• Title/Summary/Keyword: anxiety research

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A Preliminary Study on the Development of Korean Medication Algorithm for Attention-Deficit Hyperactivity Disorder (한국형 주의력결핍 과잉행동장애 약물치료 알고리듬 개발을 위한 예비연구)

  • Park, Jae-Hong;Kim, Bung-Nyun;Kim, Jae-Won;Kim, Ji-Hoon;Son, Jung-Woo;Shin, Dong-Won;Shin, Yun-Mi;Yang, Su-Jin;Yoo, Hanik-K.;Yoo, Hee-Jeong;Lee, Soyoung Irene;Cheon, Keun-Ah;Hong, Hyun-Ju;Hwang, Jun-Won
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.22 no.1
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    • pp.25-37
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    • 2011
  • Objectives:This study was conducted to develop a Korean algorithm of pharmacological and non-pharmacological treatment strategies in attention-deficit hyperactivity disorder (ADHD) and its specific comorbid disorders (e.g. tic disorder, depressive disorder, anxiety disorder, bipolar disorder, and oppositional defiant disorder/conduct disorder). Methods:Based on a literature review and expert consensus, both paper- and web-based survey tools were developed with respect to a comprehensive range of questions. Most options were scored using a 9-point scale for rating the appropriateness of medical decisions. For the other options, the surveyed experts were asked to provide answers (e.g., duration of treatment, aver-age dosage) or check boxes to indicate their preferred answers. The survey was performed on-line in a self-administered manner. Ultimately, 49 Korean child & adolescent psychiatrists, who had been considered experts in the treatment of ADHD, vol untarily completed the questionnaire. In analyzing the responses to items rated using the 9-point scale, consensus on each option was defined as a non-random distribution of scores as determined by a chi-square test. We assigned a categorical rank (first line/preferred choice, second line/alternate choice, third line/usually inappropriate) to each option based on the 95% confidence interval around the mean rating score. Results:Specific medication strategies for key clinical situations in ADHD and its comorbid disorders were indicated and described. We organized the suggested algorithms of ADHD treatment mainly on the basis of the opinions of the Korean experts. The suggested algorithm was constructed according to the templates of the Texas Child & Adolescent medication algorithm Project (CMAP). Conclusion:We have proposed a Korean treatment algorithm for ADHD, both with and without comorbid disorders through expert consensus and a broad literature review. As the tools available for ADHD treatment evolve, this algorithm could be reorganized and modified as required to suit updated scientific and clinical research findings.

A Study to Determine the Effectsiveness of Severance Hospice Home Care Program (호스피스케어에 대한 평가 연구 - 세브란스호스피스 중심으로)

  • Kingsley, Marian R.N.;Cho, Won-Jung;Kim, Cho-Ja;Lee, Won-Hee;Yoo, Ji-Soo
    • The Korean Nurse
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    • v.29 no.4
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    • pp.51-72
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    • 1990
  • The purpose of this study was to determine whether Severance Hospice Home Care Pro gram was able to meet its objectives. This was done in order to show in detail the effects of hospice home care on the quality of life of terminally ill patients and to provide rationale for setting up more hospice home care programs in korea. The results of the study were as follows: The subjects of the study were 100 terminally ill patients who hnd died 'while in the hospice program and 64 family members who were registered with Severance Hospice Home Care Program between march 1988 and Feb. 1990. The nursing needs of these terminally ill patients were assessed by the nursing records of these patients. The need for pain control(82%) was the highest nursing need so far as the physical aspects were concerned. This was followed by poor appetite(37%), 8 dyspnea(34%), nausea and vomiting(30%) in that order of frequency. In reqard to spiritual needs, the need for religious' support was also high at 72%. Their main psychological symptoms were anxiety and fear(34% ). Burn-out was a major problem for 44% of the family members. The psychological process experiencel by the terminal ill patients was compared to the dying process, described by Kiibler Ross. In comparison of the five stages outlined by kubler Ross with the dying process of the subjects it was found that the subjects not only experienced the five stages but also experienced denial and doubt-fulness or denial with acceptance or acceptance with the expectation of a miracle. But rather than acceptance of the dying process, giving up was a frequent end point of the psychological process, of the subjects. However, when the combination of states was observed, most of the patients reached the state of acceptance in the dying process. It was difficult to identify a definite pattern of change in the psychological process of the subjects. Also it was difficult to identify the factors that influenced the psychological process. The symptoms of the terminally j]] subjects just before dying, that is, 3-4 days before dying included apparent signs of dying. These were a reduction of intake(77%), reduction of the amount of urination(63%), increase in sleeping time (64%) and acceptance of dying by patients and their families who had been unaccepting be before that time(66%). The primary care givers(family member's) degree of satisfaction with the care given to the patient by the hospice was 88.7%. The results of this study show that Severance Hospice Home Care Program had a positie effeet on the quality of life of the terminally ill patients and their family members as they faced the death of the patient. It can be seen from this study that there is an urgent need to extend hospice programs - in order to provide quality of care for terminally ill patient and their families. Based upon the reesults of this study several suggestions are presente as follows: 1) A follow up study should be carried out to identify the dying process as it is unique to Korea. 2) A comparison should be made of other hospice care programs. 3) A comparison study should- be made with subjects who do not receive any hospice care as compared to those who do by use of an experimental and control group methodology. 4) There is a need to determine a scientific method to adequeto measure the interventions carried out to meet the hospice patients nursing care needs. 5) A study should be made using quality research methodology to evaluate effects of hospiec care from the patients, their family members and the nurrse's perspective.

