• Title/Summary/Keyword: 집단 외상

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Effect of HSEP on elderly Women's Life Function Fitness and Health-related QOL (재가운동 프로그램이 여성 고령자의 생활기능 체력과 건강관련 삶의 질에 미치는 영향)

  • Kim, Yun-Sik;Shin, Sang-Keun;Ahn, Jeong-Deok
    • The Journal of the Korea Contents Association
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    • v.13 no.3
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    • pp.381-391
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    • 2013
  • The purpose of this study was try to check the change of a subjective evaluation about the life function fitness and health-related quality of life by executing the home support exercise program three times a week for total 16 weeks with elderly women that are order than 70 years old. The experiment group(total : 17 people, mean age : 79.4) and the control group(total : 17 people, mean age : 80.7) live Yeonje-gu in Busan city, and they don't have any physical injury and any inconvenience to move. and they are all composed of elderly women who agree to participate in this study. We carried out an analysis of covariance with SAS 9.2 statistics package. These are the results from it. First, the experiment group showed statistically significant increase(p<.001) in lifting dumbbells, repeatedly standing up and sitting down, 2.24m shuttle running, walking at the same place for 2 minutes. Second, there was no particular effect with the experiment group in flexibility(catching hands with their backs leaned against each other). This result point out that there is a need of supplementation like adding exercise item which can improve flexibility to home support exercise program. Third, there was no particular difference between the experiment group and the control group in 8 sub-factors with the subjective evaluation about health-related quality of life through SF-36. However, there the bodily pain and vitality sub-factors of experiment group was better than that of the control group with p<.10 level, so we considered this result showed us the positive effect slightly.

Fibromyalgia from the Psychiatric Perspective (정신과적 관점에서의 섬유근통)

  • Lee, Yunna;Lee, Sang-Shin;Kim, Hyunseuk;Kim, Hochan
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.2
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    • pp.99-107
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    • 2020
  • Fibromyalgia is a disorder characterized by the core symptom of chronic widespread pain, along with fatigue, sleep disturbances, mood changes, and cognitive difficulties. The etiology of fibromyalgia involves a combination of biological factors, such as genetic vulnerability, alterations in pain processing and stress response system ; psychological factors, such as anxiety, depression, anger, and perceived stress ; environmental factors, such as infections, febrile diseases, and trauma. Central sensitization, which is amplified in the process of sensory stimulation, has been emphasized as a key etiological factor, as supported by enhanced wind-up, delayed aftersensation, decreased nociceptive flexion reflex threshold and functional imaging studies. Several guidelines recommend that a multimodal approach be used to treat fibromyalgia, including both pharmacological and non-pharmacological treatments, tailored to each individual, and that clinicians should provide an intellectual framework through sufficient education and emphasis on the importance of self-management. The prevalence of mood disorders, anxiety disorders, and other psychiatric problems is 7-9 times higher in patients with fibromyalgia than in the general population ; moreover, the association between fibromyalgia and certain psychopathologies or sleep problems has also been suggested. Since psychiatric problems, with shared vulnerabilities and risk factors, interact with fibromyalgia bidirectionally and also affect the disease course, an integrated management approach is needed to determine the risk of comorbidities.

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.

Validation of the Korean Version of the Continuing Bonds Scale (한국판 지속 유대 척도의 타당화)

