본문 바로가기
KERD
논문KCI 등재

주의력 결핍 과잉행동장애의 근거기반치료

Evidence-Based Treatments of Attention Deficit Hyperactivity Disorder

조선미
한국임상심리학회 (Korean Clinical Psychology Association)|2018.11|Korean Journal of Clinical Psychology|제37권 제4호|pp. 621-636|DOI https://doi.org/10.15842/kjcp.2018.37.4.013

0

조회

0

다운로드

7

인용

0

참고문헌

키워드

ADHDbehavioral parent training주의력 결핍 과잉행동장애행동수정에 기반한 부모교육행동수정에 기반한 교실관리행동수정에 기반한 또래관계 개입behavioral classroom managementbehavioral peer interventions
주제분류심리과학

초록

주의력 결핍 과잉행동장애(ADHD)는 아동기에 흔한 장애이며, 아동 및 청소년, 성인기에 이르기까지 영향을 미칠 수 있다. ADHD에 대한심리치료방법이 다양해지면서 예전에 비하면 어떤 방식의 심리치료를 시행할 것인지 정하는 것이 복잡하고 어려워졌다. 본 논문은 ADHD 치료에 대한 문헌을 고찰해 근거가 확립된 치료기법을 확인해보고자 하였다. 미국과 한국에서 이루어진 메타 연구에 따르면 ADHD에 가장 효과가 높은 심리치료는 행동수정에 기반한 부모교육, 행동수정에 기반한 교실 관리, 행동수정에 기반한 또래관계 개입 및 행동적 기법의 조합으로 확인되었다. 즉, 행동수정의 원리가 ADHD의 심리적 개입으로는 가장 우수한 방법이며, 이런 결과는 반복해서 입증되었다. 한국 연구에서는 행동수정 외에 놀이치료나 그림 치료와 같은 방법도 효과가 있는 것으로 나타났으나 연구방식이나 측정도구와 같은 요인이 영향을 미쳤을 것으로 추정되어 추후 잘 설계된 연구를 통해 확인할 필요가 있을 것 같다.

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is a common and impairing disorder affecting children, adolescents, and adults. Due to the increasing range of available options, selection and prioritization of treatments is becoming harder for clinicians. This review aims to provide a review of the literature on evidence-based psychotherapy treatments for ADHD supplemented by expert opinion on plausibility of symptoms improvement. In this paper, several meta-studies, which were conducted mainly in the United State and Korea were reviewed. As a result, behavioral parental training, behavioral classroom management, behavioral peer relationship intervention, and a combination of behavioral techniques were suggested as psychological treatment techniques. These techniques have been repeatedly proven to be effective in well-designed studies. In Korean studies, the effectiveness of non-behavioral techniques such as play therapy or art therapy has been demonstrated. These findings of this review are likely to be influenced by a number of factors such as research design, use of a control group, and measurement selection. Better designed follow-up studies are needed.

참고문헌 (85)

