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Severity of Musculoskeletal Pain and Its Effect on Psychosocial Factors in Veterans With Posttraumatic Stress Disorder

  • Kwon, Chun-suk;Kim, Suhn-yeop
    • Journal of the Korean Society of Physical Medicine
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    • v.10 no.3
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    • pp.29-37
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    • 2015
  • PURPOSE: The aim of this study is to investigate the relationship between psychosocial factors and the severity of musculoskeletal pain in veterans with posttraumatic stress disorder (PTSD). METHODS: A total of 60 subjects were recruited from among the veterans with musculoskeletal pain at D Veterans Hospital. PTSD was evaluated by using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition; severity of pain was measured by using the short-form McGill Pain Questionnaire (SF-MPQ); depression and anxiety were measured by using the Symptom Checklist-90-Revision; and the quality of sleep was measured by using the Pittsburgh Sleep Quality Index. All data were analyzed using SPSS 18.0 software for Windows. RESULTS: The averages cores of pain intensity ($7.48{\pm}1.67$), SF-MPQ-sensory ($13.84{\pm}7.52$), SF-MPQ-affective ($4.41{\pm}3.79$), depression ($19.30{\pm}11.37$), anxiety ($13.39{\pm}7.99$), and quality of sleep ($10.05{\pm}5.89$) were obtained in veterans with PTSD. SF-MPQ-sensory measures sleep quality (r=0.346, p<0.01), SF-MPQ-affective measures depression (r=0.318, p<0.01) and anxiety (r=0.404, p<0.01), and these showed a statistically significant positive correlation in veterans with PTSD. Pain levels were observed to be higher in veterans with PTSD. Moreover, in these subjects, physical pain had a significant influence on the anxiety variable among the psychosocial factors. CONCLUSION: These findings suggest that musculoskeletal pain provides meaningful information about depression, anxiety, and sleep disorder in veterans with PTSD. Our data suggest that musculoskeletal pain may need to be addressed as part of the health management process of veterans.

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.

Treatment Response and Symptomatic Changes after Eye Movement Desensitization and Reprocessing in Psychiatric Disorders Other than Posttraumatic Stress Disorder (외상후 스트레스 장애 이외의 정신 장애에 대한 EMDR 전후의 치료 반응 및 증상 변화)

  • Lee, Hae-Won;Kim, Dae-Ho;Bae, Hwal-Lip;Choi, Joon-Ho;Oh, Dong-Hoon;Park, Yong-Chon
    • Anxiety and mood
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    • v.4 no.1
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    • pp.55-61
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    • 2008
  • Objective : Eye movement desensitization and reprocessing (EMDR) has been established as an effective treatment for patients with posttraumatic stress disorder (PTSD). However, the literature is unclear as to whether EMDR is effective in the treatment of other psychiatric disorders. The purpose of this study was to evaluate the potential use of EMDR in the treatment of psychiatric disorders other than PTSD by using a clinician's impression of patient response and a subjective symptom evaluation. Methods : Seventeen diagnostically heterogenous patients without PTSD underwent an average of 4.3 sessions of EMDR. Symptom severity was assessed by the Clinical Global Impression-Change Scale (CGIC), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), and Symptom Checklist-90- Revised (SCL-90-R) before and after EMDR. Those whose CGI-C scores were 'very much improved' and 'much improved' after EMDR were classified as 'responders.' The patients' before and after treatment scores of symptom severity and group differences were compared. Results : Twelve of the 17 participants (12/17, 71%) were classified as 'responders.' The patients' scores on all of the scales, with the exception of the trait anxiety scale and obsession-compulsion scale of the SCL- 90-R, significantly decreased after treatment. There was no difference in sociodemographic and clinical variables between the responders and non-responders. Conclusion : The results of our study suggest that EMDR can be a promising candidate for the treatment of patients with psychiatric disorders other than PTSD, and thus further controlled studies are needed to determine whether EMDR can be applied to various psychiatric populations.

