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알코올중독자의 아동기 부정적 경험이 주관적 건강상태에 미치는 영향: 스트레스의 매개효과를 중심으로

Effect of Adverse Childhood Experiences on Subjective Health Status among People with Alcohol Addiction: Focusing on the mediating effect of stress

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초록

본 연구는 알코올중독자의 아동기 부정적 경험 수준을 파악하고 아동기 부정적 경험과 주관적 건강상태의 관계에서 스트레스의 매개효과를 검증하는 것을 목적으로 한다. 이를 위해 한국중독당사자지원센터에서 2023년에 10월과 11월에 온·오프라인 방식으로 진행한 ‘중독당사자가 인식한 낙인 연구’의 원 자료 226명 중 알코올중독자 181명을 분석에 활용하였다. 분석에는 IBM SPSS 27.0과 SPSS PROCESS macro 4.2 통계 프로그램을 이용하였다. 주요 연구결과는 다음과 같다. 첫째, 알코올중독자의 95.5%가 2개 이상의 아동기 부정적 경험을 보고한 것으로 나타났다. 둘째, 아동기 부정적 경험 누적이 많을수록 주관적 건강상태에 부정적인 영향을 미치는 것으로 나타났다. 셋째, 아동기 부정적 경험과 주관적 건강상태의 관계에서 스트레스는 매개효과를 보여주었다. 이러한 연구결과를 바탕으로 아동기 부정적 경험에 노출된 알코올중독자의 스트레스 감소를 위한 대처와 주관적 건강상태를 향상시키기 위한 실천적 함의를 제시하였다.

Abstract

The study aims to explore the level of adverse childhood experiences (ACE) among people with alcohol addiction and to examine how stress mediates the relationship between ACE and subjective health status. This study used the data of 181 out of 226 people with alcohol addiction in the raw data of “Study about Stigma Perceived by People with Addiction,” conducted online and offline at the Korea Addicts Right Center in October and November 2023. IBM SPSS 27.0 and SPSS PROCESS macro 4.2 statistical programs were used for the analysis. The main results were as follows. First, 95.5% of the people with alcohol addiction reported two or more ACE. Second, a higher accumulation of ACE had a negative impact on subjective health status. Third, stress mediated the relationship between ACE and subjective health status. Based on these findings, practical implications were provided for reducing stress and improving subjective health in people with alcohol addiction exposed to ACE.

참고문헌 (72)

