This research was supported by the Basic Science Research Program through the National Research Foundation of Korea funded by Ministry of Science and ICT (NRF-2019M3C7A1032262) and by Healthcare AI Convergence Research & Development Program through the National IT Industry Promotion Agency of Korea (NIPA) funded by the Ministry of Science and ICT (No. Also, it is possible that most PD patients maintain minimal functions levels in their daily lives, even if they suffer from symptoms. Additionally, we studied PD patients of acute-care at a hospital in an early phase, and there is a possibility that the effect size of ETISR-SF was not as large as other measurements, so it was not reflected in our results. For another reason, early emotional trauma was related to functional impairment in SAD patients, especially because of the association between greater depression and lower self-esteem. Cortisol levels predict a decrease in the volume of the hippocampus and the prefrontal cortex volume, which are involved in memory processing and executive function, both of which are critical functions of learning. One possible explanation of this finding is that individuals with exposure to early trauma with post-traumatic stress symptoms were associated with the high levels of cortisol compared to individuals without exposure to early trauma, which might be driving functional impairment.
Some studies have examined the relationship between early trauma and functional impairment in bipolar disorder.
This study demonstrated that early trauma cannot significantly increase the risk of functional impairment in PD patients. Moreover, the last question, “days unproductive during a week,” is a measure of how many days in the last week individuals felt so impaired by their symptoms due to reduced their productivity in school or work, even though they have performed routine tasks over the past week. Additionally, the question, “days lost during a week,” is used to measure how many days in the last week normal daily routine responsibilities, such as school or work, could not be carried out due to symptoms. These three domains are measured via a visual analog scale ranging from 0 (not at all), 1–3 (mildly), 4–6 (moderately), 7–9 (markedly), to 10 (extremely). However, these instruments have not been studied in terms of their relationship with functional impairment in PD patients.ĭeveloped by David Sheehan, SDS is a brief, self-rated, cost-effective instrument to measure functional impairment levels by psychiatric or medical symptoms in three major domains showing adequate levels of reliability (Cronbach’s alpha: 0.89) and validity in the study of PD patients : 1) work/school, 2) social life/leisure, and 3) family life/home responsibilities. Moreover, defined as fear of anxiety symptoms, AS differs from phobia or agoraphobia in that it is more motivational and logical because individuals with high AS usually explain the logical reasons for fear of anxiety symptoms. The former represents a particular tendency to respond fearfully to anxiety symptoms, whereas the latter to generally respond fearfully to stressors. In addition, AS is a concept distinguishable from trait anxiety.
Both early trauma and PD-specific scales such as the Panic Disorder Severity Scale (PDSS) and Anxiety Sensitivity Inventory-Revised (ASI-R) assess anxiety sensitivity (AS), which is defined as a fundamental fear of anxiety-related sensations, distinct from derivative ones. For the above-mentioned reasons, many previous studies have shown that there were several risk factors of functional impairment in work and interpersonal relationships such as anxiety and depressive symptoms, older age, lower education level, and neuroticism in anxiety and depressive disorders.
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