• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제13권1호
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• pp.38-46
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• 2002

재해정신의학은 재해를 당한 아동과 청소년들에게 적시에 개입하여 심리적 후유증을 최소화하고 장기적인 후유증을 줄이고, 또한 재해를 당한 지역과 사회가 일상으로의 복구를 할 수 있도록 돕는 정신과의 한 영역이다. 전 세계적으로 점차 많은 아동과 청소년들이 재해에 노출되고 있고, 이로 인해 재해정신의학에 대한 필요성과 요구가 증가하고 있다. 재해를 당한 아동들은 나이와 발달, 그리고 주변의 지지에 따라 개인적으로 받는 심리적인 영향이 다르고, 그 회복 과정과 장기적인 후유증도 달라질 수 있다. 재해시 정신의학적 개입은 위기 개입과 지지적 정신치료로 이루어지는데, 상담, 봉사, 지역사회 자문조정, 현장교육, 대중 교육과 정보 및 진료 의뢰 등이 포함된다. 본 고에서는 재해정신의학에 대한 개념을 요약하고, 아동과 청소년이 재해시에 나타내는 일반적인 심리적인 반응과 이에 대한 정신과적 개입에 대해 고찰하였다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제29권3호
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• pp.88-100
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• 2018

Objectives: In this study, we aimed to conduct a systematic review of studies investigating psychosocial factors affecting children exposed to disasters. Methods: In total, 140 studies were retrieved. The studies were published from 1988 to 2015. A systematic review was performed using the PRISMA guidelines. MEDLINE, EMBASE, Cochrane Central, Web of Science, PsycINFO, PubMed, and Google Scholar were searched. Each database was searched using the following terms: 'Child,' 'Adolescent,' 'Youth,' 'Disaster,' 'Posttraumatic,' 'Psychosocial,' 'Assessment,' 'Evaluation,' and 'Screening.' The identified studies were subjected to data extraction and appraisal. Results: The database search identified 713 articles. Based on the titles and abstracts, the full texts of 118 articles were obtained. The findings of this review can be used as a basis for the design of a psychosocial evaluation tool for disaster preparedness. Conclusion: Given the paramount importance of post-disaster evaluation and the weaknesses of current disaster evaluation tools, the need to develop valid and reliable tools and psychometric evaluations cannot be overstated. Our findings provide current evidence supporting various assessments in children, who are very vulnerable psychologically following disasters.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제13권1호
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• pp.24-29
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• 2002

본고는 최근 미국의 911 사태이후 정신의학 분야에서 관심사로 떠오르고 있는 재해정신의학 (Disaster Psychiatry)에대한 고찰을 통해 국내에서 대형재해 발생시 소아청소년 정신과 의사로서의 일정역할을 모색코자하는 목적의 일환이다. 우선 성인과 달리 소아청소년 재해환자에대한 치료를 다룰 때 어떤점을 고려하여야하는가에대한 연령 발달적 특이성를 살펴보고, 예방프로그램과 소아청소년 특유의 치료법은 무엇인가에대해 살펴보았다. 이를 요약하면 1) 소아는 타인에게 의존해야하는 존재로 부모 혹은 가족의 아이에대한 태도와 지지가 예후 결정에 가장 중요한 요소임으로 가족치료 부모교육의 중요성이 강조되며, 2) 개인치료에서는 인지행동적 요소가 여러 연구 문헌을 통해 가장 효과가 입증된 치료기법이고, 3) 놀이면담치료, fellow victim으로 구성된 집단치료 역시 효과적이며, 4) 1회성 재해를 당한 공포환자의 경우 특수기법인 EMDR(Eye Movement Desensitization and Reprocessing)의 시도가 추천되고, 5) 약물치료의 경우 2차적 혹은 보조치료수단이 되는데 성인에서 시도되는 다양한 약물의 적용이 가능하지만 부작용에대한 주의가 필요하다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제27권3호
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• pp.164-172
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• 2016

