• 정신신체의학
• /
• 제6권2호
• /
• pp.136-146
• /
• 1998

Objectives : This study was performed to evaluate the effects of PTSD on memory function, to investigate the difference of memory function between PTSD and non-PTSD patients, and to identify major variables correlated to PTSD scale and Memory Assessment Scale. Methods: The authors used PTSD-scale(Mississippi scale and Combat Exposure Scale) for measuring PTSD severity. And, Beck Depression Inventory was also used. Memory assessment scale was assessed by well trained psychologist. Thirty one Vietnam veterans who had been hospitalized were collected consecutively. These patients were evaluated by psychiatrists with interview and measurement for fifteen months since March, 1997. The collected data were analyzed by SPSS and the stastistic methods used for analysis Chi-square, t-test, and Pearson's correlation. Results : 1) There were significant differences in short-term memory and verbal memory between PTSD and non-PTSD in Vietnam veterans. 2) Mississippi scale and Combat Exposure Scale were negatively correlated to short-term memory and verbal memory(Pearson's correlation). 3) Religion status was a significant variable between PTSD and non-PTSD in Vietnam veterans. 4) There is no significant difference in visual memory and total memory scale between PTSD and Non-PTSD in Vietnam veterans Conclusions : Neuropsychological changes were found in the posttraumatic stress disorder. There were significant differences in short-term memory and verbal memory between PTSD and non-PTSD in Vietnam veterans. Mississippi scale and Combat Exposure Scale were negatively correlated to short-term memory and verbal memory. We suggest that neuropsychological test might be used for an objective assessment of patients with the combat related PTSD and be considered helpful in the assessment of patients with the diagnosis. And we also suggest rehabilitation strategies would be used to compensate for memory deficits in PTSD patients.

• 생물정신의학
• /
• 제19권1호
• /
• pp.53-59
• /
• 2012

Objectives : Autobiographical memory (ABM) is a special type of episodic memory, containing events that have occurred in a personal life. Overgeneral tendency of ABM refers to the retrieval of memory with only general and categorical descriptions rather than specific events. ABM specificity in depression and posttraumatic stress disorder is a robust finding with relation to cognitive vulnerability, affect regulation, problem-solving ability. It is also implicated in bipolar disorder with frequent relapses. In this study, we investigated whether ABM specificity was related to manic or euthymic mood states in patients with bipolar disorder. Methods : Forty bipolar patients with manic and euthymic episodes and 25 healthy controls participated in this study. Prompted by 5 positively and 5 negatively valenced emotional cue words, each participant was instructed to recall positive or negative memories and describe them in detail. The One-way ANOVA was used to compare ABM scores and post-hoc analyses were done. Results : Comapred to the healthy persons, the bipolar patients reported significantly more general than specific negative memories in both manic and euthymic episodes (p = 0.003). However, there was no significant difference between manic and euthymic patients (p = 0.074). Conclusions : These results suggest that overgeneral tendency of negative ABM may be a trait abnormality in bipolar disorder. Moreover, this phenomenon might be related to underlying cognitive deficits or affect regulation irrespective of the mood state.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• 제29권2호
• /
• pp.32-39
• /
• 2018

Objectives: This study aimed to investigate the 3-year mean periods aftermath of child sexual abuse and to compare the sexual violence victims regard to the treatment. Methods: 682 sexual violence victims were recruited by Seoul Sunflower Children Center, a nation-funded sexual violence victim protection center for children age 13, from 2004 to 2008. Data from 49 victims among 116 consented a follow-up, were analyzed. The victims were assessed by psychological test. Data was analyzed by SPSS ver. 15.0 (SPSS Inc.). Results: The average time elapsed from the last presumed sexual abuse was 39.7 months [standard deviation (SD) 26.02]. Overall, Children's Depression Inventory (CDI) was significantly decreased from 15.8 (SD 9.33) to 10.4 (SD 9.98), and several subscales (depression, anxiety, anger, posttraumatic stress, and dissociation) of Trauma Symptom Checklist for Children (TSCC) were also significantly decreased. CDI and TSCC scores showed no statistical difference between treatment-given and not-given groups, but Revised Children's Manifest Anxiety Scale (RCMAS) was decreased in treatment-given group, whereas it was increased in treatment-not-given group. The difference of RCMAS scores between the two groups was statistically significant [F(1,28)=4.54, p<0.05]. Conclusion: Sexually abused children showed overall symptom decreases over time, but anxiety was not decreased in treatment not-given group.

