• 제목/요약/키워드: PTSD

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외상 후 스트레스 장애의 신경기반 : 부적점화과제와 기능자기공명영상 연구 (Neural Substrates of Posttraumatic Stress Disorder : Functional Magnetic Resonance Imaging Study Using Negative Priming Task)

  • 이병택;유정;이동훈;손명호;강내희;함병주;최남희
    • 생물정신의학
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    • 제15권2호
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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.

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소방공무원과 외상 후 스트레스 장애 (Firefighters and Posttraumatic Stress Disorder)

  • 류지아;하은희;정최경희;김지은;박신원;김현주
    • 생물정신의학
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    • 제24권1호
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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.

연천 사고 피해 PTSD 환자의 해마 용적 : 8개월 추적 연구 (Hippocampal Volume of Patients who got Posttraumatic Stress Disorder from Yun-cheon Accident : 8-month Follow Up Study)

  • 강석훈;김태용;이수영;정문용;최진희;정혜경;김재천
    • 대한불안의학회지
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    • 제3권2호
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    • pp.123-127
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    • 2007
  • Objective : This study was conducted to evaluate the relation between symptoms and hippocampal volume in patients with posttraumatic stress disorder (PTSD). Methods : Eight patients with PTSD and five normal controls were enrolled in the present study. The severity of PTSD symptoms was measured using the clinician administered PTSD scale (CAPS), Hamilton Rating Scale for Depression (HAMD), Hamilton Anxiety Rating Scale (HAMA). Magnetic resonance imaging (MRI) was used to measure hippocampal volume. Results : There were significant differences in the CAPS, HAMD, and HAMA scores between the PTSD patients and normal controls. The left and right hippocampal volumes were smaller in the PTSD patients than in the normal controls, but this difference was not statistically significant. The results showed that PTSD symptoms were not related to hippocampal volume. Conclusion : In this study, we could not identify a difference in hippocampal volume between normal controls and patients with PTSD at eight months after trauma. Future research with different subjects and a larger sample size is needed in order to confirm the difference in hippocampal volume.

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중환자실 생존자의 외상 후 스트레스장애 발생정도와 영향요인 (Influential Factors of Post-Traumatic Stress Disorder in Survivors of Intensive Care Units)

  • 김소혜;주현옥
    • 임상간호연구
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    • 제26권1호
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    • pp.97-106
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    • 2020
  • Purpose: This study was conducted to investigate the incidence and associated factors with post-traumatic stress disorders (PTSD) in patients with intensive care units (ICU) admission experience. Methods: This study is a retrospective observational study using self-reporting questionnaire. Patients who were admitted to ICU more than 72 hours and agreed to participate were enrolled in this study. PTSD were assessed by Korean version of post-traumatic diagnosis scale, and PTSD was defined as 20 points or more. Medical records of participants were reviewed to identify influencing factors of PTSD. To analyzed the data, descriptive statistics, Mann-Whitney U test, Kruskal-Wallis test and gamma regression were utilized using SPSS/WIN 23.0 program. Results: A total of 128 patients participated in the study. Mean age of participants was 58.3±11.7 years and 50 patients (39.1%) were female. Mean duration of ICU stay was 8.43±8.09 days and PTSD was diagnosed in 12 patients (9.4%). In the results of a Gamma regression analysis, Psychiatric history (B=1.09, p=.002), APACHEII score (B=.04, p=.005), CPR experience (B=1.65, p=.017) and physical restraint (B=.68, p=.049) were independently associated with PTSD occurrence. Conclusion: The results of this study suggest that a various factors influencing PTSD should be identified to prevent PTSD in patients who requires ICU care. In addition, post-ICU care programs are required to assess and reduce PTSD.

경찰공무원의 심리적 외상(Trauma)과 외상후 스트레스 장애(PTSD) 대응 방안에 관한 연구 -대상자 심층면접을 중심으로- (A Study on Countermeasure against Trauma and PTSD of Police Officers -Focused on In-depth Interview with Targets-)

