• Title/Summary/Keyword: Severe anxiety

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PRELIMINARY STUDY OF MENTAL REPRESENTATIONS OF PRESCHOOL CHILDREN EXPERIENCING SINGLE, SEVERE TRAUMA (심한 정신적 외상 경험을 한 학령 전기 아동의 정신적 표상에 대한 예비연구)

  • Eon, So-Yong;Song, Won-Woung;Oh, Kyung-Ja;Choi, Eui-Gyum;Shim, Eun-Ji;Shin, Yee-Jin
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.15 no.1
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    • pp.61-74
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    • 2004
  • Objectives:This study was performed to introduce a psychoeducational family therapy model for the families of schizophrenic patient and to investigate the effect of this model on the changes in coping style and depressive symptoms of the family members, and in perception of emotional support by families and depressive symptoms of patients. Methods:Nine preschool children, 3-5 years old, experiencing physical injuries caused by attack from a psychotic patient at kindergarten, were evaluated for psychological assessments;Intelligence test, MSSB(MacArthur Story-Stem Battery), H-T-P test(House-Tree-Person test). And their parents completed rating scale, KPI-C(Korean Personality Inventory for Children about children’s psychological conditions). Results:With respects to the contents and emotional reactions of MSSB, 9 preschool children showed generally high levels of anxiety, depression, avoidance, aggression, probably related to the traumatic experiences. Even though children couldn't verbally report directly about their traumatic experiences, in both MSSB, structured play narrative assessment tool, and HPT, free drawing and association test, they demonstrated psychiatric problems through reenactment plays, regardless of clinical diagnoses. Conclusion:Present study allowed us the chance to see beyond the outer pathological behaviors of PTSD in preschool children, through deeper evaluations of their mental representation. These preliminary data suggest deep understanding of internal representation would be of help for thorough evaluations and treatment plan for preschool children, experiencing severe trauma.

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The Relationship between Noise Exposure Level in Worksite and Workers' Stress Symptoms (산업장의 소음폭로수준과 근로자의 스트레스 증상간의 관련성)

  • Park, Kyung-Ok;Lee, Myung-Sun
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.2 s.53
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    • pp.239-254
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    • 1996
  • Health services on industrial noisy environment have been provided only for noise-induced hearing loss management until now. But gradually, modem diseases and death have come to be related to stress and mental health deeply, therefore noise-induced mental disorder, like a stress became very important. In this point, the purpose of this study was to analyze the relationship between noise exposure level in worksite and workers' stress symptoms. This study included a survey of 786 manual workers selected from 89 worksites in 21 factories in Puchon. The results were as follows: 1. For demographic characteristics, most of the workers were males(80.8%), the $20\sim29years$ old were 34.5% and those who graduated from high school were 65.3%. The workers whose monthly income ranged from 100,000 to 800,000 won were 37.5% and who have a religion were 47.9%. 2. For occupational characteristics, workers who had worked $1\sim5$ years in the factories were 33.0%. Those who were much for them workload were 43.9% and who worked more than 8 hours a day were 73.9%. Those who were disatisfied with their job and pay were 31.9% and 50.6%. The workers who responsed ventilation condition of their worksites were bad were 51.9% and the dissatisfed with working environment of their worksites were 45.9%. 3. Workers who were suffering from tinnitus were 53.3% and those who perceived hearing loss were 50.1%. Persons who reported they always wore earplugs at work were 35.4%. Those who felt earplugs bigger than their ears were 30.6% and those who experienced eardiseases caused by earplugs were 25.6%. 4. For the noise exposure level in worksite, workers who were exposed to $80\sim90dB$ were 30.3%, $90\sim100dB$ were 26.4% and $50\sim70dB$ were 19.2%. 5. Workers' stress symptoms were significantly related to marital status and their monthly income(p<0.05). Workers who were single and had lower monthly income showed higher PSI (Psychiatric Symptom Index) scores than those who were married and had higher monthly income. Higher PSI scores were also significantly related to $1\sim2$ days hight-work per week, much for them workload, dissatisfaction with their job, and bad relationship with their bosses and coworkers. 6. Higher PSI scores were significantly related to severe tinnitus and perceived hearing losso(p<0.001). Workers who felt the earplugs they use did not fit their ears showed significantly higher PSI scores(p<0.01). Workers who reported that they did not feel they need earplugs showed. significantly higher PSI scores (p<0.05). Increased experience of eardisease caused by earplugs that did not fit were also significantly related to higher PSI scores(p<0.01). 7. The higher noise exposure level in worksite from 80dB was, the more severe stress symptoms including PSI subparts were reported; Anxiety, Anger, Depression, and Cognitive disorder(p<0.001). 5. According to the results of stepwise multiple regression analysis, factors affecting workers' PSI scores were perceived hearing loss$(R^2=0.160)$, noise exposure level in worksite$(R^2=0.110)$, realtionship with coworkers, amount of workload, monthly income and relationship with bosses orderly and the total $R^2$ of this 6 factors was 0.371. 9. The most significant factors that have impact on manual workers' stress symptoms were perceived hearing loss and noise exposure level in worksite, especially noise exposure level in the worksite was the most affective factor on the depression symptom.

