• Title/Summary/Keyword: 외상 후 스트레스

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Electrodermal Responses in Patients with Posttraumatic Stress Disorder by Motor Vehicle Accidents ; a Pilot Study (교통사고에 의한 외상 후 스트레스장애 환자의 피부 전기반응 : 예비 연구)

  • Seo, Ho-Jun;Jung, Young-Eun;Lee, Hye-Won;Moon, Hyun-Jin;Park, Ju-Mi;Kim, Seon-Kyung;Chae, Jeong-Ho
    • Anxiety and mood
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    • v.3 no.2
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    • pp.104-109
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    • 2007
  • Objective : In the present study, we evaluated the differences between the skin electric conductance of patients with posttraumatic stress disorder (PTSD) and normal controls in order to determine the possibility of using skin electric conductance as a diagnostic measure. Method : The PTSD group included 14 subjects who were diagnosed with PTSD in St. Mary's Hospital after a motor vehicle accident, and the normal control group included 12 healthy subjects. The conductivity and capacitance of both groups were measured twice, and the data from each group was compared. Results : There was no significant difference in gender, but the patients in the PTSD group were significantly older than those in normal control group. The activity (conductivity) between the left head-left hand, right hand-right head, and right head-left head was significantly elevated in the PTSD group as compared with the normal control group. In addition, the reactivity (capacitance) between the right head-left head, left head-left hand, right hand-left hand, right hand-right foot, right foot-left foot, and left foot-left hand was significantly elevated in the PTSD group. Conclusion : In this study, the skin electric conductance of the patients with PTSD was significantly elevated in comparison with that of the healthy subjects. Although there were some limitations of this study, the results of this study suggested that skin electric conductance can be used to evaluate elevated psychophysiological responses in patients with PTSD. Future studies with more subjects and more structure are needed in order to confirm our results.

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D2 Dopamine Receptor (DRD2) Gene Polymorphism and Combat-Related Posttraumatic Stress Disorder in Vietnam Veterans (월남전 참전 재향군인에서 도파민 D2 수용체 유전자 다형성과 외상후 스트레스 장애)

  • Lee, Soo-Young;Chung, Hae-Gyung;Kim, Tae-Yong;Choi, Jin-Hee;Chung, Moon-Yong;So, Hyoung-Seok;Shin, Han-Sang;Lee, Shi-Eun
    • Anxiety and mood
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    • v.4 no.2
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    • pp.142-147
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    • 2008
  • Objective : Evidence from recent studies supports the role of genetic factors in the development of Posttraumatic Stress Disorder (PTSD). The primary aim of this study is to investigate the association between the dopamine D2 receptor (DRD2) TaqI A polymorphism and PTSD. The second aim is to examine the association between the DRD2 TaqI A polymorphism and clinical symptoms in patients with PTSD. Methods : We recruited 189 Vietnam veterans for participation in this study, among whom 99 were PTSD patients and 90 were control subjects. The presence of the DRD2 TaqI A polymorphism was determined by polymerase chain reaction (PCR). Several standardized research scales were used in the clinical assessment of PTSD, including the Combat Exposure Scale (CES), Clinician Administered PTSD Scale (CAPS), Beck Depression Inventory (BDI), and Clinical Global Impression (CGI). Results : There was no significant difference in the distribution of the DRD2 genotype, frequency and prevalence of the A1 allele, or the frequency of heterozygotes between the patients with PTSD and the controls. In the PTSD group, the patients with the A1 allele (A1A1, A1A2) scored higher on the CAPS-total (p=0.044), CAPS-avoidance symptoms (p=0.016) and BDI (p=0.024) than those without the A1 allele (A2A2). Conclusion : We could not find an association between the dopamine D2 receptor (DRD2) TaqI A polymorphism and PTSD. However, the A1 allele of DRD2 seemsto influence avoidance symptoms in patients with PTSD.

