• Title/Summary/Keyword: 심리적 외상

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Clinical Characteristics in Patients for Mental Disability Assessment Following Traumatic Brain Injury -Comparison between Patients with and without Abnormal Brain Imaging- (두부외상 후 장애평가 환자들의 임상적 특징 -뇌영상검사 이상유무에 따른 비교-)

  • Ha, Kang-Su;Kim, Sang-Hoon;Kim, Hack-Ryul;Park, Sang-Hag;Pyo, Kyung-Sik;Cho, Yong-Rae
    • Korean Journal of Psychosomatic Medicine
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    • v.9 no.1
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    • pp.28-36
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    • 2001
  • Objectives : This study was undertaken to identify the clinical and psychological characteristics in patients of mental disability assessment following traumatic brain injury who had the finding with or without abnormal brain imaging study. Methods : A consecutive series of 59 patients were assessed in hospital from January 1994 to December 1998. Patients were divided into 2 groups based on normal or abnormal brain imaging and the two groups were compared in demographic characteristics, psychiatric symptoms, type of head injury, clinical psychological findings. There were 27 patients with abnormal findings and 32 with normal findings in brain imaging study. Results : Abnormal finding group in brain imaging study had significantly higher incidence of psychosis, decreased memory, decreased appetite, increased nihilistic idea, and intracranial hemorrhage. Also, abnormal finding group showed significantly lower level of performance on the block design subtest of K-WAIS and had significantly lower scores on F, hypochodriasis, depression, hysteria, psychopathic deviate, psychasthenia and schizophrenia subscale of the MMPI. Conclusion : The findings suggest that the patients undergone brain surgery due to intracranial hemorrage at that time of brain injury may have higher frequency of abnormal findings in brain imaging study, complain more cognitive and affective symptoms, and have lower the abstract concept formation and perceptual organization abilities.

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A Study on the Purpose-in-Life Level in Patients with Traumatic Brain Injury (외상성 뇌 손상 환자의 삶의 목적 수준에 관한 연구)

  • Rho, Seung-Ho;Kim, Sung-Woo
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.2
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    • pp.184-195
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    • 1999
  • Objectives : As traumatic brain injury(TBI) leaves chronic sequelae in mind and body, the injured patients should rectify the meaning and object that they have pursued in their lives and set up a new purpose in life that they may make the rest of their lives meaningful. This study was designed to investigate the purpose and quality of life levels and the influence of demographic and clinical variables on the levels in the patients with TBI, and to be of some help to their rehabilitation. Methods : In order to assess the purpose in life(PIL) and the quality of life(QOL) levels, Purpose-in-Life Test, Sickness Impact Profile, Quality of Life Index, Head Injury Symptom Ckecklist, and Neurobehavioral Rating Scale were administered to the subjects. The subjects were thirty-two patients with TBI and the same numbered normal controls. The TBI group was composed of 16 to 65 year-aged patients who had received mild or severe TBI at least 12 months before, and the controls were siblings or friends of the patients whose age, sex, and educational level were similar to them. Results : 1) The PIL and QOL levels of the patients with TBI remained significantly lower than that of control group after their symptoms of injury were stabilized(p<.01, p<.01). 2) The mean PIL score of TBI group was $58.8{\pm}23.2$, which was to be regarded as the level of existential vacuum. 3) The PIL level of TBI group was significantly correlated with the QOL level(p <.01). 4) The subgroup with lower PIL level in patients with TBI has significantly higher rate of female than that with higher PIL(p<.05), the PIL level of female patients was significantly lower than that of male patients(p <.05). 5) The significant differences in PIL levels were not found, in which comparison was performed between each pair of subgroups of patients with TBI divided by severity of injury(mild vs severe), marital status(married vs unmarried), and occupational status prior to injury(employed vs unemployed). Conclusion : The PIL of patients with TBI still remained the level of existential vacuum after symptoms of sequelae had been stabilized, The QOL level was also extremely low, and as the PIL level was low the QOL was also low. The demographic and clinical variables except sex did not have influence on the PIL level in brain-injured patients. It is suggested that every patient should admit their mental and physical limitations caused by brain injury and revise their purpose in life for successful rehabilitation.

