코로나 엔데믹 상황에서의 사회적 인식과 행동변화

이현희 한림대학교 특수대학원 2025 국내석사

Objectives :It examines social perception and behavioral changes in the context of the coronavirus pandemic. Methods : This study is a study that examines social awareness and behavioral changes in the COVID-19 endemic situation by utilizing a questionnaire survey in 2024. With the responses of 113 survey respondents, we examined whether the hypothesis that there is no difference in social awareness or behavioral changes during the Omicron epidemic period in the first half of 2022 and after the crisis stage adjustment in August 2023 was rejected through a paired sample t-test and a Wilcoxon signed-rank test. Results : First, the overall, male and female, 60s and under and 70s and over, infectivity, and vaccination power all showed lower average values ​​in terms of awareness of COVID-19 infection, compliance rate of COVID-19 infection prevention guidelines, and awareness of Perception of the effectiveness ofinterventions related to COVID-19 after the adjustment of the crisis level in August 2023 than during the Omicron epidemic period in the first half of 2022. Second, the overall, male and female, 60s and under and 70s and over, infectivity and non-infection, vaccination and non-vaccination power all showed the largest average difference in the compliance rate of COVID-19 infection prevention guidelines after the adjustment of the crisis level in August 2023 and during the Omicron epidemic period in the first half of 2022. Third, after the adjustment of the crisis level in August 2022 and 2023, the Wilcoxon signed-rank test was performed on the entire subject, gender, age group, infection history, and vaccination status. As a result, there was a significant difference in the awareness of COVID-19 infection in the entire subject, a significant difference in the compliance rate of quarantine rules for COVID-19 infection prevention, and a significant difference in the Perception of the effectiveness ofinterventions related to COVID-19. In the unvaccinated subject, there was no statistically significant difference in the awareness of COVID-19 infection, the compliance rate of quarantine rules for COVID-19 infection prevention, the entire subject, a significant difference in the compliance rate of quarantine rules for COVID-19 infection prevention, and a significant difference in the Perception of the effectiveness ofinterventions related to COVID-19. In the unvaccinated subject, there was no statistically significant difference in the awareness of COVID-19 infection, the compliance rate of quarantine rules for COVID-19 infection prevention, and the awareness of government policies related to COVID-19. Conclusions : Compared to the first half of 2022, when the Omicron epidemic was in full swing, awareness of the risk of COVID-19 infection and Perception of the effectiveness ofinterventions related to COVID-19 have both declined since the crisis level adjustment in August 2023, and even the rate of compliance with quarantine rules for COVID-19 infection prevention has declined. In conclusion, it will be necessary to continuously recommend the practice of personal hygiene rules and maintain awareness of the risk of infectious diseases. Key words :Risk awareness of infection, rate of compliance with quarantine rules for infection prevention, Perception of the effectiveness ofinterventions related to COVID-19

