MENTAL REPRESENTATION OF PRESCHOOL CHILDREN：ASSOCIATION WITH PARENTAL MENTAL REPRESENTATION

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미성년 성폭력 사건의 문제점과 대책

In Korea, concerns over child sexual abuse have been rising recently because of the fatal consequences for victims and the fact that the incidence has continued to increase even after the government’s efforts to intensify the punishment of perpetrators. While the angry and painful responses of many Koreans to recent incidents of child sexual abuse, such as the Jo Doo Soon case, are intense enough to lead to the government’s urgent reactions to resolve it, few systematic, comprehensive approaches to coping with and preventing sexual abuse of children and adolescents have been developed. To establish efficient systems for coping with and preventing child sexual abuse, well trained experts such as physicians, psychologists, and social workers, and social service systems to train these professionals as well as institutions to provide appropriate medical and welfare services are essential. However, the current systems supporting victims of child sexual abuse, such as the Sunflower Children’s Center, One-stop Center, and other counseling centers, are not well coordinated and lack knowledgeable professionals. Furthermore, since there is no responsible government department to integrate the social welfare and legal systems for child sexual abuse, services are inefficient and decentralized. Thus to cope with and prevent child sexual abuse in Korea, we need to establish good, efficient social service systems to train experts, to coordinate each organizations, to integrate child sexual abuse treatment and prevention into the general child welfare system, and to establish enough service centers to provide all legal, medical, welfare, and other services requiredope

Understanding of Sexual Violence and the Role of Health Care Provider in Korea

The issues raised by the ‘me too’ movement, which have been alarming members of Korean society since early 2018, are ‘unspeakable.’ In past instances of sexual violence, the silence of some victims indicated there was no crime and no harm. The societal approach that did not identify, name, or reveal the damage made the existence of ‘sexual violence’ possible. In the medical community, it is necessary for sexual violence victims who visit medical institutions to ensure the victim can “talk” to a health care provider. Medical practitioners need to have the knowledge, skills, and experiences to enable victims of sexual violence to engage in professional interventions at each stage of sexual violence treatment. During each stage, medical staff should base their treatment on an understanding of the specific situation of the sexual violence victim. In this review article, we introduce various phenomena associated with sexual violence that is aimed at minority groups, including technology-facilitated sexual violence.ope

Conversational Agent for Supporting Self-regulation in Children’s Daily Activities in the Pandemic Era

Background COVID-19 has brought significant changes to the lives of young children. In particular, changes in school life have negatively impacted children’s daily activities, and physical and developmental difficulties have been observed. This study confirms a newly found problem that children are facing due to COVID-19 and the effectiveness of a digital assistant that is developed to help them tackle the problem. Methods Study 1 utilized interviews with school staff to identify problems. The interview data were analyzed based on thematic analysis. In light of the results of Study 1, Study 2 included a conversational agent prototype that would operate in a home to help children perform daily tasks. Study 2 was conducted as a field study with 11 children. A survey involving children was conducted to determine whether using prototypes was helpful for daily routine formation and self-efficacy among children. Interviews were conducted with parents and children. Quantitative and qualitative analyses were also conducted. Results The results of Study 1 suggest that students have endured various difficulties due to the COVID-19 pandemic. Study 1 concludes that children required a more defined routine lifestyle during the pandemic. Study 2 establishes that the developed assistant improved daily routine task execution and self-efficacy. The post-study interviews confirm that children were supported in acquiring regularity and that they perceived the conversational agent as helpful. Conclusions This study reveals the value required for target users, designs a prototype to deliver it, and confirms the protype’s effectiveness. The study proposes a new method for increasing the quality of life of children in unique environments, such as that caused by the COVID-19 pandemic.ope

Model Development of School Mental Health Service：2. Model Development of School Mental Health Service in Korean Urban Communities

