• 대한불안의학회지
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• 제9권2호
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• pp.121-127
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• 2013

Objective : Several studies have reported the association between posttraumatic stress disorder (PTSD) and hypertension (HTN). The aim of this study was to evaluate the impact of PTSD symptoms on blood pressure. Methods : Korean veterans of the Vietnam War with (n=62) or without PTSD (n=87) participated in this study. The clinician administered PTSD scale (CAPS) and alcohol use disorder identification test (AUDIT) were applied. Blood pressure, pulse rate, risk factors of HTN and demographic data of the subjects were collected. Effects of potential explanatory variables on HTN were analyzed with logistic regression. Results : Diastolic blood pressure was significantly higher in PTSD group (p=0.015). However, PTSD subjects showed significantly lower pulse rate than non-PTSD subjects (p=0.004). Logistic regression analysis showed that avoidance symptom might be a predictor for hypertension (OR=1.065, p=0.030). Conclusion : These results suggest that PTSD, especially avoidance symptom, might be a risk factor on HTN in the elderly with PTSD. Further studies are needed to evaluate the change of blood pressure according to the clinical improvement of PTSD.

• 대한불안의학회지
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• 제8권2호
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• pp.127-132
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• 2012

Objective : This study aims to investigate the relationship between addictive mobile phone use and post-traumatic stress disorder (PTSD) symptoms in bullies who experienced school violence. Methods : The study subjects consisted of 97 adolescents in The Foundation for Preventing Youth Violence after school violence. The participants conducted self-report questionnaire for addictive mobile phone use and Impacted Event Scale-revised-Korean version (IES-R-K). Partial correlation and multiple logistic regressions were performed. Results : The scores related to addictive mobile phone use were correlated with total score (r=0.21, p=0.04), avoidance score (r=0.21, p=0.04) and intrusive score (r=0.26, p=0.01) related to PTSD symptoms on the IES-R-K. Intrusive score related to PTSD symptoms on the IES-R-K were significant risk factor for addictive mobile phone use (O.R=1.25, 95% CI=1.12-1.39). Conclusion : This data supports that PTSD intrusive symptoms could be predictable factor of addictive mobile phone use. An appropriate intervention about PTSD symptoms might play a useful role in preventing addictive mobile phone use in bullies of school violence.

• 중환자간호학회지
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• 제12권1호
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• pp.82-93
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• 2019

Purpose : The purpose of this study was to investigate the degree of post-traumatic stress disorder (PTSD) symptoms and the effect of PTSD on quality of life (QoL) among coronary artery disease (CAD) patients. Methods: The participants were 135 CAD patients who visited outpatient clinics in a university hospital in B city of Korea. Their PTSD symptoms and QoL were measured by structured questionnaires and analyzed with multiple hierarchical regression analysis. Results: Among the 135 participants, 20.7% were classified as moderate risk, and 3.7% as high risk for PTSD. PTSD symptoms were significantly higher in participants who were diagnosed with CAD within 6 months (t=26.02, p<.001). The physical component of health-related QoL was influenced by gender (${\beta}=-.25$, p =.003), recurrence of CAD (${\beta}=.21$, p =.008), and PTSD symptoms (${\beta}=-.33$, p <.001). The mental component of health-related QoL was influenced by religion (${\beta}=-.17$, p =.044), body mass index (${\beta}=.17$, p =.033), and PTSD symptoms (${\beta}=-.37$, p <.001). Conclusion: Patients who had had a CAD diagnosis for less than 6 months were found to be vulnerable to PTSD, and PTSD was found to have a negative impact on the physical and mental components of their QoL. It is necessary to develop an intervention program for the effective prevention and management of PTSD symptoms in patients with CAD.

