• Title/Summary/Keyword: Posttraumatic stress disorder (PTSD)

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Pharmacologic Considerations for Youth with Posttraumatic Stress Disorder

  • Keeshin, Brooks;Strawn, Jeffrey R.
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.28 no.1
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    • pp.14-19
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    • 2017
  • Children exposed to potentially traumatic events are at risk of developing posttraumatic stress disorder (PTSD). However, the subsequent developmental course of posttraumatic stress symptoms appears to vary considerably. In this regard, some PTSD symptoms resolve without significant interventions, while for many children and adolescents, they persist until the patient receives appropriate treatment specifically designed to address PTSD and other trauma related symptoms. Evidence-based psychotherapies represent the standard of care for children with PTSD and, while psychopharmacologic interventions are utilized for many youth with posttraumatic stress symptoms and PTSD, there is little data available to guide the use of these medications in this population. However, given the structural challenges involved in disseminating and delivering evidence-based psychotherapies in all settings, prescribing clinicians should be aware of the medications whose use in children with pediatric PTSD has been studied. Herein, we review the PTSD assessment modalities, as well as the use of pharmacologic interventions in PTSD, including antiadrenergic agents, selective serotonin reuptake inhibitors and other medications.

An analysis of posttraumatic stress disorder(PTSD) of fire fighters (소방공무원의 현장충격 스트레스에 대한 분석)

  • Kim, Jee-Hee
    • 한국방재학회:학술대회논문집
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    • 2008.02a
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    • pp.381-384
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    • 2008
  • The purpose of this study is to evaluate influence factors of secondary traumatic stress, burnout, and physical symptoms which were experienced by fire fighters. The questionnaire research was done for field service fire fighters who work in Korea. I analyzed 358 questionnaires and the questionnaires consisted of stress scale, work force, burden of physical symptoms, and self-control to stress. Through this study I will propose the solution for the posttraumatic stress disorder(PTSD) for the near future.

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Factors Influencing Posttraumatic Stress Disorder Symptoms in Burn Injured Patients : Embitterment, Depression and Meaning in Life (화상환자의 외상후 스트레스 장애 증상에 대한 영향 요인 : 울분, 우울, 삶의 의미)

  • Hwang, Jihyun;Lee, Boung Chul;Chae, Jeong-Ho
    • Anxiety and mood
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    • v.15 no.1
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    • pp.29-34
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    • 2019
  • Objective : To determine predictors of posttraumatic stress disorder (PTSD) symptoms in burn injured patients and evaluate factors for identifying high risk group of PTSD. Methods : This study examined sixty one patients aged in the range of 19-65 years with burn injuries. All subjects completed self-assessment inventories about PTSD (The PTSD Check List for DSM-5. PCL-5), depression (Patient Health Questionnaire-9, PHQ-9), embitterment (Posttraumatic embitterment disorder self-rating scale, PTED scale) and meaning of life (Meaning in Life Questionnaire, MLQ). Stepwise multiple regression and ROC curve analysis were the tools used for analysis. Results : The results revealed higher depression, embitterment and lower presence of meaning in life predicted severe PTSD symptoms. ROC analysis indicated PTED scale and PHQ-9 were useful for discriminating high risk group of PTSD. Conclusion : The present study established that the need to consider embitterment, depression and meaning of life for alleviation and prevention of PTSD symptoms in burn patients.

The Changes in Biogenic Amines and Cortisol in Patients with Posttraumatic Stress Disorder After Long-Term Pharmacological Treatment (외상후 스트레스장애 환자에서 장기 치료에 따른 카테콜아민과 코르티솔 변화)

  • Kang, Suk-Hoon;Chung, Moon-Young;Kim, Tae-Yong;Chung, Hae-Gyung
    • Anxiety and mood
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    • v.4 no.1
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    • pp.19-27
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    • 2008
  • Objective : This study was conducted to evaluate the changes in the levels of neurotransmitters and cortisol in patients with chronic posttraumatic stress disorder (PTSD) and to evaluate their correlation with symptoms after long-term pharmacological treatment. Methods : Twenty-eight Vietnam veterans with chronic PTSD and 34 non-PTSD patients were consecutively recruited. The Combat Exposure Scale (CES), Mississippi Scale for Combat-Related Posttraumatic Stress Disorder (M-PTSD), Clinician Administered PTSD Scale (CAPS), Hamilton Rating Scale for Depression (HRSD) and Hamilton Anxiety Scale (HAS) were used to evaluate symptom severity. High performance liquid chromatography (HPLC) was used to measure the plasma levels of epinephrine, norepinephrine, and dopamine, and a radioimmunoassay (RIA) was performed to evaluate the plasma level of cortisol. Results : Plasma cortisol was significantly lower in PTSD patients than in control subjects, while there was no significant difference in plasma epinephrine, norepinephrine and dopamine between the two groups. The scores of M-PTSD, CAPS, HAMD and HAMA were signigicantly higher in PTSD patients than control group. Conclusion : After long-term treatment, the levels of neurotransmitters in PTSD patients returned to within the normal range, and the patients' symptoms showed some improvement. However, the core symptoms of PTSD continued to appear intermittently, and they are thought to be associated with hormonal systems, such as the HPA axis. It is also suggested that PTSD should be considered to be a complex disorder associated with multiple systems and that combinations of the effective medications for each system should be used to treat patients with PTSD.

