The Hypomania Symptom Checklist-32 (HCL-32) has been developed in several European countries to detect and diagnose present or past hypomanic episodes. The purpose of this study was to develop a Korean version of the HCL-32 scale and validate its psychometric properties. The participation in our study were 200 patients with a principal DSM-IV diagnosis of type I (N=55) or type II (N=37) bipolar disorder or unipolar major depression (N=108). All underwent a formal, structured diagnostic assessment. The internal consistency of the Korean version of the HCL-32 was found to be 0.88. We analysed the best cut-off point by means of a ROC curve analysis and, for 12 affirmative responses, obtained a sensitivity of 0.80 and a specificity of 0.55. It has suggested that the Korean version has two main factors as found in previous studies. The Korean version of the HCL-32 has good psychometric properties and sufficient sensitivity and specificity. While it is expected that this scale will be helpful in clinical settings and research protocols in Korea, further studies are needed with larger samples of bipolar patients.
The purpose of this study was to investigate the diagnostic availability of the MMPI-2 profile in patients with depression and patients with schizophrenia. The participants were 37 patients with depression, 36 patients with schizophrenia and 36 normal controls. The patients with depression showed a mean profile of 2-7-0 and significantly high T scores (T≥ 65) in 2 and 7. The patients with schizophrenia showed a mean profile of 8-6, but the T scores of the two scales were not clinically significant (T < 65). In the normal group, the T scores on the clinical and content scales were almost all under 50. A series of logistic regression analyses was conducted to examine the diagnostic ability of the clinical and content scales to differentiate between the three groups. Consistent with the previous literature, the content scales of DEP and TPA proved to be the most powerful predictors in distinguishing the depressed patients from the normal controls, and the clinical scale 8 (Sc) and the content scales OBS, BIZ, ANG proved to be the most powerful predictors in distinguishing the schizophrenia patients from the normal group. The clinical scale 2 (D) and the content scales BIZ and ANG proved to be the most powerful predictors in distinguishing depressed patients from patients with schizophrenia. The limitations of this study and suggested directions for future research were discussed.
The purpose of this study was to investigate the influence of perfectionism and the moderating effects of academic motivation on academic procrastination. A total of 600 university students completed a perfectionism scale_(Multidimensional Perfectionism Scale: MPS) and an academic motivation scale_(the motivation-related Study Problems Questionnaire: SPQ). Two weeks later they completed a measure of academic procrastination_ (Procrastination Assessment Scale for Students: PASS). The latter findings showed the necessity of controlling context effects. According to Council(1993; see also Council, Kirsch & Grant, 1996), when self-report measures are administered during the same testing session, respondents appear to infer a relationship between the measures and adjust their responses in the direction of the inferred relationship. To controlling context effects Council(1993; see also Council, Kirsch & Grant, 1996) proposed that the same self-report measures are administered at separate testing intervals(i.e. weeks apart), as different research projects that are carried out by different investigators. This study followed this way. The final group of participants used in this study comprised 382 students (187 males and 195 females). The data were analysed by correlation and multiple regression. The correlation analysis showed statistically significant negative correlations between perfectionism and academic procrastination and between academic motivation and academic procrastination. A positive correlation between perfectionism and academic motivation was also statistically significant. The multiple regression analysis showed that the interaction of perfectionism and academic motivation was significantly associated with academic procrastination. Taken together, perfectionism, academic motivation, and the interaction of perfectionism and academic motivation explained 18.3% of the variance of academic procrastination. Taken separately, academic motivation, the interaction of perfectionism and academic motivation, and perfectionism explained 13.2%, 2.9%, and 2.1% of the variance in academic procrastination, respectively. Academic motivation was found to have a mediating influence on the negative relationship between perfectionism and academic procrastination: the higher the level of academic motivation, the lower was the size of the negative relationship between perfectionism and procrastination. The implications and limitations of the study were discussed.
The purpose of this study was to investigate the effect of near misses and gambling severity on the persistence of gambling behavior. The near miss has been considered a factor which encourages people to gamble. Eighty-two participants were recruited from a casino, a race track, and a bicycle race track and were divided into two groups, a pathological gambler group and a recreational gambler group. The subjects in each of these groups were then assigned to one of two experimental conditions, according to the existence of near misses. The results showed that, under near miss conditions, the pathological gamblers demonstrated significantly longer response times and played the game significantly more than recreational gamblers. Response latencies were unaffected by the presence or absence of near misses in either the pathological or recreational gambler groups, but the response latencies in the pathological group were nevertheless different from those in the recreational gamblers. The results of the present study confirm the findings of previous research on the effects of near misses and gambling severity on gambling behavior.
