• Sleep Medicine and Psychophysiology
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• v.6 no.1
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• pp.76-84
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• 1999

Objectives: A number of studies have shown that sleep deprivation results in reduced vigilance and increased negative affects such as tension, depression and anger. However there are few studies about effects of sleep deprivation on anxiety. The purpose of this study was to investigate the effects of 40 hour sleep deprivation on state anxiety, affects, sleepiness and fatigue. The authors also intended to study the effect of trait-anxiety on these psychological variables after sleep deprivation. Methods: Twenty nine subjects(22 men, 7 women, $24.59{\pm}1.35$ years of age) participated in this study. Subjects had no past history of psychiatric disorders and physical illnesses, and had normal sleep-waking cycle without current sleep disturbances. All of the subjects completed sleep dairy for two weeks to exclude some who suffered from chronic sleep deprivation or sleep disturbances. Subjects were instructed to get a normal sleep as usual at night before the study. After awakening, subjects remained awake for 40 hours under continuous surveillance. They completed State-Trait Anxiety Inventory, Index of General Affect, Stanford Sleepiness Scale and Fatigue Questionnaire every three hours, therefore they completed the scales 14 times totally. Subjects were dictated not to take caffeine, alcohol, or any medications on the day of the study. Heavy exercises and naps were restricted too. Results: Sleep deprivation resulted in increased state anxiety, negative general affects, and increased sleepiness and fatigue(p<.001). Dividing into high trait-anxiety group and low trait-anxiety group, there was significant sleep deprivation x traitanxiety interaction effect on general affect(p<.05). But, there was no significant sleep deprivation x trait-anxiety interaction effect on state-anxiety, sleepiness and fatigue. During sleep deprivation, the highest ratings of scales on anxiety, negative affect, sleepiness and fatigue occurred between 4 : 00AM and 7 : 00AM. Conclusions: These results show that sleep deprivation results in increased anxiety, mood state disturbance and increment of sleepiness and fatigue. These findings also suggest that trait-anxiety is a factor that influences the degree of worsening in general affect caused by sleep deprivation. During sleep deprivation, the rating curves of anxiety, affect, sleepiness and fatigue show rhythmicity that may be related to circadian rhythm.

• Korean Journal of Social Welfare
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• v.52
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• pp.143-170
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• 2003

This study investigated the effectiveness of the assessment of psychosocial treatment outcome in symptomatology and social functioning as rated by the depressed client's significant other in explaining the client's symptomatology and social adjustment at 6 and 12 month follow-up period after the 16-week psychosocial treatment was terminated. The data were drawn from the National Institute of Mental Health Treatment of Depression Collaborative Research Program of the U.S. Significant others of depressed clients have rarely participated in the assessment of treatment outcome, although they are major participants of the clients' daily life and have meaningful opportunities to observe the clients' functioning in different social situations. Thus, this study aimed to examine the explanatory power of the significant others' outcome assessment in depressive symptomatology and social functioning for the long-term outcome in symptomatology and social adjustment. The outcome measures used by the significant others were actual performance, expected performance, gap between actual and expected performance, and symptomatology drawn from the Katz Adjustment Scale-Relatives Form. Three major findings were: (1) in general, the posttreatment assessment by the significant other demonstrated stronger explanatory power of the follow-up status than the assessment rated at pretreatment in all of the four outcome domains; (2) the significant other's assessment of actual and expected performance at both pre- and posttreatment demonstrated significant explanatory power of the follow-up status in symptomatology and social/leisure and work adjustment; and (3) the significant other's assessment of social functioning at pretreatment improved the explanatory power over and above the explanation by symptomatology in the follow-up status of social/leisure and work adjustment; however, at posttreatment, symptomatology improved the explanation over and above social functioning more frequently in predicting both symptomatology and social/leisure and work adjustment. These findings suggest the effectiveness of the measures of symptomatology and actual and expected performance as assessed by significant others. The results imply that mental health professionals and researchers need to involve the depressed client's significant other in the treatment and make good use of their contribution in treatment planning and further intervention in the follow-up period to prevent relapse.

