• 정신신체의학
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• 제7권2호
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• pp.174-183
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• 1999

본 연구는 자동차사고 이후 신체적 증상에 대한 치료를 받은 후 정신과적 진단 및 치료 또는 정신감정을 위해 정신과로 의뢰되었던 44명의 환자를 대상으로 자동차사고와 외상후 스트레스장애와의 관계를 평가하기 위한 것이다. 외상후 스트레스장애 진단은 외상후 스트레스장애 척도(CAPS)를 사용하여 DSM-IV 진단기준에 따라 분류하였고, 축소형 부상척도(AIS)를 사용하여 신체적 손상과 외상후 스트레스장애 증상과의 관계를 조사하고 외상후 스트레스장애와 Axis I 공존질환 유무에 대해 알아 보았다. 자동차 사고후 정신과에 의뢰된 대상자 44명중 20명(45.5%)이 외상후 스트레스장애로 진단되었고 13명(29.5%)이 아증후성 외상후 스트레스장애에 속하였다. 신체적 부상의 정도는 외상후 스트레스장애 증상을 예견하는 것으로 나타났다. 외상후 스트레스장애군은 외상후 스트레스장애 진단 기준 BCD 모든 증상에서 높은 비율을 나타냈고, 아증후성 외상후 스트레스장애군은 기준 B와 D 증상에서 비교적 높은 비율을 나타냈으며, 두 군 모두 기준 B 가운데 '사건에 대한 반복된 꿈' 항목의 비율이 가장 높았다. 외상후 스트레스장애군의 55%가 주요우울증을 동반하였다. 결론적으로 본연구의 결과는 외상후 스트레스장애가 자동차사고 이후 흔히 올 수 있는 정신장애임을 시사하고 있다. 따라서 자동차사고 후 신체적 손상에 대한 치료를 받고 마지막으로 정신과에 의뢰된 환자들에 대해서는 적어도 치료계획에서 외상후 스트레스장애라는 진단을 정규적으로 고려해야만 할 젓이고. 특히 취약성이 있는 환자들에 대해서는 조기 중재가 외상후 스트레스장애 증상을 예방할 수 있을 것이라고 생각된다.

• 대한불안의학회지
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• 제9권2호
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• pp.121-127
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• 2013

Objective : Several studies have reported the association between posttraumatic stress disorder (PTSD) and hypertension (HTN). The aim of this study was to evaluate the impact of PTSD symptoms on blood pressure. Methods : Korean veterans of the Vietnam War with (n=62) or without PTSD (n=87) participated in this study. The clinician administered PTSD scale (CAPS) and alcohol use disorder identification test (AUDIT) were applied. Blood pressure, pulse rate, risk factors of HTN and demographic data of the subjects were collected. Effects of potential explanatory variables on HTN were analyzed with logistic regression. Results : Diastolic blood pressure was significantly higher in PTSD group (p=0.015). However, PTSD subjects showed significantly lower pulse rate than non-PTSD subjects (p=0.004). Logistic regression analysis showed that avoidance symptom might be a predictor for hypertension (OR=1.065, p=0.030). Conclusion : These results suggest that PTSD, especially avoidance symptom, might be a risk factor on HTN in the elderly with PTSD. Further studies are needed to evaluate the change of blood pressure according to the clinical improvement of PTSD.

• 한국심리학회지 : 문화 및 사회문제
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• 제28권2호
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• pp.187-217
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• 2022

본 연구는 한국판 외상 후 스트레스 장애 체크리스트-5(PCL-5)의 타당화 연구를 진행하였다. 이를 위해 성인을 대상으로 두 시점에서 온라인 설문을 1년 간격으로 실시하였고, 1시점에서는 1,077명, 2시점에서는 563명의 자료를 본 연구에서 사용하였다. 확인적 요인분석을 통해 1요인, 4요인, 6요인, 7요인의 모형 적합도를 확인한 결과, 4, 6, 7요인이 수용가능한 수준으로 나타났으며, 그 중 7, 6, 4요인 순으로 우수한 적합도를 보였다. 다음으로 내적일치도, 오메가 계수, 개념신뢰도, 분산추출지수, 검사-재검사 신뢰도를 확인한 결과 모두 양호한 것으로 나타났다. 타당도를 확인하기 위해 한국판 외상 후 스트레스 선별 평가지(K-PC-PTSD-5)와 단축형 간이정신진단 검사-18(BSI-18)와의 상관분석을 실시한 결과, 두 검사 모두와 정적상관이 나타났다. 한국판 PCL-5가 향후 PTSD, 우울, 불안, 신체화 증상을 예측할 수 있는지 확인하고자 위계적 다중회귀분석을 실시한 결과, 1시점에서 한국판 PCL-5로 측정한 PTSD 증상이 2시점의 PTSD, 우울, 불안, 신체화 증상을 예측하는 것으로 나타났다. 본 연구에서는 ROC 곡선 분석을 통해 PCL-5의 PTSD 증상집단 구분에 대한 변별력을 확인하고 최적 절단점을 제시하였다. PCL-5의 한국판 종단타당화 결과, 본 척도가 한국인에게 신뢰롭고 타당한 척도인 것으로 나타났다. 본 연구는 예측타당도 분석을 통해 한국판 PCL-5가 PTSD 증상뿐만 아니라 우울, 불안, 신체화와 같은 PTSD 관련 증상을 예측가능함을 제시하였으며, PTSD 증상집단에 대한 변별이 가능한 절단점을 제시하였다는 점에서 PTSD 증상을 측정하는 기존 타당화 연구와 차별점을 지닌다.

