로샤검사에서 나타난 ADHD 아동의 심리적 특성

배금예 ( Geum Ye Bae ) 한국정서.행동장애아교육학회(구.한국정서학습장애아교육학회) 2005 정서ㆍ행동장애연구 Vol.21 No.4

본 연구는 로샤검사를 사용하여 주의력 결핍 과잉행동장애(ADHD)의 다양한 심리적 특성을 평가하고자 하였다. 본 연구의 대상은 초등학교 1-6학년 중에서 ADHD로 선정된 30명과 연령 및 학력 수준을 매치한 정상 아동 29명이었다. 연구결과, 두 집단간에 연령과 학력에 따른 유의한 차이는 없었고 전체 IQ에서도 차이가 없었으나 ADHD 아동이 주의집중 지표점수에서 유의하게 낮은 점수를 보였다. ADS에서도 누락오류와 오경보오류 및 반응시간 표준편차에서 ADHD 아동이 유의하게 높은 점수를 보였는 반면에 d`(민감도)에서 ADHD 집단이 유의하게 낮은 점수를 보였다. 이러한 결과는 ADHD 아동이 부주의성, 충동성, 탈억제와 같은 고유의 행동 특징이 분명하고 표적 자극과 비표적 자극을 변별하는 반응 민감성이 저하되어 있음을 시사한다. 또한 분석된 25개의 로샤 자료에서 EB, D, Adj D, 3r+(2)/R, H, X+%, X-%, WSum6, PTI, DEPI, CDI 변인에서만 두 집단간에 유의한 차이를 보였다. ADHD 아동은 핵심 영역에서 EB의 비율, D, Adj D 점수, 자기지각 영역에서는 3r+(2)/R 그리고 대인관계 영역에서는 H반응의 점수가 유의하게 낮았다. 중재 영역에서는 X+%가 유의하게 높았는 반면에 X-%는 정상 아동보다 낮았고, 사고 영역에서는 WSum6가 유의하게 높았다. 이러한 결과는 ADHD 아동이 욕구지연 능력이 부족하고 스트레스에 대한 통제능력과 내성이 약하며 부정적인 자기상을 가지고 낮은 자존감을 보일 뿐 아니라 타인과의 관계형성에 어려움을 보이고 주변 환경적 자극을 현실적으로 지각하는 능력이 부족하며 인지적 과정의 왜곡 가능성이 더 많다는 것을 시사한다. 3가지 특수지표(PTI, DEPI, CDI)를 가장 잘 설명해주는 로샤 변인을 알아보기 위해 단계적 중회귀분석을 실시한 결과, X-%, Sum Shading 순서로 PTI의 57.9%를 설명해주었고 Sum Shading, L, 3r+(2)/R의 순서로 62%의 DEPI를 설명해주었으며 Adj D가 42.5%의 CDI 지표를 설명해주었다. This study investigated various psychological characteristics in a group of children diagnosed with 30 ADHD using the Rorschach test and compared them to matched by age and education samples of 29 normal group. The findings indicated that a significant differences in age, education, and Total IQ is not found between ADHD and normal group, but Freedom from Distractibility Index(FDI) is significantly lower on the ADHD group. In ADS, ommission error, commission error and response SD are higher than the normal group, but d` is significantly lower on the ADHD group. This results suggested that ADHD children have inattention, impulsivity, disinhibition and discriminant abilities between target and non-target stimulus are declined. In 25 Rorschach variables, EB, D, Adj D, 3r+(2)/R, H, X+%, X-%, WSum6, PTI, DEPI, CDI variables showed only a significant differences between ADHD and normal group. In Core section, ratio of EB, D and Adj D are significantly lower on the ADHD group. 3r+(2)/R in Self-perception section and pure H in Interpersonal section are also significantly lower on the ADHD group. In Mediation and Ideation section, X+% and WSum6 are significantly higher on the ADHD, but X-% was significantly lower on the ADHD group. This results suggested that ADHD children may difficult for delay responding, control and tolerance of stress. Also, they experience generally negative self-esteem and tend to make poor interpersonal relationships as well as distort reality and exhibited more disturbed thinking including unconventional and unrealistic patterns of thought. To determine the relative contributors in PTI, DEPI, CDI indices, stepwise multiple regression analysis was conducted. Results revealed X-% and Sum Shading explained 57.9% of variance of PTI; Sum Shading, L and 3r+(2)/R explained 62% of variance of DEPI; and Adj D explained 42.5% of variance of CDI.

