주의 피드백 인식 및 조절 훈련이 대학생의 주의편향 및 범불안에 미치는 효과
Effect of Attention Feedback Awareness and Control Training on Attention Bias and Generalized Anxiety Symptoms in college students
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본 연구는 범불안 성향의 대학생을 대상으로 주의편향 및 범불안 증상에 대한 주의 피드백 인식 및 조절 훈련의 효과를 확인하였다. 범불안장애 척도(GAD-7) 10점 이상 또는 펜실베니아 걱정 질문지 척도(K-PSWQ) 56점 이상이며, 주의편향을 나타내는 범불안 성향의 대학생 31명을 선발하여 주의 피드백 인식 및 조절 훈련(Attention Feedback Awareness and Control Training, A-FACT) 집단(n = 11), 주의편향수정(Attention Bias Modification, ABM) 집단(n = 10) 및 활성 위약 통제(Active Placebo Control, APC) 집단(n = 10)에 무선할당하였다. A-FACT 집단은 탐침탐사과제를 이용한 주의편향수정 훈련 시, 개인의 기저반응시간(Baseline Neutral Response time, BNR)을 기준으로 편향 여부에 대한 피드백을 실시간으로 제공받았다. ABM 집단은 기존 ABM 절차와 동일하며, APC 집단은 주의편향을 감소시키기 위한 프로그램이라는 안내는 주어지지만 피드백이 주어지지 않는 탐침탐사과제를 실시하였다. 총 8회기로 구성되어, 주 2회로 4주간 진행되었다. 주의편향수정 훈련의 효과는 주의편향점수(Attention Bias Score, ABS)와 GAD-7, K-PSWQ 및 상태 및 특성 불안 검사(K-STAI) 점수 변화로 평가하였다. 반복측정 변량분석 결과, A-FACT 집단은 ABM 집단과 APC 집단에 비해 ABS가 유의하게 감소하였으며, GAD-7, K-PSWQ 및 K-STAI 점수도 유의하게 감소하였다. 이는 주의편향수정 훈련 시 편향에 대한 피드백을 통해 편향의 여부를 인식시키고 이를 통한 주의의 자기 조절적 통제가 주의편향 및 범불안장애 증상 경감에 효과적일 가능성을 시사한다
Abstract
This study examined the effect of Attention Feedback Awareness and Control Training(A-FACT) on attention bias and generalized anxiety symptoms in college students. A total of 31 college students with at least 10 points on the Generalized Anxiety Disorder 7-item (GAD-7) scale or at least 56 points on the Korean version of the Penn State Worry Questionnaire (K-PSWQ) with attention bias were randomly assigned to one of three groups: A-FACT(n = 11), Attention Bias Modification (ABM)(n = 10) and Active Placebo Control (APC)(n = 10). Participants in A-FACT group received real-time feedback on attention bias based on their Baseline Neutral Response time(BNR) during A-FACT using a dot probe task. Participants in the ABM group received standard ABM, and those in the APC performed a dot probe task that they were informed was a program to reduce attention bias, but feedback was not provided. A total of eight sessions was conducted twice a week over a 4-week period. After every two sessions, GAD-7, K-PSWQ and K-STAI were rated. The effect of attention bias modification training was rated by changes in the Attention Bias Score(ABS), and in GAD-7, K-PSWQ and K-STAI scores. The results of repeated measure ANOVA indicated that the A-FACT group showed a significant decrease in ABS as well as in GAD-7, K-PSWQ and K-STAI scores compared to the other groups. Current results suggest that self-regulatory control of attention, that is, recognition of bias through feedback in A-FACT, may be effective in alleviating attention bias and generalized anxiety symptoms by recognizing bias through feedback on bias in attention bias modification training.
