• 대한불안의학회지
• /
• 제4권1호
• /
• pp.55-61
• /
• 2008

Objective : Eye movement desensitization and reprocessing (EMDR) has been established as an effective treatment for patients with posttraumatic stress disorder (PTSD). However, the literature is unclear as to whether EMDR is effective in the treatment of other psychiatric disorders. The purpose of this study was to evaluate the potential use of EMDR in the treatment of psychiatric disorders other than PTSD by using a clinician's impression of patient response and a subjective symptom evaluation. Methods : Seventeen diagnostically heterogenous patients without PTSD underwent an average of 4.3 sessions of EMDR. Symptom severity was assessed by the Clinical Global Impression-Change Scale (CGIC), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), and Symptom Checklist-90- Revised (SCL-90-R) before and after EMDR. Those whose CGI-C scores were 'very much improved' and 'much improved' after EMDR were classified as 'responders.' The patients' before and after treatment scores of symptom severity and group differences were compared. Results : Twelve of the 17 participants (12/17, 71%) were classified as 'responders.' The patients' scores on all of the scales, with the exception of the trait anxiety scale and obsession-compulsion scale of the SCL- 90-R, significantly decreased after treatment. There was no difference in sociodemographic and clinical variables between the responders and non-responders. Conclusion : The results of our study suggest that EMDR can be a promising candidate for the treatment of patients with psychiatric disorders other than PTSD, and thus further controlled studies are needed to determine whether EMDR can be applied to various psychiatric populations.

• 대한불안의학회지
• /
• 제2권2호
• /
• pp.142-146
• /
• 2006

People who were exposed to chronic interpersonal traumas in their early life consistently demonstrate complex psychological disturbances and many of them meet the criteria for proposed diagnosis of complex posttraumatic stress disorder (complx PTSD). The author reports a case of the successful sequential integrative treatment mainly composed of eye movement desensitization and reprocessing (EMDR) in a complex PTSD patient. The patient did not respond to the previous treatment with psychotropic medications and supportive psychotherapy. Twelve sessions of EMDR and three sessions of supportive psychotherapy were done for the patient. Psychological assessments were performed before starting the treatment and a week after completing the treatment. After the treatment, the patient improved on all the psychological scales and behavioral measures. This case suggests that the sequential integrative treatment mainly composed of EMDR may be effective for complex PTSD patients.

• 대한불안의학회지
• /
• 제8권1호
• /
• pp.22-30
• /
• 2012

Objective : We investigated whether Posttraumatic stress disorder patients have a higher tendency to exaggerate the extent of their psychological symptoms compared to other psychiatric patients. Methods : Medical records of patients, who had received psychiatric treatment at four university hospitals in Korea between January 2009 and December 2010, were retrospectively reviewed. We compared a group of 37 patients diagnosed with PTSD, and another group of 41 patients diagnosed with neurotic, stress-related and somatoform disorders according to the ICD-10. To compare the extent of malingering in the two groups, we compared the validity scales of MMPI-2 and Personality Assessment Inventory. We determined the number of participants in both groups feigning their responses by using various cutoff scores of the validity indicators. Results : The PTSD group showed significantly higher scores on the F (p=0.001), F (B)(p=0.000), F (P)(p=0.030), F-K (p=0.003) scale of the MMPI-2 compared to the other group of psychiatric patients. The PTSD group had a significantly higher NIM score (p=0.001) but a lower PIM score (p=0.020) of the PAI compared to the other group of psychiatric patients. Using the cutoff scores, the PTSD group showed a significantly higher number of patients who feigned responses compared to the other group ($Fb{\geq}75$ (p=0.010), $F-K{\geq}1$ (p=0.005), $F-K{\geq}10$ (p=0.011) from the MMPI-2, and $NIM{\geq}80$ (p=0.001) from the PAI). Conclusion : These results suggest that PTSD patients have a tendency to exaggerate their symptom. This group of patients overreported the severity of their condition during standardized personality assessment that included the MMPI-2 or PAI compared to patients diagnosed with other psychiatric disorders. Additional research is required to determine the factors influencing symptom exaggeration in PTSD.

