• 한국심리학회지 : 문화 및 사회문제
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• 제25권4호
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• pp.325-351
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• 2019

본 연구는 외상 사건을 경험한 국내 성인의 외상 후 스트레스(Post Traumatic Stress Disorder) 증상과 외상 후 성장(Post Traumatic Growth) 양상을 토대로 잠재계층(latent class)을 도출하고, 각 집단 구분에 영향을 미치는 특성을 탐색하며, 집단에 따른 자기파괴적 행동의 차이를 탐색함으로써, 외상 사건을 경험한 개인에 대해 보다 심층적으로 이해하고자 한다. 이를 위해 본 연구에서는 DSM-5 진단기준에 해당하는 외상 사건을 경험한 국내성인 860명을 대상으로 잠재프로파일분석(Latent Profile Analysis)과 R-3STEP 방식을 이용하였다. 집단 예측 변인으로 개인의 인구사회학적 변인(성별, 연령, 최종 학력, 종교유무, 종교활동 정도, 월 평균 소득)과 사회적 고립, 외상 경험 빈도가 포함되었으며, 종속변인으로 자기파괴적 행동(폭식 정도, 비자살적 자해 유무, 음주의 양, 음주 형태, 음주로 인한 정신 사회적 문제)을 포함하였다. 연구결과 집단은 '저PTSD/중 PTG집단', '저 PTSD/고 PTG집단', '고 PTSD/고 PTG집단'으로 분류되었다. 또한 성별, 최종학력, 사회적 고립, 외상 노출 빈도가 집단 예측 변인으로 영향을 미치는 것으로 나타났으며, 폭식 정도, 비자살적 자해 유무, 음주 형태, 음주로 인한 정신사회적인 문제에서 집단 간 차이가 있는 것으로 나타났다. 마지막으로 본 연구의 결과를 바탕으로 논의와 시사점을 제시하였다.

• 대한불안의학회지
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• 제15권2호
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• pp.94-100
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• 2019

Objective : The purpose of this study was to investigate differences in anxiety and depression symptoms, comorbidity according to the patterns of temperament and character in patients with posttraumatic stress disorder (PTSD). Methods : The temperament and character inventory (TCI), beck depression inventory (BDI) and beck anxiety inventory (BAI) were administered to 151 PTSD patients classified into four groups of adaptation, vulnerable temperament, immature personality and composite vulnerability according to the results of the Temperament and Character Inventory (TCI). MANOVA and Chi-square tests were conducted to analyze differences in BDI, BAI, temperament and character scores and rate of comorbid disorders between the four groups. Results : The immature character and complex vulnerability group showed the higher rate of comorbid depression disorder. Anxiety and depression severity were significantly different among groups, especially depression severity had higher scores in the immature character and complex vulnerability groups and anxiety severity had higher scores in the complex vulnerability group than adaptive group. The immature character and complex vulnerability groups showed significantly lower score on the temperament scale of reward dependence and persistent. Conclusion : The results demonstrate the significance of adaptive characteristics on anxiety and depression symptoms regardless of vulnerable temperaments, and its consequent role in the management of character factors relative to intervention regarding PTSD.

• 생물정신의학
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• 제8권1호
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• pp.131-139
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• 2001

This study was conducted to evaluate the effect of PTSD on memory function and hippocampal volume, and to identify major variables correlated to hippocampal volume and memory function. Thirty four Vietnam veterans were collected for this study, among whom eighteen were PTSD patients and sixteen were combat control subjects. The author used Impact of Event Scale(IES), Combat Exposure Scale(CES), Hamilton Depression Rating Scale(HDRS) and Beck Depression Inventory (BDI). Korea Memory Assessment Scale(K-MAS) was assessed for memory function. Magnetic resonance imaging(MRI) was used to measure hippocampal volume. There were significant differences between PTSD and Non-PTSD veterans in IES, HDRS and BDI. Significant difference was found in verbal memory and total memory of K-MAS between PTSD and Non-PTSD veterans. There was significant difference in hippocampal volume between PTSD and Non-PTSD veterans. Short term memory, verbal memory and total memory were positively correlated to hippocampal volume. Hippocampal volume was negatively correlated to IES, HDRS, and BDI. These results suggest that PTSD severity be associated with hippocampal atrophy and memory dysfunction. Reduced or smaller hippocampal volume may be preexisting risk factor for stress exposure or the development of PTSD on combat exposure.

