Characteristics of Intelligence and Behavioral Problems of ADHD Youth in Welfare Institutions Sun-ju Kim Eun-hye Ha Sookmyung Women s University The purpose of this study was to examine the characteristics of intelligence and behavioral problems of ADHD Youth in Welfare Institutions and to determine the intellectual difference between Other Psychological Disorder (OPD) group and ADHD group by dividing the levels of intelligence as follows: above average and below average. The intelligence of 297 children and adolescents(boys:182. girls:115) was tested using K-WISC-III (Korean-Wechsler Intelligence Scale for Children-Third Edition), and behavior problems were examined using K-CBCL 6-18 (Korea-Child Behavior Checklist 6-18). The sample was divided into the OPD group and the ADHD group using a T-score cut-off point of 70, the cut off score for examining ADHD using the DSM ADHD scale, and the characteristics of behavioral problems and intelligence of each group were compared. As a result, first, the institutionalized ADHD group scored significantly higher on the problem behavior scale of CBCL compared to the OPD group. Second, the samples were divided into two groups again based on intelligence level (one group with higher-than-average intelligence and one group with lower-than-average intelligence), and each group s intelligence was compared. The results showed no significant difference between ADHD and OPD group among those with higher-than-average intelligence. However, regarding those with lower-than-average intelligence, the ADHD group scored significantly lower on Verbal Comprehension, Freedom from Distractibility Factor Index, Verbal IQ, and Comprehension and Similarities subtests compared to the OPD group. These results indicate that if the intelligence level is above average, ability of language is not affected regardless of the severity of ADHD symptoms, and that ADHD is not always accompanied by defectived language ability. Keywords: Youth in Welfare Institutions, ADHD, intelligence, problem behavior Correspondence concerning this article should be addressed to Eun-hye Ha, Sookmyung Women's University. 100, Cheongpa-ro 47-gil, Yongsan-gu, Seoul, Korea. Tel: 02-2077-7176, E-mail: graceha@sookmyung.ac.kr
.,,,, (Byun, 2011).,,,. (Lee, 1988). (DSM-IV) ADHD,,,., (Yoo, Han, & Choi, 2001).,, (Lee, Sung, & Yi, 2002). 6~18 674 9~11% 18~40%, 21~42% (Şimşek, Erol, Öztop, & Özcan, 2008). (foster care system), 13 ~18 88 67% (McCann, James, Willson, & Dunn, 1996). 42% (Garland et al., 2001), (ADHD) (McMillen et al., 2005). ADHD (American Psychiatric Association, 1994). 1982 2001 ADHD(attentiondeficit/ hyperactivity disorder), ADD(attention deficit disorder), HKD(hyperkinetic disorder), ADHD 50 ADHD 1% 20% (Faraone, Sergeant, Gillberg, & Biederman, 2003). 1978 2005 ADHD 303, ADHD 5.29% (Polanczyk, Silva de Lima, Horta, Biederman, & Rohde, 2007). ADHD,, ADHD (prefrontal, parietal & temporal regions) (McLaughlin et al., 2014).
