OBJECTIVES: Firefighters are prone to suffer from psychological trauma and post-traumatic stress disorder (PTSD) in the workplace, and have a poor prognosis after PTSD. Reliable models for predicting PTSD allow for effective identification and intervention for patients with early PTSD. By collecting the psychological traits, psychological states and work situations of firefighters, this study aims to develop a machine learning algorithm with the aim of effectively and accurately identifying the onset of PTSD in firefighters, as well as detecting some important predictors of PTSD onset. METHODS: This study conducted a cross-sectional survey through convenient sampling of firefighters from 20 fire brigades in Changsha, which were evenly distributed across 6 districts and Changsha County, with a total of 628 firefighters. We used the synthetic minority oversampling technique (SMOTE) to process data sets and used grid search to finish the parameter tuning. The predictive capability of several commonly used machine learning models was compared by 5-fold cross-validation and using the area under the receiver operating characteristic curve (ROC-AUC), accuracy, precision, recall, and F1 score. RESULTS: The random forest model achieved good performance in predicting PTSD with an average AUC score at 0.790. The mean accuracy of the model was 90.1%, with an F1 score of 0.945. The three most important predictors were perseverance, forced thinking, and reflective deep thinking, with weights of 0.165, 0.158, and 0.152, respectively. The next most important predictors were employment time, psychological power, and optimism. CONCLUSIONS PTSD onset prediction model for Changsha firefighters constructed by random forest has strong predictive ability, and both psychological characteristics and work situation can be used as predictors of PTSD onset risk for firefighters. In the next step of the study, validation using other large datasets is needed to ensure that the predictive models can be used in clinical setting.
Humans ; Stress Disorders, Post-Traumatic/diagnosis* ; Firefighters/psychology* ; Cross-Sectional Studies ; Algorithms ; Machine Learning

OBJECTIVES: The goals of the study are how to establish the cohort systems for the children and adolescents victims with sexual abuse in Korea and to identify the risk and protective factors that influence mental health in child sexual abuse (CSA). This is initial assessment data based on the analysis of cohort variables for baseline evaluation of subjects. METHODS: We constructed the cohort systems for CSA victims recruited by Seoul Sunflower Children Center, CSA victims protection center. The initial assessment data which consisted of demographic and psychological inventories of CSA victims and their parents/families, psychiatric diagnoses were the results of statistical analysis of 65 subjects under 19 years old for 3 years 7 months. RESULTS: The initial data were followings : female participants, N=56; mean age, 11.6 (SD=4.5); the most sexual assault, molestation 71.8%; victims, family and acquaintance 87.1%; 61.5% of the subjects diagnosed with psychiatric disorder; 29.2% diagnosed with PTSD and 23.1% diagnosed with depression. Mean duration for abuse to report is 1.5 years. Mean score of IES-R-K, TSCYC-avoidant and CBCL-problematic behavior were increased above clinical cut-off. CONCLUSIONS: CSA victims tend to have high risks in mental health problem. The cohort study could provide the risk and protective factors of CSA in mental health, and construct the predictive model for mental illness in Korea.
Adolescent ; Child Abuse, Sexual ; Child ; Cohort Studies ; Depression ; Diagnosis ; Equipment and Supplies ; Female ; Helianthus ; Humans ; Korea ; Mental Health ; Protective Factors ; Seoul ; Sex Offenses ; Stress Disorders, Post-Traumatic

PURPOSE: Childhood leukemia is a serious trauma affecting both adolescents and their parents, who experience painful process. However, adolescents with leukemia and their parents also experience positive changes, which is referred to as posttraumatic growth. We examined posttraumatic growth, core beliefs, impact of event, and event-related rumination in adolescents within 5 years of a diagnosis of childhood leukemia and their parents. METHODS: The participants were 68 adolescents with childhood leukemia (aged 13~18 years) and their parents, who were recruited from C university hospital in Korea from May to September 2016. The Posttraumatic Growth Inventory, Core Belief Inventory, Impact of Event Scale-Revised, and Event-related Rumination Inventory were completed by the adolescents and their parents. The mean scores and correlations between variables were investigated for both set of participants. RESULTS: Parents showed significantly higher levels of posttraumatic growth, disruption of core beliefs, impact of event, and invasive rumination than adolescents. Disruption of core beliefs and deliberate rumination were positively correlated with posttraumatic growth in both groups. CONCLUSION: Nursing intervention programs that involve modifying core beliefs and inducing a positive thought can help adolescents with leukemia and their parents grow after traumatic events.
Adolescent* ; Diagnosis ; Humans ; Korea ; Leukemia* ; Nursing ; Parents* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Stress Disorders, Post-Traumatic