• Journal of Korean Society of Forest Science
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• v.103 no.1
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• pp.129-136
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• 2014

This study aims to investigate the effect of frequency of using forest environment on workers' stress. Workers in medical and counseling industry, which is recently known to require heavy emotional burden and thus cause a lot of stress and burnout syndrome, participated in the study. We classified 370 subjects, who were working at medical and counseling service institutions in Seoul metropolitan area, into two groups according to frequency of using forest environment by conducting a screening survey. 69 subjects submitted written consent and were recruited for either forest therapy program or control-group test; the "high" group (n=27) at the high frequency of using forest environment and the "low" group (n=42) at the low level. We measured the level of stress by using psychosocial indicators such as Worker's Stress Response Inventory (WSRI), Recovery Experience Questionnaire (REQ), and Maslach Burnout Inventory-General Survey (MBI-GS) and biological ones such as heart rate variability (HRV), cortisol, and Natural Killer cell (NK cell). The results suggested that the level of stress differed by frequency. The "high" group showed significantly low scores in the depression and work sub-scale and the total score of WSRI, emotional exhaustion, professional efficacy and total score of MBI-GS, and high scores in the total score of REQ. Similar tendencies were observed in the most of other indicators of psychosocial measures. Regarding the biological indicators, the "high" group showed the highest SDNN, RMSSD and TP measures of HRV and NK Cell activity and the low cortisol, although the statistical power did not reach the significant level. Our results suggest that the subjects who use forest environment frequently show favorable stress level both psychologically and biologically.

• Sleep Medicine and Psychophysiology
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• v.5 no.1
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• pp.71-79
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• 1998

Objectives : This study was to evaluate sleep patterns and daytime sleepiness resulting from rotating shiftwork. The authors, also, tried to find out the relationship between the severity of daytime sleepiness and personality factors. Methods : The subjects consisted of 41 female rotating shiftwork nurses and the control group consisted of 39 female day timeworkers. All of them completed the Sleep questionnaire of Korea University Sleep Disorder Clinic, the Epworth Sleepiness Scale(ESS), the 16 Personality Factors(16PF), the Beck Depression Inventory(BDI) and the State Trait Anxiety Inventory(STAI). Multiple regression analysis of 16PF of the rotating shiftwork nurses was done to find out possible predictors of the severity of daytime sleepiness. Results : The mean duration of deprived sleep due to rotating shiftwork was $64.26\;{\pm}\;14.54\;min$. The frequency of sleep difficulty($1.24\;{\pm}\;1.17\;day/week$ vs $0.67\;{\pm}\;1.31\;day/week$, p < 0.05), time needed to fall asleep($103.05\;{\pm}\;73.48\;min$. vs $70.00\;{\pm}\;60.08\;min$, p < 0.05), sleep duration when having some difficulties in sleep ($204.25\;{\pm}\;79.90\;min$. vs $280.44\;{\pm}\;111.59\;min$., p < 0.001), recent changes in energy($x^2\;=\;4.16$, p < 0.05), worrying about sleep($x^2\;=\;11.08$, p < 0.05), and taking naps($x^2\;=\;4.98$, p < 0.05) showed significant differences between rotating shiftworkers and normal controls. The ESS socre of shiftworkers ($8.68\;{\pm}\;3.04$) was greater than that of normal controls ($6.86\;{\pm}\;3.04$)(p < 0.01). Personality factors such as C factor($R^2\;=0.283$), I factor($R^2\;=0.358$) and G factor($R^2\;=0.470$) were related with the severity of the daytime sleepiness(p < 0.001). Conclusions : The rotating shiftwork nurses had more difficulties in sleep such as having difficulties in falling asleep and in maintaining sleep, and showed lowered energy, decreased senses of well-being and so on. The rotating shiftwork nurses experienced more severe daytime sleepiness than controls did. Personality factors, such as C factor, I factor, and G factor of 16PF were suggested to be useful for predicting the severity of daytime sleepiness resulting from rotating shiftwork.

