공황장애 환자의 초기부적응 심리도식의 특성

우나영,이병욱,이홍석,정명훈,이중서,Woo, Na Young,Lee, Byung Wook,Lee, Hong Seock,Jung, Myung Hoon,Yi, Jung Seo 대한불안의학회 2011 대한불안의학회지 Vol.7 No.2

본 연구에서는 공황장애 환자의 심리도식 특성을 조사하였다. 대조군에 비해 환자군은 상태 및 특성불안, 우울 점수가 유의하게 높았으며 YSQ 중에서는 유기/불안정, 위험/질병에 대한 취약성 도식 점수가 유의하게 높았다. 환자군에서 ST-AI로 평가한 불안 수준은 모든 심리도식과, BDI로 평가한 우울 수준은 특권의식/과대성을 제외한 14개 도식과 상관관계가 있었으나 대조군에서는 훨씬 적은 수의 도식만이 상관관계를 보였다. 환자군에서 위험/질병에 대한 취약성, 유기/불안정 도식이 특성불안 수준을 가장 잘 예측하였으며 의존/무능, 유기/불안정 도식은 상태불안 수준을, 결함/수치심, 복종 도식은 우울 수준을 가장 잘 예측하였다. 이를 종합할 때, 초기부적응 심리도식은 공황장애의 발병과 경과 그리고 치료 반응에 영향을 미칠 가능성이 있다. 향후 대규모 집단을 대상으로 공황장애 환자의 심리도식 특성을 파악하고 치료에 접목시키는 작업이 필요할 것으로 생각된다. Objective : This study aimed to investigate the characteristics of the early maladaptive schemas in patients with panic disorder. Methods : Patients (n=35) included people who had met the DSM-IV-TR criteria for panic disorder. The normal control group (n=35) were those people who had no psychiatric disorder and had never experienced panic attack. The early maladaptive schemas and the severity of depression and anxiety were assessed by the Young Schema Questionnaire Short-form (YSQ-SF), the Beck Depression Inventory (BDI), and the Spielberger State-Trait Anxiety Inventory (STAI). Results : The scores on the STAI-S, STAI-T, and BDI were significantly higher in the patient group. Compared to the control group, the scores of vulnerability to harm and illness, and abandonment/instability schemas were significantly higher in the patient group. In the patient group, defectiveness/shame and subjugation schemas were found to predict BDI, dependent/incompetence, abandonment/instability schemas were found to predict STAI-S, and vulnerability to harm and illness, and abandonment/instability schemas were found to predict STAI-T. In normal controls, failure and insufficient self-control/self-discipline, failure, and emotion inhibition schemas were found to predict BDI, STAI-T, and STAI-S. Conclusions : Vulnerability to harm and illness and abandonment/instability schemas may be characteristic schema in patients with panic disorder.

직장 여성의 불안, 충동성과 음주문제

이현재,한덕현,이영식,기백석,권해진,박두병,Lee, Hyun Jae,Han, Doug Hyun,Lee, Young Sik,Kee, Baik Seok,Kwon, Hye Jin,Park, Doo Byung 대한불안의학회 2011 대한불안의학회지 Vol.7 No.2

