• Title/Summary/Keyword: Posttraumatic Symptoms

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Effect of Terazosin on Posttraumatic Nightmares : A Pilot Study (외상 후 스트레스장애 환자의 악몽치료에서 Terazosin의 효과 : 예비 연구)

  • Chung, Moon-Yong;Jung, Ji-Young;Lee, Tae-Young;Kang, Suk-Hoon;Kim, Tae-Yong;Choi, Jin-Hee;Chung, Ha- Kyoung
    • Anxiety and mood
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    • v.2 no.1
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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.

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The Psychological Impacts of Chemical, Biological and Radiological Disasters (화학, 생물, 방사능 사고의 정신적 영향)

  • Lee, Da Young;Sim, Minyoung
    • Anxiety and mood
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    • v.13 no.1
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    • pp.1-9
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    • 2017
  • We reviewed the scientific literature on psychological effects of Chemical, Biological, Radiological, Nuclear, Explosive (CBRNE) disaster, which is one of the biggest threat to modern society. CBRNE disaster has the potential to cause specific physical symptoms and psychological distress in victims ; moreover, various toxic symptoms and carcinogenesis/mutation would be an important issue. Bioterrorism can cause localized outbreaks of infectious disease or pandemic disaster. Somatization as well as posttraumatic stress symptoms and depression are the characteristic psychological symptoms in CBRNE disaster's victims. CBRNE disasters could lead to large-scale public fear and social chaos due to the difficulties involved in verifying the extent of exposure and unfamiliar area to the common people. In the evacuation process, problems associated with adjustment and conflict between victims and residents should be considered.

Somatic Symptoms after Psychological Trauma (심리외상 이후의 신체증상)

  • Park, Joo Eon;Ahn, Hyun-Nie;Kim, Won-Hyoung
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.1
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    • pp.43-53
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    • 2016
  • Objectives : Somatic symptoms after the exposure of psychological trauma frequently developed. However, the somatic symptoms are not covered under the diagnostic criteria of posttraumatic stress disorder(PTSD) in detail, although they are often associated with social and occupational functioning and patient-doctor relationships. The aim of this article is to highlight the potential mechanisms, the common manifestations, and the treatment of the somatic symptoms. Methods : This article studied the somatic symptoms searched using academic search engines like PubMed, Scopus, Google Scholar, KoreaMed and KISS from the earliest available date of indexing to March 31, 2016. Results : The mechanism of somatic symptoms after the exposure was described as psychological and physiological aspects. Psychological mechanism consisted of psychodynamic theory, cognitive behavioral theory, and others. Physiological mechanism involved changes in neuroendocrine and immune system, autonomic nervous system and central nervous system. Somatization associated with psychological trauma manifested various health conditions on head and neck, chest, abdominal, musculoskeletal, and dermatological and immune system. Few studies described the standardization of treatment for the somatic symptoms. Conclusions : Clinicians and disaster behavioral health providers should think of the accompanying somatic symptoms during intervention of psychological trauma and PTSD. Further studies are needed on the somatic symptoms seen in psychological trauma and PTSD.

Effects of Vicarious Trauma on Mental Health in Firefighters (소방 공무원에서 간접 외상이 정신 건강에 미치는 영향)

  • Baik, Jun-Hyuck;Jung, Young-Eun;Chae, Jung-Mi;Myong, Jun-Pyo;Yim, Hyeon-Woo;Cha, Jeong-Ho
    • Anxiety and mood
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    • v.6 no.1
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    • pp.65-70
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    • 2010
  • Objectives : Indirect contact with trauma may occur when a person empathically listens to detailed descriptions, exposing the person to intense emotional pain from trauma victims. Although less severe than direct trauma, indirectly traumatized persons may experience the same fear, rage, and despair as direct trauma victims. This phenomenon has been variously termed vicarious trauma, traumatic countertransference, burnout, compassion fatigue, and secondary traumatic stress. Using a psychiatric symptoms questionnaires, this study investigated the effects of indirect exposure to co-worker's trauma on the mental health of firefighters who had not directly experienced traumatic events in the previous year. Methods : We administered self-report questionnaires, such as the Impact of Event Scale-Revised (IESR) and Alcohol Use Disorder Identification Test (AUDIT), to firefighters working at two fire stations in a metropolitan city. We analyzed 188 of 232 collected surveys, after excluding falsely entered data (28 cases) and questionnaires by directly-traumatized victims (16 cases). Results : Alcohol consumption and posttraumatic stress disorder (PTSD) symptoms, as determined by the AUDIT and IES-R, were significantly higher in the indirectly-traumatized group. The ratio of high-risk members scoring higher than 23 in IES-R was larger in the indirectly traumatized group, although this was not statistically significant. Conclusion : Alcohol consumption was significantly higher in the indirectly traumatized group. This group also included more members at high risk for PTSD. Further research, with a larger group of indirectly traumatized firefighters and ongoing investigation of PTSD development and other psychiatric symptoms, is needed.