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A Clinical Study on Treatments of Hwabyung with Oriental Medicine (홧병환자의 한의학적 치료에 대한 임상적 연구)

  • Kim, Jong-Woo;Whang, Wei-Wan
    • The Journal of Korean Medicine
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    • v.19 no.2
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    • pp.5-16
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    • 1998
  • Hwabyung is a common emotional disorder which has symptoms expressed like firt's explosion in middle-aged after long period of emotional suppression among Koreans. It is similar in its characteristics such as neurosis, anxiety, panic attacks in Western Medicine, though the treatment method was not effective. So we have done a clinical research on Oriental Medical Method, especially on Acupuncture Therapy, and obtained following results. 1. Patients with Hwabyung complained of pressure pain around the Chunjung(?中, CV-17) point distinctively. About 70% of those were located on the CV-17 point, 25% were 1cm upper than the CV-17 point and 5% of those were 1cm lower point than the CV-17 point. 2. Degrees of pressure pain were divided into 5 grades from ade 1(feeling pain with slight pressure) to grade 5(feeling no pain with severe pressure), respectively. 3. Patients with Hwabyung showed various symptoms compared to fire's explosion such as anger, chest discomfort, difficulty in breathing. tachycardia. and feeling of epigasfric mass etc., and the degrees were divided into 5 grades according to the severities from grade 1(can't keep their usual living) to grade 5(no complaints with heavy stresses), respectively. 4. For the treatment of Hwabyung in this study, we had given Acupuncture therapy on some points such as Chunjung:?中:CV-17, Jungwan:中脘:CV-12) and Chunchu:天樞:S-25, etc. for 15 minutes a time twice a week. And Bunshimkiumgmnihang(分心氣飮加味方) was administered 3 times a day. 5. About 40% of the patients took treatment for more than 2 months, 29% of those took 1 to 2 months and 31% of those took less than 1 month. In this study, we excluded those who stopped treatment within a month without any expected effects. 6. We evaluated the changes of severity of pain according to the following categories such as - for no change, + for 1 grade, ++ for 2 grades, +++ for 3 grades, and ++++ for 4 grades of improvements. Among the patients taken 1 to 2 months of treatment. 48% of the those showed +, 7% of those showed ++, 3% of those showed +++ and 41% of those showed no change. Among the patients taken less than 2 months of treatment, 20%of those showed +, 40% of those showed ++, 28% of those showed +++ and 13% of those showed no change. 7. We evaluate the changes of symptoms according to the following categories such as - for no change, + for 1 grade, ++ for 2 grades, +++ for 3 grades and +++ for 4 grades of improvements. Among the patients taken 1 to 2 months of treatment, 34% of those showed +, 14% of those showed ++ and 52% of those showed no change. Among the patients taken more than 2 months of treatment, 20% of those showed +, 43% of those showed 20% of those showed +++, 3% of those showed +++ and 15% of those showed no change. 8. When we compare the changes of pain and symptoms according to the periods of treatment, the changes in quantity of pain in 1 to 2 months group was $0.72{\pm}0.75$, in more than 2 months group was $1.83{\pm}0.98$, and the changes in quantity of symptoms in 1 to 2 months group was $0.62{\pm}0.73$, in more than 2 months group was $1.75{\pm}1.03$. According to the above results, we have concluded that more than 2 months of treatment is more beneficial than 1 to 2 months of treatment.

