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한국형 심리부검 기반 이차원적 자살유형 연구: 자살행동과 자살위험요인을 중심으로 (The Study of the Two-Dimensional Suicidal Type Based on Psychological Autopsy: A Focus on Suicidal Behaviors and Suicidal Risk Factors)

  • 육성필;서종한
    • 한국심리학회지 : 문화 및 사회문제
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    • 제29권1호
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    • pp.75-99
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    • 2023
  • 본 연구는 심리부검을 통해 완결된 자살자의 자살행동과 자살위험요인을 탐색하고 이를 지표로 자살 유형을 살펴보는 데 목적이 있다. 또한 각 유형에 영향을 미치는 영향요인을 이차적으로 살펴보고자 하였다. 본 연구를 위해 128명의 완결된 자살자와 관련 유가족과 지인을 대상으로 심리부검 면담을 실시했고 유형 분석에 필요한 지표변수를 최종 선정하였다. 자살위험요인 지표변수로 정신장애, 자살/자해, 중대한 신체변화, 배우자간 갈등, 직장/학교 내 적응 및 관계문제, 실직/해고, 사업실패, 무직, 심각한 재정적 문제가 선정되었다. 자살행동 지표변수로 자살의지표현, 자살유서, 구조도움요청, 자살시간/장소/방법, 과거 자살/자해 시도, 자살자 최초발견이 선정되었다. 잠재계층분석(Latent Class Analysis)과 3단계 분석 방법(3-step method)을 이용하여 유형을 분석하였고 각 유형에 대한 차이를 규명하고자 외부변수(경제적 변화, 동거, 스트레스 존재/변화, 관계변화, 가족 중 정신장애/알코올문제/신체질병, 학교/직장 만족)를 활용하였다. 분석 결과 자살행동을 기반으로 한 유형 분석에는 5가지 계층(경제문제, 적응문제, 복합문제, 정신과문제, 사건반응), 자살위험요인을 기반으로 한 유형 분석에서는 3가지 계층(주거지-자살시도-가족발견형, 비주거지-비자살시도-지인발견형, 주거지-비자살시도-가족발견형)이 탐색되었다. 자살행동 기반 3가지 유형 간에는 성별, 결혼상태, 동거여부, 관계변화에서 유의미한 차이를 보였고 특히 유형 3(주거지-비자살시도-가족발견형)의 경우 다른 유형에 비해 동거중인 상태로, 기혼자일 가능성이 높고 대인관계 갈등이 두드러졌다. 자살위험요인 기반 5가지 유형 간에는 경제적 변화, 동거, 스트레스, 관계변화, 가족 관련 문제, 학교/직장 만족도에서 차이를 보였는데 특히 유형3(복합문제)은 상대적으로 가족 관련 문제는 없으나 개인적인 스트레스 발생과 악화가 두드러졌다. 향후 해당 유형과 유형별 영향요인에 맞는 자살예방과 위기개입 방안이 필요할 것으로 보인다.

Gain of a New Exon by a Lineage-Specific Alu Element-Integration Event in the BCS1L Gene during Primate Evolution

  • Park, Sang-Je;Kim, Young-Hyun;Lee, Sang-Rae;Choe, Se-Hee;Kim, Myung-Jin;Kim, Sun-Uk;Kim, Ji-Su;Sim, Bo-Woong;Song, Bong-Seok;Jeong, Kang-Jin;Jin, Yeung-Bae;Lee, Youngjeon;Park, Young-Ho;Park, Young Il;Huh, Jae-Won;Chang, Kyu-Tae
    • Molecules and Cells
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    • 제38권11호
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    • pp.950-958
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    • 2015
  • BCS1L gene encodes mitochondrial protein and is a member of conserved AAA protein family. This gene is involved in the incorporation of Rieske FeS and Qcr10p into complex III of respiratory chain. In our previous study, AluYRa2-derived alternative transcript in rhesus monkey genome was identified. However, this transcript has not been reported in human genome. In present study, we conducted evolutionary analysis of AluYRa2-exonized transcript with various primate genomic DNAs and cDNAs from humans, rhesus monkeys, and crabeating monkeys. Remarkably, our results show that AluYRa2 element has only been integrated into genomes of Macaca species. This Macaca lineage-specific integration of AluYRa2 element led to exonization event in the first intron region of BCS1L gene by producing a conserved 3' splice site. Intriguingly, in rhesus and crabeating monkeys, more diverse transcript variants by alternative splicing (AS) events, including exon skipping and different 5' splice sites from humans, were identified. Alignment of amino acid sequences revealed that AluYRa2-exonized transcript has short N-terminal peptides. Therefore, AS events play a major role in the generation of various transcripts and proteins during primate evolution. In particular, lineage-specific integration of Alu elements and species-specific Alu-derived exonization events could be important sources of gene diversification in primates.

