• 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.

• Journal of Preventive Medicine and Public Health
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• 제54권2호
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• pp.86-95
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• 2021

Objectives: This study investigated associations between perceptions of coronavirus disease 2019 (COVID-19) and the prevalence of posttraumatic stress disorder (PTSD) in workers at hospitals designated to treat COVID-19, as well as the difference in the magnitude of these associations by occupational type and previous Middle East respiratory syndrome coronavirus (MERS-CoV) experience. Methods: The participants were workers at hospitals designated to treat COVID-19 who completed a questionnaire about their perceptions related to COVID-19, work experience during the previous MERS-CoV outbreak, and symptoms of PTSD ascertained by the PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders. Participants' characteristics were compared using the chi-square test. Multivariable logistic regression was performed to evaluate the associations between perceptions and the prevalence of PTSD, stratified by occupational type and previous MERS-CoV experience. Results: Non-medical personnel showed stronger associations with PTSD than medical personnel according to general fear (odds ratio [OR], 6.67; 95% confidence interval [CI], 1.92 to 23.20), shortages of supplies (OR, 1.29; 95% CI, 1.07 to 1.56), and issue-specific fear (OR, 1.29; 95% CI, 1.05 to 1.59). Those with prior MERS-CoV quarantine experience were more prone to PTSD than those without such experience in terms of general fear (OR, 1.70; 95% CI, 1.22 to 2.37), shortages of supplies (OR, 1.24; 95% CI, 1.10 to 1.40), and issue-specific fear (OR, 1.21; 95% CI, 1.06 to 1.38). Conclusions: During the COVID-19 pandemic, non-medical personnel tended to have higher odds of being categorized as having PTSD. Workers with prior MERS-CoV experience were more susceptible than those without such experience. These findings suggest the need for timely interventions to manage human resources for a sustainable quarantine system.

• Journal of Trauma and Injury
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• 제37권1호
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• pp.67-73
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• 2024

Purpose: Posttraumatic stress disorder (PTSD) is prevalent and is associated with protracted recovery and worse outcomes after injury. This study compared PTSD prevalence using the PTSD Checklist for DSM-5 (PCL-5) with the prevalence of PTSD risk using the Injured Trauma Survivor Screen (ITSS). Methods: Adult trauma patients at a level I trauma center were screened with the PCL-5 (sample 1) at follow-up visits or using the ITSS as inpatients (sample 2). Results: Sample 1 (n=285) had significantly fewer patients with gunshot wounds than sample 2 (n=45) (8.1% vs. 22.2%, P=0.003), nonsignificantly fewer patients with a fall from a height (17.2% vs. 28.9%, P=0.06), and similar numbers of patients with motor vehicle collision (40.7% vs. 37.8%, P=0.07). Screening was performed at a mean of 154 days following injury for sample 1 versus 7.1 days in sample 2. The mean age of the patients in sample 1 was 45.4 years, and the mean age of those in sample 2 was 46.1 years. The two samples had similar proportions of female patients (38.2% vs. 40.0%, P=0.80). The positive screening rate was 18.9% in sample 1 and 40.0% in sample 2 (P=0.001). For specific mechanisms, the positive rates were as follows: motor vehicle collisions, 17.2% in sample 1 and 17.6% in sample 2 (P>0.999); fall from height, 12.2% in sample 1 and 30.8% in sample 2 (P=0.20); and gunshot wounds, 39.1% in sample 1 and 80.0% in sample 2 (P=0.06). Conclusions: The ITSS was obtained earlier than PCL-5 and may identify PTSD in more orthopedic trauma patients. Differences in the frequency of PTSD may also be related to the screening tool itself, or underlying patient risk factors, such as mechanism of injury, or mental or social health.

• Journal of Acupuncture Research
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• 제24권6호
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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.

• Child Health Nursing Research
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• 제25권1호
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• pp.9-16
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• 2019

Purpose: Childhood leukemia is a serious trauma affecting both adolescents and their parents, who experience painful process. However, adolescents with leukemia and their parents also experience positive changes, which is referred to as posttraumatic growth. We examined posttraumatic growth, core beliefs, impact of event, and event-related rumination in adolescents within 5 years of a diagnosis of childhood leukemia and their parents. Methods: The participants were 68 adolescents with childhood leukemia (aged 13~18 years) and their parents, who were recruited from C university hospital in Korea from May to September 2016. The Posttraumatic Growth Inventory, Core Belief Inventory, Impact of Event Scale-Revised, and Event-related Rumination Inventory were completed by the adolescents and their parents. The mean scores and correlations between variables were investigated for both set of participants. Results: Parents showed significantly higher levels of posttraumatic growth, disruption of core beliefs, impact of event, and invasive rumination than adolescents. Disruption of core beliefs and deliberate rumination were positively correlated with posttraumatic growth in both groups. Conclusion: Nursing intervention programs that involve modifying core beliefs and inducing a positive thought can help adolescents with leukemia and their parents grow after traumatic events.

