• 제목/요약/키워드: Psychopathological

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외상후 울분장애의 이해 (Understanding of Posttraumatic Embitterment Disorder (PTED))

  • 고한석;한창수;채정호
    • 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.

Development of a Cognitive Level Explanation Model in Brain Injury : Comparisons between Disability and Non-Disability Evaluation Groups

  • Shin, Tae-Hee;Gong, Chang-Bong;Kim, Min-Su;Kim, Jin-Sung;Bai, Dai-Seg;Kim, Oh-Lyong
    • Journal of Korean Neurosurgical Society
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    • 제48권6호
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    • pp.506-517
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    • 2010
  • Objective : We investigated whether Disability Evaluation (DE) situations influence patients' neuropsychological test performances and psychopathological characteristics and which variable play a role to establish an explanation model using statistical analysis. Methods : Patients were 536 (56.6%) brain-injured persons who met inclusion and exclusion criteria, classified into the DE group (DE; n = 300, 56.0%) and the non-DE group (NDE; n = 236, 44.0%) according to the neuropsychological testing's purpose. Next, we classified DE subjects into DE cluster 1 (DEC1; 91, 17.0%), DE cluster 2 (DEC2; 125; 23.3%), and DE cluster 3 (DEC3; 84, 15.7%) via two-step cluster analysis, to specify DE characteristics. All patients completed the K-WAIS, K-MAS, K-BNT, SCL-90-R, and MMPI. Results : In comparisons between DE and NDE, the DE group showed lower intelligence quotients and more severe psychopathologic symptoms, as evaluated by the SCL-90-R and MMPI, than the NDE group did. When comparing the intelligence among the DE groups and NDE group, DEC1 group performed worst on intelligence and memory and had most severe psychopathologic symptoms than the NDE group did. The DEC2 group showed modest performance increase over the DEC1 and DEC3, similar to the NDE group. Paradoxically, the DEC3 group performed better than the NDE group did on all variables. Conclusion : The DE group showed minimal "faking bad" patterns. When we divided the DE group into three groups, the DEC1 group showed typical malingering patterns, the DEC2 group showed passive malingering patterns, and the DEC3 group suggested denial of symptoms and resistance to treatment.

조현병 환자의 유병기간에 따른 강박증상 (Obsessive-Compulsive Symptoms in Relation to Duration of Schizophrenia)

  • 서주현;백인호;김임렬;김수룡;조정민
    • 생물정신의학
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    • 제25권2호
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    • pp.31-37
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    • 2018
  • Objectives The aim of this study was to evaluate the psychopathological features such as depression and anxiety in schizophrenics with obsessive-compulsive symptoms (OCS) as well as the severity of OCS according to duration of schizophrenia. Methods We randomly selected sixty four inpatients with schizophrenia. We classified the patients into two groups (OCS group, non-OCS group) according to the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Clinical and demographic features were evaluated. To assess OCS, Y-BOCS were performed. The Korean version of the Positive and Negative Syndrome Scale(K-PANSS), the Brief Psychiatric Rating Scale (BPRS), the Korean version of the Calgary Depression Scale for Schizophrenia (K-CDSS), the Beck Anxiety Inventory (BAI) and the Satisfaction With Life Scale (SWLS) were conducted. Independent t-test and chi-square test were conducted to compare the two groups. Pearson correlation analysis was performed to examine the relationship between the duration of schizophrenia and the Y-BOCS score. Results The Y-BOCS, K-CDSS, and BAI scores were higher in the OCS group. There was a significant correlation between the duration of schizophrenia and the Y-BOCS score. Conclusions Anxiety and depression symptoms were severe in the OCS group. In addition, the results of this study indicate that the longer duration of schizophrenia, the more severe the OCS. Therefore, the evaluation of OCS in schizophrenics should be accompanied by treatment intervention.