피질하 혈관성 인지장애 환자의 운동학적 쓰기 특성

김효정 한림대학교 보건과학대학원 2022 국내석사

장.노년층 위기감이 생활만족도에 미치는 영향 : 원주시를 중심으로

김홍연 한림대학교 사회복지대학원 2005 국내석사

최근 우리나라는 수명의 증가와 출산율의 저하로 인하여 노인인구가 급증하는 인구 고령화 사회로 진입하고 있다. 고령화 사회란 전체 인구에서 노인이 차지하는 비중이 다른 연령집단에 비해 상대적으로 높은 사회를 말한다. 고령화 사회는 또한 노인인구의 비중이 증가하게 됨에 따라서 다양한 사회경제적인 변화를 겪는 사회를 말한다. 본 연구는 고령사회로 변화되어 가고 있는 이 시기에 중년의 위기감은 신체적․심리적․사회적 특징 등으로 다양한 면에서 사회 연령적으로 확대 될 것으로 판단하고 원주시에 거주하는 중년기와 노년기에 걸친 45세에서 75세 300명을 장․노년층으로 구분하여 위기감과 생활만족도를 조사하고, 위기감이 생활만족도에 미치는 영향에 관하여 연구하였다. 분석결과 본 조사 대상자의 위기감 수준은 5점 척도에서 평균 2.92로 나타났고, 생활만족도 수준은 5점 척도에서 평균 3.23으로 나타났다. 위기감의 하위 척도별로는 개별화 과정 3.36, 활력의 상실감 3.18, 직업 불만족도 3.04, 정서적 위기감 2.76, 결혼 불만족도 2.47, 자녀 관계 2.44 순으로 개별화 과정이 가장 높게 나타났다. 또한 조사 대상자의 전체 생활만족도는 평균 3.23으로 나타났다. 일반적 특성에 따른 장․노년층의 위기감은 모두 유의미한 차이가 있는 것으로 나타났다. 먼저 성별로는 여성 3.00 남성 2.79로 여성이 남성에 비해 장․노년층의 위기감이 높게 나타났고, 연령별로는 장년층 3.02 노년층 2.77로 장년층이 노년층에 비해 위기감이 높게 나타났다. 그리고 교육수준별로는 초졸 3.06, 중졸 2.96, 고졸 2.88, 무학 2.83, 대학이상 2.82 순으로 교육수준이 낮을수록 장․노년층 위기감이 높게 나타났으며, 결혼상태별로는 미혼 3.68, 사별 3.21, 이혼 3.14, 별거 2.90, 배우자가 있다 2.87 순으로 배우자가 없는 상태일수록 장․노년층 위기감이 높게 나타났다. 또한 건강상태별로는 건강하지 못하다 3.33, 보통이다 2.94, 건강하다 2.68 순으로 건강상태가 나쁠수록 장․노년층 위기감이 높게 나타났으며, 생활정도별로는 어려운 편이다 3.20, 보통이다 2.87, 부유한 편이다 2.53 순으로 생활정도가 어려울수록 장․노년층 위기감은 높게 나타났다. 일반적 특성에 따른 장․노년층의 생활만족도는 성별, 연령을 제외하고 모두 유의미한 차이가 있는 것으로 나타났다. 먼저 교육수준별로는 대학이상 3.31, 고졸 3.28, 중졸 3.23, 무학 3.25, 초졸 3.07 순으로 교육수준이 낮을수록 장․노년층 생활만족도는 낮게 나타났고, 결혼상태별로는 별거 3.47, 배우자가 있다 3.29, 사별 2.88, 이혼 2.85, 미혼 2.68 순으로 배우자가 없는 상태일수록 장․노년층 생활만족도는 낮게 나타났다. 그리고 건강상태별로는 건강하다 3.48, 보통이다 3.18, 건강하지 못하다 2.86 순으로 건강상태가 나쁠수록 장․노년층 생활만족도는 낮게 나타났으며, 생활정도 또한 부유한 편이다 3.74, 보통이다 3.29, 어려운 편이다 2.84 순으로 생활정도가 어려울수록 장․노년층 생활만족도는 낮게 나타났다. 위기감과 생활만족도의 관계로 위기감 하위척도에서 결혼 불만족도, 자녀 관계를 제외한 정서적 위기감, 직업 불만족도, 개별화 과정, 활력의 상실감에 따라 장․노년층의 생활만족도에는 유의미한 차이가 있는 것으로 나타났다. 특히, 위기감 하위척도에서 정서적 위기감이 생활만족도에 가장 큰 영향력이 있는 변수로 나타났다. 앞으로 다가올 고령사회의 노인이 될 현재의 장․노년층을 대할 때 위기감에 대한 이해와 보다 깊은 배려가 따라야 할 것이다. 더욱이 생활만족도에 영향을 미치는 정서적 위기감, 직업 불만족도, 개별화 과정, 활력의 상실감을 긍정적으로 발전시킬 수 있는 심리적 관련 요인들을 탐색하는 것은 앞으로의 과제가 될 것이다. 궁극적으로는 현재 장․노년층의 위기감을 낮추고 생활만족도를 높이려는 다양한 방법 모색이 좁게는 질적인 프로그램 기획으로부터 넓게는 앞으로의 노인복지 정책에도 동반되어야 할 것이다. Recently, Korea is advancing into Aging Society because of increase of life span and decrease of birth rate. Aging Society means the society that the rate of the age is relatively higher than other age groups in the whole population. Also, it means a society that experiences various kinds of social and economical change as the rate of the old increases. This study concludes that the crisis of the middle aged will be enlarged in various aspects of society and age with physical, psychological and social characteristics at present that is changing into Aging Society. And it surveyed crisis and life satisfaction by dividing 300 persons in their 45~75 age over middle age and old age residing in Wonju City into maturity class, and studied the effect of crisis on the satisfaction in life. From the result of analysis, the crisis level of the objects in the survey was 2.92 on average in the index of 5, and the satisfaction level was 3.23 on average in the index of 5. In the lower rank of crisis, it was 3.36 in individualization course, 3.18 in loss of life forces, 3.04 in job unsatisfaction, 2.76 in emotional crisis, 2.47 in unsatisfaction of marriage, and 2.44 in relationship with offsprings respectively, and individualization course showed the highest point. Also, the whole living satisfaction rate of objects was 3.23 on average. The crisis of maturity class according to general characteristics was found out that there are all significant difference. Firstly, by sex, it was 3.00 in female and 2.79 in male. So female showed higher crisis than male in maturity class. By age, it as 3.02 in the middle age and 2.77 in the old age. So crisis was higher in the middle age than the old age. And by educational level, it was 3.06 in elementary school graduate, 2.96 in middle school graduate, 2.88 in high school graduate, 2.83 in illiteracy and 2.82 in university graduate respectively. So, the crisis of maturity class was higher as the educational level is lower. By marriage, it was 3.68 in the unmarried, 3.21 in widows and widowers, 3.14 in the divorced, 2.90 in the separated, and 2.87 in the married. So, the crisis of maturity class was higher if there is no spouse. Also, by health condition, it was 3.33 when being healthy, 2.94 when being normal and 2.68 when being healthy. So, the crisis in the maturity class was higher as the healthy condition was bad. By the standard of living, it was 3.20 when being low, 2.87 when being normal and 2.53 when being high. So, the crisis in the maturity class was higher as the standard of living was lower. The life satisfaction of maturity class according to general characteristics was found out that there is significant difference except sex and age. Firstly, by educational level, it was 3.31 in university graduate, 3.28 in high school graduate, 3.23 in middle school graduate and 3.07 in elementary school graduate respectively. So, the life satisfaction of the maturity class was lower as the educational level was lower. By marriage, it was 3.47 in the separated, 3.29 in the married, 2.88 in widows and widowers, 2.85 in the divorced and 2.68 in the unmarried. So, the living satisfaction of the maturity class was lower as there is no spouse. And by health condition, it was 3.48 when being healthy, 3.18 when being normal and 2.86 when being not healthy. So the life satisfaction in the maturity class was lower as the health condition is bad. Also, by the standard of living, it was 3.74 when being high, 3.29 when being normal, and 2.84 when being low respectively. So, the life satisfaction of the maturity class was lower as the standard of living was lower. In the relationship between crisis and life satisfaction, it was found out that there is significant difference in the life satisfaction of the maturity class by unsatisfaction in marriage, emotional crisis except relationship with offspring, job unsatisfaction, individualization course, and loss of life forces in the lower standard of crisis. Especially, emotional crisis in the lower standard of crisis was found out as the most effective variable in the life satisfaction. When confronting the maturity class at present who will be the old in the coming Aging Society, understanding about crisis and more care should be prepared. Moreover, it would be the subject in the future to search psychological factors to progress positively emotional crisis, job unsatisfaction, individualization course, and loss of life force that can influence on life satisfaction. Ultimately, the search for various kinds of way to lower the crisis of the maturity class at present and to raise life satisfaction should be accompanied to qualified program planning and the elderly welfare policy in the future.

