• Anxiety and mood
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• v.7 no.2
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• pp.92-100
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• 2011

Objectives : The aim of this study was to investigate Post Traumatic Stress Disorder (PTSD)-related symptom severity, level of functional impairment and personality profiles between full-blown PTSD, partial PTSD and non-PTSD groups among 59 adolescent survivals from the Incheon fire disaster. Method : Using Short Screening Scale for DSM-IV PTSD, victims of the disaster were assigned to a full-blown PTSD group (n=18), a partial PTSD (n=22), or a non-PTSD group (n=19). Assessments included the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), the Impact of Event Scales (IES), the McBride's Degree of General Labor Loss, and the Korean Version of Temperament and Character Inventory (K-TCI). Results : Significantly severe PTSD symptoms (F=4.832, df=2, p<.05) and functional impairment (F=12.144, df=2, p<.01) were demonstrated by PTSD groups as compared to the non-PTSD group. Interestingly, full and partial PTSD did not differ in these comparisons. Similarly, the subtypes of PTSD did not differ with respect to personality profiles using the K-TCI ; however, personality profiles were sharply differentiated between the PTSD and non-PTSD group. Conclusion : Although high subject homogeneity and small sample size may limit the results of this study, the present results highlight the possibility of the underestimation as well as the insufficient, treatment and compensation of partial vs full PTSD.

• Anxiety and mood
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• v.11 no.2
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• pp.91-105
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• 2015

Objectives : After disaster, some people develop posttraumatic stress sequelae such as posttraumatic stress disorder (PTSD), major depression, substance use disorders, and suicide. To date, numerous screening and assessment tools for behavioral health issues including mental health problems, psychosocial maladjustment and status of recovery after disaster have been developed. In this condition, one of important topics is to choose instruments that can quickly and accurately measure the issues. Methods : This article reviewed several self-reported scales in adults for disaster behavioral health, which were searched using academic search engines like PubMed, Scopus, KoreaMed and KISS from the earliest available date of indexing through January 31, 2015. Results : More than 40 eligible instruments evaluating the disaster behavioral health issues containing posttraumatic stress sequelae, psychological and social resources, non-disaster stress, and general functions were presented in terms of availability, effectiveness, and expeditiousness. Also, we introduced basic frame aiming on practical usage, which includes standard version and brief version of the instruments for disaster behavioral health. Conclusion : We suggest the accessibility and the applicability of assessment instruments for disaster behavioral health. The systemic review of this article will provide further directions for them.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.10 no.1
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• pp.43-49
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• 1999

Objectives：One of the most common developmental problems is communication disorder in which a child appears normal in every way but who has failed to begin speaking or speaks very little. A few studies have examined the temperamental characteristics of children with communication disorders. This study was to investigate the temperamental characteristics of Korean children with communication disorders. Methods：The parents of 20 Korean children with communication disorders and the parents of 50 normal control children, the age of both groups ranges from 3 to 7, completed Korean version of Parental Temperamental Questionnaire developed by Thomas and Chess. Children with a pervasive developmental disorder, mental retardation, or speech-motor or sensory deficit were excluded. The scores of each temperamental scale of two groups and the diagnostic clusters of two groups were compared. Results：The children with communication disorders were characterized by lower mood scores and higher intensity of reaction scores than normal controls. The two groups showed no significant correlation in terms of the temperamental diagnostic clusters. Conclusion：This findings suggest the existence of a distinct temperamental profile of the children with communication disorders. Early detection of the profile may be of great value for parents in understanding the developmental characteristics of the children with communication disorders and in providing appropriate parenting approaches.

• Korean Journal of Biological Psychiatry
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• v.21 no.4
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• pp.168-174
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• 2014

Objectives Sensory gating dysfunctions in patients with schizophrenia and bipolar disorder have been investigated through two similar methods ; P50 suppression and prepulse inhibition paradigms. However, recent studies have demonstrated that the two measures are not correlated but rather constitute as distinct neural processes. Recent studies adopting spectral frequency analysis suggest that P50 suppression reflects the interaction between gamma and other frequency bands. The aim of the present study is to investigate which frequency component shows more significant interaction with gamma band. Methods A total of 108 mood disorder patients and 36 normal subjects were included in the study. The P50 responses to conditioning and test stimuli with an intra-pair interval of 500 msec were measured in the study population. According to P50 ratio (amplitude to the test stimulus/amplitude to the conditioning stimulus), the subjects with P50 ratio less than 0.2 were defined as suppressed group (SG) ; non-suppressed group (NSG) consisted of P50 ratio more than 0.8. Thirty-five and 25 subjects were included in SG and NSG, respectively. Point-to-point correlation coefficients (PPCCs) of both groups were calculated between two time-windows : the first window (S1) was defined as the time-window of one hundred millisecond after the conditioning auditory stimulus and the second window (S2) was defined as the time-window of 100 msec after the test auditory stimulus. Spectral frequency analysis was performed to investigate which frequency band results in the difference of PPCC between SG and NSG. Results Significant reduction of PPCC between S1 and S2 was observed in the SG (Pearson's r = 0.24), compared to PPCC of the NSG (r = 0.58, p < 0.05). In spectral frequency analysis, gamma band showed "phase-reset" and similar responses after the two auditory stimuli in suppressed and non-suppressed group. However in the case of alpha band, comparison showed significantly low PPCC in SG (r = -0.14) compared to NSG (r = 0.36, p < 0.05). This may be reflecting "phase-out" of alpha band against gamma band at approximately 50 msecs after the test stimulus in the SG. Conclusions Our study suggests that normal P50 suppression is caused by phase-out of alpha band against gamma band after the second auditory stimulus. Thus it is demonstrated that normal sensory gating process is constituted with attenuated alpha power, superimposed on consistent gamma response. Implications of preserved gamma and decreased alpha band in sensory gating function are discussed.

