잠재프로파일분석(LPA)을 활용한 PTSD 증상과 외상 후 성장 수준의 양상: 폭식, 비자살적 자해, 문제성 음주의 차이
Latent Profile Analysis of PTSD symptoms and PTG among Adults in South Korea: the Differences in Binge Eating, Non-Suicidal Self-Injury, and Problem Drinking
0
조회
0
다운로드
8
인용
0
참고문헌
키워드
초록
본 연구는 외상 사건을 경험한 국내 성인의 외상 후 스트레스(Post Traumatic Stress Disorder) 증상과 외상 후 성장(Post Traumatic Growth) 양상을 토대로 잠재계층(latent class)을 도출하고, 각 집단 구분에 영향을 미치는 특성을 탐색하며, 집단에 따른 자기파괴적 행동의 차이를 탐색함으로써, 외상 사건을 경험한 개인에 대해 보다 심층적으로 이해하고자 한다. 이를 위해 본 연구에서는 DSM-5 진단기준에 해당하는 외상 사건을 경험한 국내성인 860명을 대상으로 잠재프로파일분석(Latent Profile Analysis)과 R-3STEP 방식을 이용하였다. 집단 예측 변인으로 개인의 인구사회학적 변인(성별, 연령, 최종 학력, 종교유무, 종교활동 정도, 월 평균 소득)과 사회적 고립, 외상 경험 빈도가 포함되었으며, 종속변인으로 자기파괴적 행동(폭식 정도, 비자살적 자해 유무, 음주의 양, 음주 형태, 음주로 인한 정신 사회적 문제)을 포함하였다. 연구결과 집단은 ‘저 PTSD/중 PTG집단’, ‘저 PTSD/고 PTG집단’, ‘고 PTSD/고 PTG집단’으로 분류되었다. 또한 성별, 최종학력, 사회적 고립, 외상 노출 빈도가 집단 예측 변인으로 영향을 미치는 것으로 나타났으며, 폭식 정도, 비자살적 자해 유무, 음주 형태, 음주로 인한 정신사회적인 문제에서 집단 간 차이가 있는 것으로 나타났다. 마지막으로 본 연구의 결과를 바탕으로 논의와 시사점을 제시하였다.
Abstract
The present study examined patterns of co-occurrence between DSM-5 posttraumatic stress disorder(PTSD) symptoms and posttraumatic growth(PTG) among Korean populations(n= 860). Latent profile analysis was used to identify subclasses and suggested that the 3-class model fit best: (1) Low PTSD/Mild PTG group (2) Low PTSD/High PTG group; (3) High PTSD/High PTG group. Class membership was predicted by demographic variables, social isolation, frequency of traumatic experiences. Classes also differed with respect to self-destructive behaviors(self-harm, alcohol use disorder, and eating disorder). These findings contribute to future research about the coexisting patterns of PTSD and PTG, and to identify high-risk individuals who suffer from trauma-related problems in clinical practice.
참고문헌 (90)
- 권재기, "범주형 혼합모형의 잠재계층 수 결정을 위한 적합도 지수의 평가 : 몬테카를로 시뮬레이션 연구", 박사, 교육학과, pp.2012
- 김교헌, "한국판 UCLA 고독척도", 16, pp.13~30 (1989), 충남대학교 학생생활연구소
- 김주은, "포항 지진을 경험한 대학생의 외상 후 스트레스 장애 및 외상 후 성장에 영향을 미치는 요인에 관한 연구: 사회적지지, 핵심신념 붕괴, 반추 스타일을 중심으로", 상담학연구, 20(2), pp.107~123 (2019), 한국상담학회[DOI]
- 김정란, "상담 및 심리치료에서의 트라우마(trauma) 연구동향(2001-2017)", 상담학연구, 20(1), pp.67~91 (2019), 한국상담학회[DOI]
- 김지윤, "PTSD 증상의 조건비율에 근거한한국 성인의 트라우마 경험에 관한 연구", 한국심리학회지: 문화 및 사회문제, 24(3), pp.365~383 (2018), 한국문화및사회문제심리학회[DOI]
- 박윤미, "외상생존자와 일하는 사회복지사의 소진에 대한 역할갈등, 업무부담과 이차적 외상 스트레스 및 자기효능감의 영향", 한국아동복지학, (36), pp.289~322 (2011), 한국아동복지학회
- 박주언, "재난정신건강평가 워크북" (2016), 대안불안의학회
- 박현정, "서울교육종단연구 2010 사용자매뉴얼", 서울특별시교육연구정보원, ~ (2011)
- 서윤아, "비자살적 자해에 영향을 미치는 복합외상 및 복합외상증후군의 탐색", 석사, 심리학과 임상및상담심리전공, pp.2014
- 송승훈, "한국판 외상후 성장 척도의 타당도 및 신뢰도 연구", 한국심리학회지: 건강, 14(1), pp.193~214 (2009), 한국건강심리학회[DOI]
- 염유성, "한국판 PC-PTSD-5의 타당화 연구", 석사, pp.2017