• Journal of Oriental Neuropsychiatry
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• v.16 no.1
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• pp.1-17
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• 2005

Objective : This empirical research is performed to recognize diagnostic concept, pattern identification, and clinical features of Hwa-byung. In other words, the aims of this research are to examine the differences of the diagnosis between Hwa-Byung and the other psychiatric disorders, and to find out pattern identification, and clinical characteristics of Hwa-Byung for prescriptions of this syndrome. Method : In the experiment, there were participated 30 patients who were met for our criterions according to HBDIS (Hwa-Byung Diagnostic interview Schedule). These patients were diagnosed as Axis1 according to criterions of DSM-IV with administering SCID-I. OMS-prime was utilized for finding out pattern identification of oriental medicine. Symptom Check List-90-Revision(SCL-90-R), Hemilton rating Scale for Depression(HRSD), Heart Rate Variability(HRV), and Digital Infrared Thermographic imaging(D.I.T.I.) were also utilized to discover clinical characteristics of Hwa-Byung Patients. Results : 1. Regarding Sex-ratio, male subjects were 3(10%), and female subjects are 27(90%). The age of subjects ranged from 22 year old to 75 $(51.87{\pm}11.04;\:Mean{\pm}SD)$ 2. In the results of diagnosis on the basis of DSM-IV, the 17(56.67%) patients were MOD (Major Depressive Disorder), the 5(16.67%) patients were USD (Undifferentiated Somatoform Disorder), the 4(13.33%) patients were Dysthymic Disorder, the 3(10%) patients were GAD (Generalized Anxiety Disorder), and the 1(3.33%) was Panic Disorder. Two of the patients who diagnosed as MOD were diagnosed as Panic Disorder too, and one of them was diagnosed as Pain Disorder too. 3. Regarding pattern identification, Hwa-Byung is positively correlated to deficiency of Heart(心). and then to stagnancy of Liver-Gall bladder. Hwa-Byung is correlated deficiency symptom-complex rather than excessiveness symptom-complex. That is also correlated positively to Pathological heat and fire. 4. In SCL90-R, the mean of PSDI was $(75.3{\pm}10.7;\:Mean{\pm}SD)$. The each mean of the other 11 factors was distributed between50-70. 5. The mean of HRSD was $(17.9{\pm}5.6;\:Mean{\pm}SD)$ in the entire subject's group. Then the group of MDD was $20.9{\pm}4.4$ and the group of USD was $12.0{\pm}4.8$ 6. In the results of HRV. the mean of TP is $972.4{\pm}1174(Mean{\pm}SD)$, this is lower than normal range 1000-200. The other factors were within normal range. Then, there were no significant differences between them (p<0.05). 7. The temperatures of each acupoint have significant differences between HNl(印堂) and PC6(內關), between CV17(顫中) and PC6(內關), between HN1(印堂) and CV8(神闕), between CV17(顫中) and CV8(神闕) in comparison with the average of body temperature in the use of D.I.T.I. (p<0.01) 8. In the analysis of correlation between SCL-90-R, HRSD, HRV. and D.I.T.I. there were no significant results. According to results that the correlation was analyzed with only the MDD group as subjects, there was negative correlation between RMSSD of HRV and HRSD, between LF of HRV and PDSIof SCL-90-R, and between LF/HF of HRV and ANX, PSY, and PDSI of SCL-90-R. Conclusion : In the observation of clinical features of 30 cases of Hwa-Byung patients by using diverse structured tests, there could make diverse diagnosis as depressive disorder, anxiety disorder, and Somatoform Disorder. Particularly. MDD was highly distributed. Considering oriental medicine's pattern identification of Hwa-Byung, this syndrome is related strongly to Heart, and there were demonstrated deficiency symptom-complex, and Pathological heat and fire. One of the limits of this study is lack of control subject's group, therefore, in the future study, it requires reexamination through a comparative research with these data to complete this study.

• Journal of Yeungnam Medical Science
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• v.22 no.2
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• pp.150-165
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• 2005

