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시공간 재활 훈련이 정신분열병 환자의 인지 기능에 미치는 효과

The effect of visuospatial rehabilitation training on improvement of cognitive functions in patients with schizophrenia

김명선|장희진|김선경|박혜정
한국임상심리학회 (Korean Clinical Psychology Association)|2008.02|Korean Journal of Clinical Psychology|제27권 제1호|pp. 51-68|DOI 10.15842/kjcp.2008.27.1.004

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참고문헌

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schizophrenia신경심리검사정신분열병neuropsychological testsvisuospatial perception시공간 지각시공간 재활훈련visuospatial rehabilitation training
주제분류심리과학

초록

만성 정신분열병 환자를 대상으로 시공간 재활 훈련을 실시한 후 재활 훈련이 환자의 인지 기능 향상에 효과적인가를 조사하였다. 사회복귀 시설에 거주하는 22명의 정신분열병 환자가 연구에 참여하였으며, 이들을 재활군(n=11)과 통제군(n=11)으로 무선적으로 구분하였다. 재활군에 포함된 환자들에게는 시공간 재활 훈련이 실시된 반면 통제군에 포함된 환자들에게는 재활 훈련이 실시되지 않았다. 시공간 재활 훈련은 10개의 하위 프로그램으로 구성되었으며, 시운동 기술, 시지각력, 심상 및 회전, 공간 지각력과 시각적 통합 능력을 훈련하도록 개발되었다. 시공간 지각력/시각 기억(Rey-Osterrieth Complex Figure Test: ROCF), 주의(Stroop Color-Word Test, Trail-Making Test: TMT, d2 Test), 언어 기억(Korean-California Verbal Learning Test: K-CVLT) 및 집행 기능(Wisconsin Card Sorting Test: WCST)을 평가하는 신경심리검사와 정신분열병의 증상을 측정하는 임상 검사(The Positive and Negative Syndrome Scale: PANSS)가 재활 훈련 전과 후에 실시되었다. 재활 훈련 전에 실시한 신경심리 검사 및 임상 검사에서 두 집단 간에 유의한 차이가 관찰되지 않았다. 그러나 재활 후에 실시된 신경심리 검사에서 재활군이 통제군에 비하여 ROCF의 모사, Stroop Color-Word Test의 Color-Word 간섭조건과 TMT, part B에서 유의하게 수행이 향상되었고, 음성 증상의 완화를 보였다. 이 결과는 시공간 재활 훈련이 만성 정신분열병 환자의 인지 기능의 향상에 효과적이라는 것과 시공간 재활 훈련이 시공간 기능뿐만 아니라 주의의 향상에도 효과적인 것으로 미루어 시공간 지각의 장애가 주의 등과 같은 인지 기능의 장애와 관련되어 있음을 시사한다.

Abstract

This study investigated the effect of visuospatial rehabilitation training on the improvement of cognitive functions in schizophrenic patients. A total of 22 patients living at the Institute for Social Return participated. The rehabilitation group and the control group each consisted of 11 patients. The visuospatial training consists of 10 sub-programs, which were developed to train the visuomotor skills, visual perception, visual imagery & rotation, spatial perception and visual integration skills. Comprehensive neuropsychological tests such as Rey-Osterrieth Complex Figure Test(ROCF), Trail-Making Test(TMT), Stroop test, d2 test, K-CVLT, Wisconsin Card Sorting Test(WCST) and PANSS were administered before and after the training. There were no significant differences between the two groups in terms of demographic variables such as age, IQ, educational level, age of onset. The two groups did not differ on the performances of any of the neuropsychological tests and the PANSS scores administered prior to rehabilitation training. The rehabilitation group showed significantly improved performances on the copy condition of ROCF, TMT, part B and Stroop, Color-Word interference condition, which were administered after the training. However, the control group did not show these improvements. In addition, the rehabilitation group showed significantly reduced negative symptoms after training, but the control group did not. These results indicate that visuospatial training is effective not only for the improvement of visuospatial functioning, but also for attention. In addition, these results indicate the importance of cognitive rehabilitation for schizophrenic patients who are preparing for social return.