• 대한불안의학회지
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• 제6권1호
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• pp.65-70
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• 2010

Objectives : Indirect contact with trauma may occur when a person empathically listens to detailed descriptions, exposing the person to intense emotional pain from trauma victims. Although less severe than direct trauma, indirectly traumatized persons may experience the same fear, rage, and despair as direct trauma victims. This phenomenon has been variously termed vicarious trauma, traumatic countertransference, burnout, compassion fatigue, and secondary traumatic stress. Using a psychiatric symptoms questionnaires, this study investigated the effects of indirect exposure to co-worker's trauma on the mental health of firefighters who had not directly experienced traumatic events in the previous year. Methods : We administered self-report questionnaires, such as the Impact of Event Scale-Revised (IESR) and Alcohol Use Disorder Identification Test (AUDIT), to firefighters working at two fire stations in a metropolitan city. We analyzed 188 of 232 collected surveys, after excluding falsely entered data (28 cases) and questionnaires by directly-traumatized victims (16 cases). Results : Alcohol consumption and posttraumatic stress disorder (PTSD) symptoms, as determined by the AUDIT and IES-R, were significantly higher in the indirectly-traumatized group. The ratio of high-risk members scoring higher than 23 in IES-R was larger in the indirectly traumatized group, although this was not statistically significant. Conclusion : Alcohol consumption was significantly higher in the indirectly traumatized group. This group also included more members at high risk for PTSD. Further research, with a larger group of indirectly traumatized firefighters and ongoing investigation of PTSD development and other psychiatric symptoms, is needed.

• 정신신체의학
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• 제30권2호
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• pp.80-98
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• 2022

외상후 스트레스 장애는 다양한 치료들에 대한 치료반응이 좋지 않아, 많은 임상가들에게 큰 도전이 되고 있다. 최근 발간된 여러 임상 진료지침들은 인지처리치료 및 지연노출치료를 포함한 트라우마 초점 정신치료들을 일차 치료로 공통적으로 권고하고 있다. 환자에게 근거에 기반한 치료적 선택지들에 대하여 정보를 제공함으로써 환자와 임상가가 함께 최선의 치료방법을 선택할 수 있도록 하는 것이 중요하며, 이를 위해 인지처리치료의 내용과 근거를 소개하는 것이 본 종설의 목적이다. 인지처리치료의 회기 구성과 내용을 요약하여 소개하고, 외상후 스트레스 장애에 대한 인지처리치료의 효과를 알아본 다양한 연구들을 민간인 집단과 재향군인/현역군인 집단으로 구분하여 제시하였다. 인지처리치료의 탈락율을 낮추고 치료성적을 올리며 치료접근도를 높일 수 있는 방법들 및 외상후 스트레스 장애에 대한 근거중심치료의 활성화를 위한 방안을 토의한다.

• 한국의사학회지
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• 제34권1호
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• pp.59-74
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• 2021

Li Gao left a great mark in the history of Chinese medicine by founding Piwei (脾胃) theory. When explaining Li Gao's medical ideology, researchers explain that his medical ideology was created by curing hunger during wartime and treating diseases of people who suffered from battle field trauma. However, Li Gao also suffered from battlefield trauma for his experience of the Mongol siege of Kaifeng (開封城) from 1232 to 1233. It is the hypothesis of this study that Li Gao himself would have suffered posttraumatic stress disorder (PTSD), and this study reexamines the process more closely from the viewpoint of PTSD and posttraumatic growth (PTG). The conclusion of this study is that his achievement in medical history is a result of his PTG. Li Gao's narrative of Piwei (脾胃) theory contains elements that seek revenge against the Mongol soldiers, and Li Gao achieved extraordinary PTG by overcoming the trauma of the siege of Kaifeng step by step.