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Mindfulness-Based Interventions for Posttraumatic Stress Disorder (외상후스트레스장애를 위한 마음챙김기반 치료)

  • Hong, Hyun-Mi;Jung, Young-Eun
    • Anxiety and mood
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    • v.18 no.1
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    • pp.1-9
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    • 2022
  • Mindfulness has been widely researched in mental, physical health, and healthy populations. The effectiveness of mindfulness-based interventions have also been demonstrated in research studies. This report reviews the research on mindfulness based interventions currently employed for the treatment of posttraumatic stress disorder (PTSD). Mindfulness-based theories postulate that symptoms of PTSD are developed and maintained by experiential avoidance and non-mindful behaviors. Recent emerging work indicates that mindfulness based interventions, such as mindfulness-based stress reduction and mindfulness-based cognitive therapy, may improve the symptoms of PTSD. Further advances are needed to gain a better understanding of the ability of mindfulness based interventions to target specific symptom dimensions of PTSD and the psychological/neurobiological mechanisms of actions underlying these interventions.

Symptoms of Posttraumatic Stress Disorder in Relation to the Alcohol Problem in Korean Veterans of Vietnam War (월남전 참전자에서 문제음주와 관련한 외상 후 스트레스 장애의 증상 차이)

  • Kwon, Tae Hyo;Chung, Hae Gyung;Kim, Dong Su;Choi, Jin Hee;Kim, Tae Yong;So, Hyung Seok;Chung, Moon Yong
    • Anxiety and mood
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    • v.7 no.2
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    • pp.119-125
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    • 2011
  • Objectives : The three symptom clusters of posttraumatic stress disorder (PTSD) are reexperience, avoidance, and hyperarousal. Alcohol use disorders frequently co-occur with PTSD, and possible functional correlations are suspected. Scholarly evaluation of the differences between the symptoms of PTSD and those of alcohol problems may be useful in understanding the pathophysiology of the comorbidity. Methods : We recruited Vietnam veterans with PTSD (n=97) and without PTSD (n=132). The alcohol use disorder identification test (AUDIT), and clinician-administered PTSD scale (CAPS) were administered to participants. The PTSD group was divided into two categories: those with PTSD only (n=57) and those with concurrent alcohol-related problems (n=40). Results : The PTSD group showed higher AUDIT scores compared to the control group. In the PTSD group, participants with alcohol problems had a severer symptoms of recurrent dream and sleep disturbance symptoms compared to the PTSD only group. No significant differences were found in the three major symptom clusters of PTSD. Conclusion : These findings support the proposed existence of a functional correlation between PTSD and alcohol use disorder. Clinicians should carefully evaluate and treat comorbid alcohol use disorder in patients with PTSD.

Plasma Serotonin Level of Vietnam War Veterans with Post-Traumatic Stress Disorder and Symptom Severity (혈장 세로토닌과 외상후 스트레스 장애 : 월남전 참전 재향군인을 대상으로)

  • Lee, Soo-Young;Kang, Suk-Hoon;Chung, Moon-Yong;Lee, Myung-Hee;Kim, Tae-Young;So, Hyung-Seok;Chung, Hae-Kyung;Choi, Jin-Hee
    • Anxiety and mood
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    • v.5 no.1
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    • pp.14-20
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    • 2009
  • Objective : The objective of this study was to examine the relationship between plasma serotonin concentration and posttraumatic stress disorder (PTSD) symptoms in chronic PTSD patients who have been taking medication. Methods : Plasma serotonin level of 14 PTSD patients and a control group of 28 Vietnam War veterans was measured by HPLC (high performance liquid chromatography). The Combat Exposure Scale (CES), Mississippi Scale for Combat-Related Posttraumatic Stress Disorder (M-PTSD), Clinician Administered PTSD Scale (CAPS), Hamilton Rating Scale for Depression (HRSD), and Hamiltion Anxiety Scale (HAS) were used to evaluate PTSD symptom severity. Results : Serotonin level was significantly higher in the PTSD group than in the control group (p=0.036, p=0.006, respectively). M-PTSD (p<0.001), CAPS (p<0.001), HRSD (p<0.001), and HAS (p<0.001) scale scores were significantly higher in the PTSD group than in the control group; however, the CES score failed to show a significant improvement (p=0.964). There were no significant differences between plasma serotonin and PTSD symptoms. Conclusion : In chronic PTSD patients who have been taking medications, we can not predict treatment effect and symptom severity by measuring only plasma serotonin levels. PTSD is a complicated disorder which may likely be related to a variety of neurotransmitter systems. Therefore, further research which investigate relationships with norepinephrine, dopamine, and other neurotransmitters as well as serotonin is needed to improve the treatment of PTSD.

