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KISEP Original Articles 12 2 2001 Korean J Child & Adol Psychiatr 12:218~224 청소년 ADHD 평가도구개발을위한예비연구- CASS(S) 의신뢰도및타당도연구 * A PRELIMINARY STUDY FOR THE DEVELOPMENT OF THE ASSESSMENT SCALE FOR ADHD IN ADOLESCENTS: RELIABILITY AND VALIDITY FOR CASSS 반건호 1) 신민섭 2) 조수철 2) 홍강의 3) Geon-Ho Bahn, M.D., 2) Min-Sup Shin, Ph.D., 2) Soo Churl Cho, M.D., 2) Kang-E Hong, M.D. 3) 요약 중심단어 서 론 Department of Neuropsychiatry, College of Medicine, KyungHee University, Seoul Division of Child & Adolescents Psychiatry, College of Medicine, Seoul National University, Children s Hospital, Seoul Department of Psychiatry, College of Medicine, Cheju National University, Cheju Corresponding author - 218 -

- 연구대상및방법 1. 연구대상 - 2. 연구방법 1) 검사도구의선정 2) 검사대상 - 219 -

Table 1. Main subjects M1* M2 M3 H1** H2 H3 Sub Grade area B + G ++ B G B G B G B G B G total Seoul, north 20 19 18 20 21 21 50 54 47 59 49 55 433 Seoul, south 51 49 51 49 47 53 50 44 50 40 50 57 591 Osan 36 34 40 62 66 11 121 32 50 452 Wonju 40 35 40 38 40 40 40 40 42 40 41 40 476 Choongju 46 28 48 49 50 47 105 174 118 155 47 53 920 Busan 40 35 41 41 35 38 37 52 25 51 56 451 Kwangju 35 40 36 31 48 52 46 45 46 49 40 50 518 Cheju 35 35 40 37 41 47 45 47 45 97 44 513 Subtotal 303 275 314 327 348 309 373 577 373 491 359 305 4,354 M1middle school, 1st grade +BBoy H1high school, 1st grade ++GGirl 3) 신뢰도평가 4) 타당도평가 3. 통계 Table 2. Test-retest reliability 결 1. 신뢰도 (Reliability) 1) 내적일관성 (Internal consistency) 2) 검사-재검사신뢰도 (Test-retest reliability) 과 2. 타당도 (Validity) 1) 공존타당도 (Concurrent validity) CASSS K-YSR Pearson CASSS 1.000.83** correlation K-YSR.83** 1.000 Significance CASSS..000 2-tailed K-YSR.000. Number CASSS 115 115 K-YSR 115 115 Correlation is significant at the.01 level2-tailed 2) 구성타당도 (construct validity) - 220 -

Table 3. Concurrent validity CASSS K-YSR Pearson CASSS 1.000.65** correlation K-YSR.65** 1.000 Significance CASSS..000 2-tailed K-YSR.000. Number CASSS 4354 4354 K-YSR 4354 4354 Correlation is significant at the.01 level2-tailed Table 4. Principal axis factor analysis for CASSS No of questions Factor 1 Factor 2 Factor 3 3.664 13.627 8.609 23.608 21.602 15.582 17.511 18.455 4.340 19.335 25.329 6.269 11.248 10.636 5.618 16.524 14.520 24.495 26.483 22.460 12.440 7.375 2.364 1.670 27.663 20.402 9.392 Table 5. Mean and standard deviation of CASSS for six groups AGE SEX MSD by sex B + 23.02 9.95 3. 경계점산출 고 찰 MSD, total Cut off score M1* 22.03 9.65 41.33 G ++ 20.92 9.19 B 22.90 9.64 M2 21.91 9.73 41.37 G 20.97 9.74 B 24.4311.33 M3 23.2510.31 43.87 G 21.92 8.87 B 24.4311.33 H1** 23.64 9.15 41.94 G 21.92 8.87 B 25.29 9.50 H2 23.52 9.19 41.90 G 22.18 8.78 B 25.11 9.58 H3 23.88 9.26 42.40 G 22.44 8.65 M1middle school, 1st grade +BBoy H1high school, 1st grade ++GGirl - 221 -

