Korean Version Of The Child Behavior Checklist Research Articles

Stress in Caregivers and Children with a Developmental Disorder Who Receive Rehabilitation.

This study aimed to evaluate the stress levels of caregivers and children with developmental disorders who were receiving rehabilitation treatment. The relationships between stress levels and factors such as early rehabilitation and home rehabilitation were quantified. Methods: This study was conducted in children with development disorders, aged from 1.5 years to 18 years, who were undergoing rehabilitation. The Korean version of the Child Behavior Checklist (K-CBCL) and the Adult Self-Report (K-ASR) were used to evaluate stress levels in children and caregivers, respectively. Results: Questionnaires were provided to 150 caregivers who agreed to participate. However, only 76 copies of the K-CBCL and 75 copies of the K-ASR were collected. The mean K-CBCL and K-ASR t scores were in the normal range. The K-CBCL score correlated positively with the K-ASR score (p value < 0.5). K-CBCL externalizing problems score correlated positively with the age at the start of rehabilitation, and the K-CBCL and K-ASR externalizing problems scores correlated negatively with home treatment delivered by caregivers. Conclusions: Stress levels of children and caregivers were closely related. Home rehabilitation provided by caregivers reduced stress in both caregivers and children. Early rehabilitation did not impart additional psychological burden on caregivers or children.

Discriminative Effects of Social Skills Training on Facial Emotion Recognition among Children with Attention-Deficit/Hyperactivity Disorder and Autism Spectrum Disorder.

Objectives:This study investigated the effect of social skills training (SST) on facial emotion recognition and discrimination in children with attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD).Methods:Twenty-three children aged 7 to 10 years participated in our SST. They included 15 children diagnosed with ADHD and 8 with ASD. The participants’ parents completed the Korean version of the Child Behavior Checklist (K-CBCL), the ADHD Rating Scale, and Conner’s Scale at baseline and post-treatment. The participants completed the Korean Wechsler Intelligence Scale for Children-IV (K-WISC-IV) and the Advanced Test of Attention at baseline and the Penn Emotion Recognition and Discrimination Task at baseline and post-treatment.Results:No significant changes in facial emotion recognition and discrimination occurred in either group before and after SST. However, when controlling for the processing speed of K-WISC and the social subscale of K-CBCL, the ADHD group showed more improvement in total (p=0.049), female (p=0.039), sad (p=0.002), mild (p=0.015), female extreme (p=0.005), male mild (p=0.038), and Caucasian (p=0.004) facial expressions than did the ASD group.Conclusion:SST improved facial expression recognition for children with ADHD more effectively than it did for children with ASD, in whom additional training to help emotion recognition and discrimination is needed.

Effects of Early Childhood Peer Relationships on Adolescent Mental Health: A 6- to 8-Year Follow-Up Study in South Korea.

ObjectivePeer relationships are one of the important factors in children's development. The present study examines the relationship between the effects of early peer relationships and adolescent psychological adjustment.MethodsThe first survey took place from 1998 to 2000, and a follow-up assessment obtained data in 2006, as the original participants reached 13–15 years of age. The first assessment used the Korean version of the Child Behavior Checklist (K-CBCL) and simple questions about peer relationships to evaluate the participants. The follow-up assessment administered the Korean Youth Self Report (K-YSR).ResultsChildren's peer relationships have longitudinal effects on mental health and adjustment. Children who had qualitative peer-relation problems were more likely to exhibit internalizing problems as adolescents.ConclusionChildren who have poor peer relationships might become more vulnerable to emotional problems and social adjustment as adolescents.