초기 부적응적 스키마의 안정성 및 우울 증상과의 관련성 : 2년간의 추적 관찰 연구

양동석,배금예,이승재 대한신경정신의학회 2012 신경정신의학 Vol.51 No.4

Objectives Early maladaptive schemas (EMS) are assumed to be stable emotional and cognitive patterns that begin early in our development and are repeated throughout life. The primary aim of this study was to examine the two-year stability of EMS using the Young Schema Questionnaire (YSQ). In addition, we investigated the relationship between EMS and depressive symptoms over time. Methods Seventy-nine medical students completed the YSQ-short form 3, the Beck Depression Inventory, and the Symptom Checklist-90-Revised during their first and third years of medical school. Results After controlling for depression severity, YSQ subscales showed significant test-retest correlations for all of the subscales (r between 0.49 and 0.77, ps<0.001). Mean scores for all of the subscales did not differ significantly at retest, with the exception of a significant reduction of vulnerability to harm/illness (t=3.71, p<0.001). Concerning the relationship with depression, some YSQ subscales showed association with the severity of depressive symptoms at each time point, as well as changes between two time points. In particular, the schemas of Defectiveness/Shame and Dependence/Incompetence showed a strong association with changes of depressive symptoms. Conclusion These findings demonstrated that EMS measured using the YSQ may show con-siderable temporal stability over time, but, in part, may be affected by an individual’s state, such as depression. 이번 연구를 통해 YSQ로 측정된 EMS는 중간 정도 이상의 강한 상대 안정성과 절대 안정성을 갖고 있는 것이 확인되었다. 우울 증상의 변화에 따라 결함/수치심, 의존/무능감의 스키마가 가장 크게 변화하여, 두 개의 스키마가 우울 증상의 발생과 회복에 밀접하게 기여하는 것으로 나타났다. 이러한 결과는 EMS가 특질적 특성과 상태적 특성을 동시에가진다는 이론을 지지하는 근거가 될 수 있다. 추후 보다 많은 일반 인구 집단 및 임상군을 대상으로 한연구를 통하여 스키마 치료에 대한 경험적 근거를 찾는 접근이 필요하겠다.

정신건강전문요원으로서의 임상심리학자의 현재와 미래

원성두,최선,배금예,배대석,이준석 한국임상심리학회 2018 Korean Journal of Clinical Psychology Vol.37 No.S

1995년 정신보건법의 제정으로 국내 임상심리학자는 국가가 발급하는 전문자격증을 취득해 국가 정신건강 사업에 참여할 수 있는 법적 지위를 얻게 되었다. 이를 통해서 임상심리학자가 정신건강전문요원 중 하나로 자리매김하게 되면서 전문가로서 진출할 수 있는 영역 및 활동범위가 확대되었다. 2016년 정신보건법이 [정신건강증진 및 정신질환자 복지서비스 지원에 관한 법률]로 전면 개정됨에 따라 정신건강임상심리사의 역할이 다양해지고 이에 맞게 수련과정이 개편되었으며 자격 취득 후의 보수교육이 의무화되었다. 국내 정신건강임상심리사 제도의 역사, 주요 업무, 배출 현황 및 수련 실태를 살펴보고 향후 발전방향을 논의하였다. 특히 정신건강 시스템의 변화로 인해 발생한 현안문제들을 고려할 때 정신건강임상심리사가 국가 전문자격증으로서 법적 지위를 지속적으로 보장받는 데 필요한 대안을 제시하였다.

