The Relationship Between Posttraumatic Embitterment Disorder and Stress, Depression, Self-Esteem, Impulsiveness, and Suicidal Ideation in Korea Soldiers in the Local Area.

BACKGROUND: The purpose of this study was to identify the prevalence of posttraumatic embitterment disorder (PTED) among soldiers, and examine its relation to stress, depression, self-esteem, impulsiveness, and suicidal ideation. METHODS: The subjects of this study were 200 soldiers and 197 control subjects, a total of 397 persons. Measurement tools used included the PTED self-rating scale, Stress Response Inventory, Beck Depression Inventory, Rosenberg Self-Esteem Inventory, Barratt Impulsiveness Scale, and Beck Scale of Suicide Ideation. RESULT: The major findings of the analysis are as follows: first, 11.5% of the soldiers were in the risk group for PTED, and 4% of them had PTED. Second, PTED in the soldiers was significantly associated with a number of variables such as their educational background, stress, depression, self-esteem, impulsiveness, and suicidal ideation, while it was not significantly associated with age. Third, through the hierarchical multiple regression analysis, it was found that academic background, stress, and depression had a statistically significant positive effect on the incidence of PTED in the soldiers. CONCLUSION: In order to prevent and effectively intervene in PTED in soldiers, there is a need for interventional efforts focused on depression and stress related to negative life events.

A Multicenter Study Investigating Empathy and Burnout Characteristics in Medical Residents with Various Specialties.

We assessed empathy in medical residents, including factors modifying empathy and the relationship between empathy and burnout. Participants (n = 317 residents, response rate = 42%) from 4 university hospitals completed a socio-demographic questionnaire, the Jefferson Scale of Empathy (Health Professional version, Korean edition), and the Maslach Burnout Inventory (MBI). Participants were classified by medical specialty: "people-oriented specialty" (POS group) or "technology-oriented specialty" (TOS group), with more women in the POS than in the TOS group, χ(2) = 14.12, P < 0.001. Being female, married, and having children were factors related to higher empathy (gender, t = -2.129, P = 0.034; marriage, t = -2.078, P = 0.038; children, t = 2.86, P = 0.005). Within specialty group, POS residents showed higher empathy scores in the fourth as compared to the first year, F = 3.166, P = 0.026. Comparing POS and TOS groups by year, fourth year POS residents had significantly higher scores than did fourth year TOS residents, t = 3.349, P = 0.002. There were negative correlations between empathy scores and 2 MBI subscales, emotional exhaustion (EE) and depersonalization (DP). Additionally, first year POS residents had higher DP scores than did first year TOS residents, t = 2.183, P = 0.031. We suggest that factors important for empathy are type of medical specialty, marriage, siblings, and children. Burnout state may be related to decreasing empathy.

Factors associated with depression among elderly Koreans: the role of chronic illness, subjective health status, and cognitive impairment.

OBJECTIVES: The objective of this cross-sectional study was to investigate the relationship between depression in elderly individuals and chronic illness, subjective health status, and cognitive impairment. METHOD: This study used the dataset of the Survey of Living Conditions and Welfare Needs of Korean Older Persons, which was conducted by the Korea Institute for Health and Social Affairs in 2011. Participants (n = 10,674) were randomly selected from a pool of individuals aged 65 years and older. Elderly depression was evaluated by the short version of the Geriatric Depression Scale. Multivariate logistic regression was used to investigate factors associated with depression in terms of their sociodemographic and health-related characteristics. RESULTS: Our results revealed that chronic illness, subjective health status, and cognitive impairment were significant factors associated with depression. In particular, subjective health status showed the highest odds ratio (OR) (OR for bad subjective health status = 4.290, P < 0.001), followed by chronic illness (OR for three or more chronic illnesses = 1.403, P < 0.01) and cognitive impairment (OR = 1.347, P < 0.001) in the final model. Interestingly, the significant association between chronic illness and depression was attenuated (OR for three or more chronic illnesses = 1.403, P = 0.01) or even disappeared (OR for two chronic illnesses = 1.138, P = 0.274; OR for one chronic illnesses = 0.999, P = 0.996) after adjustment for subjective health status in the final model; this may be attributable to the close relationship among the variables studied: chronic illness, subjective health status, and depression. CONCLUSIONS: Development and implementation of prevention strategies, including management of chronic illness, individual's perception of health status, and cognitive impairment, could possibly reduce the impact of depression.