• The Korean Journal of Pain
• /
• 제24권1호
• /
• pp.13-21
• /
• 2011

Background: This study aimed to evaluate processes from the mutual maintenance model in relation to daily functioning in patients with both chronic pain and a history of a traumatic experience. The mechanism illustrated the structural relations for daily functioning among pain intensity, hyperarousal, re-experiencing, trauma avoidance, and pain avoidance. Methods: Archival data (N = 214) was used for this study and data were analyzed for 142 chronic pain patients reporting a traumatic experience and seeking treatment at a tertiary pain clinic in Korea. Results: The results indicated that pain intensity, hyperarousal, and pain avoidance had significant direct effects on daily functioning. Also, pain intensity showed significant indirect effects on daily functioning through hyperarousal and pain avoidance; and hyperarousal through pain avoidance. Conclusions: Results suggest a direct contribution of high levels of pain, hyperarousal symptoms of PTSD, and pain avoidance behaviors to reduced daily functioning. Also, elevated pain as reminders of the trauma may trigger high levels of hyperarousal symptoms of PTSD. Subsequently, avoidant coping strategies may be used to minimize pain so that the trauma would not be re-experienced, thus inhibiting the activation of hyperarousal symptoms of PTSD. However, prolonged use of such strategies may contribute to decline in daily functioning.

• 한국융합학회논문지
• /
• 제12권2호
• /
• pp.233-246
• /
• 2021

본 연구에서는 외상 유형(단순 외상과 복합 외상)에 따라 PTSD 증상의 심각도와 자기 및 타인개념에 차이가 있는지를 확인하고자 하였다. 총 166명의 대학생 및 대학원생들 중 단순 외상(n=31)과 복합 외상(n=30)으로 분류된 참여자들의 자료를 최종 분석에 포함하였다. 참여자들은 생활사건 체크리스트(LEC), 개정된 사건 충격 척도(IES-R)와 E-prime으로 제작된 정서 스트룹 과제를 수행하였다. 결과는 다음과 같다. 첫째, 단순 외상 집단보다 복합 외상 집단에서 더 높은 수준의 PTSD 증상이 나타났다. 둘째, 스트룹 과제에서 부정적인 자기개념을 반영하는 단어를 2초 제시한 조건에서 복합 외상 집단이 단순 외상 집단보다 반응시간이 더 길었다. 이러한 결과는 복합 외상 집단과 단순 외상 집단이 적어도 PTSD 증상 및 자기개념에 다른 특성을 가지고 있다는 것을 제안한다. 마지막으로, 본 연구의 의의와 한계점에 대해 논의하였다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• 제33권3호
• /
• pp.73-81
• /
• 2022

Since dissociative identity disorder (DID) has symptoms similar to schizophrenia, such as auditory hallucinations and delusional thoughts of being controlled, there are difficulties in its differential diagnosis. A 16-year-old adolescent male patient who was previously diagnosed with schizophrenia from a different hospital was admitted to our inpatient psychiatric unit for the evaluation of auditory hallucinations and suicide attempts. Through psychiatric evaluations, it was determined that the patient suffered from identity alternation, dissociation, and amnesia. As for the diagnostic evaluations, the following measures were implemented: a psychiatric interview regarding the diagnostic criteria, mental status examination, laboratory tests, brain imaging studies, electroencephalography, and full psychological test for adolescents, and the self-reported measure of the Adolescent Dissociative Experiences Scale. The patient was diagnosed with DID, and the following treatments were administered: pharmacotherapy, ego state therapy, psychoeducation regarding emotions, trauma-focused psychotherapy including stabilization, and family therapy. Following treatment, in the internal dimensions, the patient was able to recognize the nine alternate identities in charge of his emotions, which established a basis for the potential integration of identities. In the external dimensions, he showed improvements in the aspects of family conflicts and issue of school refusal. This is the first reported case of DID in an adolescent in Korea; it emphasizes the consideration of DID in the differential diagnosis of other mental illnesses such as schizophrenia, bipolar disorder, and posttraumatic stress disorder and expands the treatment opportunities for DID by sharing the procedures of ego state therapy.