  1. Abikoff, H., "Remediating organizational functioning in children with ADHD : Immediate and long-term effects from a randomized controlled trial", Journal of Consulting and Clinical Psychology, 81, pp.113~ (2013)
  2. Akhondzadeh, S., "Zinc sulfate as an adjunct to methylphenidate for the treatment of attention deficit hyperactivity disorder in children : A double blind and randomized trial", BMC Psychiatry, 4, pp.8~9 (2004)
  3. Anastopoulos, A. D., "Stimulant medication and parent training therapies for attention deficit-hyperactivity disorder", Journal of Learning Disabilities, 24, pp.210~218 (1991)
  4. American Psychiatry Association, "Diagnostic and statistical manual of mental disorders (DSM-5th ed)" (2013), American Psychiatric Pub
  5. Babinski, D. E., "Behavioral observations of parents with ADHD during parent training", Journal of Attention Disorders, 22, pp.1289~1296 (2015)
  6. Barkley, R. A., "Defiant children" (1987), Guilford Press
  7. Barkley, R. A., "Defiant children: A clinician’s manual for assessment and parent training" (2013), Guilford Press
  8. Barkley, R. A., "The unique contribution of emotional impulsiveness to impairment in major life activities in hyperactive children as adults", Journal of the American Academy of Child & Adolescent Psychiatry, 49, pp.503~513 (2010)
  9. Barkley, R. A., "ADHD in adults: What the science says" (2010), Guilford Press
  10. Beck, S. J., "A controlled trial of working memory training for children and adolescents with ADHD", J Clin Child Adolesc Psychol, 39, pp.825~836 (2010)
  11. Bul, K. C., "Behavioral outcome effects of serious gaming as an adjunct to treatment for children with attention-deficit", hyperactivity disorder: A Randomized Controlled Trial, 2016, pp.18, e26~
  12. Chacko, A., "Enhancing traditional behavioral parent training for single mothers of children with ADHD", J Clin Child Adolesc Psychol, 38, pp.206~218 (2009)
  13. 채드E, "Knowledge, attitudes, and usage of evidence-based assessment and treatment practices in the Korean mental health system: Current status and future directions", Korean Journal of Clinical Psychology, 33(4), pp.891~917 (2014), 한국임상심리학회[DOI]
  14. Chambless, D. L., "Empirically supported psychological interventions : Controversies and evidence", Annual Review of Psychology, 52, pp.685~716 (2001)
  15. Chronis-Tuscano, A., "Personalized treatment of mothers with ADHD and their young at-risk children : A SMART pilot", Journal of Clinical Child & Adolescent Psychology, 45, pp.510~521 (2016)
  16. Correll, C. U., "Endocrine and metabolic adverse effects of psychotropic medications in children and adolescents", Journal of the American Academy of Child & Adolescent Psychiatry, 45, pp.771~791 (2006)
  17. Danforth, J. S., "A Flow Chart of Behavior Management Strategies for Families of Children with Co-Occurring Attention-Deficit Hyperactivity Disorder and Conduct Problem Behavior", Behavior Analysis in Practice, 9, pp.64~76 (2016)
  18. Dinkmeyer, D., "Parenting Young Children, Systematic Training for Effective Parenting of Children Under Six", pp.74~91 (1997), American Guidance Service
  19. Dosreis, S., "Parental perceptions and satisfaction with stimulant medication for attention-deficit hyperactivity disorder", Journal of Developmental & Behavioral Pediatrics, 24, pp.155~162 (2003)
  20. DuPaul, G., "Comparison of parent education and functional assessment-based intervention across 24 months for young children with attention deficit hyperactivity disorder", School Psychology Review, 42, pp.56~ (2013)
  21. Erhardt, D., "Initial sociometric impressions of attention-deficit hyperactivity disorder and comparison boys : Predictions from social behaviors and from nonbehavioral variables", Journal of Consulting and Clinical Psychology, 62, pp.833~ (1994)
  22. Evans, S. W., "Evidence-based psychosocial treatments for children and adolescents with attention-deficit", hyperactivity disorder, 2014, pp.43, 527~551
  23. Evans, S. W., "Effectiveness of the Challenging Horizons after-school program for young adolescents with ADHD", J Behavior therapy, 42, pp.462~474 (2011)
  24. Fabiano, G. A., "A meta-analysis of behavioral treatments for attention-deficit", hyperactivity disorder, 2009, pp.29, 129~140
  25. Fabiano, G. A., "A waitlist-controlled trial of behavioral parent training for fathers of children with ADHD", Journal of Clinical Child Adolescent Psychology, 41, pp.337~345 (2012)
  26. Fabiano, G. A., "Enhancing the effectiveness of special education programming for children with attention deficit hyperactivity disorder using a daily report card", School Psychology Review, 39, pp.219~ (2010)
  27. Fabiano, G. A., "Enhancing the effectiveness of special education programming for children with attention deficit hyperactivity disorder using a daily report card", School Psychology, 39, pp.219~239 (2010)
  28. Faraone, S. V., "The age-dependent decline of attention deficit hyperactivity disorder : A Meta-Analysis of Follow-up Studies", Psychological Medicine, 36, pp.159~165 (2006)
  29. Froehlich, T. E., "Prevalence, recognition, and treatment of attention-deficit", hyperactivity disorder in a national sample of US children, 2007, pp.161, 857~864