본 연구 결과 여성에서의 문제음주와 알코올 의존 비율이 남성보다는 적지만 9.8%로 상당수의 여성들이 알코올 문제를 겪고 있음을 알 수 있었다. 그리고 직장 생활을 하는 여성에서 음주 노출 기회가 더 많고, 실제로 음주에 대한 문제가 더 많이 발생하며 이는 여성의 상태불안과 충동성과 관계가 있다. 여성에서는 직업을 가짐으로써 음주 노출기회가 많아지고 직장 생활에서의 불안 및 충동성이 문제 음주를 일으키는 원인이 될 수 있음을 예상해 볼 수 있겠다. 따라서 직장 여성의 음주 노출 기회와 불안 및 충동성 조절이 음주 위험 요소의 중요한 조절 요인으로 생각된다. Objectives : This study examined drinking habits, anxiety, and impulsiveness in employed women. Methods : We sampled 925 residents aged over 20 years in Gwanak-gu of Seoul. In the process, we divided subjects into employed women and unemployed women groups and then used the Korean Version of Alcohol Use Disorder Identification Test (AUDIT-K), State-Trait Anxiety Inventory (STAI), and Barratt Impulsiveness Scale (BIS) to identify patterns in subjects' alcohol drinking, anxiety and impulsiveness. Results : Among the 925 respondents, 95.7% drank alcohol, and after the analysis, female problematic drinking ($12{\leq}AUDIT-K{\leq}25$) and alcohol dependence ($AUDIT-K{\geq}26$) was apparent in 61 (9.5%) and 2 respondents (0.3%), respectively. Female respondents who had jobs tended to drink more and exhibit higher ratios of problematic drinking, with a higher exposure to alcohol than those that were unemployed. The psychological attributes related to female respondents' alcohol problems related to state of anxiety and impulsiveness. Employed women respondents also showed a higher state of anxiety and impulsiveness than unemployed women. Conclusion : Controlling the frequency of exposure to alcohol, anxiety, and impulsiveness in employed women should be considered to be crucial controlling factors related to the hazards of excessive drinking.

소방공무원의 스트레스 및 우울의 위험 요인 : 개인 및 직무요인을 중심으로

이나빈,이정현,김지애,전경선,심민영 대한불안의학회 2019 대한불안의학회지 Vol.15 No.1

Objective : The aim of this study was to investigate the individual and job related factors as risk factors for mental health of firefighters. Methods : The data of 202 fire-fighters was analyzed by using a multinomial logistic regression analysis. All participants completed self-reported questionnaires including demographics (sex, age, work duration), the Childhood Trauma Questionnaire, the Ways of Coping Checklist, the Colleague related traumatic events, the Korean occupational stress scale, the Korean Perceived Stress Scale-10, and the Beck Depression Inventory. Participants were divided into three groups according to the level of stress and depressive symptom scores: Low Stress-Low Depression (LS-LD), High Stress-Low Depression (HS-LD), and High Stress-High Depression (HS-HD). Results : A job related factor-organizational injustice-was a significant factor related to HS-LD, while individual factors such as active coping level and childhood trauma experience and a job related factor-difficult physical environment-were significantly associated with HS-HD. Conclusion : These results imply the need to take both individual and environmental approaches into account when managing the stress and depression of firefighters. More specifically, psycho-education to facilitate active coping strategy and adaptive emotional regulation at the individual level and the improvement of physical work environment of firefighters should be supported. (Anxiety and Mood 2019;15(1):35-44)

성격특성과 불안장애의 관계

박수빈,홍진표,Park, Su-Bin,Hong, Jin-Pyo 대한불안의학회 2009 대한불안의학회지 Vol.5 No.1

In this article, we review research on how normal personality traits and personality disorder traits may relate to anxiety disorders ; as predisposing factors, 2) as complications, 3) as pathoplastic factors, and 4) as manifestations of common underlying etiologies. Based on current literatures, we draw a conclusion as follows : 1) Normal personality traits such as high neuroticism and low extraversion and personality disorder traits, especially cluster C traits, are at least risk factors for certain anxiety disorders ; 2) Anxiety disorders in early life might influence a later development of personality disorder ; 3) Personality disorder traits may have negative influence on the outcome of anxiety disorders ; 4) Personality and anxiety disorders may be manifestations of common genetic and environmental etiologies.