• 신경정신의학
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• 제56권1호
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• pp.28-34
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• 2017

Objectives The purpose of this study was to evaluate psychological effects of an outbreak of Middle East respiratory syndrome (MERS), a newly emerged infectious disease, on doctors. Methods After the MERS outbreak was over, we conducted an online survey of doctors who worked at the hospitals in which exposure to MERS cases had been confirmed or who were directly involved in MERS diagnosis and treatment. The Patient Health Questionnaires-9 (PHQ-9) and the Impact of Event Scale-Revised (IES-R) assessment methods were used to assess the severity of depressive and posttraumatic stress symptoms among the 64 doctors participating in the survey. Results The results of the survey indicate that 26.6% (n=17) of participants exhibited depressive symptoms and 7.8% (n=5) had post-traumatic stress symptoms. The doctors employed at hospitals with MERS cases had higher PHQ-9 and IES-R mean scores than those in doctors were not so employed. In contrast, there was no significant difference in those test scores between doctors who participated directly in MERS diagnosis and treatment and those doctors who did not. Conclusion The survey demonstrated that 28.1% (n=18) of doctors involved in MERS care suffered from depressive or posttraumatic stress symptoms, even though the MERS infection was being controlled. Working at a hospital with MERS cases was the primary determinant of the adverse psychological outcomes among doctors ; however, direct participation in the diagnosis and care of MERS patients was not significantly related to such outcomes.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제15권1호
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• pp.61-74
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• 2004

연구목적：아동기에 경험한 심각한 정신적 외상은 외상후 스트레스 장애(Posttraumatic Stress Disorder；PTSD) 증상을 야기할 뿐 아니라, 전반적인 심리 발달에도 부정적인 영향을 미친다. 특히 정신적 외상은 학령전기 아동의 정신적 표상에 부정적인 영향을 미쳐 향후 인격형성에 문제를 일으킬 것으로 예상된다. 본 연구는 한차례의 심한 정신적 외상을 경험한 9명의 학령전기 아동들의 심리적 표상이 어떻게 형성되어 있는지를 조사하여 이들의 정신적 문제를 진단적 범주 차원을 넘어 내면의 심리적 차원의 이해를 높이고자 하였다. 방 법：유치원 점심시간에 침입한 정신질환자에게 칼로 심한 신체적 상해를 입은 동일한 한 차례의 심한 정신적 외상을 경험한 만 $3{\sim}5$세 아동 9명(남아 6명, 여아 3명)을 대상으로, 사고 발생 1개월 경과 후 신체적 상해를 치료한 시점에서 심리적 평가를 시행하였다. 평가는 부모 면담, 아동에 대한 정신의학적 면담 및 관찰, 아동에 대한 심리평가(지능검사, House-Tree-Person test；HTP, MacArthur Stem Story Battery；MSSB) 등이 포괄적으로 이루어졌다. 본 연구에서는 아동의 정신적 표상을 반영하는 MSSB, HTP 검사 결과를 분석하였다. 결 과：9명의 아동은 모두 진단(5명이 PTSD 진단에 해당됨)과 상관없이 보편적으로 외상 경험과 관련되어 보이는 높은 불안감, 우울감, 위축과 회피 등의 감정 반응을 주로 나타내었는데, 이런 반응들은 부모 보고에 의한 평가에서는 거의 나타나지 않았다. 특히 병원 치료에 대한 공포, 사고에 대한 재현, 공격적 주제, 양육자와의 이별 등의 내용이 아동의 그림이나 이야기 속에서 자주 나타났으며 이런 내용은 직접적 질문이나 대화에서는 거의 나타나지 않았다. 결 론：본 연구에서 한번의 심각한 외상 경험을 한 학령 전기 아동들은 PTSD 진단 여부와 관계없이, 전반적 정신적 표상으로 외상과 관련된 부정적 정서 경험과 사고 내용을 보였다. 따라서 향 후 심한 정신적 충격을 받은 학령전기 아동들의 경우 PTSD 증상 뿐 아니라 사고로 야기된 부정적 정신적 표상에 대한 평가와 개입이 필요하다고 판단된다.