The aim of this study was to describe a case series of physically abused children who received an individual cognitive-behavioral treatment program. Seven physically abused children took part in 14 weeks of twice weekly individual therapy. The treatment program was developed with a focus on gradual exposure and on cognitive and emotional processing. The children were assessed before and after treatment using measures of post-traumatic stress, anxiety, depression, anger, and attribution style. Significant improvements were found in depression, anxiety, post-traumatic stress, feeling different from peers and interpersonal distrust. The implications and limitations of this study were discussed with suggestions for future study.
According to the temporal model (Frazier, Berman, & Steward, 2002), the dimensions of perceived control consist of past, present, future, and vicarious control, as well as future likelihood. This study was conducted to examine the independent effects of the dimensions of perceived control and the unique effect of avoidance coping on post-traumatic stress symptoms, and to shed light on the specific mechanism through which domestic violence influences post-traumatic stress symptoms in a sample of female assault victims. The participants were 103 women in shelter and related counseling centers, who experienced domestic violence. All completed the Korean versions of the Revised Conflict Tactic Scale, the Assault Attribution Questionnaire, the Impact of Event Scale-Revised, and the Coping Style Scale. Simultaneous multiple regression analysis revealed that only past control independently contributed to post-traumatic stress symptoms above and beyond the other dimensions of perceived control. None of the unique effects of the other dimensions of perceived control on post-traumatic stress symptoms were significant. Hierarchical multiple regression analyses revealed that avoidance coping uniquely contributed to post-traumatic stress symptoms above and beyond all the dimensions of perceived control. Based on these results and those of previous studies, partial and full mediation models, in which past control and avoidance coping mediate the relationship between domestic violence and post-traumatic symptoms, were proposed addition to the simple effect model. Structural equation modeling (SEM) was used to evaluate and compare the two mediation models and the simple effect model. The results of SEM revealed that the full mediation model was superior to both the other models. In the full mediation model, the mediation effect of past control appeared to be relatively stronger than that of avoidance coping. In conclusion, the findings indicate the impotance of considering the role of avoidance coping as well as past control in order to prevent and treat the post-traumatic stress symptoms of female assault victims more effectively.
The purpose of this study was to investigate the psychological differences in between panic disorder and non-panic anxiety disorder patients and to explore more effective ways of treating patients with panic disorder. The MMPI and the Rorschach test were administered to 77 patients with panic disorders and 72 patients with non-panic anxiety disorders. The Rorschach was administered, scored and analyzed in accordance with the Comprehensive System developed by Exner(1993). Rorschach variables were classified in terms of five clusters(Capacity for Control and Stress Tolerance, Cognition, Affect, Self-perception, Interpersonal Perception). Various additional qualitative features were also analyzed. The results showed that the two groups of patients shared a similar pattern of self-recognition of symptoms, both groups were weak in managing resources and modulating affect, and each group demonstrated negative self- perceptions. However, some interesting differences emerged in the thought contents, thought processes, and coping strategies of the two groups. Firstly, patients in the panic disorder group showed higher stress due to affective constraints, efforts in cognitive control, and the poor management of resources. Secondly, while patients with non-panic anxiety disorders exhibited greater levels of social anxiety, patients with panic disorder displayed more negative ideas about their physical functioning. This finding illustrates an important point of contrast between the two groups. The non-panic anxiety patients held negative cognitions about their social functioning, but, for the panic disorder patients, the loss of objectivity occurred in relation to their catastrophic and unrealistic cognitions about their physical functioning. A logistic regression analysis indicated that self-awareness of symptoms, negative self-perception, and focusing on physical symptoms were important features discriminating between the two groups. These findings suggest that therapy for panic disorder patients could be more effective if patients are encouraged to adopt a more realistic set of beliefs and can be made more aware of their defensiveness, affective constraint, and excessive focus on physical symptoms.
Marital beliefs are an important factor in the cognitive-behavioral approach to marital problems. The purpose of this study was to develop a scale for assessing marital beliefs and to investigate its psychometric properties. A 30 item marital beliefs scale was constructed on the basis of the results of a factor analysis of scores on 60 preliminary items (five items in each of 12 marital life areas). The factor analysis yielded two factors: traditional and modern marital beliefs. The marital beliefs scale was administered to another sample of subjects to examine its reliability and validity. The internal consistency of the scale was comparatively high. But its correlation with a general marital dissatisfaction scale (sub-scale of the Korean Marital Satisfaction Inventory) was not. However, when couple's data were investigated, a low, but statistically significant, positive correlation was found between a couple's marital dissatisfaction and the magnitude of their differences on the marital beliefs scale. This result indicated that the important factor in how marital beliefs lead to marital conflict is not the rigid or unreasonable nature of the beliefs held by husbands and wives, but rather the extent to which the they have different beliefs.
