• The Journal of Korean Academic Society of Nursing Education
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• v.26 no.1
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• pp.47-55
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• 2020

Purpose: The aim of this study was to examine the validity and reliability of the Korean version of the PTSD scale (K-PTSD) for measuring attitudes and knowledge of PTSD. Methods: A cross-sectional study design was used. The K-PTSD scale consisted of 8 items for attitudes, 8 items for general knowledge of PTSD, and 3 items for knowledge of PTSD treatment; 211 nursing students and paramedic students participated. Content validity, item analysis, and factor analysis were used to examine the construct validity. Criterion validity was tested by using educational experience with PTSD as a criterion. Cronbach's α was used to identify internal consistency reliability in the attitude scale. Results: Construct validity of the K-PTSD was verified by exploratory factor analysis, with factor loadings for attitude ranging from .59 to .84. Criterion validity in comparing knowledge of PTSD (t=2.02, p=.044) and PTSD treatment (t=3.19, p=.022) showed a significant difference according to PTSD educational experience. Cronbach's α for the attitude scale was .79 and .59. Conclusion: The findings suggest that the K-PTSD is a valid and reliable tool that can measure attitudes and knowledge of PTSD among nursing and paramedic students. However, further study is needed to retest the verification of this scale with more diverse participants.

• Korean Journal of Biological Psychiatry
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• v.15 no.2
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• pp.110-117
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• 2008

Objectives : Posttraumatic stress disorder(PTSD) has been primarily associated with emotional problems. Recently, however, the impact of PTSD on cognitive processes has interested a growing number of researchers. The current study is aimed at investigating the cognitive aspects of PTSD at both behavioral and neurological levels. Methods : We recruited individuals with PTSD who survived the Daegu subway explosion in 2003 as well as non-PTSD individuals as a control group. To evaluate the inhibitory processes and the neural mechanisms, we had these individuals perform the negative priming task simultaneously with functional MRI scanning. Results : Behaviorally, the negative priming effect was intact in the control group but was not evident in the PTSD group. In the imaging results, only the PTSD group showed the negative priming effect (i.e., increased activation of the negative priming condition as opposed to the neutral condition) in the dorsolateral prefrontal cortex, anterior cingulate cortex, and inferior temporal gyrus. The PTSD group also showed increased activity for the positive priming condition as opposed to the neutral condition in the claustrum. These results confirm and extend the previous findings that the integrity of the ACC is compromised in the trauma survivors due to disrupted white matter tract. Conclusions : The current results suggest that deteriorated performance of the PTSD group may be due to the functional problem as well as the structural abnormalities.

• Korean Journal of Biological Psychiatry
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• v.24 no.1
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• pp.10-18
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• 2017

Occupational hazards of firefighting and rescue works include frequent exposure to emergencies and life-threatening situations. These stressful work conditions of being constantly under pressure and exposed to potentially traumatic events put them at higher risk of developing posttraumatic stress disorder (PTSD), compared to the general population. PTSD is a potentially debilitating mental disorder, due to persistent intrusive thoughts, negative alterations of mood and cognition, hypervigilance, avoidance of similar situations and reminders, and re-experiences of the traumatic event. Previous studies have shown a relatively high prevalence of PTSD among firefighters, indicating the need for a systematic approach of early detection and prevention. Therefore, a critical review of the current literature on PTSD in firefighters would provide valuable insights into developing effective prevention and intervention programs. Literature indicated that there are risk factors of PTSD in firefighters, such as pre-existing depression, anxiety, sleep disorders, occupational stress, physical symptoms, and binge drinking, whereas social support and adequate rewards are protective factors. Although there are differences in the prevalence of PTSD across studies, partly due to various assessment tools utilized, different sample sizes, and sample characteristics, over one tenth of the firefighters were estimated to have PTSD. The current review warrants further investigations to precisely assess PTSD and co-morbid mental disorders, functional outcomes, and associated factors, and to develop evidence-based preventive and interventional programs to help firefighters with PTSD.

