본문 바로가기
KERD
논문KCI 등재

아동기 및 성인 ADHD 증상에 따른 대학생 OCD 집단의 실행기능 결함, 우울 및 불안의 차이

Differences in executive function deficit, depression, and anxiety in college student OCD groups according to childhood & adult ADHD symptoms

김선주
한국임상심리학회 (Korean Clinical Psychology Association)|2022.12|한국심리학회지: 임상심리 연구와 실제 (Clinical Psychology in Korea: Research and Practice)|제8권 제4호|pp. 615-635|DOI http://doi.org/10.15842/CPKJOURNAL.PUB.8.4.615

0

조회

0

다운로드

0

인용

0

참고문헌

키워드

우울depressionanxietyADHD실행기능 결함불안OCD강박증executive function deficit

초록

본 연구의 목적은 대학생 OCD 성향 집단의 아동기 ADHD 및 성인기 ADHD 증상의 유병율을 확인하고, 아동기 ADHD 증상을 동반하는 OCD 성향 집단, 성인기 ADHD 증상을 동반하는 OCD 성향 집단, ADHD가 없는 OCD 성향 집단 및 정상집단 간 실행기능의 결함, 우울 및 불안에 차이가 있는지 검증하는 것이다. 이를 위해 지역사회 대학생 1082명 중 강박성향군(SCL-90-R OCD score > 18) 121명과 정상집단 50명을 선발하여 총 171명(남64명, 여107명)의 남녀 대학생을 대상으로 아동기 ADHD 증상(Childhood Symptom Scale), 성인기 ADHD 증상(K-AADHDS), 실행기능 결함(K-BDEFS), 강박증과 우울 및 불안(SCL-90-R)에 대한 자기보고 평가를 실시하였다. 분석 결과, 아동기 ADHD 증상을 동반하는 OCD 성향 집단의 억제결함과 강박증상이 성인기 ADHD 증상을 동반하는 OCD 성향 집단, ADHD가 없는 OCD 성향 집단 및 정상집단 보다 유의하게 높았다. 또한 아동기 및 성인기 ADHD를 동반하는 OCD 성향 집단이 ADHD가 없는 OCD 성향 집단에 비해 실행기능 결함의 모든 요인에서 유의하게 더 높은 결함을 보였다. 따라서 OCD 성향 집단의 실행기능 결함은 동반 ADHD로 인한 영향일 가능성이 높아 보인다. 한편 불안과 우울은 정상집단 보다 OCD 성향 집단의 점수가 유의하게 높았으나 OCD 성향 집단 간 차이는 유의하지 않았다. 우울이나 불안은 ADHD 증상보다 강박증상과 관련성이 더 높아 보인다.

Abstract

This study aimed to determine the prevalence of childhood ADHD and adult ADHD symptoms in the OCD tendency group of college students. And this is to verify whether there is a difference in executive function deficits, depression, and anxiety between the OCD group with childhood and adult ADHD symptoms and the OCD group without ADHD and the normal group. For this purpose, a total of 171(64 males and 107 females) college students were selected, including 121 with OCD and 50 from the normal group among 1,082 community college students. They conducted self-reported assessments of childhood ADHD symptoms, adult ADHD symptoms(K-AADHDS), executive function deficits(K-BDEFS), OCD, depression and anxiety(SCL-90-R). As a result of the analysis, the inhibition deficit and obsessive- compulsive symptoms in the OCD group with childhood ADHD were significantly higher than in other groups. Also, the OCD group with childhood and adult ADHD showed significantly higher deficits of self-organization/problem-solving, inhibition, self-motivation, and self-regulation of emotion in executive function than the OCD group without ADHD.