  1. 강경림, "회복중인 알코올 중독자를 위한 마음챙김명상 프로그램의 효과", 알코올과 건강행동연구, 24(2), pp.13~28 (2023)[DOI]
  2. 김용석, "한국어판 정신건강 선별도구(K10, K6)의 타당화 연구 : 재가복지서비스이용자를 대상으로", 정신건강과 사회복지, 36, pp.65~88 (2011)
  3. 김은희, "불운한 아동기 경험이 성인기 신체 및 정신건강에 미치는 영향", 한국심리학회지 : 건강, 27(4), pp.627~648 (2022)
  4. 김준범, "아동기 역경경험과 생애 자살시도의 관계에 관한 연구", 아동학회지, 41(2), pp.27~39 (2020)[DOI]
  5. 김희경, "알코올중독자 성인자녀의 극복력에 대한 통합적 문헌고찰 : 조작적 정의와 조절변수 중심으로", 정신간호학회지, 28(1), pp.50~63 (2019)[DOI]
  6. 생애주기별 학대경험의 상호관계성, "류정희", 한국보건사회연구원, ~ (2017)
  7. 중독당사자가 인식한 낙인에 관한 연구, "박소연", 한국중독당사자지원센터, ~ (2023)
  8. "2021년 정신건강실태조사 보고서" (2021), 보건복지부[URL]
  9. 신명식, "한국성인의 문제음주행태 관련요인 분석", 한국알코올과학회지, 3(1), pp.111~130 (2002)
  10. 안혜용, "RP기반 집단미술치료가 알코올 중독자의 우울, 스트레스대처능력 및 금주자기효능감에 미치는 효과", 예술심리치료연구, 16(2), pp.323~348 (2020)
  11. 우재희, "알코올중독자의 스트레스 대처방식, 사회적 지지와 변화동기의 상관관계", 정신보건과 사회사업, 40(4), pp.116~145 (2012)
  12. 윤명숙, "알코올중독자의 자살생각에 미치는 음주의 조절효과", 정신건강과 사회복지, 38, pp.113~140 (2011)
  13. 이래혁, "학교 밖 청소년의 사회적 낙인감이 비행에 미치는 영향 : 충동성을 통한 학업중단 기간의 조절된 매개효과", 보건과 복지, 23(2), pp.165~190 (2021)[DOI]
  14. 이유진, "의료시설 접근성과 대중교통 접근성이 농촌 및 도시 지역 거주노인의 주관적 건강상태에 미치는 영향 분석 : 일반화된 순서형 로짓 모형의 적용", 한국지역개발학회지, 27(1), pp.65~88 (2015)
  15. 이진희, "지역적 건강불평등과 개인 및 지역수준의 건강결정요인", 보건사회연구, 36(2), pp.345~384 (2016)[DOI]
  16. 이하나, "아동기 부정적 생애경험과 성인의 우울 증상: 성인기사회적 지지의 조절효과에 대한 탐색", 한국가족복지학, 68(2), pp.127~156 (2021)[DOI]
  17. 이하나, "아동기 부정적 생애경험과 성인기 건강 간의 관계 : 성별 차이의 탐색", 아동학회지, 42(3), pp.343~357 (2021)[DOI]
  18. 임성범, "알코올중독 재발에 영향을 미치는 요인에 관한 연구", 사회복지개발연구, 15(4), pp.338~411 (2009)
  19. 전진용, "알코올 사용과 스트레스와의 관련성", 신경정신의학, 45(4), pp.343~348 (2006)
  20. 정재원, "지역사회에서 회복중인 알코올중독자의 스트레스와 대처", Stress, 27(3), pp.277~286 (2019)[DOI]
  21. "지역사회건강조사: 2022 지역건강통계 한눈에 보기" (2023), 질병관리청[URL]
  22. 최경원, "청소년의 주관적 건강인식 관련 요인 : 한국청소년패널 자료 활용", 보건교육건강증진학회지, 31(3), pp.35~50 (2014)[DOI]
  23. 최유경, "입원한 알코올중독 환자에 대한 팀 접근 사례 연구", 정신건강과 사회복지, 24(1), pp.161~174 (2006)
  24. 최순주, "스트레스 완화 임상미술치료가 여성알코올 의존자의 뇌기능지수에 미치는 효과", 임상미술치료학연구, 8(1), pp.18~25 (2013)
  25. 최창용, "아동기 역경과 성인기 건강 간의 관계", 한국복지패널 학술대회 논문집, 15, pp.73~90 (2022)
  26. "17차 웨이브 설문지" (2023), 한국복지패널[URL]
  27. Aldwin, C., "Effects of stress on health and aging : Two paradoxes", California Agriculture, 64(4), pp.183~188 (2010)[DOI]
  28. Almuneef, M., "Gender-based disparities in the impact of adverse childhood experiences on adult health : Findings from a national study in the Kingdom of Saudi Arabia", International Journal for Equity in Health, 16(90), pp.1~9 (2017)[DOI]
  29. Anda, R. F., "The enduring effects of abuse and related adverse experiences in childhood", European Archives of Psychiatry and Clinical Neuroscience, 256(3), pp.174~186 (2006)[DOI]
  30. Card, A. J., "Moving beyond the WHO definition of health : A new perspective for an aging world and the emerging era of value-based care", World Medical & Health Policy, 9(1), pp.127~137 (2017)[DOI]
  31. Charney, D. A., "Early recovery from alcohol dependence : Factors that promote or impede abstinence", Journal of Substance Abuse Treatment, 38(1), pp.42~50 (2010)[DOI]
  32. Connelly, J. E., "Health perception of primary care patients and the influence on health care utilization", Medical Care, 27(3), pp.S99~109 (1989)[DOI]
  33. Constitution of the World Health Organization, "In World Health Organization:Basic documents", World Health Organization, ~ (2005)
  34. De Bellis, D., "Developmental traumatology : a contributory mechanism for alcohol and substance use disorders", Psychoneuroendocrinology, 27, pp.155~170 (2002)[DOI]
  35. De Venter, M. D., "The relationship between adverse childhood experiences and mental health in adulthood. A systematic literature review", Tijdschrift voor Psychiatrie, 55(4), pp.259~268 (2013)
  36. Evans, G., "Multiple risk exposure as a potential explanatory mechanism for the socioeconomic status–health gradient", Annals of the New York Academy of Sciences, 1186(1), pp.174~189 (2010)[DOI]
  37. Felitti, V. J., "Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults : The adverse childhood experiences(ACE)study", American Journal of Preventive Medicine, 14(4), pp.245~258 (1998)[DOI]
  38. Friedmann, D. P., "Alcohol use in adults", New England Journal of Medicine, 368(4), pp.365~373 (2013)[DOI]
  39. Garbarski, D., "Research in and prospects for the measurement of health using self-rated health", Public Opinion Quarterly, 80(4), pp.977~997 (2016)[DOI]
  40. Garrity, T. F., "Correlates of subjective stress among drug court clients", International Journal of Offender Therapy and Comparative Criminology, 50(3), pp.269~279 (2006)[DOI]
  41. Grummitt, L., "An umbrella review of the links between adverse childhood experiences and substance misuse : What, why, and where do we go from here?", Substance Abuse and Rehabilitation, 13, pp.83~100 (2022)[DOI]
  42. Hayes, A. F., "Introduction to mediation, moderation, and conditional process analysis: A regression-based perspective" (2018), The Guilford Press
  43. Jacobson, N., "Recovery as policy in mental health service : Strategies emerging from the states", Psychiatric Rehabilitation Journal, 23(4), pp.333~341 (2000)[DOI]