This research was aimed at developing a model for school mental health service. Subjects were students at two elementary schools located in an urban community. The goals of the study included； 1) early detection and intervation in children with mental health problems；2) developing educational programs for parents and teachers；3) developing programs linking mental health resources in the community with the school system(school consultation, telephone counselling, and group activities for high risk-students). Subjects wers 1,732 students at 2 primary schools in a community of Seoul. Problem children were selected thorugh screening with CBCL and were examined by psychiatrists. The results were as follows： 1) Of 1,732 students, nearly 8% had mental health problems. The parents of the studyents with mental health problems were urged to seek psychiatric care. However, only 8% of them had a positive response. On the other hand, telephone counselling was preferred and 40% of them said they had vistied a psychiatric clinic. 2) Regarding the education of parents, they preferred telephone counselling and written information to direct counselling or participating in education programs. In most cases, they avoided talking about their childern’s problems. 3) Teachers showed a ggod sense for decting children’s mental health problems, but they suffered from a feeling of helplessness because of lack of knowledge and skills. 4) Special education programs were needed for suudents with serious behavior prblems. Group activities, which were directed by college student volunteers, had been proved to be effective in helping children with high risks. 5) This suggests that the stigma for mental disorder is still an obstacle in mental health service and that fechers need on-going systemic education on children’s mental health since college period. Based on these study results, the authors surggest a model of school mental health service linking the school system, family(parents) and professional mental health resources in the community.ope

NEUROBIOLOGY OF ATTACHMENT

It is difficult to think of any behavioral process that is more intrinsically important to human beings than social attachment. Feeding, sleeping and locomotion are all necessary for survival, but humans are 'a social animal' and it is our social attachment that we live for. One of the early pioneers in this area, Harry Harlow, described the different behavioral processes that are involved in the formation of parent-infant, filial and pair(male-female) bonds. Each of these involves multi-sensory processing and complex motor responses. Over the past decades, studies in a range of vertebrates, including humans, have begun to address the neural basis of attachment at a molecular, cellular and systemic level. This review describes some of important insights from these works, involving three different areas：1) Neurobiological research of infant-parent, parent-infant attachment, 2) Animal studies regarding attachment, 3) Neurobehavioral studies of maltreatment/deprivation causing serious breakdown of attachment relationship in humans.ope

Correlations Between Cognitive Functions and Clinical Symptoms in Adolescents With Complex Post-traumatic Stress Disorder

Introduction: Complex post-traumatic stress disorder (C-PTSD) is characterized by the typical symptoms of PTSD, in addition to affective dysregulation, negative self-concept, and disturbances in interpersonal relationships. Children and adolescents with C-PTSD have been reported to have deficits in emotional and cognitive functions. We hypothesized that the following are associated with the severity of C-PTSD symptoms: (1) adolescents with C-PTSD who show deficits in emotional perception and cognitive functions, including executive function and attention; and (2) deficits in neurocognitive functions. Methods: Information on 69 adolescents with PTSD, aged 10-19 years, was gathered from seven shelters. All participants were assessed using complete clinical scales, including the C-PTSD Interview and Depression, Anxiety, and Stress Scales, and neurocognitive function tests, including the emotional perception, mental rotation, and modified Tower of London tests. Results: Adolescents with C-PTSD were more likely to have a history of sexual assault, dissociation, and self-harm than those with PTSD. The total and subscale scores of the C-PTSD Interview Scale in adolescents with C-PTSD were higher than that in adolescents with PTSD. In addition, neurocognitive functions, including emotional perception, attention, and working memory, were correlated with the severity of C-PTSD symptoms. Discussion: Adolescents with C-PTSD experienced more serious clinical symptoms and showed more deficits in neurocognitive functions than adolescents with PTSD. Clinicians should pay careful attention toward the emotional and neurocognitive functions when assessing and treating patients with C-PTSD.ope