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THE CLASSIFICATION OF ADOLESCENTS IN RUNAWAY SHELTERS BY THE EVALUATION OF THEIR PSYCHOPATHOLOGY (보호시설 가출청소년의 정신병리에 대한 평가와 분류)

  • Lee, Jong-Sung;Kwack, Young-Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.12 no.2
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    • pp.192-217
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    • 2001
  • Object:This study was carried out to classify adolescents in runaway shelters by evaluating their psychopathology. And the ultimate purpose is to offer basic data for preventing adolescents‘ runaway and for diversifying runaway shelters suitable for the problem of individual adolescent. Method:128 adolescents who stay in the runaway shelters were asked to complete self-report qeustionnaires including basic sociodemographic data, Child Behavior Check List(CBCL), Minnesota Multiphasic Personality Inventory(MMPI), and Symptom Check List-90-Revised(SCL-90-R). Korean Wechsler Adult Intelligence Scale(K-WAIS)[or Korean Educational Developmental Institute-Wechsler Intelligence Scale for Children(KEDI-WISC)] and Bender-Gestalt test(BGT) were also done by clinical psychologists. Results:The most common age of the subjects were 15-year-old, and they dropped out their schools in the middle school most commonly. Mostly they were from middle class family and their parents' educational level were high school graduates. The first runaway episode was most common in the middleschool period, and their runaways were repeated. The most common frequency of runaways were more than 10 times. About 10% of them abused drugs and about 80% of them abused alcohol. One third of them had experiences of illegal problems and 10% of them engaged in sexual activity for money. 95 adolescents(83%) in CBCL, 42 adolescents(36%) in SCL-90-R, and 70 adolescents(69.3%) in MMPI showed clinical significance. In intelligence test, 22 adolescents(22%) were mentally retarded. In BGT, 35 adolescents(39.4%) manifested brain dysfunction signs. Conclusion:Runaway adolescents in the shelters have variable and severe psychopathology. Their psychopathology is classified as follows;The behavior disorder group, the mood disorder group with anxiety/depression, the somatic disorder group with somatic symptoms, and the psychosis group with possibility of severe psychopathology. Therefore it is very important to evaluate psychiatric problems of runaway adolescents, and specific therapeutic interventions according to their problems are required.