• 생물정신의학
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• 제17권2호
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• pp.79-85
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• 2010

Objectives : Trauma patients have attentional bias which enforces traumatic memories and causes cognitive errors. Understanding of such selective attention may explain many aspects of the posttraumatic stress disorder(PTSD) symptoms. Methods : We used the rapid serial visual presentation(RSVP) method to verify attentional blink in burn patients with PTSD. International affective picture system(IAPS) was used as stimuli and distracters. In the 'neutral test', patients have been presented series of pictures with human face picture as target stimuli. Each picture had 100ms interval. However the distance between target facial pictures was randomized and recognition of second facial picture accuracy was measured. In the 'stress test', the first target was stress picture which arouses patient emotions instead of the facial picture. Neutral and Stress tests were done with seven PTSD patients and 20 controls. In '85ms test' the interval was reduced to 85ms. The accuracy of recognition of second target facial picture was rated in all three tests. Eighty-five ms study was done with eighteen PTSD patients. Results : Attentional blinks were observed in 100-400ms of RSVP. PTSD patients showed increased recognition rate in the 'stress test' compared with the 'neutral test'. When presentation interval was decreased to 85 ms, PTSD patient showed decrease of attentional blink effect when target facial picture interval was 170ms. Conclusion : We found attentional blink effect could be affected by stress stimulus in burn patients. And attentional blink may be affected by stimulus interval and the character of stimulus. There may be some other specific mechanism related with selective attention in attentional blink especially with facial picture processing.

• 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.

• 동의신경정신과학회지
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• 제22권4호
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• pp.77-86
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• 2011

Objectives : These days assaults and other natural and human disasters are increasing. But oriental medical treatment researches in Korea are limited in car accident PTSD patients only. Our object is to explore an oriental medical intervention model for the evidence-based approach to PTSD after diverse trauma including disasters. Methods : Domestic papers for Korean researches are obtained from oriental medical related journals by internet searching. International materials are obtained from PubMed searching and a publication from Department of Veterans' Affairs. After assorting searched articles into RCTs and non-RCTs, we analyzed the articles according to the elapsed time from trauma. Results : We confirmed that acupuncture, CBT, and PMR were effective in acute stage after traumatic event. And EMDR, EFT, and relaxation therapy were effective in chronic stage after traumatic event. Building on the findings, we proposed a model of oriental medicine for Disaster Mental Health. Conclusions : Analyzing previous researches about oriental medicine on PTSD, several interventions were confirmed the effectiveness on specific treatment stage. We could find the possibility of Oriental Medicine as a Disaster Mental Heath and proposed a model of Oriental medicine for Disaster Mental Health.

• 대한불안의학회지
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• 제8권2호
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• pp.106-112
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• 2012

Objective : In posttraumatic stress disorder (PTSD), it is essential to evaluate the severity of trauma with a reliable instrument. The combat exposure scale (CES) is one of the most widely used measures for the combat-related trauma. The present study was conducted to test the reliability and validity of the Korean version of CES (CES-K). Methods : One hundred and forty-five male Korean veterans of the Vietnam War participated in this study. CES-K, the structured clinical interview for DSM-III-R (SCID), clinician administered PTSD scale (CAPS), and the Korean version life events checklist (LEC-K) were administered. Results : Cronbach's coefficient of CES-K was .85, and the test-retest reliability was .94. The mean [standard deviation (SD)] scores of CES-K were 20.4 (9.0) in the PTSD group and 12.0 (8.6) in the non-PTSD group (p<.001). CES-K showed a significant correlation with LEC-K (r=.31, p<.001) and CAPS (r=.52, p<.001). Only one factor was revealed by the factor analysis. Conclusion : CES-K showed good reliability and validity for assessing the severity of combat exposure. Further, it demonstrated comparable psychometric properties to the previous study. It is expected that CES-K will be a useful tool for evaluating the severity of combat exposure in Korea.