Purpose: This study was conducted to investigate the prognostic factors of postpsychotic depressive symptoms in patients with schizophrenia. Materials and Methods: Eighty patients were selected based on the diagnostic criteria from the DSM-IV, PANSS and ESRS. For all patients information was collected on demographic and clinical characteristics. The subjective depressive symptoms and the objective depressive symptoms, as well as patients insight regarding psychosis were evaluated. The subjective depressive symptoms were evaluated by BDI and ZDS; the objective depressive symptoms were evaluated by HDRS and CDSS, and patient insight into the psychosis was evaluated by KISP. Results: The comparisons using demographic and clinical characteristics showed that HDRS and CDSS had significant difference with regard to gender and suicide attempts; the BDI was associated with difference in education level and age of onset. The patients with scores above cuff-off score for each scale were 20(25.0%) for the BDI, 16(20.0%) for the ZDS, 18(22.5%) for the CDSS and 6(7.5%) for the HDRS. The results of the stepwise multiple regression analysis showed that the scores for the KISP, education levels, gender and suicide attempts were the main prognostic factors in patients with the psychotic depressive disorder of schizophrenia. Conclusion: The main prognostic factors in psychotic depressive disorder of schizophrenia included: insight into psychosis, suicidal attempts. Insight into the psychosis was the most reliable prognostic factor but this characteristic had a negative relationship to the with depressive symptoms.

• Korean Journal of Psychosomatic Medicine
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• v.28 no.2
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• pp.126-134
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• 2020

Objectives : The purpose of this study was to investigate the needs for return-to-work support of cancer survivors and related factors in patients with cancer and their caregivers. Methods : 182 patients and 114 caregivers were recruited. Distress Thermometer and Problem List and scale ranging 0~10 measuring the degree of needs for return-to-work support were utilized. The needs for return-to-work support between the patient group and caregiver group (patient's needs evaluated by the caregiver) were compared, and related factors were investigated using logistic regression analysis. Results : 34.6% and 28.1% of patients and caregivers reported return-to-work support of cancer survivors is "very necessary". The degree of needs was 6.60±3.365 points in the patient group and 6.17±3.454 points in the caregiver group, with no significant difference (p=0.282). The needs for return-to-work support evaluated by patients was high when they underwent surgery (OR=2.592, p=0.007), has fertility problems (OR=6.137, p=0.025), has appearance problems (OR=2.081, p=0.041), or has fatigue (OR=2.330, p=0.020). The needs for return-to-work support of patients evaluated by caregivers was high when patients treated with breast cancer (vs respiratory cancer, OR=13.038, p=0.022 ; vs leukemia/lymphoma, OR=4.517, p=0.025 ; vs other cancer, OR=13.102, p=0.019), has work/school problems (OR=4.578, p=0.005), or has depression (OR=3.213, p=0.022). Conclusions : The degree of needs for return-to-work support of cancer survivors was high, and factors related to the needs were different between the two groups. This suggests that return-to-work support of cancer survivors is required, and clinical characteristics, the distress of patients, and differences between patients and their caregivers should be considered in establishing a support plan.

• Journal of Distribution Research
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• v.15 no.1
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• pp.49-71
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• 2010