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Mild Impairments in Cognitive Function in the Elderly with Restless Legs Syndrome (노인 하지불안증후군에서의 인지기능 저하)

  • Kim, Eun Soo;Yoon, In-Young;Kweon, Kukju;Park, Hye Youn;Lee, Chung Suk;Han, Eun Kyoung;Kim, Ki Woong
    • Sleep Medicine and Psychophysiology
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    • v.20 no.1
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    • pp.15-21
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    • 2013
  • Objectives: Cognitive impairment in restless legs syndrome (RLS) patients can be affected by sleep deprivation, anxiety and depression, which are common in RLS. The objective of this study is to investigate relationship between cognitive impairment and RLS in the non-medicated Korean elderly with controlling for psychiatric conditions. Method: The study sample for this study comprised 25 non-medicated Korean elderly RLS patients and 50 age-, sex-, and education- matched controls. All subjects were evaluated with comprehensive cognitive function assessment tools- including the Korean version of Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (CERAD-K), severe cognitive impairment rating scale (SCIRS), frontal assessment battery (FAB), and clock drawing test (CLOX). Sleep quality and depression were also assessed with Pittsburgh sleep quality index (PSQI) and geriatric depression scale (GDS). Results: PSQI and GDS score showed no difference between RLS and control group. There was no significant difference between two groups in nearly all the cognitive function except in constructional recognition test, in which subjects with RLS showed lower performance than control group (t=-2.384, p=0.02). Subjects with depression ($GDS{\geq}10$) showed significant cognitive impairment compared to control in verbal fluency, Korean version of Mini Mental Status Examination in the CERAD-K (MMSE-KC), word list memory, trail making test, and frontal assessment battery (FAB). In contrast, no difference was observed between subjects who have low sleep quality (PSQI>5) and control group. Conclusions: At the exclusion of the impact of insomnia and depression, cognitive function was found to be relatively preserved in RLS patients compared to control. Impairment of visual recognition in RLS patients can be explained in terms of dopaminergic dysfunction in RLS.

Effects of Perceived Stress, Sleep, and Depression on Resilience of Female Nurses in Rotating Shift and Daytime Fixed Work Schedules (순환교대근무와 주간고정근무 여성 간호사의 회복탄력성에 대한 스트레스, 수면, 우울증의 영향)

  • Jeong, Ju Li;Kwon, Hyuk Min;Kim, Tae Hyung;Choi, Mal Rye;Eun, Hun Jeong
    • Sleep Medicine and Psychophysiology
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    • v.26 no.2
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    • pp.111-124
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    • 2019
  • Objectives: Healthy sleep is important and can have a positive effect on resilience. The aim of the present study was to compare the differences in resilience between two group nurses in rotating shift and daytime fixed work schedules and to investigate stress perception, coping factors, social and psychological health, and sleep factors that may affect resilience. Methods: A total of 400 female nurses having rotating shift and daytime fixed work schedules at two hospitals was surveyed from June 12, 2017 to June 12, 2018. All participants completed perceived stress scale (PSS), stress coping short form (Brief COPE), psycho-social wellbeing Index short form (PWI-SF) or general health questionnaire-18 (GHQ-18), center for epidemiologic studies depression scale (CES-D), STAI-X-1 in state-trait anxiety inventory (STAI), Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale (ESS), insomnia severity index (ISI), Conner Davidson resilience scale (CD-RISC). Independent t-test, paired t-test, Pearson correlation analysis, and multiple regression analysis were applied to the results of the final 373 questionnaires of 400 nurses in two general hospitals. Results: Comparing the variable statistics between the two groups of rotating shift and daytime fixed work nurses, showed statistically significant differences in all variables except perceived stress, sleep quality, and daytime sleepiness. Factors that had a significant correlation with resilience were stress coping strategies, depression, and insomnia severity (p < 0.001). In multiple regression analysis, larger positive reframing1 (β = 0.206, p < 0.001), severe less depression (β = -3.45, p < 0.001), and higher psychosocial health (β = 0.193, p < 0.001). As acceptance coping2 increased (β = 0.129, p < 0.05), as daytime sleepiness decreased (β = -1.17, p < 0.05), and as active coping2 increased (β = 0.118, p < 0.05), as the positive reframing2 increases (β = 0.110, p < 0.05), the resilience increased. Conclusion: This study, it was found that resilience was higher in daytime fixed workers than in shift workers. In addition, specific stress coping strategies, psycho-social health, sleep, and depression factors were associated with resilience.

