• 제목/요약/키워드: Clinician-Administered PTSD Scale

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임상가용 아동 및 청소년을 위한 외상 후 스트레스장애 척도를 통한 학교폭력 피해아동의 인지행동집단치료 효과 : 예비연구 (The Effects of Cognitive-Behavioral Group Therapy on Victims of School Violence as Assessed by the Clinician-Administered PTSD Scale for Children and Adolescents (CAPS-CA) : A Preliminary Study)

  • 김형욱;김태형;은헌정;최말례;권태완;구정일;조수진;송옥선
    • 대한불안의학회지
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    • 제3권2호
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    • pp.97-103
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    • 2007
  • Objective : The present study was carried out in order to assess the effects of Cognitive-Behavioral Group Therapy (CBGT) on victims of school violence, as assessed by the CAPS-CA. Methods : The subjects were 14 children who had experienced school violence and were subsequently diagnosed with PTSD and partial PTSD using the Clinician-Administered PTSD scale for Children and Adolescents (CAPS-CA). Seven children agreed to participate in CBGT, and they received 10 sessions of therapy. After CBGT, both the CBGT and non-CBGT groups were assessed using the CAPS-CA and School Adaptation Test. Results : The study results showed significant decreases in avoidance (p=0.010) and hyperarousal in the CBGT group (p=0.009) following the completion of CBGT. The analysis of school adaptation showed that there was a significant improvement in peer relationships after CBGT in the CBGT group (p=0.045). Conclusion : CBGT is effective in improving PTSD symptoms in children who experience school violence and subsequently suffer from PTSD.

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PTSD 환자의 피해 사고 및 피해 사고에 기여하는 심리학적 요인 (Idea of Persecution and Psychological Factors Associated With Idea of Persecution in Patients With PTSD)

  • 이승윤;문영경;이소라;최하연
    • 정신신체의학
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    • 제31권2호
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    • pp.155-164
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    • 2023
  • 연구목적 본 연구는 외상 후 스트레스 장애 환자(Post-traumatic stress disorder, PTSD) 중 Clinician-Administered PTSD Scale (CAPS) Minnesota Multiphasic Personality Inventory-2 (MMPI-2)를 시행한 환자들을 대상으로 피해 사고에 영향을 미치는 요인을 확인하고자 한다. 방 법 2013년 5월부터 2020년 4월까지 중앙보훈병원에서 CAPS와 MMPI-2를 시행한 116명의 환자를 후향적으로 검토하였다. CAPS 점수를 기준으로 하여 환자들은 PTSD군(n=63, 연령: 58.16±17.84)과 외상 노출이 있는 비PTSD군(n=53, 연령: 67.34±12.05)으로 나뉘었다. 피해사고, CAPS 및 MMPI-2의 척도들 간의 상관 관계를 확인한 후 임상적으로 관련된 위험 요인을 확인하기 위해 선형 회귀 분석을 시행하였다. 결 과 PTSD 군은 외상 노출이 있는 비PTSD 군에 비해 MMPI-2에서 정신분열증, 피해 사고, 역기능적 부정적 정서, 기태적 경험, 정신증, 부정적 정서성/신경증, 불안, 우울, 분노 척도에서 유의한 차이를 보였다. 피해 사고와 CAPS, MMPI-2의 상관 관계를 보았을 때, 피해 사고와 MMPI-2 항목들 간에는 통제 결여 항목을 제외하고 강한 관련성을 보였다. PTSD 군에서 다중선형회귀분석을 통해 역기능적 부정적 정서 및 분노 척도가 피해 사고의 위험 요인임을 확인하였다. 결 론 PTSD 군은 외상 노출이 있는 비 PTSD 군에 비해 피해 사고가 높게 나타나고, 역기능적 부정적 정서 및 분노 척도가 피해 사고의 위험 요인일 수 있어 이에 대해 평가하고 적절한 치료를 제공하는 것이 필요하다.

