• Title/Summary/Keyword: 강박성

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Developing a Tool to Assess Competency to Consent to Treatment in the Mentally Ill Patient: Reliability and Validity (정신장애인의 치료동의능력 평가 도구 개발 : 신뢰도와 타당화)

  • Seo, Mi-Kyoung;Rhee, MinKyu;Kim, Seung-Hyun;Cho, Sung-Nam;Ko, Young-hun;Lee, Hyuk;Lee, Moon-Soo
    • Korean Journal of Health Psychology
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    • v.14 no.3
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    • pp.579-596
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    • 2009
  • This study aimed to develop the Korean tool of competency to consent to psychiatric treatment and to analyze the reliability and validity of this tool. Also the developed tool's efficiency in determining whether a patient possesses treatment consent competence was checked using the Receiver Operating Characteristic curve and the relevant indices. A total of 193 patients with mental illness, who were hospitalized in a mental hospital or were in community mental health center, participated in this study. We administered a questionnaire consisting of 14 questions concerning understanding, appreciation, reasoning ability, and expression of a choice to the subjects. To investigate the validity of the tool, we conducted the K-MMSE, insight test, estimated IQ, and BPRS. The tool's reliability and usefulness were examined via Cronbach's alpha, ICC, and ROC analysis, and criterion related validation was performed. This tool showed that internal consistency and agreement between raters was relatively high(ICC .80~.98, Cronbach's alpha .56~.83)and the confirmatory factor analysis for constructive validation showed that the tool was valid. Also, estimated IQ, and MMSE were significantly correlated to understanding, appreciation, expression of a choice, and reasoning ability. However, the BPRS did not show significant correlation with any subcompetences. In ROC analysis, full scale cutoff score 18.5 was suggested. Subscale cutoff scores were understanding 4.5, appreciation 8.5, reasoning ability 3.5, and expression of a choice 0.5. These results suggest that this assessment tool is reliable, valid and efficient diagnostically. Finally, limitations and implications of this study were discussed.

Effect of Repetitive Transcranial Magnetic Stimulation in Drug Resistant Depressed Patients (치료 저항성 우울증 환자에서 반복적 경두개 자기자극후 국소뇌혈류 변화)

  • Chung, Yong-An;Yoo, Ie-Ryung;Kang, Bong-Joo;Chae, Jeong-Ho;Lee, Hye-Won;Moon, Hyun-Jin;Kim, Sung-Hoon;Sohn, Hyung-Sun;Chung, Soo-Kyo
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.1
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    • pp.9-15
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    • 2007
  • Purpose: Repetitive transcranial magnetic stimulation (rTMS) has recently been clinically applied in the treatment of drug resistant depressed patients. There are mixed findings about the efficacy of rTMS on depression. Furthermore, the influence of rTMS on the physiology of the brain is not clear. We prospectively evaluated changes of regional cerebral blood flow (rCBF) between pre- and post-rTMS treatment in patients with drug resistant depression. Materials and Methods: Twelve patients with drug-resistant depression (7 male, 5 female; age range: $19{\sim}52$ years; mean age: $29.3{\pm}9.3$ years) were given rTMS on right prefrontal lobe with low frequency (1 Hz) and on left prefrontal lobe with high frequency (20 Hz), with 20-minute-duration each day for 3 weeks. Tc-99m ECD brain perfusion SPECT was obtained before and after rTMS treatment. The changes of cerebral perfusion were analyzed using statistical parametric mapping (SPM; t=3.14, uncorrected p<0.01, voxel=100). Results: Following areas showed significant increase in rCBF after 3 weeks rTMS treatment: the cingulate gyrus, fusiform gyrus of right temporal lobe, precuneus, and left lateral globus pallidus. Significant decrement was noted in: the precental and middle frontal gyrus of right frontal lobe, and fusiform gyrus of left occipital lobe. Conclusion: Low-frequency rTMS on the right prefrontal cortex and high-frequency rTMS on the left prefrontal cortex for 3 weeks as an add-on regimen have increased and decreased rCBF in the specific brain regions in drug-resistant depressed patients. Further analyses correlating clinical characteristics and treatment paradigm with functional imaging data may be helpful in clarifying the pathophysiology of drug-resistant depressed patients.