• 대한간호학회지
• /
• 제52권6호
• /
• pp.608-623
• /
• 2022

Purpose: This study aimed to evaluate the effects of a combined biofeedback and brief emotion regulation (C-BABER) program for sexually abused adolescents. Methods: This study employed a non-equivalent control group pretest-posttest design. The participants included 26 sexually abused adolescents from eight Sunflower Centers of South Korea-with 13 in the experimental group and 13 in the control group. The experimental group received four sessions of the individual C-BABER program, each lasting 60 minutes. Results: Compared with the control group, sexually abused adolescents in the experimental group exhibited significant score differences in traumatic symptoms, including depression (Z = - 2.24, p = .025), dissociation (Z = - 2.21, p = .027), anxiety (Z = - 2.02, p = .044), and posttraumatic stress (Z = - 2.01 p = .045); and impulsivity, including positive urgency (Z = - 3.35, p = .001) and negative urgency (Z = - 2.28, p = .023). Additionally, the experimental group exhibited significant score differences in meta-mood, including emotional attention (Z = - 2.45, p = .014), emotional clarity (Z = - 2.30, p = .021), and emotional repair (Z = - 2.28, p = .022); and emotional regulation modes, including emotional suppression (Z = - 2.65, p = .008) and cognitive reappraisal (Z = - 1.98, p = .047). Regarding bio-attention, significant changes were identified in the experimental group for the bio-attention rate and attention maintenance time in the posttest compared to the pretest (p = .001). Conclusion: The C-BABER program for sexually abused adolescents is effective in decreasing traumatic symptoms and impulsivity, and in improving meta-mood, emotional regulation mode, and bio-attention. Therefore, we recommend providing sexually abused adolescents the C-BABER program to help them regulate their emotions and effectively adapt to their lives.

• 동의신경정신과학회지
• /
• 제35권1호
• /
• pp.15-26
• /
• 2024

Objectives: The objective of this study is to develop a specialized clinical research protocol for acupuncture treatment specifically designed for disaster survivors based on insights from an expert survey. Methods: An expert panel comprising specialists in neuropsychiatry, acupuncture, and clinical research methodology was assembled. Initial data to inform the clinical research protocol design was collected utilizing open-ended responses, multiple-choice questions, and a 5-point Likert scale to gauge agreement levels. Next, this data was disseminated to a panel of experts. A cohesive clinical research protocol was then formulated during a core panel meeting by integrating insights from a panel of 10 experts. Results: The protocol developed herein entails a non-randomized controlled study involving participants aged 19~64 years old who have been identified as high-risk or cautious according to the National Trauma Center screening test. The study design includes the establishment of an active control group, which allows for the assessment of an additional effect through comparison with conventional therapy. The selected acupuncture approach involves a combination of manual acupuncture and ear acupuncture. For clinical outcome assessment, the Clinician-Administered Posttraumatic Stress Disorder Scale for DSM-5 was proposed to gauge trauma symptoms. Representative scales for various domains such as depression, anxiety, anger, insomnia, pain, and quality of life were also provided for reference. Conclusions: The developed protocol is anticipated to streamline the swift design and initiation of clinical trials during disaster scenarios. It is also designed to be scalable, thereby enabling its application in both non-randomized control group studies and single-group before-and-after comparisons.

