한국판 Liebowitz사회불안척도(LSAS)의 요인구조 및 진단적 유용성 -대학생 집단과 사회공포증환자 집단을 중심으로

유은승,안창일,박기환 한국임상심리학회 2007 Korean Journal of Clinical Psychology Vol.26 No.1

This study attempted to examine the factor structure of a Korean version of the Liebowitz Social Anxiety Scale (K-LSAS) and its diagnostic efficiency. Subjects consisted of 755 college students and 32 social phobic patients and exploratory factor analysis was used to identify situational factors provoking intensive fear in social phobia. As a result, the following 5 factors were extracted: (1) speaking, (2) doing something while being observed, (3) public situation, (4) interaction with stranger, and (5) assertive situation. The reliability and validity of K-LSAS is also highly significant among these subjects. Finally we examined the difference of score on K-LSAS and its subscales between two groups, and discussed the value of K-LSAS on accurate diagnosis for social phobia. The application to specific cutoff scores of each subscale and total score on the K-LSAS would greatly enhance the diagnostic utility for social phobia. Therefore, K-LSAS can be beneficial for clinicians to evaluate social phobic individuals accurately in order to make efficient treatment plans.

한국판 수면에 대한 역기능적 신념 및 태도 척도에 대한 타당화 연구

유은승,고영건,성기혜,권정혜 한국임상심리학회 2009 Korean Journal of Clinical Psychology Vol.28 No.1

The present study examined the reliability, validity and factor structure of a Korean version of the Dysfunctional Beliefs and Attitudes about Sleep-brief version (DBAS-16). The Korean version of the DBAS-16, ISI and the, SCL-90-R depression, anxiety and hostility subscale were administered too the313 undergraduate students and 213 adults in the general population. The results of factor analysis of the K-DBAS-16 revealed a 4-factor structure: “misattribution or amplification of the insomnia's causes and consequences”, “loss of control and worry about sleep”, “unrealistic sleep expectation”, and “attitude toward medication.” In addition, the results showed relatively high internal consistency, adequate test-retest reliability over a four-week period and, good convergent and discriminant validity of the K-DBAS-16. Finally,the implications and limitations of the present study and suggestions for the future research were discussed.

암환자 디스트레스(distress)의 선별, 평가 및 관리

박예슬,유은승 한국임상심리학회 2019 Korean Journal of Clinical Psychology Vol.38 No.2

Distress is an unpleasant emotional experience that may interfere with the ability to cope effectively with cancer. Distress can range from normal emotional responses, such as sadness and fear, to psychopathological states that damage psychosocial functioning, such as depression, anxiety, panic, social withdrawal, and existential crisis. It is reported that approximately 35– 45% of cancer patients experience clinically significant levels of distress, and the distress continues after treatment. Currently, about 1.74 million cancer patients and survivors live in Korea. Over the past 10 years, the survival rate has increased by 1.3 times and will most likely continue to increase. Although interest in cancer patients’ psychological difficulties and awareness of the need for psychological interventions are increasing, rarely is distress management provided by clinical psychologists in integrative cancer care systems. This comprehensive review aimed to explore 1) the concept of distress in cancer patients, 2) the basic model and principles of distress management, 3) available distress screening and assessment tools, and 4) current status of distress management and its clinical applications in Korea. Further, we discussed the roles of clinical psychologists and researchers in oncological settings in optimizing distress management in cancer patients.

암환자를 위한 정신약물요법의 개요

김종흔,유은승 대한신경정신의학회 2010 신경정신의학 Vol.49 No.1

Cancer patients experience various physical and psychological symptoms, which can be alleviated by psychotropic medications. In the process of developing the recommendations for distress management in cancer patients, the Korean psycho-oncology research group performed systematic reviews on the oncological psychopharmacotherapy literature. This study describes the general principles and some practical suggestions.

