각 40명씩 선발하여 각 집단별로 절반씩 평가위협조건과 중성적인 조건에 무선 할당한 후 지적 능력 과제(언어추리검사와 바꿔쓰기검사)를 실시하였다. 결 과 : 평가위협 조건에서 자기 불일치 고 집단이 저 집단에 비해 과제 수행동안의 상태불안수준이 유의하게 높았을 뿐만 아니라.자기 불일치 고 집단의 경우 중성적인 조건에 비해 평가위협 조건에서 상태 불안수준이 더 높았으며, 이러한 차이는 통계적으로 유의한 경향성을 보였다. 그 반면에,중성적 조건에서 두 집단간 차이와. 자기 불일치 저 집단에서 스트레스 수준간의 차이는 모두 유의하지 않았다. 또한 자기 불일치 고 집단이 저 집단에 비해 스트레스 수준에 상관없이 과제를 수행하는 동안 인지적 방해를 더 많이 받았다. 자기 불일치 고 집단이 저 집단에 비해 스트레스 수준에 상관없이 바꿔쓰기검사에서 더 낮은 수행을 보이는 경향이 있었으나. 언어추리검사에서는 어떤 효과도 유의하지 않았다. 결 론: 수행불안은 성취관련 자기 불일치와 평가위협 스트레스에 의해 영향을 받으며, 이 두 가지 변인의 상호 작용에 의하여 발생할 것이라는 가설은 수행불안의 정서적 측정치에서 비교적 강하게 지지되었다. 뿐만 아니라. 이러한 가설은 수행불안의 인지적 및 행동적 측정치에서도 역시 부분적으로 지지되었다. 이러한 결과들로 보아 수행불안의 발생과정을 이해하고 이런 불안을 효과적으로 예방하거나 감소시키기 위해서는 성취관련 자기 불일치 변인과 평가위협 스트레스를 함께 고려하는 것이 중요하다고 결론 내릴 수 있다. 0bjectives The purpose of this study to examine if the levels of anxiety(emotional, cognitive, and behavioral measures) during performance are influenced by interaction of both achievement related self discrepancy( = psychological vulnerability variable) and evaluative threat stress(=stressor) based on vulnerability-stress model in order to identify the mechanism of development of performance anxiety and futhermore to suggest psychological intervention strategies to reduce and prevent it effectively. Method : High and lows self discrepancy subjects consisted of students from the upper(n=40) and lower 15%(n=40) on achievement related self discrepancy scale, respectively. They were randomly assigned to either evaluative threat condition or neutral condition, and then all subjects took intellective task(verbal reasoning test and digit symbol test). Results : The results were as fo11ows : 1) High self discrepancy subjects under evaluative threat reported significantly higher level of state anxiety during performance than low self discrepancy subjects under any condition and also experienced higher degreee of state anxiety with marginal significance than high self discrepancy subjects under neutral condition, whereas there were no significant effects on the anxiety level of group variable under neutral condition or of stress variable in low self discrepancy subjects. 2) High self discrepancy subjects reported more cognitive interference during performance than low self discrepancy subjects regardless of the level of stress. 3) High self discrepancy subjects performed marginally significantly more poorly in digit symbol test than low self discrepancy subjects regardless of the level of stress, whereas there were no significant effects on verbal reasoning test. Conclusion : The hypothesis that performance anxiety could be affected by achievement related self discrepancy and stress, and specially by interaction between self discrepancy and stress was relatively strongly supported by the results on emotional measure of performance anxiety. In addition, this hypothesis received partial support by the results on cognitive and behavioral measures. We might conclude that it is important to consider achievement-related self discrepancy and evaluative threat stress together to understand the mechanism of development of performance anxity and to reduce or prevent this anxiety effectively.

양성 및 음성증상 정신분열병환자의 기억수행에 관한 연구

표경식,이형영,윤보현 大韓神經精神醫學會 1994 신경정신의학 Vol.33 No.5

This study was designed to investigate memory performance in positive and negative symptom schizophrenics. The subjects consisted of 3 group of 40 positive symptom schizophrenics, 40 negative symptom schizophrenics, and 40 normal controls. Before the Memory performance test, 3 groups were matched to age, sex, scaled score of information of K-WAIS, duration of illnes and daily dose of antipsychotics. Analyses were done by scores of recall and recognition task, scores of memory clustering and recognition error. The results were as follows : 1) For the free recall, the schizophrenics(positive and negative group) showed significantly lower scores than normal controls(p<.05). Negative group showed significantly lower scores than positive group(p<.05). Cue conditioned schizophrenics showed significantly high scores than non-cue conditioned schizophrenics. 2) For the memory clustering of free recall task, schizophrenics showed significantly lower scores than normal controls(p<.05). But there was no significant difference between positive and negative group. Cue conditioned schizophrenics showed significantly higher scores than non-cue conditioned schizophrenics. 3) For the memory strategy, normal controls exhibited semantic clustering. But schizophrenics exhibited serial clustering. 4) For the recognition, there was no significant difference between positive group and normal controls. But negative group showed significantly lower scores than positive group and normal controls(p<.05). There was no cuing effect among 3 groups. 5) For the recognition error, schizophrenics showed significantly lower scores than normal controls(p<.05). But there was no significant difference between positive and negative group. There was no cuing effect among 3 groups. In conclusion, this study suggests positive symptom schizophrenics exhibited memory deficit.

