• 한국콘텐츠학회논문지
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• 제21권12호
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• pp.621-631
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• 2021

본 연구는 청소년의 학교폭력 피해 경험이 복합 외상 후 스트레스에 미치는 영향과 이 관계에서 자아존중감의 조절효과를 검증하고자 하였다. 이를 위해 291명의 청소년을 대상으로 조사된 자료를 연구에 활용하였으며, 조절회귀분석을 통해 연구모형을 검증하였다. 연구 결과, 학교폭력 피해 경험과 자아존중감은 복합 외상 후 스트레스에 유의미한 영향을 가진 것으로 나타나 학교폭력 피해 경험의 수준이 높을수록, 자아존중감이 낮을수록 복합 외상 후 스트레스가 증가하게 됨을 확인하였다. 또한 자아존중감은 학교폭력 피해 경험이 복합 외상 후 스트레스에 미치는 영향을 조절하고 있음을 확인하여 같은 수준의 학교폭력 피해 경험이 있더라도 자아존중감이 높은 경우 복합외상 후 스트레스의 문제를 완화할 수 있음을 확인하였다. 연구 결과를 바탕으로 청소년의 학교폭력과 이로 인해 발생하는 복합 외상 후 스트레스의 문제를 완화하기 위한 방안을 제시하였다.

• 동의신경정신과학회지
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• 제34권3호
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• pp.307-317
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• 2023

Objectives: To introduce the progress of treatment and improve clinical use after application of Emotion-to-Emotion Therapy (ETE Therapy) for treating Post-traumatic Stress Disorder (PTSD). Methods: A patient who was diagnosed with PTSD that occurred after violence in the family mainly complained about abdominal pain, depression, and fear. We treated the patient with ETE therapy as the main treatment. Subjective Units of Distress scale (SUDs), The Core Seven-Emotions Inventory Short Form (CSEI-s), and Mentalizing the Rooms of Mind (MRM) were evaluated before and after the treatment for assessing the clinical effect. Results: After treatment, overall clinical symptoms of the patient were alleviated. This result was supported by a decrease in SUDs. There were meaningful drops in 'Fear', 'Fright', 'Sorrow' in CSEI-s scores, consistent with the direction of 'Sa-seung-Gong (思勝恐)' used as major technique of ETE therapy. Resources and positive emotions in MRM were increased after treatment. Conclusions: ETE therapy may be effective for treating PTSD. It might play a significant role in cognitive reconstruction.

• 중환자간호학회지
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• 제13권3호
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• pp.62-74
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• 2020

Purpose : This study aimed to investigate the prevalence and risk factors of mental health problems in patients discharged from the intensive care unit (ICU). Methods : This was a secondary analysis study using data from a multicenter prospective cohort of post-ICU patients. We analyzed data of 311 patients enrolled in the primary cohort study who responded to the mental health questionnaire three months after the discharge. Anxiety and depression were measured on the Hospital Anxiety-Depression Scale, and post-traumatic stress disorder (PTSD) was measured on the Posttraumatic Diagnostic Scale. Results : The prevalence of anxiety, depression, and PTSD in patients at three months after ICU discharge were 25.7%, 17.4%, and 18.0%, respectively, and 7.7% of them experienced all three problems. Unemployment (OR=1.99, p=.033) and unplanned ICU admission (OR=2.28, p=.017) were risk factors for depression, while women gender (OR=2.34, p=.009), comorbid diseases (OR=2.88, p=.004), non-surgical ICUs (trauma ICU: OR=7.31, p=.002, medical ICU: OR=3.72, p=.007, neurological ICU: OR=2.95, p=.019) and delirium (OR=2.89, p=.009) were risk factors for PTSD. Conclusion : ICU nurses should proactively monitor risk factors for post-ICU mental health problems. In particular, guidelines on the detection and management of delirium in critically ill patients should be observed.

• Journal of Korean Biological Nursing Science
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• 제24권1호
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• pp.1-16
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• 2022

Purpose: Recently, oxytocin has been introduced experimentally as a pharmacological treatment for post-traumatic stress disorder (PTSD). This study attempted to investigate the possibility of oxytocin as a treatment option for patients with PTSD by examining its dose, interval, and effectiveness in patients with PTSD. Methods: A systematic review was done on articles published from 1967 to 2020 using the PubMed, PsycINFO, and Cochrane databases. Our inclusion criteria were 1) subjects 18 years of age or older diagnosed with PTSD or exposed to a traumatic event that met criterion A of the Diagnostic and Statistical Manual of Mental Disorders (DSM) for PTSD, 2) oxytocin was administered at least once, 3) clinical trials, and 4) studies published in Korean or English. Two independent researchers reviewed 22 articles and recorded the contents. The risk of bias was evaluated to determine the quality of the reviewed article. Results: The parameters for evaluating the effectiveness of oxytocin were identified as socio-behavioral measures in 11 articles, neuronal imaging in 9, and biomarkers in 4. In 5 papers, oxytocin was administered multiple times. Socio-behavioral measures were improved in 3 out of 5 studies in which oxytocin was administered multiple times. In 2 studies in which prolonged exposure treatment and nasal oxytocin administration were combined for 10 weeks, patient symptoms were decreased compared to the control group. Conclusion: The possibility of oxytocin as an adjuvant treatment for PTSD psychotherapy was confirmed. Further studies are necessary to evaluate the long term effectiveness of administering oxytocin multiple times combined with psychotherapy.