Effects for kangaroo care: systematic review & meta analysis (캥거루 케어가 미숙아와 어머니에게 미치는 효과 : 체계적 문헌고찰 및 메타분석)

  • Lim, Junghee;Kim, Gaeun;Shin, Yeonghee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.3
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    • pp.599-610
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    • 2016
  • This paper reports the results of a systematic review (SR) and meta-analysis research to compare the effect of Kangaroo care, targeting mothers and premature infants. A randomized clinical trial study was performed until February 2015. The domestic literature contained the non-randomized clinical trial research without restriction according to the level of the study design. A search of the Ovid-Medline, CINAHL, PubMed and KoreaMed, the National Library of KOREA, the National Assembly Library, NDSL, KISS and RISS. Through the KMbase we searched and combined the main term ((kangaroo OR KC OR skin-to-skin) AND (care OR contact)) AND (infant OR preterm OR Low Birth Weight OR LBW), ((kangaroo OR kangaroo OR kangaroo) AND (care OR nursing care OR management OR skin contact)) was made; these were all combined with a keywords search through the selection process. They were excluded in the final 25 studies (n=3051). A methodology checklist for randomized controlled trials (RCTs) designed by SIGN (Scottish Intercollegiate Guidelines Network) was utilized to assess the risk of bias. The overall risk of bias was regarded as low. In 16 studies that were evaluated as a grade of "++", 9 studies were evaluated as a grade of "+". As a result of meta-analysis, kangaroo care regarding the effects of premature mortality, severe infection/sepsis had an insignificant effect. Hyperthermia incidence, growth and development (height and weight), mother-infant attachment, hypothermia incidence, length of hospital days, breast feeding rate, sleeping, anxiety, confidence, and gratification of mothering role were considered significant. In satisfaction of the role performance, depression and stress presented contradictory research results for individual studies showing overall significant difference. This study has some limitations due to the few RCTs comparing kangaroo care in the country. Therefore, further RCTs comparing kangaroo care should be conducted.

A Clinical Study on Treatments of Hwabyung with Oriental Medicine (홧병환자의 한의학적 치료에 대한 임상적 연구)

  • Kim, Jong-Woo;Whang, Wei-Wan
    • The Journal of Korean Medicine
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    • v.19 no.2
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    • pp.5-16
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    • 1998
  • Hwabyung is a common emotional disorder which has symptoms expressed like firt's explosion in middle-aged after long period of emotional suppression among Koreans. It is similar in its characteristics such as neurosis, anxiety, panic attacks in Western Medicine, though the treatment method was not effective. So we have done a clinical research on Oriental Medical Method, especially on Acupuncture Therapy, and obtained following results. 1. Patients with Hwabyung complained of pressure pain around the Chunjung(?中, CV-17) point distinctively. About 70% of those were located on the CV-17 point, 25% were 1cm upper than the CV-17 point and 5% of those were 1cm lower point than the CV-17 point. 2. Degrees of pressure pain were divided into 5 grades from ade 1(feeling pain with slight pressure) to grade 5(feeling no pain with severe pressure), respectively. 3. Patients with Hwabyung showed various symptoms compared to fire's explosion such as anger, chest discomfort, difficulty in breathing. tachycardia. and feeling of epigasfric mass etc., and the degrees were divided into 5 grades according to the severities from grade 1(can't keep their usual living) to grade 5(no complaints with heavy stresses), respectively. 4. For the treatment of Hwabyung in this study, we had given Acupuncture therapy on some points such as Chunjung:?中:CV-17, Jungwan:中脘:CV-12) and Chunchu:天樞:S-25, etc. for 15 minutes a time twice a week. And Bunshimkiumgmnihang(分心氣飮加味方) was administered 3 times a day. 5. About 40% of the patients took treatment for more than 2 months, 29% of those took 1 to 2 months and 31% of those took less than 1 month. In this study, we excluded those who stopped treatment within a month without any expected effects. 6. We evaluated the changes of severity of pain according to the following categories such as - for no change, + for 1 grade, ++ for 2 grades, +++ for 3 grades, and ++++ for 4 grades of improvements. Among the patients taken 1 to 2 months of treatment. 48% of the those showed +, 7% of those showed ++, 3% of those showed +++ and 41% of those showed no change. Among the patients taken less than 2 months of treatment, 20%of those showed +, 40% of those showed ++, 28% of those showed +++ and 13% of those showed no change. 7. We evaluate the changes of symptoms according to the following categories such as - for no change, + for 1 grade, ++ for 2 grades, +++ for 3 grades and +++ for 4 grades of improvements. Among the patients taken 1 to 2 months of treatment, 34% of those showed +, 14% of those showed ++ and 52% of those showed no change. Among the patients taken more than 2 months of treatment, 20% of those showed +, 43% of those showed 20% of those showed +++, 3% of those showed +++ and 15% of those showed no change. 8. When we compare the changes of pain and symptoms according to the periods of treatment, the changes in quantity of pain in 1 to 2 months group was $0.72{\pm}0.75$, in more than 2 months group was $1.83{\pm}0.98$, and the changes in quantity of symptoms in 1 to 2 months group was $0.62{\pm}0.73$, in more than 2 months group was $1.75{\pm}1.03$. According to the above results, we have concluded that more than 2 months of treatment is more beneficial than 1 to 2 months of treatment.