, ADHD (Lee & Kwon, 1999)., ADHD, (Andreu, Agapitou, & Karapetsas, 2005). 1980 2002 10 ADHD 123 ADHD, 62 ADHD (Frazier, Demaree, & Youngstrom, 2004). ADHD, 7~15 (Chae, Kim, & Noh, 2003; Faraone et al., 1993; Fischer, Barkley, Fletcher, & Smallish, 1990; Frazier et al., 2004; McGee, Williams, Moffitt, & Anderson, 1989). ADHD IQ 70~ 80% ADHD ADHD IQ, ADHD IQ (Zeeuw et al., 2012). ADHD (40 ) (40 ) KEDI-WISC, ADHD (Kim & Oh, 1997). K-WISC-III ADHD,,, (Choi, 2002)., (Verbal skill) ADHD K-WISC-III,,, (Andreou et al., 2005; Lee et al., 2007). ADHD,,. ADHD (Loney, 1974; Prinz & Loney, 1974), ADHD (Mahone et al., 2002) (Schuck & Crinella, 2005). ADHD (44 ), ADHD (41 ), (44 ) K-WISC-III, (Lee & Hong, 2006). ADHD (Kim, Seo, Koo, & Bai, 2012; Ross, 1982). ADHD
, (Lee et al., 2007)., ADHD,,. IQ ADHD., ADHD, ADHD (Rohrer-Baumgartner et al., 2014)., ADHD ADHD. ADHD. ADHD. (CBCL). (Child Behavior Checklist: CBCL; Achenbach & Edelbrock, 1983),, (Moon et al., 1999). ADHD CBCL6-18. CBCL6-18 DSM ADHD (Lee et al., 2015). 161 ADHD 420 (Lacalle, Ezpeleta, & Doménech, 2012) DSM ADHD ADHD AUC=.80. ADHD Nakamura (Nakamura, Ebesutani, Bernstein, & Chorpita, 2009) DSM ADHD DSM-IV ADHD (Lee et al., 2015). Lee (2015) ADHD 43, 34, 42 K-CBCL6-18, DSM ADHD. DSM ADHD, ADHD, 70/75T (Lee et al., 2015). (CBCL) 25%~31% (Auslander et al., 2002; Heflinger, Simpkins, & Combs-Orme, 2000).
110 K-WISC-IV K-CBCL6-18., 83.26(SD= 14.36), / K-CBCL (Lee et al., 2014)., K-CBCL4-17, K-WPSSI-IV K-CBCL4-17,,,, (Kuem, Park, & Park, 2014)., CBCL. ADHD, ADHD ADHD., ADHD., (Pusan: Lee, 2011, Seoul: Choi, 2013; Kim, 2004; Lee et al., 2014; Min & Oh, 2013).. 160 ADHD (Other Psychological Disorder: OPD). ADHD OPD? ADHD OPD? ADHD OPD? 2013 (Korea Children's Welfare Association & Department of Health and Human Services, 2014). 170 (,, ),, +,., K-CBCL6-18.
160 ( 22, 10, 13, 4, 6, 9, 12, 7, 9, 12, 9, 19, 13, 12, 3) 46, 351, 299 696.,,,,,,. K-CBCL6-18 K-WISC-III 297 ( 52, 2, 17, 8, 32, 11, 3, 39, 7, 18, 12, 24, 29, 17, 17, 6). 182 (61.3%), 115 (38.7%), 6 16, 297 10.77 (2.61). K-CBCL6-18 DSM ADHD 70T ADHD, 69T OPD. ADHD 102 (34.3%), OPD 195 (65.7%). Table 1. (SMWU-1412-HR-069). (3 ) (Korean- Age ADHD group Boys n n=102 Girls Wechsler Intelligence Scale for Children -Third Edition; K-WISC- ; Kwak, Park, & Kim, 2001) 3 (WISC-III, 1991) 6 16. n Boys OPD group n= 195 K-WISC-,,,,,.,,,,,,,,, 10,,, 3 n Girls 6 1 1 4 0 7 4 4 11 2 8 8 7 14 8 9 13 8 22 6 10 4 6 18 5 11 6 6 16 13 12 3 5 14 12 13 5 5 8 4 14 8 1 4 12 15 4 0 7 4 16 1 2 7 4 N (%) 57 (55.9) 45 (44.1) 125 (64.1) n 70 (35.9)
13. 11. K-WISC-III.951,.955,.863, Cronbach α.74 ~.96, Cronbach α.98 (Kwak et al., 2001). K-CBCL6-18 Achenbach Rescorla(2001), Oh, Kim, Ha, Lee Hong(2010). K-CBCL6-18 120, 0, 1 2 ( - - ) 3. /, /,, (Thought Problems),, (Delinquent Behavior), (Aggressive Behavior), 8,,. K-CBCL6-18 DSM(Diagnostic and Statistical Manual of Mental Disorders) DMS DSM 6 (DSM, DSM, DSM, DSM ADHD, DSM, DSM ). DSM ADHD, 7. DSM T 70, T 65, T 65~69. K-CBCL6-18 DSM ADHD 70T ADHD, 69T OPD. Cronbach s α.62~.95, -.56~.80 (Oh et al., 2010). K-CBCL 6-18, ADHD OPD t. ADHD OPD t. SPSS 18.0.