참고문헌 (66)

  1. 김정기, "K-CVLT(Korean- California Verbal Learning Test), 신경심리학적 기억검사" (1999), 특수교육
  2. 박윤정, "주의력 재활 훈련이 정신분열병 환자의 인지 기능에 미치는 효과", 한국심리학회지 임상, 24(4), pp.721~737 (2005), 한국임상심리학회
  3. 박혜정, "만성 정신분열병 환자의 시지각과 주의의 관련성에 관한 연구", 석사, pp.2007
  4. 안석균, "만성 정신분열병 환자에서 전산화 인지재활 프로그램을 이용한 주의력 훈련의 효과", 신경정신의학, 36(1), pp.72~79 (1997)
  5. 염태호, "K-WAIS 실시요강" (1992), 한국가이던스
  6. American Psychiatric Association, "Diagnostic and statistical manual of mental disorder.4th ed", ~ (1994)
  7. Banich, M., "Neuropsychology: The mental bases of mental function" (1997), Houghton-Mifflin
  8. Bellucci, D. M., "Computer-assisted cognitive rehabilitation reduces negative symptoms in the severely mentally ill", Schizophrenia Research, 59, pp.225~232 (2002)
  9. Benedict, R., "Effects of attention training on information processing in schizophrenia.Schizophrenia", Schizophrenia Bulletin, 20, pp.537~546 (1994)
  10. Bozikas, V. P., "Neuropsychological profile of cognitively impaired patients with schizophrenia.Comprehensive", Psychiatry, 47, pp.136~143 (2006)
  11. Bracy, O. L., "PSS CogReHab visuospatial manua" (1994), Psychological Software Services Inc.
  12. Bradt, S., "Computer training for the young adult patients with chronic mental illness", Journal of Rehabilitation, 59, pp.51~54 (1993)
  13. Braff, D. L., "Neuropsychological functioning and time-linked information processing in schizophrenia", Review of Psychiatry, 10, pp.60~78 (1991)
  14. Brenner, C. A., "Visual processing and neuropsychological function in schizophrenia and schizoaffective disorder", Psychiatry Research, 111, pp.125~136 (2002)
  15. Brickenkamp, R., "The d2 test of attention" (1998), Hogrefe &Huber Publishers.
  16. Buchanan, R. W., "The comparative efficacy and long-term effect of clozapine treatment on neuropsychological test performance", Biological Psychiatry, 36, pp.717~725 (1994)
  17. Burda, P. C., "Computer administered treatment of psychiatric inpatients", Computer and Human Behavior, 7, pp.1~5 (1991)
  18. Chen, Y., "Motion perception in schizophrenia", Archives of General Psychiatry, 56, pp.149~154 (1999)
  19. Chervinsky, A. B., "Comparison of four methods of scoring the Rey-Osterrieth Complex Figure Drawing Test on four age groups of normal elderly", Brain Dysfunction, 5, pp.267~287 (1992)
  20. Chiulli, S. J., "Impact of age on drawing the Rey-Osterrieth Figure", The Clinical Neuropsychologist, 9, pp.219~224 (1995)
  21. Corteen, R. S., "Autonomic responses to shock-associated words in an unattended channel", Journal of Experimental Psychology, 94(3), pp.308~313 (1972)
  22. Doniger, G. M., "Impaired visual object recognition and dorsal", ventral stream interaction in schizophrenia, 2002, pp.59, 1011~1020
  23. Eimon, M. C., "Performance of schizophrenic patients on a motor-free visual perception test", American Journal of Occupational Therapy, 37, pp.327~332 (1983)
  24. Field, C. D., "Computerized cognitive rehabilitation: possible application to the attentional deficit of schizophrenia, a report of negative results", Perception and Motor skills, 85, pp.995~1002 (1997)
  25. Fiszdon, J. M., "Durability of cognitive remediation training in schizophrenia: performance on two memory tasks at 6-month and 12-month follow-up", Psychiatry Research, 125, pp.1~7 (2004)
  26. Gianutsos, R., "Rehabilitating the verbal recall of brain injured patients by mnemonic training: an experimental demonstration using single case methodology", Clinical Psychology, 1, pp.117~122 (1979)
  27. Green, M. F., "What are the functional consequences of neurocognitive deficits in schizophrenia", American Journal of Psychiatry, 153, pp.321~330 (1996)
  28. Green, M. F., "Backward masking performance in unaffected siblings of schizophrenic patients", Archives of General Psychiatry, 54, pp.465~472 (1997)
  29. Heaton, R. K., "Wisconsin card sorting test manual" (1981), Psychological Assessment Cooperation Press
  30. Heinrichs, R. W., "Neurocognitive deficit in schizophrenia: a quantitative review of the evidence", Neuropsychology, 12, pp.426~445 (1998)
  31. Hermanutz, M., "Computer-assisted attention training in schizophrenics", European Archives of Psychiatry and Clinical Neuroscience, 240, pp.282~287 (1990)
  32. Hillyard, S. A., "Electrical signs of selective attention in the human brain", Science, 182, pp.177~179 (1973)
  33. Isaacs, E. B., "Cortical anomalies associated with visuospatial processing deficits", Annals of Neurology, 53, pp.768~773 (2003)
  34. Kay, S. R., "The positive and negative syndrome scale (PANSS) for schizophrenia", Schizophrenia Bulletin, 2, pp.261~276 (1987)
  35. Kim, M. S., "Neuropsychological correlates of P300 abnormalities in patients with schizophrenia and obsessive-compulsive disorder", Psychiatry Research: Neuroimaging, 123, pp.109~123 (2003)