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Psychosocial support interventions for women with gestational diabetes mellitus: a systematic review

  • Jung, Seulgi;Kim, Yoojin;Park, Jeongok;Choi, Miyoung;Kim, Sue
    • Women's Health Nursing
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    • v.27 no.2
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    • pp.75-92
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    • 2021
  • Purpose: This study aimed to analyze the content and effectiveness of psychosocial support interventions for women with gestational diabetes mellitus (GDM). Methods: The following databases were searched with no limitation of the time period: Ovid-MEDLINE, Cochrane Library, Ovid-Embase, CINAHL, PsycINFO, NDSL, KoreaMed, RISS, and KISS. Two investigators independently reviewed and selected articles according to the predefined inclusion/exclusion criteria. ROB 2.0 and the RoBANS 2.0 checklist were used to evaluate study quality. Results: Based on the 14 selected studies, psychosocial support interventions were provided for the purpose of (1) informational support (including GDM and diabetes mellitus information; how to manage diet, exercise, stress, blood glucose, and weight; postpartum management; and prevention of type 2 diabetes mellitus); (2) self-management motivation (setting goals for diet and exercise management, glucose monitoring, and enhancing positive health behaviors); (3) relaxation (practicing breathing and/or meditation); and (4) emotional support (sharing opinions and support). Psychosocial supportive interventions to women with GDM lead to behavioral change, mostly in the form of self-care behavior; they also reduce depression, anxiety and stress, and have an impact on improving self-efficacy. These interventions contribute to lowering physiological parameters such as fasting plasma glucose, glycated hemoglobin, and 2-hour postprandial glucose levels. Conclusion: Psychosocial supportive interventions can indeed positively affect self-care behaviors, lifestyle changes, and physiological parameters in women with GDM. Nurses can play a pivotal role in integrative management and can streamline the care for women with GDM during pregnancy and following birth, especially through psychosocial support interventions.

A Study on a Coping Method of the Family Caregivers of Demented Patients (치매노인 가족부양자의 대처방법에 관한 연구)

  • You, Kwang-Soo
    • Research in Community and Public Health Nursing
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    • v.13 no.4
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    • pp.648-667
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    • 2002
  • This was a descriptive study designed to identify the level of coping method and its influencing factors on the family caregivers of demented patients, and resolve the family caregivers' level of stress. The data were collected from September 10 to October 10, 2001. Subjects for this study were recruited from four clinics, which were chosen from 15 clinics located in Chunbuk-Do as the study sites because of their cooperation for the study. They were similar in terms of size, the characteristics of the local community. and the population and registration status of the demented patients. The instruments used for the study were as follows: 1. Problematic behaviors of demented patients are measured by the Memory and Behavior Problem Checklist (Zarit, 1980), and the Linguistic Communication Symptoms Questionnaire (Bayles and Tomoeda, 1991) 2. The ability to carry out daily activities was measured using the Barthel Index (1965) and Katz Index (1963), which as well-known ADL assessment methods. 3. Burden was measured using Cost of Care Index by the Kosberg and Cairl (1986). 4. Coping strategy was measured Bell's 18 methods (1977). The data were analyzed using SPSS/PC. The study results were as follows: 1. The total stress score was 2.90 out of a maximum score of 5. The highest score reported was 3.09 on the dimension of restriction of individual and social activities, and the lowest region reported was 2.58 on the dimension of mental and physical health. 2. The total score of the coping method was 2.65 out of a maximum score of 5. The highest score reported was 4.01 on the dimension of thinking that includes an ideation such that it is better than any possible worst case, and the lowest score reported was 1.45 on the dimension of the self-image as a scapegoat. 3. There were significant differences in coping method among the subjects by age (F=2.752 p=0.04), caregiver (F=4.33 p=0.003), care-giving period (F=2.68 p=0.049), and dementia stage (F=2.87 p=0.034). 4. There were highly negative correlations ($\gamma$=-0.301 p=0.000) between problematic behaviors of demented patients and the coping method of their family caregivers. The highest correlation coefficient ($\gamma$=-0.339 p=0.000) was found between aggressive behaviors of the demented patients and the coping method of their family caregivers. 5. There was a low negative correlation ($\gamma$=-0.201 p=0.019) between the ADL of the demented patients and the coping method of their family caregivers. 6. There were highly negative correlations ($\gamma$=-0.213 p=0.005) between stress and the coping method of the family caregivers. The highest correlation was found between financial burden ($\gamma$=-.327 P=.000) and the coping method of the family caregivers. There was no significant correlation among unpleasant aspects of the demented patients, willingness to the demented patients, and the coping method of the family caregivers.

