• 대한불안의학회지
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• 제8권1호
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• pp.31-40
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• 2012

Objective : The purpose of this study was to analyze the correlation between symptom severity and neurocognitive factors in traumatic head injury patients. In addition, the effect of frontal lobe damage on these parameters was examined. Methods : We selected 18 patients who had brain damage for the moderate to severe traumatic brain injury (MSTBI) group, and 17 patients who met the diagnostic criteria for post-traumatic stress disorder (PTSD) without the finding of brain damage for the comparison group. For the evaluation of neurocognitive function, K-WAIS, Rey-Kim Memory Test, K-FENT, WCST, and MMPI-2 were used. Results : The results of the comparison (using the malingering scale) revealed that the values of PDS and PK, which express the severity of symptoms, and the values of the validity scale F, F (B), and F (P) were significantly higher in the overly-expressed group. F (B) in overly-expressed group and PK, Pt, and Sc in the properly-expressed group had significant correlation with the severity of symptoms. F (B), S, and Stroop error inhibition in PTSD, and PK, Pt, Sc, and MQ in MSTBI had significant correlation with the severity of symptoms. The results of the comparison based on the finding of frontal lobe damage revealed that PDS, EIQ, and MQ ware significantly higher in the group without brain damage. Conclusions : It was revealed that each neurocognitive factor was correlated with the severity of symptoms. There was a decrease in complaints or symptoms reported by the frontal lobe injury group, and this is believed to be due to degenerative change in the personality and emotional functioning of these patients following frontal lobe damage.

• 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.

• 대한불안의학회지
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• 제14권2호
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• pp.99-105
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• 2018

Objective : The purpose of this study was to investigate effects of depression and anxiety on treatment response of social skills training in adolescents with autism spectrum disorders (ASD). Methods : A total of 107 teenagers that participated in the Program for the Education and Enrichment of Relational Skills (PEERS$^{(R)}$) between 2011 and 2015 were analyzed using linear regression. Outcome measures used were the Korean version of Social Responsiveness Scale (SRS), the Test of Adolescent Social Skills Knowledge-Revised (TASSK-R), and the Korean version of Autism Diagnostic Observation Schedule (K-ADOS). Depression and anxiety were assessed by the Korean version of Child Depression Inventory (CDI), the Korean version of State and Trait Anxiety Inventory for Children (STAIC), and the Korean version of Child Behavior Checklist (K-CBCL). Results : As a result, depressive symptoms measured by CDI (p<0.05) and anxiety symptoms measured by STAIC (p<0.05) had significant influence on score change of social interaction domain of ADOS. It remained significant even after the baseline score was adjusted as covariates (p<0.05). Conclusion : We observed that pre-treatment anxiety and depressive symptoms of teenagers had significant effects on the treatment outcome of PEERS$^{(R)}$, especially in terms of face-to-face social interaction.

• 대한불안의학회지
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• 제15권1호
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• pp.1-12
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• 2019

Thought-action fusion (TAF) is a tendency to blindly assume causal relations between their thoughts and external reality. On the other hand, cognitive fusion (CF) is a tendency to take internal experiences, such as thoughts and feeling, literally rather than view them as random events. However, these two terms are often confusedly used and, in fact, have conceptual overlaps. Therefore, this study aimed to identify their distinctive features through a comprehensive review of the definition, origin, measurements and clinical implications especially on the understanding of obsessive-compulsive symptoms. The cognitive-behavioral concept of TAF is confined to erroneous and maladaptive beliefs about the connection between thoughts and behaviors. The CF is a broader construct that entails taking thoughts and feelings as facts and engaging or struggling with them such that the quality of life is lowered. They also have different theoretical backgrounds, developing processes and therapeutic approaches. From the perspective of the obsessive-compulsive disorder, both concepts have been studied as mid-structures for this illness. Recently, the effectiveness of psychological therapies related to these concepts such as defusion therapy has been tested. However, it is yet still in its infancy. In the future, complementary advances between the two concepts with studies on biological substrates is needed.

