Non-pharmacological treatments have long been used for paraphilia or sexual offenders, but few clinical studies were conducted. However, recently there were issued cognitive behavioral therapy of paraphilia or sexual offenders based on the research findings obtained so far. In addition, there were the changes of Diagnostic and Statistical Manual of Mental Disorder by American Psychiatric Association at 2014. The methods of cognitive behavioral therapy for paraphilia or sexual offenders were electric aversion therapy, olfactory aversion therapy, ammonia aversion therapy, covert sensitization, masturbatory reconditioning, directed masturbation, verbal satiation, social skill training, assertiveness training etc. By synthesizing the newly reported foreign guidelines for treatment and review articles, the aim of this study is to investigate the non-pharmacologic therapies used for treatment of paraphilia or sexual offenders.

Objective : Previous research showed that childhood trauma or domestic violence resulted in difficulties in controlling emotion and problem solving and vulnerability to psychiatric disorders. To understand the long term effect of childhood trauma, this study investigated their influences on cognitive processing of anger-evoking event and anger behavior among prisoners. Methods : All data were collected from 198 prisoners off our districts in Korea. After they consented to participate, prison officer distributed a questionnaire that included scales to demographic measure, childhood abuse (emotional abuse, physical abuse, and neglect), cognitive response of anger (attentional focus, suspicion, rumination, and hostile attitude) and behavior of anger (impulsive reaction, verbal aggression, physical confrontation, and indirect expression). For statistical analyses, SPSS 18.0 were used and path coefficients were evaluated from the structural equational modeling using LISREL 8.52. Results : Almost 50% of prisoners of our sample experienced one or more trauma during childhood. Then we tested the long term effect of childhood trauma on anger response by structural equation modeling. As expected, childhood trauma was associated with cognitive processing of anger-evoking event and anger behavior. More specifically, emotional abuse (${\beta}$=0.21, p<0.01) predicted suspicion which in turn associated with impulsive reaction (${\beta}$=0.73, p<0.001) and verbal aggression (${\beta}$=0.87, p<0.001). Emotional abuse (${\beta}$=0.24, p<0.01) also predicted hostile attitude which associated with physical confrontation (${\beta}$=0.80, p<0.001) and indirect expression (${\beta}$=0.80, p<0.001). Interestingly, physical abuse associated directly with impulsive reaction (${\beta}$=0.23, p<0.01) and indirect expression (${\beta}$=0.17, p<0.05). Neglect predicted rumination (${\beta}$=0.15, p <0.05) which associated with indirect expression marginally (${\beta}$=0.11, P<0.10). Conclusion : The results of this study, suggest longitudinal and harmful effect of childhood trauma on difficulties in controlling anger. Especially, it was revealed that childhood abuse related with processing anger evoking events more suspicious and hostile and then various anger-expressing behaviors.

Objective : The objective of this study was to examine the association between childhood adversity and parenting attitude and neuroticism in adulthood. Methods : Forty nine women were recruited from community and completed Early Trauma Inventory-Short Form (ETI-SF). We compared scores on the Maternal Behavior Research Instrument (MBRI), Neuroticism of NEO Personality Inventory (NEO-PI), and Beck Depression Inventory (BDI) between women with and without childhood adversity. Results : Compared to women without childhood adversity, women with childhood adversity showed more rejecting parenting attitude and higher Depression and Self-Consciousness scores on Neuroticism domain of NEO-PI. Total ETI-SF scores and emotional abuse scores were positively correlated with rejecting attitude scores on the MBRI and BDI scores. Physical abuse scores were positively correlated with rejecting attitude scores. There were positive correlations between rejecting attitude scores on the MBRI, Neuroticism scores on the NEO-PI, and BDI scores. Conclusion : Our results suggest that childhood adversity may have a negative impact on parenting attitude and emotional state in adulthood. For girls who experienced traumatic event, early intervention is needed to prevent the development of neurotic temperament and rejecting parenting in adulthood.