치매노인의 요양시설 입소에 미치는 영향: 배우자 부양자 대 성인자녀 부양자 (Predictors of Nursing Home Placement for the Elderly with Dementia: Adult Child Caregivers VS. Spousal Caregivers)

  • 백주희
    • 한국노년학
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    • 제25권2호
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    • pp.127-141
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    • 2005
  • 치매노인을 부양하는 배우자와 성인자녀가 접하는 어려움이 다름에도 불구하고, 선행 연구들은 이들을 한 집단으로 묶어 요양시설로의 입소에 미치는 요소를 분석하였다. 미국 뉴저지(New Jersey)와 오하이오(Ohio)주에 거주하는 치매 노인 부양자 456명을 대상으로 사건사 분석(Event History Analysis)을 실시한 결과, 배우자 부양자가 성인자녀 부양자에 비해 치매노인을 더 빨리 요양시설로 보내는 경향을 보여주었다. 치매노인의 연령과 역할 구속감(Role Captivity)은 두 집단 모두에게 유의미한 변수였는데, 치매노인의 연령과 부양자의 역할 구속감(Role Captivity)이 높을수록 요양시설로의 입소가 빨라지는 경향을 보였다. 교육수준과 소득은 성인자녀 부양자에게만 유의미한 변수로, 교육수준이 높을수록 시설로의 입소가 지연되었던 반면, 소득이 높을수록 시설로의 입소는 빨라지는 경향을 보였다. 한편 탁노소(Adult Day Care) 이용과 피부양자의 문제행동(Behavioral Problems)은 배우자 부양자에게만 유의미한 변수였으며, 탁노소를 이용할 경우와 피부양자의 문제행동이 증가할수록 요양시설로의 입소가 빨라지는 경향을 보였다.

Attitude, Beliefs, and Intentions to Care for SARS Patients among Korean Clinical Nurses: An Application of Theory of Planned Behavior

  • Kim Cho-Ja;Yoo Hye-Ra;Yoo Myung-Sook;Kwon Bo-Eun;Hwang Kyung-Ja
    • 대한간호학회지
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    • 제36권4호
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    • pp.596-603
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    • 2006
  • Purpose. This study examined Korean clinical nurses' intentions to care for SARS patients and identify determinants of the intentions. Theory of planned behavior was the framework to explain the intentions of Korean nurses for SARS patients care. Methods. A convenient sample of six hundreds and seventy nine clinical nurses from four university-affiliated hospitals located in Seoul and in Kyung-gi province was used. Self-administered (83-items) questionnaire was used to collect data. Intentions, attitude, subjective norm, perceive behavioral control, behavioral beliefs, normative beliefs, and control beliefs were the study variables. All items were measured using 7point Likert scale (-3 to +3). Data were analyzed using descriptive statistics, Pearson correlation method, and stepwise multiple regression methods. Results. Intentions and attitudes toward SARS patient care among Korean clinical nurses were moderate, but their subjective norm and perceive behavioral control of SARS patients care were negative. Stepwise multiple regression analysis indicated that attitude toward SARS patient care, perceived behavioral control, subjective norm were the determinants of the intentions for SARS patients care as theory proposed. Among the behavioral beliefs, 'SARS-patient caring would be a new experience', 'during SARS-patient caring, I should be apart from my family', 'after completing SARS-patient caring, I would be proud of myself being able to cope with a stressful event' and 'with my SARS-patient caring, patients could recover from SARS' were the significant determinants. Among the normative beliefs, colleague approval, spouse approval, and physician approval were significant determinants of the intentions. Among the control beliefs, 'SARS-patient caring would be a challenge' 'SARS-patient caring is a professional responsibility', 'tension during the care of SARS patients' and 'support from team members' were the significant determinants of the intentions. Conclusions. Korean clinical nurses in this study were not willing to care for SARS patients and showed negative attitude toward the care. They believed their friends and family were not approved their care for SARS patients. Nurses were in conflicts between professional responsibilities to care for SARS patients and personal safety. This study was the first to understand stress and burden of Korean clinical nurses who are in front line to care for newly developed communicable disease such as SARS. Under the circumstance where several fatal communicable diseases are predictable, conflicts between professional responsibility and their personal risks should be taken into considerations by nurses themselves and by nursing administrators in order to improve quality of care.