한국어 개정판 친밀관계경험 척도의 단축형 개발

윤혜림,이원기,배금예,이상원,우정민,원승희,Yun, Hyerim,Lee, Won-Kee,Bae, Geumye,Lee, Sang-Won,Woo, Jungmin,Won, Seunghee 대한불안의학회 2017 대한불안의학회지 Vol.13 No.2

Objective : The experiences in close relationships questionnaire-revised (ECR-R) (Fraley, Waller & Brennan, 2000) is a valuable tool for measuring adult attachment, and its Korean version, the ECRR-K (Kim, 2004), is widely used in Korea. However, given its substantial length, this study was aimed to develop and validate a short version of the ECRR-K called the ECRR-K14. Methods : Two hundred and ninety-four medical students participated in this study in 2016. They completed the ECRR-K, the Perceived Stress Scale (PSS), the Rosenberg Self-Esteem Scale (RSES), and the UCLA Loneliness Scale (UCLA-LS). The study authors applied the Rasch rating scale to check each item's model fit and then performed confirmatory factor analyses (CFAs) to test the new scale's validity. Results : The authors selected seven items each for the anxiety and avoidance subscales, and the ECRR-K14 showed fair to good internal consistency (Cronbach's ${\alpha}=0.93$ and 0.92 for anxiety and avoidance, respectively). The anxiety subscale showed concurrent validity with the PSS and the RSES while the avoidance subscale showed concurrent validity with the UCLA-LS. The CFAs also demonstrated the validity of the model with a goodness-of-fit index of 0.916. Conclusion : The ECRR-K14 showed excellent reliability and validity and appears to be a promising instrument for measuring the two attachment dimensions in adults.

시지각적 자극의 특성이 이름대기 검사결과에 미치는 영향

손세익(Se Ik Son),배금예(Geum Ye Bae),원승희(Seung-Hee Won),김병수(Byung-Soo Kim) 대한생물치료정신의학회 2016 생물치료정신의학 Vol.22 No.1

Objectives:The 15-item Modified Boston Naming Test in CERAD-K(BNT-KC) is composed of line drawings and has the possibility of lacking accuracy due to visual perceptual ambiguity of the stimulation. In order to minimize this, we developed a revised version of BNT-KC composed of photographic stimulation of the same contents, and compared the diagnostic accuracy of it with the original version. Methods:Pictures of the same objects in the original BNT-KC were taken by camera or downloaded from the internet. One hundred and eighty-four elderly, who visited the memory clinic for the diagnosis of dementia(95 Alzheimer’s dementia(AD), 89 normal), completed both the versions of BNT-KC. Difference in the total score was compared using paired t-test. To verify whether there is a difference with the matched pairs of items, the McNemar’s test was carried out. Area under a receiver operating characteristic curve(AUC) was obtained to compare the performance of each test. Results:There was a significant difference between the total score of the original version and the photographic version of BNT-KC(t=14.26, p<0.001). Eight items, “Cobweb,” “Balloon,” “Bat,” “Traffic light,” “Acorn,” “Pomegranate,” “Funnel,” and “Monk’s hat,” demonstrated significant differences in the McNemar’s test after the Bonferroni correction(p<0.003). AUCs for the diagnosis of AD in the original and photographic versions were 0.696 and 0.705, respectively. AUCs for the identification of moderate to severe AD(CDR 2 or higher) from others were 0.784 for the original version and 0.808 for the photographic version. Conclusion:Characteristics of visual perceptual stimuli influenced the diagnostic accuracy of BNT-KC, especially in the identification of patients with moderate to severe AD. Revision of BNT-KC is required to enhance the diagnostic accuracy for dementia.