복부 안정화를 동반한 목 안정화 운동이 목긴근의 두께와 목빗근, 목갈비근의 근활성도에 미치는 영향

김태호 한림대학교 보건과학대학원 2017 국내석사

Purpose: The purpose of the study is to demonstrate that cervical stabilizing exercise accompanied by abdominal stabilization affects shrinking relationship of deep cervical flexor muscle and surface cervical flexor muscle and prevents compensation movement of cervical flexor muscle, so it can help activity of deep cervical flexor muscle. Method: For 30 healthy adults, changes in muscle activity of SCM, scalene, RA, EO, and IO and muscle thickness of SCM, EO, IO, longus colli, and TrA were compared in accordance with different cervical stabilizing exercise methods of conventional cervical stabilizing exercise, cervical stabilizing exercise with hip joint and knee joint 90° posture, and cervical stabilizing exercise accompanied by abdominal stabilization. Result: In terms of muscle activity and the amount of change in muscle thickness of SCM and scalene, cervical stabilizing exercise accompanied by abdominal stabilization decreased muscle activity and the amount of change in muscle thickness more than hip and knee joint 90° posture and conventional cervical stabilizing exercise did, while in terms of the amount of muscle thickness of longus colli, it increased the amount of change in muscle thickness more than hip and knee joint 90° posture and conventional cervical stabilizing exercise did. Conclusion: The abdominal stabilization helps to improve the muscle strength of longus colli by preventing compensation of cervical flexor muscle through the provision of the stability of trunk and the avoidance of chest lift. 연구목적: 심부 목굽힘근과 표면 목굽힘근의 수축관계를 밝히고 복부 안정화 운동를 동반한 목 안정화 운동이 경추의 보상 움직임을 방지하여 심부 목굽힘근 활성에 도움을 주어 효과적인 목 안정화 운동을 증명하기 위함이다. 연구방법: 건강한 사람 30명을 대상으로 전통적인 목 안정화 운동과 엉덩관절, 무릎관절 90° 자세 목 안정화 운동, 복부 안정화를 동반한 목 안정화 운동으로 목 안정화 운동방법에 따라 목빗근, 목갈비근, 배곧은근, 배바깥빗근, 배속빗근의 근활성도 변화와 목빗근, 배바깥빗근, 배속빗근, 목긴근, 배가로근의 근 두께 변화를 비교하였다. 연구 결과: 목빗근과 목갈비근의 근활성도와 근 두께 변화량 에서 복부 안정화를 동반한 목 안정화 운동이 엉덩관절 무릎관절 90°자세 목 안정화 운동과 전통적인 목 안정화 운동보다 근활성도와 근두께 변화량이 감소하였고(p<.05), 목긴근의 근두께 변화량에서 복부안정화를 동반한 목 안정화 운동이 엉덩관절 무릎관절 90°자세 목 안정화 운동과 전통적인 목 안정화 운동보다 근두께 변화량이 증가하였다(p<.05). 결론: 복부의 안정화는 체간의 안정성 제공과 흉곽 거상을 방지하여 표면 목굽힘근 보상작용을 막아 목긴근의 근력 향상에 도움이 된다.