혈장 세로토닌과 외상후 스트레스 장애 : 월남전 참전 재향군인을 대상으로 (Plasma Serotonin Level of Vietnam War Veterans with Post-Traumatic Stress Disorder and Symptom Severity)

  • 이수영;강석훈;정문용;이명희;김태용;소형석;정혜경;최진희
    • 대한불안의학회지
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    • 제5권1호
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    • pp.14-20
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    • 2009
  • Objective : The objective of this study was to examine the relationship between plasma serotonin concentration and posttraumatic stress disorder (PTSD) symptoms in chronic PTSD patients who have been taking medication. Methods : Plasma serotonin level of 14 PTSD patients and a control group of 28 Vietnam War veterans was measured by HPLC (high performance liquid chromatography). The Combat Exposure Scale (CES), Mississippi Scale for Combat-Related Posttraumatic Stress Disorder (M-PTSD), Clinician Administered PTSD Scale (CAPS), Hamilton Rating Scale for Depression (HRSD), and Hamiltion Anxiety Scale (HAS) were used to evaluate PTSD symptom severity. Results : Serotonin level was significantly higher in the PTSD group than in the control group (p=0.036, p=0.006, respectively). M-PTSD (p<0.001), CAPS (p<0.001), HRSD (p<0.001), and HAS (p<0.001) scale scores were significantly higher in the PTSD group than in the control group; however, the CES score failed to show a significant improvement (p=0.964). There were no significant differences between plasma serotonin and PTSD symptoms. Conclusion : In chronic PTSD patients who have been taking medications, we can not predict treatment effect and symptom severity by measuring only plasma serotonin levels. PTSD is a complicated disorder which may likely be related to a variety of neurotransmitter systems. Therefore, further research which investigate relationships with norepinephrine, dopamine, and other neurotransmitters as well as serotonin is needed to improve the treatment of PTSD.

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외상후 스트레스장애 환자에서 장기 치료에 따른 카테콜아민과 코르티솔 변화 (The Changes in Biogenic Amines and Cortisol in Patients with Posttraumatic Stress Disorder After Long-Term Pharmacological Treatment)

  • 강석훈;정문용;김태용;정혜경
    • 대한불안의학회지
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    • 제4권1호
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    • pp.19-27
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    • 2008
  • Objective : This study was conducted to evaluate the changes in the levels of neurotransmitters and cortisol in patients with chronic posttraumatic stress disorder (PTSD) and to evaluate their correlation with symptoms after long-term pharmacological treatment. Methods : Twenty-eight Vietnam veterans with chronic PTSD and 34 non-PTSD patients were consecutively recruited. The Combat Exposure Scale (CES), Mississippi Scale for Combat-Related Posttraumatic Stress Disorder (M-PTSD), Clinician Administered PTSD Scale (CAPS), Hamilton Rating Scale for Depression (HRSD) and Hamilton Anxiety Scale (HAS) were used to evaluate symptom severity. High performance liquid chromatography (HPLC) was used to measure the plasma levels of epinephrine, norepinephrine, and dopamine, and a radioimmunoassay (RIA) was performed to evaluate the plasma level of cortisol. Results : Plasma cortisol was significantly lower in PTSD patients than in control subjects, while there was no significant difference in plasma epinephrine, norepinephrine and dopamine between the two groups. The scores of M-PTSD, CAPS, HAMD and HAMA were signigicantly higher in PTSD patients than control group. Conclusion : After long-term treatment, the levels of neurotransmitters in PTSD patients returned to within the normal range, and the patients' symptoms showed some improvement. However, the core symptoms of PTSD continued to appear intermittently, and they are thought to be associated with hormonal systems, such as the HPA axis. It is also suggested that PTSD should be considered to be a complex disorder associated with multiple systems and that combinations of the effective medications for each system should be used to treat patients with PTSD.

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Add-on Eye Movement Desensitization and Reprocessing (EMDR) Therapy for Adults with Post-traumatic Stress Disorder Who Failed to Respond to Initial Antidepressant Pharmacotherapy

  • Bae, Hwallip;Kim, Daeho;Cho, Yubin;Kim, Dongjoo;Kim, Seok Hyeon
    • Journal of Korean Medical Science
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    • 제33권48호
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    • pp.306.1-306.6
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    • 2018
  • This study examined the add-on efficacy of eye movement desensitization and reprocessing (EMDR) therapy among adult civilians with post-traumatic stress disorder (PTSD) who continued to be symptomatic after more than 12 weeks of initial antidepressant treatment. Scores for the Clinician Administered PTSD Scale (CAPS) were rated pre- and post-EMDR and at a 6-month follow-up. After an average of six sessions of EMDR treatment, seven of 14 patients (50%) showed more than a 30% decrease in CAPS score and eight (57%) no longer met the criteria for PTSD. Our results indicate that EMDR could be successfully added after failure of initial pharmacotherapy for PTSD.