Analysis of Pre-service Science Teachers' Responsive Teaching Types and Barriers of Practice (예비과학교사들의 반응적 교수 유형 및 실행의 제약점 분석)

  • Cho, Mihyun;Paik, Seoung-Hey
    • Journal of The Korean Association For Science Education
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    • v.40 no.2
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    • pp.177-189
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    • 2020
  • In this study, we implemented an education program to improve the responsive teaching ability of pre-service science teachers, and analyzed the responsive teaching practices revealed during the program process. Through this, we derived the types and characteristics of responsive teaching practice, identified factors that made it difficult for pre-service teachers to practice, and obtained empirical data on under what conditions the responsive teaching capacity of pre-service teachers was developed. For this purpose, a practice-based teacher education program was designed and carried out for 14 pre-service teachers who had no experience in responsive teaching. The program consists of four steps; observation of class, practice through rehearsal, application in practicum, and post-reflection on educational practice. In particular, qualitative analysis was conducted on the types of responsive teaching and their detrimental factors revealed during application in practicum. As a result of the analysis, four types were derived; discriminator type, communicator type, guide type, and facilitator type. Each type was identified as having a common responsive teaching step element. The education program implemented in this study was effective for pre-service teachers to recognize the importance of student-participation class and the educational effect of responsive teaching. However, three barriers that prevented pre-service teachers from responsive teaching practice were also analyzed. First was the pressure to achieve specific learning goals within a given class time. Second was the rigid belief of the fixed curriculum. Third was the obsession that the teacher should lead the class. Based on these results, it was suggested that in order to improve the responsive teaching ability of pre-service teachers, it is necessary to support the recognition of breaking out of the thinking the time constraint, the flexibility of the curriculum, and the role of teacher as a class supporter.

ASSOCIATION BETWEEN TOURETTE DISORDER AND CATECHOL-O-METHYL TRANSFERASE(COMT) GENE IN KOREAN SUBJECTS (한국인에 있어서의 뚜렛 장애와 COMT유전자간의 상관 관계에 대한 연구)

  • Kim, Boong-Nyun;Lim, Jae-In;Cho, Soo-Churl
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.15 no.2
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    • pp.178-184
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    • 2004
  • Objectives : This study was conducted to investigate the association of the COMT polymorphism with the TD in Korean sample of families with TD probands. The relationship between risk alleles and specific clinical features (tic severity, comorbidity, drug response) was also explored. Method : Patients were recruited from the Tic Disorder clinic at the Child & Adolescent Psychiatric Division of Seoul National University Hospital and assessed through 2 stage evaluation. Firstly, all the patients and parents received semistructured interview using Korean version of K-SADS-PL. Secondly all the patients received clinical interview and tic severity assessment with Korean version of YGTSS. The subjects in control group were recruited from the health promotion center in out hospital and were evaluated by SCL-90 and SCID-IV. Through these process, total of 42 children and adolescents with TD, their 84 parents and 86 control subjects were finally recruited. Genotyping for The Val158Met polymorphism of the COMT gene was done by standardized method. After collection of genetic data of all the patients, parents and control subjects, case-control comparison and tranmission dysequilibrium test was executed by SPSS version 11. Result : From the case-control comparison, the frequency of L-allele and LL genotype was significantly higher in TD group. However, no differences were found from the TDT. No significant differences were found in in family history of tic, ADHD, OCD, drug response and comorbid conditions among the three different genotypes in patients with TD. Conclusion : Though this study results should be interpreted cautiously due to small sample size and negative finding in TDT test, this study is the first report that there is positive association between the functional polymorphism of COMT gene the TD.