Epilepsy-related clinical factors and psychosocial functions in pediatric epilepsy

PurposeThe aim of this study was to identify the different influencing patterns of demographic and epilepsy-related variables on various aspects of psychosocial function in pediatric epilepsy. MethodFive hundred ninety-eight patients with pediatric epilepsy between the ages of 4 and 18years (boys=360, 60% and girls=238, 40%) and their parents participated in the study. Parents completed the Social Maturity Scale (SMS), the Korean version of the Child Behavior Checklist (K-CBCL), and the Korean version of the Quality of Life in Childhood Epilepsy Questionnaire (K-QOLCE) to assess daily living function, behavior, and quality of life. The Children's Global Assessment Scale (CGAS) was completed by clinicians to assess general adaptive function. Demographic variables, such as age and sex of child, and epilepsy-related clinical variables, including seizure type, seizure frequency, duration of epilepsy, and number of medications, were obtained from medical records. ResultsDemographic and epilepsy-related clinical variables had a strong influence (22–32%) on the cognition-related domain such as general adaptive function, school/total competence, and quality of life for cognitive function while a comparatively smaller effect (2–16%) on the more psychological domain including behavioral, emotional, and social variables. Younger age, shorter duration of illness, and smaller number of medications showed a strong positive impact on psychosocial function in pediatric epilepsy, particularly for adaptive function, competence, and quality-of-life aspects. ConclusionGiven the wide range of impact of demographic and clinical variables on various facets of psychosocial functions, more specific understanding of the various aspects of factors and their particular pattern of influence may enable more effective therapeutic approaches that address both the medical and psychological needs in pediatric epilepsy.

The validities and efficiencies of korean ADHD rating scale and korean child behavior checklist for screening children with ADHD in the community.

ObjectiveThe purpose of this study is to examine the validity of primary screening tools for attention deficit hyperactivity disorder (ADHD) in a community-based sample of children using the Korean version of the Child Behavior Checklist (K-CBCL) and the Korean version of the ADHD Rating Scale (K-ARS).MethodsA large-scale community-based study for ADHD screening was conducted in the Jeollabuk province in the Republic of Korea. In 2010-2011, we surveyed a total of 49,088 first- and fourth-grade elementary school students. All of the participants in this study were assessed by the K-ARS-Parent version (K-ARS-P) and the K-ARS-Teacher version (K-ARS-T) as the primary screening instruments. The Diagnostic Interview Schedule for Children Version IV (DISC-IV) was used for confirming the diagnosis of ADHD. DISC-IV was administered to subjects who received top 10% scores in the K-ARS-P or K-ARS-T tests.ResultsOf the 3,085 subjects who completed the DISC-IV, 1,215 were diagnosed as having ADHD. A reasonable level of sensitivity, specificity, and negative predictive value were obtained when the total K-ARS-P scores were ≥90th percentile. The positive predictive value and specificity increased significantly when the total K-ARS-P scores were ≥90th percentile, T scores were ≥60 in the attention problems of K-CBCL, and T scores were ≥63 in the total problems of K-CBCL.ConclusionThese results suggested that the K-ARS-P could effectively serve as a primary screening tool to identify elementary school children with ADHD in the community. Also, there might be some increment in the effectiveness of K-ARS-P when combined with K-CBCL-A and K-CBCL-T as a secondary screening tool.

European child and adolescent psychiatry—endorse the importance of prospective longitudinal study designs