주요우울장애, 양극성장애, 강박장애, 편집형 정신분열병 환자의 부논특성 비교

손옥선(Ok-Sun Son),배금예(Geum-Ye Bae),이승재(Seung Jae Lee) 대한생물치료정신의학회 2009 생물치료정신의학 Vol.15 No.2

Objectives: This study was carried out to assess anger level and way of anger expression in patients with psychiatric disorders; Major depressive disorder, Bipolar disorder, Obsessive-Compulsive disorder, Paranoid Schizophrenia. And it was intended to identify relationship between anger-in symptoms and underlying depression. Methods: MMPI-2(Minnesota Multiphasic Personality Inventory-2) and Rorschach test were completed by patients(MDD : 22, BD : 17, OCD : 14, SPR-P : 19). Correlation test was carried out to examine the relationship between MMPI-2 and Rorschach variables related to anger, depressive mood, somatization, hostility, aggression, impulsivity and interpersonal relationship, ego function. ANOVA, Scheffe test and ANCOVA which is exclusive depressive mood variable were conducted to compare character of anger expression between each diagnostic groups. Results: Forty four percent of patients were classified as an anger-in type across four diagnostic groups. Each diagnostic group showed the differential expressive types of suppressed anger; somatization in MDD, externalizing impulsive behavior in BD, argument in OCD, persecutory thinking, impulsive and aggressive behaviors in SPR-P. After controlling depression, these differences disappeared except that impulsivity in SPR-P and BP. Especially high ego function patients is more trying to suppress and anger-in but these effort are failed, they tend to have more anger and anger-attack. Conclusion: This study shows that patients with psychiatric disorders have high trait-anger but they tend to suppress or anger-in. And each group express another way their suppressed anger but their anger-in symptoms are more related to underlying depression than diagnosed type. Hence, these results suggest that first of all the intervention of depression is helpful to reduce anger-in symptoms for all diagnostic groups. And High ego function patients need more attention to their underlying depression, therapeutic approaches that they could express anger more appropriate.

초기 알츠하이머병 환자와 주요 우울증 환자의 기억기능 비교

이지성(Ji Soung Lee),배금예(Geum Ye Bae),이정재(Jung Jae Lee),김기웅(Ki Woong Kim) 대한생물치료정신의학회 2010 생물치료정신의학 Vol.16 No.2

Objectives : We aimed to evaluate the memory function of early Alzheimer’s disease(AD) group and Major depressive disorder(MDD) group compared with normal control(NC) group and to investigate the accuracy of memory function in differentiation of each group. Methods : Fifty early AD patients and 30 MDD patients and 30 age- and sex- and education-matched NC subjects were selected. The Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease assessment packet(CERAD-K), Logical Memory Test(LMT), and Benton Visual Retention Test(BVRT) were administered. Results : Early AD group performed significantly worse than MDD and NC group in most verbal and visual memory tests. In contrast, MDD group obtained more impaired score than NC in most tests but no significantly differences were found between MDD and NC except for delayed recall test of verbal memory. Discrimination analysis of quantitative indices demonstrated 86.3% of diagnosis precision rate. Also discrimination analysis of qualitative indices which measured the process of memory indicated that overall percentage correct classification was 93.8%. Conclusion : In quantitative indices, constructional recall test(CRT) and word list recall(WLR) were highly correlated with function which discriminates between early AD and MDD group. In qualitative indices, learning slope of LMT, false positive error and intrusion error of CERAD-K, distortion error of BVRT, and response time of BVRT have high discriminating power.