  • 강길주;이상열
    • 시큐리티연구
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    • 제56호
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    • pp.31-54
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    • 2018
  • 본 연구는 매일 발생하는 각종 사건 사고 처리와 국가적 재난사고 현장의 최일선에서 국민의 생명과 안전을 지키는 지역사회경찰활동으로 인해 심리적 외상(Trauma)과 외상 후 스트레스(PTSD)를 경험하는 경찰관의 심리적 복지 향상방안을 마련하는데 목적이 있다. 이를 위해 Trauma 및 PTSD 관련 문헌연구와 Trauma 및 PTSD를 경험한 경찰공무원을 심층면담을 통해 다음과 같은 대응방안을 제시하였다. 첫째, 경찰공무원을 위한 심리검사가 적극적이고 실질적으로 시행되어야 한다. 경찰공무원은 체력적인 부담뿐만 아니라 대민서비스로 인한 감정노동 스트레스도 높기 때문에 육체적인 휴식과 더불어 정기적인 심리검사가 제도적으로 확립되어야 한다. 둘째, 경찰공무원을 위한 정기적인 심리검사와 결과에 대한 적절한 조치가 필요하다. 셋째, 경찰공무원의 심리지원을 위한 제도가 정착되어야 한다. 이를 위해 경찰 마음동행센터의 확대와 내실 있는 운영이 이루어져야 한다. 넷째, 경찰공무원의 스트레스 해소기회를 제공해야 한다. 이를 위해 동호회를 활성화하도록 지원예산을 편성하고 활동여건을 조성해야 한다.

외상후스트레스장애 환자의 증상 정도와 스트레스 대처 방식, 사회적 지지, 자존감의 관련성 (The Association among Stress Coping Strategies, Social Support, and Self-Esteem in Patients with Posttraumatic Stress Disorder)

  • 정재희;권주한;박종일;양종철
    • 대한불안의학회지
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    • 제17권2호
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    • pp.59-66
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    • 2021
  • Objective : The purpose of this study is to investigate the relationship among the degree of symptoms of posttraumatic stress disorder (PTSD) and social support, stress coping strategies, and self-esteem in patients with PTSD. Methods : A total of 48 patients meeting DSM-5 criteria for PTSD and 48 normal controls were recruited for participation in this study. We evaluated subjects using the Clinician-Administered PTSD Scale (CAPS), Hamilton Anxiety Scale (HAM-A), Hamilton Depression Scale (HAM-D), Rosenberg Self-Esteem Scale (RSES), Multidimensional Scale of Perceived Social Support (MSPSS) and The Ways of Stress Coping Questionnaire (SCQ). We analyzed data using an independent t-test and Pearson's correlation analysis. Results : In PTSD patients, total CAPS scores showed a significant positive correlation with HAM-A and HAM-D scores and a significant negative correlation with MSPSS scores. RSES scores showed a significant positive correlation with MSPSS and SCQ scores. MSPSS scores showed a significant negative correlation with PTSD avoidance and numbing and HAM-D scores. SCQ scores showed a significant negative correlation with PTSD avoidance and numbing. Conclusion : These results revealed that the better the stress coping strategies and social support, the lower the degree of symptoms in patients with PTSD. In addition, it was found that the higher the social support and self-esteem, the lower the degree of depression and anxiety. Therefore, in the treatment process, it seems important to identify and correct the self-esteem, social support system, and stress coping strategies of patients with PTSD.

외상후 스트레스장애에서 기질 및 성격의 변화 (Change of Temperament and Personality in Post-traumatic Stress Disorders)

  • 최효선;김대호;김은경
    • 정신신체의학
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    • 제28권2호
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    • pp.155-160
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    • 2020
  • 연구목적 본 연구는 외상후 스트레스장애(Posttraumatic Stress Disorder, PTSD)를 비롯한 정신질환자의 기질과 성격의 변화 양상을 확인하고 한다 방 법 PTSD 환자 33명과 비PTSD 환자 69명을 대상으로 Temperament and Character Inventory (TCI)를 1, 2차에 걸쳐 측정하였고, 그 결과값에 대해 반복측정 ANOVA와 단순 주효과분석을 시행하였다. 결 과 비PTSD 집단에서는 1차와 2차 검사 결과의 차이가 나타나지 않았다. 반면, PTSD 집단에서는 위험회피, 사회적 민감성, 자율성, 연대감에서 유의미한 차이가 있었다. 또한 위험회피, 사회적 민감성, 자율성, 연대감에서 시간과 그룹 간의 상호작용과 시간에 따른 주효과가 유의하게 나타났다. 결 론 본 연구는 외상적 사건이 자율성, 연대감과 같은 성격적 특성은 물론, 위험회피와 사회적 민감성과 같은 기질적 특성의 변화에 영향을 미칠 수 있음을 확인하였다는 점에서 의의가 있다.

