Understanding Key Predictors of Life Satisfaction in a Nationally Representative Sample of Koreans.

The purpose of this study was to examine the factors that predict life satisfaction in a large representative sample of Koreans by analyzing data from the Gallup World Poll. The primary objective was to identify important predictors and suggest strategies to improve quality of life in Korea. The study used available Korean data from 2006 to 2017, which included 14,101 participants (mean age = 46.42). Predictors included demographic and psychological variables, with the Cantril Ladder of Life Scale serving as the outcome variable. The results show a decline in life satisfaction with advancing age, and that the relationship between life satisfaction and age varied by gender. Among the predictors examined, satisfaction with the standard of living and household income emerged as the most influential factors in determining life evaluation; other strong predictors included positive affect and negative affect, social support, gender, and education level. These results imply that, to increase life satisfaction, it is imperative to provide job opportunities and social services specifically targeted to individuals in low-income groups. In addition, it is crucial to implement tailored psychosocial interventions that address the unique developmental tasks and psychological challenges experienced by individuals according to their gender and life cycle stage.

Post-traumatic stress symptoms in hemodialysis patients with MERS-CoV exposure.

BACKGROUND: Post-traumatic stress symptoms can occur in patients with medical illness. During the Middle East Respiratory Syndrome (MERS) outbreak in South Korea in 2015, some dialysis patients in three centers who were incidentally exposed to patients or medical staff with confirmed MERS-CoV infection were isolated to interrupt the spread of the infection. We aimed to investigate post-traumatic stress symptoms and risk factors among these patients. MATERIALS AND METHODS: In total, 116 hemodialysis (HD) patients in contact with MERS-CoV-confirmed subjects were isolated using three strategies, namely, single room isolation, cohort isolation, and self-quarantine. We used the Impact of Event Scale-Revised-Korean (IES-R-K) to examine post-traumatic stress symptoms at 12 months after the isolation period. RESULTS: Of the 116 HD patients, 27 were lost to follow-up. Of the 89 patients, 67 (75.3%) completed the questionnaires. Single room isolation was used on 40 (58.8%) of the patients, cohort isolation on 20 (29.4%), and self-imposed quarantine on 8 (11.8%). In total, 17.9% of participants (n = 12) reported post-traumatic stress symptoms exceeding the IES-R-K's cutoff point (≧18). Prevalence rates of IES-R-K ≧18 did not differ significantly according to isolation method. However, isolation duration was linearly associated with the IES-R-K score (standardized ß coefficient - 0.272, P = 0.026). Scores in Avoidance, Emotional numbing and Dissociation subscale were higher in patients with longer isolation period. CONCLUSION: MERS was a traumatic experience for quarantined HD patients. IES-R-K scores were not significantly different by isolation methods. However, short isolation was associated with post-traumatic stress symptoms.

Inevitable isolation and the change of stress markers in hemodialysis patients during the 2015 MERS-CoV outbreak in Korea.

During the outbreak of Middle East respiratory syndrome coronavirus(MERS-CoV) in 2015, one hemodialysis patient was infected with MERS-CoV, and the remaining hemodialysis(HD) patients (n = 83) and medical staff (n = 12) had to undergo dialysis treatment in an isolated environment. This study was performed to investigate the effects of stress caused by dialysis treatment under isolation. Plasma samples from the HD patients and medical staff were collected at the time of isolation(M0), the following month(M1), and three months after isolation(M3). Parameters for stress included circulating cell-free genomic DNA(ccf-gDNA), circulating cell-free mitochondria DNA(ccf-mtDNA), and pentraxin-3(PTX-3). Decreased values of Hct, kt/v and ca x p were recovered after the end of two weeks of isolation. The levels of ccf-gDNA and ccf-mtDNA were the highest at M0 and decreased gradually in both HD patients and the medical staff. The normalization of ccf-gDNA and ccf-mtDNA was significantly delayed in HD patients compared with the response in the medical staff. PTX-3 increased only in HD patients and was highest at M0, and it then gradually decreased. Medical isolation and subnormal quality of care during the MERS outbreak caused extreme stress in HD patients. Plasma cell-free DNA and PTX-3 seems to be good indicators of stress and quality of care in HD patients.

Posttraumatic Stress Disorder Symptoms and Posttraumatic Growth Following Indirect Trauma from the Sewol Ferry Disaster, 2014.