Objective : The correlation between age of onset and symptoms/severity of panic disorder has not yet been determined. The aim of this research is to determine the different clinical features of panic disorder according to the age of onset. Methods : Patients diagnosed with panic disorder were placed into two groups according to onset of age. The subjects were checked for 13 different panic symptoms presented in the DSM-IV. The investigation was also executed by severity, the anxiety sensitivity index, the scale for depression and anxiety. Results : The early onset group had significantly higher frequencies than the late onset group in the areas of "choking feeling" and "derealization or paresthesia". It was found that only "choking feeling" was statically significant as a risk factor of early onset panic disorder. Among the objective anxiety scale, the subscale of psychological anxiety was higher in the early onset group compared to the late onset group. Conclusion : "Choking feeling" was the only panic symptom that showed a significant difference in accordance with onset age. Earlier onset patients tend to experience a more frequent "choking feeling," which is related to respiratory symptoms. This could mean that earlier onset patients are more likely to have higher psychological anxiety.

Objective : Existing depression rating scales do not fully reflect depressed patients' perspective of remission, which goes beyond symptom resolution. The Remission from Depression Questionnaire (RDQ) captures a broader array of domains, and the present study examines the reliability and validity of the Korean Version of the RDQ (K-RDQ). Methods : The test-retest reliability of the K-RDQ was studied in 60 depressed patients and 30 normal subjects working at a university hospital. Subjects were evaluated at baseline and again 1-2 weeks later. The validity of the K-RDQ was studied in 200 depressed patients who were rated on the 17-item HDRS and the CGI-S ; each patient also completed the QIDS-SR, STAI-S, GHQ/QL-12, and SDS. Results : The K-RDQ demonstrated excellent internal consistency, with a Cronbach's ${\alpha}$ of 0.965 for the total scale and above 0.80 for each of the 7 subscales. The test-retest reliability of the total scale was 0.951. Mean K-RDQ scores ($45.79{\pm}18.65$) of the depressed patients were significantly higher than those ($15.87{\pm}10.60$) of the mentally healthy subjects (t=12.8, p<0.001). Five factors from the K-RDQ were extracted by principal axis factoring with equimax rotation. Conclusion : These results indicate that the K-RDQ is a reliable and valid measure that evaluates multiple domains that depressed patients consider important in determining remission. Thus, the K-RDQ maybe considered an appropriate tool for use in the clinical setting.

Objective : This study aimed to examine impact of anxiety and demographic factors on relationship between severity of depressive symptom and quality of life and disability. Methods : One hundred ninety five patients who met DSM-IV-TR criteria for depressive disorder were enrolled. It includes "Hamilton Rating Scale for Depression (HRSD)", "State-Trait Anxiety Inventory-State (STAI-S)", "General Health Questionnaire/Quality of Life-12 (GHQ/QL-12)", and "Sheehan Disability Scale (SDS)". Correlation analysis was used to see the correlations of each variable. Hierarchical regression analysis was used to see mediating effect of anxiety in the relationship. Sobel test was used to verify mediating effect. Multiple regression analysis was used to see moderating effect of demographic factors in the relationship. Results : There was partial mediating effect of anxiety on the relationship between severity of depressive symptoms and decreased quality of life (z=-11.68, p<.001)/increased disability (z=10.42, p<.001). Only religion was found to be moderating effect on the relationship between depressive symptoms and decreased quality of life. Conclusion : Rapid relief of anxiety along with depressive symptom had important implications for the treatment of patients with depression.

Objective : The aim of this study was to investigate the relationship among daytime sleepiness, depressive symptoms, anxiety symptoms, and stress response of students in a university Methods : A total of 557 students were recruited in this study. The participants filled out stress response inventory, Epworth sleepiness scale, overall anxiety severity and impairment scale, and quality of life scale. Results : Excessive daytime sleepiness group showed higher scores in all factors in stress response inventory, overall anxiety severity and impairment scale, and quality of life scale. Sleepiness might be correlated with somatization and depression and anger in Stress response inventory. Conclusion : Excessive daytime sleepiness group exhibited poor quality of life scale. Screening about overall quality of sleep, such as mood and anxiety should be considered for students in a university.