참고문헌 (74)

  1. 김광일, "간이정신진단검사 실시요강" (1984), 중앙적성출판사
  2. 김빛나, "아임상 강박성향군의 세부-편향적 시지각 특성에 관한 연구", Korean Journal of Clinical Psychology, 28(3), pp.911~928 (2009), 한국임상심리학회[DOI]
  3. 김선주, "아동기 및 성인기 ADHD 증상이 대학생의 심리적 부적응, 대인관계 문제와 학업성취에 미치는 영향에서 실행기능 결함의 매개효과", 한국심리학회지: 상담 및 심리치료, 32(4), pp.1863~1892 (2020), 한국상담심리학회[DOI]
  4. 김은정, "한국형 성인 ADHD 척도의 타당화 연구: 대학생 표본을 중심으로", Korean Journal of Clinical Psychology, 22(4), pp.897~911 (2003), 한국임상심리학회
  5. 김일중, "강박장애에 대한 근거기반치료", Korean Journal of Clinical Psychology, 36(4), pp.509~525 (2017), 한국임상심리학회[DOI]
  6. 원호택, "간이정신진단검사 SCL-90-R 매뉴얼" (2015), ㈜휴노
  7. 이한별, "한국어판 바클리 집행기능결핍척도의 신뢰도 및 타당도 연구", Korean Journal of Clinical Psychology, 35(2), pp.519~539 (2016), 한국임상심리학회[DOI]
  8. 장문선, "성인 ADHD 성향집단의 하위군집 탐색:우울, 자아 존중감 및 대인관계 문제를 중심으로", Korean Journal of Clinical Psychology, 26(4), pp.827~843 (2007), 한국임상심리학회[DOI]
  9. 조은주, "불완전감과 강박신념이 강박증상에 미치는 영향: 마음챙김의 조절된 매개효과", Korean Journal of Clinical Psychology, 40(3), pp.258~268 (2021), 한국임상심리학회[DOI]
  10. Abramovitch, A., "The neuropsychology of adult obsessive–compulsive disorder: a meta-analysis", Clinical Psychology Review, 33(8), pp.1163~1171 (2013)
  11. American Psychiatric Association, "Diagnostic and statistical manual of mental disorders" (2000), American Psychiatric Press
  12. American Psychiatric Association, "Diagnostic and statistical manual of mental disorders, DSM-5" (2013), American Psychiatric Association
  13. Barkley, R. A., "Major life activity and health outcomes associated with attention- deficit", hyperactivity disorder, 2002, pp.63, 10~15
  14. Barkley, R. A., "Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment" (2006), Guilford
  15. Barkley, R. A., "Barkley Deficits in Executive Functioning Scale (BDEFS)" (2011), Guilford Press
  16. Barkley, R. A., "Attention-Deficit Hyperactivity Disorder: A clinical workbook" (1998), Guilford Press
  17. Barkley, R. A., "Impairment in occupational functioning and adult ADHD: the predictive utility of executive function (EF) ratings versus EF tests", Archives of Clinical Neuropsychology, 25(3), pp.157~173 (2010)
  18. Bradshaw, J. L., "The neurodevelopmental frontostriatal disorders: evolutionary adaptiveness and anomalous lateralization", Brain and Language, 73, pp.297~320 (2000)
  19. Brem, S., "The neurobiological link between OCD and ADHD", ADHD Attention Deficit and Hyperactivity Disorders, 6(3), pp.175~202 (2014)
  20. Casey, B. J., "Clinical, imaging, lesion, and genetic approaches toward a model of cognitive control", Developmental Psychobiology, 40, pp.237~254 (2002)
  21. Çelebi, F., "The features of comorbidity of childhood ADHD in patients with obsessive compulsive disorder", Journal of Attention Disorders, 24(7), pp.973~980 (2020)
  22. Derogatis, L. R., "Confirmation of the dimensional structure of the SCL‐90: a study in construct validation", Journal of Clinical Psychology, 33(4), pp.981~989 (1977)
  23. DuPaul, G. J., "Preschool children with attention-deficit", hyperactivity disorder: Impairments in behavioral, social, and school functioning, 2001, pp.40(5), 508~515
  24. DuPaul, G. J., "College students with ADHD: Current status and future directions", Journal of Attention Disorder, 13(3), pp.234~250 (2009)
  25. Durston, S., "Integrating genetic, psychopharmacological and neuroimaging studies: A converging methods approach to understanding the neurobiology of ADHD", Developmental Review, 27(3), pp.374~395 (2007)
  26. Farrell, L. J., "Clinical expression and treatment response among children with comorbid obsessive compulsive disorder and attention -deficit", hyperactivity disorder, 2020, pp.266, 585~594
  27. Fischer, M., "Executive functioning in hyperactive children as young adults: Attention, inhibition, response perserveration and, the impact of the comorbidity", Developmental Neuropsychology, 27(1), pp.107~133 (2005)
  28. Frazier, T. W., "Meta-analysis of intellectual and neuropsychological test performance in attention-deficit", hyperactivity disorder, 2004, pp.18(3), 543~
