• 생물정신의학
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• 제15권2호
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• pp.110-117
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• 2008

Objectives : Posttraumatic stress disorder(PTSD) has been primarily associated with emotional problems. Recently, however, the impact of PTSD on cognitive processes has interested a growing number of researchers. The current study is aimed at investigating the cognitive aspects of PTSD at both behavioral and neurological levels. Methods : We recruited individuals with PTSD who survived the Daegu subway explosion in 2003 as well as non-PTSD individuals as a control group. To evaluate the inhibitory processes and the neural mechanisms, we had these individuals perform the negative priming task simultaneously with functional MRI scanning. Results : Behaviorally, the negative priming effect was intact in the control group but was not evident in the PTSD group. In the imaging results, only the PTSD group showed the negative priming effect (i.e., increased activation of the negative priming condition as opposed to the neutral condition) in the dorsolateral prefrontal cortex, anterior cingulate cortex, and inferior temporal gyrus. The PTSD group also showed increased activity for the positive priming condition as opposed to the neutral condition in the claustrum. These results confirm and extend the previous findings that the integrity of the ACC is compromised in the trauma survivors due to disrupted white matter tract. Conclusions : The current results suggest that deteriorated performance of the PTSD group may be due to the functional problem as well as the structural abnormalities.

• 대한불안의학회지
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• 제3권2호
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• pp.123-127
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• 2007

Objective : This study was conducted to evaluate the relation between symptoms and hippocampal volume in patients with posttraumatic stress disorder (PTSD). Methods : Eight patients with PTSD and five normal controls were enrolled in the present study. The severity of PTSD symptoms was measured using the clinician administered PTSD scale (CAPS), Hamilton Rating Scale for Depression (HAMD), Hamilton Anxiety Rating Scale (HAMA). Magnetic resonance imaging (MRI) was used to measure hippocampal volume. Results : There were significant differences in the CAPS, HAMD, and HAMA scores between the PTSD patients and normal controls. The left and right hippocampal volumes were smaller in the PTSD patients than in the normal controls, but this difference was not statistically significant. The results showed that PTSD symptoms were not related to hippocampal volume. Conclusion : In this study, we could not identify a difference in hippocampal volume between normal controls and patients with PTSD at eight months after trauma. Future research with different subjects and a larger sample size is needed in order to confirm the difference in hippocampal volume.

• 대한불안의학회지
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• 제9권1호
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• pp.54-60
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• 2013

Objectives : Posttraumatic stress disorder (PTSD) is classified as an anxiety disorder. PTSD occurrence is known to be increased in middle-aged and older people, female, and individuals with a previous history of psychiatric disorders, lower education levels, low socioeconomic status, and severely injured patients. Anxiety symptoms are also related to later development of PTSD. In this study, we investigate the influences of injury severity and sociodemographic factors on severe anxiety in PTSD patients with no previous history of psychiatric disorders. Methods : Forty-one PTSD patients without previous history of psychiatric disorders were recruited from the psychiatric clinic at Chosun University Hospital. Subjects underwent psychiatric and physical examinations including the Injury Severity Score (ISS), Beck Anxiety Inventory (BAI), and Korean-Wechsler Adult Intelligence Scale (K-WAIS). We defined severe anxiety as a BAI scores of 30 or more. Logistic regression analyses and multi-step model selection were applied to identify predictive factors for severe anxiety. Results : In univariate analysis, age, ISS, and socioeconomic status were found to be significant factors. Through multivariate logistic regression analyses and a stepwise model selection, we found the combination of age and ISS to be the best-fitted model for affecting severe anxiety in PTSD patients without a previous history of psychiatric disorders. Conclusion : Our findings suggest that the combination of age and ISS could develop severe anxiety in PTSD patients with no previous history of psychiatric disorders.

• 대한불안의학회지
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• 제9권2호
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• pp.147-153
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• 2013

Objective : Despite the chronic nature and high social costs, individuals with anxiety disorders seldom seek treatment. Thus, education for public awareness and screening for the illness is tremendously important for mental health professionals. This study summaries and presents the results from Anxiety Disorder Screening Program during the Mental Health Exposition held in Seoul in April, 2013. Methods : We analyzed the data from 116 participants who agreed and completed the screening questionnaires during their visits to two-day Anxiety Disorder Screening Program prepared by the Korean Academy of Anxiety Disorder. The questionnaire comprised of modified Mobility inventory for agoraphobia, Contents of worries, Penn State Worry Questionnaire, Life Events Checklist, and Abbreviated Posttraumatic Stress Disorder Checklist. Results : Participants demonstrated high rates of anxiety symptoms and possible anxiety disorders. Experience of panic attack was reported by 45%, lifetime and 16% in the past month by respondents. Phobia was reported by 46%. Participants had an average of 3.3 pathological worries and among those, social or interpersonal content was most common (46%). At least one lifetime traumatic event was reported by 64%. By the cut-off scores in the literature, 46% had possible generalized anxiety disorder and 58% possible posttraumatic stress disorder. Conclusion : Our results suggested that many visitors to Anxiety Disorder Screening Program were in fact treatment seeking after experiencing some forms of anxiety symptoms. Further efforts for delivery of medical information and increasing public awareness for anxiety disorders are needed.

• 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.

• 대한불안의학회지
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• 제4권2호
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• pp.121-126
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• 2008

PTSD 환자들에서 성별에 따른 증상의 차이를 보기 위한 본 다기관 연구에서, 여성은 남성에 비해 재경험, 회피 항목에서 높은 빈도와 심각도를 보였다. 즉 과도한 기억과 각성, 만성적인 회피로 이어지는 PTSD 발생 과정에서 남, 녀간 차이가 있을 수 있다는 것을 시사하며, 앞으로 이를 확인하기 위한 연구가 더욱 필요할 것이다.