• 한국산학기술학회논문지
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• 제18권7호
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• pp.539-547
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• 2017

본 연구는 작업치료를 전공하는 학생을 대상으로 재난 및 외상 후 스트레스장애에 대한 인식 조사를 실시하여 그 결과를 향후 작업치료 교육에 필요한 기초자료를 제공할 목적으로 진행되었다. 전국에 있는 3년제와 4년제 대학의 작업치료과 재학생 545명에 대한 설문조사를 실시하여 연구를 진행하였다. 설문조사결과는 SPSS 19.0 win 프로그램을 활용하여 빈도 분석(Frequency analysis)을 통해 빈도백분율을 산출하였다. 분석된 설문자료의 검증을 위하여 카이제곱검정을 실시하였다. 설문항에 대한 Cronbach'alpha는 0.891이다. 조사결과에 의하면 작업치료를 전공으로 하고 있는 학습자의 약 20%가 외상 후 스트레스장애의 증상 및 발생기전 그리고 진단기준에 대해서 인지하지 못하였다. 산업재해를 통해 신체적인 손상뿐 아니라 외상 후 스트레스장애와 같은 정신적인 증상을 초래하는 근본적인 이유에 대한 지식은 Likert 5점 척도로 2.92로 충분하지 못했다. 재활치료를 효과적으로 하기 위해서 작업치료적인 측면에서 접근하는 교육을 실시하여야 하는가에 대해서는 Likert 5점 척도로 3.90으로 매우 중요하게 생각하였다. 재난에 대한 인지도간의 상관성보다 재난에 대한 교육의 필요성에 대한 Pearson 상관계수가 높게 나타났다.

• 대한불안의학회지
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• 제18권2호
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• pp.39-47
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• 2022

Objective : This study investigated brain functional connectivity in male firefighters who showed subclinical post-traumatic stress disorder (PTSD) symptoms. Methods : We compared the data of 17 firefighters who were not diagnosed with PTSD and 18 healthy controls who had no trauma exposure. The following instruments were applied to assess psychiatric symptoms: Korean version of the Post-traumatic stress disorder Checklist for DSM-5 (PCL-5-K), Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI). For all subjects, functional magnetic resonance imaging was performed, and functional connectivity was compared between the two groups (family-wise error-corrected p<0.05). Additionally, correlations between psychiatric symptoms and functional connectivity were explored. Results : The following connectivity was higher than that of healthy controls: 1) the central opercular cortex-superior temporal gyrus, 2) planum polare-parahippocampal gyrus, 3) angular gyrus-amygdala, and 4) temporal fusiform cortex-parahippocampal gyrus. The functional connectivity of 1) the lateral occipital cortex-inferior temporal gyrus, 2) superior parietal lobule-caudate, and 3) middle temporal gyrus-thalamus were lower in firefighters. In firefighters, the connectivity of the planum polare-parahippocampal gyrus showed a negative correlation with the severity of arousal symptoms (rho=-0.586, p=0.013). The connectivity of the middle temporal gyrus-thalamus showed a positive correlation with the severity of intrusion (rho=0.552, p=0.022) and arousal symptoms (rho=0.619, p=0.008). The connectivity of the temporal fusiform cortex-parahippocampal gyrus was negatively correlated with intrusion (rho=-0.491, p=0.045) and arousal (rho=-0.579, p=0.015). Conclusion : Our results indicate that the brain functional connectivity is associated with occupational trauma exposure in firefighters without PTSD. Therefore, this study provides evidence that close monitoring and early intervention are important for firefighters with traumatic experience even at a subthreshold level.