  • Kyeyang Kim ;Jongwon Park ;Wan-Suk Gim
    • Korean Journal of Culture and Social Issue
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    • v.22 no.2
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    • pp.263-283
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    • 2016
  • The present study aimed at examining the factor structure, reliability and validity of the Korean version of the Continuing Bonds Scale (K-CBS). In study 1, exploratory factor analysis was administered to 293 bereaved adults who had experienced the death of a loved one, and it revealed a single factor structure with 10 items that explained 52.59% of the total variance. The K-CBS showed good internal consistency with Cronbach's alpha of .92. In study 2, confirmatory factor analysis in a different sample of 200 bereaved adults indicated satisfactory standardized regression weights of all items. However, one item had a squared multiple correlation less than .40, hence, this item was discarded, and 9 items remained for the final scale. The single factor model with 9 items displayed a good fit. The K-CBS had strong positive correlation with grief symptoms, and weak positive correlation with depression. After controlling for grief, however, the K-CBS was predictive of a decrease in depression. The K-CBS was positively associated with posttraumatic growth. In addition, significant differences in scores of the K-CBS were shown among groups based on the deceased's relation to the bereaved and expectedness of loss. These results suggest that the K-CBS is a reliable and valid instrument to measure continuing bonds. Finally, implications, limitations, and directions for future research were discussed.

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NEUROPSYCHIATRIC SEQUELAE AND ITS EVALUATION IN CHILDREN AND ADOLESCENTS WITH TRAUMATIC BRAIN INJURY (외상성 뇌손상 아동의 신경정신과적 후유증 평가)

  • Kim, Hae-Gyoung;Bhang, Hyung-Suk;Park, Gwang-Soo;Wang, Mi-Rhan;Min, Seong-Ho;Park, Ki-Chang;Ahn, Joung-Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.10 no.2
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    • pp.212-219
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    • 1999
  • Objective:This study is designed to get clinical guidelines for management of children with TBI by examining neuropsychiatric sequelae of TBI, determining whether the severity of TBI, type of treatment, and enviornmental factors are related to those sequelae, and defining the adequacy of public psychological tests as evaluating tools for them. Method:This is chart review of 47 children, aged 5 to 14 years, referred to a psychiatric outpatient clinic for neuropsychiatric evaluation at least 6 months after TBI. Data on the initial GCS score, associated injury, treatment type, and duration of hospital stay are obtained from medical records. EEG, MRI, intelligent test, and several psychological tests are administrated at the point of assessment. Results:1) Cognitive symptoms outnumber externalizing behavioral, emotional, and somatic symptoms, with no significant differences of frequencies of those 4 categorical symptoms between mild injury group and moderate to severe group. 2) Children treated with non-surgical method(p<0.01) complain more cognitive symptoms than the others. 3) Behavioral symptoms are related to younger age(p<0.05), and to anticonvulsant medication(p<0.05). 4) Children with associated injury complain emotional symptoms more frequently(p<0.05). 5) More somatic symptoms are presented by children with no medication(p<0.05), and with higher I.Q(p<0.05). 6) Low I.Q is correlated to low GCS score (p<0.05). Cognitive impairment is confirmed in 25 in 42 children complaining cognitive symptoms though I.Q test and BGT, whose hospital stay is longer than the others(p<0.05). 7) emotional disturbance is confirmed in 22 in 25 children showing emotional problems through psychological tests, who complain cognitive symptoms more frequently(p<0.05). Conclusion:This findings suggest that even mild TBI children need to be followed-up and treated as complaining neuropsychiatric symptoms over 6 months after injury, and shorter hospital stay is recommended for cognitive and emotional status of children, and for better evaluation of neuropsychiatric sequelae of TBI, more specific tests should be included in neuropsychological test tools.

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Cephalometric Characteristics of TMD Patients based on RDC/TMD Axis I Diagnosis (RDC/TMD Axis I 진단에 따른 측두하악장애 환자의 측두 두부방사선적 특징에 관한 연구)