• 대한불안의학회지
• /
• 제3권1호
• /
• pp.41-45
• /
• 2007

Objective : The present study investigates patterns of consumption of alcohol, cigarettes, and over the counter drugs (OTC) in Korean patients with PTSD and psychiatric patient controls and healthy controls from multicenter hospital samples. Method : Data were collected from 18 hospitals nationwide. Patients with PTSD were compared with nonpsychotic psychiatric disorders control and healthy control subjects on psychometric measures of consumption of alcohol, cigarettes, and OTC drugs. Result : Ninety-three patients with PTSD, 73 patients with psychiatric disorders control, and 88 healthy control subjects were enrolled. There were significant differences in the frequency of alcohol drinking among the three groups ($X^2$=12.93, df=6, p=0.044). Only 3.2% of healthy control subjects drank alcohol more than 4 times a week, but 43.9% of PTSD group and 46.5% of mental disorder controls drank alcohol more than 4 times a week, respectively. Regarding cigarette smoking, there were no differences among the three groups. There were significant differences in uses of OTC drugs among the three groups; 16.7 % in the PTSD group, 14.9% in the psychiatric control group and 1.3% in the heath control group, respectively ($X^2$=11.31, df=2, p=0.004). Conclusion : In this study, patients with PTSD showed significant differences in the frequency of consumption of alcohol and OTC drugs, as compared with healthy controls. However, there were no differences between the PTSD and psychiatric patient control groups. Since all subjects were enrolled from hospital based sample, results may differ in the community samples. Further studies will be needed for the evaluation of substance uses in these groups.

• 한국융합학회논문지
• /
• 제6권2호
• /
• pp.13-18
• /
• 2015

본 연구의 목적은 소방공무원의 외상후 스트레스 장애의 원인을 파악하고 스트레스를 진단하기 위한 척도와 도구에 대한 고찰을 통해 위기상황 스트레스 관리 교육프로그램과 대책을 제안하고자 하는데 그 목적이 있다. 외상후 스트레스 장애는 침습 증상, 회피 증상, 인지와 기분의 부정적 변화, 과각성 증상을 특징을 포함한다. 트라우마의 기억은 외현 기억(explicit memory)과 암묵 기억(implicit memory)이 있다. 외현 기억은 의식적, 인지적, 서술적이며, 변연계 구조물 중 해마가 관여한다. 사건 당시 정보 처리는 억제적이며, 내러티브 언어구성을 갖는다. 암묵 기억은 무의식적, 정서적, 절차적이며, 몸이 기억을 한다. 관련된 변연계 구조물은 편도체이고 사건 당시 정보처리는 활성화되어 있고, 말로 표현할 수 없는 언어구성을 갖는다. 암묵 기억의 소거가 트라우마 치료에서 가장 중요하다. 위기상황 스트레스 관리(critical incident stress management, CISM)는 위기 상황으로 인해 발생되는 스트레스의 유해성을 감소시키고, 조절하기 위한 포괄적이고 체계적인 접근 방법이다. 결론적으로 CISM의 핵심적 목표는 외상후 스트레스 장애에 의한 심리적 상태의 종결이라고 할 수 있다. 본 연구는 외상후 스트레스 장애의 원인과 대처방법에 대한 문헌 고찰을 통해 소방공무원의 외상후 스트레스 장애 해소를 위한 교육프로그램 개발을 제안하고자 하였다.

• 생물정신의학
• /
• 제10권2호
• /
• pp.147-158
• /
• 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.