The Clinical Study On Posttraumatic Stress Disorder Patients due to a Serise of Traffic Accidents;SCL-90-R (교통사고 후 외상성 스트레스 장애 후유증 환자에 대한 고찰;SCL-90-R 중심으로)

  • Ko, Kyoung-Mo;Choi, Sung-Hun;Kim, Jae-Su;Park, Seo-Young;Lee, Yun-Kyu;Lee, Yoon-Kyoung;Lee, Kyung-Min;Lee, Bong-Hyo;Lim, Seong-Chul;Choi, Hong-Sik;Lee, Eun-Kyung;Jung, Tae-Young;Seo, Jung-Chul
    • Journal of Acupuncture Research
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    • v.24 no.6
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    • pp.63-68
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    • 2007
  • Objectives : The purpose of this study was designed to estimate the effects of Oriental medical treatment on posttraumatic stress disorder patient due to a series of traffic accidents by using SCL-90-R. Methods : We studied 20 patients who were admitted to Daegu Haany University Oriental Hospital from October2006 to May 2007. Results : 4 symptoms of SCL-90-R, somatization, obsessive-compulsive, depression and anxiety were significantly different when comparing after-treatment with before-treatment. But, 5 symptoms of SCL-90-R, interpersonal sensitivity, hostility, phobic anxiety, paranoid ideation and psychoticism showed no difference between after-treatment with, before-treatment measurements. The total impact or SCL-90-R was significant comparing after-treatment with before-treatment measurements. Conclusions : We concluded that there was a significant effectof Oriental medical treatment on posttraumatic stress disorder patients caused by a seriesof traffic accident. However, the findings of this study need to be confirmed in more patients with further studies.

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D2 Dopamine Receptor (DRD2) Gene Polymorphism and Combat-Related Posttraumatic Stress Disorder in Vietnam Veterans (월남전 참전 재향군인에서 도파민 D2 수용체 유전자 다형성과 외상후 스트레스 장애)

  • Lee, Soo-Young;Chung, Hae-Gyung;Kim, Tae-Yong;Choi, Jin-Hee;Chung, Moon-Yong;So, Hyoung-Seok;Shin, Han-Sang;Lee, Shi-Eun
    • Anxiety and mood
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    • v.4 no.2
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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.

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Institutional Betrayal to Sexual Victimization and Depression: The Mediating Role of Posttraumatic Cognitions (성폭력 피해에 대한 조직배반과 우울의 관계: 외상 후 인지의 매개효과)

  • Park, Youn Kyung;Ahn, Hyunnie
    • Korean Journal of Culture and Social Issue
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    • v.27 no.1
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    • pp.19-34
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    • 2021
  • Many survivors of sexual violence disclose their experience to others. When they receive negative social reactions, this can be a traumatic event for the survivor where their trust towards others is violated and can cause posttraumatic cognitions and depression. Likewise, institutional betrayal, or negative reactions from trusted institutions regarding the disclosure of sexual victimization can be a traumatic event for the survivor and is associated with depression as well. However, studies investigating the mechanism underlying the relationship between institutional betrayal and depression is yet limited. Therefore, based on cognitive behavioral theory (CBT), which is known as the most effective approach to date for understanding and treating posttraumatic symptoms, this study examined if posttraumatic cognitions mediate the relationship between institutional betrayal and depression. Questionnaires were administered to 462 women who had experienced institutional betrayal to their sexual victimization. Results showed that institutional betrayal had an effect on depression only through negative cognitions about the self and world. This suggests the importance of identifying and treating trauma-related cognitions in order to prevent or cure depression of those who had experienced institutional betrayal to their sexual victimization. Limitations and implications of this study are also discussed.

Psychiatric Symptoms Among Female Adult Victims of Sexual Molestation : Comparison with Rape Victims (성인 여성 성추행 피해자들의 정신적 증상 : 강간 피해자들과의 비교)

