• 대한불안의학회지
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• 제14권2호
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• pp.71-79
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• 2018

Objective : Several earlier studies have reported similar symptoms in patients with posttraumatic stress disorder (PTSD) who have been repeatedly exposed to relevant media after disasters and trauma. This study aimed to examine the effects of indirect trauma experience through media rather than direct traumatic events on an individual's social life. Methods : Five hundred and fifty-four individuals participated in our online, self-reported questionnaire survey. All subjects were asked to complete a demographic questionnaire, Posttraumatic Diagnostic Scale, Beck Depression Inventory, the Impact of Event Scale-Revised, State-Trait Anxiety Inventory, Korean version of Alcohol Use Disorder Identification Test, Patient Health Questionnaire-15, Suicidal Behaviors Questionnaire-Revised. Participants were assessed in regards to their experience of violent media exposure within the past three months. Results : Data from our study indicates that the group exposed to violent media had significantly higher perceived stress, physical symptoms, insomnia, and suicide ideation in comparison to the control group. Among the major symptoms of PTSD, the proportion of intrusion symptoms was relatively high in the media exposed group. Conclusion : This suggests that indirect trauma caused by media exposure could cause post-traumatic stress symptoms. The PTSD caused by indirect trauma may have slight differences from the PTSD caused by direct trauma. Therefore, it is necessary to understand, prevent, and control the adverse effects of media.

• 정신신체의학
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• 제30권2호
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• pp.145-154
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• 2022

연구목적 본 연구는 메르스 생존자에서 감염 당시 낙인에 대한 인식, 12개월 후 이들이 사용하는 대처전략, 24개월 후 우울 및 외상후 스트레스 증상에 끼치는 영향 간의 연관성을 확인하고자 하였다. 방 법 63명의 2015년 메르스 생존자를 대상으로 코호트 연구를 진행하여 12개월 및 24개월 후에 인구학적 정보, 메르스 감염의 심각도, 우울 및 외상후 스트레스 증상, 대처전략, 낙인에 대한 인식 등을 조사했다. 결 과 감염 당시 낙인의 인식은 12개월 후 부정적 대처전략(p=0.003), 24개월 후 우울(p=0.058) 및 외상후 스트레스 증상(p=0.011)과 연관성을 보였다. 12개월 후 부정적 대처전략과 24개월 후 우울(p=0.002) 및 외상후 스트레스 증상(p<0.001) 간에도 유의한 연관성이 있었다. 결 론 감염자에 대한 낙인은 생존자들의 장기적 정신 건강에 부정적 영향을 줄 수 있다. 향후 신종감염병 유행 시 낙인 문제를 개선하고 생존자들이 적응적 대처전략을 가지도록 도와야 한다.

• 가정∙방문간호학회지
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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.

• 신경정신의학
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• 제56권1호
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• pp.28-34
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• 2017

Objectives The purpose of this study was to evaluate psychological effects of an outbreak of Middle East respiratory syndrome (MERS), a newly emerged infectious disease, on doctors. Methods After the MERS outbreak was over, we conducted an online survey of doctors who worked at the hospitals in which exposure to MERS cases had been confirmed or who were directly involved in MERS diagnosis and treatment. The Patient Health Questionnaires-9 (PHQ-9) and the Impact of Event Scale-Revised (IES-R) assessment methods were used to assess the severity of depressive and posttraumatic stress symptoms among the 64 doctors participating in the survey. Results The results of the survey indicate that 26.6% (n=17) of participants exhibited depressive symptoms and 7.8% (n=5) had post-traumatic stress symptoms. The doctors employed at hospitals with MERS cases had higher PHQ-9 and IES-R mean scores than those in doctors were not so employed. In contrast, there was no significant difference in those test scores between doctors who participated directly in MERS diagnosis and treatment and those doctors who did not. Conclusion The survey demonstrated that 28.1% (n=18) of doctors involved in MERS care suffered from depressive or posttraumatic stress symptoms, even though the MERS infection was being controlled. Working at a hospital with MERS cases was the primary determinant of the adverse psychological outcomes among doctors ; however, direct participation in the diagnosis and care of MERS patients was not significantly related to such outcomes.

