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PTSD에 대한 마음챙김 명상의 적용가능성

Applicability of mindfulness meditation to PTSD

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참고문헌

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초록

본 논문은 PTSD에 대한 전통적인 치료방법의 한계를 보완할 수 있는 마음챙김 명상의 적용 가능성을 행동과학적 검토와 더불어 뇌과학적 기반을 검토하고자 했다. 이러한 목적을 달성하기 위해 2000년 이후 PTSD에 대한 명상문헌들을 검색하여 과학적 기반을 갖춘 연구들을 자료로 사용하였다. 먼저, 마음챙김의 적용기제와 기제의 특성을 확인하고 PTSD에 적용한 결과들을 살펴보았다. 나아가 이에 대한 연구는 초보단계이기 때문에 연구들이 적은 관계로 심리적 측정기반의 연구로는 적용 가능성을 확인하는데 제한점이 있다. 그래서 추가적으로 뇌과학적 기반에서 PTSD의 뇌와 명상의 뇌 효과를 검토했다. 검토 결과에 의하면, PTSD에 적용할 수 있는 명상의 기제는 크게 주의조절, 현재 순간의 인식, 비판단적 태도이다. 이러한 기제는 PTSD치료에 유기적으로 작용하여 PTSD의 치료에 효과를 갖는 것으로 판단된다. PTSD의 뇌는 해마, 전측대상피질, 편도체, 전전두피질의 부피가 감소된 반면에 명상의 뇌효과는 PTSD와 상반되게 해마, 전측대상피질, 전전두피질의 활성화와 부피 증가를 초래하는 것으로 확인되었다. 따라서 명상의 뇌 효과는 PTSD에 의한 뇌의 비정상적 손실을 줄일 수 있는 것으로 확인했다. 마지막으로 심리측정 기반의 결과와 뇌과학 기반의 결과로 PTSD에 적용 가능성을 논하고 현재 연구의 제한점을 제시했다.

Abstract

This paper attempted to confirm the applicability of mindfulness meditation to PTSD. First, the application mechanism of mindfulness and the characteristics of the mechanism were examined and the results applied to PTSD were examined. The mechanism of meditation that can be applied to PTSD is attention control, perception of the current moment, and non-critical attitude. This mechanism is thought to have an effect on the treatment of PTSD by acting organically. However, since the research on this is in its infancy, there are few studies, and there are limitations in confirming the applicability as studies based on psychological measurement So we looked at the brain effects of PTSD and meditation on an additional brain science basis. PTSD brain was found to decrease the volume of hippocampus, anterior cingulate cortex, amygdala, and prefrontal cortex, whereas the brain effect of meditation resulted in activation and volume increase of hippocampus, anterior cingulate cortex, and prefrontal cortex. Therefore, it was confirmed that the brain effect of meditation can reduce abnormal brain loss due to PTSD. Finally, the results of psychometric and brain science-based results confirmed the applicability of PTSD.

