본문 바로가기
KERD
논문KCI 등재

정신증 유무에 따른 K-WAIS-IV 프로파일의 하위유형과 임상적 특성: 탐색적 연구

K-WAIS-IV Profiles and Their Clinical Correlates in Psychiatric Patients With/Without Psychotic Symptoms: An Exploratory Study

최지영|김하림
한국임상심리학회 (Korean Clinical Psychology Association)|2020.05|Korean Journal of Clinical Psychology|제39권 제2호|pp. 148-163|DOI http://doi.org/10.15842/KJCP.PUB.39.2.148

1

조회

0

다운로드

0

인용

0

참고문헌

키워드

K-WAIS-IV잠재프로파일분석정신증MMPI-2-RF
주제분류심리과학

초록

본 연구는 사례중심적 접근을 통해 정신과 내원 환자들의 K-WAIS-IV 프로파일의 하위유형을 탐색하고 정신증 유무에 따른 하위유형의임상적 특성을 확인하고자 하였다. 이를 위해 218명의 정신증적 장애 환자(조현병 및 정신증을 동반한 기분장애)와 232명의 정신증을 동반하지 않은 기분장애 환자들 각각에 대하여 K-WAIS-IV 지표점수 및 전체 지능지수에 대한 잠재 프로파일 분석을 실시하였으며, 도출된하위집단의 MMPI-2-RF 점수를 비교하였다. 잠재 프로파일 분석 결과, 정신증적 장애군과 비정신증적 장애군 모두 ‘전반적 손상 집단’ , ‘선택적 손상 집단’ , ‘정상 집단’으로 구성된 3계층 모형이 가장 적합한 것으로 나타났다. 그러나 ‘선택적 손상 집단’에서 관찰되는 손상 영역은정신증 유무에 따라 상이하였는데, 정신증적 장애군은 언어이해를 제외한 모든 지표가 저하되었던 반면, 비정신증적 장애군은 언어이해와 함께 작업기억 지표 또한 유지되는 점이 특징적이었다. 임상적 특성과 관련하여서는 일반적으로 인지기능 손상이 전반적일수록, 그리고정신증적 장애군보다는 비정신증적 장애군일 때 더 높은 수준의 증상을 호소하는 양상이었으나, 일부 임상적 특성의 경우 정신증 유무에따라 하위집단 간 증상 호소의 양상이 달라짐을 확인할 수 있었다. 이러한 결과를 토대로 본 연구결과의 시사점과 한계점에 관하여 논의하였다.

Abstract

The purpose of this study was to explore the subgroups of K-WAIS-IV profiles among psychiatric patients with and without psychotic symptoms using a data-driven approach and to identify their clinical characteristics. Latent profile analyses were conducted using K-WAIS-IV performance data from 218 patients with psychotic disorders and 232 patients with non-psy￾chotic affective disorders. Subgroups were then compared on their MMPI-2-RF scores, diagnosis, and demographic vari￾ables. A three-cluster solution including a “cognitively normal,” a “selectively impaired,” and a “globally impaired” group was selected for both psychotic and non-psychotic patients. However, the profiles of the selectively impaired group differed be￾tween the psychotic and non-psychotic patients. In psychotic patients, the selectively impaired group showed lowered perfor￾mance on general intelligence and all other index scores except for VCI, while the non-psychotic patients showed average performance on WMI as well as VCI. Regarding the MMPI-2-RF results, in general, patients with more pervasive cognitive impairment and those with psychotic disorders rather than non-psychotic disorders tended to report significantly higher scores across various scales. However, on some scales, the profiles of subgroups were found to differ between psychotic and non-psychotic patients. Based on these results, the implications and limitations of the study are discussed.

참고문헌 (47)

