• Journal of Dental Anesthesia and Pain Medicine
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• v.15 no.2
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• pp.85-92
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• 2015

Background: Many people experience varying levels of discomfort when confronted with the prospect of dental treatment. Dental treatment can be a traumatic experience, especially for children and adolescents with dental anxiety. In this age group, dental fear causes a significant problem in dental management and has been related to severe dental caries and dental pain. The Dental Fear Survey (DFS) is the most widely used measure of dental fear. This study was undertaken to develop the Korean version of the DFS (K-DFS) and test its reliability and validity. Methods: The K-DFS, which uses projective techniques to measure children's and adolescents' dental fear, was developed. The DFS was translated into Korean and participants were selected via convenience sampling. Reliability and validity were tested using data from a sample of 813 middle school students in Gyeonggi Province, selected from the Self questionnaire survey. The K-DFS was administered twice to 102 adolescents aged 12-15 years. Results: The K-DFS had high internal consistency reliability (99.1%) but low test-retest reliability. Conclusions: The results indicate that the Korean versions of the DFS have good internal consistency reliabilities and test-retest validities. However, we need to further examine the test-retest reliability of the K-DFS and replicate the current study in different samples covering various age groups.

• Psychiatry investigation
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• v.15 no.11
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• pp.1079-1086
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• 2018

Objective The pathophysiology of social anxiety disorder (SAD) is not yet well understood, but previous research has suggested that oxytocin is associated with social behavior and may play a role in human anxiety states and anxiety-related traits. The aim of this study was to investigate the possible relationship between social anxiety symptoms and plasma oxytocin levels. Methods Twenty-three male patients with SAD and 28 healthy male controls participated in this study. All participants were assessed using the Mini International Neuropsychiatric Interview (MINI) and the Liebowitz Social Anxiety Scale (LSAS). Multivariate regression analysis was performed to identify associations between plasma oxytocin levels and SAD. Results In multiple regression models, after controlling for age and years of education, we found that higher oxytocin levels were significantly associated with higher total LSAS scores ($R^2=0.157$, coefficient=0.145, 95% CI=-0.0005-0.291, p=0.051) and fear subscale scores ($R^2=0.134$, coefficient=0.083, 95% CI=0.007-0.159, p=0.034) in the SAD group. Conclusion In this study, increased plasma oxytocin levels were associated with higher social anxiety symptoms among SAD patients, but not among controls. This might be because among SAD patients, higher oxytocin (OT) secretion is an insufficient compensatory attempt to reduce social anxiety symptoms.

• Korean Journal of School Psychology
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• v.17 no.3
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• pp.333-356
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• 2020

This study examined the mediating effects of fear of negative evaluation(FNE), fear of positive evaluation(FPE) and disqualification of positive social outcomes(DPSO) on the relationship between public self-consciousness(PSC) and social anxiety(SA) among college students. In this study, SA was divided into social interaction anxiety(SIA) and performance anxiety(PA). Participants included 316 undergraduates who completed a survey. There were three major results. First, PSC, SIA, PA, FNE, FPE and DPSO were positively correlated with each other. Second, FNE, FPE and DPSO had significant mediating effects on the relationship between PSC and SA. Third, when FNE, FPE and DPSO mediated the relationship between PSC and SA, the effect on PA was significantly greater than the effect on SIA, and in the path mediated by FNE, the effect on SIA was greater than the effect on PA. This paper discusses the findings and implications of this study.

• Journal of dental hygiene science
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• v.23 no.4
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• pp.255-263
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• 2023

Background: This study used text mining techniques to determine public perceptions of dental fear, extracted keywords related to dental fear, identified the connection between the keywords, and categorized and visualized perceptions related to dental fear. Methods: Keywords in texts posted on Internet portal sites (NAVER and Google) between 1 January, 2000, and 31 December, 2022, were collected. The four stages of analysis were used to explore the keywords: frequency analysis, term frequency-inverse document frequency (TF-IDF), centrality analysis and co-occurrence analysis, and convergent correlations. Results: In the top ten keywords based on frequency analysis, the most frequently used keyword was 'treatment,' followed by 'fear,' 'dental implant,' 'conscious sedation,' 'pain,' 'dental fear,' 'comfort,' 'taking medication,' 'experience,' and 'tooth.' In the TF-IDF analysis, the top three keywords were dental implant, conscious sedation, and dental fear. The co-occurrence analysis was used to explore keywords that appear together and showed that 'fear and treatment' and 'treatment and pain' appeared the most frequently. Conclusion: Texts collected via unstructured big data were analyzed to identify general perceptions related to dental fear, and this study is valuable as a source data for understanding public perceptions of dental fear by grouping associated keywords. The results of this study will be helpful to understand dental fear and used as factors affecting oral health in the future.

