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Volume 13(2); June 2005
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Review Articles
Hwabyung-Assessment and Management
Jongwoo Kim
Korean J Str Res. 2005;13(2):43-48.   Published online June 22, 2005
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Hwabyung does not belong to any medical category yet, so it is usually diagnosed as Depression, Somatization disorder or Panic disorder, although it is a very usual disorder among Korean middle-aged women. But recently Hwabyung occupy the attention in Medical field because of it's specific symptoms and anger. There are many diagnostic tools for Hwabyung like interview, Questionnaire, DITI, etc. and with this instrument studies for differential diagnosis between Hwabyung and Depression have been conducting. Treatment with drugs for Hwabyung is usual but supporting and cognitive therapy and anger management can be applied. And also specific Hwabyung managing program or nursing intervention program can be carried out. (Korean J Str Res 2005;13:43∼47)
Comparison of Two Job Stress Models: Demand-Control Model and Effort-Reward Imbalance Model
Sung-Il Cho
Korean J Str Res. 2005;13(2):49-58.   Published online June 22, 2005
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No abstract availble
Heart Rate Variadility and the Measurement of Stress
Whan Seck Choi, M.D., Ph.D.
Korean J Str Res. 2005;13(2):59-64.   Published online June 22, 2005
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As stress becomes very important, there were many attempts to evaluate stress. Among many methods, there is a way to measure stress by observing physiologic response, such as using activity of pituitary-adrenal axis and autonomic nervous system. Task force of the European Society of Cardiology and The North American Society of pacing and Electrophysiology made standard methods of measurement, interpretation, and clinical use of HRV. The measurement of HRV is divided to Time domain methods and frequency domain methods. Time domain methods use heart rate, SDNN, RMSSD, and frequency domain methods use total power, VLF (very low frequency), LF (low frequency), HF (high frequency). The SDNN is the standard deviation of all the normal R-R intervals in the entire 24-hour ECG recording. Along with stability of cardiovascular system, it is used as strong index of ability of autonomic nervous system. RMSSD is the root mean square of successive differences between the normal heart beat It is used as estimating the high frequency beat-to-beat variations in HRV which provides an estimate of the parasympathetic regulation of the heart. HF reflects parasympathetic or vagal activity, and LF can reflect both sympathetic and parasympathetic activity. However in most cases LF reflects more of sympathetic activity. Total power provides information of activity of autonomic nervous system along with sympathetic nervous system. The high number of LF/HF ratio means that sympathetic nervous system increased or parasympathetic nervous system decreased. This ratio can be used to calculate the balance of autonomic nervous system. As the measurement of HRV is not invasive and quantitative, it will be used widely in study and practice of stress. (Korean J Str Res 2005;13:59∼63)
Stress and Drug Abuse
Seikwan Oh
Korean J Str Res. 2005;13(2):65-72.   Published online June 22, 2005
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Stress is the non-specific response to adjust the balance of body function following danger, challenge, continuous stimulus. The immobilization stress using plastic rodent restrainer among the several stressor used to animal model to investigat the biological effects of psychological stress. Drugs of abuse cause long-lasting changes in brain that underlie the behavioral abnormalities associated with drug addiction. What is not understood is why, when drugs are unavailable for long periods or even when users succeed in curbing their own drug use for extended periods, users remain vulnerable to relapse. Relapse is a major characteristic of drug addiction, and remain the primary problem for the treatment of drug abuse. The foodshock stressor reliably reinstated extinguished cocaine- and heroine-taking behavior. Rats trained to self-administer cocaine, exposure to acute intermittent footshock stress induces reinstatement of cocaine-taking behavior after prolonged extinction sessions and after a 4-to 6-week drug-free period. Several findings suggest that glucocorticoid hormones are involved in determining the propensity of an individual to develop cocaine abuse. The selective inactivation of the glucocorticoid (GR) receptor gene in the brains of mice profoundly flattened the dose-response function for cocaine intravenous self-administration and suppressed sensitization. Recent interest has focused on the role of amygdala in the learned association that occur during the process of drug addiction and relapse. The basolateral amygdala (BLA) complex plays a critical role in this behavior, because permanent lesions or reversible pharmacological inactivation of the BLA attenuates conditioned-cued reinstatement without affecting cocaine self-administration or cocaine-primed reinstatement. Pretreatment with the selective CRF1 receptor antagonist, CP-154,526, significantly attenuated the reinstatement effect of the stressor in both heroin- and cocaine-trained rats. Collectively, It has been known that several specific brain regions which is closely related with stress-induced activation have important roles in the drug abuse (relapse), and specific CRF receptor, glutamate receptor and glucocorticoid receptor antagonists suppressed the self-administration of drug. These results suggest a clue to develop the anti- narcotic drugs and provide new therapeutic strategies to treat drug addiction. (Korean J Str Res 2005;13:65∼72)
Stress and Pathological Gambling
Young Chul Shin, M.D.
