Polysomnographic Sleep and Attentional Deficits in Traumatized North Korean Refugees

Lee, Jooyoung; Jeon, Sanghun; Kim, Somin; Seo, Yumin; Park, Jinme; Lee, Yu Jin; Kim, Seog Ju

doi:10.2147/nss.s308968

Cited by 5 publications

(4 citation statements)

References 72 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…26 The range of CPTSD prevalence was 11.3% 27 to 40.7%, 9 while another study reported a lifetime prevalence of 15.3%. 11 Twenty-four studies were conducted with participants living in the community, 9,11,[28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][46][47][48]61,62 8 studies at Hanawon (The Settlement Support Center for North Korean defectors), 26,27,[50][51][52][53][54][55] 6 studies at medical centers, 25,45,48,[56][57][58][59] and 2 studies were conducted using an online survey. 49,60 Out of 40 studies reviewed, only one study reported the longitudinal trajectories of the mental health of North Korean defectors.…”

Section: General Characteristics Of the Included Proms And Studiesmentioning

confidence: 99%

Properties of Patient-Reported Outcome Measures for Post-Traumatic Stress Disorder in North Korean Defectors: A Scoping Review

Kim¹,

Kim²,

Chu³

2023

Psychiatry Investig

View full text Add to dashboard Cite

Objective Posttraumatic stress disorder (PTSD) is highly prevalent among North Korean defectors. This scoping review aimed to appraise the measurement properties of patient-reported outcome measures (PROMs) that assess PTSD among North Korean defectors.Methods A systematic search was conducted using Research Information Sharing Service, ScienceON, PubMed, and Embase from their inception up to September 15, 2022. Each measurement properties of the included PROMs were evaluated using COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) methodology. First, the methodological quality of each study on measurement properties was evaluated using the COSMIN Risk of Bias checklist. Second, the result of each single study on a measurement property was rated against the updated criteria for good measurement properties.Results After screening the articles, nine instruments from 40 studies were included. Among these instruments, Impact of Event ScaleRevised was the most frequently used (13 studies [38.1%]), followed by the Trauma Scale for North Korean Refugees, PTSD Checklist, and Posttraumatic Diagnostic Scale. The theoretical basis of all PROMs was secure in terms of content validity. The most frequently tested characteristics in measurement properties for internal structure were internal consistency, criterion validity, and convergent validity. No study reported sufficient structural validity as confirmatory factor analysis results with a model fit.Conclusion There is insufficient evidence to support the recommendation of a specific PROM for use among North Korean defectors with PTSD.

show abstract

Section: General Characteristics Of the Included Proms And Studiesmentioning

confidence: 99%

Properties of Patient-Reported Outcome Measures for Post-Traumatic Stress Disorder in North Korean Defectors: A Scoping Review

Kim¹,

Kim²,

Chu³

2023

Psychiatry Investig

View full text Add to dashboard Cite

show abstract

“…Several studies using polysomnography (PSG) to measure sleep architecture, specifically looking at the cyclical pattern of sleep and sleep stage shifts in patients suffering from PTSD, have found abnormal sleep architecture, but the findings are inconsistent (Germain, 2013 ; Kobayashi et al, 2007 ; Lee et al, 2021 ; Maher et al, 2006 ; Mellman et al, 2014 ; Mohsenin & Mohsenin, 2014 ). A meta-analysis on findings from PSG showed decreased total sleep time and sleep efficiency, increased number of awakenings after sleep onset, and decreased amount of slow-wave sleep (Zhang et al, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

“…The above-mentioned inconsistencies in findings regarding sleep quality, sleep architecture, and sleep disorders may be caused by differences between studies concerning adequate controls, demographics, and clinical factors such as gender, age, trauma type, and PTSD severity. No previous studies have compared sleep quality, sleep architecture, and sleep disorders in trauma-affected refugees to HCs (Lee et al, 2021 ). Owing to the above-mentioned potential differences between trauma-affected refugees and other trauma-affected populations, a thorough understanding of these aspects in this specific refugee population may contribute knowledge of importance for enhancing the outcomes of PTSD treatment.…”

Section: Introductionmentioning

confidence: 99%

Sleep impairments in refugees diagnosed with post-traumatic stress disorder: a polysomnographic and self-report study

