• Korean Journal of Cognitive Science
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• v.26 no.2
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• pp.167-207
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• 2015

This study focused on the awareness and coping methods of psychological trauma and human suffering in the contemporary era after the development of posttraumatic stress disorder(PTSD) including the situations in the Korean society, and proposed principles for an alternative paradigm of trauma recovery. Trauma is defined as an 'external' stress causing chronic suffering mediated by memory, and the American Psychiatric Association approved PTSD in the Diagnostic and Statistical Manual of Mental Disorders in 1980. The development of PTSD empowered moral legitimacy to the victims, opened a successful way to treatment, and accomplished explosive amount of research in the area of neurobiology and cognitive neuroscience. However, this also narrowed the understanding of human suffering, and the importance of an alternative coping method which overcomes the limitations of technical intervention became overlooked. Moreover, the Korean society has an underlying mechanism of replacing the matter of trauma to a problem of an individual. This is shown among the historical context of splitting and denial, and among medicalized bureaucracy. Trauma should be acknowledged as a social suffering, and searching for an alternative paradigm is in need. This study suggested the following principles; seeking for truth and justice, survivor as the agent of recovery emphasizing the responsibility of the community, ecological adaptations of recent bio-psychological achievements, and finally putting emphasis on continuous discussions about the definition of recovery.

• Anxiety and mood
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• v.2 no.1
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• pp.39-44
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• 2006

Objective : Chronic posttraumatic stress disorder (PTSD) is defined by the coexistence of symptoms (reexperiencing, avoidance and hyperarousal), persisting for more than months or years that causes significant impairment in social occupational functioning. This study was conducted to evaluate the effects of terazosin on posttraumatic nightmares which is one of chronic PTSD symptoms. Methods : Twenty patients with chronic PTSD and severe trauma-related nightmares were treated with terazosin (3-7 mg/day) for 8 weeks. Recurrent distressing dreams item of the Clinician administered PTSD Scale (CAPS), Total CAPS score, Clinical Global Impressions-Severity Scale (CGI-S) and Clinical Global Impressions-Change Scale (CGI-C) were performed at baseline, 4-week and 8-week. Mississippi Scale for Combat-Related PTSD and Combat Exposure Scale (CES) were used to evaluate PTSD symptom pattern and degree of exposure. Results : Significant decrease in recurrent distressing dreams item, reexperiencing, avoidance and hyperarousal symptom score and total CAPS score were at 4-week and 8-week treatment compared to baseline (recurrent distressing dreams item : $2.70{\pm}1.88$ and $1.25{\pm}1.49$ ; reexperiencing, avoidance and hyperarousal symptom score : $2.30{\pm}2.49$, $1.20{\pm}1.05$, $3.10{\pm}1.68$ and $4.00{\pm}3.59$, $1.55{\pm}1.50$, $5.60{\pm}3.23$ ; total CAPS score : $8.20{\pm}6.26$ and $5.40{\pm}5.89$). There were significant correlation between dosage of terazosin and improvement of PTSD symptoms. Adverse effects such as fatigue and orthostatic hypotension were showed, which were mild and self-limited. Conclusion : These results suggest that terazosin may improve severe trauma-related nightmares and overall PTSD symptoms. Randomized controlled study with more subjects would be necessary in the future.

• Anxiety and mood
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• v.3 no.2
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• pp.104-109
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• 2007

Objective : In the present study, we evaluated the differences between the skin electric conductance of patients with posttraumatic stress disorder (PTSD) and normal controls in order to determine the possibility of using skin electric conductance as a diagnostic measure. Method : The PTSD group included 14 subjects who were diagnosed with PTSD in St. Mary's Hospital after a motor vehicle accident, and the normal control group included 12 healthy subjects. The conductivity and capacitance of both groups were measured twice, and the data from each group was compared. Results : There was no significant difference in gender, but the patients in the PTSD group were significantly older than those in normal control group. The activity (conductivity) between the left head-left hand, right hand-right head, and right head-left head was significantly elevated in the PTSD group as compared with the normal control group. In addition, the reactivity (capacitance) between the right head-left head, left head-left hand, right hand-left hand, right hand-right foot, right foot-left foot, and left foot-left hand was significantly elevated in the PTSD group. Conclusion : In this study, the skin electric conductance of the patients with PTSD was significantly elevated in comparison with that of the healthy subjects. Although there were some limitations of this study, the results of this study suggested that skin electric conductance can be used to evaluate elevated psychophysiological responses in patients with PTSD. Future studies with more subjects and more structure are needed in order to confirm our results.