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조수철2001도시지역초등학생에서주의력결핍과잉운동장애의유병율. 조선의대논문집출판중 6) Connell HM, Irvine L, Rodney J1982Psychiatric disorder in Queensland primary school chidren. Aust Paediatr J 18177-182 7) Offord DR, Boyle MH, Szatmari P, Rae-Gant N, et al 1987Ontario child health study Ⅱsix month of prevalence of disorfer and rates of service utilization. Arch Gen Psychiatry 44:832-836 8) American Psychiatric Association1987Diagnostic and Statistical Manul of Mental Disorders, Revised 3rd ed.(dsm-Ⅲ-r), Washington DC 9) Esser G, Schmidt MH, Woerner W1990Epidemiology and course of psychiatric disorders in schoolage childern-results of longitudinal study. J Child Psychol Psychiatry 31243-263 10) World Health Organization1992The ICD-10 classification of mental and behavioural disorders Clinical descriptions and diagnostic guidelines, WHO, Geneva 11) Rutter M, Tijard J, Whitmore K1970Education, Health and Behavior. London, Longsmans 12) Nicholas PL, Chen TC1980Minimal brain dysfunctiona prospective study. Hillsdale, NJ, Elbaum 13) Bird HR, Canino G, Rubio-Stipec M, et al1998 Estimate of the prevalence of childhood maladjustment in a community servey in Puerto RICO. Arch Gen Psychiatry 451120-1126 14) Shekim WO, Kashani J, Beck N, et al1985the prevalence of attention deficit disorders in a rural midwestern community sample of nine-year children. J Am Acad Child Psychology 24:765-770 15) Wender PH1995Attention-deficit hyperactivity disorder in adults. New York, Oxford University Press 16) Weiss G, Hechtman L, Milroy T1985Psychiatric status of hyperactives as adualtsa controlled prospective 15-year follow-up of 63 hyperactive children. J Am Acad Child Psychiatry 23211-220 17) Mannuzza S, Gittelman-Klein R, Bonagura N1988 Hyperactive boys almost grown-upⅡstatus of subjects without a mental disorders. Arch Gen Psychiatry 4513-18 18) Mannuzza S, Gittelman-Klein R, Horowitz-Konig P 1989Criminality and its relationship to psychiatric status. Arch Gen Psyshiatry 461073-1079 19) Klein RG1990Relationship between childhood hyperactivity and adult affective, antisocal and substance use disorders. Paper presented at 3rd Annual Research Conference of the New York State Office of Mental Health, Albany 20) Conners CK1997Conners Rating Scales-Revised Technical Manual. New York: Multi-Health Systems. 21) 오경자, 홍강의, 이혜련1997K-YSR 청소년자기행동평가척도. 중앙적성연구소 22) Duprey TR, Greenberg LM1993T.O.V.A. Manual. LA, U.A.D. 23) 신민섭, 조성준, 전선영, 홍강의2000전산화된주의력장애진단시스템의개발및표준화연구. 소아청소년정신의학 1191-99 24) Merrell KW1999Behavioral, social, and emotional assessment of children & adolescents. Lawrence Erlbaum Associates, Inc., Publishers, Mahwah, NJ, pp211-240 25) Pruitt DB1999Your adolescent. HarperCollins Publishers Inc. New York, pp225-232 26) Lambert N, Hartbaugh C, Sasson D1987Persistence of hyperactivity symptoms from childhood to adolescence. Am J Orthopsychiatry 5722-31 27) Lambert N1988Adolescent outcomes of hyperactive children. Am Psychol 43786-799 28) Rucklidge J, Tannock R2000Apparent adolescent onset of ADHD--beware! J Am Acad Child Adolesc Psychiatry 3991075-1076 - 223 -

ABSTRACT Korean J Child & Adol Psychiatr 12:218~224, 2001 A PRELIMINARY STUDY FOR THE DEVELOPMENT OF THE ASSESSMENT SCALE FOR ADHD IN ADOLESCENTS RELIABILITY AND VALIDITY FOR CASSS Geon-Ho Bahn, M.D., Min-Sup Shin, Ph.D., Soo Churl Cho, M.D., Kang-E Hong, M.D. Department of Neuropsychiatry, College of Medicine, KyungHee University, Seoul Although Attention Deficit Hyperactivity DisorderADHD has been considered as the disorder occurring during childhood, the prevalence is increasing among adolescents and adults. The prevalence rate varies from 2.0 to 14.3% due to the difference of diagnostic criteria, different assessment methods, or subjects age difference. Therefore, it needs to make age specifici.e., for children, for adolescents, and for adults assessment tools. Authors translated Conners-Wells Adolescents Self-Report Scalesshort form[casss] in to Korean to get validity and reliability as a way of development of assessment tool for adolescent with ADHD in Korea. CASSS was translated and corrtected by three psychiatrists and one clinical psychologist. To examine the concurrent validity and test-retest validity, CASSS was applied with K-YSR on one class of each grade in a middle school in Seoul with two week intervaltotal 115:male 58, female 57. To test validity, authors analysed and got Cronbach s as internal consistency. Construct validity was done by principal axis factor analysis on 4,354 students. As a result, Cronbach s alpha for internal consistency was.88, Pearson coefficient for test-retest reliability.83, and coefficient for concurrent validity.65. And in the factor analysis to examine construct validity, three factors were revealed as cognition, hyperactivity, and conduct. These results shows that CASSS may be useful tool for adolescents with ADHD, although there was a limit not to be done the comparison with clinical groups. KEY WORDS:ADHD Conners-Wells Self-Report Scaleshort form Adolescent Reliability Validity. - 224 -