외상 후 스트레스 장애 환자에서 발생한 환각 경험의 임상적 의미 (Clinical Meaning of Hallucinatory Experience among PTSD Patients)

  • 박지훈;이중서;이홍석
    • 대한불안의학회지
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    • 제9권2호
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    • pp.113-120
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    • 2013
  • Objectives : The aim of this study was to investigate clinical meaning of hallucination among patients with posttraumatic stress disorder (PTSD). Methods : PTSD patients with hallucination (n=50) were selected and matched with the PTSD patients without hallucination (n=50) by age and sex. The patients were evaluated in two different aspects, pathologic aspects which can develop after traumatic event, and positive/adaptive aspects which are concerned in positive psychology. In addition to these, temperament and character features between two groups were also evaluated using the Temperament and Character Inventory (TCI). Results : Except for the total score of DES (Dissociative Experience Scale) and the score of re-experience subscale of CAPS (Clinician Administered PTSD Scale), clinical characteristics did not show any significant difference between the two groups. Among the comparison of seven higher dimensions in TCI profiles, only Self-transcendence showed significant difference between the two groups. Conclusion : The two groups did not show significant differences in pathologic aspects except for factors that may contribute to development of hallucination. Furthermore, authors could not find any differences in positive/adaptive aspects.

외상 후 스트레스 장애 동반 여부에 따른 정신분열병 환자의 임상증상과 치료효과의 비교 : 1년간의 전향적 추적연구 (Comorbidity of Posttraumatic Stress Disorder and Its Effect on Treatment Outcomes in Patients with Schizophrenia : One-Year Prospective Follow-Up Study)

  • 박성종;김남희;정재열;이선이
    • 생물정신의학
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    • 제16권4호
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    • pp.256-265
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    • 2009
  • Objectives : The aims of this study were to assess a) the prevalence of trauma and posttraumatic stress disorder(PTSD) in schizophrenic patients and b) the differences in symptomatology and outcome after 1year treatment between those with and without PTSD. Methods : Twenty eight schizophrenia and schizoaffective disorder patients completed the Positive and Negative Syndrome Scale(PANSS), Life Stressor Checklist-Revised(LSCL-R), Clinician-Administered PTSD Scale(CAPS), Dissociative Experiences Scale(DES), Hamilton Psychiatry Rating Scale for Depression(HAM-D), and Rosenberg Self-Esteem Scale(RSE). Results : Twenty six patients(92.9%) had at least one trauma in their life time. Eleven patients(39.3%) were diagnosed with PTSD. PTSD group had significantly higher scores on HAM-D and DES but lower scores on RSE. PTSD group also had significantly lower score in the baseline PANSS Negative score. Higher CAPS scores were significantly correlated with lower baseline PANSS Negative score and greater change after 1year of PANSS Negative score. Conclusion : These results showed that the prevalences of trauma and PTSD are high in schizophrenic patients and suggested that PTSD and trauma-related symptoms affected the symptomatology and treatment outcome. More research is warranted to better understand the effects of PTSD in schizophrenic patients.

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외상후스트레스장애 환자의 증상 정도와 스트레스 대처 방식, 사회적 지지, 자존감의 관련성 (The Association among Stress Coping Strategies, Social Support, and Self-Esteem in Patients with Posttraumatic Stress Disorder)