OBJECTIVE: The definition of psychological trauma, which was traditionally restricted to immediate and direct experience, is now expanding to include mediated or vicarious experience. So the present study aims to examine the relationship between the negative effects and the positive outcomes to a national disaster by assessing the posttraumatic stress disorder (PTSD) symptoms and posttraumatic growth of the general public. METHODS: A nationwide survey of the Korean population (n=811) who were exposed to the Sewol ferry disaster through the media participated in this research, completing a self-report questionnaire consisting of demographic characteristics, Impact of Event Scale-Revised- Korean, and Korean-Stress-related Growth Scale-Revised. The participants were divided into three groups according to the severity of PTSD symptoms, then one-way ANOVA were conducted. RESULTS: The results revealed 30.4% of the sampled participants reported stress symptoms equivalent to partial or full PTSD. Posttraumatic growth was significantly higher in the full and the partial PTSD symptom groups when compared to the normal group [F (2, 759)=20.534, p<0.001]. At a subscale level, mature thinking showed a more significant result [F (2,759)=23.146, p<0.001] than religious growth [F (2, 180.984)=4.811, p<0.01]. CONCLUSION: The results indicated a general linear trend between the severity of PTSD symptoms and posttraumatic growth level, suggesting that indirect trauma also induces both PTSD symptoms and posttraumatic growth like direct trauma does. The theoretical implications based on these findings were discussed.

Schedule for personality assessment from notes and documents (SPAN-DOC): Preliminary validation, links to the ICD-11 classification of personality disorder, and use in eating disorders.

BACKGROUND: The underlying core of personality is insufficiently assessed by any single instrument. This has led to the development of instruments adapted for written records in the assessment of personality disorder. AIMS: To test the construct validity and inter-rater reliability of a new personality assessment method. METHOD: This study (four parts) assessed the construct validity of the Schedule for Personality Assessment from Notes and Documents (SPAN-DOC), a dimensional assessment from clinical records. We examined inter-rater reliability using case vignettes (Part 1) and convergent validity in three ways: by comparison with NEO Five-Factor Inventory in 130 Korean patients (Part 2), with agreed ICD-11 personality severity levels in two populations (Part 3) and determining its use in assessing the personality status in 90 British patients with eating disorders (Part 4). RESULTS: Internal consistency (alpha = .90) and inter-rater reliability (intraclass correlation coefficient ≥ .88) were satisfactory. Each factor in the five-factor model of personality was correlated with conceptually valid SPAN-DOC variables. The SPAN-DOC domain traits in those with eating disorders were categorized into 3 clusters: self-aggrandisement, emotionally unstable, and anxious/dependent. CONCLUSIONS: This study provides preliminary support for the usefulness of SPAN-DOC in the assessment of personality disorder. Copyright © 2016 John Wiley & Sons, Ltd.

Preliminary field trial of a putative research algorithm for diagnosing ICD-11 personality disorders in psychiatric patients: 2. Proposed trait domains.

This field trial examines the discriminant validity of five trait domains of the originally proposed research algorithm for diagnosing International Classification of Diseases (ICD)-11 personality disorders. This trial was carried out in South Korea where a total of 124 patients with personality disorder participated in the study. Participants were assessed using originally proposed monothetic trait domains of asocial-schizoid, antisocial-dissocial, anxious-dependent, emotionally unstable and anankastic-obsessional groups of the research algorithm in ICD-11. Their assessments were compared to those from the Personality Assessment Schedule interview, and the five-factor model (FFM). A total of 48.4% of patients were found to have pathology in two or more domains. In the discriminant analysis, 64.2% of the grouped cases of the originally proposed ICD-11 domains were correctly classified by the five domain categories using the Personality Assessment Schedule, with the highest accuracy in the anankastic-obsessional domain and the lowest accuracy in the emotionally unstable domain. In comparison, the asocial-schizoid, anxious-dependent and the emotionally unstable domains were moderately correlated with the FFM, whereas the anankastic-obsessional or antisocial-dissocial domains were not significantly correlated with the FFM. In this field trial, we demonstrated the limited discriminant and the convergent validities of the originally proposed trait domains of the research algorithm for diagnosing ICD-11 personality disorder. The results suggest that the anankastic, asocial and dissocial domains show good discrimination, whereas the anxious-dependent and emotionally unstable ones overlap too much and have been subsequently revised.