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Comparison of the Pattern of Changes in Salivary Cortisol by Degree of Burn and CAPS Score (화상 정도 및 CAPS 점수에 따른 타액 코티졸의 변화 양상 비교)

  • Kim, Jin-Na;Kim, Jee Wook;Choi, Ihn-Geun;Chun, Wook;Seo, Cheong Hoon;Kim, Kyung Ja;Lee, Boung Chul
    • Anxiety and mood
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    • v.8 no.2
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    • pp.93-98
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    • 2012
  • Objective : Cortisol, a product of hypothalamus-pituitary-adrenal axis (HPA axis), is one of our defensive mechanisms in response to stress. The level of cortisol in the saliva is a major biomarker of the stress response by HPA axis and shows diurnal variation. We measured salivary cortisol level and its diurnal variation to compare the pattern of changes by degree of burn and Clinician-Administered PTSD Scale (CAPS) score. Methods : We measured the salivary cortisol levels of 37 subjects hospitalized in the burn center at our facility from March to June 2012. Salivary cortisol levels were measured at 6 : 00 AM and at 7 : 00 PM. All subjects were tested for CAPS to evaluate the severity of posttraumatic stress disorder and the Hamilton Depression Rating Scale to evaluate and to control the coexisting depression. Results : Factorial ANOVA test revealed that there was a statistically significant difference in terms of the effect of the interaction between the degree of burn and the patient's CAPS score. Unlike the mild burn group, in the severe burn group, the patients who had a low CAPS score didn't show a normal diurnal variation and the patients who had a high CAPS score showed the normal diurnal variation. After a few months follow up, we found a greater degree of psychiatric complications in severe burn patients that had a lower cortisol stress response. Conclusion : We suppose that the disappearance of the stress response changes in salivary cortisol seen in the severe burn group may be caused by an impaired stress response. Through followed observation of the subjects, this disruption of cortisol response may cause psychiatric problems afterwards.

A Study for cost of road traffic accident taken offender's PTSD in consideration (교통사고 가해자의 외상 후 스트레스 장애를 고려한 도로교통사고 비용 연구)

  • Jang, Seok-Yong;Jeong, Heon-Yeong;Go, Sang-Seon
    • Journal of Korean Society of Transportation
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    • v.28 no.5
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    • pp.17-29
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    • 2010
  • The main objective of this study is to consider the necessity of introducing owner expenses in estimating the cost of traffic accidents, as is done in some advanced countries. It is known as "owner cost" in the U.S, "enterprise project price" in Japan, and "human cost" in the U.K. To achieve this, the seriousness and present state of post-traumatic stress disorder (PTSD) of traffic accident offenders, which is generally not observed when traffic accidents occur, are evaluated; countermeasures reflecting personal characteristics are prepared according to degree of affliction. The results could be summarized as follows. First, the present condition and seriousness of PTSD from traffic accidents that has been estimated only within the accidents offenders are evaluated through a survey. Second, a distinction analysis model is developed. 'Insomnia caused by accidents' and 'mental daunting in accident situations or similar ones during driving' are chosen as the variables of the discriminant. Third, as a result of the construction of an Ordered Probit Model to comprehend the seriousness of PTSD, the variables turns out in the order of 'seriousness of the most damaged victim, 'nightmare about the accident', 'insomnia experience', 'mental daunting during driving', 'gender', and 'major driving area'. Finally, the cures reflecting characteristics of gender and region are suggested, which are preferred for degree of seriousness of PTSD. The analysis shows that the method to minimize the damage, such as decline of work efficiency, by moving ahead the rehabilitation of the offenders would be suggested and this could minimize the direct and indirect damages that could happen to business owners for whom the drivers work.

Measuring Symptom Exaggeration in Posttraumatic Stress Disorder using the MMPI-2 and the Personality Assessment Inventory Symptom Validity Scales (MMPI-2와 Personality Assessment Inventory 타당도 척도를 이용한 외상후 스트레스 장애 환자의 증상과장 평가)

  • Kong, Sung-Whoi;Chae, Jeong-Ho;Lee, Jong-Hun;Hahn, Sang-Woo;Park, Eun-Jin;Choi, Kyeong-Sook
    • Anxiety and mood
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    • v.8 no.1
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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.