  • 정재희;권주한;박종일;양종철
    • 대한불안의학회지
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    • 제17권2호
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    • pp.59-66
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    • 2021
  • Objective : The purpose of this study is to investigate the relationship among the degree of symptoms of posttraumatic stress disorder (PTSD) and social support, stress coping strategies, and self-esteem in patients with PTSD. Methods : A total of 48 patients meeting DSM-5 criteria for PTSD and 48 normal controls were recruited for participation in this study. We evaluated subjects using the Clinician-Administered PTSD Scale (CAPS), Hamilton Anxiety Scale (HAM-A), Hamilton Depression Scale (HAM-D), Rosenberg Self-Esteem Scale (RSES), Multidimensional Scale of Perceived Social Support (MSPSS) and The Ways of Stress Coping Questionnaire (SCQ). We analyzed data using an independent t-test and Pearson's correlation analysis. Results : In PTSD patients, total CAPS scores showed a significant positive correlation with HAM-A and HAM-D scores and a significant negative correlation with MSPSS scores. RSES scores showed a significant positive correlation with MSPSS and SCQ scores. MSPSS scores showed a significant negative correlation with PTSD avoidance and numbing and HAM-D scores. SCQ scores showed a significant negative correlation with PTSD avoidance and numbing. Conclusion : These results revealed that the better the stress coping strategies and social support, the lower the degree of symptoms in patients with PTSD. In addition, it was found that the higher the social support and self-esteem, the lower the degree of depression and anxiety. Therefore, in the treatment process, it seems important to identify and correct the self-esteem, social support system, and stress coping strategies of patients with PTSD.

월남전 참전자에서 문제음주와 관련한 외상 후 스트레스 장애의 증상 차이 (Symptoms of Posttraumatic Stress Disorder in Relation to the Alcohol Problem in Korean Veterans of Vietnam War)

  • 권태효;정혜경;김동수;최진희;김태용;소형석;정문용
    • 대한불안의학회지
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    • 제7권2호
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    • pp.119-125
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    • 2011
  • Objectives : The three symptom clusters of posttraumatic stress disorder (PTSD) are reexperience, avoidance, and hyperarousal. Alcohol use disorders frequently co-occur with PTSD, and possible functional correlations are suspected. Scholarly evaluation of the differences between the symptoms of PTSD and those of alcohol problems may be useful in understanding the pathophysiology of the comorbidity. Methods : We recruited Vietnam veterans with PTSD (n=97) and without PTSD (n=132). The alcohol use disorder identification test (AUDIT), and clinician-administered PTSD scale (CAPS) were administered to participants. The PTSD group was divided into two categories: those with PTSD only (n=57) and those with concurrent alcohol-related problems (n=40). Results : The PTSD group showed higher AUDIT scores compared to the control group. In the PTSD group, participants with alcohol problems had a severer symptoms of recurrent dream and sleep disturbance symptoms compared to the PTSD only group. No significant differences were found in the three major symptom clusters of PTSD. Conclusion : These findings support the proposed existence of a functional correlation between PTSD and alcohol use disorder. Clinicians should carefully evaluate and treat comorbid alcohol use disorder in patients with PTSD.

전투 관련 외상 후 스트레스 장애 진단에 있어서 임상가를 위한 외상 후 스트레스 장애 척도의 적용 (The Application of the Clinician Administered Posttraumatic Stress Disorder Scale to Identify Combat Related Posttraumatic Stress Disorder)

  • 김해정;김태용;최진희;소형석;정문용;김동수;방유진;정혜경
    • 대한불안의학회지
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    • 제8권2호
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    • pp.113-119
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    • 2012
  • Objective : The purpose of this study is to assess the utility of clinician administered posttraumatic stress disorder scale (CAPS) to diagnose combat related posttraumatic stress disorder (PTSD) in Korean veterans of the Vietnam War. Methods : Sixty-one Korean male veterans of the Vietnam war participated in this study. We compared the diagnostic values of CAPS, Korean version of mini international neuropsychiatric interview (MINI) against the Structured Clinical Interview for DSM-IV (SCID) in diagnosing PTSD. Results : The overall internal consistency of CAPS was 0.93. Compared to the SCID, total severity 45 (TSEV45) showed the best results among 5 CAPS scoring rules. In detail, sensitivity was 71.4%, specificity was 85.1, positive predictive value was 58.8%, negative predictive value was 90.9%, and accuracy was 82.0. Conclusion : CAPS was demonstrated as a reliable tool to diagnose combat related PTSD in the elderly. The optimum CAPS scoring was TSEV45.