Field trial of a putative research algorithm for diagnosing ICD-11 personality disorders in psychiatric patients: 1. Severity of personality disturbance.

This preliminary field trial examines the reliability and validity of a proposed research algorithm for diagnosing International Classification of Diseases (ICD)-11 personality disorders and its association with other psychiatric assessments for the primary classification of a single dimension of the five severity levels of personality dysfunction. In total, 137 psychiatric patients (119 with personality disorders and 18 without personality disorders) in Korea were assessed. In the first part of the study, inter-rater reliability was evaluated with an independent assessment of personality (personality assessment schedule). In the second part of the study, (1) the algorithm that identified any personality disturbance was compared with the ICD-10 and DSM-IV personality disorder diagnostic equivalents, and (ii) the four levels of severity were examined for their associations with clinical pathology and social functioning. The results showed good agreement between the algorithm and the test instruments for identifying a personality disorder. A graded increase in clinical pathology and social dysfunction was observed with increasing severity of personality disorder. These findings suggest that a simple algorithm for recording severity of a personality disturbance had both construct validity and was useful in practice, which supports severity classification as a valuable concept. These findings need to be confirmed in other cultures and ethnic groups.

Anti-intrusion effect of Lorazepam: an experimental study.

OBJECTIVE: Easy triggering of trauma-related episodic memory fragments caused by perceptual cues is tied to strong perceptual priming in the implicit memory system. And among benzodiazepines, only lorazepam has been consistently reported to have an atypical suppression effect on perceptual priming processes. The aim of this study was to investigate the effects of single doses of lorazepam, diazepam, and a placebo on intrusive memories after exposure to a distressing videotape and to explore whether the anti-intrusive effect of lorazepam is acquired as a result of the suppression of perceptual but not conceptual priming processes. METHODS: Under prospective, randomized, and double-blind conditions, we compared the anti-intrusion effect of a single dose of lorazepam (n=22) with that of diazepam (n=22) and a placebo (n=21) in young healthy Korean college students following exposure to a traumatic videotape. RESULTS: We present the first finding for an anti-intrusion effect of lorazepam. One day after the medication, lorazepam, rather than diazepam or the placebo, significantly reduced the extent of intrusion and data-driven processing of the traumatic information. There were no differences among the three conditions in state anxiety, depression, and an arousal scale throughout the experiment. CONCLUSION: Results from this study suggest the possibility of lorazepam as a candidate anti-intrusion drug, as well as the cautious use of diazepam in the treatment of PTSD patients. The anti-intrusive effect of lorazepam is directly related to its atypical inhibitory effect on implicit perceptual priming processes. The present study provides support for the enhanced perceptual priming hypothesis of PTSD.

Plasma Levels of IL-23 and IL-17 before and after Antidepressant Treatment in Patients with Major Depressive Disorder.

OBJECTIVE: Cytokines are believed to have a role in the pathophysiology of major depression. The alteration in levels of pro-inflammatory cytokines [interleukin 1ß (IL-1ß), IL-2, IL-6, IL-12, interferon γ, and tumor necrosis factor α] in major depression supports the cytokine hypothesis of this illness. IL-23 and IL-17 are also pro-inflammatory cytokines, but few studies have focused on their role in major depression. This study investigated the potential role of the IL-23 and IL-17 axis in major depression. METHODS: Plasma IL-23 and IL-17 levels were measured in 26 major depressive disorder (MDD) patients before and after 6-week treatment with antidepressants; these levels were measured in 28 age- and sex-matched normal controls. Depression severity was assessed using the Hamilton Depression Rating Scale (HDRS). IL-23 and IL-17 plasma levels were estimated using quantitative enzyme-linked immunosorbent assay. RESULTS: Pre-treatment plasma levels of IL-23 and IL-17 in MDD patients were not significantly different from those of normal controls. In MDD patients, IL-23 and IL-17 levels after 6 weeks of antidepressant treatment were not different from the baseline levels. There was no significant correlation between changes in the cytokine levels and changes in the HDRS scores representing the severity of depression. CONCLUSION: The present study does not support a potential involvement of IL-23 and IL-17 axis in major depression. Replication and extension using a larger sample are required.

State effect of traumatic experience on personality structure.