Influencing Factors of High PTSD Among Medical Staff During COVID-19: Evidences From Both Meta-analysis and Subgroup Analysis

  • Qi, Guojia;Yuan, Ping;Qi, Miao;Hu, Xiuli;Shi, Shangpeng;Shi, Xiuquan
    • Safety and Health at Work
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    • 제13권3호
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    • pp.269-278
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    • 2022
  • Background: PTSD (Post-traumatic stress disorder, PTSD) had a great impact on health care workers during the COVID-19 (Corona Virus Disease 2019, COVID-19). Better knowledge of the prevalence of PTSD and its risk factors is a major public health problem. This study was conducted to assess the prevalence and important risk factors of PTSD among medical staff during the COVID-19. Methods: The databases were searched for studies published during the COVID-19, and a PRISMA (preferred reporting items for systematic review and meta-analysis) compliant systematic review (PROSPERO-CRD 42021278970) was carried out to identify articles from multiple databases reporting the prevalence of PTSD outcomes among medical staff. Proportion random effect analysis, I2 statistic, quality assessment, subgroup analysis, and sensitivity analysis were carried out. Results: A total of 28 cross-sectional studies and the PTSD results of doctors and nurses were summarized from 14 and 27 studies: the prevalences were 31% (95% CI [confidence interval, CI]: 21%-40%) and 38% (95% CI: 30%-45%) in doctors and nurses, respectively. The results also showed seven risks (p < 0.05): long working hours, isolation wards, COVID-19 symptoms, nurses, women, fear of infection, and pre-existing mental illness. Two factors were of borderline significance: higher professional titles and married. Conclusion: Health care workers have a higher prevalence of PTSD during COVID-19. Health departments should provide targeted preventive measures for medical staff away from PTSD.

마음챙김 명상과 이정변기요법을 이용한 PTSD 환자 치험례 (A Case Report for PTSD Patients Based on Mindfulness & I-Jeong-Byeon-Gi Therapy)

  • 박종민;이고은;서주희;배달빛;최성열;강형원
    • 동의신경정신과학회지
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    • 제25권1호
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    • pp.73-84
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    • 2014
  • The purpose of this study was to introduce a PTSD patient who experienced significant effects of mindfulness meditation and Ii-Gyeung-Byun-Qi therapy. Our psychotherapy was executed five times a week for the 14-year-old male patient who attended middle school and was diagnosed by DSM-IV Diagnostic Criteria for PTSD, and then the MMPI-A was evaluated to determine the effects after 3 months. The results showed normal profiles of MMPI-A validity scales and Clinical Scales profile after his treatment, positive changes in content scales, and significant decreases of PSYC (psychoticism) and NEGE (negative emotionality) in PSY-5 scales. This study made through a case report on the treated psychotherapy for PTSD by the applications of modern psychological techniques in the Korean psychotherapy. We expected that this case report will have a role in development of standardized psychotherapy programs for PTSD.

외상후 스트레스 장애 환자의 신경인지기능 (Neurocognitive Functions in Posttraumatic Stress Disorder)

  • 김선국;이강준;이승환;남민;정영조
    • 생물정신의학
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    • 제10권2호
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    • pp.147-158
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    • 2003
  • Objective:The differences of various neurocognitive functions, including attention, memory, motor function, and higher cognitive function were compared between PTSD patients and normal control subjects. Also, correlation with PTSD symptom severity and neurocognitive functions were evaluated between PTSD patients and normal control subjects. Method:We assessed the neurocognitive functions by computerized neurocognitive test(CNT) batteries. The visual continuous performance test(CPT) and digit span test, finger tapping test and Wisconsin card sorting test(WCST) were executed. The Impact of Event Scale-Revised(IES-R) was used in the evaluation of the severity of PTSD. Result:The PTSD patients showed significantly impaired neurocognitive performance in all of the items, compared with normal control subjects. The relation between impairment in neurocognitive functions and symptom severity showed significant correlations. Conclusion:These results imply that PTSD patients have impaired neurocognitive functions concerning with specific brain areas, especially the frontal area. For the thorough evaluation of further neurocognitive functions, more detailed evaluation items of neurocognitive functions and brain imaging studies are necessary in the future study.

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