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Sleep and Psychological Problems in Medical Students (의학전문대학원 학생들의 수면과 심리적 요인)

  • Kim, Dae-Wook;Kim, Sung-Gon;Kim, Ji-Hoon;Yang, Young-Hui;Jung, Woo-Young;Lee, Jin-Seong
    • Sleep Medicine and Psychophysiology
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    • v.20 no.2
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    • pp.69-74
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    • 2013
  • Introduction: Although it is well known that medical students are not getting an adequate amount of sleep, there have been only a few studies on the sleep patterns of medical students and the related factors. Therefore, the present study aimed to investigate the medical students' sleep patterns and the related factors. Methods: A questionnaire package was administered to the $1^{st}$ to $4^{th}$ year medical students at one medical school. It consisted of questions asking about their lifestyles as well as Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale (ESS), global assessment of recent stress scale (GASS), the center for epidemiologic studies-depression scale (CES-D), and Moudsley obsessive-compulsive inventory (MOCI). A total of 352 students (206 males and 146 females) responded to the survey and the result was analyzed using the independent t-test, the chi-square test, the paired t-test, Pearson's correlation and ANOVA. p-values of less than 0.05 were considered statistically significant in analyses. Results: The weekend bedtime was significantly delayed (0 : 49 on weekday ; 1 : 34 on weekend ; t=-5.23, p<0.001), the weekend rise time was delayed (6 : 58 on weekday ; 9 : 30 on weekend ; t=-24.48, p<0.001) and the total sleep time was increased on weekends (5 : 36 on weekday ; 7 : 39 on weekend ; t=15.94, p<0.001). The PSQI score of all subjects was 6.43{\pm}2.64. PSQI was positively correlated with ESS (r=0.383, p<0.001), GASS (r=0.326, p<0.001), CES-D (r=0.393, p< 0.001), and MOCI (r=0.247, p<0.001), but not with GPA (r=0.072, p=0.228. The more senior students had lower PSQI, GASS, CES-D, and MOCI score (p<0.05). Conclusion: Medical students were experiencing a lack of sleep during weekdays as they have a later bedtime and earlier rise time, and consequently had more hours of sleep on weekends. Overall, the medical students were experiencing poor sleep quality and sleep deprivation. Poor sleep quality is associated with psychological problems (daytime sleepiness, stress, depression, and obsessive tendency).

The Healing Effect of 'Self-archetype' Manifested in the Analysis of 'Hunger' and 'Compulsive Overeating' : Investigation Focused on the 'Serpent' Imago ('배고픔'과 '폭식충동'을 주소로 하는 내담자의 분석과정에서 발현된 '자기원형'의 치유적 기능 : '뱀'의 상징을 중심으로 한 고찰)

  • Kim, Kye-Hee
    • Korean Journal of Psychosomatic Medicine
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    • v.25 no.1
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    • pp.73-85
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    • 2017
  • Objectives : In this study I made investigations how 'strange hunger' and 'compulsive overeating' threatening the ego could be resolved and healed. And I aim to present a healing model of psychotherapy and analysis as one of methods of treatment for 'eating disorder'. Methods : The analysands of this study were outpatients who visited the department of psychiatry of Yong-In Mental Hospital from March 2008 to February 2017 with 'hunger' and 'compulsive overeating' as their chief complaints. This study is based on the detailed records of the process of analysis including dreams and visions. Results : 1) Throughout the process of analysis that explore both consciousness and unconsciousness(dream, vision), hunger and compulsive overeating is improved and healed in all analysands. 2) The Imago of 'Snake' appeared in dreams and visions of all analysands. 3) By suffering impulse rather than acting it out, impulse transformes itself into 'Imago'. As impulse transforms into 'Imago' and reveals the 'meaning' of it, ego-threatening power of impulse weakens and mood is calmed. And as a result, synthesis of consciousness and unconsciousness and creative transformation of personality can be possible. Conclusions : In some people, 'hunger' and 'compulsive overeating' are 'creative impulses' that aim 'Self-realization' which can be fruited as creative transformation of personality and as creative transformation in the relation with the world. 'Creative impulses', which often can be experienced as instinctive impulse or emotional suffering unless ego realizes the meaning, reveal the meaning in dreams or visions through 'Imago' and 'Symbol'.