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Self-Efficacy, Self-Care Behavior, Posttraumatic Growth, and Quality of Life in Patients with Cancer according to Disease Characteristics (질병관련 특성에 따른 암환자의 자기효능감, 자가간호행위, 외상 후 성장, 삶의 질)

  • Choi, Jinho;Lee, Sunyoung;An, Byungduck
    • Journal of Hospice and Palliative Care
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    • v.19 no.2
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    • pp.170-179
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    • 2016
  • Purpose: This study examined self-efficacy, self-care behavior, posttraumatic growth, and quality of life in cancer patients and their levels by disease characteristics groups to identify patient groups that require psychosocial intervention. Methods: We surveyed 107 patients using a structured questionnaire about the four factors and analyzed the factors by stratifying the patients by the period after the cancer diagnosis, by stage and by current treatment status. Results: The mean score for self-efficacy was 37.78, and that for self-care behavior 49.96. Patients who were diagnosed less than one year ago scored higher on medication, a sub-category of self-care behavior, than the post-diagnosis period of 1~2 year group. The score was higher in the currently-treated group than the follow-up and distant metastasis groups. For posttraumatic growth, the mean was 56.17, and the factor was higher in the 1~2 year post-diagnosis group after than the less than one year group. The score was higher in the follow-up group than the currently-treated group. With regard to quality of life, the mean score was 25.79, and no significant correlation was found with disease characteristics. Conclusion: A shorter post-diagnosis period increased self-care behavior, and the greatest posttraumatic growth was reported by the 1~2 year post-diagnosis group. It may be necessary to provide cancer patients with an education program and other strategies less than one year after the diagnosis to improve self-efficacy and self-care behavior. To promote post-traumatic growth, it may be helpful to provide patients with psychosocial intervention within two years after the diagnosis.

The Effects of Cognitive Training Using Application Games of Smart Device on Cognitive Function in Patients With Mild Traumatic Brain Injury (스마트기기 애플리케이션 게임을 이용한 인지훈련이 경미한 손상이 있는 외상성 뇌손상 환자의 인지기능에 미치는 영향)

  • Kang, Seon-Hwa;Kim, Young-Sil;Kang, So-La;Moon, Jong-Hoon
    • Journal of Korean Society of Neurocognitive Rehabilitation
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    • v.10 no.2
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    • pp.9-18
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    • 2018
  • The research has sought to examine the effect of cognition training using smart device application games on the cognition function of traumatic brain injury patients. The research was conducted to the seventeen traumatic brain injury patients with slight symptoms who were treated with occupational therapy. The patients were divided into the two groups, nine for the experimental group and eight for the control group. The experimental group was assigned to conduct cognition training using smart device application games and traditional cognition training for fifteen minutes each, and the control group has conducted the traditional cognition training for 30 minutes. All arbitrations were conducted for 30 minutes a day, five times a week and for four weeks. To assess the cognitive function, Korean Mini-Mental State Examination (K-MMSE), Lowenstein Occupational Therapy Cognitive Assessment (LOTCA) and visual memory 1 and 2 of Motor-free Visual Perception Test-3 (MVPT-3) were measured before and after the intervention. In the comparison of the change between the two groups, the experimental groups showed a significant improvement in the visual memory of Motor-free Visual Perception Test-3 and remembrance section of the Korean Mini-Mental State Examination (p<.05). The result of this research has confirmed that the cognition training using the smart device application game can make the positive change to the visual memory of the traumatic brain injury patients more than the traditional cognition training.

Neuropsychiatric Evaluation of Head-Injured Patients(II) : A Comparative Study of Brain-injured Patients with and without Abnormal Findings in the Structural Brain Imaging - Mainly in Relation to Functional Brain Studies and Psychological Evaluation (두부외상 환자의 신경정신의학적 평가(II) : 뇌의 구조적 영상검사상의 병변 유무에 따른 두부외상 환자군의 비교 - 기능적 및 심리적 검사소견과의 연관성을 중심으로)