  1. Akaike, H., "Factor analysis and AIC", Psychometrika, 52, pp.317~332 (1987)[DOI]
  2. Diagnostic and Statistical Manual of Mental Disorders, "American Psychiatric Association", American Psychiatric Publishing, ~ (2013)
  3. Aylward, E., "Intelligence in schizophrenia : Meta-analysis of the research", Schizophrenia bulletin, 10, pp.430~459 (1984)
  4. Barch, D. M., "Cognitive impairments in psychotic disorders : Common mechanisms and measurement", World Psychiatry, 13, pp.224~232 (2014)
  5. Blyler, C. R., "Short form of the WAIS-III for use with patients with schizophrenia", Schizophrenia Research, 46, pp.209~215 (2000)[DOI]
  6. Conway, A. R. A., "A latent variable analysis of working memory capacity, short-term memory capacity, processing speed, and general fluid intelligence", Intelligence, 30, pp.163~183 (2002)[DOI]
  7. Cotrena, C., "Quality of life, functioning and cognition in bipolar disorder and major depression : A latent profile analysis", Psychiatry Research, 241, pp.289~296 (2016)[DOI]
  8. Crawford, J. R., "WAIS-R subtest pattern clusters in closedhead-injured and healthy samples", The Clinical Neuropsychologist, 11, pp.249~257 (1997)
  9. Crouse, J. J., "Parcellating cognitive heterogeneity in early psychosis-spectrum illnesses : A cluster analysis", Schizophrenia Research, 202, pp.91~98 (2018)[DOI]
  10. Deary, I. J., "Intelligence and education : Causal perceptions drive analytic processes and therefore conclusions", International Journal of Epidemiology, 39, pp.1362~1369 (2010)[DOI]
  11. Doyle, A. E., "Cross-disorder cognitive impairments in youth referred for neuropsychiatric evaluation", Journal of the International Neuropsychological Society, 24, pp.91~103 (2018)[DOI]
  12. Engle, R. W., "Working memory capacity as executive attention", Current Directions in Psychological Science, 11, pp.19~23 (2002)[DOI]
  13. Gisselgård, J., "Verbal working memory deficits predict levels of auditory hallucination in firstepisode psychosis", Schizophrenia Research, 153, pp.38~41 (2014)[DOI]
  14. Gitlin, M. J., "The difficult lives of individuals with bipolar disorder : A review of functional outcomes and their implications for treatment", Journal of Affective Disorders, 209, pp.147~154 (2017)[DOI]
  15. Glahn, D. C., "Differential working memory impairment in bipolar disorder and schizophrenia : Effects of lifetime history of psychosis", Bipolar Disorders, 8, pp.117~123 (2006)[DOI]
  16. Goes, F. S., "Psychotic features in bipolar and unipolar depression", Bipolar Disorders, 9, pp.901~906 (2007)
  17. Gorlyn, M., "The WAIS-III and major depression : Absence of VIQ", PIQ differences, 2006, pp.28, 1145~1157
  18. Han, K. H., "The Korean Version of Minnesota Multiphasic Personality Inventory-2-RF manual" (2011), Maumsarang
  19. Harvey, P. O., "Executive functions and updating of the contents of working memory in unipolar depression", Journal of Psychiatric Research, 38, pp.567~576 (2004)[DOI]
  20. Heinrichs, R. W., "Neurocognitive deficit in schizophrenia : A quantitative review of the evidence", Neuropsychology, 12, pp.426~445 (1998)[DOI]
  21. Hermens, D. F., "Neuropsychological clustering highlights cognitive differences in young people presenting with depressive symptoms", Journal of the International Neuropsychological Society, 17, pp.267~276 (2011)[DOI]
  22. Hwang, S. T., "K-WAIS-IV Administration and Scoring Manual" (2012), Korea Psychology
  23. Ivleva, E. I., "Genetics and intermediate phenotypes of the schizophrenia-bipolar disorder boundary", Neuroscience and Biobehavioral Reviews, 34, pp.897~921 (2010)[DOI]
  24. Muthén, B., "Handbook of quantitative methodology for the social sciences", pp.345~368 (2004), Sage
  25. 고하영, "만성 조현병 환자 집단의 인지기능과 심리-사회적 기능 간 관련성", Korean Journal of Clinical Psychology, 36(1), pp.10~19 (2017), 한국임상심리학회[DOI]
  26. Lewandowski, K. E., "Reproducibility of cognitive profiles in psychosis using cluster analysis", Journal of the International Neuropsychological Society, 2017, pp.1~9 (2017)[DOI]
  27. Lewandowski, K. E., "Cognitive variability in psychotic disorders : A cross-diagnostic cluster analysis", Psychological Medicine, 44, pp.3239~3248 (2014)[DOI]
  28. Lo, Y., "Testing the number of components in a normal mixture", Biometrika, 88, pp.767~778 (2001)[DOI]
  29. McClintock, S. M., "Association between depression severity and neurocognitive function in major depressive disorder : A review and synthesis", Neuropsychology, 24, pp.9~34 (2010)[DOI]
  30. McLachlan, G. J., "On bootstrapping the likelihood ratio test stastistic for the number of components in a normal mixture", Applied Statistics, 36, pp.318~324 (1987)[DOI]
  31. McLachlan, G., "Finite mixture models" (2004), John Wiley & Sons
  32. Menon, V., "Functional neuroanatomy of auditory working memory in schizophrenia : Relation to positive and negative symptoms", Neuroimage, 13, pp.433~446 (2001)
  33. Michel, N. M., "WAIS-IV profile of cognition in schizophrenia", Assessment, 20, pp.462~473 (2013)[DOI]
  34. Millan, M. J., "Cognitive dysfunction in psychiatric disorders : Characteristics, causes and the quest for improved therapy", Nature Reviews Drug Discovery, 11, pp.141~168 (2012)
  35. "The Survey of Mental Disorders in Korea" (2016)[URL]
  36. 남덕현, "양극성장애 환자의 K-WAIS-Ⅳ 프로파일 분석", Korean Journal of Clinical Psychology, 35(2), pp.393~410 (2016), 한국임상심리학회[DOI]
  37. Owen, M. J., "The genetic deconstruction of psychosis", Schizophrenia Bulletin, 33, pp.905~911 (2007)[DOI]
  38. Potter, A. I., "IQ subtypes in schizophrenia : Distinct symptom and neuropsychological profiles", Journal of Nervous and Mental Disease, 198, pp.580~585 (2010)[DOI]
  39. Quraishi, S., "Neuropsychology of bipolar disorder : A review", Journal of Affective Disorders, 72, pp.209~226 (2002)[DOI]
  40. Reser, M. P., "Exploring cognitive heterogeneity in first-episode psychosis : What cluster analysis can reveal", Psychiatry Research, 229, pp.819~827 (2015)[DOI]
  41. Sclove, S. L., "Application of model-selection criteria to some problems in multivariate analysis", Psychometrika, 52, pp.333~343 (1987)
  42. 서리나, "조현병 환자의 K-WAIS-IV 프로파일", Korean Journal of Clinical Psychology, 33(4), pp.719~734 (2014), 한국임상심리학회[DOI]
  43. Smith, T. E., "Recovery from psychosis in schizophrenia and schizoaffective disorder : Symptoms and neurocognitive rate-limiters for the development of social behavior skills", Schizophrenia Research, 55, pp.229~237 (2002)[DOI]
  44. Tickell, A. M., "Neurocognitive clusters : A pilot study of young people with affective disorders in an inpatient facility", Journal of Affective Disorders, 242, pp.80~86 (2019)[DOI]
  45. Van Rheenen, T. E., "Characterizing cognitive heterogeneity on the schizophrenia-bipolar disorder spectrum", Psychological Medicine, 47, pp.1848~1864 (2017)[DOI]
  46. Wang, M., "Latent class procedures : Applications to organizational research", Organizational Research Methods, 14, pp.24~31 (2011)
  47. Wechsler, D., "The measurement and appraisal of adult intelligence" (1958), Williams & Wilkins Co

