• Anxiety and mood
• /
• v.18 no.2
• /
• pp.39-47
• /
• 2022

Objective : This study investigated brain functional connectivity in male firefighters who showed subclinical post-traumatic stress disorder (PTSD) symptoms. Methods : We compared the data of 17 firefighters who were not diagnosed with PTSD and 18 healthy controls who had no trauma exposure. The following instruments were applied to assess psychiatric symptoms: Korean version of the Post-traumatic stress disorder Checklist for DSM-5 (PCL-5-K), Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI). For all subjects, functional magnetic resonance imaging was performed, and functional connectivity was compared between the two groups (family-wise error-corrected p<0.05). Additionally, correlations between psychiatric symptoms and functional connectivity were explored. Results : The following connectivity was higher than that of healthy controls: 1) the central opercular cortex-superior temporal gyrus, 2) planum polare-parahippocampal gyrus, 3) angular gyrus-amygdala, and 4) temporal fusiform cortex-parahippocampal gyrus. The functional connectivity of 1) the lateral occipital cortex-inferior temporal gyrus, 2) superior parietal lobule-caudate, and 3) middle temporal gyrus-thalamus were lower in firefighters. In firefighters, the connectivity of the planum polare-parahippocampal gyrus showed a negative correlation with the severity of arousal symptoms (rho=-0.586, p=0.013). The connectivity of the middle temporal gyrus-thalamus showed a positive correlation with the severity of intrusion (rho=0.552, p=0.022) and arousal symptoms (rho=0.619, p=0.008). The connectivity of the temporal fusiform cortex-parahippocampal gyrus was negatively correlated with intrusion (rho=-0.491, p=0.045) and arousal (rho=-0.579, p=0.015). Conclusion : Our results indicate that the brain functional connectivity is associated with occupational trauma exposure in firefighters without PTSD. Therefore, this study provides evidence that close monitoring and early intervention are important for firefighters with traumatic experience even at a subthreshold level.

• Anxiety and mood
• /
• v.12 no.2
• /
• pp.69-78
• /
• 2016

Objective : Disaster causes psychological distress to a large number of people in a short period of time, by both direct and indirect exposure to traumatic events embedded in various realms of disaster experience. Optimal, well-planned treatment interventions should follow from the early acute period to recovery phase, extending up to several months later. In this context, there is an increasing need for systemic review to gain comprehensive insights for disaster interventions. These need to be added to public policy, and for the prevention and treatment of disaster-related psychopathology. Here, we review the published studies on psychological interventions for disaster-related posttraumatic stress disorder. Methods : Specific psychological interventions regarded as effective treatments for have been selected for this review, such as CBT (Cognitive-Behavior Therapy), Exposure Therapy, EMDR (Eye Movement Desensitization & Reprocessing), SIT (Stress Inoculation Therapy) and Psychoeducation. In addition, natural disasters, industrial disasters, and accidents involving aircraft and ships were also categorized as disasters, along with war and combat trauma. Results : Cognitive behavior therapy and exposure therapy had the strongest research support for effectiveness, and could be considered as the first-choice treatment for disaster-related PTSD. The second line of treatment is EMDR, although this treatment modality has the advantage of reaching certain treatment improvements in fewer sessions. However, the effects of SIT and psychoeducation to the survivors of disasters, remains unclear at this point. Additionally, we propose the possibilities of using virtual reality component and imagery rescripting as modified forms of traditional cognitive behavior therapy and exposure therapy. Conclusion : Cognitive behavior therapy and exposure therapy, deemed effective treatments for various trauma, are considered to be effective for survivors from disasters. However, the efficacy of other interventions has not yet been examined methodologically in well-designed studies, such as randomized controlled trials. In particular, future empirical studies are needed, since it is difficult to conclude that psychological interventions have similar effects on different types of disasters.

• Korean Journal of Adult Nursing
• /
• v.24 no.1
• /
• pp.38-51
• /
• 2012

Purpose: In this study the literature of compassion fatigue in nurses was reviewed in order to analyze the trends of overall research for level of fatigue, symptoms, and factors. Methods: For this study, five databases were searched using the key words 'compassion fatigue', 'secondary traumatization', 'secondary traumatic stress', and 'vicarious traumatization'. Thirty-six papers were analyzed. Results: Most of the compassion fatigue research (86%) was conducted between 2006 and 2011 and the most frequent research approach was quantitative research with the ProQOL which was the most frequently used instrument in the studies. He research was conducted in pediatric, emergency & trauma, oncology, psychiatric, and hospice units with no consistent patterns of t compassion fatigue levels. Factors affecting compassion fatigue were personal factors such as age, education background, work-related factors such as caring for trauma patients, work hours, psychological factors such as work stress, burnout, and support/coping factors such as organizational support, and coping resources. Conclusion: Nurses' compassion fatigue varied from low to high by nursing specialties. Many factors affected the compassion fatigue of nurses. In the future there is a need for study on Korean nurses, and identification of groups at risk for compassion fatigue. Furthermore there is a need to develop management programs on compassion fatigue in nurses, stress reduction and wellbeing.

