Min Sup Shin

The relationship between temperament and character and psychopathology in community children with overweight.

ABSTRACT. This study investigated the relationship between temperament and character and psychopathology in at risk of overweight and overweight children. The Child Behavior Checklist (CBCL) and the Junior Temperament and Character Inventory (JTCI) questionnaires were administered to 453 children (10-12 years of age, 203 boys and 250 girls) in Kimpo, South Korea. Subjects were divided into three groups; (1)nonoverweight children (n = 345), (2) children at risk of overweight (n = 72), and (3) overweight children (n = 36). CBCL and the JTCI scores were compared among three groups. In addition, the relationships between subscales of the CBCL and the JTCI were evaluated. On the CBCL, overweight children had higher scores in social problems, delinquent problems, and total problems compared to nonoverweight children. Children at risk of overweight showed higher scores only in social problems compared to nonoverweight children. On the JTCI, lower persistence and tendency of higher novelty seeking was observed in overweight children compared to nonoverweight children. Persistence scores were negatively correlated with scores of delinquent problems, externalizing problems, and total problems in overweight children. Compared to nonoverweight and children at risk of overweight, overweight children had distinct patterns of temperament and character that were related to the specific psychopathology.

Are Teacher Ratings and Parent Ratings Differently Associated with Children's Intelligence and Cognitive Performance?

Objective The present study investigated whether teacher ratings and parent ratings of inattentive or hyperactive/impulsive symptoms were differently associated with intelligence or cognitive performance in Korean children. Methods Six hundred sixty-seven children were recruited from nine schools in five Korean cities. The teachers and parents of 580 of these children (9.0±0.7 years old, 333 boys and 306 girls) completed the Korean version of the Attention-Deficit/Hyperactivity Disorder Rating Scales (K-ARS), and the children performed the abbreviated form of the Korean Educational Development Institute-Wechsler Intelligence Scales (KEDI-WISC) and a neurocognitive battery consisting of the continuous performance test, the Childrens Color Trails Test, and the Stroop Color-Word Test. Diagnosis of full-syndrome and subthreshold attention-deficit/hyperactivity disorder (ADHD) were based on the Diagnostic Interview Schedule for Children Version-IV (DISC-IV). Results The level of agreement between teacher and parent ratings was low (r=0.21-0.26) in children with full-syndrome and subthreshold ADHD and low to moderate (r=0.31-0.41) in the normative sample. Teacher-rated ARS showed significant correlations with most sub-scores of KEDI-WISC and the neurocognitive battery both in the normative sample (r=-0.50-0.37) and in children with full-syndrome and subthreshold ADHD (r=-0.26-0.29). Correlations between parent-rated ARS and cognitive tests were lower and were found in fewer subscales of tests. Conclusion These results suggest the importance of considering the teachers report of a childs school functioning during the assessment of ADHD.

Supporting diagnosis of attention-deficit hyperactive disorder with novelty detection

OBJECTIVEnComputerized continuous performance test (CPT) is a widely used diagnostic tool for attention-deficit hyperactivity disorder (ADHD). It measures the number of correctly detected stimuli as well as response times. Typically, when calculating a cut-off score for discriminating between normal and abnormal, only the normal childrens data are collected. Then the average and standard deviation of each measure or variable is computed. If any of variables is larger than 2 sigma above the average, that child is diagnosed as abnormal. We will call this approach as T-score 70 classifier. However, its performance has a lot to be desired due to a high false negative error. In order to improve the classification accuracy we propose to use novelty detection approaches for supporting ADHD diagnosis.nnnMETHODS AND MATERIALnNovelty detection is a model building framework where a classifier is constructed using only one class of training data and a new input pattern is classified according to its similarity to the training data. A total of eight novelty detectors are introduced and applied to our ADHD datasets collected from two modes of tests, visual and auditory. They are evaluated and compared with the T-score model on validation datasets in terms of false positive and negative error rates, and area under receiver operating characteristics curve (AuROC).nnnRESULTSnExperimental results show that the cut-off score of 70 is suboptimal which leads to a low false positive error but a very high false negative error. A few novelty detectors such as Parzen density estimators yield much more balanced classification performances. Moreover, most novelty detectors outperform the T-score method for most age groups statistically with a significance level of 1% in terms of AuROC. In particular, we recommend the Parzen and Gaussian density estimators, kernel principal component analysis, one-class support vector machine, and K-means clustering novelty detector which can improve upon the T-score method on average by at least 30% for the visual test and 40% for the auditory test. In addition, their performances are relatively stable over various parameter values as long as they are within reasonable ranges.nnnCONCLUSIONnThe proposed novelty detection approaches can replace the T-score method which has been considered the gold standard for supporting ADHD diagnosis. Furthermore, they can be applied to other psychological tests where only normal data are available.