• 대한불안의학회지
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• 제8권1호
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• pp.22-30
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• 2012

Objective : We investigated whether Posttraumatic stress disorder patients have a higher tendency to exaggerate the extent of their psychological symptoms compared to other psychiatric patients. Methods : Medical records of patients, who had received psychiatric treatment at four university hospitals in Korea between January 2009 and December 2010, were retrospectively reviewed. We compared a group of 37 patients diagnosed with PTSD, and another group of 41 patients diagnosed with neurotic, stress-related and somatoform disorders according to the ICD-10. To compare the extent of malingering in the two groups, we compared the validity scales of MMPI-2 and Personality Assessment Inventory. We determined the number of participants in both groups feigning their responses by using various cutoff scores of the validity indicators. Results : The PTSD group showed significantly higher scores on the F (p=0.001), F (B)(p=0.000), F (P)(p=0.030), F-K (p=0.003) scale of the MMPI-2 compared to the other group of psychiatric patients. The PTSD group had a significantly higher NIM score (p=0.001) but a lower PIM score (p=0.020) of the PAI compared to the other group of psychiatric patients. Using the cutoff scores, the PTSD group showed a significantly higher number of patients who feigned responses compared to the other group ($Fb{\geq}75$ (p=0.010), $F-K{\geq}1$ (p=0.005), $F-K{\geq}10$ (p=0.011) from the MMPI-2, and $NIM{\geq}80$ (p=0.001) from the PAI). Conclusion : These results suggest that PTSD patients have a tendency to exaggerate their symptom. This group of patients overreported the severity of their condition during standardized personality assessment that included the MMPI-2 or PAI compared to patients diagnosed with other psychiatric disorders. Additional research is required to determine the factors influencing symptom exaggeration in PTSD.

• 대한불안의학회지
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• 제18권2호
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• pp.39-47
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• 2022

Objective : This study investigated brain functional connectivity in male firefighters who showed subclinical post-traumatic stress disorder (PTSD) symptoms. Methods : We compared the data of 17 firefighters who were not diagnosed with PTSD and 18 healthy controls who had no trauma exposure. The following instruments were applied to assess psychiatric symptoms: Korean version of the Post-traumatic stress disorder Checklist for DSM-5 (PCL-5-K), Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI). For all subjects, functional magnetic resonance imaging was performed, and functional connectivity was compared between the two groups (family-wise error-corrected p<0.05). Additionally, correlations between psychiatric symptoms and functional connectivity were explored. Results : The following connectivity was higher than that of healthy controls: 1) the central opercular cortex-superior temporal gyrus, 2) planum polare-parahippocampal gyrus, 3) angular gyrus-amygdala, and 4) temporal fusiform cortex-parahippocampal gyrus. The functional connectivity of 1) the lateral occipital cortex-inferior temporal gyrus, 2) superior parietal lobule-caudate, and 3) middle temporal gyrus-thalamus were lower in firefighters. In firefighters, the connectivity of the planum polare-parahippocampal gyrus showed a negative correlation with the severity of arousal symptoms (rho=-0.586, p=0.013). The connectivity of the middle temporal gyrus-thalamus showed a positive correlation with the severity of intrusion (rho=0.552, p=0.022) and arousal symptoms (rho=0.619, p=0.008). The connectivity of the temporal fusiform cortex-parahippocampal gyrus was negatively correlated with intrusion (rho=-0.491, p=0.045) and arousal (rho=-0.579, p=0.015). Conclusion : Our results indicate that the brain functional connectivity is associated with occupational trauma exposure in firefighters without PTSD. Therefore, this study provides evidence that close monitoring and early intervention are important for firefighters with traumatic experience even at a subthreshold level.