Media representations of standardized beauty and its effect on self-esteem related issues in Korea : 한국에서 미디어가 묘사한 아름다움 기준과 그것이 자아 존중감에 미치는 영향에 관한 연구

Fisseha, Israel 한림대학교 대학원 2017 국내석사

The focal point of the research will be how ideal standards of beauty in South Korea is affecting in how college students see their body and the behavioral change that follows. The study have two parts. The first part of study provide a theoretical background for how mass media representation of standardized beauty could contribute to body dissatisfaction and low self-esteem issues. This part is aiming to identify what the standard of beauty for Korea and it will build a theoretical background about the connection between media, ideal beauty and self-esteem. While building the connection with media and its instigated psychological problems, this part of the study in short analysis will look into the real life situation in South Korea’s definition of what a standard beauty is. Again look into social changes that brought and encouraged the normalization of those standards. The second part of the study then is conducted to test the theory built in the first part of the study on college students of Hallym University in South Korea. This part of the study will use focus- group session to test out how far the statement of the problem is really a problem. In this paper thus the guideline for conducting the focus group session and guiding questions are included. 본 연구는 대한민국에서의 이상적인 아름다움의 기준이 대학생들이 자기에 대한가치관에 어떤 영향을 미치는지, 또한 그에 따른 행동변화에 초점을 두고 있다. 연구를 크게 두 부분으로 볼 수 있다. 첫 부분에서 대중 매체가 표한 아름다움의 기준이 신체 불만족과 낮은 자아 존중감을 기여하는지에 대한 이론적 배경을 제시하였다.이 부분에서는 한국의 아름다움 (미)의 기준이 무엇인지를 알아보며 미디어, 이상적인 아름다움, 자아 존중감 등 간에 관계에 대한 이론적인 배경을 구성하였다. 이 부분에 미디어와 그가 부추기는 심리적인 문제들을 연결 시키는 동시에 대한민국의 아름다움 기준의 정의에 대한 실제상황을 단기적으로 분석하여 보았다. 또한 그가 일으킨 사회변화를 보았고 그 기준들의 정상화를 촉구하였다. 연구의 두 번째 부분에서는 이전 부분에서 설정했던 이론을 한림대학교 학생들에게 실시 해보았다. 초점 집단 세션을 통해서 제시된 문제가 실제에 어느 정도 심각한 지를 검증했다.이 연구에서는 초점 집단 세션 실행과 질문을 이끌어 가는 방법에 대한 가드라인이 등이 함유된다.

일반 아동과 말소리장애 아동의 무의미 낱말 따라말하기와 말지각 및 음운기억 간의 관계

원호슬 한림대학교 보건과학대학원 2022 국내석사

Purpose: The aim of this study was to compare the nonword repetition performances and find out the correlation between the nonword repetition(NWR), speech perception(SP), and phonological memory(PM) children with speech sound disorder(SSD) and the children with typical development(TD). Methods: Twenty-six children participated in this study, 12 children with SSD and 14 children with TD(aged 5 to 6 years). NWR, SP, PM tasks were conducted for all participants, and the scores of NWR task were divided into the retrieval and sequencing. repeated two-way ANOVA was performed to examine whether NWR were significantly different between the groups and the syllable lengths. In addition, error patterns of NWR are examined. independent t-test was performed to examine whether SP and PM were significantly different between the groups. pearson correlation analysis was performed to examine the correlation between the NWR, SP, PM performances are investigated. Results: Significant group differences revealed in both retrieval and sequencing tasks. Children with SSD showed lower phonological working memory perfomances than children with TD. In the children with SSD, both retrieval and sequencing performances were related to phonological shor-term memory performances. Children with TD showed significant correlation between the retrieval and the SP performances Conclusions: This study is meaningful in that it examined the Processes before speech execution of speech in various factors, such as speech perception and phonological memory, and comprehensively looked at nonword repetition and related factors.