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소방공무원의 무조건적 자기수용과 자기노출이 외상 후 성장에 미치는 영향 (The Influence of Unconditional Self-Acceptance and Self-Exposure on Post-traumatic Growth of Firefighters)

  • 황창의
    • 한국화재소방학회논문지
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    • 제34권3호
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    • pp.126-133
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    • 2020
  • 본 연구는 소방공무원의 무조건적 자기수용과 자기노출이 외상 후 성장에 미치는 영향을 알아봄으로써 외상 후 스트레스 장애 등 병리적 결과에 머물지 않고 이전 수준을 뛰어넘는 외상 후 성장을 이룰 수 있는 프로그램 개발 등에 도움을 주고자 하였다. 이를 위해 무조건적 자기수용, 자기노출, 한국판 외상 후 성장 척도 등을 활용하였으며, 연구결과는 다음과 같다. 첫째, 소방공무원의 무조건적 자기수용, 자기노출이 외상 후 성장과 상관관계가 있음이 확인되었다. 둘째, 소방공무원의 무조건적 자기수용과 자기노출 변인 중 외상 후 성장에 미치는 상대적 영향력을 알아보기 위해 위계적 회귀분석을 실시한 결과, 무조건적 자기수용이 자기노출 보다 더 많은 영향을 주는 것으로 확인되었다. 본 연구결과를 토대로 소방공무원 외상 후 성장을 촉진시키는 프로그램 개발 방향 및 치료적 개입 전략 등을 제안하였다.

The Analysis of Self-Mutilation in Adolescence Based on the Theory of Mentalization: From Sukhvinder in the Novel 'Casual Vacancy'

  • Oh, Mi Ae;Park, Chanmin;Lee, Yeon Jeong;Hong, Minha;Han, Ju Hee;Oh, Soo Hyun;Park, Jun Heon;Bahn, Geon Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제30권3호
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    • pp.100-108
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    • 2019
  • Objectives: Adolescence involves a number of developmental processes, as well as unique psychological characteristics and behaviors. An increased rate of internet and game addictions, school violence, and suicide may either represent aspects of adolescence or a psychopathological phenomenon. There is an urgent need to develop software programs that can prevent and resolve adolescent behavioral problems. We applied the mentalization theory to interpret and find solutions for problems faced by adolescent characters in literature. Methods: In Joan Rowling's novel "Casual Vacancy," Sukhvinder is a girl with problems representative of those encountered by modern adolescents; she is a victim of bullying and engages in self-mutilation. We targeted her problematic behaviors as representative of a prementalized state. Results: Born into an upper-class English family with Pakistani origins, Sukhvinder, unlike her siblings, fails her parents' expectations. Whenever she faces a psychological crisis, she regresses into the teleological mode (the most primitive pre-mentalization stage) and regains her sense of self by cutting herself. After her friend's suicide, however, she begins to communicate with her parents and moves toward mentalization. Conclusion: By analyzing Sukhvinder's behavior, we assessed patterns of attachment, empathy, and mentalization, and identified corrective approaches for problematic behaviors. We believe that the presented interpretation may serve as a foundation for the development of models for understanding adolescent deviant behaviors.

조현병의 질환단계에 따른 자살경향성과 정신병리의 관계 (Suicidality and Related Psychopathology across Different Stages of Schizophrenia)

  • 조유원;박경우;이동균;이형래;김철응;류승형
    • 대한조현병학회지
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    • 제23권1호
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    • pp.8-14
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    • 2020
  • Objectives: This study aimed to investigate suicidal behaviors and the related psychopathology across the different stages of schizophrenia. Methods: We recruited 131 patients with schizophrenia and categorized them into two groups, according to the duration of illness (DI) as follows: ≤10 years (n=39) and >10 years (n=92). Psychopathology and suicidality were assessed using the 18-item Brief Psychiatric Rating Scale (BPRS-18) and the suicidality module from the Mini-International Neuropsychiatric Interview, respectively. Results: One-quarter of the patients with a DI ≤10 years and nearly one-sixth of the patients with a DI >10 years experienced suicidal behaviors in the previous month. Suicidality scores were significantly associated with the "affect" factor scores of the BPRS-18 in patients with a DI ≤10 years (β=0.55, p=0.003) and with the "resistance" factor scores in patients with a DI of >10 years (β=0.29, p=0.006). Conclusion: The present study demonstrated that psychopathological factors were differentially associated with suicidality in patients with schizophrenia according to the illness stage. Our findings suggest that for effective suicide prevention, different approaches are required for the management of each stage of schizophrenia.