참고문헌 (56)
- 김근향, "범불안장애의 근거기반심리치료", Korean Journal of Clinical Psychology, 36(4), pp.494~508 (2017), 한국임상심리학회[DOI]
- 김도현, "주의편향 수정훈련에 대한 피드백이 사회불안에 미치는 영향", 청소년학연구, 25(4), pp.77~104 (2018), 한국청소년학회[DOI]
- 김민지, "섭식 절제, 섭식 장애 위험 수준에 따른 고칼로리 음식에 대한 주의편향과 뇌 활동 분석", 한국 HCI 학회 학술대회, pp.1051~1054 (2017)
- 김정원, "걱정과 불확실성에 대한 인내력 부족 및 문제해결 방식의 관계", 한국심리학회 학술대회 자료집, 1998(1), pp.83~92 (1998)
- 김지원, "사회불안 아동의 역할극에 대한 비디오 피드백이 자기-평가에 미치는 영향", 한국심리학회지:일반, 30(4), pp.995~1010 (2011), 한국심리학회
- 김현택, "바이오피드백의 심리학적 활용", 한국심리학회 학술대회 자료집, 2007(1), pp.94~95 (2007)
- 박영남, "우울장애와 불안장애의 공유 특성", 생물치료정신의학, 9(1), pp.118~128 (2003), 대한생물치료정신의학회
- 박태진, "IAPS 자극에 대한 한국 대학생의 정서 평가", 인지과학, 20(2), pp.183~195 (2009), 한국인지과학회[DOI]
- 2016년도 정신질환실태 조사, "보건복지부", 보건복지부 삼성서울병원, ~ (2016)
- 심상민, "주의편향 수정훈련이 유사외상장면의 침습에 미치는 효과", 인지행동치료, 16(3), pp.347~364 (2016), 한국인지행동치료학회
- 천은진, "우울 및 불안 장애를 중심으로 본 성인 정신과 환자에서의 뉴로피드백 치료", 생물치료정신의학, 19(2), pp.85~92 (2013), 대한생물치료정신의학회
- 한덕웅, "Spielberger. 상태-특성불안검사 YZ 형 실시와 사용설명서" (2000), 학지사
- American Psychiatric Association, (2015), 학지사
- Amir, N., "Attention modification program in individuals with generalized anxiety disorder", Journal of Abnormal Psychology, 118(1), pp.28~33 (2009)
- Bar-Haim, Y., "Threat-related attentional bias in anxious and nonanxious individuals : a meta-analytic study", Psychological Bulletin, 133(1), pp.1~24 (2007)
- Bar-Haim, Y., "Research review : attention bias modification(ABM) : a novel treatment for anxiety disorders", Journal of Child Psychology and Psychiatry, 51(8), pp.859~870 (2010)
- Beard, C., "Efficacy of attention bias modification using threat and appetitive stimuli : A meta-analytic review", Behavior Therapy, 43(4), pp.724~740 (2012)
- Beard, C., "Combined cognitive bias modification treatment for social anxiety disorder : a pilot trial", Depression and Anxiety, 28(11), pp.981~988 (2011)
- Bernstein, A., "Attention Feedback Awareness and Control Training(A-FACT) : Experimental test of a novel intervention paradigm targeting attentional bias", Behaviour Research and Therapy, 55, pp.18~26 (2014)
- Botella, C., "A self-applied, Internet-based intervention for fear of public speaking", Journal of Clinical Psychology, 60(8), pp.821~830 (2004)
- Carlbring, P., "Internet-delivered attention bias modification training in individuals with social anxiety disorder-a double blind randomized controlled trial", BMC Psychiatry, 12(1), pp.66~ (2012)
- Clark, D. A., "Cognitive theory and therapy of anxiety and depression : Convergence with neurobiological findings", Trends in Cognitive Sciences, 14(9), pp.418~424 (2010)
- Clarke, P. J., "Absence of evidence or evidence of absence : reflecting on therapeutic implementations of attentional bias modification", BMC Psychiatry, 14(1), pp.8~ (2014)
- Colzato, L. S., "Meditation-induced states predict attentional control over time", Consciousness and Cognition, 37, pp.57~62 (2015)
- Cristea, I. A., "Efficacy of cognitive bias modification interventions in anxiety and depression : meta-analysis", The British Journal of Psychiatry, 206(1), pp.7~16 (2015)
- Eisenberg, N., "Emotion-related self-regulation and its relation to children's maladjustment", Annual Review of Clinical Psychology, 6, pp.495~525 (2010)
- Eldar, S., "Attention bias modification treatment for pediatric anxiety disorders : a randomized controlled trial", American Journal of Psychiatry, 169(2), pp.213~230 (2012)
- Eldar, S., "Neural plasticity in response to attention training in anxiety", Psychological Medicine, 40(4), pp.667~677 (2010)
- Enock, P. M., "Attention bias modification training via smartphone to reduce social anxiety : A randomized, controlled multi-session experiment", Cognitive Therapy and Research, 38(2), pp.200~216 (2014)
- Everaert, J., "Attention bias modification via single-session dot-probe training : Failures to replicate", Journal of Behavior Therapy and Experimental Psychiatry, 49, pp.5~12 (2015)
- Fox, E., "Preconscious processing biases predict emotional reactivity to stress", Biological Psychiatry, 67(4), pp.371~377 (2010)
