• 정신신체의학
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• 제7권1호
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• pp.51-60
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• 1999

본 연구에서는 불안과 우울감과 같은 정서상태가 만성적인 통증 인지와 상관관계가 있는지를 알아보고자 PTSD 환자군의 압통에 대한 역치와 불안증상, 우울증상의 정도를 측정하였고, 불안, 우울증상의 정도와 압통역치의 상관관계를 대조군과 비교하였다. 연구대상 환자군은 1997년 10월부터 1998년 3월까지 중앙대학교 의과대학 부속필동병원 및 용산병원 신경정신과에 입원한 환자와 외래환자들 중에서 PTSD에 진단된, 20-60세에 해당되는 성인 남자환자 23명을 대상으로 하였다. 결과는 다음과 같다. 1) PTSD 환자군에서 통계적으로 의미있게 높은 우울증상과 불안증상을 보였다(p<.05). 2) 압통에 대한 역치는 환자군에서 유의하게 높은 결과를 보였다(p<.05). 이런 결과를 보인 요인으로는, 환자군의 불안증상보다는 만성적인 우울증상이 통증역치의 증가에 부분적으로나마 영향을 주었을 것으로 추정되며 그외에 환자군에서의 opiate system의 이상, 환자군의 질병역할, 환자군이 처한 여러 사회환경적인 상황의 영향 등과 같은 여러 요인이 관련되었을 것이라고 생각한다. 결론적으로 PTSD의 만성 통증은 감정, 특히 우울증과 관련이 있을 것으로 보였으나, 그 인과관계에 대한 결론을 내리기에는 미흡한 점들이 있다. 앞서 언급한 여러 제한점들을 보완한 향후 연구를 통해 정서적 증상과 동통과의 보다 특이적인 연관성을 규명하는 연구가 필요할 것이라 생각한다.

• 대한불안의학회지
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• 제4권2호
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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.

• 대한약침학회지
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• 제27권1호
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• pp.27-37
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• 2024

Objectives: Posttraumatic stress disorder (PTSD) is a prevalent mental health condition, and techniques using sensory stimulation in processing traumatic memories have gained attention. The Emotional Freedom Techniques (EFT) is a psychotherapy that combines tapping on acupoints with exposure to cognitive reframing. This pilot study aimed to assess the feasibility of EFT as a treatment for PTSD by answering the following research questions: 1) What is the compliance and completion rate of patients with PTSD with regard to EFT protocol? Is the dropout rate reasonable? 2) Is the effect size of EFT protocol for PTSD sufficient to justify a future trial? Methods: Thirty participants diagnosed with PTSD were recruited. They received weekly EFT sessions for five weeks, in which they repeated a statement acknowledging the problem and accepting themselves while tapping the SI3 acupoint on the side of their hand. PTSD symptoms were evaluated using the PTSD Checklist for DSM-5 (PCL-5) before and after the intervention. Results: Of the 30 PTSD patients (mean age: 34.1 ± 9.1, 80% female), 96.7% showed over 80% compliance to the EFT sessions, and 86.7% completed the entire study process. The mean PCL-5 total score decreased significantly after the intervention, with a large effect size (change from baseline: -14.33 [95% CI: -19.79, -8.86], p < 0.0001, d = 1.06). Conclusion: The study suggests that EFT is a feasible treatment for PTSD, with high session compliance and low dropout rates. The effect size observed in this study supports the need for a larger trial in the future to further investigate EFT as a treatment for PTSD. However, the lack of a control group and the use of a self-rated questionnaire for PTSD symptoms are limitations of this study. The findings of this pilot study can be used to plan a future trial.

• 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.

