• Title/Summary/Keyword: Traumatic stress

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Psychological Effects on Medical Doctors from the Middle East Respiratory Syndrome (MERS) Outbreak : A Comparison of Whether They Worked at the MERS Occurred Hospital or Not, and Whether They Participated in MERS Diagnosis and Treatment (메르스(Middle East Respiratory Syndrom)의 유행이 의사의 정신건강에 미치는 영향 : 확진자 발생 병원 근무 여부, 메르스 진료 참여 여부에 따른 비교)

  • Um, Dae Hyun;Kim, Jang Sub;Lee, Hae Woo;Lee, So Hee
    • Journal of Korean Neuropsychiatric Association
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    • v.56 no.1
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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.

A Case Report on the Meniscal Tear due to Repetitive Foot-Switch Stepping (반복적으로 풋스위치를 밟는 작업에 의한 반월상 연골 손상 증례)

  • Yu, Sun-Hee;Lim, Hyun-Sul;Kim, Doo-Hie;Chae, Dong-Ju;Kang, Suk
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.4 s.59
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    • pp.805-814
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    • 1997
  • Injuries to the menisci occur in a variety of ways, most commonly with a twist, pivot, squat, or valgus stress to the knee. Tear patterns are classified to longitudinal, horizontal, or transverse features according to the mechanism of injury. Work-related meniscal tear usually occurs with a repetitive usage of the foot, hence it can be classified as a cumulative traumatic disorder. We found a 47 year-old female worker who had been taking charge of repetitive foot-switch stepping for 8 years. She suffered from pain in the right knee since 5 months ago. Tenderness along the medial joint line of the right knee was observed and pain was aggravated with full flexion of the right knee. On magnetic resonance imaging, high signal intensity was observed at the posterior horn of the medial meniscus of the right knee. Degenerative longitudinal and transverse complex tear in the medial meniscus was observed on arthroscopy. Arthroscopic partial meniscectomy was performed. We surveyed the work process and the health status of co-workers. It turned out that the work process was compatible to injure the meniscus and nine out of fourteen co-worker(64.3%) complained pain of the knee. No other factors related to her meniscal tear could be found except for the situation at her work. Therefore, we conclude that meniscal tear is related to the repetitive stepping of foot switch.

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Daily Functioning in Chronic Pain: Study of Structural Relations with Posttraumatic Stress Disorder Symptoms, Pain Intensity, and Pain Avoidance

  • Cho, Sung-Kun;Heiby, Elaine M.;McCracken, Lance M.;Moon, Dong-Eon;Lee, Jang-Han
    • The Korean Journal of Pain
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    • v.24 no.1
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    • pp.13-21
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    • 2011
  • Background: This study aimed to evaluate processes from the mutual maintenance model in relation to daily functioning in patients with both chronic pain and a history of a traumatic experience. The mechanism illustrated the structural relations for daily functioning among pain intensity, hyperarousal, re-experiencing, trauma avoidance, and pain avoidance. Methods: Archival data (N = 214) was used for this study and data were analyzed for 142 chronic pain patients reporting a traumatic experience and seeking treatment at a tertiary pain clinic in Korea. Results: The results indicated that pain intensity, hyperarousal, and pain avoidance had significant direct effects on daily functioning. Also, pain intensity showed significant indirect effects on daily functioning through hyperarousal and pain avoidance; and hyperarousal through pain avoidance. Conclusions: Results suggest a direct contribution of high levels of pain, hyperarousal symptoms of PTSD, and pain avoidance behaviors to reduced daily functioning. Also, elevated pain as reminders of the trauma may trigger high levels of hyperarousal symptoms of PTSD. Subsequently, avoidant coping strategies may be used to minimize pain so that the trauma would not be re-experienced, thus inhibiting the activation of hyperarousal symptoms of PTSD. However, prolonged use of such strategies may contribute to decline in daily functioning.

Cure and Ethics Implied in Trauma Literature: Don DeLillo's Falling Man and Joy Kogawa's Obasan (외상문학에 함축된 치유와 윤리 -돈 드릴로의 『추락하는 남자』와 조이 코가와의 『오바상』 병치 연구)

