Objectives: ：This study aimed to examine the mediating effect of sleep quality and interpretation bias for ambiguity in the relationship between hopelessness and suicidal ideation in psychiatric patients. Methods: ：A total of 231 psychiatric outpatients and inpatients completed the Beck Hopelessness Scale, Pittsburgh Sleep Quality Index, Ambiguous/Unambiguous Situations Diary-Extended Version, and Ultra-Short Suicidal Ideation Scale. Data analysis was conducted using regression analyses and bootstrap sampling. Results: ：The results of this study showed that hopelessness had a direct effect on suicidal ideation, and that sleep quality and interpretation bias for ambiguity mediated the association between hopelessness and suicidal ideation. Moreover, there was a significant double mediating effect of sleep quality and interpretation bias for am-biguity on the relationship between hopelessness and suicidal ideation. Conclusions ：These results suggest that it is important to consider both sleep quality and interpretation bias for ambiguity to prevent hopelessness from leading to suicidal idea. These results suggest that considering both sleep quality and interpretation bias for ambiguity may be important in preventing hopelessness from leading to suicidal ideation.

The Illness Intrusiveness Rating Scale (IIRS) measures illness-induced disruptions to 13 domains of lifestyles, activities, and interests. A stable three-factor structure has been well documented; however, the cross-cultural validity of this scale needs to be tested. This study investigated the factor structure of the Korean version of IIRS in 712 outpatients at a university medical center. A predominant diagnosis of the patients was rheumatoid arthritis (47%). The Center for Epidemiological Studies-Depression Scale (CES-D), and Health Assessment Questionnaire (HAQ) were also administered. Exploratory Principal Component Analysis identified a two-factor structure, "Relationships and Personal Development (RPD)" and "Instrumen-tal", accounting for 57% of the variance. Confirmatory analyses extracted an identical factor structure. However, a goodness-of-the fit test failed to support two-factor solution (X2 =138.2, df=43, p<.001). Two factors had high internal consistency (RPD, alpha=.89; Instrumental, alpha=.75) and significantly correlated with scores of HAQ (RPD, r=.53, p<.001; Instrumental, .r=44, p<.001) and CES-D (RPD, .r=55, p<.001; Instrumental, .r=43, p<.001). These findings supported construct validity of the Korean version of IIRS, but did not support cross-cultural equivalence of the factor structure.
Adult ; Aged ; Asian Continental Ancestry Group ; *Cross-Cultural Comparison ; Factor Analysis, Statistical ; Female ; Humans ; Male ; Middle Aged ; Reproducibility of Results ; *Sickness Impact Profile

OBJECTIVE: The goal of the present study was to evaluate demographic and clinical factors that affect the intention to participate in commonly-conducted research in patients with schizophrenia. METHODS: Thirty-four outpatients with a diagnosis of schizophrenia were enrolled in this study. They were asked whether they would have any intention to participate in four imaginary studies: a simple questionnaire, a genetic study, a study of complex tasks and a risky study. We analyzed the differences in general psychopathology, insight and demographic characteristics of the participants according to their responses (acceptance or refusal) to the four proposed studies. RESULTS: Younger and better-educated patients tended to decline participation in a risky study. Patients with a longer duration of regular psychiatric follow-ups tended to willingly participate in the simple questionnaire. There were no overall statistical differences in general psychopathology and insight between patients who agreed or declined to participate in studies. CONCLUSION: Age and education level may be factors that influence decisions to participate in schizophrenia studies. Further research is needed to confirm and expand on the current findings.
Demography ; Follow-Up Studies ; Humans ; Informed Consent ; Intention ; Outpatients ; Patient Participation ; Pilot Projects ; Psychopathology ; Surveys and Questionnaires ; Research Subjects ; Schizophrenia

OBJECTIVES: This study investigated the psychosocial factors and clinical symptoms related to the duration of untreated psychosis (DUP) in 35 consecutive first-episode inpatients with schizophrenia. METHODS: Data from 35 schizophrenic patients were obtained from two general psychiatric inpatient units at a university medical center. These data included scores from Index of Social Position (ISP), Positive and Negative Syndrome Scale (PANSS) and Symptom Checklist-90-Revised (SCL-90-R) as well as socio-demographic informations. RESULTS: Among socio-demographic variables, lower social position (r=.610, p<.001), male sex (r=.407, p=.015), and grew up in rural area (r=.335, p=.045) were significantly correlated with DUP. The interpersonal sensitivity of SCL-90-R was the only symptomatic variable significantly correlated with DUP (r=.379, p=.027). However, after controlling interactive effects of the variables, only lower social position and interpersonal sensitivity remained significant. Lower social position was more influential on DUP than interpersonal sensitivity in the multiple regression model. CONCLUSION: Both social and symptomatic factors independently influenced DUP in schizophrenic patients. Lower social position defined by education and occupation of patients or caretakers may reflect barriers to psychiatric services or poor identification of mental illness. This together with patients' subjective distress in interpersonal interactions may delay the intervention of psychiatric services.
Academic Medical Centers ; Education ; Humans ; Inpatients ; Male ; Occupations ; Psychology ; Psychotic Disorders* ; Schizophrenia*