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Associations between Vasomotor Symptoms and Depression, Stress and Quality of Life in Midlife Women (중년여성에서의 혈관운동증상과 우울, 스트레스, 삶의 질과의 상관성)

  • Nam, Yoon-Min;Joe, Sook-Haeng;Kwon, Eun-Joo;Ham, Byung-Joo;Han, Chang-Su;Ko, Young-Hoon
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.2
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    • pp.146-156
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    • 2016
  • Objectives : The aim of this study was to evaluate the associations between vasomotor symptoms and factors such as sociodemographics, health behaviors, medical condition, depression, stress, anxiety, attitude toward menopause, and quality of life. Methods : We conducted a cross-sectional study in peri- and post-menopausal women enrolled by the Korean Association of Health Promotion. Subjects submitted self-report questionnaires about vasomotor symptoms and other clinical symptoms. Associations between vasomotor symptoms and clinical variables were analyzed using stepwise multiple regression analyses. Results : 1951 women completed self-report questionnaires and 1022 women were enrolled in the study. The prevalence of vasomotor symptoms in peri- and post-menopausal women was 63.9%. Variables showing significant differences between subjects with vasomotor symptoms and subjects without them were score of Beck Depression Inventory, Brief Encounter Psychosocial Instrument-Korean Version, proportions of clinically significant depression(Beck Depression Inventory ${\geq}16$), Menopausal rating scale, attitude towards menopause, the 4 subscales of World Health Organization Quality of Life-BREF(Physical health, psychological, social relationships, environment), and a History of Premenstrual syndrome/Premenstrual dysphoric disorder. Stepwise multiple regression analyses indicated that Beck Depression Inventory, Brief Encounter Psychosocial Instrument-Korean Version, Menopausal Rating Scale, and the Psychological subscale of World Health Organization Quality of Life -BREF show associations with vasomotor symptoms. Conclusions : Menopausal vasomotor symptoms are associated with various psychological factors, especially with depression. Midlife women suffering vasomotor symptoms should therefore be screened for depression. Future prospective studies where clinical subjects are diagnosed using structured interviews, focusing on the causal relationship between depression and vasomotor symptoms are necessary.

A Study on Setup for Preliminary Decision Criterion of Continuum Rock Mass Slope with Fair to Good Rating (양호한 연속체 암반사면의 예비 판정기준 설정 연구)

  • Kim, Hyung-Min;Lee, Su-gon;Lee, Byok-Kyu;Woo, Jae-Gyung
    • The Journal of Engineering Geology
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    • v.29 no.2
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    • pp.85-97
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    • 2019
  • It can be observed that steep slopes ($65^{\circ}$ to $80^{\circ}$) consist of rock masses were kept stable for a long time. In rock-mass slopes with similar ground condition, steeper slopes than 1 : 0.5 ($63^{\circ}$) may be applied if the discontinuities of rock-mass slope are distributed in a direction favorable to the stability of the slope. In making a decision the angle of the slope, if the preliminary rock mass conditions applicable to steep slope are quantitatively setup, they may be used as guidance in design practice. In this study, the above rock mass was defined as a good continuum rock mass and the quantitative setup criterion range was proposed using RMR, SMR and GSI classifications for the purpose of providing engineering standard for good continuum rock mass conditions. The methods of study are as follows. The stable slope at steep slopes ($65^{\circ}$ to $80^{\circ}$) for each rock type was selected as the study area, and RMR, SMR and GSI were classified to reflect the face mapping results. The results were reviewed by applying the calculated shear strength to the stable analysis of the current state of rock mass slope using the Hoek-Brown failure criterion. It is intended to verify the validity of the preliminary criterion as a rock mass condition that remains stable on a steep slope. Based on the analysis and review by the above research method, it was analyzed that a good continuum rock mass slope can be set to Basic RMR ${\geq}50$ (45 in sedimentary rock), GSI and SMR ${\geq}45$. The safety factor of the LEM is between Fs = 14.08 and 67.50 (average 32.9), and the displacement of the FEM is 0.13 to 0.64 mm (average 0.27 mm). This can be seen as a result of quantitative representation and verification of the stability of a good continuum rock mass slope that has been maintained stable for a long period of time with steep slopes ($65^{\circ}$ to $80^{\circ}$). The setup guideline for a good continuum rock mass slope will be able to establish a more detailed setup standard when the data are accumulated, and it is also a further study project. If stable even on steep slopes of 1 : 0.1 to 0.3, the upper limit of steep slopes is 1 : 0.3 with reference to the overseas design standards and report, thus giving the benefit of ensuring economic and eco-friendlyness. Also, the development of excavation technology and plantation technology and various eco-friendly slope design techniques will help overcome psychological anxiety and rapid weathering and relaxation due to steep slope construction.