농업계 특수전문대학 학생들의 학습 환경에 따른 정신병리 차이와 개인상담의 효과검증 (Differences in Psychopathology and Effectiveness of Individual Counselling According to Learning Environment of Agricultural Specialized College Students)

  • 이도균;노환국;정달상;안진선
    • 현장농수산연구지
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    • 제19권1호
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    • pp.153-163
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    • 2017
  • This study is aimed at researching on psychopathological characteristics of agriculture-specialized college students, in a specific educational environment, consulting some students who show maladjusted characteristics, verifying its effects and providing basic data for college life instructions. The complete survey MMPI was conducted for 676 freshmen and juniors attending K agriculture-specialized college located in Jeollabuk-do. To analyze the results, basic statistics, bivariate correlation analysis, and multiple regression analysis were implemented. The results of this study are as follows; First, the level of overall clinical scale was lower than 50 points, standard point, and freshmen showed higher depression (D), hysteria (Hy) and psychasthenia (Pt) in general. Such results are different from the other study results. It is considered an anxiety in early stage, resulted from a living in a dormitory. For the juniors who came back from one-year practice, anxiety about employment seems little because they are already employed. Second, The effects of personal consultation for maladjusted students were proved (p<.01). The students who got consultation showed improvement effect from 'very bad condition' to 'considerable depression', which is low score. This study has a meaning in preventing from any accident, by screening maladjusted students who are supposed to learn in a specific situation, by relieving their symptoms through consultation and letting them concentrate on learning.

고형장기이식 환자의 정신건강: 이식의 시기별 이슈 (Mental Health Issues in Solid-Organ Transplant Recipients; Pre-, Peri-, and Post-Transplant Phases)

  • 정연진;강지인
    • 대한불안의학회지
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    • 제19권2호
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    • pp.37-47
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    • 2023
  • This review article explores the psychological characteristics, comorbid mental disorders, and psychosocial assessments throughout the solid organ transplant journey, spanning the pre-transplant, peri-transplant, and post-transplant phases for transplant recipients. The psychological burden and anxiety in the pre-transplant phase are high for organ failure patients with complex physical difficulties who are deciding to undergo transplantation and are on the waiting list. The pre-transplant psychosocial evaluation covers various aspects, including the patient's readiness, awareness of, and commitment to transplant treatment, medical compliance, psychopathological conditions such as cognitive function and personality disorders, lifestyle factors, including substance abuse, as well as various psychosocial factors like social support. During the peri-transplant phase, mental health problems such as postoperative delirium should be carefully recognized and addressed. After transplantation, it is essential to assist patients in coping with the various stressful experiences they encounter, manage psychiatric symptoms such as depression, anxiety, and insomnia, and improve treatment adherence and quality of life during long-term care for the transplanted organ. Managing psychiatric problems in post-transplant patients requires a deep understanding of immunosuppressant medications and a keen awareness of associated risks, including adverse effects and potential drug interactions. This comprehensive review emphasizes the significance of proactive mental health care and psychosocial evaluation, highlighting the necessity of a multidisciplinary approach to enhance the quality of life and overall success of transplant patients throughout all phases of transplantation.