The print media is still one of major sources for health-related information. To shed light on how the media accurately delivers information for post-traumatic stress disorder (PTSD), we searched the newspaper articles and analyzed their contents for accuracy in the description of symptoms, causes, and treatment of PTSD. The articles featuring PSTD were searched from the very first available to 2010 at on-line search systems of three major Korean newspapers. A total of 123 articles appeared and the first article appeared in 1984. The number of articles steadily increased till the early 2000s but we found the robust increase in the late 2000s. Among the mentioned symptoms of PTSD: re-experience (39%) was most common, followed by avoidance or numbing (28%) and hyperarousal (22%). Of the 29 articles mentioning treatment of PTSD, 13 mentioned psychotherapy only and 11 mentioned both psychotherapy and medication equally. However, the psychotherapies mentioned were non-specific and only five articles mentioned any empirically supported therapies. The number of articles on PTSD in Korean newspapers has continually increased during the last three decades. However, the quality of information on the treatment of PTSD was questionable.
Health Knowledge, Attitudes, Practice ; Humans ; *Information Dissemination ; Newspapers/*statistics & numerical data ; Republic of Korea/epidemiology ; Stress Disorders, Post-Traumatic/*epidemiology

OBJECTIVE: Research suggests that the contents of delusions in schizophrenia are influenced by culture and social environment. However, few studies have investigated the chronological change of such delusions within a society. To investigate specifically the changes in the persecutory delusions of schizophrenia that have occurred over time, we compared the nature of the persecutors and their persecutory behaviors among inpatients with schizophrenia. METHODS: All admissions to the psychiatric unit of Hanyang University Guri Hospital with discharge diagnoses of schizophrenia during two different five-year time frames (1996-2000 and 2006-2010) were reviewed. From their inpatient medical records, we investigated the descriptions of persecutors and their persecutory behaviors in the delusions of 124 patients (54 in the1990s and 72 in the 2000s). RESULTS: Overall, persecutory behaviors and nature of persecutors in the delusions of schizophrenia did not differ between the two time frames. However, subgroup analysis revealed that in women but not in men, rejection as a persecutory behavior was significantly higher in the 1990s (p<0.05). CONCLUSION: The ten-year time interval may be too short to find significant changes in delusional content in general. However, our additional finding in women may be a result of the tremendous change in status of Korean women during the last decade.
Delusions ; Ethnopsychology ; Female ; Humans ; Inpatients ; Male ; Medical Records ; Rejection (Psychology) ; Schizophrenia ; Social Environment

While cognitive behavior therapy is considered to be the first-line therapy for adolescent depression, there are limited data on whether other psychotherapeutic techniques are also effective in treating adolescents with depression. This report suggests the potential application of eye movement desensitization and reprocessing (EMDR) for treatment of depressive disorder related, not to trauma, but to stressful life events. At present, EMDR has only been empirically validated for only trauma-related disorders such as posttraumatic stress disorder. Two teenagers with major depressive disorder (MDD) underwent three and seven sessions of EMDR aimed at memories of stressful life events. After treatment, their depressive symptoms decreased to the level of full remission, and the therapeutic gains were maintained after two and three months of follow up. The effectiveness of EMDR for depression is explained by the model of adaptive information processing. Given the powerful effects observed within a brief period of time, the authors suggest that further investigation of EMDR for depressive disorders is warranted.
Adolescent* ; Automatic Data Processing ; Cognitive Therapy ; Depression* ; Depressive Disorder ; Depressive Disorder, Major ; Eye Movement Desensitization Reprocessing ; Eye Movements* ; Follow-Up Studies ; Humans ; Psychotherapy ; Stress Disorders, Post-Traumatic