  30. Gevensleben, H., "Distinct EEG effects related to neurofeedback training in children with ADHD : A randomized controlled trial", International Journal of Psychophysiology, 74, pp.149~157 (2009)
  31. Graham, J., "European guidelines on managing adverse effects of medication for ADHD", European Child & Adolescent Psychiatry, 20, pp.17~37 (2011)
  32. Grizenko, N., "Is the inattentive subtype of ADHD different from the combined", hyperactive subtype?, 2010, pp.13, 649~657
  33. Grizenko, N., "Relation of maternal stress during pregnancy to symptom severity and response to treatment in children with ADHD", Journal of Psychiatry & Neuroscience, 33, pp.10~ (2008)
  34. Hales, R. E., "The American psychiatric publishing textbook of psychiatry" (2008), American Psychiatric Pub
  35. Harpin, V. A., "The effect of ADHD on the life of an individual, their family, and community from preschool to adult life", Archives of Disease in Childhood, 90(suppl 1), pp.2~7 (2005)
  36. Hunt, R. D., "An open trial of guanfacine in the treatment of attention-deficit hyperactivity disorder", Journal of the American Academy of Child & Adolescent Psychiatry, 34, pp.50~54 (1995)
  37. Jans, T., "Does intensive multimodal treatment for maternal ADHD improve the efficacy of parent training for children with ADHD? A randomized controlled multicenter trial", Journal of Child Psychology and Psychiatry, 56, pp.1298~1313 (2015)
  38. Jensen, P. S., "A 14-month randomized clinical trial of treatment strategies for attention-deficit", hyperactivity disorder, 1999, pp.56, 1073~1086
  39. Jensen, P. S., "Comorbidity in ADHD : Implications for research, practice, and DSM-V", Journal of the American Academy of Child & Adolescent Psychiatry, 36, pp.1065~1079 (1997)
  40. Johnson, M., "Omega-3", omega-6 fatty acids for attention deficit hyperactivity disorder : A randomized placebo-controlled trial in children and adolescents, 2009, pp.12, 394~401
  41. Kanarek, R. B., "Does sucrose or aspartame cause hyperactivity in children?", Nutrition reviews, 52, pp.173~175 (1994)
  42. Kazdin, A. E., "Parent management training: Treatment for oppositional, aggressive, and antisocial behavior in children and adolescents" (2008), Oxford University Press
  43. Kessler, R. C., "The prevalence and correlates of adult ADHD in the United States : results from the National Comorbidity Survey Replication", American Journal of psychiatry, 163, pp.716~723 (2006)
  44. 김재원, "지역사회에서의 주의력결핍-과잉행동장애 선별기준에 대한 연구", 신경정신의학, 43(2), pp.200~208 (2004), 대한신경정신의학회
  45. Knouse, L. E., "Recent developments in the psychosocial treatment of adult ADHD", Expert Review of Neurotherapeutics, 8, pp.1537~1548 (2008)
  46. Konofal, E., "Effects of iron supplementation on attention deficit hyperactivity disorder in children", Pediatric Neurology, 38, pp.20~26 (2008)
  47. Langberg, J. M., "Parent-reported homework problems in the MTA study : Evidence for sustained improvement with behavioral treatment", Journal of Clinical Child & Adolescent Psychology, 39, pp.220~233 (2010)
  48. Langberg, J. M., "Evaluation of the Homework, Organization, and Planning Skills(HOPS)intervention for middle school students with ADHD as implemented by school mental health providers", School Psychology Review, 41, pp.342~364 (2012)
  49. Mabe, P. A., "Parent management training", Child and Adolescent Psychiatric Clinics, 10, pp.451~464 (2001)
  50. Maleki, Z. H., "Barkley’s parent training program, working memory training and their combination for children with ADHD : Attention Deficit Hyperactivity Disorder", Iranian journal of psychiatry, 9, pp.47~ (2014)
  51. Mannuzza, S., "Long-term prognosis in attention-deficit", hyperactivity disorder, 2000, pp.9, 711~726
  52. McGrath, P. J., "Telephonebased mental health interventions for child disruptive behavior or anxiety disorders : Randomized trials and overall analysis", Journal of the American Academy of Child & Adolescent Psychiatry, 50, pp.1162~1172 (2011)
  53. Meyer, K., "Improving homework in adolescents with attention-deficit", hyperactivity disorder : Self vs. parent monitoring of homework behavior and study skills, 2007, pp.29, 25~42
  54. Mikami, A., "Parental influence on children with attention-deficit", hyperactivity disorder : II. Results of a pilot intervention training parents as friendship coaches for children, 2010, pp.38, 737~749
  55. Mikami, A. Y., "A randomized trial of a classroom intervention to increase peers’ social inclusion of children with attention-deficit", hyperactivity disorder, 2013, pp.81, 100~
  56. Molina, B. S., "Feasibility and preliminary efficacy of an after-school program for middle schoolers with ADHD : A randomized trial in a large public middle school", Journal of Attention Disorders, 12, pp.207~217 (2008)
  57. Mostofsky, S. H., "Response inhibition and response selection : two sides of the same coin", Journal of Cognitive Neuroscience, 20, pp.751~761 (2008)
  58. Newcorn, J. H., "Symptom profiles in children with ADHD : Effects of comorbidity and gender", Journal of the American Academy of Child & Adolescent Psychiatry, 40, pp.137~146 (2001)