  36. Lee, T. M., "The relationship between visual-preception and attention in Chinese with schizophrenia", Schizophrenia Research, 72, pp.185~193 (2005)
  37. Lewis, J. L., "Semantic processing of unattended messages using dichotic listening", Journal of Experimental Psychology, 85, pp.225~228 (1970)
  38. Lezak, M. D., "Neuropsychological assessment" (1995), Oxford
  39. Liddle, P. F., "Schizophrenic syndromes, cognitive performance and neurological dysfunction", Psychological Medicine, 17, pp.49~57 (1988)
  40. Liddle, P. F., "Schizophrenic syndromes and frontal lobe performance", British Journal of Psychiatry, 158, pp.340~345 (1991)
  41. Mangun, G. R., "Spatial gradients of visual attention: Behavioral and electrophysiological evidence", Electroencephalography and Clinical Neurophysiology, 70, pp.417~428 (1988)
  42. Massel, H. K., "Conversation skills training in thought-disordered schizophrenics through attention focusing", Psychiatry Research, 38, pp.51~61 (1991)
  43. Medalia, A., "Effectiveness of attention training in schizophrenics", Schizophrenia Bulletin, 24, pp.147~152 (1998)
  44. Meltzer, H., "Recent advances in the pharmacotherapy of schizophrenia", Acta Psychiatrica Scandinavica, 90, pp.95~101 (1994)
  45. Meyer, T. D., "Are there attentional deficits in people putatively at risk for affective disorder", Journal of Affective Disorder, 84, pp.63~72 (2005)
  46. Meyers, J. E., "Rey complex figure test and recognition trial" (1995), PAR
  47. Mulet, B., "Sustained and selective attention deficits as vulnerability markers to psychosis", European Psychiatry, 22, pp.171~176 (2007)
  48. Ngan, E. T. C., "Reaction time, symptom profiles and course of illness in schizophrenia", Schizophrenia Research, 46, pp.195~201 (2000)
  49. Ritter, I. M., "Neurocognitive measures of prefrontal cortical dysfunction in schizophrenia", Schizophrenia Research, 68, pp.65~73 (2004)
  50. Ross, R. G., "Early expression of smooth-pursuit eye movement abnormalities in children of schizophrenic parent", Journal of the American Academy of Child and Adolescent Psychiatry, 35, pp.941~949 (1996)
  51. Sauer, H., "Efficacy and safety of venlafaxine ER vs. amitriptyline ER in patients with major depression of moderate severity", Pharmacopsychiatry, 36, pp.169~175 (2003)
  52. Schechter, I., "Magnocellular and parvocellular contributions to backward masking dysfunction in schizophrenia", Schizophrenia Research, 64, pp.91~101 (2003)
  53. Schwartz, B. D., "High velocity transient visual processing deficits diminish ability of patients with schizophrenia to recognize objects", Neuropsychiatry Neuropsychology and Behavioral Neurology, 12, pp.170~177 (1999)
  54. Sergi, M. J., "Social perception and early visual processing in schizophrenia", Schizophrenia Research, 59, pp.233~241 (2002)
  55. Shorr, J. S., "Memory for the Rey-Osterrieth figure: perceptual clustering, encoding and storage", Neuropsychologia, 6, pp.43~50 (1992)
  56. Silverstein, A. B., "Agrement between a short-form and the full scale as a function of the correlation between them", Journal of Clinical Psychology, 45(6), pp.929~931 (1989)
  57. Silverstein, S. M., "Stimulus configuration and context effects in perceptual organization in schizophrenia", Journal of Abnormal Psychology, 105, pp.410~420 (1996)
  58. Silverstein, S. M., "Perceptual organization of configural and nonconfigural visual patterns in schizophrenia: effects of repeated exposure", Cognitive Neuropsychiatry, 3, pp.209~223 (1998)
  59. Silverstein, S. M., "Cognitive deficits and psychiatric rehabilitation outcomes in schizophrenia", Psychiatric Quarterly, 69, pp.169~191 (1998)
  60. Stroop, J. R., "Studies of inference in serial verbal reactions", Journal of Experimental Psychology, 18, pp.643~662 (1935)
  61. Tsakanikos, E., "Visuo-spatial processing and dimensions of schizotypy: figure-ground segregation as a function of psychotic-like features", Personality and Individual differences, 35, pp.703~712 (2003)
  62. Uhlhaas, P. J., "Perceptual organization in schizophrenia spectrum disorder: a review of empirical research and associated theories", Psychological Bulletin, 131, pp.618~632 (2005)
  63. Umilta, C., "The handbook of cognitive neuropsychology: What deficits reveal about the human mind", pp.2001, Psychology Press
  64. van der Stern, O., "Attentional modulation of early-stage visual processing in schizophrenia", Brain Research, 1125, pp.194~198 (2006)
  65. Weinberger, D., "Cortical maldevelopment, anti-psychotic drugs and schizophrenia: a search for common ground", Schizophrenia Research, 16, pp.87~110 (1995)
  66. Wykes, T., "The effects of neurocognitive remediation on executive processing in patients with schizophrenia", Bulletin, 24, pp.291~308 (1999)