OBJECTIVE: The Childhood Trauma Questionnaire (CTQ) is perhaps the most widely used and well-studied retrospective measure of childhood abuse or neglect. This study tested the initial reliability and validity of a Korean translation of the Childhood Trauma Questionnaire (CTQ-K) among non-psychotic psychiatric outpatients. METHODS: The CTQ-K was administered to a total of 163 non-psychotic psychiatric outpatients at a university-affiliated training hospital. Internal consistency, four-week test-retest reliability, and validity were calculated. A portion of the participants (n=65) also completed the Trauma Assessment Questionnaire (TAQ), the Impact of Events Scale-Revised, and the Dissociative Experiences Scale-Taxon. RESULTS: Four-week test-retest reliability was high (r=0.87) and internal consistency was good (Cronbach's alpha=0.88). Each type of childhood trauma was significantly correlated with the corresponding subscale of the TAQ, thus confirming its concurrent validity. In addition, the CTQ-K total score was positively related to post-traumatic symptoms and pathological dissociation, demonstrating the convergent validity of the scale. The CTQ-K was also negatively correlated with the competence and safety subscale of the TAQ, confirming discriminant validity. Additionally, we confirmed the factorial validity by identifying a five-factor structure that explained 64% of the total variance. CONCLUSION: Our study indicates that the CTQ-K is a measure of psychometric soundness that can be used to assess childhood abuse or neglect in Korean patients. It also supports the cross-cultural equivalence of the scale.
Child ; Child Abuse ; Dissociative Disorders ; Humans ; Mental Competency ; Outpatients ; Psychometrics ; Surveys and Questionnaires ; Reproducibility of Results ; Retrospective Studies

OBJECTIVES: This study sought to determine ethnic difference in physical violence and to see if ethnicity is an independent predictor of violence by surveying eight Korean or Han ethnic elementary schools in Yanji city, China. A total of 2,316 school children from fourth through sixth grade participated the study. METHODS: Participants completed a questionnaire on sociodemographic background and experiences of physical violence during the previous year using the Conflict Tactics Scale. The history of physical violence was categorized as within the family, by peers, or by teachers. RESULTS: Han children reported significantly higher rates of physical abuse compared with Koreans (76.2% vs. 54.9%, chi2=116.12, df=1, p=<.001). Binary logistic regression analysis identified five risk factors for physical violence:(1) ethnic Han (odds ratio [OR]=3.01, 95% confidence interval [CI]=2.47-3.66), (2) boys (OR=2.76, 95% CI=2.28-3.36), (3) poor economic status (OR=1.69, 95% CI=1.17-2.42), (4) single or absent parents (OR=1.42, 95% CI=1.09-1.86), (5) interaction of fourth-graders with promotive or neutral opinions of corporal punishment (OR=2.41, 95% CI=1.86-3.13). Ethnicity remained an independent risk factor after other sociodemographic variables were controlled. CONCLUSION: These findings showed cross-cultural risk factors of child physical abuse, including ethnicity which previously identified as a factor in literature. This study particularly reports lower prevalence of physical violence in ethnic minority, Korean-Chinese, compared with the Han ethnic group. This result explained a special environment of Korean self-government district and the successful adaptation of the ethnic minority to the mainstream culture.
Asian Continental Ancestry Group* ; Child ; Child Abuse ; China ; Ethnic Groups ; Humans ; Logistic Models ; Parents ; Prevalence* ; Punishment ; Surveys and Questionnaires ; Risk Factors ; Violence*

OBJECTIVES: Effects of multiple trauma are complex and extend beyond core PTSD symptoms. However, few psychological instruments for trauma assessment address this issue of symptom complexity. The Trauma Symptom Checklist-40 (TSC-40) is a self-report scale that assesses wide range of symptoms associated with childhood or adult traumatic experience. The purpose of the present study was to evaluate the validity of the Korean Version of the TSC-40 in a sample of psychiatric outpatients. METHODS: Data of 367 treatment-seeking patients with DSM-IV diagnoses were obtained from an outpatient department of psychiatric unit at a university hospital. The diagnoses were anxiety disorder, posttraumatic stress disorder, depressive disorder, adjustment disorder and others. Included in the psychometric data were the TSC-40, the Life events checklist, the Impact of Event Scale-Revised, the Zung's Self-report Depression Scale, and the Zung's Self-report Anxiety Scale. Cronbach's α for internal consistency were calculated. Convergent and concurrent validity was approached with correlation between the TSC-40 and other scales (PTSD, anxiety and depression). RESULTS: Exploratory factor analysis of the Korean Version of TSC-40 extracted seven-factor structure accounted for 59.55% of total variance that was contextually similar to a six-factor structure and five-factor structure of the original English version. The Korean Version of TSC-40 demonstrated a high level of internal consistency. (Cronbach's α=0.94) and good concurrent and convergent validity with another PTSD scale and anxiety and depression scales. CONCLUSIONS: Excellent construct validity of The Korean Version of TSC-40 was proved in this study. And subtle difference in the factor structure may reflect the cultural issues and the sample characteristics such as heterogeneous clinical population (including non-trauma related disorders) and outpatient status. Overall, this study TSCdemonstrated that the Korean version of TSC-40 is psychometrically sound and can be used for Korean clinical population.
Adjustment Disorders ; Adult ; Anxiety ; Anxiety Disorders ; Checklist ; Depression ; Depressive Disorder ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Multiple Trauma ; Outpatients ; Psychometrics ; Stress Disorders, Post-Traumatic ; Weights and Measures