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Psychological Characteristics of Infant Outpatients and their Parents in Korean Traditional Clinic (한의원 내원 환아 및 보호자의 정신건강 특성 연구)

  • Lee, Soo-Jin;Byun, Soon-Im;Kim, Kyung-Seon;Kim, Hye-Jin;Yang, You-Jin;Gang, Ki-Rim;Kim, Myoung-Geun;Choi, Hyeon;Chae, Han
    • The Journal of Korean Medicine
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    • v.30 no.5
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    • pp.88-101
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    • 2009
  • Objectives: Since Korean traditional medicine has an integrative perspective by its nature, the patients' psychological and physical problems in a Korean traditional clinic may be resolved through a more integrative approach. The purpose of this study was to describe the latent characteristics of psychological health of child outpatients and their parents visiting Korean traditional clinic with physical complaints and was to propose an alternative curriculum to meet their needs based on their psychological and physical aspects. Methods: Subjects studied consisted of 100 outpatients (59 boys, 41 girls, mean age 55 months, age range 18 to 83 months) and their parents. Behavior characteristics for children were measured by Korean version of Child Behavior Checklist for Ages 1.5-5 (CBCL1.5-5) while parenting stress, depression, and anxiety for parent were measured by Korean-Parenting Stress Index-Short Form (K-PSI-SF), Center for Epidemiologic Studies Depression Scale (CES-D) and State-Trait Anxiety Inventory (STAI), respectively. The data of subjects were compared to those of standardized groups and then were compared according to child's gender within sample. Results: Child participants were reported to have significantly higher scores of all CBCL 1.5-5 subscales than the standardized group. When compared, no differences of K-PSI-SF, CES-D, and STAI was found between parents of participants and the standardized groups. However, parents of child participants with at-risk psychological problems showed significantly higher scores of all parenting stress subscales than those of all child participants. In addition, the mothers of boy participants demonstrated significantly higher anxiety, depression and parenting stress than those of girl participants irrespective of psychological severity. Conclusions: We discussed the implication of these results in clinical situation and make recommendations for curriculum of psychiatry and pediatrics with the aim of improving proper diagnosis, consulting and treatment.

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Effects of Occupational Trauma Exposure on Brain Functional Connectivity in Firefighters With Subclinical Post-Traumatic Stress Symptoms: A Resting-State Functional Magnetic Resonance Imaging Study (직업적 외상 노출이 역치 하 외상 후 스트레스 증상을 보이는 소방공무원의 뇌 기능적 연결성에 미치는 영향: 휴지기 기능적 자기공명영상 연구)

  • Heo, Yul;Bang, Minji;Lee, Sang-Hyuk;Lee, Kang Soo
    • Anxiety and mood
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    • v.18 no.2
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    • pp.39-47
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    • 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.

A Meta-analysis of Related Factors Depression of Korea University Student (한국 대학생의 우울 관련 요인에 대한 메타분석)

  • Jeon, Byoung-Jin;Song, Bo-Kyong;Ko, Koung-Min;Kim, Ji-Yoon;Park, Sang-Eun;Yu, Yi-Seul;Lee, Du-Ri;Choi, Young-Ju
    • The Journal of Korean society of community based occupational therapy
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    • v.5 no.2
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    • pp.43-55
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    • 2015
  • Objective : This study was a meta-analysis of previous studies to examine the integration of related factors depression University students of Korea, and to determine the relative importance among the relevant factors based on it. Methods : 2000-2014 papers posted on the National Science and Technology Information Center (NDSL), Nurimedia (DBpia), Academic Research Information Service (RISS), Korea Research Information(KISS), provide the text of the Library of Congress were collected using the service. The Key words a 'University Student', 'Depression', 'Depression Factors' was used. Used the Down & Black level, evidence-based checklist was developed by the research (1998) (checklist) had analyzed the selected document metadata to assess the quality. Results : 47-studies selected research groups are divided into five factors(self-esteem, suicidal ideation, positive thinking, stresses, Internet and smartphone addiction). Using meta-analysis, we analyzed the effect sizes, statistical heterogeneity and publication amenities. As a result, the self-esteem of the five factors were not found heterogeneity. Effect size is a self-esteem and suicidal ideation "large effect size", positive thinking and stress "medium effect size", internet and smart phone addiction"small effect size". Conclusion : Self-esteem and suicidal ideation are among the factors associated with depression in University students of Korea was found that the most relevant. It identified the factors associated with depression in college students, and could utilized as basis for the prevention of depression.