• 대한불안의학회지
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• 제16권2호
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• pp.83-90
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• 2020

Objective : Heart rate variability (HRV) is known to reflect autonomic nervous system activity. Individuals with posttraumatic stress disorder (PTSD) are reported to have lower HRVs. We attempted to find HRV indices with head up tilt position that reflect the symptoms well in order to evaluate PTSD symptoms. Methods : Sixty-seven patients with PTSD and 72 patients without PTSD were assessed using the PTSD Checklist for DSM-5 (PCL-5), the Beck Depression Inventory, the Beck Anxiety Inventory and the Pittsburgh Sleep Quality Index. HRV was measured in the head-up tilt position. We collected data regarding heart rate (HR), standard deviation of the NN intervals (SDNN), the square root of the mean squared differences of successive NN intervals (RMSSD), log low-frequency (LNLF) and log high-frequency (LNHF). Results : The value of LNHF was different according to presence or absence of PTSD after head-up tilt position. In the findings of the association between PTSD symptoms and HRV indices as based on head-up tilt, LNHF had a significant correlation with the total score of PCL-5. Conclusion : The reduction of the high-frequency component of HRVs in the PTSD group might reflect more PTSD symptoms.

• 대한불안의학회지
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• 제8권2호
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• pp.86-92
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• 2012

Objective : This study investigated the relationship between the resilience and posttraumatic stress symptoms, as well as comorbid symptoms in firefighters. Methods : We collected 764 firefighters, who worked at six fire department stations in Gangwon-do. We investigated the impact of event scale-revised (IES-R), the life events checklists (LEC), Connor-Davidson resilience scale (CD-RISC), Beck depression inventory (BDI), state trait anxiety inventory (STAI) and alcohol use disorder identification test (AUDIT). Full PTSD groups, partial PTSD groups and non-PTSD groups, which were classified by IES-R scores, were compared in the LEC, CD-RISC, BDI, STAI and AUDIT, ; multiple linear regression analyses were done for independent predictors of variables. Results : Of the 764 firefighters, there were significant differences in LEC (p<0.001), CD-RISC (p<0.001), BDI (p<0.001), and AUDIT (p=0.001) among the full PTSD groups, partial PTSD groups and non-PTSD groups. However, STAI did not show significant difference among three groups. In multiple regression analysis, CD-RISC (${\beta}=-0.168$, p<0.001), LEC (${\beta}=0.211$, p<0.001) and AUDIT (${\beta}=0.115$, p=0.001) were significant predictors for IES-R. Conclusion : The results of the present study suggested that resilience might be a protective factor in PTSD and comorbid symptoms of PTSD.

• 가정간호학회지
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• 제15권1호
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• pp.5-13
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• 2008

Purpose: The purpose of this study was to evaluate for the presence of posttraumatic stress disorder (PTSD)-related symptoms, anxiety, and depression after stroke. Eighty-four patients were enrolled between 2 and 12 months after their first ischemic or hemorrhagic stroke. Methods: PTSD symptoms were evaluated using the Impact of Event Scale (IES). The IES is a 15-item scale measuring intrusion and avoidance symptoms. The authors assessed mood alterations using the Hospital Anxiety and Depression Scale (HAD). The HAD is a brief, 14-item, self-reported questionnaire used to detect symptoms of anxiety (HADA) and depression (HADD). The survey data were analyzed using the SPSS 10.0 program. Frequency, mean, standard deviation, percentage t-test, and Pearson correlation coefficient were determined. Results: Twenty nine of the 84 (34.5%) patients scored higher than the cutoff for PTSD on the IES (IES>26). With use of the HAD scale, 44% of the patients reached the cutoff for anxiety ($HADA\;{\geq}8$). On the HSD scale, 44.1% of the patients reached the cutoff for depression ($HADD\;{\geq}8$). PTSD symptoms and anxiety were more frequent in women under age 39, without spouses, who had operations. Depression was more frequent in patients without spouses. There was a statistically significant correlation among posttraumatic stress symptoms, anxiety, and depression. Conclusion: There was statistically significant correlation among PTSD symptoms, anxiety, and depression in stroke patients. Therefore, it is necessary to develop nursing intervention for stroke patients with these clinical manifestations.

• 대한불안의학회지
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• 제6권1호
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• pp.37-44
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• 2010

Objectives : This study investigated the influence of traumatic experience on the ego identity, self-esteem, and general psychopathology of adolescent North Korean refugees. Methods : The participants were 146 adolescents North Korean refugees who attended H High School for North Korean refugees. We divided the subjects into two groups according to the severity of their traumatic experience : the more-traumatic-experience group and the less-traumatic-experience group. Each group performed self-report assessments including an assessment to reveal demographic characteristics, the Traumatic Experiences Scale for North Korean Defectors, the Scale for Ego identity, the Scale for Self-esteem and the Symptom Check-90-Revision (SCL-90-R). Statistical analysis of t-test and multiple regression utilized SPSS 12.0 for Window for comparison between more-traumatic-experience group and less-traumatic-experience group. Results : The prevalence of posttraumatic stress disorder among adolescents North Korean refugees was 37%. The factor with the greatest influence on ego identity was length of time living in South Korea, while, for self-esteem the most influential factor was perception of health. The more-traumatic-experience group had lower self-esteem scores on some subscales of the Scale for Ego identity. They had higher scores on all SCL-90-R subscales than the less-traumatic-experience group. Conclusion : Adolescent North Korean refugees experienced high rates of posttraumatic stress disorder. The more traumatic-experience-group had lower self esteem and poorer ego identity and mental health than the less-traumatic-experience group.