  29. Friedman, N. P., "Not all executive functions are related to intelligence", Psychological Science, 17(2), pp.172~179 (2006)
  30. Frost, R. O., "Psychopathology and personality characteristics of nonclinical compulsive checkers", Behaviour Research and Therapy, 24(2), pp.133~143 (1986)
  31. Geller, D. A., "Obsessive-compulsive and spectrum disorders in children and adolescents", Psychiatric Clinics, 29(2), pp.353~370 (2006)
  32. Geller, D., "Clinical correlates of obsessive compulsive disorder in children and adolescents referred to specialized and non‐specialized clinical settings", Depression and Anxiety, 11(4), pp.163~168 (2000)
  33. Geller, D. A., "Attention- deficit", hyperactivity disorder in children and adolescents with obsessive-compulsive disorder: fact or artifact?, 2002, pp.41(1), 52~58
  34. Geller, D. A., "Does comorbid attention-deficit", hyperactivity disorder impact the clinical expression of pediatric obsessive- compulsive disorder?, 2003, pp.8(4), 259~264
  35. Geller, D. A., "Re-examining comorbidity of obsessive compulsive and attention-deficit hyperactivity disorder using an empirically derived taxonomy", European Child & Adolescent Psychiatry, 13(2), pp.83~91 (2004)
  36. Gershuny, B. S., "Compulsive checking and anxiety in a nonclinical sample: Differences in cognition, behavior, personality, and affect", Journal of Psychopathology and Behavioral Assessment, 17(1), pp.19~38 (1995)
  37. Goldstein, S., "Handbook of executive functioning", pp.3~12 (2014), Springer
  38. Goodwin, A. H., "Deficits in set-shifting ability in nonclinical compulsive checkers", Journal of Psychopathology and Behavioral Assessment, 14(1), pp.81~92 (1992)
  39. Grados, M. A., "Latent class analysis of Gilles de la Tourette syndrome using comorbidities: clinical and genetic implications", Biological Psychiatry, 64(3), pp.219~225 (2008)
  40. Hollmann, K., "Internet-based cognitive behavioral therapy in children and adolescents with obsessive compulsive disorder: a feasibility study", Journal of Neural Transmission, 128(9), pp.1445~1459 (2021)
  41. The survey of mental disorders in Korea in 2016, "Hong, J. P.", Ministry of Health and Welfare, Samsung Medical Center, ~ (2016)
  42. Huisman-van Dijk, H. M., "The relationship between tics, OC, ADHD and autism symptoms: A cross-disorder symptom analysis in Gilles de la Tourette syndrome patients and family- members", Psychiatry Research, 237, pp.138~146 (2016)
  43. Ibrahim, L., "Prevalence and correlates of attention deficit hyperactivity disorder in obsessive-compulsive disorder patients", Middle East Current Psychiatry, 27(1), pp.3~ (2020)
  44. Janusis, G. M., "An Exploratory Study of Substance Use and Misuse Among College Students With and Without ADHD and Other Disabilities", Journal of Attention Disorders, 14(3), pp.205~215 (2010)
  45. Jassi, A. D., "Examining clinical correlates, treatment outcomes and mediators in young people with comorbid obsessive-compulsive disorder and autism spectrum disorder", European child & Adolescent Psychiatry, pp.1~10 (2021)
  46. Kessler, R. C., "Individual and societal effects of mental disorders on earnings in the United States: results from the national comorbidity survey replication", American Journal of Psychiatry, 165(6), pp.703~711 (2008)
  47. 김선주, "대학생의 아동기 ADHD의 지속 및 감소와 성인기 ADHD의 발현에 따른 유병률과 부적응: 실행기능 결함, 심리적 부적응 및 대인관계 문제를 중심으로", Korean Journal of Clinical Psychology, 39(2), pp.134~147 (2020), 한국임상심리학회[DOI]
  48. Kooij, S. J., "European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD", BMC Psychiatry, 10(1), pp.67~ (2010)
  49. Kuelz, A., "Neuropsychological performance in obsessive- compulsive disorder: A critical review", Biological Psychology, 65(3), pp.185~236 (2004)
  50. Lamothe, H., "Is sustained attention deficit related to subclinical obsessive thoughts in children and adolescents with ADHD?", International Journal of Psychiatry in Clinical Practice, pp.1~7 (2020)