This current issue of European child and adolescent psychiatry (ECAP) presents a substantial number of relevant publications. More specifically, two studies on psychopathology present results from Korea [11, 18], one from Finland [19] and one from the Netherlands [20]. Over the years the methodological standards of studies published in ECAP have vastly improved, e.g., in sample size or by implementing a longitudinal design. The value of the latter as well as other methodological improvements has been highlighted by Sir Michael Rutter [16] in ECAP in his review ‘‘Child and adolescent psychiatry: past scientific achievements and challenges for the future’’. The present longitudinal study by Shin et al. [18] is a prime example of these aforementioned advancements. They conducted a baseline examination of parental ratings of 3,808 children aged 6.85 years using the Korean version of the child behavior checklist (K-CBCL). To identify the predictors of juvenile delinquent tendencies, they administered the Korean youth self-report (K-YSR) at the 6to 8-year follow-up for at least 1,821 adolescents aged 13.75 years. This current issue also presents findings by Lee et al. [11] who investigated a large sample, i.e. a total of 4,899 Korean students aged 13–18 years by implementing several self-report forms of questionnaires to identify possible relationships between the Type D personality construct and other mental health measures. Type D personality is characterized by both normal and stable personality traits, negative affectivity (NA, the tendency to experience negative emotions), and social inhibition (SI, the tendency to inhibit expression of emotions). The authors concluded that the administered validated Korean version of the Type D Personality-14 scale (DS14) can be useful in a community mental health program designed for adolescents. Taking into consideration that validity and reliability of the DS14 have been verified in both European and Korean populations, this raises the question as to why the authors, as many others previously, did not conduct a cross-cultural study in an attempt to gain further insights regarding the Type D construct. This shortfall could be seen as a reflection of the small amount of available studies on crosscultural comparisons of psychopathology constructs. Nevertheless, exceptions can be found, also in this issue of ECAP. Veen et al. [21] compared mental health issues between incarcerated adolescents of Dutch and Moroccan origin. Their findings indicate that native Dutch adolescent offenders show higher levels of mental health problems than incarcerated adolescents with an ethnic minority (Moroccan) background. Meanwhile there exists an excellent basic list of steps to be taken to achieve valid assessment across cultures [15]. In a previous editorial, Hoekstra [8] highlighted the need for a long-term perspective in child and adolescent psychiatry. The current issue, but also previous issues of recent years, has presented a large increase in longitudinal studies [1, 2, 5–7, 9, 22]. In addition to the welcome international orientation, ECAP also serves as a platform for innovative topics and findings which at times may seem somewhat ‘‘off the mainstream of research’’. In their present work, de Bruin et al. [3] report that the existence of finger print discordance, as a possible marker of prenatal instability, was associated with the occurrence of formal thought disorder in girls. Similarly, unique topics have been the decreased serum cholesterol levels in child and adolescent psychiatric V. Roessner (&) Department of Child and Adolescent Psychiatry, University of Dresden Medical School, Fetscherstrasse 74, D-01307 Dresden, Germany e-mail: Veit.Roessner@uniklinikum-dresden.de

아동의 우울보고에 따른 부모 아동행동평가의 차이

Objectives : Childhood is a critical period involving various developmental tasks that need to be accomplished. Childhood depression has overall negative implications for certain areas of development, including cognition, emotion, social skills, academic achievement, and ability to cope with stress. Yet, because depression can be "masked" by accompanying behavioral problems, early detection and diagnosis of childhood depression is somewhat challenging. In this study, using the Korean version of the Child Behavior Checklist (K-CBCL), we evaluated the association between children's self reports on depression and parents' assessment of children's behaviors. Methods : Subjects were recruited from the S city, a cohort comprising a non-random convenience sample of 226, 10-year-old ethnic Koreans in their fourth year of elementary school and their parents. All participants underwent several tests, including Children's Depression Inventory (CDI) and K-CBCL. Results : A total of 226 children, including 166 boys (73.5%) and 60 girls (26.5%), participated in the study. The average CDI for the participants was 14.57 (SD=7.54). Two items on the K-CBCL, total scale of adjustment scale and social withdrawal problems, showed a close association with the CDI. Conclusion : Although much remains to be elucidated, after controlling for covariates, the results of this study suggested that behavioral problems observed in children may be closely associated with depression.

Effects of a Responsive Parenting Education Program on Child's Behavioral Problems and Pivotal Developmental Behaviors in Children at Risk for Attention Deficit Hyperactivity Disorder

Purpose: This study was done to determine whether a parenting education program using responsive teaching strategies is effective for parenting stress, maternal interactional behavior and behavioral problems in children at risk for Attention Deficit Hyperactivity Disorder (ADHD). Methods: Participants in this study were 17 elementary school children and their parents. The ADHD risk group was determined by scores on the Korean-ADHD Rating Scale. The parenting education program was developed based on Dr. Mahoney’s responsive teaching curriculum. Mothers participated in the program once a week for 8 sessions. Treatment outcome was evaluated using the Korean version of the Child Behavior CheckList (K-CBCL), parenting stress, maternal interactional behavior, and child pivotal developmental behavior. Data were analyzed using Wilcoxon signed rank test, Mann-Whitney test, and regression analysis. Results: After the parenting education program, no significant difference in parenting stress (Z=-1.00, p=.320) was found, but there was a significant decrease in the child’s internal behavior problems (Z=-2.05, p=.040), and also a significant improvement in maternal interactional behavior and a significant difference in child pivotal developmental behavior (Z=-2.67, p=.008). Conclusion: The results indicate that parenting education programs based on responsive teaching strategies are effective and that application of a program is recommended to prevent behavioral problems and improve maternal child interaction for children at risk for ADHD.

