Validation of the Korean version of the eating disorder inventory-2: psychometric properties and cross-cultural comparision

PURPOSE: The purpose of the present study was to examine the validity and reliability of the Korean version of the Eating Disorder Inventory-2 (EDI-2) in Korean patients with eating disorders and healthy controls, and to investigate cultural differences of EDI-2 between a Korean group and a North American standardization sample. MATERIALS AND METHODS: The Korean version of the EDI-2 was prepared after comprehensive clinical assessment of Korean patients with eating disorders (n=327) as well as female undergraduates (n=176). Results were compared between eating disorder subgroups (anorexia nervosa, bulimia nervosa and eating disorders not otherwise specified) and those of a North American standardization sample and healthy controls. RESULTS: The results showed that the Korean EDI-2 had adequate internal consistency (0.77-0.93) and discriminated well between patients with eating disorders and healthy controls on all subscales. Significant differences in EDI-2 subscale scores between the eating disorder groups and the healthy control group were observed; however, there was no discernible difference among the eating disorder subgroups. When compared with a North American standardization sample, the Korean control group showed significantly higher scores for drive for thinness and asceticism. When patient groups were compared, the Korean group showed significantly lower scores for perfectionism. CONCLUSION: As expected, the results accurately reflected psychometric properties of the Korean version of EDI-2 for eating disorder patients in Korea. These findings also suggest that common characteristics for the eating disorder exist as a whole rather than with significant difference between each subgroup. In addition, significant differences between the Korean and the North American groups for both patients and controls also demonstrated specific cultural differences.ope

Impaired Social and Role Function in Ultra-High Risk for Psychosis and First-Episode Schizophrenia: Its Relations with Negative Symptoms

OBJECTIVE: Psychosocial dysfunction was a nettlesome of schizophrenia even in their prodromal phase as well as first episode and its relations with psychopathology were not determined. The aim of the present study was to examine whether the social and role function impairment was found in ultra-high risk for psychosis (UHR) individuals as well as first-episode schizophrenia patients and to explore its relations with psychopathology. METHODS: Thirty-seven normal controls, 63 UHR participants and 28 young, first-episode schizophrenia patients were recruited. Psychosocial functioning was examined by using Global function: Social and Role scale. Psychopathologies of positive, negative and depressive symptom were also measured. RESULTS: Social and role functioning in UHR were compromised at the equivalent level of those of first-episode schizophrenia patients. Multiple linear regression analysis revealed that social and role dysfunction was associated with negative symptoms in each UHR and first-episode schizophrenia group. CONCLUSION: These findings suggest that the significant impairment of social and role function may be appeared before the active psychosis onset at the level of extent to those of first-episode schizophrenia patients. The psychosocial intervention strategy especially targeting the negative symptoms should be developed and provided to individuals from their prepsychotic stage of schizophrenia.ope

The Association between Sleep Duration and Self-Rated Health in the Korean General Population

STUDY OBJECTIVES: Sleep duration is recognized as one of the most common issues in modern society. Self-rated health is a commonly used subjective health measure based on a single question asking individuals to rate their general health on a four- or five-point scale. However, few studies have examined the relationship between sleep duration and self-rated health. Here, we examined the association between sleep duration and poor self-rated health, using a large representative sample of the general Korean adult population. DESIGN: We conducted a cross-sectional study of 15,252 participants in the Korea National Health and Nutrition Examination Survey IV (2007-2009) who were aged 19 years and older. Sleep duration was categorized as ≤ 5, 6, 7, 8, or ≥ 9 hours. The main outcome of interest was poor self-rated health (n = 3,705, 19.7%). Multiple logistic regression analysis was performed to examine the association between sleep duration and self-rated health. RESULTS: We found both short (≤ 5 h) and long (≥ 9 h) sleep duration to be associated with poor self-rated health independent of sociodemographic, health risk, and health status variables. Compared with 7-h sleep duration, the multivariate odds of poor self-rated health were 1.358 times higher (95% CI 1.167-1.580) with short sleep duration and 1.322 times higher (95% CI 1.091-1.601) with long sleep duration. This association persisted in subgroup analyses of gender, body mass index, and age by gender. CONCLUSIONS: In a large representative sample of the Korean general adult population, compared with sleep duration of 7 hours, we found a positive association between short and long sleep duration and poor self-rated health in Korean adults. Furthermore, the association between sleep duration and poor self-rated health was consistently present in subgroups divided by gender, age, and BMI.ope

