Objective: The Emotion Regulation Questionnaire (ERQ) is one of the widely used instruments to assess emotion regulation skills in many countries, including Korea. However, its psychometric properties have not been validated within this population. Also, the ERQ has increasingly been used in studies with psychiatric patients despite a general lack of validation in clinical settings. Therefore, the present study aimed to investigate the psychometric properties of the Korean version of the ERQ (K-ERQ) using a clinical sample in Korea. Methods: One hundred and ninety-three psychiatric patients completed a packet of self-report measures, including K-ERQ, K-BDI-II, K-ASI-3, PCL-5-K, AUDIT-K. Confirmatory factor analysis (CFA) was administered to investigate the factor structure of the K-ERQ, and internal reliability and validity were examined. Results: Results of the CFA supported the two-factor structure, but only after the removal of one item. The K-ERQ showed good internal consistency reliability, and its concurrent validity was also confirmed. Cognitive reappraisal was negatively correlated with depression and alcohol use disorder-related symptoms, and expressive suppression was positively correlated with depression, anxiety sensitivity, posttraumatic stress disorder (PTSD)-related symptoms and alcohol use disorder-related symptoms. Significant group differences were found in the use of emotion regulation strategies; patients with PTSD reported the higher level of cognitive reappraisal than patients with depressive disorders, bipolar disorders, and attention-deficit hyperactivity disorder. Conclusion The 9-itemed K-ERQ is a reliable and valid tool to assess the emotion regulation strategies in a Korean clinical sample. Our study also adds preliminary evidence on the usefulness of the ERQ in clinical settings.

Background: This study aimed to empirically derive and validate subtypes of nonsuicidal selfinjury (NSSI) based on the forms of self-harm behavior. Methods: Sixty young adults who exhibited repetitive NSSI completed a clinical interview and baseline measures, followed by a two-week ecological momentary assessment (EMA).A latent class analysis was administered to identify NSSI subtypes based on the forms of self-harm behavior. The subtypes were then compared to baseline clinical and EMA variables, including emotions and urges to self-harm. Results: The best-fitting model supported two subtypes: 1) substance abuse and suicide attempt subtype and 2) cutting and scratching subtype. The substance abuse and suicide attempt subtype reported a higher rate of engaging in lifetime suicide plans and suicide attempts and a higher number of lifetime suicide attempts. They also showed significantly higher severity of self-harm behavior, borderline personality traits, anger, posttraumatic symptoms, and difficulties in emotion regulation when compared to the cutting and scratching subtype. However, there was no inter-subtype difference in self-esteem. In the EMA data, anger toward others, feeling of rejection, loneliness, and helplessness were significantly high in the substance abuse and suicide attempt subtype. The variability of anger toward others was also higher in this subtype compared to the cutting and scratching subtype. Finally, in the two-week research period, the substance abuse and suicide attempt group showed a higher rate of reported urges to self-harm with or without suicidal intent. Conclusion Findings support the validity of the subtypes based on the forms of self-harm behavior, suggesting the clinical utility of addressing heterogeneity within individuals exhibiting self-harm for assessment and treatment.

BACKGROUND: Telomerase, a ribonucleoprotein enzyme capable of synthesizing telomeric repeats, attracts attention for its possible role in determining the replicative capacity of normal somatic cells, transformed cells, and cells of the germline lineage. Differently from normal somatic cells with no telomerase activity, normal lymphocytes has been reported to have telomerase activity comparable to that found in transformed cells during development and activation, which substantiate a role in supporting the capacity of lymphocytes for extensive clonal expansion. METHODS: Here, in order to define the telomerase regulation in murine T lymphocytes, telomerase activity in cloned murine CD8+ T cells and naive CD8+ T cells isolated from C57BL/6 mice was examined. Next, the regulatory mechanism of telomerase activity at transcriptional and post- translational levels was investigated by determining the expression level of the TERT protein, a key component for telomerase activity. RESULTS: It was demonstrated that telomerase activity was expressed in an inactivated state as well as in an activated state in the murine CD8+ T lymphocytes by using TRAP assay. The increase of telomerase activity was partially dependent on the net increase of TERT expression. Also, telomerase activity was decreased after treatment with protein kinase inhibitors, indicating that telomerase activation was prevented by inhibition of phosphorylation. CONCLUSION: Therefore, these results suggest that telomerase activity is constitutively expressed in the murine resting T lymphocytes and controlled by both transcriptional regulation and post-translational modifications.
Animals ; Clone Cells ; Lymphocytes ; Mice ; Phosphorylation ; Protein Kinase Inhibitors ; Protein Processing, Post-Translational ; Ribonucleoproteins ; T-Lymphocytes* ; Telomerase*

Purpose: The prevalence rate of non-suicidal self-injury (NSSI) in the clinical population is higher than that in the community sample, necessitating the need to investigate the predicting factors of NSSI in this group. The present study aimed to develop a prediction model of NSSI among psychiatric patients in Korea. Materials and Methods: Decision tree analysis was conducted on a sample of 224 psychiatric patients. Emotion regulation strategies (rumination, cognitive reappraisal, and expressive suppression), impulsivity, problematic alcohol use, working memory, depressive mood, and gender were included in the model as predictors of NSSI. Results: Results indicated that rumination, problematic alcohol use, and working memory predicted lifetime NSSI engagement among psychiatric patients. The best predictor of lifetime NSSI engagement was rumination. Specifically, when the level of rumination was high, the level of working memory was lower, and the risk of NSSI was higher. In the case of low levels of rumination, the higher the level of problematic alcohol use, the higher the risk of NSSI. The highest prevalence of lifetime NSSI engagement was found in a subgroup of patients with high levels of rumination and low levels of working memory. Conclusion The major contribution of this study is finding a combination of factors to predict the high-risk group of NSSI among psychiatric patients in Korea. This study provides evidence on the effect of rumination, working memory, and problematic alcohol use on NSSI. It is suggested that clinicians and researchers should pay more attention to emotion regulation and related vulnerabilities in preventing and treating NSSI.