  • Kim, Bong Eun
    • Journal of English Language & Literature
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    • v.57 no.1
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    • pp.107-127
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    • 2011
  • Don DeLillo has shown considerable interest in terror, frequently depicting extreme dread of something terrible to happen, in his literary texts. Since more than three thousand innocent people in New York were killed by the 9-11 terrorist attack in 2001, the anticipation about what kind of fiction he would write as a New Yorker was high. DeLillo's novel Falling Man (2007) in fragmentary detail represents the scene of the terrorism from the perspective of Keith Neudecker, a lawyer who escapes the collapsing world trader center. Neudecker's post-traumatic stress disorder in the first chapter is followed by the free-associative portrayal of various impacts of the 9-11 terror on Neudecker's wife Lienne in the second chapter. The random mixture of the first person narratives from such diverse view-point characters as Neudecker's son Justin, relatives and friends, with dialogues and recollections yields a very close picture of the consequences of terrorism. Reading DeLillo's Falling Man in juxtaposition with a Japanese Canadian novel Obasan by Joy Kogawa, reminiscences of the maltreatment of Japanese Canadians during and after the second world war, surfaces the authorial intention of the two novels. They as trauma literature emerge to aim at curing the readers and proposing post-traumatic ethics. Laurie Vickroy's theory of trauma narrative and cure, E. Ann Kaplan's theory of trauma witness narrative and responsibility, and Emmanuel Levinas's theory of trauma memory and ethics offer theoretical grounds for the convincing analysis of the two texts.

The Effects of the Combined Biofeedback and Brief Emotion Regulation Nursing Intervention Based on the Gross Model for Sexually Abused Adolescents (성폭력 피해 청소년을 위한 바이오피드백 병행 Gross 모델기반 단기 정서조절 간호중재 효과)

  • Kim, Jieun;Park, Wanju
    • Journal of Korean Academy of Nursing
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    • v.52 no.6
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    • pp.608-623
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    • 2022
  • Purpose: This study aimed to evaluate the effects of a combined biofeedback and brief emotion regulation (C-BABER) program for sexually abused adolescents. Methods: This study employed a non-equivalent control group pretest-posttest design. The participants included 26 sexually abused adolescents from eight Sunflower Centers of South Korea-with 13 in the experimental group and 13 in the control group. The experimental group received four sessions of the individual C-BABER program, each lasting 60 minutes. Results: Compared with the control group, sexually abused adolescents in the experimental group exhibited significant score differences in traumatic symptoms, including depression (Z = - 2.24, p = .025), dissociation (Z = - 2.21, p = .027), anxiety (Z = - 2.02, p = .044), and posttraumatic stress (Z = - 2.01 p = .045); and impulsivity, including positive urgency (Z = - 3.35, p = .001) and negative urgency (Z = - 2.28, p = .023). Additionally, the experimental group exhibited significant score differences in meta-mood, including emotional attention (Z = - 2.45, p = .014), emotional clarity (Z = - 2.30, p = .021), and emotional repair (Z = - 2.28, p = .022); and emotional regulation modes, including emotional suppression (Z = - 2.65, p = .008) and cognitive reappraisal (Z = - 1.98, p = .047). Regarding bio-attention, significant changes were identified in the experimental group for the bio-attention rate and attention maintenance time in the posttest compared to the pretest (p = .001). Conclusion: The C-BABER program for sexually abused adolescents is effective in decreasing traumatic symptoms and impulsivity, and in improving meta-mood, emotional regulation mode, and bio-attention. Therefore, we recommend providing sexually abused adolescents the C-BABER program to help them regulate their emotions and effectively adapt to their lives.

Coping Strategies, Compassion Fatigue and Compassion Satisfaction among Nurses in Emergency Room (응급실 간호사의 대처방식과 공감피로, 공감만족)

  • Jang, Yang Min;Kim, Souk Young
    • Journal of Korean Clinical Nursing Research
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    • v.20 no.3
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    • pp.348-358
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    • 2014
  • Purpose: This was a descriptive correlation study to identify emergency room (ER) nurses' coping types and factors affecting compassion satisfaction (CS) and compassion fatigue. Methods: During March and April 2013, 170 questionnaires were distributed to ER nurses working in general hospitals in D and C regions. Data were analyzed using descriptive statistics, t-test, ANOVA, correlation analysis, and stepwise regression analysis. Results: Compassion fatigue was most strongly affected by emotional expression for burnout and by practical support pursuit for secondary traumatic stress. Positive coping, emotional expression, position, positive reinterpretation, and self-blame explained 42% of CS. Conclusion: Results indicate that nurses with moderate levels of career had high compassion fatigue and low compassion satisfaction. Thus these nurses need to be given an opportunity to achieve self-development and improve their ability as nurses; interventions that can reinforce positive coping strategies should be provided as personal coping strategies affect compassion fatigue and compassion satisfaction.