  • Cho, Seoung Wook;Chang, Hwan-Il
    • Korean Journal of Biological Psychiatry
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    • v.3 no.1
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    • pp.66-74
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    • 1996
  • There has been an increase in head trauma due to rapid industralization and improvement in transportation. This poses difficulties in differentiating between neuropsychiatric disabilities resulting from real organic changes and those arising from compensation issues. It is the purpose of this study to seek out the differences between normal and abnormal finding group in the structural brain imaging studies via the results of the functional brain imaging studies and psychological tests. Out of 132 subjects, 62 comprised normal and 70 the abnormal finding group. EEG and SPECT were chosen for inspection of functional brain imaging. MMPI and K-WAIS were chosen for psychological test. The subjects were further divided into right hemispheric damage, left hemispheric damage, both hemispheric damage, diffuse damage group and negative group in order to find out whether any differences in the psychological lest results could be localized. The results are as follows : 1) The abnormal finding group, the EEG and SPECT were proven to be a good predictor of brain lesion. This implies that even in the functional brain studies, abnormalities are more easily detected if there are visible brain lesions. 2) The FSIQ of the abnormal finding group is lower than that of normal finding group. this difference is mainly due to low V1Q. The left hemispheric damage group lend to shaw low V1Q. This lowered in was the difference between left hemispheric damage group and negative group. Furthermore, there were no group differences in the PIQ. It is concluded that K-WAIS is effective as evaluator of VIQ mainly of those patients with left hemispheric damage and it is ineffective as a evaluator of PIQ. 3) In the MMPI profile, the both groups displayed high neurotic profiles. There was no difference in the psychotic profiles. The scores of the Depression and Hystery were high in abnormal finding group. This can be seen as one of the lypical findings of chronic head trauma patients. 4) The abnormal finding group tend to be diagnosed as organic mental disorder in the psychological tests more frequently.

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Assessment Instruments for Posttraumatic Stress Disorder (외상후 스트레스장애의 평가 도구)

  • Seo, Ho-Jun;Kim, Tae-Suk;Chae, Jeong-Ho
    • Anxiety and mood
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    • v.6 no.1
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    • pp.3-9
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    • 2010
  • Even experienced clinicians have difficulties in diagnosing posttraumatic stress disorder (PTSD) exactly, due to its diverse clinical features, which vary according to individuals, traumas, and various comorbid psychopathologies, and its related compensation issues. It is usually mandatory for clinicians and researchers to use screening and assessment tools when diagnosing and evaluating PTSD. To date, research has developed numerous PTSD screening and assessment tools ; therefore one of the cardinal issues is to select the best of the various tools, the one most suitable for the clinician's or researcher's purposes. This article reviews several currently-available subjective and objective instruments for the diagnosis and evaluation of PTSD and groups them according to whether they are Diagnostic and Statistical Manual for Mental Disorders-Correspondent Measures ; PTSD-Focused, Non-DSM-Correspondent Measures ; or Empirically Derived Measures. We present the instruments' psychometric properties and scoring methods and describe their merits and weak points, focusing on their practical usage.

Cognitive and Psychological Characteristics of Psychiatric Patients with Military Service Eligibility Issues (군 복무 적합성 판정을 위해 내원한 환자들의 인지적 및 심리적 특성)

  • Nam, Jisoo;Choi, Junho;Kim, Eunkyeong
    • Korean Journal of Psychosomatic Medicine
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    • v.27 no.2
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    • pp.119-129
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    • 2019
  • Objectives : The purpose of this study was to examine cognitive and psychological characteristics of patients who visited psychiatric outpatient clinic with military service suitability issues. Methods : Since January, 2017 to September, 2018, patients were recruited from the department of psychiatry of university hospital. Participants were diagnosed using DSM-5 criteria by board certified psychiatrists. And each of participants tested with K-WAIS-IV, K-SCL-95 by clinical psychologist. The data were analyzed using SPSS 18.0. Results : The results indicated 24.6% of the patients have significantly low level of intellectual functioning. and 10.8% of the patients have borderline level of intellectual functioning, and 26.3% of them were below average. The results of psychological characteristics showed patients have cautious and potentially dangerous level of depression, anxiety, agoraphobia, and suicidal idea. And PTSD subscale's mean score was above problematic level. Next, we divided patients into two groups based on question of whether the patient is eligible to serve in the military service or not arises from recruitment process or army training center. But two group didn't differ significantly. And for further analyses, we also divided patients into two groups based on if they got single psychiatric diagnosis or more than one psychiatric diagnosis. Conclusions : The results indicated that group which has coexisting psychiatric disorders were more depressed, had higher level of anger and aggression, and had more serious levels of suicidal ideas than single psychiatric diagnosis group. The implications and limitations were discussed along with some suggestions for the future studies.