- Hirsch, C. R., "A cognitive model of pathological worry", Behaviour Research and Therapy, 50(10), pp.636~646 (2012)
- Jacobson, E., "Progressive muscle relaxation. Interview Behaviour", Journal of Abnormal Psychology, 75(1), pp.18~ (1938)
- Julian, K., "Attention training to reduce attention bias and social stressor reactivity : an attempt to replicate and extend previous findings", Behaviour Research and Therapy, 50(5), pp.350~358 (2012)
- Klumpp, H., "Preliminary study of attention training to threat and neutral faces on anxious reactivity to a social stressor in social anxiety", Cognitive Therapy and Research, 34(3), pp.263~271 (2010)
- Kross, E., "Making meaning out of negative experiences by self-distancing", Current Directions in Psychological Science, 20(3), pp.187~191 (2011)
- Kuckertz, J. M., "Attention bias modification for anxiety and phobias : current status and future directions", Current Psychiatry Reports, 17(2), pp.9~ (2015)
- Lenze, E. J., "Generalized anxiety disorder in late life : lifetime course and comorbidity with major depressive disorder", The American Journal of Geriatric Psychiatry, 13(1), pp.77~80 (2005)
- Linetzky, M., "Quantitative evaluation of the clinical efficacy of attention bias modification treatment for anxiety disorders", Depression and Anxiety, 32(6), pp.383~391 (2015)
- Macaluso, E., "The curious incident of attention in multisensory integration: bottom-up vs. top-down", Multisensory Research, 29(6-7), pp.557~583 (2016)
- MacLeod, C., "The attentional bias modification approach to anxiety intervention", Clinical Psychological Science, 3(1), pp.58~78 (2015)
- MacLeod, C., "Attentional bias in emotional disorders", Journal of Abnormal Psychology, 95(1), pp.15~20 (1986)
- MacLeod, C., "Selective attention and emotional vulnerability : assessing the casual basis of their association through the experimental manipulation of attentional bias", Journal of Abnormal Psychology, 111(1), pp.107~123 (2002)
- Mathews, A., "Cognitive vulnerability to emotional disorders", Annual Review of Clinical Psychology, 1, pp.167~195 (2005)
- Mennin, D. S., "Comorbid generalized anxiety disorder in primary social phobia : symptom severity, functional impairment, and treatment response", Journal of anxiety disorders, 14(4), pp.325~343 (2000)
- Mennin, D. S., "Preliminary evidence for an emotion dysregulation model of generalized anxiety disorder", Behaviour Research and Therapy, 43(10), pp.1281~1310 (2005)
- Meyer, T. J., "Development and validation of the penn state worry questionnaire", Behaviour Research and Therapy, 28(6), pp.487~495 (1990)
- Mogg, K., "Attention bias modification(abm) : review of effects of multisession ABM training on anxiety and threat-related attention in high-anxious individuals", Clinical Psychological Science, 5(4), pp.698~717 (2017)
- Molina, S., "Worrying: Perspectives on theory, assessment and treatment", pp.265~283 (1994), Wiley
- Pergamin-Hight, L., "Attention bias modification for youth with social anxiety disorder", Journal of Child Psychology and Psychiatry, 57(11), pp.1317~1325 (2016)
- Rozenman, M., "Thinking anxious, feeling anxious, or both? Cognitive bias moderates the relationship between anxiety disorder status and sympathetic arousal in youth", Journal of Anxiety Disorders, 45, pp.34~42 (2017)
- Sanchez, A., "Attention training through gaze-contingent feedback : Effects on reappraisal and negative emotions", Emotion, 16(7), pp.1074~1085 (2016)
- Spitzer, R. L., "A brief measure for assessing generalized anxiety disorder : the GAD-7", Archives of Internal Medicine, 166(10), pp.1092~1097 (2006)
- Sussman, T. J., "Top-down and bottom-up factors in threat-related perception and attention in anxiety", Biological Psychology, 121, pp.160~172 (2016)
- Tacón, A. M., "Mindfulness meditation, anxiety reduction, and heart disease : a pilot study", Family & Community Health, 26(1), pp.25~33 (2003)
- Wittchen, H. U., "Generalized anxiety disorder : prevalence, burden, and cost to society", Depression and Anxiety, 16(4), pp.162~171 (2002)