  51. Langberg, J. M., "Alcohol use longitudinally predicts adjustment and impairment in college students with ADHD: The role of executive functions", Psychology of Addictive Behaviors, 29(2), pp.444~454 (2015)
  52. Langley, A. K., "Correlates of comorbid anxiety and externalizing disorders in childhood obsessive compulsive disorder", European Child & Adolescent Psychiatry, 19(8), pp.637~645 (2010)
  53. Mariani, M. A., "Neuropsychological and academic functioning in preschool boys with attention deficit hyperactivity disorder", Developmental Neuro Psychology, 13(1), pp.111~129 (1997)
  54. Mataix-Cols, D., "Hemispheric functional imbalance in a sub-clinical obsessive-compulsive sample assessed by the Continuous Performance Test, Identical Pairs version", Psychiatry Research, 72(2), pp.115~126 (1997)
  55. Masi, G., "Comorbidity of obsessive-compulsive disorder and attention-deficit", hyperactivity disorder in referred children and adolescents, 2006, pp.47(1), 42~47
  56. Miller, E. K., "An integrative theory of prefrontal cortex function", Annual Review of Neuroscience, 24, pp.167~202 (2001)
  57. Murphy, K. R., "Preliminary normative data on DSM-IV criteria for adults", ADHD Report, 3(33), pp.6~7 (1995)
  58. Murphy, K. R., "Prevalence of DSM-IV symptoms of ADHD in adult licensed drivers: Implications for clinical diagnosis", Journal of Attention Disorders, 1, pp.147~161 (1996)
  59. Pallanti, S., "Obsessive–compulsive disorder comorbidity: clinical assessment and therapeutic implications", Frontiers In Psychiatry, 2, pp.70~ (2011)
  60. Pallanti, S., "The Burden of Adult ADHD in Comorbid Psychiatric and Neurological Disorders", pp.183~199 (2020), Springer
  61. Pérez-Vigil, A., "Association of obsessive-compulsive disorder with objective indicators of educational attainment: a nationwide register-based sibling control study", JAMA Psychiatry, 75(1), pp.47~55 (2018)
  62. Piacentini, J., "Functional impairment in children and adolescents with obsessive -compulsive disorder", Journal of Child Adolescent Psychopharmacology, 13(2 Supplement 1), pp.61~69 (2003)
  63. Rachman, S., "Abnormal and normal obsessions", Behaviour Research and Therapy, 16(4), pp.233~248 (1978)
  64. Rauch, S. L., "Probing striato-thalamic function in obsessive-compulsive disorder and Tourette syndrome using neuroimaging methods", Advances in Neurology, 85, pp.207~224 (2001)
  65. Rubia, K., "Disorder‐specific dysfunctions in patients with attention deficit", hyperactivity disorder compared to patients with obsessive‐compulsive disorder during interference inhibition and attention allocation, 2011, pp.32(4), 601~611
  66. Ruscio, A. M., "The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication", Molecular Psychiatry, 15(1), pp.53~63 (2010)
  67. Salkovskis, P. M., "Abnormal and normal obsessions-a replication", Behaviour Research and Therapy, 22(5), pp.549~552 (1984)
  68. Schmidtke, K., "Cognitive frontal lobe dysfunction in obsessive-compulsive disorder", Biological Psychiatry, 43(9), pp.666~673 (1998)
  69. Sonuga-Barke, E. J., "Causal models of attention-deficit", hyperactivity disorder: from common simple deficits to multiple developmental pathways, 2005, pp.57(11), 1231~1238
  70. Sukhodolsky, D. G., "Adaptive, emotional, and family functioning of children with obsessive-compulsive disorder and comorbid attention deficit hyperactivity disorder", American Journal of Psychiatry, 162(6), pp.1125~1132 (2005)
  71. Summerfeldt, L. J., "Understanding and treating incompleteness in obsessive compulsive disorder", Journal of Clinical Psychology, 60, pp.1155~1168 (2004)
  72. Tan, O., "Obsessive-compulsive adults with and without childhood ADHD symptoms", ADHD Attention Deficit and Hyperactivity Disorders, 8(3), pp.131~138 (2016)
  73. Vloet, T. D., "Neurocognitive performance in children with ADHD and OCD", Journal of Abnormal Child Psychology, 38(7), pp.961~969 (2010)
  74. Wolf, L. E., "College students with attention- deficit", hyperactivity disorder, 2009, pp.11(5), 415~421