참고문헌 (112)

  1. 김찬형, "외상후 스트레스 장애", 대한내과학회지, 69(3), pp.237~240 (2005)
  2. 신지은, "마음챙김을 기반으로 한 표현예술치료가 산재환자의 PTSD 증상 감소에 미치는 효과", 한국심리학회지: 상담 및 심리치료, 26(3), pp.683~711 (2014), 한국상담심리학회
  3. 윤병수, "집중명상과 마음챙김명상이 뇌의 주의체계에 미치는 영향", 한국심리학회지: 건강, 17(1), pp.65~77 (2012), 한국건강심리학회[DOI]
  4. 윤병수, "한국형 마음챙김에 기반한 스트레스 감소(K-MBSR) 프로그램이 주의에 미치는 영향", 한국심리학회지:일반, 31(2), pp.521~540 (2012), 한국심리학회
  5. 윤병수, "한국형 마음챙김을 기반한 스트레스 감소(K-MBSR) 프로그램이 대학생의 스트레스와 주의력 개선에 미치는 효과", 스트레스 硏究, 22(4), pp.231~240 (2014), 대한스트레스학회
  6. 은헌정, "일 도시 지역의 외상후 스트레스 장애 역학 조사", 신경정신의학, 40(4), pp.581~591 (2001), 대한신경정신의학회
  7. 주수진, "수용 전념 치료가대인 외상 경험이 있는 대학생의 외상후 스트레스 증상과 복합 외상후 스트레스 증상에 미치는 효과", Korean Journal of Clinical Psychology, 34(2), pp.353~374 (2015), 한국임상심리학회[DOI]
  8. Allen, M., "Cognitive-affective neural plasticity following active-controlled mindfulness intervention", Journal of Neuroscience, 32(44), pp.15601~15610 (2012)
  9. American Psychiatric Association, "DSM-5 간편 정신질환진단통계편람" (2018), 학지사
  10. Amir, N., "Attention modification program in individuals with generalized anxiety disorder", Journal of Abnormal Psychology, 118, pp.28~33 (2009)
  11. Arch, J. J., "Mechanisms of mindfulness : Emotion regulation following a focused breathing induction", Behaviour and Research Therapy, 44, pp.1849~1858 (2006)
  12. Arch, J. J., "Laboratory stressors in clinically anxious and nonanxious individuals : The moderating role of mindfulness", Behaviour Research and Therapy, 48, pp.495~505 (2010)
  13. Baer, R. A., "Mindfulness training as a clinical intervention : A conceptual and empirical review", Clinical Psychology : Science and Practice, 10, pp.125~143 (2003)
  14. Baer, R. A., "Assessment of mindfulness by self-report : The kentucky inventor of mindfulness skills", Assessment, 13(1), pp.191~206 (2004)
  15. Beard, C., "A multi-session interpretation modification program : Changes in interpretation and social anxiety symptoms", Behaviour Research and Therapy, 46, pp.1135~1141 (2008)
  16. Becker, C. B., "A survey of psychologists’attitudes towards and utilization of exposure therapy for PTSD", Behaviour Research and Therapy, 42, pp.277~292 (2004)
  17. Bernstein, A., "Concurrent relations between mindful attention and awareness and psychopathology among trauma-exposed adults : Preliminary evidence of transdiagnostic resilience", Journal of Cognitive Psychotherapy : An International Quarterly, 25, pp.99~113 (2011)
  18. The meditative mind: A comprehensive meta-analysis of MRI studies, "Boccia, M.", BioMed Research International, ~ (2015)
  19. Bohlmeijer, E., "Psychometric properties of the five facet mindfulness questionnaire in depressed adults and development of a short form", Assessment, 18(3), pp.308~320 (2011)
  20. Boscarino, J. A, "Diseases among men 20 years after exposure to severe stress : implications for clinical research and medical care", Psychosomatic Medicine, 59(6), pp.605~614 (1997)
  21. Bremner, J. D., "Hypotheses and controversies related to effects of stress on the hippocampus : an argument for stress-induced damage to the hippocampus in patients with posttraumatic stress disorder", Hippocampus, 11, pp.75~81 (2001)
  22. Bremner, J. D., "MRI-based measurement of hippocampal volume in patients with combat-related posttraumatic stress disorder", American Journal of Psychiatry, 152, pp.973~981 (1995)
  23. Bremner, J. D., "Magnetic resonance imaging-based measurement of hippocampal volume in posttraumatic stress disorder related to childhood physical and sexual abuse-A preliminary report", Biological Psychiatry, 41, pp.23~32 (1997)