Objective: Limited data exist on non-suicidal self-injury (NSSI) and suicide attempts among psychiatric patients in Korea. In this study,we investigated the clinical characteristics of patients who engaged in NSSI and/or suicide attempts. Methods: We performed a retrospective medical chart review of patients with NSSI and/or suicide attempts at the psychiatric departmentof a university medical center in Seoul between 2017 and 2019. According to their history, patients were allocated to one of threegroups: NSSI only, suicide attempts only and NSSI and suicide attempts group. Groups were compared based on sociodemographic characteristicsand psychological assessments. Results: Overall, 80 patients with NSSI and/or suicide attempts were evaluated. Patients with NSSI and suicide attempts were more likelyto be female than the other two groups. Patients with NSSI and suicide attempts were more likely to suffer from Cluster B personality disorderthan the other groups. And patients with NSSI and suicide attempts scored significantly higher on novelty-seeking in TCI and RC8,RC9 in MMPI-2. Conclusion Patients with NSSI and/or suicide attempts were more likely to be female, younger, and showed higher levels of psychologicaldisturbances. These findings highlight the importance of early detection and intervention for patients with NSSI.Psychiatry Investig 2020;17(4):320-330

OBJECTIVE: This study aimed to analyze the expression pattern of glycogen synthase kinase 3β (GSK3β) and its phosphorylated forms, GSK3β phosphorylated at Ser9 (pS9GSK3β), and GSK3β phosphorylated at Tyr216 (pY216GSK3β), in cervical squamous cell carcinoma (SCC) and adenocarcinoma (AC). METHODS: We performed immunohistochemical staining for GSK3β, pS9GSK3β, and pY216GSK3β in 64 SCC and 20 AC cases and compared their expression patterns between the 2 tumor types. RESULTS: Increased GSK3β and pS9GSK3β expression but decreased pY216GSK3β expression compared with that in the normal cervix were observed in both SCC and AC specimens. Specifically, the levels of GSK3β and pS9GSK3β were significantly increased in SCC and AC, respectively. GSK3β was localized in the nucleus and/or cytoplasm of SCC and AC cells. However, pS9GSK3β was predominantly localized in the membrane of AC cells, whereas it was present in the nucleus and/or cytoplasm of SCC cells. CONCLUSION: The results suggest that the phosphorylation status of GSK3β changes during cervical cancer development and the different expression levels and patterns of GSK3β and pS9GSK3β are associated with the specific histologic phenotype of cervical cancer.
Adenocarcinoma ; Carcinoma, Squamous Cell ; Cervix Uteri ; Cytoplasm ; Epithelial Cells ; Female ; Glycogen Synthase Kinases ; Membranes ; Phenotype ; Phosphorylation ; Uterine Cervical Neoplasms

Purpose: The purpose of this study was to examine the acceptability, availability and sustainability of a pilot prenatal program developed by an interdisciplinary team. Methods: Out of 19 multicultural women participated in the 6-session prenatal program, 6 women took part in an exit- focus group interview as a part of formative evaluation. The verbatim transcriptions of semi-structured interview data were analyzed using conventional content analysis. Results: In general, the participants expressed high satisfaction with program content, educators and education methods. A hybrid model including health professionals and community health workers and using online and offline education modes was suggested as a way to disseminate the program at a national level. Interventions using aesthetic approaches such as music and an integrated method such as the introduction of available social services in pregnancy and during the postpartum period may play a role as the facilitator of the program participation of multicultural women. These approaches may also help them develop healthy coping skills, problem solving skills and empowerment in multicultural childbearing women who need to adjust to life in a new country simultaneously taking a new role as a mother. Conclusion An interdisciplinary prenatal program using a holistic approach contributes to enhancing multicultural women’s empowerment to become a mother in a new country.

Non-thrombotic pulmonary embolism (NTPE) is a rare but potentially fatal complication of filler injections. It can result not only from direct intravascular injection but also from the migration of fillers into veins due to local pressure. Here, we report the autopsy findings of two deaths resulting from NTPE following vaginal filler injections. The first case involved a 38-year-old woman who lost consciousness 20-40 minutes after receiving an injection of 15 mL of hyaluronic acid (HA) filler. A large amount of filler was observed in the vagina with gross embolization of the paravaginal vessels. Microscopic examination revealed HA embolism in the lungs. Despite treatment, the patient died 10 days after the procedure. The second case involved a 35-year-old woman who experienced desaturation and cardiac arrest 4 minutes after receiving a collagen filler and a hybrid filler consisting of HA and polylactic acid. An autopsy revealed NTPE and systemic embolism of the collagen filler. She died 1 month after treatment in the intensive care unit. The vagina poses a significant risk for filler injections owing to its rich venous plexus. Doctors should be fully aware of this risk, and a complete autopsy should be performed in such cases.