• 한국심리학회지ㆍ일반
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• 제36권2호
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• pp.241-270
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• 2017

본 연구는 성인 1,000명을 대상으로 트라우마 이전(pretrauma)의 성격적 특성인 성격 5요인, 외상 후 인지, 반추, PTSD 증상, 외상 후 성장간의 구조적 관계를 살펴보자 하였다. 이를 위해 본 연구에서는 성격 5요인이 외상 후 인지와 침습적 반추를 거쳐 의도적 반추에 영향을 주는 경로가 포함된 가설적 연구모형과 침습적 반추에서 의도적 반추로 가는 경로가 제외된 경쟁모형을 각각 설정하였다. 연구결과 첫째, 외향성, 우호성, 성실성은 외상 후 성장과 PTSD 증상 간에 외상 후 인지 및 반추의 매개효과가 유의하지 않았다. 둘째, 개방성은 PTSD 증상 및 외상 후 성장으로 가는 경로에서 침습적 반추와 의도적 반추가 순차적으로 매개하는 것으로 밝혀졌다. 셋째, 신경증적 경향성은 PTSD 증상 및 외상 후 성장으로 가는 경로에서 외상 후 인지, 사건관련 반추가 순차적으로 매개하는 것으로 밝혀졌다. 본 연구결과는 외상 후 성장모델의 인지과정을 지지하는 것으로 나타났다. 본 연구의 결과에 근거하여 의의와 한계점에 대하여 논의하였다.

• 대한불안의학회지
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• 제4권1호
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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.

• 정신신체의학
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• 제7권2호
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• pp.174-183
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• 1999

본 연구는 자동차사고 이후 신체적 증상에 대한 치료를 받은 후 정신과적 진단 및 치료 또는 정신감정을 위해 정신과로 의뢰되었던 44명의 환자를 대상으로 자동차사고와 외상후 스트레스장애와의 관계를 평가하기 위한 것이다. 외상후 스트레스장애 진단은 외상후 스트레스장애 척도(CAPS)를 사용하여 DSM-IV 진단기준에 따라 분류하였고, 축소형 부상척도(AIS)를 사용하여 신체적 손상과 외상후 스트레스장애 증상과의 관계를 조사하고 외상후 스트레스장애와 Axis I 공존질환 유무에 대해 알아 보았다. 자동차 사고후 정신과에 의뢰된 대상자 44명중 20명(45.5%)이 외상후 스트레스장애로 진단되었고 13명(29.5%)이 아증후성 외상후 스트레스장애에 속하였다. 신체적 부상의 정도는 외상후 스트레스장애 증상을 예견하는 것으로 나타났다. 외상후 스트레스장애군은 외상후 스트레스장애 진단 기준 BCD 모든 증상에서 높은 비율을 나타냈고, 아증후성 외상후 스트레스장애군은 기준 B와 D 증상에서 비교적 높은 비율을 나타냈으며, 두 군 모두 기준 B 가운데 '사건에 대한 반복된 꿈' 항목의 비율이 가장 높았다. 외상후 스트레스장애군의 55%가 주요우울증을 동반하였다. 결론적으로 본연구의 결과는 외상후 스트레스장애가 자동차사고 이후 흔히 올 수 있는 정신장애임을 시사하고 있다. 따라서 자동차사고 후 신체적 손상에 대한 치료를 받고 마지막으로 정신과에 의뢰된 환자들에 대해서는 적어도 치료계획에서 외상후 스트레스장애라는 진단을 정규적으로 고려해야만 할 젓이고. 특히 취약성이 있는 환자들에 대해서는 조기 중재가 외상후 스트레스장애 증상을 예방할 수 있을 것이라고 생각된다.

• 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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• 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.

• 대한불안의학회지
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• 제5권2호
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• pp.133-138
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• 2009

Diagnosing post-traumatic stress disorder (PTSD) is challenging for several reasons: a lack of training in trauma assessment for most clinicians, underreporting and avoidance by patients, the overlapping of symptoms, and a high comorbidity with other mental disorders. Thus, a careful evaluation and differential diagnosis are essential for the treatment and management of this population. A concept of posttraumatic reaction in people with narcissistic vulnerability, called Trauma-Associated Narcissistic Symptoms (TANS) had appeared in the literature; this has not been, however, systemically investigated. This study examines three cases of TANS that developed after traumatic events such as traffic accidents and physical assault. TANS may mimic PTSD and can show similar features; however, a careful attention to the context and meaning of symptoms can help the clinicians in differentiating TANS from PTSD. Clinicians working with trauma and compensation evaluators should be on alert for this easily overlooked condition.