  24. Bremner, J. D., "Neural correlates of the classic color and emotional stroop in women with abuse-related posttraumatic stress disorder", Biological Psychiatry, 55, pp.612~620 (2004)
  25. Buckley, T. C., "Information processing and PTSD : A review of the empirical literature", Clinical Psychology Review, 28, pp.1041~1065 (2000)
  26. Clark, C. R., "Cerebral function in posttraumatic stress disorder during verbal working memory updating : A positron emission tomography study", Biological Psychiatry, 53, pp.474~481 (2003)
  27. Clark, D. M., "A cognitive approach to panic", Behaviour Research and Therapy, 24, pp.461~470 (1986)
  28. Creswell, J. D., "Neural correlates of dispositional mindfulness during affect labeling", Psychosomatic Medicine, 69(6), pp.560~565 (2007)
  29. Cusack, K. J., "Unrecognized trauma and ptsd among public mental health consumers with chronic and severe mental illness", Community Mental Health Journal, 42, pp.487~500 (2006)
  30. Davidson, J. R. T, "Recognition and treatment of posttraumatic stress disorder", JAMA, 286(5), pp.584~588 (2001)
  31. Ehring, T., "An experimental analogue study into the role of abstract thinking in trauma-related rumination", Behaviour Research and Therapy, 47, pp.285~293 (2009)
  32. Eldridge, L. L., "Remembering episodes : a selective role for the hippocampus during retrieval", Nature Neuroscience, 3, pp.1149~1152 (2000)
  33. Farb, N. A., "Attending to the present : Mindfulness meditation reveals distinct neural modes of self-reference", Social Cognitive and Affective Neuroscience, 2(4), pp.313~322 (2007)
  34. Fox, K. C., "Is meditation associated with altered brain structure? A systematic review and meta-analysis of morphometric neuroimaging in meditation practitioners", Neuroscience and Biobehavioral Reviews, 43, pp.48~73 (2014)
  35. Friedel, S., "Dispositional mindfulness is predicted by structural development of the insula during late adolescence", Developmental Cognitive Neuroscience, 14, pp.62~70 (2015)
  36. Gilbertson, M. W., "Smaller hippocampal volume predicts pathologic vulnerability to psychological trauma", Nature Neuroscience, 5, pp.1242~1247 (2002)
  37. Goldfarb, E. V., "Fighting the Return of Fear : Roles of Mindfulness-Based Stress Reduction and the Hippocampus", Biological Psychiatry, 86(9), pp.652~653 (2019)
  38. Goldin, P., "Mindfulness-based stress reduction(MBSR)for social anxiety disorder : Neural and behavioral correlates", Biological Psychiatry, 69(9), pp.210~ (2011)
  39. Goldin, P., "Mindfulness meditation training and selfreferential processing in social anxiety disorder : Behavioral and neural effects", Journal of Cognitive Psychotherapy, 23(3), pp.242~257 (2009)
  40. Goldin, P., "MBSR vs aerobic exercise in social anxiety : fMRI of emotion regulation of negative self-beliefs", Social Cognitive & Affective Neuroscience January, 8(1), pp.65~72 (2013)
  41. Golier, J. A., "Memory performance in Holocaust survivors with posttraumatic stress disorder", American Journal of Psychiatry, 159, pp.1682~1688 (2002)
  42. Goleman, D., "Meditation and Consciousness : An Asian Approach to Mental Health", American Journal of Psychotherapy, 30(1), pp.41~54 (1976)
  43. Grossman, P., "Mindfulness-based stress reduction and health benefits : A meta-analysis", Journal of Psychosomatic Research, 57, pp.35~43 (2004)
  44. Gurvits, T. V., "Magnetic resonance imaging study of hippocampal volume in chronic, combatrelated posttraumatic stress disorder", Biological Psychiatry, 40, pp.1091~1099 (1996)
  45. Haase, L., "A pilot study investigating changes in neural processing after mindfulness training in elite athletes", Frontiers in Behavioral Neuroscience, 9, pp.229~ (2015)