Switching from Methylphenidate-Immediate Release (MPH-IR) to Methylphenidate-OROS (OROS-MPH): A Multi-center, Open-label Study in Korea.

Objective The objective of this study was to evaluate the efficacy and safety of methylphenidate HCL OROS extended-release (OROS-MPH) among children with attention deficit hyperactivity disorder (ADHD) who had been previously treated with methylphenidate HCL immediate-release (MPH-IR). Methods The sample included 102 children aged 6-12 (9.4±2.6) years who had been diagnosed with ADHD according the criteria of the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV; American Psychiatric Association, 1994) and who were attending seven centers in Korea. All participants had been medicated with a stable dose of MPH (10-60 mg/day) for at least 3 weeks before entry into the study. Doses of OROS-MPH were comparable to daily doses of MPH. Efficacy was assessed at baseline (day 0) and at day 28 with the Inattentive-Overactive with Aggression (IOWA) Conners Rating Scale, which was completed by parents/caregivers and teachers, the Peer Interaction Rating Items, which were completed by teachers, and the Clinical Global Impression (CGI) scale, which was completed by child psychiatrists. Paired t-tests were used, and P-values were set at the 0.05 level. Results Of the subjects, 92.2% were boys and 79.4% were students in the first to fourth grades of elementary school. 72% were diagnosed with the combined type of ADHD, 23% were diagnosed with the inattentive type, and 5% were diagnosed with the hyperactive-impulsive type. The results of the parents responses to the Inattention/Hyperactivity (I/H) and Oppositional/Defiant (O/D) subscales of the IOWA Conners scale indicated statistically significant improvement in childrens behavior after 4 weeks of treatment with OROS-MPH (t=6.28, p<.001, t=4.12, p<.001). However, the teachers responses to the Conners I/H and O/D subscales indicated no significant improvement at 4 weeks. The teachers also reported no significant improvements under the OROS-MPH compared with the MPH-IR condition with respect to peer interactions. Scores on the CGI scale showed that 46.1% of children with ADHD were rated by psychiatrists as minimally improved, 27.5% as much improved, 1.0% as very much improved, 3.9% as minimally worse, and 16.7% as showing no change. Children exhibited significantly fewer tics with OROS-MPH treatment than with MPH-IR treatment (19.6% vs. 27.7%). We found no differences between in sleep and appetite problems according to medication. Conclusion The results of this study indicated that an MPH-IR regimen can be successfully changed to a once-daily OROS-MPH regimen without any serious adverse effects. The changes in parent/caregiver IOWA Conners ratings suggested that OROS-MPH improved the control of symptoms after school, a finding that is consistent with the 12-h duration of action of this medication. Because the therapeutic effect of OROS-MPH is sufficiently longer than that of a b.i.d. dose of MPH-IR, OROS-MPH had significant positive effects on oppositional/defiant behavior in addition to its effects on the core symptoms of ADHD.

NEURAL NETWORK BASED AUTOMATIC DIAGNOSIS OF CHILDREN WITH BRAIN DYSFUNCTION

This paper proposes the use of multilayer perceptron for brain dysfunction diagnosis. The performance of MLP was better than that of Discriminant Analysis and Decision Tree classifiers, with an 85% accuracy rate in an experimental test involving 332 subjects. In addition, the neural network employing Bayesian learning was able to identify the most important input variable. These two results demonstrate that the neural network can be effectively used in the diagnosis of children with brain dysfunction.