• 대한불안의학회지
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• 제2권1호
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• pp.39-44
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• 2006

Objective : Chronic posttraumatic stress disorder (PTSD) is defined by the coexistence of symptoms (reexperiencing, avoidance and hyperarousal), persisting for more than months or years that causes significant impairment in social occupational functioning. This study was conducted to evaluate the effects of terazosin on posttraumatic nightmares which is one of chronic PTSD symptoms. Methods : Twenty patients with chronic PTSD and severe trauma-related nightmares were treated with terazosin (3-7 mg/day) for 8 weeks. Recurrent distressing dreams item of the Clinician administered PTSD Scale (CAPS), Total CAPS score, Clinical Global Impressions-Severity Scale (CGI-S) and Clinical Global Impressions-Change Scale (CGI-C) were performed at baseline, 4-week and 8-week. Mississippi Scale for Combat-Related PTSD and Combat Exposure Scale (CES) were used to evaluate PTSD symptom pattern and degree of exposure. Results : Significant decrease in recurrent distressing dreams item, reexperiencing, avoidance and hyperarousal symptom score and total CAPS score were at 4-week and 8-week treatment compared to baseline (recurrent distressing dreams item : $2.70{\pm}1.88$ and $1.25{\pm}1.49$ ; reexperiencing, avoidance and hyperarousal symptom score : $2.30{\pm}2.49$, $1.20{\pm}1.05$, $3.10{\pm}1.68$ and $4.00{\pm}3.59$, $1.55{\pm}1.50$, $5.60{\pm}3.23$ ; total CAPS score : $8.20{\pm}6.26$ and $5.40{\pm}5.89$). There were significant correlation between dosage of terazosin and improvement of PTSD symptoms. Adverse effects such as fatigue and orthostatic hypotension were showed, which were mild and self-limited. Conclusion : These results suggest that terazosin may improve severe trauma-related nightmares and overall PTSD symptoms. Randomized controlled study with more subjects would be necessary in the future.

• 대한가정학회지
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• 제48권3호
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• pp.55-69
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• 2010

A college student who exhibited several post traumatic stress disorder (PTSD) symptoms was used as a case study in order to investigate the therapeutic effects of sandplay therapy for PTSD sufferers. In total, 27 sessions of the sandplay treatment program were used to conduct psychological tests before and after the sessions. Any changes in the manner of expressions on the sand box during the treatment, and the results of pre and post psychological tests on aspects of depression, anxiety and interrelationships were analyzed. Overall results showed that the subject exhibited progressive behavioral improvement and signs of recovery. Psychological tests revealed reduced levels of depression and anxiety, and improved interrelationship scores. In conclusion, sandplay therapy does exhibit positive benefits as an effective treatment modality for PTSD in adolescents and young adults.

• 대한불안의학회지
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• 제18권1호
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• pp.1-9
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• 2022

Mindfulness has been widely researched in mental, physical health, and healthy populations. The effectiveness of mindfulness-based interventions have also been demonstrated in research studies. This report reviews the research on mindfulness based interventions currently employed for the treatment of posttraumatic stress disorder (PTSD). Mindfulness-based theories postulate that symptoms of PTSD are developed and maintained by experiential avoidance and non-mindful behaviors. Recent emerging work indicates that mindfulness based interventions, such as mindfulness-based stress reduction and mindfulness-based cognitive therapy, may improve the symptoms of PTSD. Further advances are needed to gain a better understanding of the ability of mindfulness based interventions to target specific symptom dimensions of PTSD and the psychological/neurobiological mechanisms of actions underlying these interventions.