텍스트 내 문장 제시 유형에 따른 초등학교 2학년 발달성 난독 아동과 일반 아동의 읽기 유창성 특성

김찬미 한림대학교 보건과학대학원 2022 국내석사

Background and Purpose: The development of reading fluency is important as decoding ability develops in the early stages of reading development and deciphering within text becomes automated as grades increase. Accuracy, speed, and prosody are recognized as important factors in reading fluency, but studies on reading fluency, including prosody, are rare. When evaluating reading fluency, reading performance varies depending on text factors. Few studies have examined visual density as sentence boundaries in children with developmental dyslexia. In this study, the characteristics of reading fluency between reading groups are examined according to vertical (sentence line breaking) and horizontal (general subject type) in which visual density is divided into new lines according to text type. Subjects and methods: The subjects of this study were second-grade students enrolled in elementary schools in Seoul, Gangwon-do, and Chungcheong-do, with 14 developmental dyslexia children and 13 general children, a total of 27 subjects. Children with no difficulty in intelligence, acceptance vocabulary, and listening comprehension were targeted, and children with developmental dyslexia and general children were divided according to KOLRA reading index 2. Accuracy, speed, and prosody total points were measured and analyzed according to the text type. Results and discussions: As a result of examining the difference in reading fluency according to the reading group and text type(F=9.517, p=.005), only the main effect according to the reading group was significant in reading accuracy. In the reading speed, an interaction effect was observed(F=6.720, p=.016), and the main effect on the reading group(F=18.579, p=<.001) and text type(F=5.302, p=<.030) was also observed. In the case of developmental dyslexia children, they read significantly slower in the horizontal type than in the vertical type(t=-2.873, p=.013). In the total prosody score, only the main effect according to the reading group was significant(F=10.400, p<.001). In conclusion, in the case of developmental dyslexia children, although text composed of self- and phoneme-matched words was presented and readable to some extent without being affected by the text type, both vertical and horizontal types showed differences in speed. In the total prosody score, children with developmental dyslexia also received significantly lower scores in the total score than ordinary children, showing difficulties in terms of prosody. This study examined visual density by dividing it into sentence boundaries according to text types, and it is meaningful to examine the characteristics of reading fluency in children with developmental dyslexia by accuracy, speed, and prosody. 배경 및 목적: 읽기가 발달하는 초기에 해독 능력이 발달하고 학년이 증가할수록 텍스트 내의 해독은 자동화가 되어 읽기 유창성의 발달이 중요하다. 읽기 유창성에서 정확도 및 속도, 운율은 중요한 요인으로 인식되지만, 운율을 포함한 읽기 유창성 연구는 드물다. 읽기 유창성을 평가할 때 텍스트 요인에 따라 읽기 수행력이 달라진다. 발달성 난독 아동을 대상으로 시각적 밀집도를 문장 경계로 살펴본 연구는 거의 없다. 본 연구에서는 시각적 밀집도를 텍스트 유형에 따라 문장을 새로 줄 바꿈으로 나눈 세로형(문장줄바꿈형)과 가로형(일반교과형)에 따라 읽기집단 간 읽기 유창성 특성을 살펴보고자 한다. 대상 및 방법: 본 연구의 대상자는 서울, 강원도 및 충청도의 초등학교에 재학 중인 2학년 학생으로 발달성 난독 아동 14명과 일반 아동 13명으로 총 27명 대상으로 하였다. 지능과 수용어휘력 및 듣기이해력에 어려움이 없는 아동을 대상으로 하였으며, KOLRA 읽기지수2에 따라 발달성 난독 아동과 일반 아동을 나누었다. 텍스트 유형에 따라 정확도, 속도, 운율 총점을 측정하여 분석하였다. 결과 및 논의: 읽기집단과 텍스트 유형에 따른 읽기 유창성의 차이를 살펴본 결과, 읽기 정확도에서 읽기 집단에 따른 주효과만 유의하게 나타났다(F=9.517, p=.005). 읽기 속도에서는 상호작용 효과가 관찰되었으며(F=6.720, p=.016), 읽기집단(F=18.579, p=<.001)과 텍스트 유형(F=5.302, p=<.030)에 대한 주효과도 나타났다. 발달성 난독 아동의 경우 세로형보다 가로형에서 유의하게 느리게 읽었다(t=-2.873, p=.013). 운율 총점에서 읽기집단에 따른 주효과만 유의하게 나타났다(F=10.400, p<.001). 결론적으로 발달성 난독 아동의 경우 자소와 음소 일치형 낱말로 구성된 텍스트를 제시하여 텍스트 유형에 따라 영향을 받지 않고 어느 정도 읽기 가능하였음에도 불구하고 세로형과 가로형 모두 속도면에서 차이가 있는 것으로 나타났다. 운율 총점에서도 발달성 난독 아동이 일반 아동 보다 총점에서 유의하게 낮은 점수를 받아 운율적 측면에서 어려움을 보였다. 본 연구는 시각적 밀집도를 텍스트 유형에 따라 문장의 경계로 나누어 살펴보았으며, 발달성 난독 아동의 읽기 유창성 특성을 정확도, 속도, 운율로 나누어 살펴본 것에 대해 의의가 있다.