Ansbjerg

Sandahl

Baandrup

et al. 2023

European Journal of Psychotraumatology

View full text Add to dashboard Cite

Background: Post-traumatic stress disorder (PTSD) is the clinical manifestation of traumatic events and is associated with sleep disturbances. Sleep disturbances, if left untreated, may perpetuate or even worsen symptoms of PTSD. Previous studies of other PTSD populations show a higher incidence of sleep impairments and sleep disorders compared to healthy controls (HCs); however, this has never been investigated in trauma-affected refugees diagnosed with PTSD. Objectives: To examine subjective sleep quality, measure sleep architecture, and identify latent sleep disorders in refugees diagnosed with PTSD compared to HCs. Method: This comparative study included 20 trauma-affected refugees diagnosed with PTSD and 20 HC matched on age, sex, and body mass index. All participants completed self-report questionnaires assessing sleep quality, insomnia severity, and disturbing nocturnal behaviour, and all took part in a one-night polysomnography (PSG) assessment. Results: Patients reported significantly poorer subjective sleep quality, sleep latency, sleep duration, and sleep efficiency compared to HCs. Subjective reports on hours spent in bed were not significantly different between patients and HCs. Patients reported significantly higher nightmare frequency and severity compared to HCs. PSG measures showed that patients had significantly reduced sleep efficiency, more awakenings, and longer REM sleep latency, and spent more time awake, whereas there was no significant differences regarding total time in bed, total sleep time, or sleep latency. The prevalence of sleep disorders was equal between groups. Conclusions: The study identified significant impairments in several sleep domains, with a preponderance of disturbed regulation of sleep resulting in awakenings. These results indicate a need for more focus on hyperarousal and nightmares as key elements of disturbed sleep in PTSD. Furthermore, the study identified a discrepancy between subjective and objective measures concerning total sleep time, raising questions regarding the causes of ‘sleep state misperception’. Trial registration: . Trial registration: Sleep Impairments in Refugees Diagnosed with PTSD (PSG-PTSD). URL: https://clinicaltrials.gov/ct2/show/NCT03535636 . ClinicalTrials.gov NCT03535636. Date of registration: 24/05/2018.

show abstract

“…Although brain structures and functions have been widely studied in other traumatized populations, only a few studies have been performed on alterations of brain structure in traumatized refugees. North Korean (NK) refugees reportedly experience chronic and repetitive trauma after defection from NK, prior to their arrival in South Korea ( 23 – 25 ). Structural and functional brain changes in NK refugees have been characterized in previous studies ( 26 – 28 ).…”

Section: Introductionmentioning

confidence: 99%

Gray Matter Volume of Thalamic Nuclei in Traumatized North Korean Refugees

Lee

Kim

Jeong³

et al. 2022

Front. Psychiatry

View full text Add to dashboard Cite

The current study investigated differences in the regional gray matter (GM) volume of specific thalamic nuclei between North Korean (NK) refugees and South Korean (SK) residents. It also investigated associations between thalamic GM volume changes and psychological symptoms. Psychological evaluations and magnetic resonance imaging were conducted on 50 traumatized NK refugees and 55 non-traumatized SK residents. The regional GM volume ratios in the bilateral thalami were calculated for all participants using voxel-based morphometry. NK refugees showed greater GM volume ratios in the right medial-posterior nuclei and left medial nuclei compared with SK residents. NK refugees also exhibited more depressive symptoms than SK residents. However, increased GM volume ratios in both right medial-posterior nuclei and left medial nuclei were correlated with fewer depressive symptoms in NK refugees, but not in SK residents. The findings indicate that traumatized NK refugees had increased GM volumes in the right medial-posterior nuclei and left medial nuclei, which were associated with fewer depressive symptoms. The enlarged specific thalamic nuclei presented among refugees in the current study might be associated with a neurobiological compensatory mechanism that prevents the development or progression of depression in refugees after repetitive traumatic experiences.

show abstract

Polysomnographic Sleep and Attentional Deficits in Traumatized North Korean Refugees

Cited by 5 publications

References 72 publications

Properties of Patient-Reported Outcome Measures for Post-Traumatic Stress Disorder in North Korean Defectors: A Scoping Review

Properties of Patient-Reported Outcome Measures for Post-Traumatic Stress Disorder in North Korean Defectors: A Scoping Review

Sleep impairments in refugees diagnosed with post-traumatic stress disorder: a polysomnographic and self-report study

Gray Matter Volume of Thalamic Nuclei in Traumatized North Korean Refugees

Contact Info

Product

Resources

About