• Title/Summary/Keyword: Trauma exposure

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Reliability and Validity of the Korean Version of the Combat Exposure Scale (한국판 전투 노출 척도의 신뢰도와 타당도)

  • Kim, Dong Su;Chung, Hae Gyung;Choi, Jin Hee;So, Hyung Seok;Kim, Hae Jung;Go, Chang Min;Kim, Tae Yong;Chung, Moon Yong
    • Anxiety and mood
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    • v.8 no.2
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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.

Review of Psychological Treatment for Post-Traumatic Stress Disorder : Focus on Survivors of Disaster (외상후 스트레스 장애에 대한 심리치료 효과 개관 : 재난 생존자를 중심으로)

  • Jang, Eun-Young;Lee, Hyunji;Kim, Daeho
    • Anxiety and mood
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    • v.12 no.2
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    • pp.69-78
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    • 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.

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Successful Management of a Comatose Patient with Traumatic Brain Exposure with a Fronto-Parieto-Occipital Flap

  • Maduba, Charles Chidiebele;Nnadozie, Ugochukwu Uzodimma
    • Journal of Trauma and Injury
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    • v.33 no.1
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    • pp.48-52
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    • 2020
  • Composite skull defects in patients with severe head injuries are very challenging to manage. The dilemma when deciding whether to perform a definitive reconstruction is how long to wait for physiological recovery before an intervention complicates the situation. The inability of such patients to tolerate prolonged anesthetic exposure is a driving factor for performing the minimal intervention necessary to facilitate recovery. Herein, we present a case involving the successful immediate reconstructive treatment of a severely head-injured adolescent with a composite scalp defect secondary to trauma. A 14-year-old boy sustained a severe head injury from a motor vehicle accident with a composite scalp defect in the right fronto-parietal region. The frontal lobe was exposed, and the right eye was crushed and devitalized. The patient was deeply unconscious for 3 days, without any significant improvements before reconstructive surgery was proposed due to fear of possible meningitis resulting from the exposure of brain structures. We successfully managed the patient with a fronto-parieto-occipital flap, after which the patient promptly recovered consciousness.

Helping Professional's Trauma Work-related Stresses : Do Secondary Traumatic Stress and Burnout differ? (외상피해원조실무자의 이차적 외상스트레스와 소진은 서로 다른가?)

  • Park, Ji Young
    • Korean Journal of Social Welfare Studies
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    • v.44 no.2
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    • pp.387-407
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    • 2013
  • The aim of the present study was to determine whether secondary traumatic stress and burnout of CPS workers in Korea differ, being significantly affected by different variables of each own. A two-way MANCOVA was conducted to determine the effect of trauma exposure and work-condition satisfaction on secondary traumatic stress(intrusion and avoidance) and burnout(emotional deprivation, depersonalization, personal achievement) while controlling for gender, age, and personal trauma history. Exposure to clients' traumatic material did not affect secondary traumatic stress and burnout either. Rather, it was found that both of secondary traumatic stress and burnout was significantly affected by the same independent variables(level of exposure to being threatened by violent abusers of victims and the level of workers' satisfaction of work conditions in workplace). Therefore, it was difficult to address that secondary traumatic stress and burnout have a completely different construct.

The Retrospective Study of Essential X-ray in Emergency Multiple Trauma Patients (응급 다발성 외상환자의 기본적 방사선 촬영부위에 관한 조사연구)

  • Yoo, Beong-Gyu
    • Journal of radiological science and technology
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    • v.19 no.2
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    • pp.51-57
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    • 1996
  • Radiography should be used judiciously and should not delay patients resuscitation. In the patient with emergency multiple trauma, three radiography should be obtained-cervical spine, anteroposterior(AP) chest, and AP pelvis. These examinations can be done in the resuscitation area, usually with a portable X-ray unit, but should not interrupt the resuscitation process. A retrospective study was carried on 157 emergency multiple trauma patients who were admitted to Yong Dong Severance Hospital from January, to December in 1995. I analyzed the types of X-ray examinations in emergency multiple trauma patients, and classified the patients by disoriented group of mentality. The results were as follows: 1. The subjects were 7.1%(157patients) of 2,208 trauma patients(7.3%) in total 30,085 emergency patients. 2. Male to female ratio was 2.57 : 1. The age distribution was highest from 31 years to 40 years(28.0% ). 3. The peak time of patient's entrance in emergency center was between 8 : 00 pm and 2 : 00 am(36.9%), and second peak time was between 2 : 00 pm and 8 : 00 pm (29.3%). 4. According to the injury type, traffic accident, motorcycle accident and falling down were 71.3%, 8.3% and 20.4% respectively. 5. According to the exposure rate of Computed Tomography, chest CT, cervical CT pelvis CT and brain CT were 39.5%, 24.2%, 69.4% and 51.6% respectively.

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Trauma Signature (TSIG) Analysis of Hebei Spirit Oil Spill, Taean, Korea : 2007 (허베이 스피리트호 유류 유출사고에 대한 Trauma Signature (TSIG) 분석)

  • Choi, Young-hyun;Lee, Moo-Sik;Lee, Jae-Kwang;Kim, Jee-A;Kim, Jung Sun
    • Journal of agricultural medicine and community health
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    • v.43 no.3
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    • pp.158-171
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    • 2018
  • This TSIG analysis regarding national actions for marine oil spills could be indicated and suggested improvements in the response system could be made based on the present study.