  46. Harvey, A. G., "Autobiographical memory in acute stress disorder", Journal of Consulting and Clinical Psychology, 66, pp.500~506 (1998)
  47. Heeren, A., "Changes in ruminative thinking mediate the clinical benefits of mindfulness : Preliminary findings", Mindfulness, 2(1), pp.8~13 (2011)
  48. Heeren, A., "How does attention training work in social phobia: Disengagement from threat or re-engagement to non-threat?", Journal of Anxiety Disorders, 25, pp.1108~1115 (2011)
  49. Hembree, E. A., "Do patients drop prematurely from exposure therapy for PTSD?", Journal of Traumatic Stress, 16, pp.555~562 (2003)
  50. Herbert, J. D., "Acceptance and mindfulness based approaches to anxiety: Conceptualization and treatment", pp.189~212 (2005), Springer
  51. Herwig, U., "Self-related awareness and emotion regulation", Neuroimage, 50(2), pp.734~741 (2010)
  52. Hofmann, S. G., "The effect of mindfulness-based therapy on anxiety and depression : A meta-analytic review", Journal of Consulting and Clinical Psychology, 78, pp.169~183 (2010)
  53. Hölzel, B. K., "Neural mechanisms of symptom improvements in generalized anxiety disorder following mindfulness training", NeuroImage Clinical, 2, pp.448~458 (2013)
  54. Hölzel, B., "Stress reduction correlates with structural changes in the amygdala", Social Cognitive and Affective Neuroscience, 5(1), pp.11~17 (2010)
  55. Hölzel, B., "How does mindfulness meditation work? Proposing mechanisms of action from a conceptual and neural perspective", Perspectives on Psychological Science, 6(6), pp.537~559 (2011)
  56. Hölzel, B., "Investigation of mindfulness meditation practitioners with voxel-based morphometry", Social Cognitive and Affective Neuroscience, 3(1), pp.55~61 (2008)
  57. Hölzel, B., "Differential engagement of anterior cingulate and adjacent medial frontal cortex in adept meditators and non-meditators", Neuroscience Letters, 421(1), pp.16~21 (2007)
  58. Hutcherson, C. A., "Loving-kindness meditation increases social connectedness", Emotion, 8(5), pp.720~724 (2008)
  59. Jacobson, L., "The role of the hippocampus in feedback regulation of the hypothalamic–pituitary–adrenocortical axis", Endocrine Reviews, 12, pp.118~134 (1991)
  60. Jain, S., "A randomized controlled trial of mindfulness meditation versus relaxation training : Effects on distress, positive states of mind, rumination, and distraction", Annals of Behavioral Medicine, 33, pp.11~21 (2007)
  61. Jaycox, L. H., "Cost-effectiveness of psychotherapy", pp.259~269 (1999), Oxford University Press
  62. Jha, A. P., "Mindfulness training modifies subsystems of attention", Cognitive, Affective, & Behavioral Neuroscience, 7, pp.109~119 (2007)
  63. Kabat-Zinn, "An outpatient program in behavioural medicine for chronic pain patients based on the practice of mindfulness meditation: Theoretical considerations and preliminary results", General Hospital Psychiatry, 4, pp.33~47 (1982)
  64. Karl, A., "Meta-analytic review of eventrelated potential studies in post-traumatic stress disorder", Biological Psychology, 71, pp.123~147 (2006)
  65. Kearney, D. J., "Effects of participation in a mindfulness program for veterans with posttraumatic stress disorder : A randomized controlled pilot study", Journal of Clinical Psychology, 69, pp.14~27 (2013)
  66. Kessler R. C, "Posttraumatic stress disorder : the burden to the individual and to society", Jouranal of Clinical Psychiatry, 61(5), pp.4~12 (2000)
  67. Kilpatrick, L. A., "Impact of indfulness-based stress reduction training on intrinsic brain connectivity", Neuroimage, 56(1), pp.290~298 (2011)
  68. Kimbrough, E., "Mindfulness intervention for child abuse survivors", Journal of Clinical Psychology, 66, pp.17~33 (2010)