Objectives: This study attempted to evaluate the usefulness and direction of development of post-traumatic assessment and interventions based on the opinions of psychiatrics and disaster and trauma-related experts using the Delphi survey technique. Methods: In-depth individual interviews served as the pre-survey and were followed by Delphi primary and secondary surveys. Specialists in child and adolescent mental health, psychological support professionals specialized in disasters and related practitioners with experience of disasters in Korea completed a set of questionnaires and participated in focus group interviews and in-depth individual interviews on post-traumatic assessment and intervention. Results: We found that the following issues have a significant impact on the interventions after disasters: the proper time of the initial interview in the event of a disaster, assessment notices, aged assessment services, mandatory enforcement measures, scale screening and treatment intervention elements, symptoms degree classification, intervention standardization, the use of a levelled program, care unit environment, and operation plan. Conclusion: This study proposed effective mental health intervention measures and has implications for the development of evaluation treatment protocols after disasters.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제27권4호
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• pp.278-305
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• 2016

Objective: The aim of this systematic literature review is to analyze the psychosocial interventions for children and adolescents after disasters. Methods: We conducted a review of the extant research literature from 1991 to 2015 via a comprehensive search of the MEDLINE, EMBASE, Cochrane CENTRAL, PubMed and PsyclNFO databases. The keywords employed in this research included: 'child', 'adolescent', 'youth', 'disaster', 'posttraumatic', 'psychosocial', 'therapy' and 'intervention'. The researchers followed the PRISMA guidelines. A total of 850 articles were screened for their eligibility and fifty-nine were found to meet the study criteria. The final data analysis was performed based on the disaster type, study design, type of intervention, sample size, age, school grade, number of sessions, setting of intervention delivery, providers, approach and parent involvement. Results: Countries worldwide have experienced various kinds of disasters, including earthquakes, hurricanes, vessel accidents, tornados, tsunamis, volcanic eruptions, war, fire, terrorism, and traffic accidents. The types of psychosocial intervention that were conducted after these disasters included: psychological first aid, psychological debriefing, psychoeducation, trauma focused cognitive behavior therapy, eye movement desensitization reprocessing, prolonged exposure therapy, group play therapy and arts therapy, project interventions, school-based interventions and web-based interventions. Conclusion: The findings of the systematic literature review suggest that an appropriate psychosocial intervention could be utilized as evidence-based mental health treatment for children and adolescents after disasters.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제29권4호
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• pp.161-171
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• 2018

Objectives: This study aimed to identify the process of psychosocial assessment, the experience of intervention, and the improvement after the disaster that Danwon high school students survived from the sinking of the Motor Vessel (MV) Sewol in South Korea on April 16, 2014. Methods: We conducted in-depth qualitative research using individual interviews from January to February 2017. Twenty-one of 75 Danwon high school students survived by the MV Sewol disaster were studied. Two interviewers participated in the in-depth interview. Interviews were transcribed verbatim, coded, and analyzed through content analysis based on psychosocial assessment and intervention after the disaster. Results: Twenty-one participants were 20 years old, where 10 were male (47.62%), and 11 were female (52.38%). More than 75% of the interviewed students felt that mental health services were needed, and more than 85% required mental health assessments. Regarding psychiatric symptoms, the students reported that they suffered depression and insomnia (19.05%), anxiety (14.29%), nightmares and phobias (9.52%), and difficulties regarding concentration, aggression, and game addiction (4.76%). Conclusion: Despite survivors experiencing the same disaster, there were differences in their responses to mental health assessments and interventions experienced during the three years, and conflicting opinions were reported. In planning future evaluations and interventions, it is necessary for strategies to cope with flexibly to consider the characteristics and symptoms of the survivors while maintaining principles.

• 대한기관윤리심의기구협의회지
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• 제4권1호
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• pp.1-4
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• 2022

Although disaster research participants are in a more vulnerable state than general research participants, various ethical issues to be considered in the study may be overlooked due to the special situation of disaster. Therefore, research ethics should be considered to reduce damage to study participants and maximize benefits. In addition, from the perspective of researchers, ethical considerations should be applied in the disaster research process, so research ethics awareness should be established. In addition, at the health care institution and national level, it is necessary to prepare research ethics that reflect the Korean situation while meeting international standards in consideration of the characteristics of local communities. In Korea, after the Ferry Sewol accident in 2014, social interest in disaster mental health increased and the National Trauma Center was established in 2018, raising the need for disaster mental health ethics guidelines. Therefore, this review aims to discuss the significance of six items: specificity of the study, prior consent and autonomy, community participation, confidentiality and feedback provision, risk minimization, and research support. So far, the experience of disaster mental health research is not sufficient in South Korea. Therefore, the current guidelines are required to be continuously revised through practical experience in the future.