우울 및 불안장애 환자에서 성별 및 성경험 유형에 따른 부정적 성경험과 정신과적 증상 사이의 연관성

지민아,정보람,채정호 대한불안의학회 2019 대한불안의학회지 Vol.15 No.2

Objective : This study aims to investigate the relationship between negative sexual experience and psychiatric symptoms by gender and compare the effects of sexual assault and unwanted sexual experiences on psychiatric symptoms in patients with depression or anxiety disorders. Methods : A total of 204 respondents who have had negative sexual experiences of outpatients diagnosed with depression or anxiety disorders were evaluated with AUDIT, PSS, STAI, BDI, and SSI. Independent samples t-test was performed to compare the psychiatric symptom scale scores between male and female and identify the difference of the psychiatric symptom scale scores between those who have had sexual assault and those who have had only unwanted sexual experience. Results : There was no difference in psychiatric symptom scale scores except for AUDIT between male and female in 204 patients with negative sexual experience. There was also no significant difference in AUDIT, PSS, and STAI scores between those who experienced sexual assault and those who experienced only unwanted sexual experiences. BDI and SSI scores are significant higher in those who experienced sexual assault than those who experienced only unwanted sexual experiences. Conclusion : This suggests that male and female may have similar levels of psychiatric symptoms after experiencing negative sexual experiences. Psychiatric symptoms caused by sexual assault may have differences from the psychiatric symptoms caused by unwanted sexual experience. Understanding the differences in psychiatric symptoms according to the type of negative sexual experience may helpful to direct the therapeutic plans. (Anxiety and Mood 2019;15(2):77-83)

한국판 사회적 외모불안 척도(Korean Version of the Social Appearance Anxiety Scale, K-SAAS) 타당화

이민지,김미리혜,김정호 대한불안의학회 2023 대한불안의학회지 Vol.19 No.1

Objective : To translate and adapt the Social Appearance Anxiety Scale into Korean and validate the Ko- rean version of the social appearance anxiety scale, which measures the fear and anxiety about being nega- tively evaluated by others based on one’s overall appearance, including body shape. Methods : For item translation and adaptation, six bilingual translators participated in the process of for- ward-adaptation and back-adaptation. Data were collected from undergraduate students. The sample size is 105 for Study 1 and 212 for Study 2. Classical item discrimination and difficulty analyses, exploratory fac- tor analysis (EFA), confirmatory factor analysis (CFA), and reliability analysis were performed. Results : A unidimensional structure was found with a high internal consistency (Cronbach’s α=0.95) and a high test-retest reliability (r=0.918). In addition, the concurrent validity was examined by correlations of the scale and several other scales measuring constructs related to social appearance anxiety. Conclusion : K-SAAS appears to be a reliable and valid scale for screening and assessing social appear- ance anxiety. (Anxiety and Mood 2023;19(1):1-9)

강박증상과 강박장애의 평가

임준석,김찬형,Lim, Joon-Suk,Kim, Chan-Hyung 대한불안의학회 2008 대한불안의학회지 Vol.4 No.1

Obsessive-compulsive disorder (OCD) affects approximately 2-3% of the adult population. OCD is associated with impairments in social and occupational functioning. Although there are effective treatments for OCD, many individuals who suffer from OCD go undiagnosed and untreated. Thus, improvements in the assessment and diagnosis of OCD are needed. This paper provides a review of the instruments used to assess and diagnose patients with OCD. We reviewed clinician-administered inventories and self-report questionnaires. The characteristics, strengths, weaknesses, reliability and validity of each instrument are discussed. We also reviewed the psychometric properties of the Korean version of each instrument.