Korean J Str Res. 2005;13(2):73-76.   Published online June 22, 2005
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Pathological gambling (PG) is characterized by persistent non-adaptive gambling and the disorder is classified as an impulse control disorder in DSM-IV. Despite of negative consequences, they can't resist to urge to gamble. In real clinical situation, environmental stress is an important precipitating factor but there are just a little direct research data about stress and PG. There are two types of PG, action gambler and escape gambler. Hyperarousal and hypoarousal state are related with these types. Therapist have to deal with stress of PG patients as well as their family members to prevent recurrence. The author discussed how to deal with PG patients and their family members, focused on stress problems in clinical situation. (Korean J Str Res 2005;13:73∼76)
Stress and Erectile Dysfunction
Jeong-Ho Chae, M.D., Ph.D.
Korean J Str Res. 2005;13(2):77-82.   Published online June 22, 2005
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It has been recently proposed that human sexual behavior, which is usually triggered by external stimuli or endogenous factors, is a multidimensional experience comprising closely interrelated components. Sexual behavior is a complex series of psycho-neuro- vascular events. Thus, the physiologic mechanism of normal sexual response includes a combination of neurogenic, psychogenic, vascular, and hormonal factors that are coordinated by the hypothalamus, limbic system, and cerebral cortex centers. Accordingly, the erectile dysfunction (ED) is a biopsychosocial process and there should be related with stress. This lecture will be covered the cutting edge findings in stress and ED. Through extensive literature review, clinical experience, and several functional imaging researches, the comprehensive approach for understanding in stress and ED was performed. The relationship with stress and ED may be grouped into patients with functional or psychogenic ED, patients with mixed, organic, psychogenic ED, and patients with ED and active psychopathology. Our neuroimaging results using functional magnetic resonance imaging definitely suggested the involvement of the brain is crucial in ED. Factors associated with stress may be perpetuating, aggravating, and accompanying factors in ED. The major psychiatric disorders as well as the psychopharmaceutical drugs interfere erectile mechanism. The complicated association between psychological factors, organic involvement, the proper understanding and management should be considered in the treatment of subjects with ED. Although many studies have suggested that, for the majority of middle aged and elderly men with ED, the primary etiology is vascular, comprehensive and multidimensional understanding for ED with an emphasis on stress is important. (Korean J Str Res 2005;13:77∼81)
Job Stress Management at Work
Hyoun-Kab Chang and Jae-Hong Bae
Korean J Str Res. 2005;13(2):83-88.   Published online June 22, 2005
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The purpose of this study is to find out the negative physical or psychological symptom caused by job stress in the workplace, and seek for the appropriate stress management model by figuring out the cause of job related stressor. In order to accomplish our goal, we will take the following three steps by cooperating with an anonymous high tech electronic company. First, we will find out the unique environmental and systematic stressor of the company. Second, we will make subjects who participated in our study recognize their stress status by quantifying job stress of each subject. Third, we will educate employee by implementing stress reduction program which is appropriate for each employee. (Korean J Str Res 2005;13:83∼87)
Stress Management and Aromatherapy
Hong Keun Oh, M.D., Ph.D
Korean J Str Res. 2005;13(2):89-92.   Published online June 22, 2005
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Aromatherapy is one of most valuable complementary therapy in the orthodox clinical medicine. Aromatic essential oils are composed of over hundreds of natural volatile chemicals and have its effects on limbic system of central nervous system through the pathway of olfactory nerve. Also it has much beneficial results if applied to the stress management. Aromatherapy would be a great potential medicine with the studies of its unproven therapeutic properties in the future. (Korean J Str Res 2005;13: 89∼91)
Neurofeedback: Principles and Clinical Application
Dong Goo Kim*, Hyung Bae Park and Young Woo Ahn
Korean J Str Res. 2005;13(2):93-98.   Published online June 22, 2005
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Neurofeedback is a kind of biofeedback called EEG (electroencephalogram) biofeedback, Neurofeedback or Neurotherapy. Neurofeedback is a biofeedback targeting EEG as a sensory subject. Neurofeedback can give a variety of beneficial effects on the variable psychiatrical and neurological diseases since the brain becomes a direct target of the neurofeedback. For applying neurofeedback, it is convenient to divide the brain function into 3 functional axes such as (1) cortical-subcortical (2) anterior-posterior and (3) lateral axes. Neurofeedback restores the balance of these 3 axes by strengthening or weakening brain waves of the particular brain region. Two representative methods of practical application are Beta/SMR (sensory motor rhythm) training and Alpha/Theta training. Beta/SMR training uses visual feedback reward and Alpha/Theta training uses auditory feedback reward. Symptoms of insomnia, anxiety, attention deficit or increased aggression can be improved by Beta/SMR training. Mood swing and headache caused by imbalance of right-left brain also can be improved after Beta/SMR training. symptoms of problems of deep internal emotion such as post-traumatic stress disorder or chronic stress can be improved by Alpha/Theta training. If we use neurofeedback appropriately, peak performance of the brain can be accomplished. Since no significant side effects were reported, increased use of neurofeedback is expected in the future. (Korean J Str Res 2005;13:93∼98)

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