  • Ahn, Ji-Yeon;Kim, Yong-Woo;Kim, Young-Ku;Lee, Jeong-Yun
    • Journal of Oral Medicine and Pain
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    • v.36 no.1
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    • pp.39-51
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    • 2011
  • The aims of this study were to investigate whether the facial skeletal patterns previously reported to be related to temporomandibular disorder (TMD) in other studies could be consistently observed in the TMD patients diagnosed according to Research Diagnostic Criteria for Temporomandibular Disorder (RDC/TMD) Axis I and evaluate its usability in the orthodontic clinics to examine the patients with TMD related symptoms. The clinical records and radiographs of female patients who visited the TMD and Orofacial Pain Clinic of Seoul National University Dental Hospital and were diagnosed as TMD were consecutively filed for this study. Patients were clinically examined and diagnosed according to the revised diagnostic algorithms of RDC/TMD Axis I and the lateral cephalogram, panoramic orthopantomogram, temporomandibular joint (TMJ) orthopantomogram, and transcranial radiograph of each patient were taken and digitalized. The data of patients who were under 18 years of age or had any systemic disease, trauma history involving the TMJ, or skeletal deformity at the time of the first examination were excluded. The remaining data of 96 female patients were finally analyzed. The obtained results were as follows: 1. There are no significant differences of cephalometric measurements between RDC I (muscle disorders) diagnostic groups. 2. Only the articular angle of the RDC group IIc (disk displacement without reduction without limited opening) patients was larger than patients of the no diagnosis of RDC II group (disk displacement). 3. Larger articular angle and smaller facial height ratio were observed in RDC IIIc group (osteoarthrosis) compared to IIIa group (arthralgia). Larger articular angle, larger Bjork sum, smaller posterior facial height, and smaller facial height ratio were observed in RDC group IIIc compared to no diagnosis of RDC III group (arthralgia, arthritis, and arthrosis). 4. According to the results of cephalometric analysis in simplified RDC groups, smaller overjet was observed in muscle disorders (MD) group. Facial height ratio and IMPA were smaller and articular angle was larger in disk displacements (DD) group than in no diagnosis of DD group. In arthrosis (AR) group, posterior facial height, and facial height ratio were smaller, and articular angle, gonial angle, facial convexity, FMA, Bjork sum, and ANB were larger than in no diagnosis of AR group. In joint pain (JP) group, only posterior facial height was smaller than no diagnosis of JP group. In conclusion, Facial morphologic patterns showing posterior-rotated mandible and lower posterior facial height is related to RDC group II and III diagnosis of the TMJ in female TMD patients. RDC/TMD Axis I diagnosis can provide a good clinical diagnostic tool for the standardized examination of the TMJ in orthodontic clinics.

COMPARATIVE STUDY OF BEHAVIOR AND COGNITIVE FUNCTION BY ADMINISTRATION OF METHYLPHENIDATE AND IMIPRAMINE IN ATTENTION DEFICIT-HYPERACTIVITY DISORDER (Methylphenidate와 Imipramine투여에 따른 주의력 결핍${\cdot}$과잉운동장애 환아의 행동 및 인지기능 변화에 대한 연구)

  • Ahn, D.H;Hong, K.E;Oh, K.J;Shin, M.S;Yoo, B.C;Chung, K.M
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.3 no.1
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    • pp.26-45
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    • 1992
  • This study presents the behavioral and cognitive changes by administration of methylphenidate(MPH) and imipramine(IMI) for the treatment of attention-deficit hyperactivity disorder(ADHD) in $5_{1/2}{\sim}12$ years old children referred to child psychiatric clinics. Behavioral changes are assessed with parent's and teacher's ratings. Drug effects on attention. short-term memory, and impulsivity are evaluated with psychological tests in laboratory. The changes were assessed twice in a 8-week periods. The data were analyzed seperately for 15 subjects each drug using repeated measured analysis of variance(ANOVA). The findings indicates that behavioral and cognitive impairments are improved by both drugs, but impulsivity is not. And MPH is superior to IMI on the improvement of attentional problem ; especially the findings indicates important differences between simple task and complex. perceptual-search task. These data confirm the effectiveness of MPH for treatment of ADHD, also raise questions regarding assessment method of attention and impulsivity as fell as importance of impulsivity in ADHD.