No association of the norepinephrine transporter gene (SLC6A2) and cognitive and behavioural phenotypes of patients with autism spectrum disorder.

We examined the association between the norepinephrine transporter (SLC6A2) gene and autism spectrum disorder (ASD) in a Korean population. In addition, we investigated which phenotypes of ASD are best attributed to the genotype of SLC6A2. A total of 184 subjects with ASD, their 156 unaffected siblings and both biological parents were recruited through university hospitals. We used the Autism Diagnostic Interview-Revised, the Aberrant Behaviour Checklist (ABC), the Child Behaviour Checklist (CBCL), the Stroop Colour-Word Interference Test and the Wisconsin Card Sorting Test (WCST) as quantitative measures of the ASD phenotypes. The associations between the quantitative measures and specific single-nucleotide polymorphisms (SNPs) were tested with linear regression analyses. We did not find any evidence of the over-transmission of either allele of the 10SLC6A2 SNPs in the DFAM test. At an empirical p value <0.05, findings that were consistent between the linear regression analyses and the QFAM tests were the positive associations between the A allele of rs36020 and attention problems on the CBCL and stereotypical behaviours on the ABC and between the C allele of rs1814270 and the number of trials required to complete the first WCST category. However, these associations did not remain after correction for multiple testing. The study results of this study do not support the association between the SLC6A2 and the diagnosis or phenotype of ASD. However, the study must be replicated in larger populations and with using more genetic markers.

Heterogeneous reservoir computing in second-order Ta2O5/HfO2 memristors.

Multiple switching modes in a Ta2O5/HfO2 memristor are studied experimentally and numerically through a reservoir computing (RC) simulation to reveal the importance of nonlinearity and heterogeneity in the RC framework. Unlike most studies, where homogeneous reservoirs are used, heterogeneity is introduced by combining different behaviors of the memristor units. The chosen memristor for the reservoir units is based on a Ta2O5/HfO2 bilayer, in which the conductances of the Ta2O5 and HfO2 layers are controlled by the oxygen vacancies and deep/shallow traps, respectively, providing both volatile and non-volatile resistive switching modes. These several control parameters make the second-order Ta2O5/HfO2 memristor system present different behaviors in agreement with its history-dependent conductance and allow the fine-tuning of the behavior of each reservoir unit. The heterogeneity in the reservoir units improves the pattern recognition performance in the heterogeneous memristor RC system with a similar physical structure.

Multiphase Reset Induced Reliable Dual-Mode Resistance Switching of the Ta/HfO2/RuO2 Memristor.

Higher functionality should be achieved within the device-level switching characteristics to secure the operational possibility of mixed-signal data processing within a memristive crossbar array. This work investigated electroforming-free Ta/HfO2/RuO2 resistive switching devices for digital- and analog-type applications through various structural and electrical analyses. The multiphase reset behavior, induced by the conducting filament modulation and oxygen vacancy generation (annihilation) in the HfO2 layer by interacting with the Ta (RuO2) electrode, was utilized for the switching mode change. Therefore, a single device can manifest stable binary switching between low and high resistance states for the digital mode and the precise 8-bit conductance modulation (256 resistance values) via an optimized pulse application for the analog mode. An in-depth analysis of the operation in different modes and comparing memristors with different electrode structures validate the proposed mechanism. The Ta/HfO2/RuO2 resistive switching device is feasible for a mixed-signal processable memristive array.

Association of the Comprehensive Attention Test and the Korean Wechsler Intelligence Scale for Children-Fourth Edition in Children and Adolescents With Attention-Deficit/Hyperactivity Disorder.