PURPOSE: The purpose of this study was to investigate the degree of post-traumatic stress disorder (PTSD) symptoms and the effect of PTSD on quality of life (QoL) among coronary artery disease (CAD) patients.METHODS: The participants were 135 CAD patients who visited outpatient clinics in a university hospital in B city of Korea. Their PTSD symptoms and QoL were measured by structured questionnaires and analyzed with multiple hierarchical regression analysis.RESULTS: Among the 135 participants, 20.7% were classified as moderate risk, and 3.7% as high risk for PTSD. PTSD symptoms were significantly higher in participants who were diagnosed with CAD within 6 months (t=26.02, p < .001). The physical component of health-related QoL was influenced by gender (β=-.25, p=.003), recurrence of CAD (β=.21, p=.008), and PTSD symptoms (β=-.33, p < .001). The mental component of health-related QoL was influenced by religion (β=-.17, p=.044), body mass index (β=.17, p=.033), and PTSD symptoms (β=-.37, p < .001).CONCLUSION: Patients who had had a CAD diagnosis for less than 6 months were found to be vulnerable to PTSD, and PTSD was found to have a negative impact on the physical and mental components of their QoL. It is necessary to develop an intervention program for the effective prevention and management of PTSD symptoms in patients with CAD.
Ambulatory Care Facilities ; Body Mass Index ; Coronary Artery Disease ; Coronary Vessels ; Diagnosis ; Humans ; Korea ; Quality of Life ; Recurrence ; Stress Disorders, Post-Traumatic

BACKGROUND: For diagnosis of post-traumatic stress disorder (PTSD), the Clinician-Administered PTSD Scale (CAPS) is one of the most widely used structured diagnostic interviews. METHODS: In this study, we aimed to develop and validate the Korean version of CAPS for the Diagnostic and Statistical Manual of Mental Disorders, 5th edition ([DSM-5] K-CAPS-5). Seventy-one subjects with PTSD, 74 with mood disorder or anxiety disorder, and 99 as healthy controls were enrolled. The Korean version of the structured clinical interview for DSM-5-research version was used to assess the convergent validity of K-CAPS-5. BDI-II, BAI, IES-R, and STAI was used to evaluate the concurrent validity. RESULTS: All subjects completed various psychometric assessments including K-CAPS-5. K-CAPS-5 presented good internal consistency (Cronbach's α = 0.92) and test-retest reliability (r = 0.91). K-CAPS-5 showed strong correlations with the structured clinical interview for DSM-5 PTSD (k = 0.893). Among the three subject groups listed above there were significant differences in the K-CAPS-5 total score. The data were best explained by a six-factor model. CONCLUSION: These results demonstrated the good reliability and validity of K-CAPS-5 and its suitability for use as a simple but structured instrument for PTSD assessment.
Anxiety Disorders ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Mood Disorders ; Psychometrics ; Reproducibility of Results ; Stress Disorders, Post-Traumatic

BACKGROUND: Two hundred and fifty 11th grade students and teachers from Danwon High School drowned, during a school trip, in the Sewol Ferry Disaster. The goal of this study was to investigate the experiences of the psychiatrists who volunteered and provided psychiatric services to the students at Danwon High School. METHODS: From the second day to the 138th day after the disaster, pro bono psychiatrists provided post-disaster interventions to the 10th and 12th-grade Danwon High School students who did not attend the trip. Officially, 167 psychiatrists conducted outreach in approximately 550 encounters. The study questionnaires were distributed retrospectively to psychiatric volunteers who conducted outreach at Danwon High School. We surveyed the pro bono psychiatrists about their experiences, including the students' chief complaints, psychiatric problems, clinical diagnoses, and psychiatrists' treatment recommendations. RESULTS: We reached 72 (43.1%) of the 167 volunteers, and they reported on 212 (38.6%) of the 550 encounters. The common chief complaints were mental health problems, companion problems, and family problems. The most frequent psychiatric symptoms were anxiety (76.89%), depressive mood (51.42%), and concentration difficulty (50.94%). The most frequent clinical diagnoses of the students were normal reaction (41.04%), acute stress disorder (24.53%), adjustment disorder (17.92%), anxiety disorders (9.43%), and posttraumatic stress disorder (6.60%). More than half of the students needed “additional counseling/therapy” (41.04%) or “referral to psychiatric treatment” (14.15%). CONCLUSION: During the acute aftermath of the Sewol Ferry Disaster, volunteer psychiatrists were able to provide services. These services included psychiatric assessments, crisis counseling, psychological first aid, and referrals for ongoing care. More than half of the students were perceived to have a psychiatric diagnosis, and a substantial proportion of students needed further treatment. Future research should focus on the short- and long-term effects of psychiatric interventions and the characterization of post-disaster mental health needs and service provision patterns.
Adjustment Disorders ; Adolescent ; Anxiety ; Anxiety Disorders ; Counseling ; Diagnosis ; Disasters ; First Aid ; Friends ; Humans ; Mental Disorders ; Mental Health ; Psychiatry ; Referral and Consultation ; Retrospective Studies ; Stress Disorders, Post-Traumatic ; Stress Disorders, Traumatic, Acute ; Volunteers