• Anxiety and mood
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• v.4 no.2
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• pp.142-147
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• 2008

Objective : Evidence from recent studies supports the role of genetic factors in the development of Posttraumatic Stress Disorder (PTSD). The primary aim of this study is to investigate the association between the dopamine D2 receptor (DRD2) TaqI A polymorphism and PTSD. The second aim is to examine the association between the DRD2 TaqI A polymorphism and clinical symptoms in patients with PTSD. Methods : We recruited 189 Vietnam veterans for participation in this study, among whom 99 were PTSD patients and 90 were control subjects. The presence of the DRD2 TaqI A polymorphism was determined by polymerase chain reaction (PCR). Several standardized research scales were used in the clinical assessment of PTSD, including the Combat Exposure Scale (CES), Clinician Administered PTSD Scale (CAPS), Beck Depression Inventory (BDI), and Clinical Global Impression (CGI). Results : There was no significant difference in the distribution of the DRD2 genotype, frequency and prevalence of the A1 allele, or the frequency of heterozygotes between the patients with PTSD and the controls. In the PTSD group, the patients with the A1 allele (A1A1, A1A2) scored higher on the CAPS-total (p=0.044), CAPS-avoidance symptoms (p=0.016) and BDI (p=0.024) than those without the A1 allele (A2A2). Conclusion : We could not find an association between the dopamine D2 receptor (DRD2) TaqI A polymorphism and PTSD. However, the A1 allele of DRD2 seemsto influence avoidance symptoms in patients with PTSD.

• Anxiety and mood
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• v.4 no.1
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• pp.42-48
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• 2008

Objective : Due to a better understanding of the pathophysiology of posttraumatic stress disorder (PTSD) and the relative limitations in the treatment of patients with PTSD, a variety of medications and treatment algorithms for PTSD have been investigated. This study was conducted to investigate the trends in the pharmacotherapy used in the treatment of inpatients with PTSD at a single university hospital in Korea. Methods : Data from 75 patients diagnosed with PTSD according to the DSM-IV criteria from January 1998 to December 2007 were collected. Demographic data and clinical data, including medications prescribed, were investigated. Results : Thirty-three of the 75 subjects included in this study were male, and 42 were female. Considering psychiatric comorbidity, depressive disorder, cognitive disorder, psychotic disorder and anxiety disorder were reported in order. Approximately 97% of the subjects were treated with antidepressants, including paroxetine in 54.7%, and 24% of the subjects were treated with two different kinds of antidepressants. In addition, atypical antipsychotics were prescribed in 33.3% of patients, mood stabilizers in 17.3%, and anxiolytics in 94.7% of the subjects. Conclusion : In our study, various kinds of antidepressants were prescribed for most patients with PTSD. Antipsychotics and mood stabilizers were added to the treatment regimens of some subjects, and anxiolytics were added to the treatment regimens of most subjects. Despite its many limitations, this study shows the prescription pattern and trends in PTSD treatment in Korea. We hope that these preliminary data would be helpful for the development and integration of a practical guideline for the treatment of PTSD in Korea.

• Anxiety and mood
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• v.9 no.2
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• pp.113-120
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• 2013

Objectives : The aim of this study was to investigate clinical meaning of hallucination among patients with posttraumatic stress disorder (PTSD). Methods : PTSD patients with hallucination (n=50) were selected and matched with the PTSD patients without hallucination (n=50) by age and sex. The patients were evaluated in two different aspects, pathologic aspects which can develop after traumatic event, and positive/adaptive aspects which are concerned in positive psychology. In addition to these, temperament and character features between two groups were also evaluated using the Temperament and Character Inventory (TCI). Results : Except for the total score of DES (Dissociative Experience Scale) and the score of re-experience subscale of CAPS (Clinician Administered PTSD Scale), clinical characteristics did not show any significant difference between the two groups. Among the comparison of seven higher dimensions in TCI profiles, only Self-transcendence showed significant difference between the two groups. Conclusion : The two groups did not show significant differences in pathologic aspects except for factors that may contribute to development of hallucination. Furthermore, authors could not find any differences in positive/adaptive aspects.