• 대한불안의학회지
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• 제4권1호
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• pp.42-48
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• 2008

현재 PTSD와 관련한 여러 병태생리 기전들이 밝혀지고 있으며 이에 초점을 둔 다양한 약물치료가 행해지고 있다. 본 연구에서는 일 대학병원에서 PTSD로 진단된 환자들의 의무기록을 검토하여 약물치료의 경향에 대해 알아보았다.1998년 1월부터 2007년 12월까지 DSM-IV에 의해 PTSD로 진단된 입원 환자 75명이 대상군이 되었으며, 이들의 인구학적 요인들, 입원기간, 외상의 종류, 외상 후 경과시간 및 정신과적 공존병리 및 처방 받은 약물을 조사하였다. 조사 결과, 75명 중 남자는 33명, 여자는 42명이었다. 정신과적 공존병리는 총 50명(66.7%)에서 존재하였으며, 우울장애, 인지장애, 정신장애 및 불안장애 순이었다.73명(97%)의 대상군은 항우울제를 처방 받았으며, 그 중 paroxetine이 54.7%로 가장 많았고 두 가지 이상의 항우울제를 처방 받은 경우도 24%였다. 또 거의 대부분의 환자에서 비정형 항정신병약물(33.3%), 기분안정제(17.3%),항불안제(94.7%)가 항우울제와 병용 처방된 것으로 조사되었다. 여러 제한점에도 불구하고 본 연구에서 얻어진 약물 처방 경향은 향후 국내 실정에 맞는 치료 지침을 수립하는 데에 하나의 근거 자료가 될 수 있을 것이다.

• 한국응급구조학회지
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• 제22권3호
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• pp.149-162
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• 2018

연구 목적: 본 연구는 소방공무원의 근무형태에 따라 수면의 질, 직무스트레스, 피로도, 직무만족 및 외상 후 스트레스 장애 차이를 알아보고, 근무형태에 맞는 심리치료의 기초자료를 제공하고자 하였다. 연구 방법: 본 연구는 온라인 설문지를 이용하였다. 소방공무원 322명을 대상으로 하였으며, 자료수집기간은 2018년 5월 2일부터 5월 20일까지였다. 수집된 자료는 SPSS 22.0을 이용하여 분석하였다. 연구 결과: 소방공무원의 근무형태에 따라 직무스트레스, 직무만족, 외상 후 스트레스 장애는 유의미한 차이를 보였으나, 수면의 질, 피로도 차이는 없었다. 직무스트레스, 직무만족, 외상 후 스트레스 장애의 유의미한 차이를 나타낸 것은 화재진압과 구조 구급근무형태였다. 또한 외상 후 스트레스 장애는 수면의 질, 직무스트레스, 직무만족, 피로도와 유의미한 차이를 보였다. 이는 외상 후 스트레스 장애를 겪고 있는 소방공무원들은 수면의 질, 직무스트레스, 직무만족, 피로도의 어려움을 함께 경험하고 있으므로 이를 개선할 수 있는 방안을 제안하였다. 결 론: 본 연구의 결과를 토대로 소방공무원 근무형태에 따라 수면의 질, 직무스트레스, 피로도, 직무만족 및 외상 후 스트레스 장애를 극복할 수 있는 심리치료 기초 자료를 제공할 때 소방공무원의 정신건강이 좋아질 것이다.

• 정신신체의학
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• 제11권1호
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• pp.36-43
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• 2003

연구목적: 본 연구의 목적은 외상후 스트레스 장애에서 증상의 정도에 따른 인지기능의 차이가 어떠한지에 대하여 연구한 것이다. 방 법: 교통사고 관련 외상후 스트레스 장애로 진단된 90명의 외래, 입원환자를 대상으로 외상후 스트레스 장애 증상의 심각도(MMPI 우울증 척도, 강박 척도, 정신분열증 척도)와 인지기능(K-WAIS)을 측정하였다. 그들을 MMPI 우울증 척도, 강박증 척도, 정신분열증 척도 점수에 따라 상위 30%에 해당하는 집단과 하위 30%에 해당하는 집단으로 구분하여 두 군간의 지능과 소검사 점수 차이에 대하여 각각 검증하였다. 결 과: 우울증 척도의 상위군과 하위군 사이에 유의한 차이는 없었다. 그리고 강박 척도에서 하위군이 상위군보다 기본지식, 어휘문제, 공통성문제, 빠진곳 찾기, 차례맞추기가 유의하게 높았다. 그리고 정신분열증 척도에서 하위군이 상위군보다 전체지능, 언어성지능, 동작성지능, 기본지식, 어휘문제, 이해문제, 산수문제, 빠진곳 찾기, 차례맞추기, 토막짜기, 모양맞추기, 바꿔쓰기가 유의하게 높았다. 결 론: 본 연구 결과, 외상후 스트레스 장애에서 증상의 정도에 따른 인지기능의 차이가 있었다. 따라서 증상의 정도가 심한 집단에서 인지기능 장애가 더 심하다는 것을 알 수 있었다. 그러므로 외상후 스트레스 장애는 불안장애이기도 하지만 인지기능 또한 증상에 의해 많은 영향을 받는다는 것을 알 수 있었다. 향후 외상후 스트레스 장애를 치료함에 있어서 약물치료 뿐만이 아니라 다양한 인지적 치료 접근이 필요할 것으로 생각된다.

• 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.