• Title/Summary/Keyword: Post-traumatic Stress disorders

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Review of Psychological Treatment for Post-Traumatic Stress Disorder : Focus on Survivors of Disaster (외상후 스트레스 장애에 대한 심리치료 효과 개관 : 재난 생존자를 중심으로)

  • Jang, Eun-Young;Lee, Hyunji;Kim, Daeho
    • Anxiety and mood
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    • v.12 no.2
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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.

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A Literature Review of Compassion Fatigue in Nursing (간호사의 공감피로 문헌분석)

  • Yang, Young-Hee;Kim, Jong-Kyung
    • Korean Journal of Adult Nursing
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    • v.24 no.1
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    • pp.38-51
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    • 2012
  • Purpose: In this study the literature of compassion fatigue in nurses was reviewed in order to analyze the trends of overall research for level of fatigue, symptoms, and factors. Methods: For this study, five databases were searched using the key words 'compassion fatigue', 'secondary traumatization', 'secondary traumatic stress', and 'vicarious traumatization'. Thirty-six papers were analyzed. Results: Most of the compassion fatigue research (86%) was conducted between 2006 and 2011 and the most frequent research approach was quantitative research with the ProQOL which was the most frequently used instrument in the studies. He research was conducted in pediatric, emergency & trauma, oncology, psychiatric, and hospice units with no consistent patterns of t compassion fatigue levels. Factors affecting compassion fatigue were personal factors such as age, education background, work-related factors such as caring for trauma patients, work hours, psychological factors such as work stress, burnout, and support/coping factors such as organizational support, and coping resources. Conclusion: Nurses' compassion fatigue varied from low to high by nursing specialties. Many factors affected the compassion fatigue of nurses. In the future there is a need for study on Korean nurses, and identification of groups at risk for compassion fatigue. Furthermore there is a need to develop management programs on compassion fatigue in nurses, stress reduction and wellbeing.

Complex Trauma and Disorder of Extreme Stress(DESNOS) (복합외상과 극단적 스트레스 장애)

  • Park, Seon-Cheol;Kim, Seok-Hyeon
    • Anxiety and mood
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    • v.5 no.2
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    • pp.80-88
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    • 2009
  • Disorder of Extreme Stress, Not Otherwise Specified (DESNOS) is the proposed diagnosis that meets the severe, complex, and prolonged psychological sequela of victims with chronic traumatization (e.g., family violence, incest, and childhood sexual or physical abuse). The hallmarks of DESNOS are a multiplicity of symptoms (e.g., somatization, dissociation, and depression), pathological changes in relationships, identity disturbances, and a propensity to experience repeated harm and injury at the hands of oneself and others. DESNOS can be directly assessed by Structured Interview of Disorder of Extreme Stress (SIDES) and Self- Report Inventory of Disorder of Extreme Stress (SIDES-SR). The treatment of DESNOS should be phaseoriented and involve movement back and forth among three basic stages : 1) stabilization ; 2) trauma processing ; 3) reintegration.

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Effect of Burnout on Post-traumatic Stress Disorder Symptoms Among Firefighters in Korea: Data From the Firefighter Research on Enhancement of Safety & Health (FRESH)

  • Kim, Woojin;Bae, Munjoo;Chang, Sei-Jin;Yoon, Jin-Ha;Jeong, Da Yee;Hyun, Dae-Sung;Ryu, Hye-Yoon;Park, Ki-Soo;Kim, Mi-Ji;Kim, Changsoo
    • Journal of Preventive Medicine and Public Health
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    • v.52 no.6
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    • pp.345-354
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    • 2019
  • Objectives: It is well-known that post-traumatic stress disorder (PTSD) among firefighters contributes to their job-related stress. However, the relationship between burnout and PTSD in firefighters has rarely been studied. This study therefore explored the association between burnout and its related factors, such as trauma and violence, and PTSD symptoms among firefighters in Korea. Methods: A total of 535 firefighters participated in the Firefighter Research on Enhancement of Safety & Health study at 3 university hospitals from 2016 to 2017. The 535 participants received a baseline health examination, including questionnaires assessing their mental health. A Web-based survey was also conducted to collect data on job-related stress, history of exposure to violence, burnout, and trauma experience. The associations among burnout, its related factors, and PTSD symptoms were investigated using structural equation modeling. Results: Job demands (${\beta}=0.411$, p<0.001) and effort-reward balance (${\beta}=-0.290$, p<0.001) were significantly related to burnout. Burnout (${\beta}=0.237$, p<0.001) and violence (${\beta}=0.123$, p=0.014) were significantly related to PTSD risk. Trauma (${\beta}=0.131$, p=0.001) was significantly related to burnout; however, trauma was not directly associated with PTSD scores (${\beta}=0.085$, p=0.081). Conclusions: Our results show that burnout and psychological, sexual, and physical violence at the hands of clients directly affected participants' PTSD symptoms. Burnout mediated the relationship between trauma experience and PTSD.