• 대한불안의학회지
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• 제11권2호
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• pp.91-105
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• 2015

재난 경험자들의 정신건강은 개인적인 측면뿐만 아니라 재난 이후의 지역사회의 회복 측면에서 매우 중요하기 때문에 개인적 수준과 사회적 수준 양쪽에서 접근해야 한다. 또한 재난 경험자들을 이해하고 돕기 위해서는 PTSD, 우울, 불안과 같은 정신 건강 분야뿐만 아니라 심리적 및 사회적 자원 분야, 물질남용 및 중독 분야, 비재난스트레스 분야, 기능상태 분야 등 다양한 방면의 평가가 필요하다. 재난정신건강 평가를 위해서 최소한 1시간 이내에 평가할 수 있는 표준 버전과 30분을 넘지 않는 단축 버전과 같은 기본적인 패키지가 필요하다. 임상 현장보다 재난 현장에서 시간 및 비용이 더 중요한 요소이고 재난 현장의 특성상 실현 가능성도 고려하여야 하기 때문에 이 모두를 고려한 구성을 해야 한다. 적극적인 재난정신건강의 다면적 평가를 통해 조기에 위험군을 선별하고 이를 적절히 관리한다면 재난 이후에 발생하는 외상후스트레스후유증을 최소화할 수 있을 것이다.

• 정신신체의학
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• 제24권2호
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• pp.125-132
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• 2016

연구목적 재난의 심리지원 및 관리에 기존 기관의 연계가 중요하다. 안산에서 세월호 참사 당시 민관기관의 연계에 대해 연구하고자 한다. 방 법 25개 기관 121명 종사자를 대상으로 평상시와 세월호 당시 연계 활동 대상기관, 모임 빈도, 연계 활동의 내용, 만족도, 낮은 만족도의 원인에 대해 설문하여, paired t-test, Chi-square test 및 McNemar test를 이용하여 평상시와 세월호 당시를 비교하였다. 결 과 연계 사업 필요성에 대한 이해, 조직적 차원의 지지는 재난 당시 더 낮은 문제 요인이었으나, 연계의 정도(n=397에서 n=251로 감소) 및 만족도는 재난 시 더욱 저하되었다. 낮은 연계만족도의 원인으로는 실적위주의 평가제도가 재난 시 유의하게 더 문제가 되는 것으로 나타났다(p=0.045). 결 론 재난 시 효과적인 연계를 위해서는 재난 이전부터 지역사회 기관에 대한 역량 분석, 연계 프로토콜 개발 등의 대비가 이루어져야 하며, 불필요한 형식적 평가제도로 인한 소진은 지양되어야 한다.

• 대한불안의학회지
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• 제7권2호
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• pp.92-100
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• 2011

Objectives : The aim of this study was to investigate Post Traumatic Stress Disorder (PTSD)-related symptom severity, level of functional impairment and personality profiles between full-blown PTSD, partial PTSD and non-PTSD groups among 59 adolescent survivals from the Incheon fire disaster. Method : Using Short Screening Scale for DSM-IV PTSD, victims of the disaster were assigned to a full-blown PTSD group (n=18), a partial PTSD (n=22), or a non-PTSD group (n=19). Assessments included the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), the Impact of Event Scales (IES), the McBride's Degree of General Labor Loss, and the Korean Version of Temperament and Character Inventory (K-TCI). Results : Significantly severe PTSD symptoms (F=4.832, df=2, p<.05) and functional impairment (F=12.144, df=2, p<.01) were demonstrated by PTSD groups as compared to the non-PTSD group. Interestingly, full and partial PTSD did not differ in these comparisons. Similarly, the subtypes of PTSD did not differ with respect to personality profiles using the K-TCI ; however, personality profiles were sharply differentiated between the PTSD and non-PTSD group. Conclusion : Although high subject homogeneity and small sample size may limit the results of this study, the present results highlight the possibility of the underestimation as well as the insufficient, treatment and compensation of partial vs full PTSD.