Prevalence of Psychological Symptoms in Patients Undergoing Pancreatoduodenectomy and Results of a Distress Management System: A Clinic-Based Study

강미주,유은승,강영화,박형민,박상재,김선회,김종흔,한성식 대한암학회 2022 Cancer Research and Treatment Vol.54 No.4

Purpose Patients undergoing pancreatoduodenectomy are a high-risk group that requires psychosocial support. This study retrospectively reviewed the prevalence of psychological symptoms in patients undergoing pancreatoduodenectomy for periampullary neoplasm and the psychosocial referral rate after implementing full screening and triage algorithm for administering a distress management protocol based on the integrated supportive care system established in 2010. Materials and Methods From September 2010 to December 2018, insomnia, anxiety, and depression were screened on the first day of admission (T1) and on the 10th postoperative day (T2). Patients with clinical levels of distress were referred to a mental health clinic for appropriate aftercare. Results The adherence rate to routine screening was 82.7% (364/440). Among the 364 patients, the prevalence of insomnia, anxiety, and depression increased from 22.0% (T1) to 32.6% (T2, p=0.001), 29.1% to 33.6% (p=0.256), and 18.4% to 27.6% (p=0.001), respectively. Less than 45% of those with psychological symptoms expressed their needs for psychological supportive care. Among those with psychological symptoms at T2, clinical insomnia, anxiety, and depression were detected via in-depth evaluations among 77.2%, 38.1%, and 82.5% of patients, respectively. Patients who had two or more symptoms at T2 had a longer postoperative hospital stay, as compared to those with one or no symptoms (a median of 20.5 days vs. 18.0 days, p=0.006). Psychiatric consultation rate was 72.8% among patients with clinical psychological symptoms, and 74% of the consulted patients completed psychiatric intervention before discharge. Conclusion Over one-third of the patients had psychological symptoms before and after pancreatoduodenectomy. Implementing a routine psychological symptoms screening with a systematic psychiatric referral protocol enhanced surgeons’ responsiveness to patients’ psychological symptoms. PurposePatients undergoing pancreatoduodenectomy are a high-risk group that requires psychosocial support. This study retrospectively reviewed the prevalence of psychological symptoms in patients undergoing pancreatoduodenectomy for periampullary neoplasm and the psychosocial referral rate after implementing full screening and triage algorithm for administering a distress management protocol based on the integrated supportive care system established in 2010.Materials and MethodsFrom September 2010 to December 2018, insomnia, anxiety, and depression were screened on the first day of admission (T1) and on the 10th postoperative day (T2). Patients with clinical levels of distress were referred to a mental health clinic for appropriate aftercare. ResultsThe adherence rate to routine screening was 82.7% (364/440). Among the 364 patients, the prevalence of insomnia, anxiety, and depression increased from 22.0% (T1) to 32.6% (T2, p=0.001), 29.1% to 33.6% (p=0.256), and 18.4% to 27.6% (p=0.001), respectively. Less than 45% of those with psychological symptoms expressed their needs for psychological supportive care. Among those with psychological symptoms at T2, clinical insomnia, anxiety, and depression were detected via in-depth evaluations among 77.2%, 38.1%, and 82.5% of patients, respectively. Patients who had two or more symptoms at T2 had a longer postoperative hospital stay, as compared to those with one or no symptoms (a median of 20.5 days vs. 18.0 days, p=0.006). Psychiatric consultation rate was 72.8% among patients with clinical psychological symptoms, and 74% of the consulted patients completed psychiatric intervention before discharge.ConclusionOver one-third of the patients had psychological symptoms before and after pancreatoduodenectomy. Implementing a routine psychological symptoms screening with a systematic psychiatric referral protocol enhanced surgeons’ responsiveness to patients’ psychological symptoms.

Cancer Survivors and Returning to Work Perspectives from Occupational Health Physicians in Korea