Characteristics of the Factor Structure of the Child Behavior Checklist Dysregulation Profile for School-aged Children (학령기 아동의 CBCL 조절곤란프로파일(Child Behavior Checklist Dysregulation Profile)의 요인구조와 특성)

  • Kim, Eun-young;Ha, Eun-hye
    • Korean Journal of School Psychology
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    • v.17 no.1
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    • pp.17-38
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    • 2020
  • This study examined the factor structure of the Child Behavior Checklist Dysregulation Profile(CBCL-DP) for school-aged children in Korea identified differences in the level of maladjustment and problematic behaviors between the clinical group which had characteristics of CBCL-DP and the control group which did not. Confirmative factor analysis was performed on three alternative models from the literature to determine which was the most appropriate factor structure for the CBCL-DP. The result showed that the bi-factor model fit the sample data better than both the one and second-factor models. To confirm that the bi-factor model was the most appropriate factor structure, regression paths with relevant variables examined. The showed that CBCL-DP with the bi-factor model was associated with executive function difficulty as reported by parents and with school adjustment and all sub-factors of strength and difficulty as reported by teachers. The results also showed that this model had a different relationship with anxiety/depression, aggressive behavior, and attention problems than the other models. The clinical group was shown to have more executive function difficulty, worse adjustment of school life and to be less likely to engage in desired behaviors than the control group. These results indicate the CBCL-DP is more related to negative outcomes than any other factor, and that the bi-factor model was found to best fit the sample data, consistent with other studies. The early discovery of CBCL-DP can be used to provide interventions for high-risk children who exhibit emotional and behavioral problems, making its detection a significant diagnostic tool. The implications of these result, the limitations of this study, and areas for future research are discussed in this paper.

Space Usage and Satisfaction with Privacy in General Hospital Inpatients (종합병원 입원환자의 공간사용 및 프라이버시 만족도)

  • Choi, In Young;Park, Hey Kyung
    • Korea Science and Art Forum
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    • v.36
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    • pp.391-400
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    • 2018
  • To ensure a user-centered treatment environment, hospital construction needs an approach that is not centered on functional aspects such as efficiency or economic feasibility but on the consideration of needs as reflected in user psychology and behavior. Patients who are physically and psychologically vulnerable experience psychological pressure when they are placed in an unfamiliar environment. Most of existing studies however focus on the evaluation of the physical environment, without paying attention to the psychological or behavioral approach to anxiety and stress that patients may experience in a special environment that a hospital may be to them. This study examines general hospital inpatients to understand the usage of major space available and their satisfaction with privacy. This study provides useful primary information needed for the user-centered design of general hospital for improved patient health and welfare. For the purpose of the study, literature review, site investigation, and survey were conducted. Major functional space and privacy in general hospitals were studied, and the site investigation was performed to identify the plans and their status. Survey was also performed to understand the usage of functional space and satisfaction with such space usage as well as satisfaction with privacy. The findings were as follows: (1) Space usage was rated as average in general. It was found that patients used their rooms and lobby on a daily basis. By age, the usage was highest in the group in their 40s; the usage was relatively lower in the groups in their 30s or younger. (2) Space satisfaction was above average, indicating that patients were fairly satisfied. Satisfaction was highest in the lobby space designed with distinct features. By case, satisfaction was highest in Case B, characterized by its wide horizontal space in the rural settings. (3) Satisfaction with privacy in hospital was average, indicating that the demand for privacy was relatively higher but what patients receive in return was lower than their expectation. It was also found that satisfaction with privacy was a crucial element that affected the overall satisfaction with hospital.

Exploring the Role of Preference Heterogeneity and Causal Attribution in Online Ratings Dynamics