A Comparison of Comorbidity and Psychological Outcomes in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder

ObjectiveThe purpose of this study was to compare psychiatric comorbid disorders and psychological outcomes in children and adolescents with Attention-deficit/hyperactivity disorder (ADHD).MethodsSubjects were divided into a child group (aged under 12 years) and an adolescent group (aged 12 years and above). All subjects were diagnosed with ADHD based on the DSM IV diagnostic criteria using the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Korean Version (K-SADS-PL-K). The K-SADS-PL-K was also used to evaluate those psychiatric disorders comorbid with ADHD. And the Korean version of the Child Behavior Checklist (K-CBCL) was used to examine the subjects' psychological outcomes.ResultsThe rate of comorbidity in adolescent group was significantly higher than that in the child group. In particular, the adolescent group had a significantly higher ratio of comorbid conduct disorder and mood disorder than the child group. With respect to the predominantly inattentive type and Not Otherwise Specified, the school subscale scores on the K-CBCL for the children were significantly higher than those for the adolescents.ConclusionThese results suggest that the psychiatric comorbidity may differ between adolescents and children with ADHD. Therefore when treating adolescents with ADHD, more careful assessment and treatment targeting a range of comorbidities are needed.

학령기 아동 정서.행동문제에 대한 부모-교사 평가 일치도

Objectives：In assessing behavioral/emotional problems in school-aged children, the importance of multi-informant reporting has been well documented. However, in clinical settings obtaining multiple informants’ opinions has proven difficult. For that reason, we researched the agreement and predictive validity of the Child Problem-Behavior Screening Questionnaire (CPSQ) in order to reveal how accurate parents’ assessments reflected teachers'opinions. Methods：We conducted the first screening for second- and third-grade children from 3 elementary schools in Seoul from 2003 to 2007 using the CPSQ. There were 1178 children included in the analysis. We then administered the Korean version of the Child Behavior Checklist (K-CBCL) as a second screening tool and subsequently, the ADHD Diagnostic System (ADS) and the Korean Educational Development Institute version of the Wechsler Intelligence Scale for Chil-dren (KEDI-WISC) was administered by a psychiatrist. We examined each item on the CPSQ and the subscale’s agree-ment between parent and teacher as well as the predictive validity of the CPSQ in children diagnosed with emotional/ behavioral problems. Results：The agreement rates between parents and teachers appeared high for questions 18 (0.433), 1 (0.385), and 2 (0.325). Among the subscales, a relatively high correlation was found for externalizing problems, attention deficit hy-peractivity disorder, and cognitive problems. For all diagnosed children, their parents revealed a higher sensitivity and lower specificity than teachers. Conclusion：From these results, we confirmed that the CPSQ can be useful for sorting out externalizing and cognitive problems. There is a need for further study, however, with a larger sample size. KEY WORDS：Agreement·Child Problem-Behavior Screening Questionnaire·School Teachers ·Parents.

Childhood Predictors of Deliberate Self-Harm Behavior and Suicide Ideation in Korean Adolescents: A Prospective Population-Based Follow-Up Study

The aim of this study was to investigate predictors of adolescence suicidality in a longitudinal study. Additionally, the prevalence of deliberate self-harm behavior and suicide ideation at age 7 and during middle school were examined. Initial assessment data was obtained from 1998 to 2000, and a follow-up assessment was performed in 2006 when the original subjects became middle school students. The addresses and names of 1,857 subjects were located from the original data; they were 910 boys and 947 girls. The subjects were evaluated with the Korean version of the Child Behavior Checklist (K-CBCL), which was administered by the parents of the children, and by various demographic and psychosocial factors. They were reassessed using self reports on the Korea Youth Self Report (K-YSR); in particular, replies to items related to self-harm behavior and suicide ideation were recorded. A logistic regression analysis showed that the factors of gender, economic status, the overall amount of behavior problems, the tendency to internalizing and externalizing problems, somatic problems, thought problems, delinquent behavior, and aggressive behavior were independent predictors of adolescent suicide ideation and self-harm behavior. The importance of total behavior problems suggested that adolescent difficulty is a consequence of an accumulation of various risk factors. Accordingly, clinicians must consider a range of internalizing and externalizing issues, especially overall adaptation, for suicide intervention.