OBJECTIVE: Personality is defined as the trait-like qualities of a person. However, it has been recently suggested that the state effect of a situation leads to changes in scores on personality assessments. We predicted that traumatic experiences would induce changes not only in personality scores but also in the factor structures of personality assessments. METHODS: MethodsaaWe conducted a cross-sectional, case-controlled study using two data sets: a traumatized adolescent sample (n=71) and a non-traumatized adolescent sample (n=296). Personality factor structures were compared between the two samples using exploratory factor analyses for 25 lower-ordered subscales of the Temperament and Character Inventory (TCI). In the non-traumatized sample, evaluation of the scree plot suggested a five-factor solution supporting TCI's original seven-factor model. RESULTS: The traumatized sample showed a three-factor structure representing a biological factor, a social factor and an existential factor. This decrease in number of personality factors was caused by strengthened correlations among personality subscales related to coping with traumatic situations. Cloninger's psychobiological model of personality (i.e., temperament-character) was adequate in capturing personality traits of non-traumatized adolescents, but the tripartite view of existential psychology (i.e., body-mind-spirit) clearly corresponded to the factor structure of the traumatized adolescents. CONCLUSION: The three-factor solution of the present traumatized group is consistent with the tripartite model of personality (i.e., body-mind-spirit), while the five-factor solution of the non-traumatized group corresponds to Cloninger's seven-factor model. This is the first study to describe the state effects of traumatic experiences on personality structure.

The five-factor gambling motivation model.

Pathological gambling is a serious social issue, but the underlying psychological motivations are poorly understood. This study developed a five-factor gambling motivation model. The five factors that motivate gambling (socialization, amusement, avoidance, excitement, and monetary motives) were derived from study data obtained from 240 college students. The structure of the five-factor model was confirmed by factor analysis of responses from 234 frequent gamblers. We then compared the "monetary motive version" of this model with the "parallel version" to determine which model more accurately describes how the five factors influence gambling. The monetary motive model holds that amusement, excitement, and avoidance motives influence gambling severity only through mediation of the monetary motive. The parallel model proposes that the five motives all independently influence gambling severity. We found that the avoidance and excitement motives did not have direct effects on gambling severity, but the monetary motive showed a direct positive influence. Thus the monetary motive model was more effective than the parallel model in explaining the influence of specific gambling motives on gambling severity. These findings may help in the improvement of therapy for pathological gambling.

The effects of antidepressant treatment on serum cytokines and nutritional status in hemodialysis patients.

The aim of this study was to investigate the effects of antidepressant treatment on serum cytokines and nutritional status in hemodialysis patients. Twenty-eight hemodialysis patients with a depressed mood were given 20 mg of fluoxetine for 8 weeks. The degree of depressive symptoms, the serum levels of interleukin-1beta, interleukin-2, interleukin-6, tumor necrosis factor-alpha, c-reactive protein, and markers of nutritional status were assessed at baseline and after treatment. The outcome was assessed in terms of response to treatment (>50% reduction in the score of the Hamilton depression rating scale). Antidepressant treatment decreased the serum level of interleukin-beta1 in both response and nonresponse groups, and increased the serum level of interleukin-6 only in the response group. At baseline, the level of interleukin-6 in the response group was lower than in the nonresponse group. Antidepressant treatment also increased fat distribution significantly in the response group which might have slightly improved the nutritional status. This study suggests that antidepressant treatment improve depressive symptoms and may affect immunological functions and nutritional status in chronic hemodialysis patients with depression.

D2 and D4 dopamine receptor gene polymorphisms and personality traits in a young Korean population.

The correlation between the D4 dopamine receptor gene (DRD4) and the D2 dopamine receptor gene (DRD2) polymorphisms was investigated with personality traits. For this study, homogeneous population consisting of 243 young alcohol- and drug-naive Koreans who were blood-unrelated with a mean age (+/-SD) of 13.87 (+/-0.30) years old was analyzed for the DRD4 and the DRD2 polymorphisms with their personality trait by Temperament and character inventory (TCI). The association between Novelty seeking (NS) score and DRD4 long alleles was only observed among the female subjects (t = 2.11, P = 0.037), but not in the male counter part. Female subjects who carried the DRD2 less frequent alleles (TaqI A1, TaqI B1, and Intron6 1) showed higher RD4 scores (dependence vs. independence) of Reward dependence (RD) than those without these alleles (P < 0.05). There was no interaction between DRD4 and DRD2 on the personality traits. These results, thus, confirmed the previous findings in which the long repeats of the DRD4-exon III polymorphism are related to NS personality trait, and also suggested that the DRD2 less frequent alleles were also associated with the reward-dependent trait.