Psychopathology, Self Esteem and Quality of Life in Cancer Patients with Radiotherapy (방사선 치료 중인 암환자의 정신병리, 자아존중감 및 삶의 질)

  • Jeong, Chan-Young;Yang, Jong-Chul;Shin, Il-Seon;Choi, Young;Yoon, Jin-Sang;Lee, Moo-Seok;Lee, Hyung-Young;Nah, Byung-Sik
    • Korean Journal of Psychosomatic Medicine
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    • v.10 no.2
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    • pp.92-100
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    • 2002
  • Objectives : As medical science develops, survival rate of cancer patients rises. Therefore, psychologic understanding and improving quality of life in cancer patients is getting greater significance. The Object of this study is to investigate sociodemographic and clinical characteristics, psychopathology, self esteem and quality of life in cancer patients and to provide useful information for therapeutic approach to cancer patients. Methods : The subjects were 41 patents who had been treated by radiotherapy and 20 normal people. Sociodemographic information and clinical characteristics of cancer patients were investigated, and SCL-90R for psychopathology, Rosenberg Self-esteem Scale for self esteem, WHOQOL-BREF for quality of life were administered to subjects. The results of both groups were compared and analysed, and correlation between variables were evaluated. Results : 1) The tendency of Somatization, obsession-compulsion, depression, anxiety, hostility, phobia, psychosis in cancer group were higher than normal group. Especially, somatization and anxiety in cancer group were significantly higher than normal group. 2) Self esteem and quality of life in cancer group were significantly lower than normal group. 3) No significance were found in comparison of psychopathology, self esteem and quality of life according to sociodemographic variables. Among clinical characteristics, higher somatization was shown in case of more weight loss, and higher somatization and lower quality of life was shown in the presence of pain. 4) Higher anxiety was significantly associated with lower self esteem, and Higher somatization and anxiety was significantly associated with lower quality of life. Conclusion : Cancer patients had various kinds of psychopathology, low self esteem and low quality of life. In particular, somatization and anxiety, self esteem and pain were found to be important factors to quality of life of cancer patients. Therefore, management of psychopathology, improving self esteem, pain control is necessary to improve quality of life in cancer patients.

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From Trauma To growth: Posttraumatic Growth Clock (외상 후 병리에서 성장으로: 외상 후 성장 시계)

  • Lee, Hong-Seock
    • Korean Journal of Cognitive Science
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    • v.27 no.4
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    • pp.501-539
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    • 2016
  • The human mind is a self-evolving system that develops along a multidimensional hierarchical pathway in response to traumatic stimulus. In absence of trauma, a mind integrated in conflict-free state is called monistic. When the monistic mind responses to a traumatic stimulus, a response polarity forms toward stimulus polarity within the mind, turning it into a bipartite structure. Dialectical interaction between the two opposites, originating from their incompatibility, creates a new third polarity in the upper dimension. Thereby, the mind turns into a trinity structure. When the interaction among the three polarities becomes optimized, the plasticity of the mind gets maximized into the "far-from-equilibrium state," and the function of three polarities is synchronized. Through this recalibration, the mind returns back to its monistic structure. If the mind with the recurred monistic structure responds to another traumatic stimulus, this cycle of hierarchical transformation repeats itself in this cyclical and fractal growth process through synchronization of basic trinity system. Applying this concept to the process of post-traumatic growth (PTG), this paper explores how the mind transforms traumatic experiences into PTG and proposes a 'PTG Clock' that shows a fundamental sequence in the development of the human mind. The PTG Clock consists of seven hierarchical phases, and each of the first six phases has two opposite sub-phases: shocked/numbed, feared/intrusive, paranoid/avoidant, obsessional/explosive, dependent/depressive, and meaningless/searching for meaning. The seventh, the synchronization phase, completes one cycle of the mind's transformation, realizing a grand trinity system, where the mind synchronizes its biological, social, and existential dimensions. At that point, the mind becomes more susceptible to not only the stimulus of its own traumatic experience but also the pain of others. Thereby, the PTG Clock sets out on a journey to another cycle of transformation in higher dimensions. The validity of this transformational process for the PTG Clock will be examined by comparing it to Horowitz's theory of stress response syndrome.