• Anxiety and mood
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• v.11 no.1
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• pp.12-18
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• 2015

Objective : The current study investigated the personality characteristics in the victims of sexual violence, by using the Minnesota Multiphasic Personality Inventory (MMPI) test which are commonly used in clinical medicine. Methods : A total of 40 victims of sexual violence (only female) completed the Korean version of the MMPI. 31 (77.5%), and theywere patients with posttraumatic stress disorder. These victims of sexual violence had been admitted to the Dankook University Hospital in Cheonan. Results : The MMPI scores of the sexual victims were significantly higher on Hs, D, Hy, Pd, Pa, Pt, Sc, and Si, than the comparison group by ANCOVA. Conclusion : The victims of sexual violence may have developed the following characteristics: hypochondriasis, depression, hysteria, psychopathic deviate, paranoia, psychasthenia, schizoid and social introversion. The finding suggests psychotic psychopathology rather than neurotic psychopathology. These results suggested that the psychopatholgy in the victims of sexual violence may be different, compared to the control group.

• Journal of Digital Convergence
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• v.16 no.3
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• pp.561-572
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• 2018

The purpose of this study is to examine the effect of Acceptance and Commitment Therapy(ACT) on Complex PTSD symptoms, acceptance and post-traumatic growth of college students with childhood emotional abuse. Four hundred and fifty students in university completed Acceptance and action Questionnaire(AAQ-II), Structured interview for disorders of extrem stress(SIDES), Korea version posttraumatic growth inventory(K-PTGI). 14 participants was selected from that result. 7 participants were assigned to the ACT group and the others were in the control group. ACT program was administered for 8 sessions twice a week for 2 month, approximately 100 minutes. There was no treatment in the control group. All participants completed post-test at the end of treatment and then follow-up test after 6 weeks. The results were that complex PTSD symptoms level in ACT group was significant decreased and acceptance and post-traumatic growth level in ACT group were significant increased than those in control group at the end of treatment and the follow-up period. Finally, the implications and the limitations of this study, and the suggestions for future study were also discussed.

• Anxiety and mood
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• v.8 no.2
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• pp.93-98
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• 2012

Objective : Cortisol, a product of hypothalamus-pituitary-adrenal axis (HPA axis), is one of our defensive mechanisms in response to stress. The level of cortisol in the saliva is a major biomarker of the stress response by HPA axis and shows diurnal variation. We measured salivary cortisol level and its diurnal variation to compare the pattern of changes by degree of burn and Clinician-Administered PTSD Scale (CAPS) score. Methods : We measured the salivary cortisol levels of 37 subjects hospitalized in the burn center at our facility from March to June 2012. Salivary cortisol levels were measured at 6 : 00 AM and at 7 : 00 PM. All subjects were tested for CAPS to evaluate the severity of posttraumatic stress disorder and the Hamilton Depression Rating Scale to evaluate and to control the coexisting depression. Results : Factorial ANOVA test revealed that there was a statistically significant difference in terms of the effect of the interaction between the degree of burn and the patient's CAPS score. Unlike the mild burn group, in the severe burn group, the patients who had a low CAPS score didn't show a normal diurnal variation and the patients who had a high CAPS score showed the normal diurnal variation. After a few months follow up, we found a greater degree of psychiatric complications in severe burn patients that had a lower cortisol stress response. Conclusion : We suppose that the disappearance of the stress response changes in salivary cortisol seen in the severe burn group may be caused by an impaired stress response. Through followed observation of the subjects, this disruption of cortisol response may cause psychiatric problems afterwards.

• The Korean Journal of Emergency Medical Services
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• v.18 no.3
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• pp.53-62
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• 2014

Purpose: This study aimed to investigate duty-related incidental stress, coping method, and stress factors in 133 new firefighters. Methods: A self-reported questionnaire was administrated to 133 new firefighters between April and May 2010. It consisted of 33 and 62 items concerning duty-related incident stress and coping methods, respectively. Data were analyzed by using the t-test, analysis of variance, Pearson correlation coefficient analysis, and multiple regression analysis. Results: New firefighters experienced the most stress when inappropriately dispatched. Duty-related incidental stress correlated with active (r = .420, p < .001) and passive coping (r = .450, p < .001). Also active coping statistically correlated with passive coping (r = .890, p < .001). Influencing factors of duty-related incidental stress were passive coping (t = 2.12, p < .05), experience of having a co-worker in a dangerous situation (t = 3.30, p < .001), having less than 6 months of work experience (t = 2.30, p < .05), and experience of having oneself in a dangerous situation (t = 2.05, p < .05). Conclusion: New firefighters need to be provided with training on active coping to prevent posttraumatic stress disorders and, social support immediately after an inappropriate and stressful dispatch.