• Safety and Health at Work
• /
• 제14권4호
• /
• pp.467-475
• /
• 2023

Background: To mitigate the spread of Covid-19, nurses infected with the virus were required to isolate themselves from their families and community. Isolated patients were reported to have experienced mental distress, posttraumatic stress disorder symptoms, and suicide. Though studies have reported the psychological impact of the Covid-19 pandemic, less is known about the lived experiences of nurses who survived Covid-19 infection in sub-Saharan Africa. Methods: A descriptive phenomenological approach was used to study the lived experiences of registered nurses who survived Covid-19 disease. In-depth interviews were conducted among nurses diagnosed with Covid-19 from two hospitals in Kenya between March and May, 2021. Purposive and snowball sampling were used to recruit registered nurses. Data were analyzed using Giorgi's steps of analysis. Results: The study included ten nurses between 29 and 45 years of age. Nurses' experiences encompassed three themes: diagnosis reaction, consequences, and coping. Reactions to the diagnosis included fear, anxiety, and sadness. The consequence of the diagnosis and isolation was stigma, isolation, and loneliness. Nurses coping mechanisms included acceptance, creating routines, support, and spirituality. Conclusion: Our findings aid in understanding how nurses experienced Covid-19 infection as patients and will provide evidence-based content for supporting nurses in future pandemics. Moreover, as we acknowledge the heroic contribution of frontline healthcare workers during the Covid-19 pandemic, it is prudent to recognize the considerable occupational risk as they balance their duty to care, and the risk of infection to themselves and their families.

• 정신신체의학
• /
• 제28권1호
• /
• pp.42-52
• /
• 2020

연구목적 소방공무원은 직무 환경 상 항상 비상대기를 해야 하는 스트레스 상황에 처해있으며, 지속적인 외상적 사건에의 노출로 인해 불면, 우울을 포함한 다양한 정신질환에 취약 해지기 쉽다. 이에 소방공무원들의 직무 유형별 정신건강요인의 차이 유무를 살펴보고, 특히 그 중에서도 업무의 지장 및 불편을 줄 수 있는 불면과 신체화 증상과의 관련성을 보고자 한다. 방 법 충청북도 소재 지역 소방서에 근무하는 소방공무원 1264명을 대상으로 자기보고식 설문지를 통하여 일반적 특성 및 관련 검사를 수행하였다. 불면증 심각성 척도(ISI), 신체화 증상 척도(PHQ-15), 사건 충격 척도(IES-R-K), 스트레스 척도(PSS-10), 회복탄력성 척도(K-CD-RISC-2), 알코올 의존 선별검사 척도(AUDIT-K), 역학연구센터 우울 척도(CES-D) 및 국제 신경정신평가(MINI-plus)의 자살 척도를 활용하여 정신건강상태 현황 조사 및 요인 간의 관련성을 평가하였다. 결 과 정신건강요인들 중 불면증과 신체화증상의 관련성은 직무 유형에 따라 유의한 차이가 있으며 구급 직군이 화재진압 직군과 구조 직군보다 유의하게 높은 것으로 보고되었다. 사건 충격, 우울, 음주도 직무 유형에 따라 유의한 차이가 있으며, 사건 충격은 구급 직군이 화재진압 직군보다 높고 우울은 구급 직군이 구조 직군보다 높으며 음주는 행정 직군이 화재진압 직군, 구급 직군보다 높은 것으로 보고되었다. 회복탄력성은 구조 직군이 구급 직군보다 유의하게 높았다. 스트레스, 자살위험성은 직무 유형에 따라 유의한 차이가 없는 것으로 보고되었다. 또한 소방공무원 신체화증상의 유의한 예측 인자로 불면증, 스트레스, 사건 충격이 있었으며, 특히 불면의 영향이 큼을 보여주었다. 결 론 본 연구를 통해 지역 소방공무원들의 직무 유형에 따라 다양한 정신건강 변인에서 유의한 차이가 있음을 확인할 수 있었으며, 특히 구급 직군의 경우가 타 직군에 비해 불면, 신체화 증상, 큰 사건 충격, 취약한 회복탄력성 등 여러 정신건강변인에서 취약한 상황으로 보고되었다. 그 중 불면의 경우 모든 직무유형에서 신체화 증상에의 의미 있는 예측인자임을 확인할 수 있었다.