Factors Affecting the Parental Stress of Children and Adolescents with Epilepsy (뇌전증 소아청소년 환아의 부모 스트레스에 영향을 주는 요인)

  • Jung, Byu Lee;Kim, Ga Eun;Lee, Hyang Woon;Kim, Eui-Jung
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.1
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    • pp.63-71
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    • 2020
  • Objectives : The aim of this study was to investigate the impact of clinical and psychological factors on the parental stress of children and adolescents with epilepsy. Methods : Children and adolescents with epilepsy (n=90, age range=6-17 years) completed questionnaires on epilepsy-related variables, children's depressive symptoms (Children's Depression Inventory, CDI), children's anxiety (Revised Children's Manifest Anxiety Scale, RCMAS) and performed the scale for children's intelligence (IQ). Parents who have children and adolescents with epilepsy completed questionnaires on parental stress (Questionnaire on Resources and stress, QRS), parental anxiety (State-Trait Anxiety Inventory, STAI), children's attention problems (Abbreviated Conners Parent Rating Scale Revised, CPRS), and children's behavioral problems (Korean Child Behavior Checklist, K-CBCL). Stepwise regression analysis was performed to determine the significant predictive variables that affect parental stress. Results : In the correlational analysis, duration of seizure treatment (r=0.253, p=0.016), children's IQ (r=-0.544, p<0.001), children's attention problems (r=0.602, p<0.001), children's depressive symptoms (r=0.335, p=0.002), children's anxiety (r=0.306, p=0.004), children's behavioral problems (r=0.618, p<0.001), and parental anxiety (r=0.478, p<0.001), showed a significant correlation with parental stress. Children's behavioral problem (β=0.241, p=0.010), children's IQ (β=-0.472, p<0.001), and parental anxiety (β=0.426, p<0.001) were significantly related to the parental stress (Adjusted R2=0.619). Conclusions : Clinicians should pay attention to children's intelligence and behavioral problems and parental anxiety, which affect parental stress with children and adolescents with epilepsy.

Feasibility of Emotional Freedom Techniques in Patients with Posttraumatic Stress Disorder: a pilot study

  • Yujin Choi;Yunna Kim;Do-Hyung Kwon;Sunyoung Choi;Young-Eun Choi;Eun Kyoung Ahn;Seung-Hun Cho;Hyungjun Kim
    • Journal of Pharmacopuncture
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    • v.27 no.1
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    • pp.27-37
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    • 2024
  • Objectives: Posttraumatic stress disorder (PTSD) is a prevalent mental health condition, and techniques using sensory stimulation in processing traumatic memories have gained attention. The Emotional Freedom Techniques (EFT) is a psychotherapy that combines tapping on acupoints with exposure to cognitive reframing. This pilot study aimed to assess the feasibility of EFT as a treatment for PTSD by answering the following research questions: 1) What is the compliance and completion rate of patients with PTSD with regard to EFT protocol? Is the dropout rate reasonable? 2) Is the effect size of EFT protocol for PTSD sufficient to justify a future trial? Methods: Thirty participants diagnosed with PTSD were recruited. They received weekly EFT sessions for five weeks, in which they repeated a statement acknowledging the problem and accepting themselves while tapping the SI3 acupoint on the side of their hand. PTSD symptoms were evaluated using the PTSD Checklist for DSM-5 (PCL-5) before and after the intervention. Results: Of the 30 PTSD patients (mean age: 34.1 ± 9.1, 80% female), 96.7% showed over 80% compliance to the EFT sessions, and 86.7% completed the entire study process. The mean PCL-5 total score decreased significantly after the intervention, with a large effect size (change from baseline: -14.33 [95% CI: -19.79, -8.86], p < 0.0001, d = 1.06). Conclusion: The study suggests that EFT is a feasible treatment for PTSD, with high session compliance and low dropout rates. The effect size observed in this study supports the need for a larger trial in the future to further investigate EFT as a treatment for PTSD. However, the lack of a control group and the use of a self-rated questionnaire for PTSD symptoms are limitations of this study. The findings of this pilot study can be used to plan a future trial.