Objective : The subgenual cingulate cortex, a part of default-mode network, has been known to playa key role in the pathophysiology of depression. The previous studies have reported abnormal functional connectivity between the subgenual cingulate cortex and other brain regions in the patients with depression. The goal of this shldy was to explore the resting-state functional connectivity of the subgenual cingulate cortex between the patients with depression and healthy subjects. Methods : Twenty patients with major depression and age- and sex-matched 20 healthy subjects underwent 5-minute resting state fMRI scans. The functional connectivity map in each subject was acquired using seed-based correlation analysis with the seed located in the subgenual cingulate cortex (Talairach coordinates; x=-10, y=5, z=-10). The functional connectivity maps were calculated using AFNI and compared between the patient and healthy subject group via two-sample T-test using 3dttest++ in AFNI package. Results : Functional connectivity was decreased between the subgenual cingulate cortex and both sides of fusiform gyrus in depressed subjects. Connectivity was also decreased between the subgenual cingulate cortex and the left cerebellum in the patient group. There was no correlation between the severity of depression and the degree of functional connectivity between the subgenual cingulate cortex and the regions showing decreased functional connectivity. Conclusion : Decreased resting-state functional connectivity between the subgenual cingulate cortex and both sides of fusiform gyrus, and decreased connectivity between the subgenual cingulate cortex and the left cerebellum found in the patients with major depression in comparison to the healthy subjects might be related to abnormal emotional and cognitive processing of depressed patients.

Objective : The aim of this study is to analyze the relationship among job stress, depression, and suicidal ideation in firefighters, particularly the mediating effects of depression. Methods : The subjects were 2,136 firefighters in Gangwon-do, who completed the short form of Korean occupational stress scale (KOSS-SF), Korean version of the Beck depression inventory (K-BDI), and the revised scale for suicide ideation (SSI) online in mental health promotion service of firefighters. The data was analyzed with correlation analysis among the variables, and the multiple regression analysis method of Bar-on and Kenny (1986) was used. Results : Job stress showed positive correlations with depression (r=0.493, p <0.01) and suicidal ideation (r=0.296, p<0.01). Depression showed a positive correlation with suicidal ideation (r=0.561, p<0.01). The result of analyzing the mediating effect of depression showed that depression was a full mediator variable between job stress and suicidal ideation. Conclusion : Based on the results, it is very likely that job stress may affect suicidal ideation via depression. These results suggested that the preventive interventions emphasized on depression may be helpful for reduction of suicide in firefighters.

Objective : This study was conducted to evaluate the validity of the Korean Inventory of Interpersonal Problems (K-IIP) with Psychopathic Personality Inventory-Revised (PPI-R) to assess interpersonal problems in Korean criminal offenders with schizophrenia. Methods : The sample consisted of 187 inpatients with schizophrenia who had committed crimes. All participants filled out self-report questionnaires ofPPI-R and K-IIP. Results : The result showed that all scales of K-IIP were correlated highly with the PPI-R total score (r range=0.25-0.65). Correlations with K-IIP scales were highest for Blame Externalization, Rebellious Nonconformity, and Machiavellian Egocentricity scales (r range=0.50-0.66, 0.43-0.64, 0.39-0.58, respectively). All scales of K-IIP exhibited a negative correlation with Social Influences, Stress Immunity, Coldheartedness (C) scale ofPPI-R. Cold/Distant scale ofK-IIP was not correlated with C scale of PPI-R. All scales of K-IIP was highly correlated with PPI-R-factor-2 (r range=0.44-0.71) and negatively correlated with PPI-R-factor-l (r range=-0.03-0.38). Conclusions : Despite of strong correlation between PPI-R total score and K-IIP total score, K-IIP was not correlated with PPI-R-I that represents affective and interpersonal deficits. It suggests K-IIP may not proper for measuring the interpersonal problems of criminal offenders with schizophrenia. It will be needed other assessment scale for measuring the interpersonal problems of psychopathy in criminal schizophrenia.