• Anxiety and mood
• /
• v.5 no.2
• /
• pp.80-88
• /
• 2009

Disorder of Extreme Stress, Not Otherwise Specified (DESNOS) is the proposed diagnosis that meets the severe, complex, and prolonged psychological sequela of victims with chronic traumatization (e.g., family violence, incest, and childhood sexual or physical abuse). The hallmarks of DESNOS are a multiplicity of symptoms (e.g., somatization, dissociation, and depression), pathological changes in relationships, identity disturbances, and a propensity to experience repeated harm and injury at the hands of oneself and others. DESNOS can be directly assessed by Structured Interview of Disorder of Extreme Stress (SIDES) and Self- Report Inventory of Disorder of Extreme Stress (SIDES-SR). The treatment of DESNOS should be phaseoriented and involve movement back and forth among three basic stages : 1) stabilization ; 2) trauma processing ; 3) reintegration.

• Journal of Preventive Medicine and Public Health
• /
• v.52 no.6
• /
• pp.345-354
• /
• 2019

Objectives: It is well-known that post-traumatic stress disorder (PTSD) among firefighters contributes to their job-related stress. However, the relationship between burnout and PTSD in firefighters has rarely been studied. This study therefore explored the association between burnout and its related factors, such as trauma and violence, and PTSD symptoms among firefighters in Korea. Methods: A total of 535 firefighters participated in the Firefighter Research on Enhancement of Safety & Health study at 3 university hospitals from 2016 to 2017. The 535 participants received a baseline health examination, including questionnaires assessing their mental health. A Web-based survey was also conducted to collect data on job-related stress, history of exposure to violence, burnout, and trauma experience. The associations among burnout, its related factors, and PTSD symptoms were investigated using structural equation modeling. Results: Job demands (${\beta}=0.411$, p<0.001) and effort-reward balance (${\beta}=-0.290$, p<0.001) were significantly related to burnout. Burnout (${\beta}=0.237$, p<0.001) and violence (${\beta}=0.123$, p=0.014) were significantly related to PTSD risk. Trauma (${\beta}=0.131$, p=0.001) was significantly related to burnout; however, trauma was not directly associated with PTSD scores (${\beta}=0.085$, p=0.081). Conclusions: Our results show that burnout and psychological, sexual, and physical violence at the hands of clients directly affected participants' PTSD symptoms. Burnout mediated the relationship between trauma experience and PTSD.

• Journal of Pharmacopuncture
• /
• v.20 no.1
• /
• pp.5-9
• /
• 2017

Objectives: Gan Mai Da Zao (GMDZ) decoction is widely used for the treatment of various diseases of the internal organ and of the central nervous system. The aim of this study is to investigate the effects of GMDZ decoction on neuropsychiatric disorders in an animal model. Methods: We searched seven databases for randomized animal studies published until April 2015: Pubmed, four Korean databases (DBpia, Oriental Medicine Advanced Searching Integrated System, Korean Studies Information Service System, and Research Information Sharing Service), and one Chinese database (China National Knowledge Infrastructure). The randomized animal studies were included if the effects of GMDZ decoction were tested on neuropsychiatric disorders. All articles were read in full and extracted predefined criteria by two independent reviewers. Results: From a total of 258 hits, six randomized controlled animal studies were included. Five studies used a Sprague Dawley rat model for acute psychological stress, post-traumatic stress disorders, and unpredictable mild stress depression whereas one study used a Kunming mouse model for prenatal depression. The results of the studies showed that GMDZ decoction improved the related outcomes. Conclusion: Regardless of the dose and concentration used, GMDZ decoction significantly improved neuropsychiatric disease-related outcomes in animal models. However, additional systematic and extensive studies should be conducted to establish a strong conclusion.