• Anxiety and mood
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• v.7 no.1
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• pp.22-28
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• 2011

Objective : Social anxiety disorder (SAD) has been characterized by a marked sense of anxiety provoked by exposure to one or more social situations. It has been well-known that the cultural characteristics of a society strongly affect the expression of SAD symptoms. The current study attempted to explore clinical and cultural characteristics of social anxiety symptoms in the Korean nonclinical population. Methods : 801 volunteers who participated in the national social anxiety screening day, which was held by Korean academy of anxiety disorders, were invited to complete the self-report version of Liebowitz social anxiety scale (LSAS-SR). A total of 691 participants completed the LSAS-SR and other information related to this study. Results : Social anxiety symptoms were reported by a great percentage of subjects, as displayed by the relatively high mean LSAS scores (44.58 ; SD=25.60). There were no significant differences in total LSAS score according to sex, education, or marital status. The three most fearful or avoided situations for participants, as measured by the percentage of subjects who had a score of more than 3 on each LSAS item were as follows: item 6 (acting, performing, or giving a talk in front of an audience ; 29.67% for fear and 22.72% for avoidance), item 16 (speaking up in a meeting ; 25.62% for fear and 21.56% for avoidance), and item 15 (being the center of attention; 13.89% for fear and 9.70% for avoidance). Conclusion : The Korean participants in this study demonstrated a high level of SAD symptoms. Our subjects reported that they were more likely to be fearful or avoid passive situations such as being the center of attention as compared with results from a study of western society which indicated that western people were more likely to be fearful or avoid active situations. These findings emphasize the importance of considering a patient's cultural background when evaluating SAD symptoms.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.4
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• pp.289-295
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• 2017

Background: This study is aimed to evaluate the level of fear and to reduce the overall fear, thereby enabling patients to receive treatment via timely visits. Methods: In a survey conducted by 460 South Korean middle school students, we used 453 data that faithfully responded to the survey. Multiple regression analysis was conducted to investigate the factors influencing subjective oral health and dental fear. The significance level used for statistical significance was ${\alpha}=0.05$. Results: The level of fear was higher for upper grade, female students. The factors affecting dental fear were higher for gingival bleeding and dental pain. Regarding factors for dental fear affecting subjective oral health, lower fear of puncture needle and tooth removal tool resulted in higher subjective oral health. Conclusions: The study found that adolescents had higher fear of dental care when they had gingival bleeding and tooth pain. Gingival bleeding is a symptom of early gingival disease and dental pain is likely due to advanced dental caries. These results suggested that it is necessary to have a program to reduce dental fear and anxiety as well as a program to prevent dental diseases through regular periodic screening and education.

• Anxiety and mood
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• v.16 no.2
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• pp.106-112
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• 2020

Objective : Social anxiety disorder (SAD) is characterized by fear of social threat and exhibits limbic hyper-reactivity toward social stimuli such as emotional faces. A previous study identified the uncinate fasciculus (UF) sub-tract as particularly related to facial memory. To explore the white matter tract relating to face-specific brain regions, we investigated the UF sub-tract in SAD. Methods : The diffusion tensor images of 22 patients with SAD and 20 healthy controls were analyzed with tractography. The UF sub-tract was delineated using the regions of interest of face patches in the anterior temporal lobe and the orbitofrontal cortex, and fractional anisotrophy (FA) and total number of streamlines (ST) were analyzed. We examined the group comparison of FA and ST of the UF sub-tract and correlations of FA and ST with the social anxiety symptoms such as the Liebowitz Social Anxiety Scale (LSAS), the Social Interaction Anxiety Scale (SIAS), the Social Phobia Scale (SPS) and the Fear of Negative Evaluation scale (FNE) in SAD. Results : There were no group differences in FA and ST of the UF sub-tract. However, negative correlations were observed between ST of the right UF sub-tract and severity of social anxiety symptoms (LSAS, r_s=-0.480, p=0.024; SIAS, r_s=-0.580, p=0.005; SPS, r_s=-0.590, p=0.004; FNE, r_s=-0.675, p=0.001) in patients with SAD. Conclusion : Although patients with SAD did not show quantitative abnormalities in the UF sub-tact connecting face-specific brain regions, this structure seems to play a role in the symptom severity of SAD.