• 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.

• Journal of the Korea Convergence Society
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• v.6 no.2
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• pp.13-18
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• 2015

The purpose of the study is to investigate the predisposing factors of posttraumatic stress disorder (PTSD) in fire fighters in Korea and to suggest the program development and solution to the critical incident stress management (CISM) in the future. PTSD is characterized by invasion, withdrawal, negative change of cognition and mood, and hypersensitivity. Trauma memory includes explicit memory and implicit memory. The explicit memory is conscious, cognitive, and descriptive and is controlled by hippocampus. The data of explicit memory have inhibitive and narrative language structure. The implicit memory is inconscious, emotional, and remembered by the body. The implicit memory is controlled by amygdala and has inexpressive language structure. The deletion of implicit memory is the key point to trauma treatment. Critical incident stress management (CISM) is the approach for the solution of PTSD. In conclusion, the essential goal of CISM is the psychological cessation of PTSD. This study tried to suggest the education program development of PTSD.

• 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.

• Anxiety and mood
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• v.14 no.2
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• pp.88-98
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• 2018

Objective : The purpose of this study was to establish a school-based mental health intervention. The success of which was indexed by its effects on the social anxiety symptoms of the enrolled adolescents. Methods : This program for promoting mental health among adolescents in the community was adopted by three middle schools that volunteered to participate in the project. The program included screening for emotional problems related to social anxiety, depression, suicide, and post-traumatic stress disorder. Case management was provided for groups considered high-risk for depression, suicide, or post-traumatic stress disorder; cognitive-behavior therapy was provided for those at high-risk of developing social anxiety. Additionally, educational programs for the prevention of suicide, a "loving life" module, and mental health promotional campaigns were also included. In total, 1,100 middle school students completed self-report questionnaires. Twenty-five students in the high-risk group for social anxiety participated in a cognitive-behavior therapy program, comprising eight sessions, and conducted by two clinical psychologists. Results : Following the suicide prevention education program, suicide awareness among students increased and coping strategies were improved. In addition, the loving life program was associated with positive self-perceptions by many students. Furthermore, social anxiety symptoms showed a statistically significant difference after the cognitive-behavior therapy program. After the therapy, not only did social anxiety symptoms improve, depressive symptoms and suicidal ideation decreased significantly, while self-esteem and psychological resilience significantly increased. Conclusion : A school-based mental health intervention was successfully implemented in three middle schools and improved the mental health of the participating students. Therefore, this intervention could be widely implemented to promote positive mental health among middle school students.

• Anxiety and mood
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• v.15 no.2
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• pp.101-108
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• 2019

Objective : This study aimed to investigate the associations of anxiety symptoms with behavior and attention in elementary school children with attention-deficit/hyperactivity disorder (ADHD). Methods : A total of 195 elementary school children with ADHD participated in the study. The Korean Version of ADHD Rating Scale (K-ARS) and Behavior Assessment System for Children(BASC-2) were used to measure the children's behavior. Anxiety and attention was assessed with State-Trait Anxiety Inventory for Children (STAIC) and ADHD Diagnostic System (ADS), respectively. Children with ADHD were categorized to two groups of ADHD with low anxiety (ADHD-LA) and ADHD with high anxiety (ADHD-HA) according to the total STAIC scores. Scores on K-ARS, BASC-2 and ADS were compared between two groups of ADHD-LA and ADHD-HA. Results : The Scores on K-ARS total and both subscales in ADHD-HA group were significantly higher than ADHD-LA group. Scores on the BASC-2 subscales including hyperactivity, aggression, conduct problem, anxiety, depression, somatization, withdrawal, attention problems were also significantly higher in ADHD-HA group compared to ADHD-LA group. In contrary, scores on ADS subscales were not significantly different between the both groups. Conclusion : Our study identified that the anxiety accompanied with ADHD was associated with the negative behavioral aspect in children with ADHD. However, the performances on attention task were not affected by the anxiety comorbid with ADHD. Future studies to reveal underlying mechanism are needed for further understanding the association with anxiety and ADHD.

• Journal of Preventive Medicine and Public Health
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• v.49 no.1
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• pp.53-60
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• 2016

Objectives: The purpose of this study is to examine the magnitude of and the factors associated with the downward mobility of first-episode psychiatric patients. Methods: This study used the claims data from the Korean Health Insurance Review and Assessment Service. The study population included 19 293 first-episode psychiatric inpatients diagnosed with alcohol use disorder (International Classification of Diseases, 10th revision [ICD-10] code F10), schizophrenia and related disorders (ICD-10 codes F20-F29), and mood disorders (ICD-10 codes F30-F33) in the first half of 2005. This study included only National Health Insurance beneficiaries in 2005. The dependent variable was the occurrence of downward mobility, which was defined as a health insurance status change from National Health Insurance to Medical Aid. Logistic regression analysis was used to assess factors associated with downward drift of first-episode psychiatric patients. Results: About 10% of the study population who were National Health Insurance beneficiaries in 2005 became Medical Aid recipients in 2007. The logistic regression analysis showed that age, gender, primary diagnosis, type of hospital at first admission, regular use of outpatient clinic, and long-term hospitalization are significant predictors in determining downward drift in newly diagnosed psychiatric patients. Conclusions: This research showed that the downward mobility of psychiatric patients is affected by long-term hospitalization and medical care utilization. The findings suggest that early intensive intervention might reduce long-term hospitalization and the downward mobility of psychiatric patients.