• 정신신체의학
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• 제18권2호
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• pp.72-81
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• 2010

연구목적 디스트레스를 조기에 발견하여 치료하는 것이 효율적인 암 환자의 관리에 필수적이라는 인식이 확대되고 있다. 본 연구에서는 유방암 환자들의 디스트레스의 유병률을 조사하고, 그 디스트레스가 삶의 질에 미치는 영향을 알아보았다. 방 법 서울의 한 대학병원 유방암 환우회 환자 95명을 대상으로 병원우울불안척도, 불면증심각도척도, 사건충격척도 개정판, Functional assessment of cancer therapy-Breast(FACT-B)를 시행하였다. 결 과 디스트레스의 유병률은 우울 26.3%, 불안 26.3%, 불면 13.7%, 외상후스트레스장애 증상 24.3%였다. 한가지 이상의 디스트레스를 겪고 있는 환자는 전체의 47.4%였으며, 이들은 정상군에 비해 FACT-B 총점으로 측정한 삶의 질 평균점수가 유의하게 낮았다(82.91 vs. 107.20, p<0.001). 정상범위의 환자들에서도 디스트레스와 삶의 질은 유의한 관계를 보였다. 결 론 유방암 환자의 디스트레스를 조기에 발견하기 위한 주기적인 선별검사와 적절한 치료가 필요하다.

• 대한불안의학회지
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• 제4권1호
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• pp.55-61
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• 2008

Objective : Eye movement desensitization and reprocessing (EMDR) has been established as an effective treatment for patients with posttraumatic stress disorder (PTSD). However, the literature is unclear as to whether EMDR is effective in the treatment of other psychiatric disorders. The purpose of this study was to evaluate the potential use of EMDR in the treatment of psychiatric disorders other than PTSD by using a clinician's impression of patient response and a subjective symptom evaluation. Methods : Seventeen diagnostically heterogenous patients without PTSD underwent an average of 4.3 sessions of EMDR. Symptom severity was assessed by the Clinical Global Impression-Change Scale (CGIC), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), and Symptom Checklist-90- Revised (SCL-90-R) before and after EMDR. Those whose CGI-C scores were 'very much improved' and 'much improved' after EMDR were classified as 'responders.' The patients' before and after treatment scores of symptom severity and group differences were compared. Results : Twelve of the 17 participants (12/17, 71%) were classified as 'responders.' The patients' scores on all of the scales, with the exception of the trait anxiety scale and obsession-compulsion scale of the SCL- 90-R, significantly decreased after treatment. There was no difference in sociodemographic and clinical variables between the responders and non-responders. Conclusion : The results of our study suggest that EMDR can be a promising candidate for the treatment of patients with psychiatric disorders other than PTSD, and thus further controlled studies are needed to determine whether EMDR can be applied to various psychiatric populations.

• 한국산학기술학회논문지
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• 제14권5호
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• pp.2225-2233
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• 2013

본 연구는 외상후스트레스 고위험군이 많이 분포된 구조대원에 대한 사건충격정도를 파악하고, 사건충격정도에 영향을 미치는 관련 요인을 분석하였다. 연구대상은 화재 및 구조출동 빈도가 높은 서울소방재난본부 소속 구조대원 415명을 통계분석 자료로 활용하였으며, 사건충격정도에 대한 신뢰도는 .975로 높게 나타났다. 분석결과 첫째, 사건충격정도의 하위요인으로 침습이 가장 높았고, 회피, 수면장애 및 정서적마비, 해리증상, 과각성 순으로 사건충격정도가 높게 나타났다. 둘째, 기혼자와 연령이 높을수록 사건충격정도가 높았으며, 셋째, 소방공무원으로서 근무연수와 구조대원 직무를 수행한 기간이 길고, 출동횟수와 사고현장 경험빈도가 높을수록 충격정도가 높게 나타났다. 특히 스트레스 해소 방법 중 음주로 해소하는 구조대원의 사건충격정도가 높게 나타나, 고위험군에 대한 체계적인 관리와 사건충격을 경험하였을 때 즉시 대처할 수 있는 예방케어프로그램 도입이 시급한 것으로 나타났다.