Three studies were conducted to examine the psychometric characteristics of a Korean version of the Brief Body Sensation Interpretation Questionnaire(K-BBSIQ) - an instrument developed to measure the tendency to misinterpret body sensations in a catastrophic manner which is considered to be a core driver of panic attacks. A sample of 137 patients who met DSM-Ⅳ criteria for panic disorder participated in Study 1. The results showed that internal consistency and the convergent, discriminant, concurrent and incremental validity of K-BBSIQ Panic Body Sensation subscales were all good. In study 2, 85 of the panic disorder patients in Study 1 received twelve sessions of group cognitive-behavioral therapy. The results indicated that the K-BBSIQ demonstrated sensitivity to change following group cognitive-behavioral therapy. The participants in Study 3 were 22 panic disorder patients, 9 non-clinical panickers (4 female, 5 male), and 21 non-panic control subjects. Panic subjects were found to be more likely to interpret ambiguous autonomic sensations as signs of immediately impending physical or mental disaster than non-panic subjects. In addition, panic disorder patients showed higher levels of misinterpretation of body sensations as assessed with the K-BBSIQ Panic Body Sensation subscales than non-clinical panic subjects. These findings suggest that the K-BBSIQ is a reliable and valid instrument for assessing the tendency to misinterpret body sensations in a catastrophic manner.
To explore the transition among healthy diet behavior, anorexic behavior, and bulimic behavior, a longitudinal study over a one year interval was performed using female Korean college students as subjects. Data were obtained from 133 participants who completed assessments of three types of eating behaviors, the Eating Disorder Inventory (EDI-2), and behavioral activation system. All of the variables were measured at the start of the study (Baseline) and three types of eating behaviors (healthy diet behavior, anorexic and bulimic behavior) were measured at again one year later. The findings indicate the following: Healthy diet behavior predicted healthy diet behavior one year later. Additionally, reward responsiveness and asceticism predicted healthy diet behavior. Anorexic behavior, healthy diet behavior, reward responsiveness, fun seeking and perfectionism predicted anorexic behavior a year after. Also, bulimic behavior, anorexic behavior, fun seeking and body dissatisfaction predicted bulimic behavior longitudinally. The factors which could facilitate the transition between two eating behaviors were also investigated. The results showed that reward responsiveness predicted positively anorexic behavior one year after among participants with a high level of healthy dieting. Also, a propensity for risk-taking behavior raised the level of bulimic behavior one year after among the participants with initially high levels of anorexic behavior. Finally, the limitations of this study and the implications for future studies are discussed.
The purpose of this study was to investigate the reliability and validity of the Korean Version of the Cognitive Avoidance Questionnaire(CAQ) which assesses five worry-related cognitive avoidance strategies, namely, Thought Suppression, Thought Substitution, Distraction, Avoidance of Threatening Stimuli, and Transformation of Images into Thoughts. This article describes two studies examining the psychometric properties of the Korean version of the Cognitive Avoidance Questionnaire. In Study 1, confirmatory factor analyses(CFA) of the Korean version of the CAQ was performed in a sample of university students (N=263). A CFA found support for proposed subscales, though the overall goodness-of-fit was lower than expected. The Korean version of the CAQ scale and subscales showed good internal consistency and good stability over a 7-week period. In Study 2, the five-factor structure was replicated in an independent sample of university students(N=277). Convergent and divergent validity were found with measures of worry, thought suppression, and coping strategies. Criterion-related validity was found with measures of worry, obsession, and rumination. These results suggest that the Korean version of the CAQ is a useful scale that measures cognitive avoidance strategies. The implications and limitations were discussed along with some suggestions for the future studies.