심혜영,이충원,유은승,박보영,양은주 대한의학회 2019 Journal of Korean medical science Vol.34 No.11

Background: This study was conducted from an occupational health perspective to document cancer survivors' ability to return to work, the role of clinical care, and the current status of effective return-to-work. Methods: This cross-sectional study was conducted to evaluate the experiences and opinions of occupational health physicians (OHPs) regarding cancer survivors' return-to-work. A self-reported survey was conducted from December 30, 2015, to January 30, 2016, targeting 337 OHPs. Questions included: 1) treatment experiences of survivors in the words of OHPs, 2) current status of the assessments of fitness for work of cancer survivors, 3) experiences associated with workplace and treatment, and 4) problems of returning to work and overcoming system. Results: Only 25% of the respondents said that they had experience treating cancer survivors, and the average number of patients was 12.6 per annum, which indicated that few cancer survivors were treated. Eleven cases included conducting assessment of fitness for work. There were 17 respondents who did not treat cancer survivors. Both those who had and did not have experience in treating survivors showed higher musculoskeletal system disorders (53.8 vs. 63.5) than cancer (15.5 vs. 11.2) in terms of frequency of the diseases in the assessment of fitness for work. Most respondents said that OHPs evaluate the current role appropriately and preferred OHPs in the future. They responded that OHPs found it difficult to treat cancer survivors, and it was psychologically tough to communicate with them (61.4%). Regarding the association of patient rehabilitation with workplaces, 48.9% said that workplaces provide inadequate support. Conclusion: As a preliminary study, we found that OHPs were found to have little experience in treating cancer survivors and undergo difficulties owing to poor collaboration with workplaces and communication with patients. This study will provide basic data for future studies to promote cancer survivors' return to workplaces.

암환자 우울증의 약물중재

김정현,함봉진,유은승 대한신경정신의학회 2010 신경정신의학 Vol.49 No.1

Objectives: A significant number of cancer patients experience depressive disorders. Numerous studies have demonstrated that depression in such patients is under-diagnosed and inadequately treated, due to various factors. One of these factors is a lack of an evidence supporting the use of antidepressants in cancer patients. The aim of this systematic review was to establish the evidence for the pharmacological treatment of depression in this population. Methods: We searched Korean domestic and international database using the keywords“cancer”,“depression”, and“pharmacological treatment”, limiting the search to articles published between 1980 and 2008 and grading the reviewed studies’ quality according to Scottish Intercollegiate Guideline Network (SIGN) methodology. Results: Of 283 studies searched, 28 studies were appropriate for review. Conclusion: The evidence for the pharmacological treatment of depression as limited. However, based on available literature, it seems the newer antidepressants are better tolerated and can be continued safely, with satisfactory efficacy, in cancer patients. Further well-designed, long-term follow-up studies should be conducted.

유방암 환자의 화병과 우울증상의 관계

하은혜,이선희,유은승,김종흔,강한성,노정실,이근석 한국여성심리학회 2011 한국심리학회지 여성 Vol.16 No.1

The purpose of this study was to clarify the common factors and differences between Hwa-Byung and depressive disorder in women with breast cancer on the basis of having the type C personality in cancer patients. The 256 breast cancer patients were recruited and they were assessed on Hwa-Byung Scale, CES-D, psychosocial variables, cancer related variables, cancer related somatic symptoms and quality of life. As a result, 16.8% were classified as Hwa-Byung and 13.7% were classified as depressive disorder. Hwa-Byung symptom scale, Hwa-Byung personality scale and total score of Hwa-Byung showed significantly positive correlations. It showed no differences all kind of sociodemographic variables and cancer related factors among Hwa-Byung, depressive disorder, and comorbid group. Also there were no significant differences of psychosocial variables, cancer related variables, cancer related somatic symptoms and quality of life among three groups. The only exception was that Hwa-Byung group showed higher active coping behaviors than depressive disorder group. So it can be concluded that there were no critical variables to discriminate between Hwa-Byung and depressive disorder in breast cancer patients. Finally it was discussed the implications for the identification and psychosocial intervention of Hwa-Byung in breast cancer patients.