• Anxiety and mood
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• v.5 no.1
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• pp.14-20
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• 2009

Objective : The objective of this study was to examine the relationship between plasma serotonin concentration and posttraumatic stress disorder (PTSD) symptoms in chronic PTSD patients who have been taking medication. Methods : Plasma serotonin level of 14 PTSD patients and a control group of 28 Vietnam War veterans was measured by HPLC (high performance liquid chromatography). The Combat Exposure Scale (CES), Mississippi Scale for Combat-Related Posttraumatic Stress Disorder (M-PTSD), Clinician Administered PTSD Scale (CAPS), Hamilton Rating Scale for Depression (HRSD), and Hamiltion Anxiety Scale (HAS) were used to evaluate PTSD symptom severity. Results : Serotonin level was significantly higher in the PTSD group than in the control group (p=0.036, p=0.006, respectively). M-PTSD (p<0.001), CAPS (p<0.001), HRSD (p<0.001), and HAS (p<0.001) scale scores were significantly higher in the PTSD group than in the control group; however, the CES score failed to show a significant improvement (p=0.964). There were no significant differences between plasma serotonin and PTSD symptoms. Conclusion : In chronic PTSD patients who have been taking medications, we can not predict treatment effect and symptom severity by measuring only plasma serotonin levels. PTSD is a complicated disorder which may likely be related to a variety of neurotransmitter systems. Therefore, further research which investigate relationships with norepinephrine, dopamine, and other neurotransmitters as well as serotonin is needed to improve the treatment of PTSD.

• Anxiety and mood
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• v.9 no.2
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• pp.106-112
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• 2013

Objective : Several reports have found abnormal levels of androgen in post-traumatic stress disorder (PTSD) patients. This abnormality in androgen is hypothesized to due to chronic psychological stress effects on the hypothalamic-pituitary-gonadal (HPG) system. The present study was conducted to estimate serum testosterone levels in PTSD patients in comparison with normal subjects. Methods : Seventy-five male Korean veterans of the Vietnam War volunteered for the study, of which eleven were excluded because of incomplete psychological assessment. To measure basal serum testosterone, blood samples were collected between 8.00 and 9.30 a.m. The clinician administered PTSD scale (CAPS), the structured clinical interview for DSM-IV (SCID), Hamilton Anxiety Rating Scale (HAM-A), Hamilton Rating Scale for Depression (HAM-D), Mini International Neuropsychiatric Interview Plus (Korean version of MINI-Plus), CES-K (Korean version of combat exposure scale). Results : The serum testosterone level of PTSD patients ($5.4{\pm}2.5ng/mL$) was higher than that of a control group ($3.1{\pm}1.7ng/mL$, p<0.001). Testosterone levels were significantly correlated with CAPS (r=.38, p<.01), HAM-A (r=.35, p<.01) and HAM-D (r=.28, p<.01) in all subjects. Conclusion : The results of the present study suggest that chronic psychological stress affects the HPG system.

• Anxiety and mood
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• v.9 no.1
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• pp.54-60
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• 2013

Objectives : Posttraumatic stress disorder (PTSD) is classified as an anxiety disorder. PTSD occurrence is known to be increased in middle-aged and older people, female, and individuals with a previous history of psychiatric disorders, lower education levels, low socioeconomic status, and severely injured patients. Anxiety symptoms are also related to later development of PTSD. In this study, we investigate the influences of injury severity and sociodemographic factors on severe anxiety in PTSD patients with no previous history of psychiatric disorders. Methods : Forty-one PTSD patients without previous history of psychiatric disorders were recruited from the psychiatric clinic at Chosun University Hospital. Subjects underwent psychiatric and physical examinations including the Injury Severity Score (ISS), Beck Anxiety Inventory (BAI), and Korean-Wechsler Adult Intelligence Scale (K-WAIS). We defined severe anxiety as a BAI scores of 30 or more. Logistic regression analyses and multi-step model selection were applied to identify predictive factors for severe anxiety. Results : In univariate analysis, age, ISS, and socioeconomic status were found to be significant factors. Through multivariate logistic regression analyses and a stepwise model selection, we found the combination of age and ISS to be the best-fitted model for affecting severe anxiety in PTSD patients without a previous history of psychiatric disorders. Conclusion : Our findings suggest that the combination of age and ISS could develop severe anxiety in PTSD patients with no previous history of psychiatric disorders.