Objectives: This study aimed to investigate the correlation between the Comprehensive Attention Test, Korean-Wechsler Intelligence Scale for Children-Fourth Edition, and Attention-Deficit/Hyperactivity Disorder (ADHD) Rating Scale-IV scores in children and adolescents with ADHD. Methods: Fifty-five children and adolescents diagnosed with ADHD and not taking psychiatric medications were included in this retrospective study. A correlation analysis was performed. Results: Although simple visual and auditory selective attention have diagnostic value in traditional continuous performance tests, this study revealed that inhibition-sustained attention and interference-selective attention are also effective in evaluating ADHD. Furthermore, the correlation between the attention and intelligence test scores varied depending on the use of visual or auditory stimuli. Conclusion: The findings of this study contribute to clarifying our understanding of the cognitive characteristics of children and adolescents with ADHD and can be used in future research.

Highly parallel stateful Boolean logic gates based on aluminum-doped self-rectifying memristors in a vertical crossbar array structure.

The self-rectifying memristor with electronic bipolar resistive switching shows electroforming-free, highly rectifying properties and low operating power. Furthermore, configuring the memristors in a vertical array structure provides a higher memory density than in a planar array structure. These combined advantages can be exploited in in-memory computing, which may provide a new and efficient stateful logic gate with high parallelism compared to the conventional stateful logic gates in the planar array structure. The different switching mechanism compared to the previous logic gates based on filamentary-type switching is explained and exploited to realize the AND and OR Boolean logic gates. Since the AND and OR logic functions are the basic operations of sum-of-product (SoP) and product-of-sum (PoS) expressions, any canonical expression for Boolean logic can be implemented in the vertical crossbar array (CBA). Accordingly, the composite logic gate, such as an exclusive OR operation, is demonstrated. In addition, the implementation of the memristive priority encoder is proposed using parallel logic gates. Although the switching speed should be improved in further work, a higher parallelism with a larger number of layers in the vertical array structure can mitigate the low operation speed issue.

The Factors Affecting Longitudinal Course of Posttraumatic Stress Disorder Symptoms in Sexual Assault Victims.

OBJECTIVE: This study aimed to identify the factors affecting posttraumatic stress disorder (PTSD) symptom remission prospectively through a 1-year follow-up of sexual assault (SA) victims. METHODS: A total 65 female SA victims who visited the crisis intervention center were included. Self-administered questionnaires regarding PTSD symptoms and PTSD related prognostic factors were conducted at both recruitment (T1) and 1 year after recruitment (T2). The multivariate analyses were used to determine the significant predictors of PTSD remission/non-remission state 1 year after SA. RESULTS: In logistic regression analysis, both anxiety and secondary victimization were identified as significant factors explaining the results on PTSD remission/non-remission state at T2 (Beck's Anxiety Inventory [BAI], p=0.003; Secondary Victimization Questionnaire, p=0.024). In a linear mixed analysis, both depression and anxiety were found to be significant variables leading to changes in Posttraumatic Diagnostic Scale for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition from T1 to T2 (BAI, p<0.001; Center for Epidemiological Studies Depression Scale, p<0.001). CONCLUSION: Depression, anxiety symptoms, and secondary victimization after SA were associated with PTSD symptom non-remission 1 year after SA.

Cognitive effects of a single dose of atypical antipsychotics in healthy volunteers compared with placebo or haloperidol.

Cognitive dysfunction in patients with schizophrenia is a strong correlate of poor outcome than any other symptom domain. To have greater knowledge about the effects of antipsychotics on cognitive function, subjects of this study were healthy volunteers who had no confounding variables typically found in patients with schizophrenia. The cognitive function of healthy volunteers in response to single doses of haloperidol, risperidone, aripiprazole, and amisulpride in a double-blind placebo-controlled trial was investigated. Assessments for the computerized neurocognitive test, mental and physical sedation, and extrapyramidal symptoms were performed within 1 week before (baseline) and approximately 4 hours after drug administration. Compared to the placebo, single administration of amisulpride at 400 mg in healthy volunteers enhanced word fluency test performance and remained intact after controlling for sedation and extrapyramidal symptoms. Significant improvement in some measurements of the computerized neurocognitive test was also observed in each antipsychotic-treated group but may have been related to practice effect. These findings suggest that amisulpride may have cognitive-enhancing effects in healthy volunteers.