Franchise businesses in South Korea have contributed to economic growth and job creation, and its growth potential remains very high. However, despite such virtues, domestic franchise businesses face many problems such as the instability of franchisor's business structure and weak financial conditions. To solve these problems, the government enacted legislation and strengthened franchise related laws. However, the strengthening of laws regulating franchisors had many side effects that interrupted the development of the franchise business. For example, legal regulations regarding franchisors have had the effect of suppressing the franchisor's leadership activities (e.g. activities such as the ability to advocate the franchisor's policies and strategies to the franchisees, in order to facilitate change and innovation). One of the main goals of the franchise business is to build cooperation between the franchisor and the franchisee for their combined success. However, franchisees can refuse to follow the franchisor's strategies because of the current state of franchise-related law and government policy. The purpose of this study to explore the effects of franchisor's leadership style on franchisee's commitment in a franchise system. We classified leadership styles according to the path-goal theory (House & Mitchell, 1974), and it was hypothesized and tested that the four leadership styles proposed by the path-goal theory (i.e. directive, supportive, participative and achievement-oriented leadership) have different effects on franchisee's commitment. Another purpose of this study to explore the how the level of franchisee's self-efficacy influences both the franchisor's leadership style and franchisee's commitment in a franchise system. Results of the present study are expected to provide important theoretical and practical implications as to the role of franchisor's leadership style, as restricted by government regulations and the franchisee's self-efficacy, which could be needed to improve the quality of the long-term relationship between the franchisor and franchisee. Quoted by Northouse(2007), one problem regarding the investigation of leadership is that there are almost as many different definitions of leadership as there are people who have tried to define it. But despite the multitude of ways in which leadership has been conceptualized, the following components can be identified as central to the phenomenon: (a) leadership is a process, (b) leadership involves influence, (c) leadership occurs in a group context, and (d) leadership involves goal attainment. Based on these components, in this study leadership is defined as a process whereby franchisor's influences a group of franchisee' to achieve a common goal. Focusing on this definition, the path-goal theory is about how leaders motivate subordinates to accomplish designated goals. Drawing heavily from research on what motivates employees, path-goal theory first appeared in the leadership literature in the early 1970s in the works of Evans (1970), House (1971), House and Dessler (1974), and House and Mitchell (1974). The stated goal of this leadership theory is to enhance employee performance and employee satisfaction by focusing on employee motivation. In brief, path-goal theory is designed to explain how leaders can help subordinates along the path to their goals by selecting specific behaviors that are best suited to subordinates' needs and to the situation in which subordinates are working (Northouse, 2007). House & Mitchell(1974) predicted that although many different leadership behaviors could have been selected to be a part of path-goal theory, this approach has so far examined directive, supportive, participative, and achievement-oriented leadership behaviors. And they suggested that leaders may exhibit any or all of these four styles with various subordinates and in different situations. However, due to restrictive government regulations, franchisors are not in a position to change their leadership style to suit their circumstances. In addition, quoted by Northouse(2007), ssubordinate characteristics determine how a leader's behavior is interpreted by subordinates in a given work context. Many researchers have focused on subordinates' needs for affiliation, preferences for structure, desires for control, and self-perceived level of task ability. In this study, we have focused on the self-perceived level of task ability, namely, the franchisee's self-efficacy. According to Bandura (1977), self-efficacy is chiefly defined as the personal attitude of one's ability to accomplish concrete tasks. Therefore, it is not an indicator of one's actual abilities, but an opinion of the extent of how one can use that ability. Thus, the judgment of maintain franchisee's commitment depends on the situation (e.g., government regulation and policy and leadership style of franchisor) and how it affects one's ability to mobilize resources to deal with the task, so even if people possess the same ability, there may be differences in self-efficacy. Figure 1 illustrates the model investigated in this study. In this model, it was hypothesized that leadership styles would affect the franchisee's commitment, and self-efficacy would moderate the relationship between leadership style and franchisee's commitment. Theoretically, quoted by Northouse(2007), the path-goal approach suggests that leaders need to choose a leadership style that best fits the needs of subordinates and the work they are doing. According to House & Mitchell (1974), the theory predicts that a directive style of leadership is best in situations in which subordinates are dogmatic and authoritarian, the task demands are ambiguous, and the organizational rule and procedures are unclear. In these situations, franchisor's directive leadership complements the work by providing guidance and psychological structure for franchisees. For work that is structured, unsatisfying, or frustrating, path-goal theory suggests that leaders should use a supportive style. Franchisor's Supportive leadership offers a sense of human touch for franchisees engaged in mundane, mechanized activity. Franchisor's participative leadership is considered best when a task is ambiguous because participation gives greater clarity to how certain paths lead to certain goals; it helps subordinates learn what actions leads to what outcome. Furthermore, House & Mitchell(1974) predicts that achievement-oriented leadership is most effective in settings in which subordinates are required to perform ambiguous tasks. Marsh and O'Neill (1984) tested the idea that organizational members' anger and decline in performance is caused by deficiencies in their level of effort and found that self-efficacy promotes accomplishment, decreases stress and negative consequences like depression and emotional instability. Based on the extant empirical findings and theoretical reasoning, we posit positive and strong relationships between the franchisor's leadership styles and the franchisee's commitment. Furthermore, the level of franchisee's self-efficacy was thought to maintain their commitment. The questionnaires sent to participants consisted of the following measures; leadership style was assessed using a 20 item 7-point likert scale developed by Indvik (1985), self-efficacy was assessed using a 24 item 6-point likert scale developed by Bandura (1977), and commitment was assessed using a 6 item 5-point likert scale developed by Morgan & Hunt (1994). Questionnaires were distributed to Korean optical franchisees in Seoul. It took about 20 days to complete the data collection. A total number of 140 questionnaires were returned and complete data were available from 137 respondents. Results of multiple regression analyses testing the relationships between the each of the four styles of leadership shown by the franchisor as independent variables and franchisee's commitment as the dependent variable showed that the relationship between supportive leadership style and commitment ($\beta$=.13, p<.001),and the relationship between participative leadership style and commitment ($\beta$=.07, p<.001)were significant. However, when participants divided into high and low self-efficacy groups, results of multiple regression analyses showed that only the relationship between achievement-oriented leadership style and commitment ($\beta$=.14, p<.001) was significant in the high self-efficacy group. In the low self-efficacy group, the relationship between supportive leadership style and commitment ($\beta$=.17, p<.001),and the relationship between participative leadership style and commitment ($\beta$=.10, p<.001) were significant. The study focused on the franchisee's self-efficacy in order to explore the possibility that regulation, originally intended to protect the franchisee, may not be the most effective method to maintain the relationships in a franchise business. The key results of the data analysis regarding the moderating role of self-efficacy between leadership behavior style as proposed by path-goal and commitment theory were as follows. First, this study proposed that franchisor should apply the appropriate type of leadership behavior to strengthen the franchisees commitment because the results demonstrated that supportive and participative leadership styles by the franchisors have a positive influence on the franchisee's level of commitment. Second, it is desirable for franchisor to validate the franchisee's efforts, since the franchisee's characteristics such as self-efficacy had a substantial, positive effect on the franchisee's commitment as well as being a meaningful moderator between leadership and commitment. Third, the results as a whole imply that the government should provide institutional support, namely to put the franchisor in a position to clearly identify the characteristics of their franchisees and provide reasonable means to administer the franchisees to achieve the company's goal.