• 한국화재소방학회:학술대회논문집
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• 한국화재소방학회 2007년도 추계학술논문발표회 논문집
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• pp.458-463
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• 2007

• Safety and Health at Work
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• 제9권3호
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• pp.277-289
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• 2018

Background: Lancashire Fire and Rescue Service (LFRS), the subject of this evaluative research document employs 1400 people. 80% of employees are operational firefighters and officers whom operate across a range of duty systems and support functions, providing prevention, protection and emergency response to the communities of Lancashire. Methods: The overarching purpose of this epidemiological study is to assess the prevalence of posttraumatic stress disorder (PTSD) amongst operational LFRS personnel and to analyse the effects upon those who may be suffering from it, whether brought about by a single traumatic event or by repeated exposure to traumatic occurrences over a period of time. A combination of primary and secondary research was carried out. Primary data was collated using two recognised clinical questionnaires and statistical analysis was conducted with the aid of the software package SPSS. Results: The findings and statistical analysis showed that out of the 100 people surveyed, 30% of respondents had signs of probable distress. Of this quota, 4% showed symptoms of PTSD. The study considers how an organisation can recognise and manage PTSD and provides recommendations to assist in better recognising and managing the associated risks. Conclusion: Based upon the findings, the authors conclude that the level of PTSD within LFRS is slightly lower than those found in other studies undertaken within the Fire and Rescue Service sector. The paper provides recommendations for future studies and a series of actions for consideration by LFRS senior management to improve PTSD support services for employees.

• 한국응급구조학회지
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• 제13권2호
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• pp.61-72
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• 2009

Purpose : This study aimed to analyze the posttraumatic stress research trends in Korean and foreign firefighters. Method : Total 63 published international articles were searched by Pub Med internet site and total 17 published Korean articles were searched by Korean Medical Database internet site using 'PTSD in firefighters'. These articles were analyzed by published time, domains of journal, research designs, key words and research subjects. Result : 1) By the published time, there were 29 disaster-related researches(46.0%) and 34 job-related researches(54.0%) among 63 international articles. However, there were 16 disaster-related researches(94.1%) and 1 job-related research (5.9%) of Korean 17 articles. 2) By the international research domain, 9 researches(14.3%) were published in The Journal of Nervous and Mental Disease. Among domestic research domain, there were 9 researches(52.9%) consisting of 6 master's degrees and 3 doctor degrees. In major analysis of Korean domain, the highest portion is 4 psychology researches. (23.5%) 3) In the term of the international research design, quantitative research methods were highly used in both 23 disaster-related researches (36.5%) and 30 job-related researches(47.5%). In domestic research, quantitative research methods were mostly used in 14 job-related researches(82.3%) and Q methodology was only used in 1 disaster-related research(5.9%). 4) Looking on the research content trends according to the key words, 9 researches (31.0%) done on posttraumatic stress and coping had the most research and was followed up by posttraumatic stress symptom. Among these researches, key words for PTSD(Posttraumatic Stress Disorder) and PTS(Posttraumatic Stress) were mostly used. Moreover, there was 1 domestic study done on verifying the trends of Posttraumatic Stress in disaster-related research with PTS as the key word. In job-related research, the relationship between the Posttraumatic Stress and other factors had the most with ten studies (62.5%). Among these researches, key words for 5 PTSD(31.3%) were mostly used. 5) According to the international research subjects, the Posttrau consist the most subjects with 16 cases each for disaster and job related stress ; however, domestic research had 16 studies(94.1%) only using firefighters and 1 (5.9%) with their families as subjects. Conclusion : Although the studies of Posttraumatic Stress on Korean firefighters had started later than those on Foreign firefighters, first used for crucial topics show research development in various fields of study and should be tested for studies like those done in abroad regarding multiple topics and methods.