Different safety profiles of risperidone and paliperidone extended-release: a double-blind, placebo-controlled trial with healthy volunteers.

OBJECTIVE: The present study investigated subjective experiences related to secondary negative symptoms and cognitive performance in healthy volunteers in response to the repeated administration of paliperidone extended-release (ER) and risperidone in a double-blind, placebo-controlled trial. METHODS: Participants (n = 32) received a fixed dose of one of three study medications for three consecutive days: 6 mg of paliperidone ER, 3 mg of risperidone, or placebo. Subjects were evaluated at baseline and after the first and third administrations of the medications by using the Neuroleptic-Induced Deficit Syndrome Scale and the Scale for the Assessment of Negative Symptoms. Cognitive function was measured at baseline and after the third administration of the medications by using the computerized neuropsychological test. RESULTS: Risperidone was associated with more detrimental subjective experiences compared with paliperidone ER and placebo (p < .05), and these differences persisted after controlling for mental and physical sedation. Analysis of computerized neuropsychological test variables revealed significant differences in the changes in Stroop word-color test results from baseline between the paliperidone ER and risperidone groups (p < .005) and between the placebo and risperidone groups (p < .005). CONCLUSIONS: These results suggest that paliperidone ER may have a better safety profile than risperidone in terms of negative subjective experiences and cognitive function among normal volunteers.

Stimulant Induced Movement Disorders in Attention Deficit Hyperactivity Disorder.

Stimulants, such as amphetamine and methylphenidate, are one of the most effective treatment modalities for attention deficit hyperactivity disorder (ADHD) and may cause various movement disorders. This review discusses various movement disorders related to stimulant use in the treatment of ADHD. We reviewed the current knowledge on various movement disorders that may be related to the therapeutic use of stimulants in patients with ADHD. Recent findings suggest that the use of stimulants and the onset/aggravation of tics are more likely to be coincidental. In rare cases, stimulants may cause stereotypies, chorea, and dyskinesia, in addition to tics. Some epidemiological studies have suggested that stimulants used for the treatment of ADHD may cause Parkinson's disease (PD) after adulthood. However, there is still a lack of evidence that the use of stimulants in patients with ADHD may cause PD, and related studies are only in the early stages. As stimulants are one of the most commonly used medications in children and adolescents, close observations and studies are necessary to assess the effects of stimulants on various movement disorders, including tic disorders and Parkinson's disease.

A Review of Cognitive and Behavioral Interventions for Tic Disorder.

OBJECTIVES: Tic disorder is a neurodevelopmental disorder characterized by multiple involuntary movements of muscles or vocalization. Although tic symptoms subside as the patient ages, some patients suffer from significant functional impairments related to severe tic symptoms. This manuscript aimed to review the latest scientific evidences for the effect of cognitive-behavioral interventions on tic disorder. METHODS: The relevant studies were identified by searching medical research databases. We focused our search on studies published between 2000 and 2020 in order to reflect the latest scientific evidence. A total of 821 articles were identified in the initial database search and 27 articles were finally included for the review after the exclusion of duplicated and irrelevant articles. RESULTS: Behavioral therapies including habit reversal training, Comprehensive Behavioral Intervention for Tics, and exposure and response prevention were the most widely studied interventions for tic disorder and are recommended as first-line treatments for tic disorders with high confidence. Cognitive psychophysiologic approaches were also reported to be effective. CONCLUSION: Further studies are needed to support the future treatment of tics with low-cost and more widely available treatments, in order to ensure better treatment outcomes.

A Brief Depression and Anxiety Rating Scale for Sexual Violence Victims.