  44. Johnson, J. E., "Research considerations : Stress and perceived health status in the rural elderly", Journal of Gerontological Nursing, 19(10), pp.24~29 (1993)[DOI]
  45. Karatekin, C., "Adverse childhood experiences(ACEs), stress and mental health in college students", Stress and Health, 34, pp.36~45 (2018)[DOI]
  46. Kendall-Tackett, K., "The health effects of childhood abuse : Four pathways by which abuse can influence health", Child Abuse & Neglect, 26(6), pp.715~729 (2002)[DOI]
  47. Kessler, R. C., "Short screening scales to monitor population prevalences and trends in non-specific psychological distress", Psychological Medicine, 32(2), pp.959~976 (2002)[DOI]
  48. Kline, R. B., "Principles and practice of structural equation modeling" (2015), Guilford Publications
  49. Kondo, N., "Income inequality, mortality, and self rated health : Meta-analysis of multilevel studies", British Medical Journal, 339(7731), pp.1178~1181 (2009)[DOI]
  50. Lazarus, R. S., "Stress, appraisal, and coping" (1984), Springer Publishing Company
  51. Leitenberg, H., "Individual differences among undergraduate women in methods of coping with stressful events : The impact of cumulative childhood stressors and abuse", Child Abuse & Neglect, 28(2), pp.181~192 (2004)[DOI]
  52. Lindström M., "Marital status, social capital, material conditions and self-rated health : A population-based study", Health Policy, 93, pp.172~179 (2009)[DOI]
  53. Manyema, M., "Stress begets stress : the association of adverse childhood experiences with psychological distress in the presence of adult life stress", BMC Public Health, 18, pp.835~ (2018)[DOI]
  54. Mc Elroy, S., "Relationship between adverse early experiences, stressors, psychosocial resources and wellbeing", Child Abuse & Neglect, 38(1), pp.65~75 (2014)[DOI]
  55. McFarlane, A. C., "Epidemiological evidence about the relationship between PTSD and alcohol abuse : the nature of the association", Addictive Behaviors, 23, pp.813~825 (1998)[DOI]
  56. Miller, G. E, "Health psychology : developing biologically plausible models linking the social world and physical health", Annual Review of Psychology, 60, pp.501~524 (2009)[DOI]
  57. Mosley-Johnson, E., "Stress that endures : Influence of adverse childhood experiences on daily life stress and physical health in adulthood", Journal of Affective Disorders, 284, pp.38~43 (2021)[DOI]
  58. Nurius, P. S., "Life course pathways from adverse child experiences to adult physical health : A structural equation model", Journal of Aging and Health, 1, pp.20~ (2019)[DOI]
  59. Pearlin, I. L., "The life course and the stress process: Some conceptual comparisons", The Journals of Gerontology: Social Sciences, 65(2), pp.207~215 (2010)[DOI]
  60. Petruccelli, K., "Adverse childhood experiences and associated health outcomes : A systematic review and meta-analysis", Child Abuse & Neglect, 97, pp.104127~ (2019)[DOI]
  61. Rariden, C., "Screening for adverse childhood experiences : Literature review an dpractice implication", The Journal for Nurse Practitioners, 17, pp.98~104 (2021)[DOI]
  62. Rogers, C. J., "Effects of multiple adverse childhood experiences on substance use in young adults : A review of the literature", Drug and Alcohol Dependence, 234, pp.109407~ (2022)[DOI]
  63. Sinha, R., "How does stress lead to risk of alcohol relapse?", Alcohol Research : Current Reviews, 34(4), pp.432~440 (2012)[DOI]
  64. Springer, K. W., "Long-term physical and mental health consequences of childhood physical abuse : Results from a large population-based sample of men and women", Child Abuse & Neglect, 31, pp.517~530 (2007)[DOI]
  65. Thoits, P. A., "Stress and health major findings and policy implications", Journal of Health and Social Behavior, 51(1), pp.S41~S53 (2010)[DOI]
  66. Underwood, J. W., "The impact of adverse childhood experiences on college student stress and well-being", Journal of College Student Retention: Research, Theory &Practice (2024)[DOI]
  67. Waldrop, A. E., "Differences in early onset alcohol use and heavy drinking among persons with childhood and adulthood trauma", The American Journal on Addictions, 16, pp.439~442 (2007)[DOI]
  68. "Addressing adverse childhood experiences to improve public health: Expert consultation" (2009)[URL]
  69. "Adverse Childhood Experiences International Questionnaire (ACE-IQ)" (2020)[URL]
  70. Widom, C. S., "Alcohol abuse as a risk factor for and consequence of child abuse", Alcohol Research & Health, 25, pp.52~57 (2001)
  71. Wilson, I. R., "Linking clinical variables with health-related quality of life : A conceptual model of patient outcomes", The Journal of the American Medical Association, 273(1), pp.59~65 (1995)[DOI]
  72. Wuorela, M., "Self-rated health and objective health status as predictors of all-cause mortality among older people : a prospective study with a 5-, 10-, and 27-year follow-up", BMC Geriatrics, 20, pp.120~ (2020)[DOI]

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