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Assessment of the Activities of General Physicians in Health Subcenters and a Scheme to Improve the Training Program (보건지소 공중보건 일반의사의 업무수행정도와 수련개선방안)

  • Park, Jung-Han;Chun, Byung-Yeol;Woo, Kuck-Hyeun
    • Journal of Preventive Medicine and Public Health
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    • v.19 no.2 s.20
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    • pp.193-202
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    • 1986
  • The activities of general physicians (GPs) in health subcenters and their competency for clinical skills were assessed to develop a scheme to improve the training program. One hundred-twenty GPs in southern four provinces (Kyungpook, Kyungnam, Chunpook, Chunnam) were randomly selected and 97 were interviewed between January 9 and February 10, 1984. Of the 97 GPs, 86 provided all the information we requested. Average number of patient visits per health subcenter in a day was 30-40 in the demonstration project area for the class II medical insurance whereas it was 3-4 visits in other area. The interviewees were asked to rate their competency in 63 clinical skills. The skills in which over 50% of the interviewees rated themselves competent were only 12 items including IM injection, IV injection, wound dressing, etc. Less than 10% of the interviewees rated themselves competent in such skills as maternal health care, emergency medical care, preventive and promotive health services. Most part of the training program of the NIH for the GPs were not applicable to their field work as the training contents were unrealistic. Clinical training at a local general hospital was of great help in 38.8% and the rest of training was not much helpful as the training was inadequate due to lack of trainer or indifference of the trainer. For more effective training of the GPs, the training program of the NIH should be modified to be more realistic and utilize competent field workers as the instructors. It may be more effective if the training is carried out at several local centers. Ideal length of the clinical training for the GPs is 4 months. A pocketbook should be developed that includes specific skills to master during the clinical training and require the trainer to confirm the achievement. The Ministry of Health and Social Affairs should provide the training hospitals with a training guideline and evaluate the training activities and make sure that the training hospital has specialist for each of the 4 major clinical departments. The Ministry of Health and Social Affairs should provide the GPs with a continuing education to assist the problem solving in the field and motivate them to actively carry out the health program. A province may be divided into several regions and a supervisory committee may be organized with specialists in each region. The committee may hold a meeting for the GPs periodically and respond to the specific questions of the GPs by mail.

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The Active Way of Trauma: Receiving the Return of the Past (도래하는 과거를 수용하는 트라우마의 능동적인 방편)

  • Seoh, Gil-Wan
    • Cross-Cultural Studies
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    • v.41
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    • pp.33-56
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    • 2015
  • Trauma studies have provided useful models for dealing with the catastrophic and disastrous events that an individual and collective group experience. Most important of all, the perspective of post-structuralist trauma study, including Cathy Caruth, became a paradigmatic model and it has been applied to almost all contexts of life. The perspective of this study model, which is called an "event-based model of trauma," focuses on the literal registration of the traumatic event and the accurate and immediate recall of the past. The person directly involved in the event becomes the passive bearer transmitting the truth of a traumatic event. From this perspective, the traumatic subject only undergoes and endures the event and cannot play an active role in constructing trauma and dealing with it. Eventually, the truth of trauma has to be obtained at the cost of the traumatic subject's autonomy and the possibility of his/her agency. The problem here is that the truth, which is reencountered through the literal return of the past, obtained at the cost of the subject's autonomy, strikes a rather fatal blow to the person, than gives help for resolving many of matters surrounding traumatic experience and curing trauma. This suggests that the active way of dealing with trauma on the part of the traumatic subject, rather than the traumatic event itself, is demanded. Furthermore, because more recently, images of disastrous events were viewed "live" by audiences and an immediacy to the event is replicated in public discourse about them, the event becomes more immediately traumatic and there is a more strong presumption that people regard themselves as traumatic victims than before. This is the reason that we must explore an active way dealing with trauma on more human position at this time. This essay aims to examine the limits of the paradigmatic model of trauma study, an "event-based model of trauma," critically through a literary, theoretical text in which it reveals how the literal return of the traumatic past have a fatal effect on the victim; and hopes to suggest "the narrative memory" as a way to deal with trauma from a more humanistic perspective.