Effects of Herbal Medicine (Gan Mai Da Zao Decoction) on Several Types of Neuropsychiatric Disorders in an Animal Model: A Systematic Review - Herbal medicine for animal studies of neuropsychiatric diseases -

  • Kim, Su Ran;Lee, Hye Won;Jun, Ji Hee;Ko, Byoung-Seob
    • Journal of Pharmacopuncture
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    • v.20 no.1
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    • pp.5-9
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    • 2017
  • Objectives: Gan Mai Da Zao (GMDZ) decoction is widely used for the treatment of various diseases of the internal organ and of the central nervous system. The aim of this study is to investigate the effects of GMDZ decoction on neuropsychiatric disorders in an animal model. Methods: We searched seven databases for randomized animal studies published until April 2015: Pubmed, four Korean databases (DBpia, Oriental Medicine Advanced Searching Integrated System, Korean Studies Information Service System, and Research Information Sharing Service), and one Chinese database (China National Knowledge Infrastructure). The randomized animal studies were included if the effects of GMDZ decoction were tested on neuropsychiatric disorders. All articles were read in full and extracted predefined criteria by two independent reviewers. Results: From a total of 258 hits, six randomized controlled animal studies were included. Five studies used a Sprague Dawley rat model for acute psychological stress, post-traumatic stress disorders, and unpredictable mild stress depression whereas one study used a Kunming mouse model for prenatal depression. The results of the studies showed that GMDZ decoction improved the related outcomes. Conclusion: Regardless of the dose and concentration used, GMDZ decoction significantly improved neuropsychiatric disease-related outcomes in animal models. However, additional systematic and extensive studies should be conducted to establish a strong conclusion.

A Review on Clinical Research Trends in the Treatment of Post Traumatic Stress Disorder (PTSD) in Korean Medicine (외상후 스트레스장애 치료에 대한 한의학 임상연구 동향)

  • Joo, Sungjun;Kwon, JungEun;Kwon, Chan-Young;Lee, Boram;Kim, Sang-ho
    • Journal of Oriental Neuropsychiatry
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    • v.30 no.3
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    • pp.251-263
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    • 2019
  • Objectives: The purpose of this study was to review the clinical research trends in the treatment of post traumatic stress disorder (PTSD) in Korean medicine (KM). Methods: We searched MEDLINE, CENTRAL, EMBASE, Google Scholar and five Korean databases through May 2019, for studies on KM to treat PTSD. Clinical research that conducted KM treatment of PTSD patients were included. Two researchers independently conducted study selection and data extraction process. Results: Totally, eight studies were included in this review. Types of traumatic events that patients experienced included physical violence/threatening, traffic accidents, sexual violence and personal tragic events. KM interventions performed included acupuncture, moxibustion, herbal medicine, physical therapy, and KM-based psychotherapy. Treatment duration varied from two days to more than five months. Follow-up began at least one week to three months after the end of treatments. It was reported that the major psychological and/or somatic symptoms of PTSD, such as anxiety, depression, insomnia, and musculoskeletal pain, subjectively improved, as well as other objective outcomes: Impact Event Scale-Revised Korean version (IES-R-K), Beck's Depression Inventory (BDI), State-Trait Anxiety Inventory, Hwabyung Symptoms/characters, Electroencephalography (EEG) change, etc. Statistical studies were conducted in three studies only. Outcomes such as Visual Analogue Scale (VAS), BDI, and IES-R-K showed statistically significant improvement after KM treatments. There was no study reporting adverse events during or after the interventions. Conclusions: According to this review, diverse types of KM treatments have been used among PTSD patients in eight studies. The KM treatments effectively improved psychological and somatic symptoms of PTSD patients. However, the lack of high quality research as well as the lack of standardization of KM treatments for PTSD are limitations. Further methodologically robust clinical trials should be performed, and the standardization of KM treatments for PTSD should be sought.