• Anxiety and mood
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• v.9 no.1
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• pp.19-24
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• 2013

Objectives: The objective of this study is to examine the association between the children's psychopathology and age, intellectual quotient, and parental psychopathology in children with post-traumatic stress disorder (PTSD). Methods: The emotional and behavioral problems of 35 children with PTSD (23 boys, 12 girls, mean age, $10.26{\pm}2.47$ years) were investigated by retrospective chart review. Their parents' anxiety and depression symptoms were also investigated. We examined the correlations between children's psychopathology and their parents' anxiety and depression symptoms, as well as their age and IQ. Results: There were positive correlations between maternal trait anxiety and depression, and children's emotional problems. State and trait anxiety of children with PTSD were positively correlated with age, and attention-deficit hyperactivity disorder symptoms were negatively correlated with age. Conclusion: Our results suggest that psychiatric manifestation of children who experienced trauma could differ according to the development stage, and the treatment of children with PTSD should involve parental education about the effect of maternal emotional states on children.

• Anxiety and mood
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• v.9 no.2
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• pp.121-127
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• 2013

Objective : Several studies have reported the association between posttraumatic stress disorder (PTSD) and hypertension (HTN). The aim of this study was to evaluate the impact of PTSD symptoms on blood pressure. Methods : Korean veterans of the Vietnam War with (n=62) or without PTSD (n=87) participated in this study. The clinician administered PTSD scale (CAPS) and alcohol use disorder identification test (AUDIT) were applied. Blood pressure, pulse rate, risk factors of HTN and demographic data of the subjects were collected. Effects of potential explanatory variables on HTN were analyzed with logistic regression. Results : Diastolic blood pressure was significantly higher in PTSD group (p=0.015). However, PTSD subjects showed significantly lower pulse rate than non-PTSD subjects (p=0.004). Logistic regression analysis showed that avoidance symptom might be a predictor for hypertension (OR=1.065, p=0.030). Conclusion : These results suggest that PTSD, especially avoidance symptom, might be a risk factor on HTN in the elderly with PTSD. Further studies are needed to evaluate the change of blood pressure according to the clinical improvement of PTSD.

• Journal of Korean Critical Care Nursing
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• v.13 no.3
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• pp.62-74
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• 2020

Purpose : This study aimed to investigate the prevalence and risk factors of mental health problems in patients discharged from the intensive care unit (ICU). Methods : This was a secondary analysis study using data from a multicenter prospective cohort of post-ICU patients. We analyzed data of 311 patients enrolled in the primary cohort study who responded to the mental health questionnaire three months after the discharge. Anxiety and depression were measured on the Hospital Anxiety-Depression Scale, and post-traumatic stress disorder (PTSD) was measured on the Posttraumatic Diagnostic Scale. Results : The prevalence of anxiety, depression, and PTSD in patients at three months after ICU discharge were 25.7%, 17.4%, and 18.0%, respectively, and 7.7% of them experienced all three problems. Unemployment (OR=1.99, p=.033) and unplanned ICU admission (OR=2.28, p=.017) were risk factors for depression, while women gender (OR=2.34, p=.009), comorbid diseases (OR=2.88, p=.004), non-surgical ICUs (trauma ICU: OR=7.31, p=.002, medical ICU: OR=3.72, p=.007, neurological ICU: OR=2.95, p=.019) and delirium (OR=2.89, p=.009) were risk factors for PTSD. Conclusion : ICU nurses should proactively monitor risk factors for post-ICU mental health problems. In particular, guidelines on the detection and management of delirium in critically ill patients should be observed.

• Anxiety and mood
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• v.4 no.2
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• pp.121-126
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• 2008

Objective : The present study investigated gender differences in the symptoms of posttraumatic stress disorder (PTSD) among Korean PTSD patients from a multicenter sample. Methods : Data were collected from 18 psychiatric units of training hospitals nationwide. All the patients were interviewed by attending psychiatrists using a structured format for PTSD by DSM-IV diagnoses. Additionally the Davidson Trauma Scale was used to evaluate all self-reported symptomatology. Results : Forty-three patients with PTSD, 23 female and 20 male patients, were enrolled in this study. There were significant differences in the frequency and severity of avoidance symptoms, and severity of re-experience symptoms. The female patients reported a higher level of re-experience and avoidance symptoms than the male patients. Conclusion : The results of the present study were found to be consistent with previous studies on gender differences. Women were more susceptible to PTSD symptoms than men, especially exaggerated re-experience and chronic avoidance. Since all patients groups were enrolled from the hospital, this findings needs to be reexamined using community samples.