Objectives: Through comparing sleep variables and autonomic activities among three shifts in shift workers, the authors intended to clarify which shift is most tolerable and to identify the characteristics of their psychological and physical problems. This study is also expected to help shift workers to adapt themselves to their work more effectively. Methods: Fifty one shift workers took part in this study. They were working in a rapidly rotating system in which they worked for 3 days in one shift with one day off between each shift. Based on a sleep diary, sleep latency (SL), sleep period time (SPT), and number of wake after sleep onset (NWASO) were estimated and compared among the three shifts. In assessing sleepiness, Epworth sleepiness scale (ESS) and visual analogue scale (VAS) were used. To evaluate mood states among the three shifts, profile of mood states (POMS) was administered. Heart rate variability (HRV), and the level of adrenaline and noradrenaline were measured to assess autonomic activities. HRV included low frequency power (LF), high frequency power (HF), and LF/HF. Results: SPT was significantly lengthened during the evening shift and SL was shortened during the night shift. The workers showed a drop in alertness at wake-up during morning shift and a drop in alertness at work during night shift. During night shift the subjects complained of physical fatigue and cognitive decline. Comparison of HRV showed that parasympathetic activity was most prominent during the evening shift. Secretion of adrenaline and noradrenaline decreased during the evening shift, though statistically not significant. Conclusion: We found that the evening shift was most tolerable among the three shifts. It is recommended that morning light exposure be done during the morning shift and nocturnal light exposure during the night shift.
Objectives: We intended to observe changes in sleep patterns and mood states of night-shift workers following light exposure. We also estimated the degree of tolerance of light exposure. By studying these, we investigated the possibility of applying light therapy to night-shift workers for improving their adaptation. Methods: Twelve night-shift nurses working at Yong-In Mental Hospital volunteered to participate in this study. The study consisted of 3 parts: 1) night-shift control study; 2) light exposure study; 3) day-shift control study. All the nurses accomplished 3 parts of the study, each of which continued for 3 days, except one nurse who did not participate in day-shift control study. During light exposure study, nurses were exposed to bright light for 4 hours from 1AM to 5AM. Sleep patterns were evaluated with wrist actigraphy and automatic sleep analysis program. Mood states and side effects of light exposure were assessed with self-report scales. Results: Sleep period time, total sleep time, and sleep efficiency were increased following light exposure compared with night-shift control study. Light exposure study showed no difference from day-shift control study in above-mentioned sleep parameters. Daily fluctuation of sleep efficiency was less prominent during light exposure study than during night-shift control study. During light exposure study, the subjects felt more elated and energetic in the evening after daytime sleep than during night-shift control study. None of the subjects complained of severe side effects related to light exposure on the third day of light exposure. Tolerance of side effects was noted to develop with the repetition of light exposure. Conclusion: Light exposure improved the daytime sleep of night-shift workers to the level of normal nighttime sleep, making the subjects more elated and energetic. Side effects of light exposure were found to be tolerable. Light exposure seems to be safely applicable to night-shift workers for their adaptation.
This study is realized using fuzzy evaluation and AHP(the analytic hierarchy process) for the optimum search of traffic route and estimated by the quantitative analysis in the vague subjective judgement. It is different from classical route search and noticed thinking method of human. Appraisal element, weight, appraisal value of route is extracted from basic of the opinion gathering fur the driving expert and example of route model was used for the finding of practice utility. Model assessment was performed attribute membership function making of estimate element, estimate value setting, weight define by the AHP, non additive presentation of weight according to $\lambda$-fuzzy measure, Choquet fuzzy integral.