ADHD 아동과 외면화 증후를 공존질환으로 갖는 ADHD 아동간의 심리사회적 변인에 관한 비교연구 (A STUDY OF PSYCHOSOCIAL VARIABLES WITHIN ADHD WITH OR WITHOUT EXTERNALIZING SYMPTOM)

  • 이경숙;유윤정;안동현;신의진
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제7권2호
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    • pp.203-212
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    • 1996
  • 주의력결핍 과잉행동장애아(ADHD)와 품행장애나 반항성장애와 같은 외면성 증후를 공존질환으로 갖는 주의력결핍 과잉행동장애아(ADHD + CD/ODD)간에 사회경제적지위, 부모 학력수준, 생활 스트레스 사건, 친인척의 정신병력을 내용으로 하는 가족 배경과 부모의 결혼 만족도, 양육자 스트레스, 양육태도 등의 심리사회적 변인에 차이가 있는지 검증하였다. 연구결과, ADHD+CD/ODD집단이 위의 가족배경에서 가장 열악한 수준을 보이고 있었고, 부모의 결혼적응도에서도 ADHD+CD/ODD 집단이 가장 낮았으며, 양육자 스트레스에서는 ADHD+CD/ODD>ADHD>통제집단 순으로 높았으며 부모가 지각한 양육태도에서 임상집단의 어머니들이 증오적, 거부적 의존성을 포함하는 양육태도를 가지고 있었으며, 아동이 지각한 부모의 양육태도에서는 임상집단의 부모가 아동에게 더 거부적이고 지배적이고, 모순적인 양육태도를 지닌 경향성을 알 수 있었다.

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구강 작엽감 증후군 (BMS)의 임상적 특징 및 치료에 관한 연구 (A Study on The Clinical Characteristics and Treatment in Burning Mouth Syndrome)

  • Mi-Jung Yeom;Chong-Youl Kim
    • Journal of Oral Medicine and Pain
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    • 제20권1호
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    • pp.39-52
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    • 1995
  • Burning mouth syndrome is characterized by a burning sensation in oral cavity without clinical signs. There has b een no established theories about the diagnosis and treatment. The purpose of this article is to examine the clinical feature of BMS patients of Korean and to present a treatment protocol that can be helpful in clinical applications. The subjects chosen for the study were 52 patients who had visited Department of Oral Diagnosis at Yonsei University Dental Hospital and were diagnosed as BMS. We did questionnaires and precise oral exam, laboratory exam, grouping of our patients, individual treatment for the groups and classification of responses to the treatment. The following results were obtained: 1. Chief complaints were throbbing (71.2%), pricking, stinging, tingling (30.8%), burning(25a%). The tongue is the most frequently affected site (82.7%), followed by full mouth, gingiva, palate, buccal mucosa, lips, throat, labial mucosa and floor of mouth. 2. The average age of onset was 48.1 year and the male to female ratio was 1 to 3. The average duration of symptom was 11.69 months for male and 23.07 months for female. 3. 32.7% of patients had appealed continuous pain, which was the most cases. Aggravating factors were peppery food, salty food, hot food, fatigue, tension conversation, sour food, cold food and toothpaste. Reducing factors were cold food, diet, going to sleep and smoking. 4. Associated symptoms were dry mouth, other life problem, altered taste perception, bad taste, throat pain, tingle and difficulty in swallowing. 5. Most of patients had appealed that there was not associated event on onset of symptom, and the order of prevalence is as fallow; dental treatment, stress, denture wearing, an attack of a systemic disease. 92.3% of patient appealed that there was no psychological withering and 7.7% of patients appealed positively. 6. There were eight males and four females that had jobs. 7. There was no family history in 100% of patients in questions about presence of family history. 8. 96.2% of patients appealed that there was no oral habits. 13.5% of patients had dryness of oral mucosa in oral exam. A significant relation to dental prosthesis was not observable, but incidence of diseases due to stress appeared high in BMS which had the clinical characteristics as above. A group having low serum iron was 63.5% and in this group period of potential iron deficiency appeared high in incidence just before move to anemia. A group represented positive response was 38.5% in fungus study for Candida albicans. Since we can expect high treatment response by prescription of iron-contained drug and antifungal drug in these patients, diagnosing patients' condition of BMS can be achieved in more various aspects through study for serum iron and Candida albicans. Furthermore, it is expected that treatment protocol can be made.