The Study on the State of Health and dietary Habits of boy′s and Girl′s High School Students in Seoul (서울시내 남.녀 고등학생들의 식습관과 건강상태에 관한 연구)

  • 박성효;정낙원;이효지
    • Korean journal of food and cookery science
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    • v.7 no.1
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    • pp.67-80
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    • 1991
  • This study researched the dietary habit of boy's and girl's high school students, and into low it was connected with the state of health between the group of having the right dietary habit and the group of having the wrong habit. Results were as follows: 1. The age about the object person of research was the most numerous in 79% at 16~17 years old, the average weight was $55.67\pm9.08$kg, the average height was $165.47\pm7.56$cm. 2. In the parent's school career of the object person of research, persons who graduated high school were many. The mother's educational level was lower than the father's school career. The parent's school career in the district south of a river was higher than the parent's school career in the district north of a river. And the parent's school career of cultural students was high. 3. The frequency of food intake in the district north of a river and in the district south of a river was a meaningful difference in the vegetables blended in green and yellow things (p<.01), fruit (p<.05), rice, flour, potatoes (p<.05), and so the district north of a river took less than the district south of a river. 4. The most regular diet in a day was lunch. The appetite of the students was generally good. 5. The general environment and state of health were a meaningful difference about melancholia (p<.05) in the district of north and south of river, and so melancholia in students of the north of a river was high. 6. The state of health according to regular diet was a meaningful difference, so regular student was better than irregular student in state of health, and was the same in study. 7. Eating habit correlated much to each state of health, Especially in physical health, the muscular frame correlated to fruit (p<.001), seaweeds (p<.05), fried food, jun, panbroiled food (p<.05), salty taste (p<.05), sour taste(p<.001).

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The Strategy of Characterizing Space that uses Anti-House as a Metaphor for Character's Self-Defense Mechanism - Focusing on the TV Series and the Theater version of - (캐릭터의 자아방어기제를 은유하는 '안티돔' 공간의 성격화 전략 - <에반게리온>의 TV 시리즈와 극장판 를 중심으로 -)

  • Yang, Se-Hyeok;Ryu, Beom-Yeol
    • Cartoon and Animation Studies
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    • s.41
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    • pp.75-106
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    • 2015
  • Animations characterize space as a strategy to effectively show the inner conflicts of characters and to highlight the theme. During the process of inner conflict, characters unconsciously use defense mechanism to protect their egos from the fear that came from deficiency, and because of the self-deceptive quality of self-defense mechanism, the reality is distorted and conflicts get intensified. This study focuses on the concept of anti-house, the space where conflicts get intensified, analyzes animations to find out the aspect of inner conflict, and interprets the characteristic of space that is used for metaphoric structure frame. Also, it aims to reveal how the defense mechanism, which intensifies the inner conflict of characters, is characterized as anti-house. The analysis in this study was mainly done with the TV series, , and the theater version of . It is because the characters have serious deficiency from broken home and have a psychological quality of closed boundary that is symbolized as 'A.T. field'. Especially, the core character, 'Shinji Ikari', shows how a character uses compulsive self-defense mechanism to deal with inner conflict and as a result, goes through ego-collapse and then introspection. This process of the character's experience is the core of the whole plot. Through analysis, the relationship between the character's self-defense mechanism and the space, anti-house(which expands to Anti-city), was inferred. The space is made up of three axes, x-axis of horizontal space, y-axis of vertical space, and in the sense that all the space has no exit, z-axis of deeper contradictory space. This thesis started with the decision that is the most suitable work in analyzing the metaphorical relationship between self-defense mechanism and anti-house. There was limitation, however, as the typical characteristics of Japanese animations, pedantic composition and the possibility of broad interpretation, hindered clear verification. Hopefully, this limitation will be overcome by following studies and this study is expected to show the importance of space in interpreting the text of animations, and to serve as database for other creative works.