Effects of Vicarious Trauma on Mental Health in Firefighters (소방 공무원에서 간접 외상이 정신 건강에 미치는 영향)

  • Baik, Jun-Hyuck;Jung, Young-Eun;Chae, Jung-Mi;Myong, Jun-Pyo;Yim, Hyeon-Woo;Cha, Jeong-Ho
    • Anxiety and mood
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    • v.6 no.1
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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.

Factors on the Pathway from Trauma to Suicidal Ideation in Adolescents

  • Kwon, Seo Young;Nam, Ji Ae;Ko, Boo Sung;Lee, Chang Wha;Choi, Kyeong-Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.30 no.1
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    • pp.26-33
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    • 2019
  • Objectives: Suicide is the most frequent cause of death among Korean adolescents, and adolescents who have experienced trauma have an increased risk of post-traumatic stress disorder (PTSD) symptoms, depression, and suicide attempts. However, resilience and self-esteem are protective factors. We examined the effects of resilience and self-esteem on the relationship among traumatic experiences, PTSD symptoms, depression, and suicidal ideation. Methods: Middle-school students (n=403) completed questionnaires assessing traumatic experiences, PTSD symptoms, depression, suicidal ideation, resilience, and self-esteem. Path analysis was performed to investigate the mediating effects of PTSD symptoms, resilience, self-esteem, and depression on the relationship between trauma exposure and suicidal ideation. Results: Traumatic experience was positively correlated with PTSD symptoms, depression, and suicidal ideation. PTSD symptoms and depression were positively correlated with suicidal ideation. The relationship between traumatic experiences and suicidal ideation was mediated by PTSD symptoms, which had both direct and indirect effects on suicidal ideation; the indirect effect was mediated by resilience, self-esteem, and depression. Conclusion: Korean adolescents who had experienced trauma were more likely to develop PTSD symptoms, increasing their risk of depression and suicidal ideation. However, self-esteem and resilience may help protect against depression and suicidal ideation. Our findings could inform suicide prevention initiatives.

Case Series: Successful Resuscitation of Severe Facial Injuries Caused by a Chainsaw

  • Choi, Han Joo
    • Journal of Trauma and Injury
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    • v.32 no.3
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    • pp.168-171
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    • 2019
  • The treatment outcome remains poor of severe facial injuries because of the high risk of compromised airway or massive bleeding. We experienced two successful treatment cases of severe facial injury by the chainsaw. A 52-year-male had his face injured by the chainsaw during his work. He was transferred to the Level I trauma center using the Doctor-Helicopter. During his flight, bleeding control was tried and the information was given to the trauma surgeons before his arrival. His consciousness was alert and the vital signs were stable. The crushing wound, mandible open fracture, deep laceration of tongue, lip, neck and arterial bleeding were noted around his mandible. Nasotracheal intubation was performed under the bronchoscope-guided. Emergency operation (open reduction & internal fixation, primary repair with neurorrhaphy) was performed. At 30 hospital days, he was discharged with facial palsy on left mandibular area. A 30-year-male had his face injured by the chainsaw. He was transferred to our Level I trauma center from the local hospital. The deep-mutiple lacerations on right upper eyelid and forehead with the bony exposure were noted. The vital signs were stable and emergency operation was performed. He was discharged at 20 hospital days. Bone loss or tissue loss were not devastating than we expected even though the injury was occurred by the chainsaw. Aggressive treatment including airway manipulation or bleeding control and maximal opportunity of therapy are absolutely needed.

Somatic Symptoms after Psychological Trauma (심리외상 이후의 신체증상)

  • Park, Joo Eon;Ahn, Hyun-Nie;Kim, Won-Hyoung
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.1
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    • pp.43-53
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    • 2016
  • Objectives : Somatic symptoms after the exposure of psychological trauma frequently developed. However, the somatic symptoms are not covered under the diagnostic criteria of posttraumatic stress disorder(PTSD) in detail, although they are often associated with social and occupational functioning and patient-doctor relationships. The aim of this article is to highlight the potential mechanisms, the common manifestations, and the treatment of the somatic symptoms. Methods : This article studied the somatic symptoms searched using academic search engines like PubMed, Scopus, Google Scholar, KoreaMed and KISS from the earliest available date of indexing to March 31, 2016. Results : The mechanism of somatic symptoms after the exposure was described as psychological and physiological aspects. Psychological mechanism consisted of psychodynamic theory, cognitive behavioral theory, and others. Physiological mechanism involved changes in neuroendocrine and immune system, autonomic nervous system and central nervous system. Somatization associated with psychological trauma manifested various health conditions on head and neck, chest, abdominal, musculoskeletal, and dermatological and immune system. Few studies described the standardization of treatment for the somatic symptoms. Conclusions : Clinicians and disaster behavioral health providers should think of the accompanying somatic symptoms during intervention of psychological trauma and PTSD. Further studies are needed on the somatic symptoms seen in psychological trauma and PTSD.