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Effect of the Early Traumatic Experience on the Mental Health of the Elderly (조기경험이 노인 정신건강에 미치는 영향)

  • Lee, Kwang-Hun;Lee, Jung-Hoon;Lee, Jong-Bum;Park, Byung-Tak;Cheung, Seung-Douk
    • Journal of Yeungnam Medical Science
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    • v.7 no.2
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    • pp.67-77
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    • 1990
  • This study was intended to analyse the relation between the psychic traumatic experience and the psychological health of the aged. The authors carried out this study by means of the combined anxiety-depression scale(CADS) and the preadolescence traumatic experience scale(PTES) with 278 aged men and women residing in Taegu from September to October 1988. The results were as follows : 1. Based on the scores avaluated by CADS, the scores of the both groups showed that comparative group was accounted for $40.15{\pm}6.19$, while the experimental group for $57.75{\pm}6.37$, which showed significantly higher score in the experimental group(p<0.001). 2. The experimental group showed significantly higher early experience score than the comparative group in the dietary difficulty, alcoholism among family members, disunion between husband and wife, trouble between mother and children, early mother loss, parent's indifference and unwanted birth(p<0.001). 3. The experimental group showed higher early experience score than the comparative group by sex, age, marital status and grown location(p<0.001). 4. When the subjects were included in the unemployed and in the middle or low classes and their parents were engaged in agriculture and commercial business and believing in buddhism or non-religion, showed higher experience score (p<0.001).

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Sleep Patterns, Daytime Sleepiness and Personality Factors in Rotating Shiftworkers (순환제 교대근무자의 수면양상과 주간의 졸리움 및 성격요인과의 관련성)