PRELIMINARY STUDY OF BRAIN SPECT IN CHILDREN WITH PERVASIVE DEVELOPMENTAL DISORDER OR DEVELOPMENTAL LANGUAGE DISORDER

Objectives：The purpose of this study was to investigate the characteristics and differences of brain function in pervasive developmental disorder and developmental language disorder. Method：The subjects were composed of 14 cases of pervasive developmental disorder and 13 cases developmental language disorder. They were investigated by technitium-99m-EDC SPECT. All SPECT were visually assessed by two nuclear medicine specialists, and then quantified by region of interest including temporal, parietal cortex, thalamus, basal ganglia and cerebellum. Result：In both groups, cerebral blood flow was decreased in the temporal, parietal cortex, basal ganglia, thalamus, cerebellum by visual assessment. There was no significant difference between the 2 groups by quantitative and qualitative assessment. Conclusion：These results suggest that pervasive developmental disorder and developmental language disorder are caused by defects in the interneural connection and that both disorders are spectrum disorders.ope

Prenatal PM 2.5 affects atopic dermatitis depending on maternal anxiety and gender: COCOA study

Background: The prevalence of atopic dermatitis (AD) is increasing worldwide. Prenatal particulate matter with an aerodynamic diameter <2.5 μm (PM2.5) and maternal anxiety during pregnancy has been suggested as a potential causes of AD. This study investigated the effects of prenatal PM2.5 and maternal anxiety on AD and identified the critical period of PM2.5 exposure for AD in infants. Methods: This study included 802 children from the COCOA birth cohort study with follow-up data at 1 year of age. PM2.5 was estimated by land-use regression models and prenatal anxiety was measured with a questionnaire. AD was diagnosed by doctor at 1 year of age. Logistic regression analysis and Bayesian distributed lag interaction models were applied. Results: Higher PM2.5 during the first trimester of pregnancy, higher prenatal maternal anxiety, and male gender were associated with AD at 1 year of age (adjusted odds ratio [aOR] and 95% confidence interval [CI]: 1.86 [1.08-3.19], 1.58 [1.01-2.47], and 1.54 [1.01-2.36], respectively). Higher PM2.5 during the first trimester and higher maternal anxiety during pregnancy showed an additive effect on the risk of AD (aOR: 3.13; 95% CI: 1.56-6.28). Among boys exposed to higher maternal anxiety during pregnancy, gestational weeks 5-8 were the critical period of PM2.5 exposure for the development of AD. Conclusions: Higher PM2.5 exposure during gestational weeks 5-8 increased the probability of AD in infancy, especially in boys with higher maternal anxiety. Avoiding PM2.5 exposure and maternal anxiety from the first trimester may prevent infant AD.ope

Allergic diseases in preschoolers are associated with psychological and behavioural problems

PURPOSE: The aim of the present study was to investigate the relationship between three major allergic diseases, asthma, allergic rhinitis (AR), and atopic dermatitis (AD), and psychological and behavioural problems in preschoolers based on a community survey. METHODS: A cross-sectional survey was conducted using a modified International Study of Asthma and Allergies in Childhood questionnaire to determine the prevalence of symptoms and diagnosed allergic diseases, and a Korean version of the Child Behaviour Checklist to assess internalizing, externalizing, and sleep problems among 780 preschoolers. Five-hundred and seventy-five preschoolers with valid data were included in this study. RESULTS: The prevalence of lifetime diagnosis and treatment in the past 12 months was 8.7% and 4.4% for asthma, 24.4% and 19.2% for AR, and 35.1% and 16.6% for AD, respectively. Scores for internalizing and sleep problems were significantly higher in those diagnosed with AR. Preschoolers who had been treated for AD in the past 12 months had higher attention problem and attention-deficit/hyperactivity disorder scores. Sleep problems were more severe in moderate to severe AD compared to control and mild AD groups, categorised according to SCOring index of AD. The severity of sleep problems correlated positively with the percentage of eosinophils in peripheral blood. CONCLUSIONS: Psychological and behavioural problems differed among the three major allergic diseases, weaker association for asthma and stronger association for AR and AD. The results of this study may lead to the identification of potential underlying shared mechanisms common to allergic diseases and psychological and behavioural problemsope