Comparative analysis of neuropsychological test profile characteristics for early differential diagnosis of autism spectrum disorder and intellectual disability/borderline intellectual functioning

강희정 한림대학교 대학원 2024 국내박사

In the realm of clinical diagnosis, a notable “gray zone” exists between autism spectrum disorder (ASD) and intellectual disability/borderline intellectual functioning (ID/BIF), posing substantial challenges in achieving accurate differentiation. This study explored the differentiation between ASD and ID/BIF in preschool children using neuropsychological assessments, including the Korean Wechsler Preschool and Primary Scale of Intelligence-IV (K-WPPSI-IV), Beery Visual-Motor Integration (VMI), and Social Maturity Scale (SMS). We also investigated the association between these assessment scores and Childhood Autism Rating Scale-Second Edition (CARS-2). From August 2020 to 2023, a retrospective analysis of medical records and developmental assessment results was conducted on 91 patients aged 4-7 years with an intelligence quotient (IQ) below 85 at the Pediatric Neurodevelopment and Behavior Clinic at Hallym University Dongtan Sacred Heart Hospital. This group included 32 and 59 patients diagnosed with ASD and ID/BIF, respectively. In both ASD and ID/BIF patients, the K-WPPSI-IV subtests consistently showed the lowest scores for the Verbal Comprehension Index (VCI) and the highest scores for the Visual Spatial Index (VSI). Positive correlations were observed among the Full-Scale IQ (FSIQ), Beery VMI score, and Social Quotient (SQ) across all groups. After adjusting for FSIQ, sex, and age, significant differences were found between the ASD and ID/BIF groups in the Working Memory Index (WMI) and SQ, with adjusted odds ratios of 0.93 and 0.91, respectively. No significant differences were observed in VCI, VSI, Fluid Reasoning Index (FRI), Processing Speed Index (PSI), or Beery VMI score between the two groups. Differences between ASD and ID/BIF were identified through differences in the K-WPPSI-IV subtests. A WMI-VCI difference of less than 1 (area under the curve [AUC] 0.661) and an FRI-VCI difference of less than 5 (AUC 0.643) were more indicative of ASD than of ID/BIF. Additionally, in ASD patients, the FSIQ, WMI, and SQ showed significant negative correlations with the CARS-2 scores. This study demonstrated that ASD patients exhibited lower levels of working memory and adaptive functions than those with ID/BIF, even when they had the same IQ. Moreover, the impairment in these functions correlated with the severity of ASD symptoms. The results indicate that smaller differences between WMI and VCI (<1 point) and those between FRI and VCI (<5 points) suggest ASD, whereas larger differences, where WMI and FRI exceed VCI by >1 and >5 points, respectively, are more indicative of ID/BIF. 임상적으로 자폐스펙트럼장애(ASD)와 지적장애/경계성 지적기능환자(ID/BIF)의 사이에는 회색지대가 존재하며, 정확한 감별에 어려움이 있다. 본 연구는 학령전기 시행하는 발달검사인 Korean Wechsler Preschool and Primary Scale of Intelligence-IV (K-WPPSI-IV), the Beery visual-motor integration (VMI), social maturity scale (SMS)를 통해 ASD와 ID/BIF를 감별하고 이러한 발달검사 점수가 Childhood Autism Rating Scale-Second Edition (CARS-2) 와 어떠한 연관성이 있는지 알아보았다. 2020년 8월부터 2023년 8월까지 한림대학교 동탄성심병원 소아신경발달행동클리닉에서 intelligence quotient (IQ)가 85 미만인 4-7세 환자 91명중 ASD로 진단된 32명과 ID/BIF로 진단된 59명을 대상으로 의무기록과 발달검사결과를 후향적으로 분석하였다. ASD환자와 ID/BIF환자에서 K-WPPSI-IV subtest은 모두 verbal comprehension index (VCI)가 가장 낮고 visual spatial index (VSI)가 가장 높게 확인되었다. Full-scale IQ (FSIQ), the Beery VMI score, social quotient (SQ)는 모든 그룹에서 서로 양의 상관관계가 있었다. FSIQ, 성별, 나이를 보정하여 두 그룹을 비교하였을 때 ASD의 working memory index (WMI)와 SQ가 ID/BIF보다 유의미하게 낮았고 조정된 오즈비는 각각 0.93, 0.91이었다. VCI, VSI, fluid reasoning index (FRI), processing speed index (PSI), the Beery VMI score는 두 그룹 간에 유의미한 차이가 없었다. K-WPPSI-IV 하위검사 간의 차이를 통해 ASD와 ID/BIF의 감별점을 찾아보았을 때는 WMI-VCI가 1 미만일 경우(AUC 0.661)와 FRI-VCI가 5 미만일 경우(AUC 0.643) ID/BIF보다는 ASD를 더 시사한다고 볼 수 있었다. 또한 ASD환자에서 FSIQ, WMI, SQ가 CARS-2 score와 유의미한 음의 상관관계를 보였다. 본 연구를 통해, 동일 IQ에서는 ASD환자가 ID/BIF환자보다 working memory와 adaptive function이 낮으며, ASD환자에 있어서는 상기 기능이 증상의 중증도와 연관이 있음을 알 수 있었다. K-WPPSI-IV 검사결과를 보았을 때, WMI-VCI가 1보다 작을 경우 및 WMI-VCI가 5보다 작을 경우 ASD를, 그 차이가 많을 경우 ID/BIF를 좀더 고려할 수 있다.

