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ADHD 아동․청소년에 대한 한국판 CBCL6-18의 진단 변별력

Clinical Utility of the Korean Version of CBCL6-18 in the Diagnosis of Attention-Deficit Hyperactivity Disorder

김영아|오경자|신예주|신민섭|윤현수|이서정|김붕년
한국임상심리학회 (Korean Clinical Psychology Association)|2015.11|Korean Journal of Clinical Psychology|제34권 제4호|pp. 829-850|DOI 10.15842/kjcp.2015.34.4.001

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키워드

주의력결핍 과잉행동장애CBCL6-18DSM ADHD 척도attention deficit/hyperactivity disorderDSM-oriented ADHD problems scale
주제분류심리과학

초록

본 연구에서는 주의력결핍 과잉행동장애(ADHD) 아동․청소년의 변별에 있어 한국판 CBCL6-18의 각 척도 점수가 갖는 임상적 유용성을 검증하고자 하였다. 이를 위해 단일진단을 받은 43명의 ADHD 주의력결핍 우세형 집단(남 35, 여 8, 평균 연령 9.77세)과 34명의 ADHD 복합형 집단(남 31, 여 3, 평균 연령 9.12세), 각 ADHD 집단과 연령 및 성별을 일치시킨 동수의 일반 비교집단, ADHD 이외의 단일진단을 받은 임상 비교집단(남 26, 여 16, 평균 연령 12.07세)을 구성하였다. ANOVA와 ROC 분석을 실시한 결과 CBCL6-18의 모든 척도는 두 ADHD 집단을 일반 비교집단으로부터 잘 변별하였으며, DSM ADHD 척도를 비롯한 다수의 척도들은 두 ADHD 집단과 임상 비교집단도 우수하게 변별하였다. 최적의 절단점 탐색을 위한 승산비 분석 결과 현재 사용되고 있는 절단점의 효과는 통계적으로 유의미하였는데, 일반 비교집단에서 ADHD 사례를 선별해내고자 할 경우 보다 낮은 절단점을 사용하는 것이 효과적일 가능성이 시사되었다. 이러한 결과를 바탕으로, 임상 현장에서 CBCL6-18을 사용하여 ADHD 사례를 선별하고자 할 때 참고할만한 본 연구의 함의와 추후 연구 필요성을 논의하였다.

Abstract

The purpose of this study was to examine the clinical utility of the Korean version of the Child Behavior Checklist for Ages 6-18 (CBCL6-18) subscales for predicting Attention Deficit/Hyperactive Disorder (ADHD) group from non-referred and non-ADHD psychiatric control groups. The ADHD inattentive type group included 43 (35 boys, 8 girls, age range 6-18, mean age 9.77 yrs) participants and the ADHD combined type group included 34 (31 boys, 3 girls, age range 7-14, mean age 9.12 yrs) participants. The non-referred group was demographically matched for sex and age (n=77, mean age 9.48) to each ADHD group. The non-ADHD psychiatric control group consisted of 26 boys and 16 girls (age range 7-16, mean age 12.07 yrs). An ANOVA, ROC curve analysis, and odds ratio analysis were performed on all the scales of CBCL6-18 data obtained on the participants. The overall results supported the efficiency and clinical utility of several scales of the CBCL6-18 in discriminating between ADHD and non-ADHD groups, and the DSM ADHD scale was the most successful. The clinical cutoff-score-criteria adopted for the CBCL6-18 were shown to be statistically valid, but lower cutoff score is more effective for discriminating the ADHD group from the non-referred group. The implications of using the CBCL6-18 in Korea as a clinical tool for diagnosing ADHD were discussed.