• 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.

• 대한불안의학회지
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• 제4권2호
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• pp.142-147
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• 2008

Objective : Evidence from recent studies supports the role of genetic factors in the development of Posttraumatic Stress Disorder (PTSD). The primary aim of this study is to investigate the association between the dopamine D2 receptor (DRD2) TaqI A polymorphism and PTSD. The second aim is to examine the association between the DRD2 TaqI A polymorphism and clinical symptoms in patients with PTSD. Methods : We recruited 189 Vietnam veterans for participation in this study, among whom 99 were PTSD patients and 90 were control subjects. The presence of the DRD2 TaqI A polymorphism was determined by polymerase chain reaction (PCR). Several standardized research scales were used in the clinical assessment of PTSD, including the Combat Exposure Scale (CES), Clinician Administered PTSD Scale (CAPS), Beck Depression Inventory (BDI), and Clinical Global Impression (CGI). Results : There was no significant difference in the distribution of the DRD2 genotype, frequency and prevalence of the A1 allele, or the frequency of heterozygotes between the patients with PTSD and the controls. In the PTSD group, the patients with the A1 allele (A1A1, A1A2) scored higher on the CAPS-total (p=0.044), CAPS-avoidance symptoms (p=0.016) and BDI (p=0.024) than those without the A1 allele (A2A2). Conclusion : We could not find an association between the dopamine D2 receptor (DRD2) TaqI A polymorphism and PTSD. However, the A1 allele of DRD2 seemsto influence avoidance symptoms in patients with PTSD.

• 한국심리학회지 : 문화 및 사회문제
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• 제25권4호
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• pp.325-351
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• 2019

본 연구는 외상 사건을 경험한 국내 성인의 외상 후 스트레스(Post Traumatic Stress Disorder) 증상과 외상 후 성장(Post Traumatic Growth) 양상을 토대로 잠재계층(latent class)을 도출하고, 각 집단 구분에 영향을 미치는 특성을 탐색하며, 집단에 따른 자기파괴적 행동의 차이를 탐색함으로써, 외상 사건을 경험한 개인에 대해 보다 심층적으로 이해하고자 한다. 이를 위해 본 연구에서는 DSM-5 진단기준에 해당하는 외상 사건을 경험한 국내성인 860명을 대상으로 잠재프로파일분석(Latent Profile Analysis)과 R-3STEP 방식을 이용하였다. 집단 예측 변인으로 개인의 인구사회학적 변인(성별, 연령, 최종 학력, 종교유무, 종교활동 정도, 월 평균 소득)과 사회적 고립, 외상 경험 빈도가 포함되었으며, 종속변인으로 자기파괴적 행동(폭식 정도, 비자살적 자해 유무, 음주의 양, 음주 형태, 음주로 인한 정신 사회적 문제)을 포함하였다. 연구결과 집단은 '저PTSD/중 PTG집단', '저 PTSD/고 PTG집단', '고 PTSD/고 PTG집단'으로 분류되었다. 또한 성별, 최종학력, 사회적 고립, 외상 노출 빈도가 집단 예측 변인으로 영향을 미치는 것으로 나타났으며, 폭식 정도, 비자살적 자해 유무, 음주 형태, 음주로 인한 정신사회적인 문제에서 집단 간 차이가 있는 것으로 나타났다. 마지막으로 본 연구의 결과를 바탕으로 논의와 시사점을 제시하였다.

• 대한불안의학회지
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• 제9권1호
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• pp.19-24
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• 2013

Objectives: The objective of this study is to examine the association between the children's psychopathology and age, intellectual quotient, and parental psychopathology in children with post-traumatic stress disorder (PTSD). Methods: The emotional and behavioral problems of 35 children with PTSD (23 boys, 12 girls, mean age, $10.26{\pm}2.47$ years) were investigated by retrospective chart review. Their parents' anxiety and depression symptoms were also investigated. We examined the correlations between children's psychopathology and their parents' anxiety and depression symptoms, as well as their age and IQ. Results: There were positive correlations between maternal trait anxiety and depression, and children's emotional problems. State and trait anxiety of children with PTSD were positively correlated with age, and attention-deficit hyperactivity disorder symptoms were negatively correlated with age. Conclusion: Our results suggest that psychiatric manifestation of children who experienced trauma could differ according to the development stage, and the treatment of children with PTSD should involve parental education about the effect of maternal emotional states on children.