  • Kim, Yeon-Sue;Kim, Sung-Jin;Kong, Bo-Geum;Kang, Je-Wook;Moon, Jung-Joon;Jeon, Dong-Wook;Lee, Sang-Min;Ju, Hyun-Bin;Jung, Do-Un
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.2
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    • pp.208-216
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    • 2016
  • Objectives : According to the recent Korean National Police Agency report, rape victims were 17.1%, but sexual molestation victims were more than the rape victims by 78.0%. Despite many international reports about the occurrence of severe psychiatric symptoms in sexual molestation victims, there is no domestic research. Therefore in this study, we investigated psychiatric symptoms of sexual molestation victims, and we also compared it with psychiatric symptoms in rape victims. Methods : 58 women who visited Busan Smile Center within 3months after sexual violence were the study subjects. Questionnaire about sociodemographic and sexual violence related characteristics were retrospectively investigated. Of the psychiatric symptoms, Beck Depression Inventory(BDI), Beck Anxiety Inventory(BAI) for severity of depression and anxiety, and Impact of Event Scale-Revised(IES-R) to check the presence of posttraumatic stress disorder(PTSD) symptoms were used. Results : Of 58 sexual violence victims, sexual molestation victims were 36(62.1%) and rape victims were 22(37.9%). In sexual molestation victims, 80.6% had more than moderate severity of depression, 83.3% had more than moderate severity of anxiety, and 94.4% had significant scores at PTSD screening test. Compared with rape victims' psychiatric symptoms(each 95.5%, 95.5%, 95.5%) there were no significant difference. Conclusions : The majority of sexual molestation victims were also accompanied by depression, anxiety and PTSD symptoms as rape victims. There results suggest that appropriate assessment and early treatment for psychiatric symptom must be made in the early stage of injury in sexual molestation victims.

Comorbidity of Posttraumatic Stress Disorder and Its Effect on Treatment Outcomes in Patients with Schizophrenia : One-Year Prospective Follow-Up Study (외상 후 스트레스 장애 동반 여부에 따른 정신분열병 환자의 임상증상과 치료효과의 비교 : 1년간의 전향적 추적연구)

  • Park, Sung-Jong;Kim, Nam Hee;Jeong, Jae-Yeol;Lee, Sunny
    • Korean Journal of Biological Psychiatry
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    • v.16 no.4
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    • pp.256-265
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    • 2009
  • Objectives : The aims of this study were to assess a) the prevalence of trauma and posttraumatic stress disorder(PTSD) in schizophrenic patients and b) the differences in symptomatology and outcome after 1year treatment between those with and without PTSD. Methods : Twenty eight schizophrenia and schizoaffective disorder patients completed the Positive and Negative Syndrome Scale(PANSS), Life Stressor Checklist-Revised(LSCL-R), Clinician-Administered PTSD Scale(CAPS), Dissociative Experiences Scale(DES), Hamilton Psychiatry Rating Scale for Depression(HAM-D), and Rosenberg Self-Esteem Scale(RSE). Results : Twenty six patients(92.9%) had at least one trauma in their life time. Eleven patients(39.3%) were diagnosed with PTSD. PTSD group had significantly higher scores on HAM-D and DES but lower scores on RSE. PTSD group also had significantly lower score in the baseline PANSS Negative score. Higher CAPS scores were significantly correlated with lower baseline PANSS Negative score and greater change after 1year of PANSS Negative score. Conclusion : These results showed that the prevalences of trauma and PTSD are high in schizophrenic patients and suggested that PTSD and trauma-related symptoms affected the symptomatology and treatment outcome. More research is warranted to better understand the effects of PTSD in schizophrenic patients.

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Firefighters and Posttraumatic Stress Disorder (소방공무원과 외상 후 스트레스 장애)

  • Ryu, Jia;Ha, Eunhee;Jeong-Choi, Kyunghee;Kim, Jieun E.;Park, Shinwon;Kim, Hyunjoo
    • Korean Journal of Biological Psychiatry
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    • v.24 no.1
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    • pp.10-18
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    • 2017
  • Occupational hazards of firefighting and rescue works include frequent exposure to emergencies and life-threatening situations. These stressful work conditions of being constantly under pressure and exposed to potentially traumatic events put them at higher risk of developing posttraumatic stress disorder (PTSD), compared to the general population. PTSD is a potentially debilitating mental disorder, due to persistent intrusive thoughts, negative alterations of mood and cognition, hypervigilance, avoidance of similar situations and reminders, and re-experiences of the traumatic event. Previous studies have shown a relatively high prevalence of PTSD among firefighters, indicating the need for a systematic approach of early detection and prevention. Therefore, a critical review of the current literature on PTSD in firefighters would provide valuable insights into developing effective prevention and intervention programs. Literature indicated that there are risk factors of PTSD in firefighters, such as pre-existing depression, anxiety, sleep disorders, occupational stress, physical symptoms, and binge drinking, whereas social support and adequate rewards are protective factors. Although there are differences in the prevalence of PTSD across studies, partly due to various assessment tools utilized, different sample sizes, and sample characteristics, over one tenth of the firefighters were estimated to have PTSD. The current review warrants further investigations to precisely assess PTSD and co-morbid mental disorders, functional outcomes, and associated factors, and to develop evidence-based preventive and interventional programs to help firefighters with PTSD.