• 대한불안의학회지
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• 제18권1호
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• pp.26-31
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• 2022

Objective : The levels of resilience and gratitude were examined in psychiatric patients with depression and/or anxiety disorders and compared to those of the general population. In addition, we analyzed the associations of positive affect, negative affect, depressive and anxiety symptoms, and gratitude on resilience in this patient population. Methods : The participants included a general population sample (n=155) and psychiatric outpatients with depression and/or anxiety disorders (n=108). All participants completed self-report questionnaires, which included demographic variables, the Connor-Davidson Resilience Scale (CD-RISC), the Gratitude Questionnaire-Six-Item Form (GQ-6), the Positive Affect Negative Affect Scale (PANAS), and the Hospital Anxiety and Depression Scale (HADS). Results : The CD-RISC and GQ-6 scores of patients with depression and/or anxiety disorders were significantly lower than those of the general population. In the patient population, hierarchical regression analysis showed that gratitude was significantly associated with resilience while controlling for a range of demographic and clinical variables. Conclusion : Patients with depression and/or anxiety disorder generally had lower resilience and gratitude. Moreover, our findings showed that gratitude could influence the levels of resilience in patients with depression and/or anxiety disorders.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제34권1호
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• pp.30-36
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• 2023

Objectives: This study examined the changes in anxiety and depressive symptoms in the parents of Korean adults with autism spectrum disorder (ASD) after participating in the Korean version of the Program for the Education and Enrichment of Relational Skills for Young Adults (PEERS^® -YA-K). Methods: Forty-six parents were enrolled (mean age 54.7 years; 22 fathers and 24 mothers), of whom 27 participated in the PEERS^® - YA-K as social coaches. Participants completed self-report scales, including the Test of Young Adult Social Skills Knowledge (TYASSK), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Symptom Check-List-90-R (SCL-90-R). The scales were administered three times: before and after the 16-week program and 4 months after the program ended. Differences between participant variables at pretreatment, post-treatment, and follow-up were analyzed using paired-sample t-tests. Results: Participants showed a significant improvement in their social skills knowledge (TYASSK) (p<0.01). There was a significant improvement in the BAI and BDI scores of parents with severe depressive and anxiety symptoms at the baseline (p<0.05). Paternal paranoia and maternal hostility results also significantly improved on the SCL-90-R. Conclusion: This study suggests that PEERS^® -YA-K can reduce parental anxiety and depressive symptoms. To the best of our knowledge, this is the first to compare the degree of depression and anxiety after PEERS^® -YA-K in parents of adults with ASD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제34권4호
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• pp.275-282
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• 2023

Objectives: This study aimed to identify the psychiatric comorbidity status of adult patients diagnosed with attention-deficit hyperactivity disorder (ADHD) and determine the impact of comorbidities on neuropsychological outcomes in ADHD. Methods: The study participants were 124 adult patients with ADHD. Clinical psychiatric assessments were performed by two board-certified psychiatrists in accordance with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. All participants were assessed using the Mini-International Neuropsychiatric Interview Plus version 5.0.0 to evaluate comorbidities. After screening, neuropsychological outcomes were assessed using the Comprehensive Attention Test (CAT) and the Korean version of the Wechsler Adult Intelligence Scale, Fourth Edition (K-WAIS-IV). Results: Mood disorders (38.7%) were the most common comorbidity of ADHD, followed by anxiety (18.5%) and substance use disorders (13.7%). The ADHD with comorbidities group showed worse results on the Perceptual Organization Index and Working Memory Index sections of the K-WAIS than the ADHD-alone group (p=0.015 and p=0.024, respectively). In addition, the presence of comorbidities was associated with worse performance on simple visual commission errors in the CAT tests (p=0.024). Conclusion: These findings suggest that psychiatric comorbidities are associated with poor neuropsychological outcomes in adult patients with ADHD, highlighting the need to identify comorbidities in these patients.

• 대한불안의학회지
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• 제20권1호
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• pp.8-16
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• 2024

Objective : The purpose of this study is to compare the signal obtained from the frontal 2-electrodes EEG with that obtained from the temporal, central, and parietal 2 electrodes. Methods : EEGs were recorded in a total of 67 patients with major depressive disorder (MDD), 104 patients with schizophrenia (SCZ), and 29 patients with Alzheimer's disease (AD). For each disease group, there were healthy controls (HC) that were paired accordingly (HC1=69, HC2=104, HC3=27). The following measurements were compared across electrodes: band power, alpha peak frequency (APF), APF power, alpha asymmetry (AA), and Kolmogorov complexity (KC). Results : Statistically significant differences were found in band power measured from frontal electrodes compared to electrodes placed in other locations. Specifically, the power of theta waves was measured higher in the temporal electorodes, alpha 1 and alpha 2 waves in the parietal, beta 1 and beta 2 in the central, and gamma waves in the temporal electrodes. Both SCZ and AD patients showed increased theta power in all electrodes. In SCZ patients, APF decreased in the central and temporal electrodes, but the APF power analysis showed no difference between the patients and controls. Additionally, AD patients exhibited increased AA in the central EEG, while SCZ patients showed decreased KC in the parietal and temporal electrodes. Conclusion : Depending on the electrode location, sensitive EEG frequencies differed. Compared with signals from other electrodes, frontal EEG in MDD patients revealed generally constant signal values, though the temporo-parieto-central electrodes appeared to be more reliable in SCZ and AD patients.