참고문헌 (57)

  1. 김영신, "한국어판 부모 및 교사용 ADHD 평가 척도(K-ARS)의 규준연구", 신경정신의학, 42(3), pp.352~359 (2003), 대한신경정신의학회
  2. 김정민, "중학생의 주의집중 문제와 학교생활적응의 관계에서 우울의 매개효과", 한국청소년연구, 25(1), pp.5~27 (2014), 한국청소년정책연구원[DOI]
  3. 김지혜, "주의력결핍", 과잉운동행동장애(ADHD)아동의 진단도구로서 부모용 행동 평가지의타당도 연구 : 한국아동인성검사와 아동, 청소년 행동평가척도를 중심으로, 2000, pp.11, 282~289
  4. 보건복지부, "문제행동아동 조기개입서비스 매뉴얼 개발", ~ (2010)
  5. 안동현, "청소년 정신건강장애", 대한의사협회지, 52(8), pp.745~757 (2009), 대한의사협회
  6. 오경자, "ASEBA 아동․청소년행동평가척도 매뉴얼" (2010), ㈜휴노
  7. 오경자, "아동, 청소년 행동평가척도(K-CBCL)" (1997), 중앙적성연구소
  8. 오경자, "주의력 결핍 과잉 활동증 평가도구로서의 단축형 Conners 평가척도의 활용", 한국심리학회지 : 임상, 8(1), pp.135~142 (1989)
  9. 유숙경, "뇌병변장애를 가진ADHD 청소년의 미술치료가 주의집중문제와 공격행동에 미치는 영향", 한국상담심리치료학회지, 4(1), pp.21~39 (2013)
  10. 이수진, "ROC 분석을 통한 주의력결핍 과잉행동장애 아동의 변별: K-CBCL 소척도를 기준으로", Korean Journal of Clinical Psychology, 27(1), pp.191~207 (2008), 한국임상심리학회
  11. 이해영, "아동․청소년 주의력결핍 과잉행동장애 평가에서 (전산화)신경심리검사의 기여도", 정서·행동장애연구, 28(4), pp.143~171 (2012), 한국정서·행동장애아교육학회
  12. Achenbach, T. M., "DSM-oriented and empirically based approaches to constructing scales from the same item pools", Journal of Clinical Child and Adolescent Psychology, 32(3), pp.328~340 (2003)
  13. Achenbach, T. M., "Manual for the ASEBA School-Age Forms &Profiles" (2001), University of Vermont, Research Center for Children, Youth, & Families
  14. Aebi, M., "Accuracy of the"DSM"-Oriented Attention Problem Scale of the Child Behavior Checklist in Diagnosing Attention-Deficit Hyperactivity Disorder", Journal of Attention Disorders, 13(5), pp.454~463 (2010)
  15. American Psychiatric Association, "Diagnostic and statistical manual of mental disorders" (2013), American Psychiatric Association
  16. Angold, A., "Comorbidity", Journal of Child Psychology and Psychiatry, 40(1), pp.57~87 (1999)
  17. Aschenbrand, S. G., "Discriminant validity and clinical utility of the CBCL with anxiety-disordered youth", Journal of Clinical Child and Adolescent Psychology, 34, pp.735~746 (2005)
  18. Bagwell, C. L., "ADHD and problems in peers relations : predictors from childhood to adolescence", Journal of the American Academy of Child and Adolescent Psychiatry, 40, pp.1285~1292 (2001)
  19. Barkley, R. A., "Distinguishing sluggish cognitive tempo from attention-deficit", hyperactivity disorder in adults, 2012, pp.121(4), 978~
  20. Barkely, R. A., "Distinguishing sluggish cognitive tempo from ADHD in children and adolescent : executive functioning, impairment, and comorbidity", Journal of Clinical Child &Adolescent Psychology, 42(2), pp.161~173 (2013)
  21. Barkley, R. A., "Comprehensive evaluation of attention deficit disorder with ad without hyperactivity as defined by research criteria", Journal of Consulting and Clinical Psychology, 58, pp.775~789 (1990)
  22. Barkley, R. A., "Young adult follow-up of hyperactive children : Antisocial activities and drug use", Journal of Child Psychology and Psychiatry, 45, pp.195~211 (2004)
  23. Barkley, R. A., "ADHD in adults : What the science says" (2008), Guilford
  24. Biederman, J., "CBCL clinical scales discriminate ADHD youth with Structured-Interview Derived Diagnosis of Oppositional Defiant Disorder(ODD)", Journal of Attention Disorders, 12(1), pp.76~82 (2008)
  25. Danckaerts, M., "Self-report of attention deficit and hyperactivity disorder in adolescents", Psychopathology, 32(2), pp.81~92 (1999)
  26. DeWolfe, N. A., "ADHD in preschool : parent-rated psychosocial correlates", Developmental Medicine &Child Neurology, 42, pp.825~830 (2000)
  27. DuPaul, G. J., "Teacher ratings of attetion deficit hyperactivity disorder symptoms : Factor structure and normative data", Psychological Assessment, 9, pp.436~444 (1997)
  28. Eiraldi, R., "Patterns of comorbidity associated with subtypes of attention-deficit", hyperactvity disorder among 6 to 12-year-old children, 1997, pp.36, 503~514
  29. Falsetti, S. A., "The Modified PTSD Symptom Scale : A brief self-report measure of posttraumatic stress disorder", Behaviour Therapist, 16, pp.161~162 (1993)
  30. Fletcher, K., "A sequential analysis of the mother-adolescent interactions of ADHD, ADHD", ODD, and Normal teenagers neutral and conflict discussions, 1996, pp.24, 271~298
  31. Hinshaw, S. P., "Preadolescent girls with attention-deficit", hyperactivity disorder : I. Background characteristics, comorbidity, cognitive and social functioning, and parenting practices, 2002, pp.70(5), 1086~