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Increased Frontal Gamma and Posterior Delta Powers as Potential Neurophysiological Correlates Differentiating Posttraumatic Stress Disorder from Anxiety Disorders

  • Moon, Sun-Young;Choi, Yoo Bin;Jung, Hee Kyung;Lee, Yoonji Irene;Choi, Soo-Hee
    • Psychiatry investigation
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    • v.15 no.11
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    • pp.1087-1093
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    • 2018
  • Objective Posttraumatic stress disorder (PTSD) is distinct from anxiety disorders in its etiology and clinical symptomatology, and was reclassified into trauma- and stressor-related disorders in DSM-5. This study aimed to find neurophysiological correlates differentiating PTSD from anxiety disorders using resting-state quantitative electroencephalography (qEEG). Methods Thirty-six patients with either PTSD or acute stress disorder and 79 patients with anxiety disorder were included in the analysis. qEEG data of absolute and relative powers and patients' medication status on the day of qEEG examination were obtained. Electrodes were grouped into frontal, central, and posterior regions to analyze for regional differences. General linear models were utilized to test for group differences in absolute and relative powers while controlling for medications. Results PTSD patients differed from those with anxiety disorders in overall absolute powers [F(5,327)=2.601, p=0.025]. Specifically, overall absolute delta powers [F(1,331)=4.363, p=0.037], and overall relative gamma powers [F(1,331)=3.965, p=0.047] were increased in PTSD group compared to anxiety disorder group. Post hoc analysis regarding brain regions showed that the increase in absolute delta powers were localized to the posterior region [F(1,107)=4.001, p=0.048]. Additionally, frontal absolute gamma powers [F(1,107)=4.138, p=0.044] were increased in PTSD group compared to anxiety disorder group. Conclusion Our study suggests increased overall absolute delta powers and relative gamma powers as potential markers that could differentiate PTSD from anxiety disorders. Moreover, increased frontal absolute gamma and posterior delta powers might pose as novel markers of PTSD, which may reflect its distinct symptomatology.

The Association among Stress Coping Strategies, Social Support, and Self-Esteem in Patients with Posttraumatic Stress Disorder (외상후스트레스장애 환자의 증상 정도와 스트레스 대처 방식, 사회적 지지, 자존감의 관련성)

  • Chung, Jae-Hee;Kwon, Joo-Han;Park, Jong-Il;Yang, Jong-Chul
    • Anxiety and mood
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    • v.17 no.2
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    • pp.59-66
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    • 2021
  • Objective : The purpose of this study is to investigate the relationship among the degree of symptoms of posttraumatic stress disorder (PTSD) and social support, stress coping strategies, and self-esteem in patients with PTSD. Methods : A total of 48 patients meeting DSM-5 criteria for PTSD and 48 normal controls were recruited for participation in this study. We evaluated subjects using the Clinician-Administered PTSD Scale (CAPS), Hamilton Anxiety Scale (HAM-A), Hamilton Depression Scale (HAM-D), Rosenberg Self-Esteem Scale (RSES), Multidimensional Scale of Perceived Social Support (MSPSS) and The Ways of Stress Coping Questionnaire (SCQ). We analyzed data using an independent t-test and Pearson's correlation analysis. Results : In PTSD patients, total CAPS scores showed a significant positive correlation with HAM-A and HAM-D scores and a significant negative correlation with MSPSS scores. RSES scores showed a significant positive correlation with MSPSS and SCQ scores. MSPSS scores showed a significant negative correlation with PTSD avoidance and numbing and HAM-D scores. SCQ scores showed a significant negative correlation with PTSD avoidance and numbing. Conclusion : These results revealed that the better the stress coping strategies and social support, the lower the degree of symptoms in patients with PTSD. In addition, it was found that the higher the social support and self-esteem, the lower the degree of depression and anxiety. Therefore, in the treatment process, it seems important to identify and correct the self-esteem, social support system, and stress coping strategies of patients with PTSD.

A Brief Screening Tool for PTSD: Validation of the Korean Version of the Primary Care PTSD Screen for DSM-5 (K-PC-PTSD-5)

  • Jung, Young-Eun;Kim, Daeho;Kim, Won-Hyoung;Roh, Daeyoung;Chae, Jeong-Ho;Park, Joo Eon
    • Journal of Korean Medical Science
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    • v.33 no.52
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    • pp.338.1-338.5
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    • 2018
  • The purpose of this study was to develop and evaluate psychometrically the Korean version of the Primary Care Posttraumatic Stress Disorder Screen for the Diagnostic and Statistical Manual-fifth edition (K-PC-PTSD-5). In total, 252 participants were interviewed with the Structured Clinical Interview for Diagnostic and Statistical Manual-fifth edition-research version (SCID-5-RV). The K-PC-PTSD-5 showed good internal consistency (${\alpha}=0.872$), test-retest reliability (r = 0.89), and concurrent validity (r = 0.81). A score of 3 was identified as the threshold for clinically significant posttraumatic stress disorder (PTSD) symptoms. Overall, the results indicate that the K-PC-PTSD-5 is a useful, timesaving instrument for screening PTSD symptoms.