화상 재활환자의 혈청 25-hydroxyvitamin D 수치와 우울 증상과의 관련성

황현미 한림대학교 보건과학대학원 2022 국내석사

Objective : The purpose of this study was to investigate the relationship between the serum 25-hydroxyvitamin [25(OH)D] level and the depressive symptoms in burn patients admitted to the rehabilitation department of one Burn Specialty Hospital. Method : From July 2022 to October 2022, 61 patients who were to be tested for the serum vitamin D, among the ones admitted to the department of rehabilitation medicine at one Burn Specialty Hospital in Seoul, were subject to the medical record survey and the questionnaire survey. According to the serum vitamin D level, the sufficient group of 30 ng/mL or more and the deficiency group of 30 ng/mL or less were classified. Depending on the depressive symptoms, the score of 13 or more on the CESD scale was classified as the depressive group, and the score of 13 or less was classified as the non-depressive group. For the statistical analysis, the Mann-Whitney U test was used to confirm the serum vitamin D levels according to the presence or absence of depressive symptoms. And, to confirm the relationship between the serum vitamin D level and depressive symptoms, the chi-squared test or Fisher's exact test was used. Also, after the univariate logistic regression analysis was performed on demographic factors, burn-related factors, and health-related factors, the multivariate logistic regression analysis was performed while controlling the variables step by step. In addition, the linear regression analysis was performed by monitoring the changes in depressive symptoms according to the vitamin D changes. Result : As a result of the analysis, the serum vitamin D level was less than 30 (insufficency) in 67.2% and more than 30 (sufficiency) in 32.8%. In addition, the CESD score was less than 13 (depressive symptom) in 34 patients (55.7%) and more than 13 (non-depressive symptom) in 27 patients (44.3%). Regarding the serum vitamin D level, the relation to the depressive symptoms was higher in the deficient group than in the sufficient group (odds ratio 1.70, 95% CI = 0.09-7.86), but there was no statistical significance. The economic difficulties (odds ratio 21.6, 95% CI 1.14-409) as a demographic factor and the large burn body surface area (TBSA) (odds ratio 1.03, 95% CI 1.00-1.09) as a burn-related factor were associated with depressive symptoms. And the low physical activity (odds ratio 50.87, 95% CI 3.31-781) as a health-related factor was related with the depressive symptoms. In order to confirm the change in depressive symptoms according to the changes in vitamin D level, the result of follow-up linear regression analysis was analyzed to have a negative (-) effect(β=-0.316). Conclusion : The vitamin D deficiency was found in 67.2% of the hospitalized patients undergoing the rehabilitation for burns. There was no significant association between the serum vitamin D levels and the depressive symptoms. However, there was the negative correlation in the changes in depressive symptoms according to the changes in serum vitamin D level through follow-up observation. In the future, the additional studies will be needed by controlling the number of samples and some confounding variables that can represent burn patients.