• Journal of dental hygiene science
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• v.17 no.1
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• pp.20-29
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• 2017

The purpose of this study was to investigate the validity and reliability of the Korean version of a tool used to measure dental anxiety and fear. The Index of Dental Anxiety and Fear ($IDAF-4C^+$) was translated into Korean, and modified and revised to adapt to Korean culture. A survey was conducted among 457 patients in a dental clinic. The validity and reliability were determined using PASW Statistics ver. 18.0 and IBM SPSS AMOS ver. 21.0. Factor analysis showed that Korean version of $IDAF-4C^+$ was composed of three elements: dental anxiety, dental phobia, feared stimulus. The validity of the model was examined by confirmatory factor analysis and satisfied relevant requirements. All elements had convergent validity and discriminant validity exceeding requirements to ensure validity. Cronbach's ${\alpha}$ showed good reliability. In conclusion, the findings of this study demonstrate that the Korean version of $IDAF-4C^+$ has high validity and reliability. Furthermore, it can be used in clinical practice and research to decrease dental anxiety and fear.

• Journal of Oriental Neuropsychiatry
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• v.34 no.1
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• pp.33-42
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• 2023

Objectives: This study was conducted to observe the progression of symptoms according to the treatment period of patients with social anxiety disorder who received complex Korean medicine treatment. Methods: The medical records of 25 patients who were diagnosed with social anxiety disorder according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and received complex Korean medicine treatment (herbal medicine, acupuncture, and Korean psychotherapy) for 12 weeks were analyzed. The State-Trait Anxiety Inventory (STAI), the Beck Depression Inventory-II (BDI-II), the Beck Anxiety Inventory (BAI), the Korean-Social Avoidance and Distress scale (K-SAD), and the Korean-Fear of Negative Evaluation (K-FNE) were measured at the initial hospital visit and during the 4, 8, and 12 weeks of treatment to evaluate the effectiveness of treatment. Missing values were replaced with the average evaluation index value at that time. Results: 1) Statistically significant changes in STAI-X1, STAI-X2, BDI-II, BAI, K-SAD, and K-FNE scores were seen according to the time of treatment. 2) When scores were compared between each treatment time point, STAI-X2 and BDI-II showed statistically significant changes between the initial visit and four weeks of treatment, the initial visit and eight weeks of treatment, and the initial visit and 12 weeks of treatment. STAI-X1 and K-FNE showed statistically significant changes between the initial visit and eight weeks of treatment and the initial visit and 12 weeks of treatment. There was a statistically significant change in BAI scores between the initial visit and the 12th week of treatment. Conclusions: Complex Korean medicine treatment alleviated anxiety, depression, fear, and avoidance of social situation symptoms in patients with social anxiety disorder. The longer the treatment period, the more symptoms tended to be alleviated. However, the evidence should be supplemented with prospective, controlled research.

• The Korean Journal of Physiology and Pharmacology
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• v.22 no.2
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• pp.183-192
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• 2018

Post-traumatic stress disorder (PTSD) is a trauma-induced psychiatric disorder characterized by impaired fear extermination, hyperarousal, anxiety, depression, and amnesic symptoms that may involve the release of monoamines in the fear circuit. The present study measured several anxiety-related behavioral responses to examine the effects of berberine (BER) on symptoms of anxiety in rats after single prolonged stress (SPS) exposure, and to determine if BER reversed the dopamine (DA) dysfunction. Rats received BER (10, 20, or 30 mg/kg, intraperitoneally, once daily) for 14 days after SPS exposure. BER administration significantly increased the time spent in the open arms and reduced grooming behavior during the elevated plus maze test, and increased the time spent in the central zone and the number of central zone crossings in the open field test. BER restored neurochemical abnormalities and the SPS-induced decrease in DA tissue levels in the hippocampus and striatum. The increased DA concentration during BER treatment may partly be attributed to mRNA expression of tyrosine hydroxylase and the DA transporter in the hippocampus, while BER exerted no significant effects on vesicular monoamine transporter mRNA expression in the hippocampus of rats with PTSD. These results suggest that BER had anxiolytic-like effects on behavioral and biochemical measures associated with anxiety. These findings support a role for reduced anxiety altered DAergic transmission and reduced anxiety in rats with PTSD. Thus, BER may be a useful agent to treat or alleviate psychiatric disorders like those observed in patients with PTSD.