A Comparative Study of Computerized Memory Test and The Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet for Assessing Memory Function in the Elderly

Objective The aim of this study was to examine the concurrent validity of a newly developed computerized memory diagnostic system (MDS) with the Korean version of the Consortium to Establish a Registry for Alzheimers Disease Assessment Packet (CERAD-K). Methods Subtests of the MDS and CERAD-K, including the auditory-verbal, visuo-spatial, and working memory tests, were administered to 43 adults aged 60 to 74 years. We calculated the correlations between the subtest scores of the MDS and CERAD-K to examine the concurrent validity of the MDS. Results We found significant correlations between the subtest scores in the verbal-auditory memory, including immediate recall, delayed recall, and delayed recognition. The working memory subtest scores between the MDS and CERAD-K also showed a significant positive correlation. Conclusion We verified the concurrent validity of the memory subtests in the MDS for the elderly. The results of the present study suggest that the MDS could be a valuable tool for an efficient and valid assessment of memory function.

Prenatal, Perinatal and Infancy History of Autism Spectrum Disorder

Objectives:The purpose of this study was to evaluate the prenatal, perinatal, and infancy history of children with autism spectrum disorder (ASD) as compared to unaffected siblings (SIB) and typically developing children (TC). Methods:Subjects with ASD, their SIB, and TC were recruited. All subjects were assessed using both the Korean version of Autism Diagnostic Interview-Revised (K-ADI-R) and the Korean version of Autism Diagnostic Observation Schedule (K-ADOS) and were subsequently identified as affected or unaffected. Prenatal, perinatal, and infancy history was obtained from the primary caregivers and each facet was compared in those with ASD, the SIB, and the TC groups using SPSS ver. 17.0 (p<.05). Results:70 individuals with ASD (63 males, 87.94±37.8months), 53 SIB (27 males, 85.40±48.06 months), and 32 TC (19 males, 104.19±23.409 months) were analyzed. The ASD group showed significantly higher rates of insufficient vaccination as they aged age (χ 2 =15.54, p=.000). Among the scheduled vaccinations, the DPT vaccination (χ 2 =10.08, p=.006) was insufficient in ASD groups. The ASD group also showed higher rates of sleep disturbances from infancy. Differences in maternal/paternal age at conception, gestational age, and growth parameters at birth were not significantly difference among the three groups. Conclusion:These results do not support the previous controversies regarding the relationship between prenatal/ perinatal complications and ASD. However, these results indicate that perinatal and prenatal factors may contribute to the development of ASD.

Advanced Test of Attention in Children with Attention-Deficit/Hyperactivity Disorder in Japan for Evaluation of Methylphenidate and Atomoxetine Effects

Objective This study was conducted to validate the Advanced Test of Attention (ATA) of the visual attention version of Japanese children with attention deficit/hyperactivity disorder (ADHD) and to evaluate the efficacy of methylphenidate (OROS-MPH) and atomoxetine medications. Methods To assess pharmacotherapy efficacy, the visual version of ATA was administered to 42 children with ADHD. Results were assessed using discriminant analysis, ANOVA for indices of ATA before and after medication treatment, and correlation analysis between the improvement of indices of ATA and clinical symptoms during medication treatment. Results Discriminant analysis showed that 69.0% of ADHD children were assigned correctly. The T score of commission errors increased as the trial progressed on the medication-off condition. T scores of commission errors and standard deviation of response times on medication-on condition were low compared to the medication-off condition. A few significant correlations were found between the improvements of indices of ATA and ADHD-Rating Scale (RS) during treatment. Conclusion The performance of the visual version of ATA on medication-off condition reflected the features of ADHD. Furthermore, the medication treatment effects were confirmed sufficiently. In addition, results suggest that indices of ATA reflected aspects of ADHD symptoms that are difficult to elucidate for ADHD-RS. For assessing symptoms and effects of medical treatment in children with ADHD, ATA might be a useful assessment tool.