CBCL Scale Total (n=297) M(SD) OPD group (n=195) M(SD) ADHD group (n=102) M(SD) t Anxious/Depressed 60.18 ( 9.48) 57.95 ( 8.22) 64.45 (10.29) 5.53*** Withdrawn/Depressed 63.30 (10.30) 62.28 (10.35) 65.25 ( 9.96) 2.38* Somatic Complaints 55.67 ( 7.84) 53.83 ( 6.28) 59.19 ( 9.24) 5.25*** Rule Breaking Behavior 68.69 ( 7.04) 65.73 ( 6.56) 71.42 ( 6.41) 7.16*** Aggressive Behavior 69.03 (10.95) 64.62 ( 8.29) 77.48 (10.48) 10.76*** Social Problems 66.22 (10.03) 62.45 ( 8.23) 73.42 ( 9.23) 10.46*** Thought Problems 60.26 ( 8.66) 57.81 ( 7.42) 64.95 ( 8.95) 7.33*** Attention Problems 68.21 (12.30) 61.86 ( 8.37) 80.35 ( 9.04) 17.59*** Internalizing 60.84 (12.01) 58.24 (10.99) 65.81 (12.36) 5.40*** Externalizing 72.51 (12.67) 67.24 ( 9.79) 82.59 (11.40) 11.55*** Total Problems 69.67 (12.01) 64.18 ( 8.55) 80.17 (10.65) 13.11*** DSM_affective problems 60.44 ( 9.14) 58.13 ( 7.91) 64.85 ( 9.74) 6.01*** DSM_anxiety problems 60.32 ( 9.64) 57.86 ( 8.21) 65.02 (10.44) 6.12*** DSM_somatic problems 54.64 ( 7.99) 53.14 ( 6.46) 57.50 ( 9.71) 4.09*** DSM_ADHD 68.82 (13.83) 60.26 ( 6.20) 85.18 ( 8.64) 28.59*** DSM_ODD problems 68.37 (12.92) 63.42 ( 9.92) 77.83 (12.75) 9.56*** DSM_conduct problems 69.85 ( 8.51) 67.06 ( 6.93) 75.29 ( 8.68) 8.23*** Note. DSM ODD problems = DSM_oppositional defiant problems. *p <.05. **p <.01. ***p <.001. K-CBCL 6-18 T Table 2. (SD) 69.67(12.01), 72.51(12.67), 68.21(12.30), 68.69(7.04), 69.03(10.95), DSM 68.37(12.92), DSM 69.85 (8.51) 65T. 66.22 (10.03)., / 60.18(9.48), / 63.30(10.30), 55.67(7.84) 60.26(8.66), 60.84 (12.01), DSM 54.64(7.99), DSM 60.44(9.14), DSM 60.32(9.64). ADHD OPD K- CBCL. ADHD OPD / (t=5.53, p<.001), / (t=2.38, p<.05), (t=5.25, p<.001), (t=7.16, p<.001),
(t=10.76, p<.001)., (t=10.46, p<.001), (t=7.33, p<.001), (t=17.59, p<.001), (t=5.40, p<.001), (t=11.55, p<.001), (t=13.11, p<.001). DSM DSM (t=6.01, p<.001), DSM (t=6.12, p<.001), DSM (t=4.09, p<.001), DSM ADHD (t=28.59, p<.001), DSM (t=9.56, p<.001), DSM (t=8.23, p<.001) ADHD OPD. K-WISC-III Total group(n=297) M(SD) OPD group(n=195) M(SD) ADHD group(n=102) M(SD) Full IQ 80.22 (17.09) 82.38 (17.34) 76.08 (15.89) 3.06** Verbal IQ 80.37 (16.91) 82.77 (16.62) 75.78 (16.59) 3.44** Performance IQ 84.86 (16.94) 