• 대한불안의학회지
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• 제20권1호
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• pp.27-34
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• 2024

Objective : Cognitive fusion, or believability, in acceptance and commitment therapy (ACT), refers to the tendency to become entangled in one's thoughts or feelings. It is an important factor in the development and maintenance of anxiety disorders. However, there is a lack of validated self-report measures for cognitive fusion and defusion, particularly for individuals with anxiety. To address this gap, this study aimed to evaluate the Korean Version of Believability of Anxious Feelings and Thoughts Questionnaire (K-BAFT). Methods : A total of 608 university students and 85 patients with obsessive-compulsive disorder (OCD) took part in this study. They were asked to complete various psychological measures, including the K-BAFT, other measures of ACT processes, and symptom scales. The researchers then analyzed the psychometric characteristics of the K-BAFT. Results : The results of the exploratory and confirmatory factor analyses indicated that the three-factor structure of the K-BAFT, which was reported in the original study, was also found in the university sample. Additionally, both the student and the OCD group demonstrated strong internal consistency (α=0.86 and 0.91, respectively). In the university sample, the K-BAFT showed a strong correlation with the Cognitive Fusion Questionnaire (r_s=0.53, p<0.001). However, it had a weak correlation with symptoms scales for depression, anxiety, and stress (all r_s<0.32). Furthermore, the OCD group had higher scores on the K-BAFT compared to the university sample. Conclusion : K-BAFT is considered to be a reliable and valid self-report tool for measuring cognitive fusion with anxious thoughts and feelings.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제16권2호
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• pp.270-278
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• 2005

목적 : 입원치료가 필요한 주의력결핍/과잉운동장애(attention deficit/hyperactivity disorder ; 이하 ADHD) 환아의 임상 특성을 조사하기 위해 본 연구를 실시하였다. 방법 : 1996년 1월 1일부터 2002년 8월 31일까지 국립서울병원 소아청소년 병동에 입원하여 DSM-IV진단기준에 의해 ADHD로 진단받은 63명(남자 58명, 여자 5명) 소아, 청소년 환아의 병록지 검토를 통해 입원 시 주문제, 병력, 역학적 특성, 가족환경, 신경인지검사 결과, 치료반응 등을 조사하였다. 결과 : 입원치료가 필요한 심한 ADHD 환아의 남녀성비는 11.6 대 1 질환의 평균 발현연령은 5.3세(63.6mo, SD 24.3mo)였다. 공존정신장애는 품행장애 (Conduct disoder ; CD)가 35명 $(55.6\%)$으로 가장 많았고, 정신지체 24명 $(38.1\%)$, 기분장애 5명$(7.9\%)$, 틱장애 및 뚜렛장애 4$(6.4\%)$, 적대적 반항 장애 3명$(5.0\%)$이었다 입원시의 주문제는 ADHD의 증상범주에 속한 경우가 23명 $(36.5\%)$이었고, ADHD에 이차적으로 발현된 품행장애의 증상범주에 속한 경우가 37명$(58.7\%)$이었다. 동반한 비행의 시작 시기는 평균 9.0세(108.2mo, SD28.8mo)로 ADHD 발현이후 평균3.6년(42.9mo, SD32.0mo)후에 비행이 시작되었다. ADHD 발현시기가 빠를수록 비행이 빨리 나타났다(p<0.05). 결론 : 입원치료가 필요한 심한 ADHD 환아의 병의 경과, 역학적 특성, 정신사회적 인자들은 이전 연구에서 조사한 일반인구에서의 ADHD 환아의 특성과 비슷하였다. ADHD 초발연령은 평균 5.3세, 동반한 비행의 시작 시기는 평균 9.0세로 ADHD 발현 후 평균 3.6년의 기간 후에 시작하였고, ADHD 발현이 빠를수록 비행의 시작시기가 빨랐다. 입원 시의 주된 문제는 이차적으로 발현된 CD의 증상(비행문제)이 가장 많았고 약 $88.9\%$가 동반정신장애를 가지고 있었으며 CD가 가장 많았다.