  32. Hinshaw S. P., "Diagnostic assessment in child and adolescent psychopathology", pp.91~126 (1999), Guilford Press
  33. Holmes, W. C., "A short, psychiatric, case-finding measure for HIV seropositive outpatients", Medical Care, 36(2), pp.237~243 (1998)
  34. Jensen, P. S., "Comorbidity in ADHD : Implications for research, practice, and DSM-V", Journal of the American Academy of Child and Adolescent Psychiatry, 36, pp.1065~1079 (1997)
  35. Keenan, K., "More than the terrible twos : The nature and severity of disruptive behavior problems in clinic-referred preschool children", Journal of Abnormal Child Psychology, 28, pp.33~46 (2000)
  36. Kendall, P. C., "아동․청소년 심리치료" (2010), 학지사
  37. Kim, J. Y., "An epidemiological study of attention-deficit hyperactivity disorder and learning disabilities in a rural area", Journal of Korean Neuropsychiatric Association, 38(4), pp.784~793 (1999)
  38. Lacalle, M., "DSM-oriented scales of the Child Behavior Checklist and Youth Self-Report in clinically referred Spanish children", The Spanish Journal of Psychology, 15(1), pp.377~387 (2012)
  39. Lahey, B. B., "Attention deficit disorder with and without hyperactivity : comparison of behavioral characteristics of clinic-referred children", Journal of the American Academy of Child & Adolescent Psychiatry, 26(5), pp.716~723 (1987)
  40. Lahey, B. B., "Attention Deficit Hyperactivity Disorder: State of the Science" (2002), Civic Research Institute
  41. Lahey, B. B., "Predictive validity of a continuous alternative to nominal subtypes of attention-deficit", hyperactivity disorder for DSM–V, 2010, pp.39(6), 761~775
  42. Lampert, T. L., "Diagnostic performance of the CBCL-Attention Problem Scale as a screening measure in a sample of Brazilian children with ADHD", Journal of Attention Disorders, 8(2), pp.63~71 (2004)
  43. Luoto, M., "Evaluation of current statistical approaches for predictive geomorphological mapping", Geomorphology, 67, pp.299~315 (2005)
  44. Millch, R., "ADHD combined type and ADHD predominantly inattentive type are distinct and unrelated disorders", Clinical Psychology : Science and Practice, 8(4), pp.463~488 (2001)
  45. Matier-Sharma, N., "Differential diagnosis of ADHD: Are objective measures of attention, impulsivity, and activity level helpful?", Child Neuropsychology, 1, pp.118~127 (1995)
  47. Morgan, A. E., "Validity of DSM-IV ADHD predominantly inattentive and combined types : Relationship to previous DSM diagnoses", subtype differences, 1996, pp.35, 325~333
  48. Moruzzi, S., "A twin study of the relationships among inattention, hyperactivity", impulsivity and sluggish cognitive tempo problems, 2014, pp.42(1), 63~75
  49. Nakamura, B. J., "A psychometric analysis of the child behavior checklist DSM-oriented scales", Journal of Psychopathology and Behavioral Assessment, 31(3), pp.178~189 (2009)
  50. Nigg, J. T., "What is to be the fate of ADHD subtypes? An introduction to the special section on research on the ADHD subtypes and implications for the DSM–V", Journal of Clinical Child & Adolescent Psychology, 39(6), pp.723~725 (2010)
  51. Ostrander, R., "Diagnosing attention deficit disorders with eh Behavioral Assessment System for Children and the Child Behavior Checklist : test and construct validity analyses using optimal discriminant classification trees", Journal of Consulting and Clinical Psychology, 66, pp.660~672 (1998)
  52. Robin, A., "Attention-deficit", hyperactivity disorder in adolescents : common pediatric concerns, 1999, pp.46(5), 1027~1038
  53. Roessner, V., "A cross-cultural comparison between samples of Brazilian and German children with ADHD", HD using the Child Behavior Checklist, 2007, pp.257(6), 352~359
  54. Sheehan, D. V., "Reliability and validity of the mini international neuropsychiatric interview for children and adolescents(MINI-KID)", The Journal of Cinical Psychiatry, 71(3), pp.313~326 (2010)
  55. Willcutt, E. G., "Understanding the complex etiologies of developmental disorder : Behavioral and molecular genetic approaches", Journal of Developmental and Behavioral Pediatrics, 31(7), pp.533~544 (2010)
  56. Wolraich, M. I., "Comparison of diagnostic criteria for attention-deficit hyperactivity disorder in a country wide sample", Journal of the America Academy of Child and Adolescent Psychiatry, 35, pp.319~324 (1996)
  57. Yoo, S. W., "Validity of Korean version of the mini-international neuropsychiatric interview", Anxiety and Mood, 2, pp.50~55 (2006)