관련 논문AI추천

조현병 환자의 K-WAIS-IV 프로파일김지혜, 박광배, 서리나, 성기혜, 최진영, 홍상황, 황순택한국임상심리학회 · Korean Journal of Clinical Psychology2014 · 제33권 제4호정신건강의학과 외래 환자의 임상 심리학적 평가 프로파일: K-WAIS-IV와 MMPI-2를 중심으로송정은, 이병욱, 이유나, 임혜진한국임상심리학회 · Korean Journal of Clinical Psychology2018 · 제37권 제2호양극성장애 환자의 K-WAIS-Ⅳ 프로파일 분석김지혜, 남덕현, 이한별, 홍상황, 황순택한국임상심리학회 · Korean Journal of Clinical Psychology2016 · 제35권 제2호K-WAIS-IV 단축형의 임상적 유용성 검증백정미, 정은주한국임상심리학회 · 한국심리학회지: 임상심리 연구와 실제2019 · 제5권 제2호K-WAIS-IV 단축형의 타당도 연구: 임상 집단을 중심으로소리나, 최종옥한국임상심리학회 · 한국심리학회지: 임상심리 연구와 실제2019 · 제5권 제3호정신분열병 환자에서 인지기능의 감퇴와 정신병리와의 관련성김진성, 박상준, 배준용, 서완석, 이종범대한생물치료정신의학회 · 생물치료정신의학2007 · 제13권 제2호

이 간행물의 다른 논문 (7건)

긍정적 자서전적 기억 회상이 우울집단의 슬픈 기분 개선에 미치는 효과임지혜, 이혜진pp. 87-97우울경향 대학생에 대한 인지적 탈융합 개입의 효과: 주의분산 개입 및 무처치 통제조건과의 비교한아람, 조용래pp. 98-110한국어판 벡자살사고척도의 신뢰도 및 타당도 연구: 일반 성인 집단을 대상으로홍상황, 이은호, 김지혜, 황순택, 최영환pp. 111-123The Effects of Cognitive Load on Craving Triggered by Food Cues in External Eaters김기호, 박미영, 이장한, 백송이pp. 124-133대학생의 아동기 ADHD의 지속 및 감소와 성인기 ADHD의 발현에 따른 유병률과 부적응: 실행기능 결함, 심리적 부적응 및 대인관계 문제를 중심으로김선주, 하은혜pp. 134-147
원문 보기