신체증상장애와 관련된 분노정서특질과 아동기 역경 경험

강성혁,박천일,김혜원,김세주,강지인 대한불안의학회 2020 대한불안의학회지 Vol.16 No.2

Objective : The present study aims to investigate differences in anger-related features in patients withsomatic symptom disorder (SSD) compared to healthy controls, and to examine whether anger trait and angerregulation strategy are associated with clinical characteristics in patients with SSD. In addition, we examinedthe relationship between childhood adversity and SSD. Methods : 26 patients with SSD and 28 healthy controls were included. Anger-related features were assessedwith State-Trait Anger Expression Inventory (STAXI). Clinical somatic symptoms were assessed usingthe somatization subscale of the Symptom Checklist-90-Revised and the Somatosensory AmplificationScale. Childhood adversity was assessed by the Childhood Traumatic Events Scale. Multivariate analysis ofcovariance was performed. Results : Disease status of SSD had a significant overall effect on anger-related features (Wilks λ=0.725,F(5, 44)=3.332, p=0.012). Patients with SSD showed a significantly high Trait-Anger (p=0.017) and they hada high score in both Anger-Out (p=0.013) and Anger-In (p=0.001) of anger expression styles. In particular, adirected inward style of anger expression was significantly associated with somatization symptom severity(p=0.003). Regarding childhood adversity, more childhood extreme illness was experienced by the SSDgroup than the control group (p=0.012). Within the SSD group, childhood extreme illness was associatedwith higher Trait-Anger (p=0.027) and Anger-Out (p=0.001). Conclusion : The present findings suggest that trait anger, anger expression styles, and childhood adversityof extreme illness may be involved in SSD. Further studies are needed to explore the role of anger-relatedfeatures and its relationship with childhood adversity in the pathophysiology of SSD. (Anxiety and Mood2020;16(2):49-56) -

영아살해와 임신거부증을 주소로 내원한 경계선 인격장애의 치료사례

정세미나,백기청,이준형,김경민,도진아,임명호,Jung, Semina,Paik, Ki Chung,Lee, Jun Hyung,Kim, Kyung Min,Doh, Jin Ah,Lim, Myung Ho 대한불안의학회 2012 대한불안의학회지 Vol.8 No.2

Though infanticide, killing the baby after birth of the neonate and denial of pregnancy, are very rare psychiatric disorder, they have been receiving a lot of social concerns. We report and review infanticide and denial of pregnancy administration in a 19 year-old adolescent with bipolar disorder and borderline personality disorder. Patients with a young age, cognitive immaturity, an unwanted child, hid the pregnancy facts were consistent with the results of previous studies. In addition, the patient's impulsivity and emotional instability is affecting infanticide. After inpatient care with pharmacotherapy (escitalopram 20mg, alprazolam 1.5 mg, clonazepam 0.5 mg, valproate sodium 1,100-1,300 mg, and quetiapine 100-400 mg) and supportive psychotherapy, and there were significant improvement of clinical symptoms.

불안 장애 환자와 우울 장애 환자의 감정표현불능증

김부용,류석환,Kim, Pu Yong,Ryu, Seuk Hwan 대한불안의학회 2015 대한불안의학회지 Vol.11 No.2

Objective : The aim of the study was to investigate the difference in alexithymia between anxiety disorder and depressive disorder. The second was to evaluate the effect of alexithymia on quality of life in patients with anxiety disorder and depressive disorder. Methods : A total of 175 patients with diagnoses of anxiety disorder or depressive disorder were recruited. Demographic, psychosocial, and clinical data were analyzed, as well as results on the 20-item Toronto alexithymia Scale (TAS-20K), the Symptom Checklist-90-Re-vised (SCL-90-R), a quality of life scale, the Beck Depression scale, and Beck Anxiety Inventory. Results : As compared with the patients with anxiety disorder, patients with depressive disorder showed significantly higher total score on the TAS-20K and for factor 1 (difficulties identifying feelings) and factor 2 (difficulties describing feeling) scales of the TAS-20K and showed significantly lower scores of psychosocial well-being on the quality of life scale. Total scores on the TAS-20K correlated significantly with scores for some subscale on the quality of life scale. Conclusion : This study suggest that patients with depressive disorder had more alexithymic symptoms and worse quality of life compared with those with anxiety disorder. Also, alexithymic symptoms are found to be associated with quality of life. Therefore, clinicians should try to focus on relieving symptoms to help patients restore their psychological well-being and improve their quality of life.