A Cohort Study of Children and Adolescents Victims with Sexual Abuse in Korea and Their Initial Assessment Results (아동청소년 성폭력 피해자들을 위한 코호트 연구 : 코호트 구축과 초기 평가 결과)

  • Kim, Kyung-Yoon;Lee, Na-Hyun;Cheon, Keun-Ah;Song, Dong-Ho
    • Korean Journal of Psychosomatic Medicine
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    • v.27 no.1
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    • pp.13-24
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    • 2019
  • Objectives : The goals of the study are how to establish the cohort systems for the children and adolescents victims with sexual abuse in Korea and to identify the risk and protective factors that influence mental health in child sexual abuse (CSA). This is initial assessment data based on the analysis of cohort variables for baseline evaluation of subjects. Methods : We constructed the cohort systems for CSA victims recruited by Seoul Sunflower Children Center, CSA victims protection center. The initial assessment data which consisted of demographic and psychological inventories of CSA victims and their parents/families, psychiatric diagnoses were the results of statistical analysis of 65 subjects under 19 years old for 3 years 7 months. Results : The initial data were followings : female participants, N=56; mean age, 11.6 (SD=4.5); the most sexual assault, molestation 71.8%; victims, family and acquaintance 87.1%; 61.5% of the subjects diagnosed with psychiatric disorder; 29.2% diagnosed with PTSD and 23.1% diagnosed with depression. Mean duration for abuse to report is 1.5 years. Mean score of IES-R-K, TSCYC-avoidant and CBCL-problematic behavior were increased above clinical cut-off. Conclusions : CSA victims tend to have high risks in mental health problem. The cohort study could provide the risk and protective factors of CSA in mental health, and construct the predictive model for mental illness in Korea.

Influence of Fear about Middle East Respiratory Syndrome Event of Hospital Worker and General Public on Socio-Psychological Health : Mediating Effect of Posttraumatic Stress (중동호흡기증후군에 대한 공포감이 병원종사자와 일반인의 사회심리적 건강에 미치는 영향 : 외상 후 스트레스의 매개효과)

  • Kim, Shinil;Kim, Taehyung;Choi, Malrye;Jeong, Joori;Kwon, Hyukmin;Kim, Hyoungwook;Kim, Byoungjo;Eun, Hunjeong
    • Anxiety and mood
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    • v.15 no.1
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    • pp.45-52
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    • 2019
  • Objective : The objective of this study is to determine the effects of fear of Middle East respiratory syndrome (MERS) on socio-psychological health during an outbreak of MERS and the post-traumatic stress as a mediator on the relationship between stress and socio-psychological health. Methods : Visual Analog Scale, Impact of Event Scale -Revised, Psychosocial well-being index short form was implemented for 150 medical persons who worked at the hospital in which exposure to MERS cases had been confirmed and 96 ordinary people. A Pearson correlation coefficient and a hierarchical multiple regression was carried out to confirm the effect of fear of MERS and the mediating effect of post-traumatic stress between fear and socio-psychological health. Results : The higher the fear, the lower the socio-psychological health in both healthcare workers and the public (r=0.32, p<0.01) and the higher post-traumatic stress (r=0.32, p<0.01). But, the research results showed that only healthcare workers had a partially mediating effect of post-traumatic stress in the relationship between fear and socio-psychological health (${\beta}=0.45$, t=6.33 p<0.001), (${\beta}$ value : 0.39>0.26). Conclusion : This study demonstrated that the post-traumatic stress can indirectly lead to a negative effect on the socio-psychological health of healthcare workers when under the fear of MERS and shows adverse effects on psycho-social wellbeing. This suggests that clinical intervention and psycho-social approach aiming at reducing post-traumatic stress is important to maintain mental health during crisis development.