• 한국산학기술학회:학술대회논문집
• /
• 한국산학기술학회 2009년도 추계학술발표논문집
• /
• pp.212-213
• /
• 2009

본 연구의 목적은 소방공무원이 현장에서 겪는 충격 스트레스로 발생하는 외상 후 스트레스장애 (posttraumatic stress disorder, PTSD) 분석을 통해 위기상황 스트레스 해소 교육 프로그램 기초 자료를 제시하고자 하는 데 있다. 연구 목적을 달성하기 위하여 독립변인(업무부담감, 스트레스, 스트레스 대응) 3개, 매개변인(현장충격 스트레스) 1개, 종속변인(신체적 증상)으로 구성하여 영향력을 파악하였다. 본 연구 대상자는 전국 970명 소방공무원으로 2007년 3월부터 12월까지 구조화된 설문지를 이용하여 조사하였다. 자료분석은 SPSS 14.0과 구조방정식 모형인 AMOS 7.0 통계패키지를 사용하였으며, 정확한 코딩데이터의 입력확인을 위해 데이터클리닝(data cleaning) 작업을 실시하였다. 가설검증을 위하여 구조방정식 모형분석을 실시한 결과, 업무부담감, 스트레스, 현장충격 스트레스가 낮고, 스트레스 대응이 높을 때 신체적 증상이 낮아지는 것으로 나타났다. 서울소방학교와 공동으로 총 10개 차시로 웹기반 교육을 구성하였으며, 2010년 1월부터 소방공무원 전체를 대상으로 웹기반 교육을 실시하고자 한다.

• 대한불안의학회지
• /
• 제9권2호
• /
• pp.113-120
• /
• 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.

• 한국가정과학회지
• /
• 제9권2호
• /
• pp.21-31
• /
• 2006

The purpose of this study is to investigate the differences in irrational faith and the school adaptation of elementary school students by experimental group and control group. To achieve these goals, the followings are setting the programs. The subjects are selected from grade 4, 5, 6 students from the elementary schools. The tools used for this study were Irrational faith Test and School adaptation Test. The followings are the results of the analysis of the collected data. First, in the analysis of irrational faith, there is no significant difference between experimental group and control group. Second, in the analysis of school adaptation, there is significant difference between experimental group and control group(t=.05, p<.05).

• 정신신체의학
• /
• 제6권2호
• /
• pp.136-146
• /
• 1998

Objectives : This study was performed to evaluate the effects of PTSD on memory function, to investigate the difference of memory function between PTSD and non-PTSD patients, and to identify major variables correlated to PTSD scale and Memory Assessment Scale. Methods: The authors used PTSD-scale(Mississippi scale and Combat Exposure Scale) for measuring PTSD severity. And, Beck Depression Inventory was also used. Memory assessment scale was assessed by well trained psychologist. Thirty one Vietnam veterans who had been hospitalized were collected consecutively. These patients were evaluated by psychiatrists with interview and measurement for fifteen months since March, 1997. The collected data were analyzed by SPSS and the stastistic methods used for analysis Chi-square, t-test, and Pearson's correlation. Results : 1) There were significant differences in short-term memory and verbal memory between PTSD and non-PTSD in Vietnam veterans. 2) Mississippi scale and Combat Exposure Scale were negatively correlated to short-term memory and verbal memory(Pearson's correlation). 3) Religion status was a significant variable between PTSD and non-PTSD in Vietnam veterans. 4) There is no significant difference in visual memory and total memory scale between PTSD and Non-PTSD in Vietnam veterans Conclusions : Neuropsychological changes were found in the posttraumatic stress disorder. There were significant differences in short-term memory and verbal memory between PTSD and non-PTSD in Vietnam veterans. Mississippi scale and Combat Exposure Scale were negatively correlated to short-term memory and verbal memory. We suggest that neuropsychological test might be used for an objective assessment of patients with the combat related PTSD and be considered helpful in the assessment of patients with the diagnosis. And we also suggest rehabilitation strategies would be used to compensate for memory deficits in PTSD patients.