아동 및 청소년 암환자와 일반 아동 및 청소년의 혐오민감도와 통증-공포 연합강도 간 상관 비교

민해원,고영건,유은승,박병규,박현진,김종흔 한국건강심리학회 2013 한국심리학회지 건강 Vol.18 No.4

The purpose of present study is to compare the correlations between the disgust sensitivity and pain-disgust association in children and adolescent patients with cancer (n=36) against non-patient children and adolescents (n=27). The participants are being administered with questionnaires of depression, anxiety, fear, and disgust sensitivity, and the Implicit Association Test (IAT) subsequently. The IAT was designed to identify which pair between fear-positivity, disgust-positivity, and fear-disgust has the strongest association with pain. The results of self-report measures indicated no differences between the cancer patient group and the non-patient group. However, the cancer patient group exhibited the result that the higher the level of disgust sensitivity, the stronger the association of pain with fear. The non-patient children and adolescents did not display a significant correlation between disgust sensitivity and pain-fear association. Based on such results, implications for cancer treatments were discussed. 본 연구의 목적은 아동 및 청소년 암환자와 일반 아동 및 청소년의 혐오민감도와 통증-공포 연합강도 간 상관을 비교하는 것이다. 이를 위해 아동 및 청소년 암환자 집단(n=36)과 일반 아동 및 청소년 집단(n=27)을 대상으로 우울, 불안, 공포, 및 혐오민감도를 조사한 후 암묵적 연합 검사(Implicit Association Test, IAT)를 실시하였다. IAT 검사는 통증이 각각 공포와 긍정, 혐오와 긍정, 공포와 혐오 쌍 중에 어느 쪽에 더 강하게 연합되어 있는지 알아보는 내용으로 설계되었다. 연구 결과 자기보고식 설문지 상에서는 암환자 집단과 통제집단 간에 유의한 차이가 나타나지 않았다. 하지만 아동 및 청소년 암환자들은 혐오민감도가 높을수록 통증을 공포와 더 강하게 연합하는 것으로 나타났다. 반면에 일반 아동 및 청소년들은 혐오민감도와 통증-공포 연합강도 간 유의한 상관을 보이지 않았다. 이러한 결과를 바탕으로 암환자 치료 과정에서의 시사점이 논의되었다.

불면증과 공격성의 관계에서정서조절방략의 조절효과

이현석,박예슬,유은승 한국건강심리학회 2018 한국심리학회지 건강 Vol.23 No.4

The aim of this study was to determine the moderation effects of emotion regulation strategies in the relationship between insomnia and aggression. The study employed a total of 387 participants. They were asked to complete the Korean version of the Insomnia Severity Index (ISI-K), the Emotion Regulation Strategy Questionnaire (ERSQ), and the hostility subscale of Symptom Checklist-90-Revised (SCL-90-R). Using correlation and regression analyses, the moderation effect of emotion regulation strategies in the relationship between insomnia and aggression were tested. The result of the study showed that there was significant moderation effect of maladaptive emotion regulation strategies in the relationship between insomnia and aggression. It was also observed that the relationship between insomnia and aggression was insignificant for those who employed less maladaptive emotion regulation strategies; however, for those who used maladaptive emotion regulation strategies frequently, the more severe the insomnia score, the more chance of increased aggression. Among cognitive, experiential, and behavioral emotion regulation strategies, the relationship between insomnia and aggression was moderated by maladaptive cognitive and experiential emotion regulation strategies. In conclusion, it was established that maladaptive emotion regulation strategies may be a risk factor in the relationship between insomnia and aggression. However, adaptive emotion regulation strategies may not serve as a protective factor. 본 연구는 불면증과 공격성의 관련성을 살펴보고 이들 간의 관계에서 적응적·부적응적 정서조절방략의 조절효과가 나타나는지 알아보고자 하였다. 이를 위해 대학생 387명을 대상으로 불면증 심각도 척도, 정서조절방략 질문지, 간이정신진단검사 중 적대감 소척도를 실시하였다. 상관분석과 회귀분석을 통해 불면증과 공격성의 관계에서 정서조절방략의 조절효과를 확인하였다. 연구 결과 불면증과 공격성의 관계에서 부적응적 정서조절방략의 조절 효과가 유의미한 것으로 나타났다. 즉 부적응적 정서조절방략을 적게 사용하는 사람들은 불면증과 공격성이 관련이 없었으나 부적응적인 정서조절 방략을 많이 사용하는 사람들은 불면증상이 심할수록 공격성이 높아질 가능성이 높았다. 정서조절방략을 인지적, 체험적, 행동적 방략으로 구분했을 때 부적응적인 인지적 방략과 부적응적인 체험적 방략이 불면증과 공격성의 관계를 조절하는 것으로 나타났다. 본 연구의 결과는 부적응적인 정서조절방략은 불면증과 공격성의 관계에서 위험요인으로 작용하며 적응적 정서조절방략은 보호요인으로서 효과가 미미하다는 것을 확인했다는 점에서 의의가 있다.