To test the construct validity of the TCI-RS, we examined the relationships among the TCI-RS as a measure of temperaments and characters, the Beck Depression Inventory(BDI) as a measure of depression, and the State-Trait Anxiety Inventory(STAI) as a measure of anxiety. On the temperament dimensions, the BDI and STAI scores were correlated positively with Harm Avoidance and negatively with Persistence. On the character dimensions, the BDI and STAI scores were correlated negatively with Self-Directedness, and Cooperativeness. After controlling the STAI score, the BDI score was predicted by Novelty Seeking, Harm Avoidance, and Self-Directedness. After controlling the BDI score, the STAI (state) score was predicted by Harm Avoidance, Persistence, Self-Directedness, and Cooperativeness, and STAI (trait) score was predicted by Novelty Seeking, Harm Avoidance, Persistence, Self-Directedness, and Cooperativeness. These results are consistent with previous studies and verified the construct validity of the TCI-RS.
The Montreal Cognitive Assessment (MoCA) was originally developed as a brief screening tool for mild cognitive impairment. However, the NINDS-CSN Vascular Cognitive Impairment Harmonization Standardization working group (Hachinski et al., 2006) suggested that the MoCA would also be a useful instrument for vascular cognitive impairment (VCI). This study was conducted to examine the validity of the newly developed Korean version of the Montreal Cognitive Assessment (K-MoCA) as an instrument for screening of VCI. Eighty-two stroke patients (mean age=71.05±9.53 years, mean education=7.53±5.01 years) with confluent white matter lesions were given the K-MoCA and the K-MMSE with a comprehensive neuropsychological test battery. Among the patients, 36 had a CDR score of 0.5 (Vascular Cognitive Impairment No Dementia, VCI-ND), and 44 had a score of 1.0 or more (Vascular Dementia, VD). Eighty-one matched healthy normal controls (mean age=69.33±8.75 years, mean education =8.14±4.60 years) who met Christensen's health criteria (Christensen et al., 1991) were recruited from the community and were given the K-MoCA and K-MMSE. The K-MoCA was re-administered to 29 normal subjects with a 4-week interval for assessing the test-retest reliability. Strong correlations between the K-MoCA and the K-MMSE were found in VD (r=.90, p<.001), VCI-ND (r=.84, p<.001), and normal controls (r=.79, p<.001). Receiver Operating Curve (ROC) analysis showed that the K-MoCA effectively differentiated stroke (VCI) patients from normal controls (AUC=.80, p<.001). Moreover, it was found that the K-MoCA could differentiate the VCI-ND (AUC=.67, p<.01) as well as the VD (AUC=.90, p<.001) from normal controls, suggesting that the K-MoCA was more sensitive for detecting the VCI-ND than the K-MMSE (AUC=.63, p<.05). Both internal consistency and test-retest reliability of the K-MoCA were significantly high (Cronbach's α=.84; ICC=.85, p<.001). These results suggest that the K-MOCA can be used reliably for screening of VCI. The K-MoCA would help identify individuals in the early stage of cognitive impairment due to cerebrovascular problems. Finally, normative data for the elderly were also presented.
The aim of this study was to investigate the clinical implications of Cloninger(1987, 2004)'s temperament-character model of personality through grafting current psychotherapeutic approaches (focusing on change and acceptance) and positive psychological researches (in which examine happiness and adaptation) onto the suggested model. In order to explore the relationships temperament-character dimensions of personality with psychological adaptation, character strengths, and personality disorders, correlation analysis and regression analysis were used. We found that psychological maladaptation and personality disorders were generally related to high novelty seeking, high harm avoidance, low reward dependence, low persistence of temperament dimensions, and low self-directedness, low cooperativeness, low self-transcendence of character dimensions. Furthermore, temperament dimensions were separately related to specific character strengths and specific clusters of personality disorders. These results showed that temperament dimensions operate both vulnerable and resilient manner upon adaptation. Based on the results, the authors discussed the meaning of the temperament regulation through character maturation in theoretical and empirical manner. Finally, the limitations of this study were discussed along with suggestions for further research.
The aim of the present study was to investigate effects of stroke on cognitive functions measured by the Cognitive Scale for Older Adults (CSOA). The test assesses cognitive measures such as basic IQ, Executive IQ, language function, and verbal memory function. The participants were 31 stroke patients and 30 normal age-matched controls. There were three main findings. First, stroke patients had lower Basic IQ as well as lower Executive IQ scores compared to normal controls. The between-group difference was greater in Executive IQ relative to Basic IQ. Second, NCI (No Cognitive Impairment), VCI (Vascular Cognitive Impairment), and VAD (Vascular Dementia) groups were similar in showing lower Executive IQ relative to Basic IQ. Third, left-brain lesioned patients showed lower language function scores well as lower verbal memory function scores than right-brain lesioned patients. These results indicate that cognitive dysfunction following stroke is most severely evident as lowered scores in executive function relative to normal controls. The neural correlates of post-stroke executive dysfunction may be lesions affecting the frontal-subcortical circuits. The results also indicate clinical utility of CSOA in measuring cognitive functions of Korean older adults.