A Longitudinal Comparative Study of Two Periods regarding the Influences of Psycho-Social Factors on Emotional Distress among Korean Adults during the Corona virus Pandemic(COVID-19) (코로나 19 팬데믹 시기 동안 한국인의 정서적 디스트레스에 영향을 미치는 심리·사회적 요인의 영향력에 대한 종단 두시점 비교연구)

  • Lee, Dong-Hun;Kim, Ye-Jin;Hwang, Hee-Hun;Nam, Seul-Ki;Jung, Da-Song
    • Korean Journal of Culture and Social Issue
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    • v.27 no.4
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    • pp.629-659
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    • 2021
  • This study compared the influences of Korean psycho-social experiences on emotional-distress(stress, depression, anxiety, anger) of Koreans between two-periods during COVID-19. First, an online survey was conducted among 600 participants between April 13, 2020 and 21, while WHO had declared the pandemic, and Daegu-Gyungbuk were declared as a special-disaster area. Second, an online survey was conducted among 482 participants out of 600 study participants from the first study during August 21 to September 2, while COVID-19 re-spreaded around the world, and total confirmed cases were over 1,000 for a week in Seoul-Gyeonggi province. Hierarchical-regression analysis was used to determine the influence of personal characteristics, fear and social constraints, relationship conflict and income-decreasing factors on stress, depression, anxiety, anger in the two-time points. Results suggest that gender, quality-of-life, 'frequent information-checking about COVID-19', 'fear of unpredictability' and 'difficulties on hospital treatment access' predicted distress(stress, depression, anxiety, anger) at both Time1 and 2. 'Difficulties with official schedule' predicted distress at Time 1, and age, vulnerability to infection and difficulties with personal schedules predicted distress(stress, depression, anxiety, anger) at Time 2. Based on the reseults, implications and recommendations were presented.

The Effects of Physical Therapy Intervention with Local Vibration on Pain, ROM and Psychological Status in Multiple Trauma Patients Caused by Traffic Accident (교통사고로 인한 다발성 외상 환자의 국소진동을 동반한 물리치료 중재가 통증 및 관절운동범위, 심리적 상태에 미치는 영향)

  • Ahn, Seung-won;Jung, Young-june;Jung, Sang-mo
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.25 no.2
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    • pp.65-72
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    • 2019
  • Background: The purpose of this study was to investigate into the effects of physical therapy intervention with local vibration on pain, ROM (range of motion) and psychological status in multiple trauma patients caused by traffic accident. Methods: A patient with multiple trauma were recruited. Before treatment, he was evaluated using numeric pain rating scale (NPRS), Korean-version impact of event scale-revised (IES-R-K), Beck Depression inventory (BDI), passive and active range of motion, and were reevaluated after 4 and 8 weeks of treatment. Results: As a result of comparing the participant before and after the experiment, the score of the IES-R-K and BDI decreased. And the passive and active ROM increased. Conclusion: According to the results above, physical intervention with local vibration by Blackroll Releazer can help improve pain, physical function and psychological status. Also, physical intervention with Blackroll's Releazer technique was able to select interventions depending on the patient's conditional and the desired goal.

A Structural Equation Model for Posttraumatic Growth among Cured Patients with COVID-19 (COVID-19 완치자의 외상 후 성장 예측모형)

  • An, Soo Young;Choi, Heejung
    • Journal of Korean Academy of Nursing
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    • v.53 no.3
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    • pp.309-323
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    • 2023
  • Purpose: This study aimed to develop and test a model for posttraumatic growth among cured patients with COVID-19. This model was based on Calhoun and Tedeschi's Posttraumatic Growth model and a literature review. Methods: The participants comprised 223 patients cured from COVID-19 who were ≥ 19 years of age. The data were collected through an online questionnaire from March 21 to 24, 2022. The assessment tools included the Impact of Event Scale: Revised Korean version, the Connor-Davidson Resilience Scale, the Distress Disclosure Index, the Multidimensional Scale of Perceived Social Support, the Korean version of the Event-related Rumination Inventory, and the Korean version of the Post-traumatic Growth Inventory. Data were analyzed using the IBM SPSS version 24.0 and IBM AMOS 26.0. Results: The modified model showed appropriate goodness of fit (χ2 = 369.90, χ2 /degree of freedom = 2.09, SRMR = .09, RMESA = .07, CFI = .94, TLI = .93). The post-traumatic growth of cured patients with COVID-19 was explained through distress perception, self-disclosure, and deliberate rumination, with the explanatory power being 70.0%. Conclusion: This study suggests preparing a disaster psychology program involving experts who can activate deliberate rumination is necessary. Further, this study may serve as basic data for developing a program to enhance the post-traumatic growth of patients cured from COVID-19.