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High-dose chemotherapy and autologous peripheral blood stem cell transplantation in the treatment of children and adolescents with Ewing sarcoma family of tumors

  • Seo, Juhee;Kim, Dong Ho;Lim, Jung Sub;Koh, Jae-Soo;Yoo, Ji Young;Kong, Chang-Bae;Song, Won Seok;Cho, Wan Hyeong;Jeon, Dae-Geun;Lee, Soo-Yong;Lee, Jun Ah
    • Clinical and Experimental Pediatrics
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    • 제56권9호
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    • pp.401-406
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    • 2013
  • Purpose: We performed a pilot study to determine the benefit of high-dose chemotherapy and autologous peripheral blood stem cell transplantation (HDCT/autoPBSCT) for patients with Ewing sarcoma family of tumors. Methods: We retrospectively analyzed the data of patients who received HDCT/autoPBSCT at Korea Cancer Center Hospital. Patients with relapsed, metastatic, or centrally located tumors were eligible for the study. Results: A total of 9 patients (3 male, 6 female), with a median age at HDCT/autoPBSCT of 13.4 years (range, 7.1 to 28.2 years), were included in this study. Patients underwent conventional chemotherapy and local control either by surgery or radiation therapy, and had achieved complete response (CR, n=7), partial response (n=1), or stable disease (n=1) prior to HDCT/autoPBSCT. There was no transplant-related mortality. However, the median duration of overall survival and event-free survival after HDCT/autoPBSCT were 13.3 months (range, 5.3 to 44.5 months) and 6.2 months (range, 2.1 to 44.5 months), respectively. At present, 4 patients are alive and 5 patients who experienced adverse events (2 metastasis, 2 local recur, and 1 progressive disease) survived for a median time of 2.8 months (range, 0.1 to 10.7 months). The 2-year survival after HDCT/autoPBSCT was $44.4%{\pm}16.6%$ and disease status at the time of HDCT/autoPBSCT tended to influence survival ($57.1%{\pm}18.7%$ of cases with CR vs. 0% of cases with non-CR, P=0.07). Conclusion: Disease status at HDCT/autoPBSCT tended to influence survival. Further studies are necessary to define the role of HDCT/autoPBSCT and to identify subgroup of patients who might benefit from this investigational treatment.

Carotenoids가 인체의 대장암 세포인 HT-29 세포의 증식에 미치는 영향 (Effect of Carotenoids on the Growth of HT-29 Human Colon Cancer Cells)