  69. King, A. P., "Altered Default Mode Network(Dmn)Resting State Functional Connectivity Following a Mindfulness-Based Exposure Therapy for Posttraumatic Stress Disorder(Ptsd)in Combat Veterans of Afghanistan and Iraq", Depress Anxiety, 33(4), pp.289~299 (2016)
  70. Kirk, U., "Mindfulness training increases cooperative decision making in economic exchanges : Evidence from fMRI", Neuroimage, 138, pp.274~283 (2016)
  71. Kong, F., "Brain regions involved in dispositional mindfulness during resting state and their relation with well-being", Social Neuroscience, 11(4), pp.331~343 (2016)
  72. Kozasa, E. H., "Meditation training increases brain efficiency in an attention task", Neuroimage, 59, pp.745~749 (2012)
  73. Lang, A. J., "Anxiety sensitivity and PTSD among female victims of intimate partner violence", Depression and Anxiety, 16, pp.77~83 (2002)
  74. Lazar, S. W., "Meditation experience is associated with increased cortical thickness", NeuroReport, 16(17), pp.1893~1897 (2005)
  75. Lyubomirsky, S., "Why ruminators are poor problem solvers : clues from the phenomenology of dysphoric rumination", Journal of personality and social psychology, 77(5), pp.1041~ (1999)
  76. MacLean, K. A., "Intensive meditation training improves perceptual discrimination and sustained attention", Psychological Science, 21, pp.829~839 (2010)
  77. Manna, A., "Neural correlates of focused attention and cognitive monitoring in meditation", Brain Research Bulletin, 82(1-2), pp.46~56 (2010)
  78. Matsuo, K., "Hypoactivation of the prefrontal cortex during verbal fluency test in PTSD : A near-infrared spectroscopy study", Psychiatry Research : Neuroimaging, 124, pp.1~10 (2003)
  79. Miyake, A., "The unity and diversity of executive functions and their contributions to complex"frontal lobe"tasks : A latent variable analysis", Cognitive Psychology, 41, pp.49~100 (2000)
  80. Modinos, G., "Individual differences in dispositional mindfulness and brain activity involved in reappraisal of emotion", Social Cognitive and Affective Neuroscience, 5(4), pp.369~377 (2010)
  81. Niles, B. L., "Comparing mindfulness and psychoeducation treatments for combat-related PTSD using a telehealth approach", Psychological Trauma:Theory, Research, Practice, and Policy, 4, pp.538~547 (2012)
  82. Nolen-Hoeksema, S., "The role of rumination in depressive disorders and mixed anxiety", depressive symptoms, 2000, pp.109(3), 504~511
  83. Nolen-Hoeksema, S., "Response styles and the duration of episodes of depressed mood", Journal of Abnormal Psychology, 102(1), pp.20~28 (1993)
  84. O’Keefe, J., "The hippocampus as a cognitive map" (1978), Clarendon Press
  85. Omidi, A., "Efficacy of mindfulness-based stress reduction on mood states of veterans with post-traumatic stress disorder", Archives of Trauma Research, 1, pp.151~154 (2013)
  86. Ospina, M. B., "Meditation practices for health: State of the research" (2007), AHRQ
  87. Polusny, M. A., "Mindfulness-Based Stress Reduction for Posttraumatic Stress Disorder Among Veterans : A Randomized Clinical Trial", JAMA, 314(5), pp.456~465 (2015)
  88. Powers, M. B., "A meta-analytic review of prolonged exposure for posttraumatic stress disorder", Clinical Psychology Review, 30, pp.635~641 (2010)
  89. Roland, L. T., "Effects of mindfulness based stress reduction therapy on subjective bother and neural connectivity in chronic tinnitus", Otolaryngology-Head and Neck Surgery, 152(5), pp.919~926 (2015)
  90. Safran, J. D., "Interpersonal process in cognitive therapy" (1990), Basic Books
  91. Schmidt, N. B., "Attention training for generalized social anxiety disorder", Journal of Abnormal Psychology, 118, pp.5~14 (2009)