  • Kim, Hyun;Kim, Leen;Suh, Kwang-Yoon
    • Sleep Medicine and Psychophysiology
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    • v.5 no.1
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    • pp.71-79
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    • 1998
  • Objectives : This study was to evaluate sleep patterns and daytime sleepiness resulting from rotating shiftwork. The authors, also, tried to find out the relationship between the severity of daytime sleepiness and personality factors. Methods : The subjects consisted of 41 female rotating shiftwork nurses and the control group consisted of 39 female day timeworkers. All of them completed the Sleep questionnaire of Korea University Sleep Disorder Clinic, the Epworth Sleepiness Scale(ESS), the 16 Personality Factors(16PF), the Beck Depression Inventory(BDI) and the State Trait Anxiety Inventory(STAI). Multiple regression analysis of 16PF of the rotating shiftwork nurses was done to find out possible predictors of the severity of daytime sleepiness. Results : The mean duration of deprived sleep due to rotating shiftwork was $64.26\;{\pm}\;14.54\;min$. The frequency of sleep difficulty($1.24\;{\pm}\;1.17\;day/week$ vs $0.67\;{\pm}\;1.31\;day/week$, p < 0.05), time needed to fall asleep($103.05\;{\pm}\;73.48\;min$. vs $70.00\;{\pm}\;60.08\;min$, p < 0.05), sleep duration when having some difficulties in sleep ($204.25\;{\pm}\;79.90\;min$. vs $280.44\;{\pm}\;111.59\;min$., p < 0.001), recent changes in energy($x^2\;=\;4.16$, p < 0.05), worrying about sleep($x^2\;=\;11.08$, p < 0.05), and taking naps($x^2\;=\;4.98$, p < 0.05) showed significant differences between rotating shiftworkers and normal controls. The ESS socre of shiftworkers ($8.68\;{\pm}\;3.04$) was greater than that of normal controls ($6.86\;{\pm}\;3.04$)(p < 0.01). Personality factors such as C factor($R^2\;=0.283$), I factor($R^2\;=0.358$) and G factor($R^2\;=0.470$) were related with the severity of the daytime sleepiness(p < 0.001). Conclusions : The rotating shiftwork nurses had more difficulties in sleep such as having difficulties in falling asleep and in maintaining sleep, and showed lowered energy, decreased senses of well-being and so on. The rotating shiftwork nurses experienced more severe daytime sleepiness than controls did. Personality factors, such as C factor, I factor, and G factor of 16PF were suggested to be useful for predicting the severity of daytime sleepiness resulting from rotating shiftwork.

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A. Artaud or the Prisoner of Language (앙토냉 아르토 혹은 언어의 수형자)

  • Park, Hyung-Sub
    • Cross-Cultural Studies
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    • v.45
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    • pp.219-243
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    • 2016
  • The life of Antonin Artaud exactly reproduces a very cruel drama. He lived in constant anguish and suffered from severe mental pain. This research will trace his thoughts in his writings while he was a prisoner of language. Artaud was a poet filled with anxiety about language, things, being, and thought. Whenever he tried to explain the mystery of being by means of mundane language, he experienced psychological agony. His poetic thoughts began to break down, because of his identity loss. Nevertheless, he was destined to grasp the world through language. Artaud had suffered from mental illness during his youth. His mental illness was associated with his difficulty in creating poetry. In this research, the letter, Correspondance avec Jacques $Rivi{\grave{e}}re$, is analyzed. The poet refers to "the collapse of the spirit's core, and the erosion of the fundamental thought that slips away" to convey his linguistic incompetence. Hereafter, he constantly demonstrated anxious mental symptoms. Even though he became mentally deranged, he maintained his consciousness, as is apparent in his writings. Also, his spiritual belief is reflected in his mental uneasiness. While he was traveling through the Tarahumaras area in Mexico, he was obsessed with its primitive belief in the Peyote rituals, and he immersed himself in performing them. His unchristian belief was the product of his mystical personality. Until his last breath, he did not give up writing. Artaud's mental derangement does not mean lunacy, but if one insists in calling it so, that is a metaphor. His derangement comes from his refusal to accept his limitations and from his aspiring to regard his body in the same light as his intellectual perceptions. His intellect could manifest more easily when his mind was elevated to the extreme. Artaud's lunacy is no different from that of a profound philosopher. The lives of poets who suffer from mental derangement are more poetic than the lives of those who do not. Artaud's atypical emotions provide a way of to measure our own limitations, helplessness, and resignation. His scream is nonsegmental but different from that of a mental patient. That difference is why people are interested in his works and wish to delve into his writings.