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시공간 재활훈련이 조현병 환자의 시공간 기능과 주의에 미치는 효과김명선, 김지현한국임상심리학회 · Korean Journal of Clinical Psychology2016 · 제35권 제4호전산화 주의 재활 훈련이 정신분열병 환자의 인지 기능에 미치는 효과김명선, 장희진한국임상심리학회 · Korean Journal of Clinical Psychology2011 · 제30권 제3호주의력 재활 훈련이 정신분열병 환자의 인지 기능에 미치는 효과윤탁, 김명선, 박윤정한국임상심리학회 · Korean Journal of Clinical Psychology2005 · 제24권 제4호전산화 집행 기능 재활이 조현병 환자의 인지 기능 향상에 미치는 효과김명선, 박주현한국임상심리학회 · Korean Journal of Clinical Psychology2015 · 제34권 제1호만성 정신분열병 환자를 위한 과정특정적 접근법에 따른 인지 재활 프로그램의 효과 - 주의력과 기억력 훈련이혁, 안수진, 이민규한국임상심리학회 · Korean Journal of Clinical Psychology2002 · 제21권 제1호입원중인 만성 정신분열병 환자를 대상으로 한 전산화 인지 재활 훈련의 효과：예비 연구박윤정, 이우경, 황태연대한신경정신의학회 · 신경정신의학2009 · 제48권 제3호

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