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전산화 주의 재활 훈련이 정신분열병 환자의 인지 기능에 미치는 효과

The Effect of Computerized Attention Training on The Improvement of Cognitive Functions in Patients with Schizophrenia

김명선|장희진
한국임상심리학회 (Korean Clinical Psychology Association)|2011.08|Korean Journal of Clinical Psychology|제30권 제3호|pp. 803-823|DOI 10.15842/kjcp.2011.30.3.010

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참고문헌

키워드

schizophreniacognitive functionneuropsychological test인지기능negative symptom신경심리검사음성증상정신분열병전산화 주의 재활computerized attention training
주제분류심리과학

초록

본 연구는 전산화 주의 재활 훈련이 정신분열병 환자의 인지 기능의 향상과 정신분열병 증상의 완화에 효과적인가를 알아보고자 하였다. 또한 재활을 받은 실험군과 재활을 받지 않은 통제군 외에 한글타자연습을 한 비교군을 포함하여 재활 훈련의 효과가 재활 훈련의 특정 효과를 반영하는지 혹은 컴퓨터 사용 및 실험자와의 상호작용 등과 같은 비특정 효과를 반영하는가를 알아보고자 하였다. 연구 대상으로 정신분열병 환자 40명이 실험군(n=13), 비교군(n=13)과 통제군(n=14)으로 무선 할당되었다. 실험군은 주의 재활 훈련을, 비교군은 한글타자연습을 받았고, 통제군은 아무 처치도 받지 않았다. 주의 재활에는 Bracy(1994)가 개발한 PSS CogReHab를 국내 상황에 맞게 수정하여 개발한 주의 재활 프로그램이 사용되었다. 주의, 시공간 지각/시각 기억, 언어 기억과 집행 기능을 평가하는 신경심리검사와 정신분열병의 증상을 측정하는 PANSS가 재활 훈련 전과 후에 실시되었다. 그 결과, 재활 훈련 전에 실시한 신경심리검사 및 임상 증상의 측정에서 세 집단 간의 유의한 차이가 관찰되지 않았으나 재활 후에 실시한 신경심리검사에서 실험군이 통제군과 비교군에 비하여 Rey 도형검사(Rey Osterrieth Complex Figure Test)의 모사, 지연 회상과 Stroop 검사의 단어-색채 조건에서 유의하게 향상된 수행을 보였다. 이와 더불어 실험군이 다른 두 집단에 비해 재활 후 유의하게 감소된 음성증상과 일반병리를 보였다. 이러한 결과는 주의 재활 훈련이 주의 및 시공간 지각/시각 기억 등의 인지 기능 향상과 정신분열병 증상의 완화에 효과적이라는 것과 정신분열병의 치료에 주의 재활 훈련을 포함한 인지 재활이 필요하다는 것을 시사한다.

Abstract

This study investigated the effect of computerized attention training on the improvement of cognitive functions in patients with schizophrenia. A total of 40 schizophrenic patients were randomly assigned to one of the three groups: the experimental(n=13), comparative(n=13) and control (n=14) groups. The attention training and Korean typing program were administered to the experimental and comparative groups, respectively. No training was given to the control group. The attention training consists of 10 sub-programs, which were developed to train sustained, selective and divided attention. Comprehensive neuropsychological tests such as the Rey-Osterrieth Complex Figure Test(ROCF), the Trail-Making Test, the Stroop test, the K-CVLT, the Wisconsin Card Sorting Test and the PANSS were administered before and after training. The three groups did not differ on the performances of any of the neuropsychological tests and for the PANSS scores administered prior to training. The experimental group showed significantly improved performances on the copy and delayed-recall conditions of the ROCF and the Stroop Color-Word Interference condition, which were administered after training, than did the comparative and control groups. In addition, the experimental group showed significantly reduced negative and general pathological symptoms after training, but the other two groups did not. These results indicate that attention rehabilitation training is effective for improving the cognitive functions of chronic schizophrenic patients. In addition, these results indicate the importance of cognitive rehabilitation for the treatment of schizophrenia.

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