  • Chu, Wujin;Roh, Minjung
    • Asia Marketing Journal
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    • v.15 no.4
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    • pp.61-101
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    • 2014
  • This study investigates when and how disagreements in online customer ratings prompt more favorable product evaluations. Among the three metrics of volume, valence, and variance that feature in the research on online customer ratings, volume and valence have exhibited consistently positive patterns in their effects on product sales or evaluations (e.g., Dellarocas, Zhang, and Awad 2007; Liu 2006). Ratings variance, or the degree of disagreement among reviewers, however, has shown rather mixed results, with some studies reporting positive effects on product sales (e.g., Clement, Proppe, and Rott 2007) while others finding negative effects on product evaluations (e.g., Zhu and Zhang 2010). This study aims to resolve these contradictory findings by introducing preference heterogeneity as a possible moderator and causal attribution as a mediator to account for the moderating effect. The main proposition of this study is that when preference heterogeneity is perceived as high, a disagreement in ratings is attributed more to reviewers' different preferences than to unreliable product quality, which in turn prompts better quality evaluations of a product. Because disagreements mostly result from differences in reviewers' tastes or the low reliability of a product's quality (Mizerski 1982; Sen and Lerman 2007), a greater level of attribution to reviewer tastes can mitigate the negative effect of disagreement on product evaluations. Specifically, if consumers infer that reviewers' heterogeneous preferences result in subjectively different experiences and thereby highly diverse ratings, they would not disregard the overall quality of a product. However, if consumers infer that reviewers' preferences are quite homogeneous and thus the low reliability of the product quality contributes to such disagreements, they would discount the overall product quality. Therefore, consumers would respond more favorably to disagreements in ratings when preference heterogeneity is perceived as high rather than low. This study furthermore extends this prediction to the various levels of average ratings. The heuristicsystematic processing model so far indicates that the engagement in effortful systematic processing occurs only when sufficient motivation is present (Hann et al. 2007; Maheswaran and Chaiken 1991; Martin and Davies 1998). One of the key factors affecting this motivation is the aspiration level of the decision maker. Only under conditions that meet or exceed his aspiration level does he tend to engage in systematic processing (Patzelt and Shepherd 2008; Stephanous and Sage 1987). Therefore, systematic causal attribution processing regarding ratings variance is likely more activated when the average rating is high enough to meet the aspiration level than when it is too low to meet it. Considering that the interaction between ratings variance and preference heterogeneity occurs through the mediation of causal attribution, this greater activation of causal attribution in high versus low average ratings would lead to more pronounced interaction between ratings variance and preference heterogeneity in high versus low average ratings. Overall, this study proposes that the interaction between ratings variance and preference heterogeneity is more pronounced when the average rating is high as compared to when it is low. Two laboratory studies lend support to these predictions. Study 1 reveals that participants exposed to a high-preference heterogeneity book title (i.e., a novel) attributed disagreement in ratings more to reviewers' tastes, and thereby more favorably evaluated books with such ratings, compared to those exposed to a low-preference heterogeneity title (i.e., an English listening practice book). Study 2 then extended these findings to the various levels of average ratings and found that this greater preference for disagreement options under high preference heterogeneity is more pronounced when the average rating is high compared to when it is low. This study makes an important theoretical contribution to the online customer ratings literature by showing that preference heterogeneity serves as a key moderator of the effect of ratings variance on product evaluations and that causal attribution acts as a mediator of this moderation effect. A more comprehensive picture of the interplay among ratings variance, preference heterogeneity, and average ratings is also provided by revealing that the interaction between ratings variance and preference heterogeneity varies as a function of the average rating. In addition, this work provides some significant managerial implications for marketers in terms of how they manage word of mouth. Because a lack of consensus creates some uncertainty and anxiety over the given information, consumers experience a psychological burden regarding their choice of a product when ratings show disagreement. The results of this study offer a way to address this problem. By explicitly clarifying that there are many more differences in tastes among reviewers than expected, marketers can allow consumers to speculate that differing tastes of reviewers rather than an uncertain or poor product quality contribute to such conflicts in ratings. Thus, when fierce disagreements are observed in the WOM arena, marketers are advised to communicate to consumers that diverse, rather than uniform, tastes govern reviews and evaluations of products.

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Development and assessment of pre-release discharge technology for response to flood on deteriorated reservoirs dealing with abnormal weather events (이상기후대비 노후저수지 홍수 대응을 위한 사전방류 기술개발 및 평가)