Psychosocial Treatment in Nicotine Dependence

Tobacco use, the most common cause of death and diseases, has been decreased by the world's efforts for the past 20 years. However, tobacco use does not decrease as much as expected, which may be due to nicotine dependence. When viewed in terms of nicotine-dependence, antismoking campaigns or the effort of quitting smoking by individuals' own is difficult reality. According to statistics, most Korean smokers try to quit smoking without any help of consultation or treatment, and only 7 percent of those who do succeed in quitting smoking for one year. According to the cognitive theory, chronic tobacco use is reinforced by positive reinforcers such as tension relief and weight reduction, and by negative reinforcers such as weight gain and withdrawal symptoms. Psychosocial interventions refer to the skills and techniques that are critical for the care of all patients with nicotine dependence. These interventions have been reported to be effective in increasing quitting rates.ope

Fragile Self and Malevolent Others: Biased Attribution Styles in Individuals at Ultra-High Risk for Psychosis

Objective: Biased attribution styles of assigning hostile intention to innocent others and placing the blame were found in schizophrenia. Attribution styles in individuals at ultra-high risk (UHR) for psychosis, however, have been less studied especially for its association with various psychological factors. We investigated whether UHR individuals show increased hostility perception and blaming bias and explored the associations of these biased styles of attribution with the factor structure of multifaceted self-related psychological variables and neurocognitive performances. Methods: Fifty-four UHR individuals and 80 healthy controls were assessed by evaluating resilience, self-perception, self-esteem, and aberrant subjective experiences of schizotypy (physical anhedonia, social anhedonia, magical ideation, and perceptual aberration), basic symptoms, and carrying out a comprehensive neurocognitive test battery. Attribution styles were assessed using the Ambiguous Intentions Hostility Questionnaire. Results: UHR individuals, compared with normal controls, showed increased hostility perception and blaming bias. Factor analysis of self-related psychological variables and neurocognitive performances in the entire subject population showed a three-factor solution, which was designated as reflective self, pre-reflective self, and neurocognition. Multiple regression analysis in UHR individuals revealed that hostility perception bias was associated with reflective self and composite blame bias was associated with reflective and pre-reflective self. Conclusion: This study supports the emergence of attribution biases in the putative 'prodromal' phase of schizophrenia. The associations of biased attribution styles with multifaceted self-related psychological constructs suggest that psychosocial interventions for biased attribution styles in UHR individuals should focus not only on reflective self but also pre-reflective self-related psychological constructs.ope

Structural and functional brain alterations associated with cancer-associated cognitive decline in gastric cancer patients: A preliminary longitudinal neuroimaging study

Objective: Despite the clinical significance of cancer-associated cognitive decline (CACD), no longitudinal study has evaluated CACD in gastric cancer patients. This preliminary study explored structural and functional neural changes of CACD in gastric cancer patients focusing on the effects of chemotherapy. Methods: 13 gastric cancer patients who received adjuvant chemotherapy (CTx+ group), 9 gastric cancer patients who did not receive adjuvant chemotherapy (CTx- group), and 10 healthy controls (HCs) were enrolled in this study. We performed self-report questionnaires, neurocognitive tests, voxel-based morphometry (VBM), and resting-state functional magnetic resonance imaging (rsfMRI) analyses before and 3 months after chemotherapy. Results: Compared to the CTx- group, the CTx+ group exhibited statistically significant decrease in attention and executive function over time and dysfunction in delayed recognition performance. The results of the rsfMRI analysis showed a significant group-by-time interaction in the left hippocampus-anterior thalamus. However, no significant structural change was observed in the VBM analysis. Conclusion: To the best of our knowledge, this is the first longitudinal neuroimaging study on CACD in gastric cancer patients. Based on the results of our preliminary study, we suggest that the neuropathological processes and clinical presentation of CACD in gastric cancer patients is similar to those of patients associated with age-related neurodegenerative disorders.ope

Neural evidence for emotional involvement in pathological alcohol craving

AIMS: Reducing craving is a key to success in the treatment of alcohol dependence. The emotion circuit may be involved in pathological craving for alcohol. In this study, we investigated neural correlates of emotional involvement in craving in alcohol dependence. METHODS: The study included 17 detoxified alcoholic patients and 25 social drinkers. We used functional magnetic resonance imaging to examine brain activation (blood oxygen level-dependent signals) while participants reported craving and emotion in response to visually presented, alcohol-related stimuli and emotional stimuli. RESULTS: In the craving-rating paradigm, negative emotional stimuli as well as alcohol cues activated craving-related brain regions in alcoholic patients. Activations of the inferior parietal lobule and dorsolateral prefrontal cortex by negative emotional stimuli were negatively correlated with craving; meanwhile limbic activation was positively correlated with craving. For the emotion paradigm, greater limbic activation was evident by alcohol-related stimuli in the alcohol-dependent group. CONCLUSIONS: Our findings constitute neural evidence for emotional involvement in pathological craving for alcohol, underscoring the importance of emotion management in abstinent alcoholic patients for relapse prevention.ope