Objective : The aim of this study was to investigate the relationship between interpersonal problems, body dissatisfaction, and suicidal idea. Methods : Two hundred ninety-four participants filled out the self-reporting questionnaires : Body dissatisfaction was measured with Body Dysmorphic Disorder Examination-Self Report (BDDE-SR) ; Interpersonal problems was measured with Korean Inventory of Interpersonal Problem (KIIP) ; Suicidal Ideation Questionnaire (SIQ) was used to assess suicidal idea. A path analysis was conducted to identify the impact of interpersonal problems and body dissatisfaction on the suicidal ideas. Results : 'Socially inhibited (KIIP_C4)', 'overly-accommodating (KIIP_C6)', age, and gender had a direct effect on their body dissatisfaction, and those factors had a indirect effect on the suicidal ideas. Also, 'cold (KIIP_C3)' and body dissatisfaction had a direct effect on the suicidal ideas. Conclusions : These findings can help to identify how interpersonal problems and body dissatisfaction influence the suicidal ideas of people. It would be useful to consider and assess suicidal ideas in the patients with 'cold (KIIP_C3)', 'socially inhibited (KIIP_C4)', 'overly-accommodating (KIIP_C6)'.

Objective : The aims of this study was to evaluate relationship between body dissatisfaction, personality characteristic, and stress in young adults. Methods : One hundred and ninety five young, healthy, and normal participants filled out all 3 types of self-reported questionnaire, the Body Dysmorphic Disorder Examination-Self Report (Korean version of BDDE-SR ; K-BDDE-SR), Neuroticism, Extraversion, Openness-Five Factor Inventory (NEO-FFI) and Stress Scale of Korean version of the Depression Anxiety Stress Scale (K-DASS-21). Results : Out of the 195 participants, 30% (n=59) was male and 70% (n=136) was female. There was no statistical difference between high K-BDDE-SR group (K-BDDE-SR score 75 percentile or higher, n=50) and low K-BDDE-SR group (K-BDDE-SR score below than 75 percentile, n=145) in terms of weight, height, and BMI. In high K-BDDE-SR group, neuroticism was significantly higher than low K-BDDE-SR group, and extraversion, agreeableness, conscientiousness were significantly lower than low K-BDDE-SR group. Also, level of stress in high K-BDDE-SR group was significantly higher than low K-BDDE-SR group. Conclusion : Our study revealed that individual's with more body dissatisfaction were more neurotic and stressful. Thus, body dissatisfaction and diverse psychiatric diseases should be considered in treating neurotic and stressful young adults.

Objective : Despite high prevalence and effective treatments of panic disorder, lots of patients are not properly treated due to lack of awareness of the disorder. This study summarizes and presents the results from Public Awareness Survey of Panic Disorder during the Mental Health Exposition held in Seoul in April, 2014. Methods : A total of 401 participants who visited the booth of the Korean Academy of Anxiety Disorder agreed and completed the survey. The questionnaires comprised of three sections; first, after given a case of patient with panic disorder, participants were asked to choose a diagnosis and treatment options. Second, participants were asked to differentiate the symptoms of panic disorder from those of other mental disorders and answer where they acquired the knowledge of the disorder. Third, visual analogue scales were used to get more detailed information for several issues about panic disorder. The incidence and ratio for each question were provided and compared. Results : Among the participants, 78% reported a patient within the case need treatment, and 30% accurately recognized it was panic disorder. As for treatment needed, 40% selected psychotherapy by psychiatrists, 28% chose counseling by psychologist, 23% said that they can overcome it by self-care. Only 2% of participants selected the pharmacotherapy as treatment needed. Approximately 40% of participants have encountered information about the disorder from gossips of celebrities, 32% from mass-media, and merely 6% from medical professionals. About 80% of participants could discriminate the symptom of panic disorder from those of depression, schizophrenia, or generalized anxiety disorder. Conclusion : Our results suggest that substantial proportions of participants have the awareness of panic disorder, while as for treatment they were strongly biased against pharmacologic treatments. Most of their source of the awareness was not relied upon professional information. Efforts for giving correct information and increasing public awareness of panic disorder are needed to bridge a gap between professionals and general public.