  • Moon, Soojin;Jeong, Changsam;Choi, Byounghan;Kim, Seungwook;Jang, Daewon
    • Journal of Korea Water Resources Association
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    • v.56 no.11
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    • pp.775-784
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    • 2023
  • With the increasing trend of extreme rainfall that exceeds the design frequency of man-made structures due to extreme weather, it is necessary to review the safety of agricultural reservoirs designed in the past. However, there are no local government-managed reservoirs (13,685) that can be discharged in an emergency, except for reservoirs over a certain size under the jurisdiction of the Korea Rural Affairs Corporation. In this case, it is important to quickly deploy a mobile siphon to the site for preliminary discharge, and this study evaluated the applicability of a mobile siphon with a diameter of 200 mm, a minimum water level difference of 6 m, 420 (m2/h), and 10,000 (m2/day), which can perform both preliminary and emergency discharge functions, to the Yugum Reservoir in Gyeongju City. The test bed, Yugum Reservoir, is a facility that was completed in 1945 and has been in use for about 78 years. According to the hydrological stability analysis, the lowest height of the current dam crest section is 27.15 (EL.m), which is 0.29m lower than the reviewed flood level of 27.44 (EL.m), indicating that there is a possibility of lunar flow through the embankment, and the headroom is insufficient by 1.72 m, so it was reviewed as not securing hydrological safety. The water level-volume curve was arbitrarily derived because it was difficult to clearly establish the water level-flow relationship curve of the reservoir since the water level-flow measurement was not carried out regularly, and based on the derived curve, the algorithm for operating small and medium-sized old reservoirs was developed to consider the pre-discharge time, the amount of spillway discharge, and to predict the reservoir lunar flow time according to the flood volume by frequency, thereby securing evacuation time in advance and reducing the risk of collapse. Based on one row of 200 mm diameter mobile siphons, the optimal pre-discharge time to secure evacuation time (about 1 hour) while maintaining 80% of the upper limit water level (about 30,000 m2) during a 30-year flood was analyzed to be 12 hours earlier. If the pre-discharge technology utilizing siphons for small and medium-sized old reservoirs and the algorithm for reservoir operation are implemented in advance in case of abnormal weather and the decision-making of managers is supported, it is possible to secure the safety of residents in the risk area of reservoir collapse, resolve the anxiety of residents through the establishment of a support system for evacuating residents, and reduce risk factors by providing risk avoidance measures in the event of a reservoir risk situation.

Psychological Meaning of Creation Myths: Focused on Darkness/Massa Confusa, Separation of World Parent and Creation of Land/Island (무의식의 창조성 관점으로 고찰한 창조신화: 흑암/혼돈, 천지개벽/분리, 섬/육지 창조 중심)

  • Jin-Sook Kim
    • Sim-seong Yeon-gu
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    • v.38 no.2
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    • pp.269-304
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    • 2023
  • The purpose of this paper is to present the psychological meaning of the creation myths by utilizing related myths, analysand's dreams, active imagination, and artwork to reveal the creative function of the unconscious. The creation myth is the phenomenon of projection when a new order is demanded in the chaotic phase of personal and human history. Depending on the attitude of the ego, it can be a sign of a reconstruction/alteration of consciousness or an invasion. Related literature such as Jung, von Franz, Neumann, Harding, and Edinger, domestic papers, and case reports are introduced to identify the background for this research. The psychological meaning of 'darkness' in creation myths is regarded as unconscious that is too dark to see. The Eskimo creation myth and an analysand's dreams of being blind and wandering in darkness are discussed in relation to nigredo in Alchemy. The psychological meaning of 'massa confusa' regards Uroboros, pleroma, early childhood experience, and a psychological womb in which everything is contained in one. With related myths and unconscious materials, a discussion is followed on how this realm can be a precursor of creation but also be trapped in an abyss. The psychological meaning of 'separation of world parent' is related to splitting one into two when unconscious contexts were touched before it became consciousness. Related myths, 'the world created between heaven and earth,' 'celestial being descending to the earth,' and 'the legend of relocation of a mountain,' as well as clinical material, are examined. Then this paper discusses the clinical implications of the separation of heaven and earth occurring on its own, that the creator's emotional aspects, such as loneliness and anxiety, are involved, and that delayed separation leads to the death of creatura and sudden separation leads to the death of the chaos. Then, the meaning of 'separation of world parent' is discussed in relation with separatio, the alchemical process of acquiring light/consciousness from darkness/unconsciousness. The psychological meaning of the creation of 'land/island' refers to the emergence of consciousness, the contents of the unconscious material into the realm of the ego. Related myths, such as the 'body of the monster/dragon becoming land' and analysand's dreams, are introduced, referring to the embodiment of Mercurius. This is followed by discussing related myths in creating the land to coagulatio in alchemy and utilizing creative work such as active imagination, art, music, and dance that can coagulate or concretize unconscious material in clinical approaches. Finally, myths of resurfaced land after the Flood or the complete destruction of the world in relation to the reconstruction of ego are discussed with related clinical material to show the importance of the analyst/therapist/supervisor's mental stability and capacity.