Attributional Style in Healthy Persons: Its Association with 'Theory of Mind' Skills

OBJECTIVE: Attributional style, especially external personal attribution bias, was found to play a pivotal role in clinical and non-clinical paranoia. The study of the relationship of the tendency to infer/perceive hostility and blame with theory of mind skills has significant theoretical importance as it may provide additional information on how persons process social situations. The aim of this study was whether hostility perception bias and blame bias might be associated with theory of mind skills, neurocognition and emotional factors in healthy persons. METHODS: Total 263 participants (133 male and 130 female) were recruited. The attributional style was measured by using the Ambiguous Intentions Hostility Questionnaire (AIHQ). Participants were requested to complete a Brüne's Theory of Mind Picture Stories task, neurocognitive task including Standard Progressive Matrices (SPM) and digit span, and other emotional dysregulation trait scales including Rosenberg's self-esteem, Spielberg's trait anxiety inventory, and Novaco anger scale. RESULTS: Multiple regression analysis showed that hostility perception bias score in ambiguous situation were found to be associated with theory of mind questionnaire score and emotional dysregulation traits of Novaco anger scale. Also, composite blame bias score in ambiguous situation were found to be associated with emotional dysregulation traits of Novaco anger scale and Spielberg's trait anxiety scale. CONCLUSION: The main finding was that the attributional style of hostility perception bias might be primarily contributed by theory of mind skills rather than neurocognitive function such as attention and working memory, and reasoning ability. The interpretations and implications would be discussed in details.ope

Prevalence and prognostic implications of psychological distress in patients with gastric cancer

BACKGROUND: The aim of this study was to investigate the prevalence and prognostic significance of psychological distress in gastric cancer patients. METHODS: The study population included 229 gastric cancer patients visiting Yonsei Cancer Center between November 2009 and March 2011. The distress was measured by available tools including the Modified Distress Thermometer (MDT), Hospital Anxiety and Depression Scale (HADS), and Center for Epidemiologic Studies-Depression Scale (CES-D). Patients with psychological distress were defined as those who scored above the cut-off values in both the MDT and either one of the HADS or CES-D. RESULTS: The median age of patients was 56 (range, 20 to 86) and 97 (42.4%) patients were with stage IV disease status at enrollment. The overall prevalence of psychological distress was 33.6% (95% CI: 27.5-39.8%) in 229 gastric cancer patients. In multiple logistic regression analysis, lower education level (odds ratio [OR] 2.39; 95% confidence interval [CI] 1.11-5.17, P = 0.026) and higher disease stage (OR 2.72; 95% CI 1.47-5.03, P = 0.001) were associated with psychological distress. In stage I-III disease, patients with psychological distress had worse disease-free survival (DFS) (5-year DFS rate: 60% vs 76%, P = 0.49) compared with those without psychological distress. In stage IV disease (n = 97), patients with psychological distress showed poorer overall survival than those without psychological distress (median OS (Overall Survival): 12.2 vs. 13.8 months, P = 0.019). CONCLUSION: Psychological distress is common in patients with all stages of gastric cancer and is associated with worse outcomes.ope

Comparison of double pants with single pants on satisfaction with colonoscopy

AIM: To increase satisfaction and diminish anxiety and shame during colonoscopy, we developed novel double pants (NDP) which consist of doubled fabrics with an inner hole. The aim of study was to compare satisfaction, anxiety and shame between NDP and conventional single pants (CSP). METHODS: Total 160 consecutive examinees were randomly divided into NDP and CSP group. Before colonoscopy, questionnaires identifying state and trait anxiety were completed. After colonoscopy, questionnaires for overall satisfaction (Group Health Association of America 9) and pants-specific satisfaction (5-20), state anxiety (20-80), and shame (6-24) were interviewed. RESULTS: Pants-specific satisfaction scores regarding willingness to repeat colonoscopy using same pants (3.3 ± 0.8 vs 2.1 ± 0.9, P < 0.001) and recommendation of same pants to other people (3.3 ± 0.7 vs 2.0 ± 1.0, P < 0.001) were significantly higher in NDP than CSP groups. State anxiety (33.0 ± 7.0 vs 35.4 ± 6.9, P = 0.028) and shame (6.6 ± 1.5 vs 8.1 ± 3.2, P = 0.001) after colonoscopy was lower in NDP group compared with CSP group. CONCLUSION: The NDP contribute to increase satisfaction and decrease anxiety and shame after colonoscopy.ope