• 대한불안의학회지
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• 제12권2호
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• pp.69-78
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• 2016

Objective : Disaster causes psychological distress to a large number of people in a short period of time, by both direct and indirect exposure to traumatic events embedded in various realms of disaster experience. Optimal, well-planned treatment interventions should follow from the early acute period to recovery phase, extending up to several months later. In this context, there is an increasing need for systemic review to gain comprehensive insights for disaster interventions. These need to be added to public policy, and for the prevention and treatment of disaster-related psychopathology. Here, we review the published studies on psychological interventions for disaster-related posttraumatic stress disorder. Methods : Specific psychological interventions regarded as effective treatments for have been selected for this review, such as CBT (Cognitive-Behavior Therapy), Exposure Therapy, EMDR (Eye Movement Desensitization & Reprocessing), SIT (Stress Inoculation Therapy) and Psychoeducation. In addition, natural disasters, industrial disasters, and accidents involving aircraft and ships were also categorized as disasters, along with war and combat trauma. Results : Cognitive behavior therapy and exposure therapy had the strongest research support for effectiveness, and could be considered as the first-choice treatment for disaster-related PTSD. The second line of treatment is EMDR, although this treatment modality has the advantage of reaching certain treatment improvements in fewer sessions. However, the effects of SIT and psychoeducation to the survivors of disasters, remains unclear at this point. Additionally, we propose the possibilities of using virtual reality component and imagery rescripting as modified forms of traditional cognitive behavior therapy and exposure therapy. Conclusion : Cognitive behavior therapy and exposure therapy, deemed effective treatments for various trauma, are considered to be effective for survivors from disasters. However, the efficacy of other interventions has not yet been examined methodologically in well-designed studies, such as randomized controlled trials. In particular, future empirical studies are needed, since it is difficult to conclude that psychological interventions have similar effects on different types of disasters.

• 스트레스연구
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• 제26권4호
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• pp.319-326
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• 2018

본 연구는 2012년부터 2015년까지 자연재난 피해자 1,182명의 자료를 활용하여 재난피해자의 외상 후 스트레스 증상을 예측하기위해 수행되었다. 연구결과는 아래와 같다. 첫번째, t-test 분석결과 PTSD군과 비PTSD군은 대인관계 만족, 대인관계 신뢰, 불안, 우울, 주관적 웰빙에서 통계적으로 유의미한 차이가 있는 것으로 나타났다. 두번째, 로지스틱 회귀분석결과 재난 PTSD발병에 영향을 미치는 요인은 재난 전 정신건강 문제, 트라우마 경험, 재난당시 인명피해 경험, 재난 후 자산감소, 경제적 어려움, 대인관계 신뢰 및 만족으로 나타났다. 본 연구는 재난피해자의 PTSD에 영향을 미치는 요인을 확인하여 PTSD예방을 위한 심리사회적 중재프로그램 개발에 기초자료로 활용할 수 있다는데 의의가 있다.

• 중환자간호학회지
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• 제12권1호
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• pp.22-35
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• 2019

Purpose : This study was to determine the levels of environmental stressor, posttraumatic stress disorder, and quality of life in intensive care units (ICU) survivors after intensive care, and to explore the factors affecting posttraumatic stress disorder and quality of life. Methods: With a longitudinal survey design, data were collected from 116 patients who were discharged from the ICU of a university hospital. The environmental stressor, posttraumatic stress disorder, and quality of life were measured immediately following and 1 month after the ICU discharge. Results: Of all the subjects, 16.4% experienced posttraumatic stress disorder after discharge. Multiple regression analysis revealed that ICU environmental stressors, experience of ICU readmission, using psychotropic drugs and narcotic analgesics, and ICU admission after surgery or cardiac intervention accounted for 22.2% of posttraumatic stress disorder. Posttraumatic stress disorder and sedation status when entering ICU accounted for 28.3% of the quality of life 1 month after ICU discharge. Conclusion: Nursing interventions focused on ICU environmental stressors would not only reduce environmental stress but also contribute to the reduction of posttraumatic stress disorder and later improvement of quality of life.

• 한국화재소방학회논문지
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• 제34권3호
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• pp.126-133
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• 2020

본 연구는 소방공무원의 무조건적 자기수용과 자기노출이 외상 후 성장에 미치는 영향을 알아봄으로써 외상 후 스트레스 장애 등 병리적 결과에 머물지 않고 이전 수준을 뛰어넘는 외상 후 성장을 이룰 수 있는 프로그램 개발 등에 도움을 주고자 하였다. 이를 위해 무조건적 자기수용, 자기노출, 한국판 외상 후 성장 척도 등을 활용하였으며, 연구결과는 다음과 같다. 첫째, 소방공무원의 무조건적 자기수용, 자기노출이 외상 후 성장과 상관관계가 있음이 확인되었다. 둘째, 소방공무원의 무조건적 자기수용과 자기노출 변인 중 외상 후 성장에 미치는 상대적 영향력을 알아보기 위해 위계적 회귀분석을 실시한 결과, 무조건적 자기수용이 자기노출 보다 더 많은 영향을 주는 것으로 확인되었다. 본 연구결과를 토대로 소방공무원 외상 후 성장을 촉진시키는 프로그램 개발 방향 및 치료적 개입 전략 등을 제안하였다.