86.82 (17.60) 81.12 (14.99) 2.78** VC 80.92 (16.83) 82.85 (16.55) 77.23 (16.82) 2.77** PO 85.63 (17.25) 87.43 (17.86) 82.21 (15.54) 2.50* FD 80.90 (17.81) 83.18 (18.57) 76.55 (15.44) 3.09** PS 87.16 (15.24) 88.43 (15.04) 84.73 (15.39) 2.00* Information 6.65 ( 3.20) 6.99 ( 3.27) 6.00 ( 2.97) 2.56* Comprehension 6.98 ( 2.82) 7.20 ( 2.74) 6.54 ( 2.92) 1.92 Vocabulary 6.94 ( 2.87) 7.23 ( 2.86) 6.39 ( 2.81) 2.41* Similarities 7.95 ( 3.10) 8.23 ( 2.94) 7.31 ( 3.23) 2.59* Arithmetic 6.95 ( 4.30) 7.47 ( 4.77) 5.94 ( 2.97) 2.94** Digit Span 7.10 ( 3.22) 7.50 ( 3.21) 6.34 ( 3.10) 2.94** Picture Completion 7.54 ( 3.01) 7.93 ( 3.08) 6.80 ( 2.73) 3.10** Picture Arrangement 7.67 ( 3.19) 7.80 ( 3.27) 7.42 ( 3.03).98 Block Design 8.18 ( 3.26) 8.51 ( 3.27) 7.55 ( 3.18) 2.39* Object Assembly 8.49 ( 2.93) 8.83 ( 2.98) 7.84 ( 2.72) 2.79** Coding 7.81 ( 2.94) 7.99 ( 2.81) 7.46 ( 3.16) 1.50 Note. VC = Verbal Comprehension; PO = Perceptual Organization; FD = Freedom from Distractibility; PS = Psychomotor s peed. *p <.05. **p <.01. ***p <.001. t
K-WISC-III Table 3. K- WISC-III 80.22(17.09) 80.37(16.91), 80.92(16.83), 80.90 (17.81). 84.86 (16.94), 85.63 (17.25), 87.16(15.24) 100(15) 20. K-CBCL6-18 DSM ADHD 70T ADHD 69T OPD. OPD 82.38 (17.34) ADHD 76.08(15.89) (t=3.06, p<.01). ADHD OPD (t=3.44, p<.01), (t=2.78, p<.01), (t=2.77, p<.01), (t=2.50, p<.05), (t=3.09, p<.01), (t=2.00, p<.05). ADHD OPD (t=2.56, p<.05), (t=2.41, p<.05), (t=2.59, p<.05), (t=2.94, p<.01), (t=3.10, p<.01), (t=2.39, p<.05), (t= 2.79, p<.01).,. ADHD ADHD IQ 89 (213, 71.7%) IQ 90 (84, 28.3%),. IQ IQ (Mean=72.43, SD=12.46, Mode=75, Skewness=-.809, Kurtosis =.020, Min=36, Max=89) IQ (Mean=99.94, SD=9.77, Mode=91. Skewness=1.304, Kurtosis=1.418, Min=90, Max= 131), ±2, ±7 (Curren & West, 1996).. IQ, ADHD OPD Table 4. ADHD OPD, ADHD 38%, ADHD 25%., ADHD OPD, ADHD OPD K-WISC-III, ADHD., ADHD OPD (t=2.73, p<.001), (t=2.15, p<.05) (t=2.07, p<.05)., (t=2.17, p<.05) (t=2.04, p<.05) ADHD OPD