일 대학교 의과대학생과 의학전문대학원생의 심리적 특성 비교

전지은,이승재,이병대,이정재,배금예,임효덕 대한신경정신의학회 2009 신경정신의학 Vol.48 No.5

의대생과 의전원생 간에 유의한 심리학적 차이가 있었다. 이러한 차이는 남자 집단 간의 비교에서 두드러졌으나 여자집단 간 비교에서는 차이를 나타내지 않았다. 전반적으로 의대생에 비해 의전원생이 정신병리에 대한 점수가 더 낮고, 심리적인 문제가 적은 경향을 나타냈다. 세부 항목에서는 남자 의대생이 남자 의전원생에 비해 우울증, 내향성, 강박증 경향이 더욱 높게 나타났다. 이러한 자료는 변화된 제도 하에 입학하게 된 의전원생의 심리적 특성을 파악하여 의전원 교육과정 및 학생 생활지도를 발전시키는데 있어 주요한 참고자료로 활용할 수 있을 것이다. 또한, 향후 보완 연구를 통해 보다 정확히 의대생과 의전원생의 심리적 특성 차이를 규명하여야 할 필요가 있다. Objectives: The conversion of medical colleges into medical schools has been attempted by the Korean government since 2005. The aim of this study was to compare psychological characteristics of undergraduate and graduate medical students before and after changes in the medical educational system. Methods: Four hundred-and-twenty-eight medical students participated in this study;247 were undergraduates and 181 were graduate students. The participants completed psychological assessments including the Minnesota Multiphasic Personality Inventory (MMPI), the Symptom Checklist-90-Revision (SCL-90-R), the Beck Depression Inventory (BDI), and the Alexithymia Scale. Results: Overall, undergraduate medical students demonstrated significantly higher scores than the graduate medical student on three of MMPI subscales (F, depression, and social introversion) and two of SCL-90-R subscales (somatization and obsessive-compulsive). When comparing the four groups (male undergraduate, female undergraduate, male graduate, female graduate) using analysis of covariance and controlling for age as a covariate, there were significant differences between male graduate and male undergraduate medical students in the same subscales except somatization, whereas there were no significant differences between female groups. Conclusion: These findings suggest that male graduate medical students may have better mental health states and less psychological problems than undergraduate medical students even after controlling for age. However, these differences were not found between female groups. Although every score of all items was within normal range regardless of group, distinctive differences between male graduate and undergraduate students were revealed for some psychological profiles such as depression, social introversion, and obsessive-compulsive traits.

위드코로나 시기 아동 돌봄 공백 해소를 위한 어린이식당 사업의 효과성: 초록우산 어린이재단 부산종합사회복지관 어린이식당 운영 경험을 바탕으로

구은미 ( Eun-mi Koo ),김수정 ( Soo Jung Kim ),배금예 ( Keum-ye Bae ) 초록우산 어린이재단 2022 동광 Vol.117 No.-

본 연구는 최근 3년간 운영해온 부산 동구 어린이식당 사업의 효과성을 밝히고, 이러한 사업이 아동 돌봄체계 구축을 위한 지역조직화 사업으로서 타당성이 있는지 살펴보고자 수행되었다. 먹거리 활동은 단순히 한 끼 식사를 의미하는 것을 넘어 관계회복 및 공동체 형성과 돌봄, 복지문제 등 여러 사회문제를 공동으로 해결하는 효과가 있음을 알 수 있다. 특히 코로나19는 우리사회 돌봄체계 문제를 가시화하였으며, 이를 계기로 돌봄서비스 다양화가 필요함을 확인할 수 있었다. 이러한 돌봄위기는 자녀돌봄의 책임이 가족에게 부과되어 돌봄이 개인과 지역사회, 국가가 함께 대응해야 할 사회적 의제임에도 불구하고 우리 사회에서 돌봄구조의 공백을 확인하는 계기가 되었다. 어린이식당은 아동이 먹거리 기본권을 보장받고 지역사회와 연대하며, 공동체 중심으로 운영될 수 있도록 노력하였고, 이를 통해 지역사회 구성원의 아동옹호역량 강화와 아동의 돌봄 사각 지대 및 가정의 양육부담 해소를 도모하여 위드코로나 시기에 대응하는 복지사업 모델을 지향하고 있다. This study was conducted to examine the effectiveness of Children's restaurant 1 project in Dong-gu, Busan for the last three years, and to examine the validity of community organization project for to establish child care system. It can be seen that food activities have the effect of jointly solving various social problems such as relationship restoration, community formation, care, and welfare problems, beyond simply meaning a single meal. In particular, COVID-19 visualized the problem of our social care system, and it was confirmed that diversification of care services was necessary. This care crisis was an opportunity to confirm the gap in the care structure in our society, even though care is a social agenda which individuals, communities, and the state should respond to together as the responsibility for caring for children was imposed on the family. The Children’s restaurant has made efforts to ensure basic food rights, to solidarity with the community, and to operate community-oriented, thereby strengthening the child protection capabilities of community members and reducing the burden of caring for children and raising families.