OBJECTIVE: This study aimed to develop a brief self-report measure of depressive and anxiety symptoms in victims of sexual violence. METHODS: The sample, which consisted of 215 victims and 255 healthy controls, was recruited between December 2016 and November 2018 from eight Sunflower Centers. Eligible items were selected from existing scales of depression (CES-DC and CES-D) and anxiety (SAI-C and BAI) symptoms by item-total correlation coefficients and item response theory (IRT) analysis. Internal consistency coefficients were computed and the receiver operating characteristics curve was inspected to assess the validity of the brief scale and determine optimal cutoff scores. RESULTS: The brief scales showed high internal consistency across all age groups. The optimal cutoff score of brief depression scale was 1.5 for children, 2.5 for adolescents, and 2.5 for the adults. That of brief anxiety scale was 8.5, 6.5, and 3.5, respectively. CONCLUSION: The results underscore the need for age-appropriate screening measures of depressive and anxiety symptoms in victims of sexual violence.

Hot-Rolling and a Subsequent Direct-Quenching Process Enable Superior High-Cycle Fatigue Resistance in Ultra-High Strength Low Alloy Steels.

The current study investigated the effect of hot rolling reduction rate of ultra-high strength low alloy steel manufactured via the direct quenching process on microstructure, tensile and high-cycle fatigue properties of the alloy. In order to control the reduction rate of ultra-high strength steels (UHSSs) differently, the steels were produced with two different thicknesses, 6 mm (46.2%-reduction rate, A) and 15 mm (11.5%-reduction rate, B). Then, the two alloys were directly quenched under the same conditions. Both the UHSSs showed martensite in the near surface region and auto-tempered martensite and bainite in the center region. Tensile results showed that alloy A with higher fraction of finer martensite had higher yield strength by about 180 MPa (1523 MPa) than alloy B. The alloy A was also found to possess a higher tensile strength (~2.1 GPa) than alloy B. In addition, alloy A had higher strength than B, and the elongation of A was about 4% higher than that of alloy B. High-cycle fatigue results showed that the fatigue limits of alloys A and B were 1125 MPa and 1025 MPa, respectively. This means that alloy A is excellent not only in strength but also high-cycle fatigue resistance. Based on the above results, the correlation between the microstructure and deformation behaviors were also discussed.

Development of the Korean Form of the Premonitory Urge for Tics Scale: A Reliability and Validity Study.

OBJECTIVES: This study aimed to evaluate the reliability and validity of the Korean Form of the Premonitory Urge for Tics Scale (K-PUTS). METHODS: Thirty-eight patients with Tourette's disorder who visited Jeonbuk National University Hospital were assessed with the K-PUTS. Together with the PUTS, the Yale Global Tic Severity Scale (YGTSS), the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS), the attention-deficit/hyperactivity disorder (ADHD) rating scale (ARS), and the Adult ADHD Self-Report Scale (ASRS) were implemented to evaluate concurrent and discriminant validity. RESULTS: The internal consistency of items on the PUTS was high, with a Cronbach's α of 0.79. The test-retest reliability of the PUTS, which was administered at 2 weeks to 2 months intervals, showed high reliability with a Pearson correlation coefficient of 0.60. There was a significant positive correlation between the overall PUTS score and the YGTSS score, showing concurrent validity. There was no correlation between the PUTS, CY-BOCS, and ASRS scores, demonstrating the discriminant validity of the PUTS. Factor analysis for construct validity revealed three factors: "presumed functional relationship between the tic and the urge to tic," "the quality of the premonitory urge," and "just right phenomena." CONCLUSION: The results of this study indicate that the K-PUTS is a reliable and valid scale for rating premonitory urge of tics.

Effect of donepezil added to atypical antipsychotics on cognition in patients with schizophrenia: an open-label trial.