  • 김은지;정재인;이현숙;강일준;;윤정한
    • 한국식품영양과학회지
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    • 제32권3호
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    • pp.428-436
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    • 2003
  • Carotenoids는 항암 효과가 있는 것으로 알려져 있으나 각각의 carotenoids가 대장암에 미치는 영향에 대해서는 명확하게 밝혀진 바가 없다. 본 연구에서는 4가지 종류의 carotenoids가 인간의 대장에서 유래한 암세포인 HT-29 세포의 증식에 미치는 영향을 조사하였다. $\alpha$-carotene, $\beta$-carotene, lutein lycopene을 농도를 달리 하여 세포 배양액 에 첨가하여 살아있는 세포의 수를 측정한 결과 $\beta$-carotene는 세포의 증식을 다소 증가시키는 반면 $\alpha$-carotene, lutein, lcopene은 세포의 증식을 감소하였다. 세포의 증식을 억제한 carotenoids 중에서 lycopene이 그 효과가 가장 컸다. ErbB receptor family는 세포의 증식을 촉진하고 대장암에서 그 발현이 증가된 것으로 보고되었기 때문에 lycopene이 heregulin-ErbB3 signaling을 억제하는지를 조사하였다. Lycopene는 ErbB2 단백질을 감소하였고 ErbB3 단백질의 변화를 초래하였다. Heregulin을 첨가하여 인산화를 유도한 경우 ErbB3의 인산화, ErbB3와 p85의 결합, Akt 인산화가 lycopene에 의해 억제되었다. 이 결과들은 carotenoids 중 lycopene이 대장암 세포 증식 억제 효과가 가장 크고, 대장암 세포의 DNA 합성을 억제하고 apoptosis를 유도하는 lycopene효과의 일부는 Erb-B3와 Akt의 인산화 감소에 기인하는 것임을 나타낸다.

전장유전체수준 메틸레이션 분석을 통한 두경부암 특이 메틸레이션 바이오마커의 발굴 (Genome-wide Methylation Analysis and Validation of Cancer Specific Biomarker of Head and Neck Cancer)

  • 장재원;박기완;홍소혜;정승남;류려화;김진만;오태정;구본석
    • 대한두경부종양학회지
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    • 제33권1호
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    • pp.21-29
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    • 2017
  • Methylation of CpG islands in the promoter region of genes acts as a significant mechanism of epigenetic gene silencing in head and neck squamous cell carcinoma (HNSCC). DNA methylation markers are particularly advantageous because DNA methylation is an early event in tumorigenesis, and the epigenetic modification, 5-methylcytosine, is a stable mark. In the present study, we assessed the genome-wide preliminary screening and were to identify novel methylation biomarker candidate in HNSCC. Genome-wide methylation analysis was performed on 10 HNSCC tumors using the Methylated DNA Isolation Assay (MeDIA) CpG island microarray. Validation was done using immunohistochemistry using tissue microarray of 135 independent HNSCC tumors. In addition, in vitro proliferation, migration/invasion assays, RT-PCR and immunoblotting were performed to elucidate molecular regulating mechanisms. Our preliminary validation using CpG microarray data set, immunohisto-chemistry for HNSCC tumor tissues and in vitro functional assays revealed that methylation of the Homeobox B5 (HOXB5) and H6 Family Homeobox 2 (HMX2) could be possible novel methylation biomarkers in HNSCC.

공동주택 화재를 대상으로 한 가상현실(VR) 프로그램 개발 및 호응도 조사 (Development and Review of Virtual Reality Fire-Training Program)

  • 김용철;정무헌;류충;김선규
    • 한국화재소방학회논문지
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    • 제33권6호
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    • pp.159-164
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    • 2019
  • 본 연구는 최근 빈번하게 발생하고 있는 공동주택 화재로 인한 인명피해 최소화를 위해 최신 IT 기법을 활용하여 공동주택(아파트)의 화재 상황을 재현 한 가상현실(VR) 화재 프로그램을 개발하고 학습도구로서의 활용가능성을 검증하였다. 이를 위해 공동주택 단위평면 크기, 가족구성 등 기본환경을 설정하였으며 공동주택에서 일어날 수 있는 화재 시나리오를 개발하여 게임형식으로 가상현실 프로그램을 구현하였다. 아울러 개발된 가상현실(VR) 화재 프로그램에 대한 호응도를 살펴보기 위해 설문조사를 실시하였다. 설문결과 가상현실(VR) 화재 프로그램에 대한 호응도가 매우 높게 나타났으며 특히 가상현실 화재 프로그램을 통한 학습효과가 높아 학습기기로서의 유효성을 확인할 수 있었다.