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

OBJECTIVE: Subthreshold posttraumatic stress disorder (SPTSD), a condition that meets the full symptomatic criteria of posttraumatic stress disorder (PTSD) without subjective functional impairment, has yet to be fully investigated. In this study, we aimed to determine the prevalence and characteristics of SPTSD. METHODS: The web-based survey including psychiatric diagnosis and experience of human error was conducted in actively working train drivers in South Korea. RESULTS: Of the 4,634 subjects, 103 (2.23%) were categorized as full PTSD and 322 (6.96%) were categorized as having SPTSD. Individuals with full PTSD showed higher impulsivity and anxiety compared to those with SPTSD and those without PTSD, while those with SPTSD had more frequent clinically meaningful depression, posttraumatic stress, and alcohol and nicotine dependence and significant human error. CONCLUSION: Despite not qualifying as a subjective functional disability, SPTSD still had significant psychiatric symptoms. More clinical attentions need to be given to the diagnosis and treatment of SPTSD.
Anxiety ; Attention ; Depression ; Diagnosis ; Humans ; Impulsive Behavior ; Korea* ; Mental Disorders ; Prevalence ; Stress Disorders, Post-Traumatic* ; Tobacco Use Disorder

OBJECTIVE: Stroke is the second most common cause of death and the leading cause of adult disability. Both stroke patients and their family can therefore experience increased traumatic stress level. METHODS: The participants are close relatives of patients (n=65) who had a first time stroke (CRPWS) hospitalized. A control group (CG) (n=61), who had no history of chronic illness in their family and had at least one traumatic life event experience. The National Institutes of Health Stroke Scale, Modified Rankin Scale, Personal Information Form, Life Events Checklist, Traumatic Stress Symptom Scale, and Multidimensional Scale of Perceived Social Support, were used in the study. RESULTS: We found no significant association between NIHSS and MRS of patients and traumatic stress level of the family member. The traumatic stress level was significantly higher in the CRPWS group than in the CG group. Traumatic stress level was higher in women than men and was not associated with perceived social support in the CRPWS group. CONCLUSION: The traumatic stress level of the relatives was not associated with the clinical features of the stroke patients. In the early phase, after the diagnosis of stroke, psychological support may be important to prevent CRPWS from PTSD.
Adult ; Cause of Death ; Checklist ; Chronic Disease ; Compassion Fatigue ; Diagnosis ; Female ; Humans ; Male ; National Institutes of Health (U.S.) ; Stress Disorders, Post-Traumatic ; Stroke*

PURPOSE: Traumatic events and adverse stressful experiences are major etiological factors in a wide variety of physical and mental disorders. Developing psychological instruments that can be easily administered and that have good psychometric properties have become an integral part for research and practice. This study investigated the reliability and validity of the Korean version of the Lifetime Stressor Checklist-Revised (LSC-R) in a consecutive sample of psychiatric outpatients. The LSC-R is a 30-item self-reporting questionnaire examining lifetime traumatic and non-traumatic stressors. MATERIALS AND METHODS: A final sample of 258 outpatients with anxiety or depressive disorders was recruited at the psychiatric department of a university-affiliated teaching hospital. Self-reported data included the Life Events Checklist (LEC), the Zung Self-Rating Depression and Anxiety Scales, and the Impact of Events Scale-Revised, in addition to the LSC-R. A convenience sample of 50 college students completed the LSC-R on two occasions separated by a three week-interval for test-retest reliability. RESULTS: Mean kappa for temporal stability was high (κ=0.651) and Cronbach alpha was moderate (α=0.724). Convergent validity was excellent with corresponding items on the LEC. Concurrent validity was good for symptoms of post-traumatic stress disorder, depression, and anxiety. An exploratory factor analysis revealed that 11 factors explained 64.3 % of the total variance. CONCLUSION: This study demonstrated good psychometric properties of the Korean version of the LSC-R, further supporting its use in clinical research and practice with a Korean speaking population.
Adult ; Anxiety/*diagnosis/epidemiology ; *Checklist ; Depression/diagnosis/epidemiology ; Depressive Disorder/*diagnosis/epidemiology ; Factor Analysis, Statistical ; Female ; Humans ; Male ; Outpatients ; Psychiatric Status Rating Scales ; Psychometrics ; Reproducibility of Results ; Republic of Korea/epidemiology ; Stress Disorders, Post-Traumatic/*diagnosis/epidemiology ; *Surveys and Questionnaires