Impact of tonsillectomy on pediatric psychological status

Tonsillectomy is one of the most commonly performed procedures in children. However, parents often hesitate to agree to the procedure because of concerns of the possible harmful impact on their child's psychological health. The present study was performed to examine the short-term psychological impact on children who had undergone tonsillectomy. Forty-three pediatric patients aged 3-11 years who underwent tonsillectomy were enrolled in the study. Postoperative pain was assessed using a 10-point visual analog scale (VAS) on postoperative days 1, 2, 7, and 21. The Korean version of the Child Behavior Checklist (K-CBCL) was given to the parents of the children to evaluate the psychosocial effect of tonsillectomy on the preoperative day and on postoperative day 21. There were no significant differences in postoperative pain according to age, tonsil size, degree of adhesion, or operation time. There was no significant relationship between postoperative pain score and K-CBCL score. Sociality, total behavioral problems, externalizing problems, internalizing problems, anxiety/depression, social immaturity, and emotional lability domain scores on the K-CBCL were improved significantly. Improvements in general emotional and social status were observed at 3 weeks after tonsillectomy. Tonsillectomy itself does not have a harmful effect on children's psychological status.

Predictors of Self-Reported Depression in Korean Children 9 to 12 Years of Age

PurposeThe aim of this study was to evaluate the relationships among various psychosocial factors, behavior problems, and depressive symptoms reported by parents, and to investigate self-reported depression in Korean children using a community sample.Materials and MethodsThe sample consisted of 1279 children between 9 and 12 years of age. The children were evaluated using the Korean version of the Child Behavior Checklist (K-CBCL) and the Child Depression Inventory (CDI).ResultsThe average self-reported depression score as measured by the CDI was 12.34 (SD: 6.79), and a cut-off point of 19 identified approximately 14% of the children as depressed. The group difference was identified by the age at which younger children were found to have higher CDI scores. Univariate logistic regression analysis showed that the high-CDI group and the low-CDI group differed in all behavioral domains identified in the parent-reported subscales of the K-CBCL. Age and father's education level were also independently associated with the risk for childhood depression. In addition, results from the logistic regression analyses indicated that parental reporting of problem internalization, total behavior problems, and social competence were independent predictors of child depression not identified by the anxious/depressed subscale.ConclusionIt is believed that extensive behavioral problems reported by parents and several sociodemographic factors are related to childhood depression. However, parents tend to under-report depressive symptoms relative to what their own children report. Thus, clinicians must consider the self-reports of children related to depression in their diagnosis and intervention, because reports of depressive symptoms from children are more valid measures than those from parents.

Cortisol is inversely correlated with aggression for those boys with attention deficit hyperactivity disorder who retain their reactivity to stress

We examined the relationship between the cortisol response to stress and aggression in patients with attention deficit hyperactivity disorder (ADHD). Based on a report stating that only some of the patients with ADHD retain their hypothalamic-pituitary-adrenal axis reactivity to stress, we separately analyzed the relationship between aggression and the cortisol response to stress in two groups according to their reactivity to stress. Using psychological testing as an indicator of stress, we measured the cortisol level in the saliva before and after administering a psychological test. Behavioral problems, including aggression, were assessed using the Korean version of the Child Behavior Checklist (K-CBCL). The increase of the cortisol level was inversely correlated with aggression in patients who retained their reactivity to stress. The absolute value of the decrease was negatively correlated with the attention score of the CBCL for the patients who showed decreases in cortisol after stress. For the patients who showed increases in their concentration of cortisol in reaction to stress, cortisol may play a protective role against aggression.