Bereavement Care in Hospice and Palliative Care (호스피스.완화의료에서의 사별 돌봄)

  • Kim, Chang-Gon
    • Journal of Hospice and Palliative Care
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    • v.10 no.3
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    • pp.120-127
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    • 2007
  • Bereavement is the state of loss resulting from death. Grief is the emotional response associated with loss, intense and acute sorrow resulting from loss. Complicated grief represent a pathological outcome involving social, physical, emotional, cognitive, spiritual morbidity. The common psychiatric disorders associated complicated grief or abnormal grief responses include clinical depression, anxiety disorders, alcohol abuse or other substance abuse, and dependence, psychotic disorders, and post-traumatic stress disorder (PTSD). Grief tasks involve a series of stage or phases following an important loss that gradually permit adjustment and recovery. Three phases of grief involve phase 1 (walking the edges), phase 2 (entering the depths), and phase 3 (reconnecting the world). For intervention to be effective they need to be individually tailored to abnormal grief reaction or unresolved grief reaction. Clear understandings of complicated grief, abnormal responses, factors increasing risk after bereavement will often enable us to prevent psychiatric disorders in bereaved patients.

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Fuctional MRI for Phobic Stimuli: Comparison study between Post Traumatic Stress Disorder (PTSD) and Control groups

  • 박지강;박종익;이호규;문찬흥;유재욱
    • Proceedings of the KSMRM Conference
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    • 2001.11a
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    • pp.106-106
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    • 2001
  • 목적: 일반인과 외상성 스트레스 장애환자들(PTSD)에서 동일한 공포 자극에 대한 기능적 뇌 자기ㆍ공명영상에서 뇌 활성화 부위의 차이를 알아보고자 하였다. 대상 및 방법: 대조군 (여자9명)과 외상성 스트레스 장애로(PTSD) 진단된 환자군 (여자9명)을 대상으로 하였고 모두 오른손잡이였다. 외상성 스트레스 장애군은 모두 교통사고와 관련되어 있었다. 1.5T MR 기기에서 EPI BOLD 기법을 이용하여 24개의 axial slice를 얻었으며, 시각자극으로 교통사고 현장 사진과 비교군으로 체크 무의 사진을 무작위로 배열하여 각각 1초씩 보여 주었다 (event related design). SOA (Stimulus Onset Asynchrony)는 3.5초로 하였고 전체 영상은 10분 동안 얻었다. 모든 환자에서 기능적 자기공명 영상은 1차례 시행하였다. 영상후 처리는 SPM 분석 프로그램을 사용하였으며 황성화 신호의 유의수준은 p=0.01을 기준으로 활성화 영상을 얻었다. 활성화 신호를 육안으로 비교 분석하였고 해마, 편도핵, 전전두엽의 활성화 정도를 중심으로 평가하였다.

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Effects of Traumatic Events on Posttraumatic Stress Disorder(PTSD), Burnout, Physical Symptoms, and Social and Occupational Functions in Korean Fire fighters (소방공무원의 외상후 스트레스장애가 정신신체적 증상에 미치는 상관관계)

  • Choi, Hea-kyung;Kim, Jee-hee
    • Proceedings of the Korea Contents Association Conference
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    • 2010.05a
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    • pp.213-215
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    • 2010
  • 본 연구의 목적은 소방대원들의 외상사건 경험이 외상후 스트레스장애 증상, 정서적 탈진, 신체증상, 사회 및 직업기능에 미치는 영향을 파악하기 위해 이들 간의 관계를 설명하는 가설적 모형을 구축하고 검증하므로써 소방공무원의 근무여건 개선 및 외상후 스트레스 관리방안 마련을 위한 기초자료를 제공하고자 하였다. 전국의 소방공무원 2,167명을 대상으로 2008년 1월20일부터 2008년 2월 15일까지 이메일을 통한 설문조사를 실시하였으며, 연구 도구는 일반적 특성 및 근무특성 설문, 외상사건경험 설문, 사건충격척도(IES-R-K), 정서적 탈진척도(MBI), 신체증상 측정도구, 사회 및 직업기능척도(SOFAS)를 사용하였다.

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Eye Movement Desensitization and Reprocessing (EMDR) for Childhood Specific Phobia : A Case Report (소아기 특정 공포증의 EMDR 치료 증례)

  • Bae, Hwal-Lip;Kim, Dae-Ho;Jang, Hee-Soon
    • Anxiety and mood
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    • v.5 no.1
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    • pp.42-47
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    • 2009
  • Recently, Eye Movement Desensitization and Reprocessing (EMDR) was given the status of an approved form of psychotherapy for the treatment of post-traumatic stress disorder. However, its effectiveness in the treatment of other anxiety disorders such as phobia is yet to be determined given that controlled studies have provided mixed results. This report summarizes the case of a child with a specific phobia (i.e. nighttime fear) which was successfully treated with two sessions of EMDR. This result suggests the further and thorough evaluation of this technique for use in childhood phobic disorders.

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