Impact of Environmental Stressors on the Risk for Posttraumatic Stress Disorder and Quality of Life in Intensive Care Unit Survivors (중환자실 환자의 환경적 스트레스 요인이 외상후 스트레스장애 위험도와 삶의 질에 미치는 영향)

  • Cha, Hyo-Jung;Ahn, Sukhee
    • Journal of Korean Critical Care Nursing
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    • v.12 no.1
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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.

Protein-Protein Interaction Analysis of Corticotropin - Releasing Hormone Receptor 1 with Corticotropin-Releasing Hormone and Sauvagine

  • Nagarajan, Santhosh Kumar
    • Journal of Integrative Natural Science
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    • v.11 no.2
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    • pp.101-106
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    • 2018
  • Corticotropin - releasing hormone receptor 1 (CRHR1) forms an integral part of the pathophysiology of disorders like post-traumatic stress disorder, stress, anxiety, addiction, and depression. Hence it is essential to look for new, potent and structure-specific inhibitors of CRHR1. We have analysed the protein-protein interaction complexes of the CRHR1 receptor with its native ligand CRF and full agonist Sauvagine. The structure of Sauvagine was predicted using homology modelling. We have identified that the residues TYR253, ASP254, GLU256, GLY265, ARG1014 and LY1060 are important in the formation of protein-protein complex formation. Future studies on these residues could throw light on the crucial structural features required for the formation of CRHR1-inhibitor complex and in studies that try to solve the structural complexities of CRHR1.

Docking Study of Corticotropin-Releasing Factor-1 Receptor with Its Antagonists

  • Babu, Sathya
    • Journal of Integrative Natural Science
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    • v.11 no.1
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    • pp.19-24
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    • 2018
  • CRFR is involved in the pathophysiology of various disorders including depression, stress, anxiety, post-traumatic stress disorder, and addiction. The discovery of novel and structurally diverse CRF1 receptor inhibitors becomes essential. In this study, we have performed molecular docking of CRF1R with the derivatives of 8-substituted-2-aryl-5-alkylaminoquinolines as CRF1R inhibitors. The antagonist molecules were optimized and docked into the binding site of the receptor. On analysing the docked complexes we have identified that the residues HIS214, THR215, ARG227, ARG1008, LYS1060 and ASP1061 are important in forming hydrogen bond with the inhibitors. Further studies on these residues could reveal important structural features required for the formation of CRF1R-inhibitor complex and thus in the discovery of novel and potent inhibitors.

The Relationship among the Coping Style, Social Support, and Post-Traumatic Stress Disorder in Breast Cancer Patients Treated with Chemotherapy (항암치료 단계 유방암 환자의 대처방식, 사회적지지 및 외상 후 스트레스 장애와의 관계)

  • Yang, Seung Kyoung;Kim, Eunshim
    • Journal of Hospice and Palliative Care
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    • v.18 no.1
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    • pp.35-41
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    • 2015
  • Purpose: This study was conducted to examine how patients' coping style and social support affect post-traumatic stress disorder (PTSD) in breast cancer patients who are treated with chemotherapy. Methods: The sample consisted of 134 outpatients who received breast cancer treatments at the cancer clinic of a university hospital. The collected data were analyzed by frequency, percentage, t-test, ANOVA, ${\chi}^2$-test, Pearson correlation coefficients using SPSS for Windows, version 18.0. Results: Among total, 26.9% of patients were classified into a high-risk PTSD group. In the high-risk group, a positive correlation was found between active and passive coping styles and between social support and active coping styles. Conclusion: In this study, the stronger the social support was, the more active the coping style was for high-risk PTSD patients with breast cancer. Considering the fact that cancer requires life-long self-management, strong social support could improve patients' healthcare capability. Furthermore, solid social support could effectively reduce the stress level and improve the quality of life for breast cancer patients in the high-risk PTSD group.