일부 초등학생의 스트레스와 건강문제에 관한 연구

박미양,표경식,류소연 조선대학교 부설 의학연구소 2002 The Medical Journal of Chosun University Vol.27 No.2

Backgrounds and Objectives: This study was performed to identify factors that affect stress and health problem and to examine the relationship between stress and health problem in some primary school children. Methods: Four hundred forty five students from four schools in Gwangju were selected and surveyed using a questionnaire pertaining to their general characteristics, stress and health problem from October 5th through 20th, 2001. The data were analysed using t-test, analysis of variance, Pearson's correlation analysis and multiple regression analysis. Results: 1. Mean of stress was 81.93 (range: 40~176), and children had the most stress when their parents urged them to study frequently. Of 6 domains of stress, parent and academic achievement were the highest domain of stress. 2. Mean of health problem was 47.18 (range: 30 ~ 112), and lots of children complained of various health problems such as headache, nervousness, anxiety and insomnia, etc. 3. School year, grades, health perception, concern for health, economic status of their family, parent's educational level, family atmosphere and living with parents were statistically significant associated factors with children's stress. 4. Gender, school year, grades, religion, health perception, concern for health, economic status of children's family, parent's educational level, family atmosphere and living with parents were statistically significant associated factors with children's health problem. 5. Pearson's correlation coefficient of stress and health was 0.570, which showed statistically significant positive correlation between them. 6. As a result of the multiple regression analysis, it showed that stress significantly affected health problem. In addition to stress, gender and health perception was associated with health problem. Conclusion: Children's stress has a significant influence on their health and the more stress they feel, the more health problems. Families, communities and societies including schools should be interested in children's stress and develop a program to prevent health problems due to their stress.

강박장애와 비합리적인 신념

황혜헌,표경식 中央醫學社 1994 中央醫學 Vol.59 No.12

The purpose of this study is to investigate the relationship between obsessive compulsive symptoms and irrational beliefs. The subjects were administered the Korean version of Maudsley Obsessive- Compulsive Inventory and the Irrational Belief Test in group.. In correlation analysis, most of the subscale scores in irrational . belief are correlated significantly with total score of Maudsley .Obsessive-Compulsive Inventory as expected, And - then. Using the Maudsley Obessive-Compulsive Inventory, Two groups of subjects were identified : obsessive group and control group. The author used discriminative function analysis to seek the discriminant variables of the irrational belief. The results were as follows. 1. Obsessive tendency correlated significantly with scales reflecting demand for approval, high self expectation, blame pronness, frustration reactivity, anxious overconcern. 2. In discriminative function analysis, anxious overconcern, blame pronness and demand for approval were significant discriminative variables, This analysis correctively classified two obsessional group and control group in 71.58% of the sample.

입원한 전반적발달장애 소아청소년의 임상특성

박태원,표경식,반건호,홍강의 대한소아ㆍ청소년정신의학회 1998 소아청소년정신의학 Vol.9 No.2

대학생의 흡연 유형 및 흡연과 심리사회적 요인의 관계에 관한 연구

김상훈,조용래,표경식,Kim, Sang-Hoon,Cho, Yong-Rae,Pyo, Kyung-Sik 한국정신신체의학회 1996 정신신체의학 Vol.4 No.2

For the purpose of examining the relationship between smoking, perceived stress and vulnerability factors, and furthermore suggesting interventions to reduce excessive smoking and prevent nicotine dependency effectively, the questionnaires of perceived stress(stressful experiences), ways of stress coping(passive and active copings), smoking motives, social influence, age, amounts of smoking, and nicotine dependency were administered to smokers among medical students in Chosun university(n=186). 1) As a result of classifying smokers by the types of smoking, the most was a type of smokers to reduce negative emotions and the next in order were addictive smokers, smoker for stimulation, smoker for pleasure, etc. 2) The effects of motive, age, and active coping style were significant, but the effects of perceived stress, passive coping style, and social influence were not significant in average amount of daily smoking. 3) The effects of motive, social influence, and age were significant, but the effects of perceived stress, passive and active coping styles were not significant in the degree of nicotine dependency. To summarize, it is concluded that there were a lot of people who smoke to solve negative emotions, but the direct effects of perceived stress and passive coping style on both average amounts of daily smoking and the degree of nicotine dependency were not significant. On the other hand, motive, age, active coping style, and social influence were proved to be more important variables than the others in explaining college students' smoking.