Lee, San;Oh, Seung-Taek;Ryu, So Yeon;Jun, Jin Yong;Lee, Kounseok;Lee, Eun;Park, Jin Young;Yi, Sang-Wook;Choi, Won-Jung
Korean Journal of Psychosomatic Medicine
/
v.24
no.1
/
pp.83-93
/
2016
Objectives : The Center for Epidemiologic Studies Depression scale-Revised is a recently revised scale which has been reported as a valid tool for the assessment of depressive symptoms. It encompasses cardinal symptoms of depression described in the Diagnostic and Statistical Manual of Mental disorders, fourth edition. In this study, we assessed the reliability, validity and psychometric properties of the Korean version of the CESD-R(K-CESD-R). Methods : Forty-eight patients diagnosed as major depressive disorder, dysthymia, depressive disorder NOS according to the DSM-IV criteria using Mini International Neuropsychiatric Interview and 48 healthy controls were enrolled in this study. They were assessed with K-CESD-R, K-MADRS, PHQ-9, KQIDS-SR, STAI to check cross-validation. Statistical analyses were performed using calculation of Cronbach's alpha, Pearson correlation coefficient, Principal Component Analysis, ROC curve and optimal cut-off value. Results : The Cronbach's alpha of K-CESD-R was 0.98. The total score of K-CESD-R revealed significantly high correlations with those of K-MADRS, PHQ-9, KQIDS-SR(r=0.910, 0.966 and 0.920, p<0.001, respectively). Factor analysis showed two factors account for 76.29% of total variance. We suggested the optimal cut-off value of K-CESD-R as 13 according to analysis of the ROC curve which value sensitivity and specificity both equally. Conclusions : These Results showed that the K-CESD-R could be a reliable and valid scale to assess depressive symptoms. The K-CESD-R is expected as a useful and effective tool for screening and measuring depressive symptoms not only in outpatient clinic but also epidemiologic studies.
Lee, Heon-Jeong;Yang, Jae-Won;Lee, Bun-Hee;Ham, Byung-Joo;Suh, Kwang-Yoon;Kim, Leen
Sleep Medicine and Psychophysiology
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v.9
no.2
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pp.122-126
/
2002
Objectives: The purpose of this study is to investigate the effects of the 37-hour sleep deprivation on visual discrimination using the Cybernetic Flicker Fusion Analyzer (FLIMK) and to see the correlation between this finding and various subjective scale scores. Methods: Twenty six subjects (20 men 6 women, $24.50{\pm}1.45$ years of age) participated in this study. Subjects remained awake for 37 hours under continuous surveillance. In the morning and evening of two study days, the FLIMK and the self-reporting scale of sleepiness, fatigue, anxiety and mood states were instituted. Results: In FLIMK, the flicker fusion threshold was significantly decreased after sleep deprivation (F=7.66, p=0.01). The number of trials (responses) before reaching fusion frequency threshold was significantly increased after sleep deprivation (F=13.16, p=0.001). The reduction of fusion frequency was correlated with the increase of sleepiness and fatigue (p<0.05), and the number of the trials was correlated with the scores of negative mood, anxiety, and fatigue (p<0.05). Conclusions: These results suggest that 37 hour total sleep deprivation cause the decrement in visual discrimination. The decrease of the fusion frequency after sleep deprivation was correlated with sleepiness and fatigue. Further study is needed to enlighten the biological mechanism of the decrement in visual function after sleep deprivation.
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.11
no.2
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pp.252-261
/
2000
Objectivity:This study was conducted to examine the depression, self-concept, perception of stress & coping strategy in children with chronic physical illness. Methods:Two groups of participants were recruited for this study, 13 children with chronic illness in outpatient or inpatient treatment at Seoul National University Children's Hospital, and 13 nonpatient children. They were assessed using Korean form of the Piers-Harris Self-Concept Scale (PHSCS), Kovacs' Children's Depression Inventory(CDI) and three subscaleds('color how you feel' 'color how others make you feel' 'A children in the rain' of Children's Self-Report and Projective Inventory(CSRPI). Result:There were significant differences between the chronic ill children and the healthy children in scores of depression and self-concept. The chronicity ill children were more depressive and had very negative self-concept, and obtained significantly lower scores than the healthy children in the subscales of PHSCS, 'intellectual/school status' and 'popularity' Among three scales of CSRPI, there was no difference in 'color how you feel' and 'color how others make you feel' But there were significant differences in all items of 'A child in the rain'(quantity of raining, duration of raining, tool, and effectiveness). 'Duration of raining' correlated most negatively with PHSCS scores, and correlated positively with CDI scores. Conclusion:The children with chronic illness are more depressive and have very negative selfconcept. And they feel that the stresses are more permanent, but have no appropriate coping strategy. The results suggest that the chronic illness strongly affects the psychological and emotional adjustment of children(i.e. depression, peer relation, stress coping strategy).
The purpose of the present study is to examine effects of anger expression and perceived emotional competence on school anger in adolescents. The participants were 304 high school students (134 males, 170 females). They were administered the anger-related subscales (anger-out, anger-in, and anger control) of the Korean Version of the State-Trait Anger Expression Inventory (STAXI-K), the Korean Version of Trait Meta-Mood Scale (K-TMMS), and the Korean Version of School Anger Inventory(SAI-K). The results showed that school anger positively correlated with anger-out and anger-in, and negatively correlated with anger control and perceived emotional competence. Neither interaction effects of anger-out and perceived emotional competence nor interaction effects of anger-in and perceived emotional competence on school anger were significant. On the contrary, interaction effects of anger control and perceived emotional competence on school anger were significant. The results of post-hoc analysis revealed that the effect of anger control on school anger was significant in the case of high perceived emotional competence but not significant in the case of low perceived emotional competence. Based on these results, it was suggested that psychological programs designed to reduce school anger in adolescents need effective measures to enhance not only anger control skills but also perceived emotional competence.