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ROC 분석을 통한 주의력결핍 과잉행동장애 아동의 변별: K-CBCL 소척도를 기준으로오경자, 이수진, 하은혜한국임상심리학회 · Korean Journal of Clinical Psychology2008 · 제27권 제1호한국판 CBCL 1.5-5의 변별타당도 및 임상적 유용성이진, 김영아, 오경자한국임상심리학회 · Korean Journal of Clinical Psychology2009 · 제28권 제1호지역사회 유아 ADHD 선별에서 CBCL 1.5-5 유아용 행동평가척도의 유용성장은경, 하은혜한국임상심리학회 · Korean Journal of Clinical Psychology2009 · 제28권 제1호주의력결핍 과잉행동장애에서 아동행동평가척도, 아동인성검사, 주의력장애 진단시스템： 주의력결핍 과잉행동장애의 진단에서 차원적 진단도구들의 역할김현우, 도진아, 임명호, 조환일대한불안의학회 · 대한불안의학회지2009 · 제5권 제2호한국어판 부모, 교사 ADHD 평가 척도의 신뢰도와 타당도 연구고선규, 고윤주, 김영신, 노주선, 소유경대한신경정신의학회 · 신경정신의학2002 · 제41권 제2호심리장애 진단아동의 K-CBCL 아동 청소년 행동평가척도 군집분석김명선, 오경자, 하은혜한국임상심리학회 · Korean Journal of Clinical Psychology2014 · 제33권 제4호

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