  59. Nigg, J. T., "Meta-analysis of attention-deficit", hyperactivity disorder or attention-deficit, Journal of the American Academy of Child & Adolescent Psychiatry, pp.2012, 51[DOI]
  60. Olfson, M., "National trends in the use of psychotropic medications by children", Journal of the American Academy of Child & Adolescent Psychiatry, 41, pp.514~521 (2002)
  61. 박완주, "한국 학령기 ADHD 아동을 위한 인지행동중재의 효과 연구: 메타분석", Journal of Korean Academy of Nursing, 45(2), pp.169~182 (2015), 한국간호과학회
  62. Pelham, E. W., "Evidencebased assessment of attention deficit hyperactivity disorder in children and adolescents", Journal of Clinical Child and Adolescent Psychology, 34, pp.449~476 (2005)
  63. Pelham, W. E., "Evidence-based psychotherapies for children and adolescents", pp.277~292 (2010), Guilford Press
  64. Pelham, W. E. Jr., "Evidence-based psychosocial treatments for attention-deficit", hyperactivity disorder, 2008, pp.37, 184~214
  65. Pfiffner, L. J., "Attention Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment, 3", pp.547~589 (2006)
  66. Pfiffner, L. J., "A randomized, controlled trial of integrated home-school behavioral treatment for ADHD, predominantly inattentive type", Journal of the American Academy of Child Adolescent Psychiatry, 46, pp.1041~1050 (2007)
  67. Power, T. J., "A family–school intervention for children with ADHD : Results of a randomized clinical trial", Journal of Consulting & Clinical Psychology Review, 80, pp.611~ (2012)
  68. Price, T. S., "Continuity and change in preschool ADHD symptoms : longitudinal genetic analysis with contrast effects", Behavior Genetics, 35, pp.121~132 (2005)
  69. Prince, J. B., "Pharmacotherapy of attention-deficit hyperactivity disorder in children and adolescents : update on new stimulant preparations, atomoxetine, and novel treatments", Child and Adolescent Psychiatric Clinics, 15, pp.13~50 (2006)
  70. Rajwan, E., "Evaluating clinically significant change in mother and child functioning : Comparison of traditional and enhanced behavioral parent training", Journal of Abnormal Child Psychology, 42, pp.1407~1412 (2014)
  71. Rasmussen, P., "Natural outcome of ADHD with developmental coordination disorder at age 22 years : A controlled, longitudinal, community-based study", Journal of the American Academy of Child & Adolescent Psychiatry, 39, pp.1424~1431 (2000)
  72. Rimestad, M. L., "Short-and long-term effects of parent training for preschool children with or at risk of ADHD: A systematic review and meta-analysis", Journal of Attention Disorders, pp.1087054716648775~ (2016)
  73. Schoenwald, S. K., "Multisystemic therapy : Monitoring treatment fidelity", Family Process, 39, pp.83~103 (2000)
  74. 서지영, "학령기 ADHD아동을 위한 비약물적 중재 프로그램의 경향과 효과에 대한 메타분석", 정신간호학회지, 19(2), pp.117~132 (2010), 한국정신간호학회
  75. 신윤미, "주의력결핍 과잉행동장애 한국형 치료 권고안(IV) - 비약물적 치료 -", Journal of the Korean Academy of Child and Adolescent Psychiatry, 28(2), pp.84~95 (2017), 대한소아청소년 정신의학회[DOI]
  76. Sonuga-Barke, E. J., "Nonpharmacological interventions for ADHD : Systematic review and meta-analyses of randomized controlled trials of dietary and psychological treatments", American Journal of Psychiatry, 170, pp.275~289 (2013)
  77. Sprich, S. E., "A randomized controlled trial of cognitive behavioral therapy for ADHD in medication‐treated adolescents", Journal of Child Psychology and Psychiatry, 57, pp.1218~1226 (2016)
  78. Steeger, C. M., "Combined cognitive and parent training interventions for adolescents with ADHD and their mothers : A randomized controlled trial", Child Neuropsychology, 22, pp.394~419 (2016)
  79. Swanson, J. M., "Clinical relevance of the primary findings of the MTA : Success rates based on severity of ADHD and ODD symptoms at the end of treatment", Journal of the American Academy of Child & Adolescent Psychiatry, 40, pp.168~179 (2001)
  80. Tamm, L., "Preliminary data suggesting the efficacy of attention training for school-aged children with ADHD", Developmental Cognitive Neuroscience, 4, pp.16~28 (2013)
  81. Thompson, M. J., "A small-scale randomized controlled trial of the revised new forest parenting programme for preschoolers with attention deficit hyperactivity disorder", European Child and Adolescent Psychiatry, 18, pp.605~616 (2009)
  82. Van Den Hoofdakker, B. J., "Effectiveness of behavioral parent training for children with ADHD in routine clinical practice : A randomized controlled study", Journal of the American Academy of Child Adolescent Psychiatry, 46, pp.1263~1271 (2007)
  83. Van der Oord, S., "A pilot study of the efficacy of a computerized executive functioning remediation training with game elements for children with ADHD in an outpatient setting : Outcome on parentand teacher-rated executive functioning and ADHD behavior", Journal of Attention Disorders, 18, pp.699~712 (2014)
  84. Willcutt, E. G., "The prevalence of DSM-IV attention-deficit", hyperactivity disorder : A meta-analytic review, 2012, pp.9, 490~499
  85. Xie, Y., "A study on the effectiveness of videoconferencing on teaching parent training skills to parents of children with ADHD", Telemedicine and e-Health, 19, pp.192~199 (2013)