• Journal of Oriental Neuropsychiatry
• /
• v.30 no.3
• /
• pp.251-263
• /
• 2019

Objectives: The purpose of this study was to review the clinical research trends in the treatment of post traumatic stress disorder (PTSD) in Korean medicine (KM). Methods: We searched MEDLINE, CENTRAL, EMBASE, Google Scholar and five Korean databases through May 2019, for studies on KM to treat PTSD. Clinical research that conducted KM treatment of PTSD patients were included. Two researchers independently conducted study selection and data extraction process. Results: Totally, eight studies were included in this review. Types of traumatic events that patients experienced included physical violence/threatening, traffic accidents, sexual violence and personal tragic events. KM interventions performed included acupuncture, moxibustion, herbal medicine, physical therapy, and KM-based psychotherapy. Treatment duration varied from two days to more than five months. Follow-up began at least one week to three months after the end of treatments. It was reported that the major psychological and/or somatic symptoms of PTSD, such as anxiety, depression, insomnia, and musculoskeletal pain, subjectively improved, as well as other objective outcomes: Impact Event Scale-Revised Korean version (IES-R-K), Beck's Depression Inventory (BDI), State-Trait Anxiety Inventory, Hwabyung Symptoms/characters, Electroencephalography (EEG) change, etc. Statistical studies were conducted in three studies only. Outcomes such as Visual Analogue Scale (VAS), BDI, and IES-R-K showed statistically significant improvement after KM treatments. There was no study reporting adverse events during or after the interventions. Conclusions: According to this review, diverse types of KM treatments have been used among PTSD patients in eight studies. The KM treatments effectively improved psychological and somatic symptoms of PTSD patients. However, the lack of high quality research as well as the lack of standardization of KM treatments for PTSD are limitations. Further methodologically robust clinical trials should be performed, and the standardization of KM treatments for PTSD should be sought.

• Journal of Korean Critical Care Nursing
• /
• v.12 no.1
• /
• pp.22-35
• /
• 2019

Purpose : This study was to determine the levels of environmental stressor, posttraumatic stress disorder, and quality of life in intensive care units (ICU) survivors after intensive care, and to explore the factors affecting posttraumatic stress disorder and quality of life. Methods: With a longitudinal survey design, data were collected from 116 patients who were discharged from the ICU of a university hospital. The environmental stressor, posttraumatic stress disorder, and quality of life were measured immediately following and 1 month after the ICU discharge. Results: Of all the subjects, 16.4% experienced posttraumatic stress disorder after discharge. Multiple regression analysis revealed that ICU environmental stressors, experience of ICU readmission, using psychotropic drugs and narcotic analgesics, and ICU admission after surgery or cardiac intervention accounted for 22.2% of posttraumatic stress disorder. Posttraumatic stress disorder and sedation status when entering ICU accounted for 28.3% of the quality of life 1 month after ICU discharge. Conclusion: Nursing interventions focused on ICU environmental stressors would not only reduce environmental stress but also contribute to the reduction of posttraumatic stress disorder and later improvement of quality of life.

• Journal of Integrative Natural Science
• /
• v.11 no.2
• /
• pp.101-106
• /
• 2018

Corticotropin - releasing hormone receptor 1 (CRHR1) forms an integral part of the pathophysiology of disorders like post-traumatic stress disorder, stress, anxiety, addiction, and depression. Hence it is essential to look for new, potent and structure-specific inhibitors of CRHR1. We have analysed the protein-protein interaction complexes of the CRHR1 receptor with its native ligand CRF and full agonist Sauvagine. The structure of Sauvagine was predicted using homology modelling. We have identified that the residues TYR253, ASP254, GLU256, GLY265, ARG1014 and LY1060 are important in the formation of protein-protein complex formation. Future studies on these residues could throw light on the crucial structural features required for the formation of CRHR1-inhibitor complex and in studies that try to solve the structural complexities of CRHR1.

• Journal of Integrative Natural Science
• /
• v.11 no.1
• /
• pp.19-24
• /
• 2018

CRFR is involved in the pathophysiology of various disorders including depression, stress, anxiety, post-traumatic stress disorder, and addiction. The discovery of novel and structurally diverse CRF1 receptor inhibitors becomes essential. In this study, we have performed molecular docking of CRF1R with the derivatives of 8-substituted-2-aryl-5-alkylaminoquinolines as CRF1R inhibitors. The antagonist molecules were optimized and docked into the binding site of the receptor. On analysing the docked complexes we have identified that the residues HIS214, THR215, ARG227, ARG1008, LYS1060 and ASP1061 are important in forming hydrogen bond with the inhibitors. Further studies on these residues could reveal important structural features required for the formation of CRF1R-inhibitor complex and thus in the discovery of novel and potent inhibitors.