관련 논문AI추천

대학생의 아동기 ADHD의 지속 및 감소와 성인기 ADHD의 발현에 따른 유병률과 부적응: 실행기능 결함, 심리적 부적응 및 대인관계 문제를 중심으로김선주, 하은혜한국임상심리학회 · Korean Journal of Clinical Psychology2020 · 제39권 제2호아동기 및 성인기 ADHD 증상이 대학생의 심리적 부적응, 대인관계 문제와 학업성취에 미치는 영향에서 실행기능 결함의 매개효과김선주한국상담심리학회 · 한국심리학회지: 상담 및 심리치료2020 · 제32권 제4호걱정사고 동반 유무에 따른 성인기 ADHD 성향집단의 연속수행과제 수행 특성이상일한국재활심리학회 · 재활심리연구2019 · 제26권 제1호성인 주의력 결핍 및 과잉 행동 장애(ADHD)환자의 실행기능 연구서보경한국심리학회 · 한국심리학회지:일반2012 · 제31권 제2호주의력결핍/과잉행동 성향을 가진 대학생의 신경심리 기능에 관한 연구김명선, 장경미한국건강심리학회 · 한국심리학회지: 건강2015 · 제20권 제3호ADHD아동의 우울 동반 여부에 따른 실행기능의 차이김소연, 배대석, 서완석, 장문선대한생물치료정신의학회 · 생물치료정신의학2009 · 제15권 제1호

이 간행물의 다른 논문 (8건)

대학생의 아동기 정서학대와 정서방임의 경험과 우울 증상 간의 관계에서 정서조절능력의 차별적인 매개효과전선영, 김은정pp. 559-588주도성과 친화성 특성에 따른 병리적 자기애의 암묵적․명시적 자존감장문선, 임종민, 전유겸pp. 589-613억제통제훈련이 도박행동에 미치는 영향윤혜영, 김동환pp. 637-658코로나 19 스트레스 척도(COVID Stress Scales, CSS)의 타당화: 한국 성인표본을 대상으로지은혜, 조용래, 김선영pp. 659-681한국판 실존불안 질문지 타당화 및 관련 변인 탐색현명호, 강규림pp. 683-711
원문 보기