Recently many treatment strategies have been developed to prevent suicidal ideation as it is increasing. Various community facilities and university centers are carrying out research to develop efficient treatment programs. This study examined how music can be used therapeutically for a case who is going through severe suicidal ideation. Various music therapy techniques are utilized including song psychotherapy, music and imagery and role play instrumental improvisation. A woman with severe depression for seven one-hour session. Both quantitative and qualitative data were collected to examine the changes in the suicidal ideation. As results, there were lots of changes in the client's attitude towards life through exploring inner world. Much of stability and sense of security were gained and emotional hardship was resolved in the process of therapy. The client was able to structure future plans productively as the suicidal ideation was reduced. In the process of role play instrumental improvisation, music allowed her to express issues regarding relationships with others, attitudes and in other areas as well. Music was used "as therapy" and solved many repressed emotions related to the trauma including psychological inhibition, tension, helplessness, lack of energy. Further music was able to bring the "false" ego with "true ego". The study implies that various psychotherapeutic interventions can alleviate depression and reduce suicidal ideation.
Objectives : Loneliness and poor sleep quality are common phenomena in old age and are associated with negative physical and mental health. However, little is known regarding the relation between loneliness and sleep quality. The aim of this study was to examine the association of loneliness and sleep quality among the elderly living alone. Methods : This is a cross-sectional study that enrolled 1,090 subjects who are the community-residing elderly living alone. Sociodemographic status, medical condition, cognition, mood disorder, sleep quality and levels of loneliness were collected using a self-administered questionnaire and a specific semi-structured interview conducted by trained nurses. Descriptive statistics were used to analyze data regarding sociodemographic variable and loneliness. Univariate and Multivariate regression analyses were applied to examine the association between loneliness and sleep quality after adjustment for multiple confounding variables. Results : The Pittsburgh Sleep Quality Index (PSQI) mean score of "lonely group" (9.2±4.2) was significantly higher than that of "not lonely group" (7.3±3.7) (student-t test, p<0.001). Loneliness was significantly associated with PSQI (standardized β=0.065, p=0.025), sleep disturbance (standardized β=0.086, p=0.005), use of sleep medication (standardized β=0.065, p=0.034) after adjustment for possible confounding variables including sex and mood disorder. Conclusions : Loneliness was associated with sleep disturbance and this finding implied negative impact of loneliness on sleep quality of older adults. Public health promotion efforts to reduce loneliness may improve sleep quality and mental health in the elderly living alone.
Objectives : Illness behavior is defined as the persistence of an adaptive/maladaptive mode of perceiving, evaluating and responding to health status and symptoms according to the status. In a cognitive aspect, somatizing symptoms are regarded as being originated from distortions, including magnification and/or amplification, of perceiving, evaluating and responding to symptoms such as bodily sensations. That is somatization may be explained by maladaptive illness behavior. In this study, we tried to investigate differences of illness behavior in depressive patient according to the presence of somatization. Methods : We divided 45 patients who were diagnosed as depression with ICD-10 diagnostic criteria into two groups(somatizing and non-somatizing group) according to the somatization subscale of Korean Depression Scale and compared two groups in the differences of illness behavior using the Illness Behavior Questionnaire. Results : Somatizing group showed significantly higher scores than non-somatizing group on the disease affirmation subscale($6.79{\pm}2.08$ vs. 4.76, p=0.003) and the denial subscale($3.25{\pm}1.22$ vs. $2.10{\pm}1.41$, p=0.006). There were no significant differences between two groups on the general hypochondriasis subscale and the affective unstability subscale. In a logistic regression analysis, somatizing group also showed higher odds ratio (OR) scores on the disease affirmation subscale(OR=1.418, p=0.089) and the denial subscale(OR=1.880, p=0.083). Conclusion : The disease affirmation and denial may be a discriminative mechanism of somatization in depressive patients. These subscales of Illness Behavior Questionnare could be useful markers, and psychiatric illnesses with somatizing and depressive symptoms may be differentially diagnosed and be predicted through these subscales.
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