  92. Schottenbauer, M. A., "Nonresponse and dropout rates in outcome studies on PTSD : Review and methodological considerations", Psychiatry, 71, pp.134~168 (2008)
  93. Sears, S., "I think therefore I om : Cognitive distortions and coping style as mediators for the effects of mindfulness meditation on anxiety, positive and negative affect, and hope", Journal of Clinical Psychology, 65, pp.561~573 (2009)
  94. Shapiro, S. L., "Mechanisms of mindfulness", Journal of Clinical Psychology, 62, pp.373~386 (2006)
  95. Shapiro, S. L., "A randomized controlled trial of mindfulness meditation versus relaxation training : effects on distress, positive states of mind, rumination, and distraction", Annals of behavioral medicine, 33(1), pp.11~21 (2007)
  96. Singer, T., "The neuronal basis and ontogeny of empathy and mind reading", Neuroscience and Biobehavioral Review, 30, pp.855~863 (2006)
  97. Smith, M. E., "Bilateral hippocampal volume reduction in adults with post-traumatic stress disorder : A meta-analysis of structural MRI studies", Hippocampus, 15, pp.798~807 (2005)
  98. Squire, L. R., "Memory and the hippocampus : a synthesis from findings with rats, monkeys, and humans", Psychological Reviews, 99, pp.195~231 (1992)
  99. Steenkamp, M. M., "Psychotherapy for Military-Related PTSD : A Review of Randomized Clinical Trials", JAMA, 314(5), pp.489~500 (2015)
  100. Stein, M. B., "Posttraumatic stress disorder in the primary care medical setting", General Hospital Psychiatry, 22, pp.261~269 (2000)
  101. Efficacy of complementary and alternative therapies for posttraumatic stress disorder, "Strauss, J. L.", ~, pp.VA-ESP Project #09–010 (2011)
  102. Thompson, B. L., "Mindfulness and experiential avoidance as predictors of posttraumatic stress disorder avoidance symptom severity", Journal of Anxiety Disorders, 24, pp.409~415 (2010)
  103. van den Hurk, P. A., "Greater efficiency in attentional processing related to mindfulness meditation", Journal of Experimental Psychology, 63, pp.1168~1180 (2010)
  104. Vasterling, J. J., "Attention and memory dysfunction in posttraumatic stress disorder", Neuropsychology, 12, pp.125~133 (1998)
  105. Villarreal, G., "Reduced hippocampal volume and total white matter volume in posttraumatic stress disorder", Biological Psychiatry, 52, pp.119~125 (2002)
  106. Vujanovic, A. A., "Mindfulness in the treatment of posttraumatic stress disorder among military veterans", Professional Psychology : Research and Practice, 42, pp.24~31 (2011)
  107. Vujanovic, A. A., "Mindfulness-based acceptance and posttraumatic stress symptoms among traumaexposed adults without axis I psychopathology", Journal of Anxiety Disorder, 23, pp.297~303 (2009)
  108. Vujanovic, A. A., "A test of the interactive effects of anxiety sensitivity and mindfulness in the prediction of anxious arousal, agoraphobic cognitions, and body vigilance", Behaviour Research and Therapy, 45, pp.1393~1400 (2007)
  109. Wells, R. E., "Meditation's impact on default mode network and hippocampus in mild cognitive impairment : A pilot study", Neuroscience Letters, 556(27), pp.15~19 (2013)
  110. Wenk-Sormaz, H., "Meditation can reduce habitual responding", Alternative Therapies in Health & Medicine, 11, pp.42~58 (2005)
  111. Winter, H., "Hippocampal volume in adult burn patients with and without posttraumatic stress disorder", American Journal of Psychiatry, 161, pp.2194~2200 (2004)
  112. Yamasaki, H., "Dissociable prefrontal brain systems for attention and emotion", Proceedings of the National Academy of Sciences, 99, pp.11447~11451 (2002)

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