The purpose of this study was to develop and validate the Recovery Attitudes Scale for persons with psychiatric disabilities. Exploratory factor analysis(N=340) using 121 initial items resulted in seven factors: (1) satisfaction with friends and neighbors, (2) knowledge of the mental health support system, (3) hope and optimistic outlook on life, (4) acceptance of illness, (5) satisfaction with family and relatives, (6) knowledge of coping strategies, (7) hope and optimistic outlook on prognosis. Considering the convenience of administration, the redundancy among items within each factor, and size of factor loadings, the final scale was reduced to 42 items. Confirmatory factor analysis using these 42 items resulted in favorable goodness of fit indexes(GFI = .959, AGFI = .954, NFI = .944, RMR = .059). Another confirmatory factor analysis for cross-validation (N=199; 42 items in 7 factors) also showed favorable goodness of fit indexes(GFI = .942, AGFI = .934, NFI = .924, RMR = .076). In addition, we calculated concurrent validities between the Recovery Attitudes Scale and the Hope scale(Snyder et al., 1991) and the ISMI(Internalized Stigma of Mental Illness; Ritsher et al., 2003). The results showed that all factors(7 factors) in the Recovery Attitudes Scale had significantly positive correlations with the Hope scale, and five out of the 7 factors in the Recovery Attitudes Scale had significantly negative correlations with the ISMI. We discussed comparisons between factor structure of the Recovery Attitudes Scale and those of previous research. Also, implications of the study and applicability of the scale were discussed.
This study compared the psychological characteristics of adolescents with a risk of internet addiction with those at risk for alcohol abuse using the MMPI-A. A sample of 924 adolescents was administered the K-scale-a Korean self report checklist for assessing internet addiction, and the CRAFFT. Four groups were identified based on the K-scale and CRAFFT screening tool for assessing adolescent substance abuse. Four groups were identified based on the K-scale and CRAFFT scores: IA, AA, IA+AA, and non-IA/AA groups. Those groups with addiction problems(IA, AA, IA+AA) showed elevated Pd, A-anx, and A-dep scale scores, suggesting that these adolescents had antisocial tendencies, anxiety, and depression in common. The two groups with alcohol problems(AA, IA+AA) were likely to employ acting-out as their primary defense mechanism as evidenced by elevated Pd and Ma scale scores. The results of a MANOVA and post-hoc analyses revealed that IA and IA+AA groups showed significantly higher scores on the Sc, A-aln, and A-lse scales than did the other two groups. The IA group showed significantly elevated D, Si, A-las, and A-sod scale scores compared with the other groups. Those groups with alcohol problems(AA, IA+AA) showed significantly higher scores on the Ma, A-ang, A-cyn, A-con, and A-fam scales than did the other two groups without alcohol problems. The IA+AA group obtained significantly elevated F, Pa, and A-biz scale scores compared with the other groups. Supplementary scale scores (MAC-R, ACK, and PRO) were significantly higher in the groups with alcohol problems(AA, IA+AA) than in the groups without alcohol problems. The results of discriminant analyses revealed that the MAC-R, Pd, A-sod, F, Pt, and A-biz scales discriminated well among the four groups. Finally, the limitations of this study and suggestions for further study were discussed.
The purpose of the present study was to achieve a better understanding of the features of borderline personality disorder, especially those involving self-destructive behavior, such as self-injury, suicide attempts, and sexual deviance including promiscuity. The subjects were 31 patients with a diagnosis of borderline personality disorder. All were interviewed to assess the incidence and severity of childhood sexual abuse (CSA), and they also completed a self-report measure of impulsivity (Barratt Impulsiveness Scale). The subjects were then categorized into three groups based on the nature of their self-destructive symptoms: self-injurious or suicidal behavior (N=11), sexual deviance (N=8), and both type of symptoms (N=12). CSA was assessed to have occurred in 27.3% of the self-injury group, in 50.0% in the sexual deviance group, and in 83.3% of the mixed-symptom group. A between group comparisons was subsequently conducted using ANCOVA with gender and age as covariates. The results showed that, compared with the self-injury group, the mixed-symptom group reported more severe CSA, and the sexual deviance group perceived themselves as being more impulsive. The findings were discussed in terms of sexual revictimization and traumatic sexualization (Finkelhor & Browne, 1985).