BACKGROUND: Despite the beneficial effects of atypical antipsychotics on cognition, many schizophrenic patients continue to suffer from cognitive impairment. Postmortem findings suggest that altered cholinergic activity is involved in cognitive impairment in schizophrenia. OBJECTIVE: This study investigated whether adjunctive donepezil added to atypical antipsychotics can improve cognition in schizophrenic patients. METHOD: We conducted an open-label trial of donepezil, at doses of up to 10 mg/day for 12 weeks, added to ongoing atypical antipsychotics in 28 stable schizophrenic patients. At baseline and 12 weeks, the patients were evaluated using the Positive and Negative Syndrome Scale (PANSS), Schizophrenia Cognition Rating Scale (SCoRS), and Computerized Neurocognitive Function Test (CNT). RESULTS: Donepezil treatment resulted in significant improvements in attention, memory, psychomotor speed, and mental set-shifting ability. CONCLUSIONS: Adjunctive treatment with donepezil improves cognition in patients with schizophrenia who are stabilized on atypical antipsychotics. Further studies controlling for smoking, age, and severity of cognitive impairment of the participants are needed.

Rhabdomyolysis and Neuroleptic Malignant Syndrome Associated with Very Low-dose Antipsychotics in Children and Adolescent.

Along with the field of adult psychiatry, antipsychotic agents are increasingly used in the field of child and adolescent psychiatry. Although neuroleptic malignant syndrome (NMS) and rhabdomyolysis are rare complication associated with antipsychotic agent, clinicians should need to pay attention to all potential adverse drug reaction (ADR). Also, ADRs in child and adolescent could show different signs and symptoms compared with those in adult. In this case report, we present a case of NMS in a child which occurred shortly after the resolution of rhabdomyolysis which was induced by low-dose risperidone.

Clinical Aspects of Premonitory Urges in Patients with Tourette's Disorder.

Most patients with Tourette's disorder experience an uncomfortable sensory phenomenon called the premonitory urge immediately before experiencing tics. It has been suggested that premonitory urges are associated with comorbidities such as obsessive compulsive disorder, anxiety disorders, and attention-deficit/hyperactivity disorder, although these associations have been inconsistent. Most patients experience tics as a result of the premonitory urges, and after the tics occur, most patients report that the premonitory urges are temporarily relieved. As a consequence, several studies have assessed the premonitory urge and its potential therapeutic utility. Based on the concept that the premonitory urge induces tics, behavioral treatments such as Exposure and Response Prevention and Habit Reversal Therapy have been developed. However, it is still unclear whether habituation, the main mechanism of these therapies, is directly related to their effectiveness. Moreover, the observed effects of pharmacological treatments on premonitory urges have been inconsistent.

Association between the alpha-2C-adrenergic receptor gene and attention deficit hyperactivity disorder in a Korean sample.

Findings from preclinical and clinical research support the involvement of central noradrenergic dysregulation in the etiology of attention deficit hyperactivity disorder (ADHD). Previous studies have suggested that the alpha-2C-adrenergic receptor gene (ADRA2C) is associated with ADHD. The aims of this study were to examine the association between the ADRA2C (GT)n repeat polymorphism (STR marker adra2c1) and ADHD in a Korean sample. In this case-control and family-based association study, we assessed 184 ADHD probands, 150 normal controls, and 98 trios. There were no significant differences in the allele frequencies of the ADRA2C polymorphism between the ADHD and control groups (p > 0.05). The overall allele-wise transmission disequilibrium test (TDT) analysis showed statistical significance (chi2 = 19.07, p = 0.025). We found a trend for preferential transmission of the 183-bp allele (chi2 = 3.72, p = 0.054), and a significantly lower-than-expected rate of transmission of the 187-bp allele (chi2 = 6.26, p = 0.012). With regard to the temperament profiles of the Junior Temperament and Character Inventory (JTCI), the ADHD subjects with the 183/183 genotype at the ADRA2C polymorphism showed a trend toward a lower score in the Novelty Seeking (p = 0.020) profile than did those with the other genotypes. Our findings provide important evidence that the ADRA2C polymorphism is involved in the etiology of ADHD in Korean subjects. In addition, our results provide evidence that the temperament of Novelty Seeking and ADHD might share molecular genetic characteristics related to the noradrenergic system.