관련 논문AI추천

ADHD 아동⋅청소년의 비약물적 중재에 대한 고찰이상훈한국정서행동장애학회 · 정서·행동장애연구2022 · 제38권 제2호주의력결핍 과잉행동장애에 대한 행동치료의 논점문장원국립특수교육원 · 특수교육연구2006 · 제13권 제1호주의력 결핍？과잉행동장애 아동을 위한 부모훈련 프로그램 중재효과에 관한 고찰강옥려한국특수교육문제연구소 · 특수교육저널:이론과 실천2007 · 제8권 제1호ADHD 아동 및 청소년의 학업문제에 대한 비약물적 개입의 동향과 과제김윤희, 서수균한국심리학회산하학교심리학회 · 한국심리학회지:학교2011 · 제8권 제1호학령기 ADHD 아동 비약물중재 효과에 대한 메타분석: 단일대상연구를 중심으로구승영, 김동일, 안예지한국정서행동장애학회 · 정서·행동장애연구2016 · 제32권 제1호ADHD 아동 프로그램 효과성에 관한 다층메타분석전동일, 정춘희한국장애인평생교육복지학회 · 장애인평생교육복지연구2025 · 제11권 제1호

이 간행물의 다른 논문 (14건)

우울증 환자 집단에서 비자살적자해가 자살시도에 미치는 영향장혜인, 이승환, 김초롱pp. 465-478성장글쓰기가 데이트 폭력 피해자의 기본 세계관과 친밀한 관계에 대한 두려움에 미치는 영향현명호, 홍혜인pp. 479-490분노표현양식이 폭식행동에 미치는 영향: 부정정서 조급성의 매개 효과박경, 임지수pp. 491-502가족응집성과 폭식행동의 관계에서 자기위로능력과 우울의 매개 효과이종헌, 박기환pp. 503-514Emotional Distress Tolerance and Pain Tolerance: The Moderating Effect of Painful Events서장원pp. 515-521
원문 보기