성격강점이 정신적 웰빙과 우울증상에 미치는 영향 : 스트레스 대처방식의 매개역할

이다영 한림대학교 일반대학원 2025 국내석사

This study aimed to move beyond a pathology-centered approach by examining the influence of character strengths—psychological resources that contribute to the realization of individual potential and the promotion of mental health—on the mental health of Korean university students, specifically focusing on mental well-being and depressive symptoms. It also explored the mediating role of stress coping strategies in these relationships. To this end, a higher-order factor structure of character strengths was derived for Korean university students, and the mediating effects of stress coping strategies in the relationship between character strengths and mental health were examined. An online survey was conducted to assess character strengths, stress coping strategies, emotion-focused coping, mental well-being, and depressive symptoms. Data from 311 participants were included in the final analyses. Exploratory factor analysis revealed five higher-order factors of character strengths: relational strengths, social/emotional strengths, temperance strengths, intellectual strengths, and judgment/insight strengths. A hierarchical factor model was then tested to examine the plausibility of a second-order single-factor structure. Subsequently, multiple mediation analyses were conducted to evaluate the effects of character strengths on mental health and the mediating roles of stress coping strategies. In addition, exploratory graph analysis was performed to further investigate the associations between character strengths and coping strategies. The results showed that all five character strength factors were positively related to mental well-being and negatively related to depressive symptoms. Moreover, the five character strength factors significantly predicted the use of various stress coping strategies. Stress coping strategies mediated the relationships between character strengths and mental health in distinct ways. Specifically, seeking social support coping positively mediated the relationship between all character strength factors and mental well-being, while problem-focused coping showed significant mediating effects in the relationships between four strength factors (excluding temperance strengths) and mental well-being. In contrast, wishful thinking coping positively mediated the relationship between all strength factors and depressive symptoms, and emotion-focused coping negatively mediated the relationship between four strength factors (excluding social/emotional strengths) and depressive symptoms. Finally, exploratory graph analysis revealed that the patterns of association between character strengths and coping strategies varied depending on the type of strength. This study contributes to the literature by confirming the diversity of coping patterns according to individual character strengths and exploring their indirect effects on mental health through mediation. By identifying the factor structure of character strengths in the Korean cultural context and empirically verifying the mediating roles of various coping strategies, the findings suggest the practical applicability of differentiated character strengths-based interventions to promote mental health among university students. Limitations of the study and directions for future research are also discussed. 본 연구는 병리 중심의 접근을 넘어, 개인의 잠재력 발현과 정신건강 증진에 기여하는 성격강점이 국내 대학생의 정신건강(정신적 웰빙 및 우울증상)에 미치는 영향을 살펴보고, 이 관계에서 스트레스 대처방식의 매개역할을 탐색하고자 하였다. 이를 위해 국내 대학생들의 성격강점의 상위 요인구조를 도출하고, 성격강점과 정신건강의 관계에서 스트레스 대처방식의 매개역할을 검증하였다. 온라인 설문조사를 통해 성격강점, 스트레스 대처방식, 정서접근적 대처, 정신적 웰빙, 우울증상을 측정하였으며, 총 311명의 자료를 최종 분석에 활용하였다. 탐색적 요인분석 결과, 24개의 성격강점은 관계적 강점, 사회/정서적 강점, 절제적 강점, 지적 강점, 판단/통찰 강점으로 5개 요인구조가 도출되었고, 위계적 요인분석을 통해 2차 단일요인 구조의 가능성을 검증하였다. 이후 다중매개분석을 통해 성격강점 요인이 정신건강에 미치는 영향과 스트레스 대처방식의 매개역할을 확인하였으며, 성격강점과 스트레스 대처방식 간의 관계를 탐색하기 위해 탐색적 그래프 분석을 추가로 실시하였다.분석 결과, 모든 성격강점 요인은 정신적 웰빙과 정적으로, 우울증상과는 부적으로 유의한 관련을 보였다. 또한 5개의 성격강점 요인은 모든 스트레스 대처방식의 사용을 유의하게 예측하였다. 스트레스 대처방식은 성격강점과 정신건강의 관계를 서로 다른 양상으로 매개하는 것으로 나타났다. 구체적으로 사회적지지추구 대처는 모든 성격강점과 정신적 웰빙 간의 관계를 정적으로 매개하였으며, 절제적 강점을 제외한 4개의 강점요인에서 문제중심 대처의 매개효과가 유의하였다. 반면 소망적 사고 대처는 모든 성격강점 요인과 우울증상의 관계에서 정적인 매개효과를 보였고, 사회/정서적 강점을 제외한 4개의 강점과 우울증상의 관계에서 정서중심 대처의 부적 매개효과가 나타났다. 마지막으로 성격강점과 대처방식 간의 관계를 살펴보기 위한 탐색적 그래프 분석 결과, 성격강점 유형에 따라 각 스트레스 대처방식과의 관계가 상이함을 확인할 수 있었다. 본 연구는 성격강점과 스트레스 대처방식 간의 관계를 통해 개인 특성에 따른 대처 양상의 다양성을 확인하고, 이를 매개로 한 정신건강에 대한 간접효과를 탐색하였다는 점에서 의의가 있다. 특히 국내 문화적 맥락에서 성격강점의 요인구조를 확인하고, 각 스트레스 대처방식의 매개역할을 검증함으로써 대학생의 정신건강 증진을 위한 차별화된 성격강점 기반 개입 및 실천적 활용 가능성을 시사하였다. 끝으로 본 연구의 제한점과 추후 연구에 대한 제언을 논의하였다.