반응성 애착장애 아동과 전반적 발달장애 아동의 발달 및 정신병리학적 특징의 비교연구 (COMPARISON OF DEVELOPMENTAL AND PSYCHOPATHOLOGlCAL CHARACTERISTICS FOR RAD AND PDD CHILDREN)

  • 윤현숙;최진숙;김태련;홍강의
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제3권1호
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    • pp.3-13
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    • 1992
  • 반응성 애착장애 아동의 발달적 특징 및 정신병리적 현상에 대한 이해를 위하여 이들과 전반적 발달장애 아동과의 비교연구를 실시하였다. 연구대상은 1989년 5월부터 1991년 9월까지 서울대학교병원 어린이병원 소아정신과 외래에서 통원치료를 하거나 주간치료실에서 치료교육하였던 아동중, 소아정신과 의사에 의하여 진단한, DSM-111-R의 진단기준을 만족시키는, 만 2세에서 만 6세까지의 아동으로, 반응성 애착장애 아동이 20명(남 18,여 2),전반적 발달장애 아동이 20명(남 20) 이었다. 이들의 정신과적 진단을 모르는 평가자에 의해 Schopler의 교육심리적 평가(PEP ; Psycho-Educational Pronto)가 실시되었으며, 각 발달영역별 기능수준과 정신병리적 특성에 관하여 두군간의 차이를 검증하였다. 연구결과는 반응성 애착장애아동은 발달 전반에 걸쳐 지체가 되어 있었으며 지체의 정도는 지각능력>모방>대근육운동>인지수행, 눈-손 협응능력>인지언어, 소근육운동 순으로 지체되어 있었다. 반응성 애착장애 아동의 정신병리적 특성으로는 언어>놀이>사람과의 관계성>대인감정>감각순으로 심한 정신병리를 보였다. 반응성 애착장애 아동과 전반적 발달장애 아동의 두집단간 발달기능수준의 차이 검중에서는 지각영역의 싹트기 점수와 대근육운동의 싹트기 반응이 두군간 차이를 보였다. 정신병리 영역에서는 대인감정과 사람과의 관계에서 반응성 애착장군군은 '없음'에, 전반적 발달장애군은 '심함'에 해당되었다. 놀이 및 자료에 대한 흥미, 감각이상, 언어병리성에서 '없음'에 반응성 애착장애군이 전반적 발달장애군에 비하여 통계적으로 유의하게 높게 나타났다.

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인터넷 섹스중독 청소년의 심리사회적 특성과 정신건강 연구 (A Study on Psychosocial Trait and Mental Health of the Adolescent's Addiction to Cybersex)

  • 이상준
    • 한국사회복지학
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    • 제55권
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    • pp.341-364
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    • 2003
  • 본 연구는 청소년의 인터넷 섹스중독의 정도와 심리사회적 특성들을 살펴보고, 이들 특성들이 인터넷 섹스중독과 어떠한 관계에 있는지를 알아보았다. 이를 위해 중 고등학생 1,742명을 대상으로 조사를 실시하였다. 연구결과 첫째, 연구대상 청소년의 1.3%가 심각한 중증중독 상태에 있고, 2.3%는 중등도중독 상태에 있으며, 4.2%는 경미한 중독 상태에 있어 전체 청소년의 7.8%가 인터넷 섹스에 중독된 것으로 나타났다. 둘째, 인터넷 섹스중독의 정도는 중학생이 가장 높았고, 그 다음 실업계 고등학생이며, 인문계 고등학생이 가장 낮게 나타났다. 셋째, 청소년이 남학생일수록, 자기통제력이 낮을수록, 부부관계가 나쁠수록, 가족지지와 친구지지가 낮을수록 인터넷 섹스에 더 많이 중독되는 것으로 나타났다. 넷째, 인터넷 섹스에 중독된 청소년들이 일반이용 청소년들에 비해 정신과적 증상을 더 많이 경험하는 것으로 나타났다. 다섯째, 청소년들의 인터넷 섹스중독이 심할수록 정신과적 증상이 심해졌으며, 인터넷 섹스중독은 특히 공포불안에 가장 많은 영향을 미치는 것으로 나타났다. 마지막으로, 인터넷 섹스중독 정도가 심할수록 정신과적 증상 T-score가 높아졌으며, 임상적 정신병리를 경험하는 T-score 70점 이상인 청소년들은 9개 증상차원에 따라 10.9%에서 45.2%까지 높게 나타났다.

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