소아청소년 주의력결핍 과잉행동장애 환자 양육자의 심리적 특성
Psychologic Characteristics in Caregivers of Children with Attention Deficit Hyperactivity Disorder
0
조회
0
다운로드
0
인용
0
참고문헌
초록
목 적: ADHD는 주의력 결핍, 충동성, 과잉행동증상의 3가지 특성을 갖는 질환으로 유병률이 전체아동의 4-7%로 흔하다. ADHD의 원인과 병리기전에 대해서는 다양한 가설이 제시되고 있다. 이들 중환경적 심리적 영향이 중요한 발병인자의 하나로 알려지고 있으며 부모의 불화, 가족 간의 갈등, 부모특히 양육자의 정신병리는 아동 심리 발달에 부정적영향을 주어 ADHD를 발병시킬 가능성이 있다. 이에 연구자들은 MMPI-2 검사를 통해 ADHD 환자양육자의 심리적 특성을 알아보고자 하였다. 방 법 : 한림대학교 강남성심병원 소아청소년과에서 2007년 1월부터 2009년 6월까지 ADHD로 진단된 환아 중 양육자에서 MMPI-2 검사를 시행한35명을 대상으로 하였으며 신경정신과적 질환이 없는 환자 34명의 양육자를 대조군으로 하였다. 양육자 심리평가 방법으로 사용된 MMPI-2는 전 세계적으로 널리 사용되는 객관적 심리검사로 기존MMPI의 문제점을 보완하여 만들어진 것으로 12세이상에서 시행할 수 있다. T 점수가 65점 이상인 경우를 유의미한 것으로 판정 하였고 T 점수 결과를신경정신과적 질환이 없는 아동 양육자인 대조군과비교 분석하였다. 결 과:본 연구 결과 ADHD 환자 양육자에서 시행한 MMPI-2 결과에서 한가지 이상의 임상 척도에서 이상을 보인 경우가 많았으며(44.1%), 우울증척도, 강박증 척도, 정신분열증 척도 등에서 대조군에 비해 유의하게 높은 점수를 보였다(P<0.05). 결 론 : 주의력 결핍 과잉행동장애 환자 양육자의MMPI-2 검사에서 이상이 있는 경우가 드물지 않아 부모의 정신병리가 ADHD 발병에 영향을 줄 수있을 것으로 사료되며 환자에 의한 부모의 정신병리유발 가능성도 있으므로 ADHD 진료시에 양육자에대한 심리평가가 필요할 것으로 사료된다.
Abstract
Purpose : ADHD (Attention Deficit Hyperactivity Disorder) is a neurodevelopmental disorder with three characteristics, such as impulsivity, inattention, and hyperactivity symptoms. This is a common disease that the prevalence reaches 4-7% of all children. There are a variety of hypothesis in the pathogenic mechanisms and etiology. Parental psychopathology influences directly and indirectly on the occurrence of ADHD in children. The aim of this study was to evaluate the clinical and psychological characteristics of caregiver of child with ADHD using the MMPI (Minnesota Multiphasic Personality Inventory)-2. Methods : The subjects consisted of 35 caregivers of patients with ADHD and 34 caregivers of children without neuropsychiatric disorders who visited to the pediatric neurology clinic of Kangnam sacred heart hospital from January 2009 to June 2011. We diagnosed ADHD according to DSM(Diagnostic and Statistical Manual of Mental Disorder)-IV criteria. We compared the psychologic characteristics between ADHD group and control group using T score of MMPI-2. Results : MMPI T scores of caregivers of children with ADHD were significantly higher on the depression(D), psychasthenia(Pt), schizophrenia(Sc), social introversion (Si) scales than control group and most of scales were significantly higher in restructured clinical (RC) scale and personality psychopathology five (PSY-5) scales. Conclusion : The results suggested that psychopathology of caregivers might induce ADHD in the children. On the contrary, ADHD symptom of children might be associated with occurrence of psychopathology in the cargiver. In order to proper treatment of ADHD patient, we need to psychologic evaluation in the caregivers of patients with ADHD.
참고문헌 (18)
- Elia J, "ADHD genetics : 2007 update", Curr Psychiatry Rep, 9, pp.434~439 (2007)
- Cunningham CE, "Preschoolers at risk for attention-deficit hyperactivity disorder and oppositional defiant disorder: family, parenting, and behavioral correlates", J Abnorm Child Psychol, 30, pp.555~569 (2002)
- Johnston C, "Families of children with attention-deficit", hyperactivity activity disorder : review and recommandations for future research, 2001, pp.4, 183~207
- Mano S, "Relationship between characteristic behaviors of children with ADHD and mothers' parenting styles", No To Hattatsu, 39, pp.19~24 (2007)
- Chronis AM, "Cognitive-behavioral depression treatment for mothers of children with attentiondeficit", hyperactivity disorder, 2006, pp.37, 143~158
- Chronis AM, "Evidencebased psychosocial treatments for children and adolescents with attention-deficit", hyperactivity disorder, 2006, pp.26, 486~502
- Ellis B, "Parenting practices and attention-deficit", hyperactivity disorder : new findings suggest partial specificity of effects, 2009, pp.48, 146~154
- Harvey E, "Parenting of children with attention-deficit", hyperactivity disorder(ADHD) : the role of parental ADHD symptomatology, 2003, pp.7, 31~42
- Bornovalova MA, "Familial transmission and heritability of childhood disruptive disorders", Am J Psychiatry, 167, pp.1066~1074 (2010)
- Loeber R, "Intergenerational transmission of multiple problem behaviors : prospective relationships between mothers and daughters", J Abnorm Child Psychol, 37, pp.1035~1048 (2009)
- Baum LJ, "A review of the minnesota multiphasic personality inventory-adolescent(MMPI-A)and the millon adolescent clinical inventory(MACI)with an emphasis on juvenile justice samples", Assessment, 16, pp.384~400 (2009)
- Klassen AF, "Health-related quality of life in children and adolescents who have a diagnosis of attention-deficit", hyperactivity disorder, 2004, pp.114, 541~547
- Coleman AR, "MMPI-2 characteristics of adults diagnosed with attention deficit disorder", Int J Neurosci, 96, pp.161~175 (1998)
- Subotnik KL, "MMPI vulnerability indicators for schizophrenia and attention deficit disorder : UCLA family study of biological parents offspring with childhood-onset schizophrenia or ADHD", Behav Genet, 35, pp.159~175 (2005)
- Holdnack JA, "MMPI charateristics in adults diagnosed with ADD : a preliminary report", Int J Neurosci, 79, pp.47~58 (1994)
- Lahey BB, "Personality characteristics of the mothers of children with disruptive behavior disorders", J Consult Clin Psychol, 57, pp.512~515 (1989)
- Lahey BB, "Psychopathology in the parents of children with conduct disorder and hyperactivity", J Am Acad Child Adolesc Psychiatry, 27, pp.163~170 (1988)
- Soon Jeong Lee, "Personality Characteristics of Mothers of Children with Attention Deficit Hyperactivity Disorder as Assessed by the Minnesota Multiphasic Personality Inventory", PSYCHIATRY INVESTIGATION, 5(4), pp.228~231 (2008), 대한신경정신의학회