Below average Full IQ group (n=213) OPD group (n=132) (62%) ADHD group (n=81) (38%) t Above average Full IQ group (n=84) OPD group (n=63) (75%) ADHD group (n=21) (25%) M (SD) M (SD) M (SD) M (SD) Verbal IQ 75.23(12.76) 70.22(13.37) 2.73** 98.56(12.10) 97.24( 8.12).46 Performance IQ 78.85(14.22) 76.60(12.51) 1.17 103.51(11.13) 98.52(10.42) 1.84 VC 75.73(12.69) 71.74(13.77) 2.15* 97.78(13.51) 98.38( 8.89) -.19 PO 80.08(13.97) 77.74(13.55) 1.20 102.83(15.14) 99.43( 9.68).96 FD 76.89(14.76) 72.49(13.78) 2.07* 96.78(18.46) 92.19(10.98) 1.08 PS 84.42(13.42) 81.96(14.84) 1.25 96.83(14.90) 95.38(12.84).40 Information 5.67( 2.64) 5.30( 2.75).98 9.75( 2.70) 8.67( 2.20) 1.66 Comprehension 6.37( 5.04) 5.65( 2.41) 2.17* 8.92( 2.76) 9.90( 2.17) -1.48 Vocabulary 6.11( 2.32) 5.61( 2.43) 1.48 9.56( 2.46) 9.33( 2.15).37 Similarities 7.04( 2.35) 6.31( 2.74) 2.04* 10.87( 2.46) 11.10( 1.89) -.38 Arithmetic 6.34( 5.04) 5.15( 2.48) 1.96 9.83( 3.05) 8.95( 2.78) 1.16 Digit Span 6.46( 2.78) 5.75( 2.93) 1.73 9.60( 3.02) 8.48( 2.80) 1.51 Picture Completion Picture Arrangement 6.90( 2.70) 6.20( 2.50) 1.88 10.06( 2.72) 9.10( 2.34) 1.46 6.60( 2.90) 6.74( 2.88) -.35 10.30( 2.48) 10.00( 2.10).50 Block Design 7.20( 2.72) 6.85( 2.90).88 11.22( 2.57) 10.24( 2.81) 1.49 Object Assembly 7.77( 2.58) 7.19( 2.51) 1.61 11.03( 2.51) 10.33( 1.98) 1.16 Coding 7.21( 2.68) 6.96( 3.12).60 9.63( 2.33) 9.33( 2.59).50 Note. VC = Verbal Comprehension; PO = Perceptual Organization; FD = Freedom from Distractibility; PS = Psychomotor speed. *p <.05. **p <.01. t., ADHD OPD. ADHD OPD K-CBCL6-18
K-WISC-III ADHD OPD.., ADHD OPD.,, K-CBCL6-18 69.67(12.01), 72.51(12.67) 65T,,,, DSM ADHD, DSM, DSM 70T., 65T,. ADHD OPD K-CBCL6-18. ADHD OPD,,,,,,. ADHD 5,., ADHD OPD.,, (297 ) K-WISC-III,,,, 85, 90 (100) 1. (IJzendoom, Luijk, & Juffer, 2008),.,. ADHD OPD, ADHD OPD K-WISC-III. ADHD (Andreou et al., 2005; Frazier et al., 2004).,, ADHD. ADHD OPD,
., ADHD ADHD OPD t. ADHD OPD, IQ 90 ADHD OPD, ADHD OPD., IQ 90 ADHD OPD, ADHD OPD. ADHD (Mahone et al., 2002) (Schuck & Crinella, 2005) ADHD (Rohrer- Baumgartner et al., 2014)., IQ 89 ADHD OPD,., ADHD., ADHD OPD. ADHD, ADHD. ADHD., ADHD, ADHD. ADHD, ADHD., ADHD.., ADHD,.,.,. ADHD,, +
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ADHD ADHD, ADHD (Other Psychological Disorder: OPD). 2013 297 ( :182, :115) K-WISC-III K-CBCL 6-18. CBCL DSM ADHD 70T ADHD OPD (ADHD:102, OPD :195).,, ADHD OPD CBCL 6-18., ADHD OPD K-WISC., ADHD OPD, ADHD OPD., ADHD OPD,,., ADHD, ADHD.