Priming Effects of Disaster-related TV News: Focusing on the Interactions of Geographical and Psychological Distance (재난 뉴스의 점화 효과: 지리적·심리적 거리의 상호작용을 중심으로)

  • Bu Jong, Kim;Yun Kyeung, Choi
    • Korean Journal of Culture and Social Issue
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    • v.29 no.1
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    • pp.53-74
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    • 2023
  • The purpose of this study was to identify the priming effects of disaster-related news. Specifically, this study aimed to examine the priming effects about trauma words and neutral words according to the geographical and psychological distance from the disaster. The participants in this study were 75 college students who had not experienced the Daegu subway fire accident, and whom were not ruled out after completing the screening measure completing the screening measure the completion of questionnaires for screening. All participants conducted a lexical decision task after watching a news video about the Daegu subway fire accident. The design was a 2 (Geographical distance: close vs. distant) × 2 (Psychological distance: close vs. distant) × 2 (Priming type: trauma priming vs. neutral priming) mixed-design. The results of this study are summarized as follows: First, the group which was geographically closer to the disaster tended to revealed a largerbigger priming effect than the distant group-a trend toward significance. Second, within the psychologically closer to the disaster, group, for those who were geographically closer too, the priming effect was larger for those who were geographically closer geographically closer than for the geographically distant group. Third, the geographically closer group had a largerbigger neutral priming effect than the distant group. Fourth, the psychologically distant group had a largerbigger neutral priming effect than the close group. To sum up, this study identified that disaster news coverage may have an implicit effect on people, and this influence can change according to the geographical and psychological distance. Finally, this study discussed the limitations of the study and recommendations for further research.

Reliability and Validity of the Korean Version of the Combat Exposure Scale (한국판 전투 노출 척도의 신뢰도와 타당도)

  • Kim, Dong Su;Chung, Hae Gyung;Choi, Jin Hee;So, Hyung Seok;Kim, Hae Jung;Go, Chang Min;Kim, Tae Yong;Chung, Moon Yong
    • Anxiety and mood
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    • v.8 no.2
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    • pp.106-112
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    • 2012
  • Objective : In posttraumatic stress disorder (PTSD), it is essential to evaluate the severity of trauma with a reliable instrument. The combat exposure scale (CES) is one of the most widely used measures for the combat-related trauma. The present study was conducted to test the reliability and validity of the Korean version of CES (CES-K). Methods : One hundred and forty-five male Korean veterans of the Vietnam War participated in this study. CES-K, the structured clinical interview for DSM-III-R (SCID), clinician administered PTSD scale (CAPS), and the Korean version life events checklist (LEC-K) were administered. Results : Cronbach's coefficient of CES-K was .85, and the test-retest reliability was .94. The mean [standard deviation (SD)] scores of CES-K were 20.4 (9.0) in the PTSD group and 12.0 (8.6) in the non-PTSD group (p<.001). CES-K showed a significant correlation with LEC-K (r=.31, p<.001) and CAPS (r=.52, p<.001). Only one factor was revealed by the factor analysis. Conclusion : CES-K showed good reliability and validity for assessing the severity of combat exposure. Further, it demonstrated comparable psychometric properties to the previous study. It is expected that CES-K will be a useful tool for evaluating the severity of combat exposure in Korea.

Treatment Response and Symptomatic Changes after Eye Movement Desensitization and Reprocessing in Psychiatric Disorders Other than Posttraumatic Stress Disorder (외상후 스트레스 장애 이외의 정신 장애에 대한 EMDR 전후의 치료 반응 및 증상 변화)

  • Lee, Hae-Won;Kim, Dae-Ho;Bae, Hwal-Lip;Choi, Joon-Ho;Oh, Dong-Hoon;Park, Yong-Chon
    • Anxiety and mood
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    • v.4 no.1
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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.

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