• Korean Journal of Psychosomatic Medicine
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• v.7 no.1
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• pp.87-102
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• 1999

Objectives : The purposes of this study were to estimate the prevalence rate of eating disorders in Korean males and to clarify their characteristics in sociodemograhic data, the eating traits, and general psychopathology through the comparison with those of female high scored group on the Korean version of Eating Attitudes Test-26(KEAT-26). Methods : Using a multi-stage questionnaire sampling method including area sampling, proportionated stratified sampling, and quota sampling, we surveyed a total of 4,400 Korean adults over 18 in a nationwide area(9 kus, 10 middle or small cities, and 17 kuns), obtaining usable responses on 3,896. Of the 3,062 subjects(1249 males and 1813 females) who were available for analysis, we ascertained 52 males and 208 females who had high score($\geq$ cutoff point 21) on the KEAT-26. Results : 1) The proportion of this high score group was 1.7% in male and 6.8% in female with a sex ratio(male versus female) of 1 : 4. 2) The mean age was higher in the male group than in the female group, although it was not statistically significant(p=0.0514). Mean Body Mass Index(BMI) of the male group was significantly higher than that of female group, and the number of male subjects with below 20 of BMI was also significantly lower than in the female group. 3) There were no significant difference in past history of physical illness between two groups. However, frequency of smoking and alcohol use, and mean amount of alcohol consumption per month were significantly higher in the male group than in the female group. There were no significant differences between the two groups on various socio-demographic correlates such as economic status, total duration of education, number of family, marital status, religious status, and area of residence, but the exception of being occupational status. 4) The 'Eating Habits Scale' score and score of 'preference for vegetables and fish, and dislike for sweet-tasting food' of the male group were significantly lower than those of the female group. Although there was no significant difference between the two groups in total scores of the KEAT-26, the mean score on 'pursuit of thinness' subscale was higher in the female group than in the male group, while scores of 'food preoccupation' and 'self-control' subscales were higher in the male group than in the female group. 5) Scores on 'psychoticism' was significantly higher in the male group than in the female group, although there were no significant differences between the two groups on 'locus of control for weight', 'depression' and 'hypochondriasis'. Conclusion : These results support a possibility of a high prevalence of eating disorders in Korean males. These results suggest that eating related characteristics of high scorer on the EAT are different by sex in spite of the same high score on the EAT, and also suggest that male patients with eating disorders have more serious personality pathology than female patients with eating disorders.