Gender-specific molecular heterosis and association studies: dopamine D2 receptor gene and smoking.

If the concept of the gender-specific molecular heterosis is not considered and tested, incorrect conclusions would easily be drawn in association studies. Therein, heterosis and its gender effect in the genetic effect of DRD2 gene for smoking were examined with 187 healthy Korean individuals. The male smokers showed a higher A1 allele frequency (P = 0.016) and prevalence (P = 0.049) than those of the male non-smokers, and the female smokers showed a lower frequency of heterozygotes (P = 0.018) than the female non-smokers. However, the association of DRD2 gene with smoking found in each gender disappeared when both males and females were considered as one group because of the opposite genetic effect of DRD2 gene for smoking: (1) while 75% of heterozygotes males were smokers, only 22% of female heterozygotes were; (2) males showed an excess of heterozygotes and the deviation from Hardy-Weinberg expectations in smokers, while these were true in the female non-smokers; and (3) in non-smokers, females were different from the males exhibiting a significantly higher prevalence (P = 0.005) and frequency (P = 0.015) of A1 allele, and significantly different genotype (P = 0.017) distribution, and higher frequency of heterozygotes (P = 0.055). Meanwhile, in smokers, males showed higher frequency of heterozygotes (P = 0.019) compared to females. The results indicate that gender-specific molecular heterosis at DRD2 gene for smoking is also applicable in healthy individuals as well as schizophrenics. Moreover, this concept has general applicability to other candidate genes and biological phenotypes.

Allelic variants interaction of dopamine receptor D4 polymorphism correlate with personality traits in young Korean female population.

Polymorphism in exon III of the dopamine D4 receptor (DRD4) gene has been implicated to be associated with the human personality trait of novelty seeking (NS). For this study, we have investigated the possible association between 48-bp VNTR in exon III and -521 C/T SNP of the DRD4 and personality traits among young ( approximately 14 years of age) Korean female population. We found that the interaction between the two alleles of DRD4 polymorphism, 48-bp VNTR and -521 C/T, were significantly high on NS (F = 4.88, P = 0.029) and persistence (P) (F = 5.05, P = 0.027) personality scores, suggesting that the variants of DRD4 gene influence the NS and P (persistent) personality traits. When analyzed independently, however, the two different alleles of DRD4 polymorphisms, 48-bp VNTR and -521 C/T, there was no direct correlation with the personality traits.

Gender-specific molecular heterosis of dopamine D2 receptor gene (DRD2) for smoking in schizophrenia.

We examined the genetic effect of DRD2 A1 allele in 167 Korean schizophrenics in relation to their smoking habit. Although there was no apparent difference in the genotype distributions of DRD2 gene among the female schizophrenics (n = 66), the male counterpart (n = 101) showed significant differences in their genotype distributions. The comparison between male smoking and non-smoking patients showed the difference in genotype distribution (P = 0.010) with a higher prevalence of A1 allele (P = 0.020) and frequency of heterozygotes (P = 0.005), but not frequency of the A1 allele. The A1A2 heterozygotes male showed significantly higher smoking rate compared to the A1A1 or A2A2 homozygotes male, and non-smokers were deficient in heterozygotes. By contrast, among female schizophrenics, the heterozygotes showed a lower smoking rate than homozygotes and there were more heterozygotes in non-smokers. The deviation from Hardy-Weinberg expectations was observed in male and female non-smokers showing quite opposite profiles. Highly significant differences were seen between male and female non-smokers in A1 prevalence (P = 0.001), genotype distribution (P = 0.00011), and frequency of heterozygotes (P = 0.00003), but not in A1 frequency. The analyses from both male and female as one group showing no significant difference in the genotype distributions between smokers and non-smokers could be explained by the gender difference in the genetic effect of DRD2 A1 allele. Our findings present the gender-specific molecular heterosis of DRD2 gene in relation specifically to the smoking status of schizophrenic patients. They indicate the importance of heterosis and gender effects that should be taken into consideration for the association studies.