• 대한물리의학회지
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• 제10권3호
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• pp.29-37
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• 2015

PURPOSE: The aim of this study is to investigate the relationship between psychosocial factors and the severity of musculoskeletal pain in veterans with posttraumatic stress disorder (PTSD). METHODS: A total of 60 subjects were recruited from among the veterans with musculoskeletal pain at D Veterans Hospital. PTSD was evaluated by using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition; severity of pain was measured by using the short-form McGill Pain Questionnaire (SF-MPQ); depression and anxiety were measured by using the Symptom Checklist-90-Revision; and the quality of sleep was measured by using the Pittsburgh Sleep Quality Index. All data were analyzed using SPSS 18.0 software for Windows. RESULTS: The averages cores of pain intensity ($7.48{\pm}1.67$), SF-MPQ-sensory ($13.84{\pm}7.52$), SF-MPQ-affective ($4.41{\pm}3.79$), depression ($19.30{\pm}11.37$), anxiety ($13.39{\pm}7.99$), and quality of sleep ($10.05{\pm}5.89$) were obtained in veterans with PTSD. SF-MPQ-sensory measures sleep quality (r=0.346, p<0.01), SF-MPQ-affective measures depression (r=0.318, p<0.01) and anxiety (r=0.404, p<0.01), and these showed a statistically significant positive correlation in veterans with PTSD. Pain levels were observed to be higher in veterans with PTSD. Moreover, in these subjects, physical pain had a significant influence on the anxiety variable among the psychosocial factors. CONCLUSION: These findings suggest that musculoskeletal pain provides meaningful information about depression, anxiety, and sleep disorder in veterans with PTSD. Our data suggest that musculoskeletal pain may need to be addressed as part of the health management process of veterans.

• 대한불안의학회지
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• 제10권1호
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• pp.3-10
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• 2014

Reactive disorder is a group of diagnosis with a definitely known etiology and whose etiological factor is essential to the diagnosis. In DSM system, such reactive disorders are listed as adjustment disorder, acute stress disorder, brief psychotic disorder with marked stressor and posttraumatic stress disorder (PTSD). However, a growing number of individuals is suffering from a prolonged feeling of embitterment after exceptional negative life events and this condition could be diagnosed neither PTSD nor adjustment disorder nor depressive disorder in the context of DSM-IV diagnostic system. This clinical condition can be described as 'posttraumatic embitterment disorder' (PTED). PTED is a reactive disorder triggered by exceptional, though normal negative life events such as conflict in the workplace, unemployment, death of a relative, divorce, severe illness, or experience of loss or separation. The common feature of such events is that they are experienced as unjust, as a personal insult, accompanied by psychological violation of basic beliefs and values. The central psychopathological response pattern in PTED is a prolonged feeling of embitterment. In particular, the core emotion of embitterment can lead to the rejection of treatment. Therefore, "wisdom therapy" as a new treatment approach specifically designed for PTED has been developed. It is assumed that many patients suffering from PTED are often misunderstood and misdiagnosed. This review would help to introduce PTED into the clinical field in psychiatry.

• 대한불안의학회지
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• 제13권2호
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• pp.123-131
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• 2017

Objective : The PTSD Checklist (PCL) is a self-report screen for posttraumatic stress disorder (PTSD) that can be scored for both diagnostic assessment and symptom severity measurement. The most recent revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) contains a number of changes to the definition of PTSD, and the aim of this study was to assess the psychometric properties of the Korean version of the PCL for the DSM-5 (PCL-5-K). Methods : The participants were 204 Korean veterans of the Vietnam War who completed the PCL-5-K, the Mini Mental Status Examination (MMSE), PTSD module of Structured Clinical Interview for DSM-5, Research Version (SCID5-RV PTSD module), Korean version of Impact of Event Scale-Revised (IES-R-K) and Combat Exposure Scale (CES-K). Results : The PCL-5-K demonstrated good internal consistency (${\alpha}=0.972$) and test-retest reliability (r=0.96); the suggested cut-off score for PTSD diagnosis was ${\geq}37$ with 0.88 sensitivity and 0.96 specificity. The PCL-5-K scale correlated highly with the IES-R-K and CES-K. Factor analysis identified only one factor. Conclusion : Among elderly Korean veterans of the Vietnam War, the PCL-5-K demonstrated similar psychometric qualities to those of both the original PCL and subsequent versions. It is expected that the PCL-5-K will be a useful PTSD screening tool.