- 오현승, "키워드 네트워크 분석을 활용한 PTSD(Post Traumatic Stress Disorder) 연구 동향 탐색", 재활심리연구, 25(4), pp.823~838 (2018), 한국재활심리학회
- 윤명숙, "사회복지사의 외상경험과 외상 후 스트레스장애의관계에 미치는 사회적 지지의 조절효과", 정신건강과 사회복지, 41(4), pp.174~200 (2013), 한국정신건강사회복지학회
- 이동훈, "성격 5요인, 외상 후 인지, 사건관련 반추, PTSD 증상, 외상 후 성장의 관계: 외상 후 성장모델을 중심으로", 한국심리학회지:일반, 36(2), pp.241~270 (2017), 한국심리학회[DOI]
- 이동훈, "세월호 재난으로 자녀를 잃은 부모들의 사회적 지지, 갈등, 고립경험에 관한 연구", 상담학연구, 18(5), pp.331~355 (2017), 한국상담학회[DOI]
- 이병욱, "한국어판 알코올 사용장애 진단 검사 (AUDIT: Alcohol Use Disorders Identification Test) 의 개발: 신뢰도 및 타당도 검사", 중독정신의학, 4, pp.83~92 (2000)
- 이수진, "외로움과 대인관계문제의 관계에서 초기부적응도식의 조절효과", 석사, 상담교육전공, pp.2012
- 이임순, "정상인의 섭식유형 및 다이어트 양상", Korean Journal of Clinical Psychology, 16(1), pp.87~100 (1997)
- 최승미, "인지적, 문제해결적 행동 대처 및 사회적 지지가 외상 후 성장에 미치는 영향: PTSD 증상 수준에 따라", 인지행동치료, 13(2), pp.307~328 (2013), 한국인지행동치료학회
- 홍세희, "잠재계층, 잠재전이, 성장혼합모형" (2019), 박영사
- American Psychiatric Association, "Diagnostic and statistical manual of mental disorders (DSM-5)" (2013), American Psychiatric Pub
- Arpawong, T. E., "Post-traumatic growth, stressful life events, and relationships with substance use behaviors among alternative high school students : A prospective study", Psychology & Health, 30(4), pp.475~494 (2015)
- Asparouhov, T., "Auxiliary variables in mixture modeling : Three-step approaches using M plus", Structural Equation Modeling : A Multidisciplinary Journal, 21(3), pp.329~341 (2014)
- Ayache, R., "Psychiatric outcomes after childbirth : can posttraumatic growth protect me from disordered eating symptoms?", Archives of Gynecology and Obstetrics, 293(6), pp.1271~1278 (2016)
- Berg, S., "Loneliness in the Swedish aged", Journal of Gerontology, 36(3), pp.342~349 (1981)
- Blevins, C. A., "The posttraumatic stress disorder checklist for DSM‐5(PCL‐5) : Development and initial psychometric evaluation", Journal of Traumatic Stress, 28(6), pp.489~498 (2015)
- Bokszczanin, A., "PTSD symptoms in children and adolescents 28 months after a flood : Age and gender differences", Journal of Traumatic Stress : Official Publication of The International Society for Traumatic Stress Studies, 20(3), pp.347~351 (2007)
- Bonanno, G. A., "Beyond resilience and PTSD: Mapping the heterogeneity of responses to potential trauma", Psychological trauma: Theory, Research, Practice, and Policy, 4(1), pp.74~ (2012)
- Burnam, M. A., "Sexual assault and mental disorders in a community population", Journal of Consulting and Clinical Psychology, 56(6), pp.843~850 (1988)
- Breslau, N., "The structure of posttraumatic stress disorder : latent class analysis in 2 community samples", Archives of General Psychiatry, 62(12), pp.1343~1351 (2005)
- Brooks, M., "Trauma characteristics and posttraumatic growth: The mediating role of avoidance coping, intrusive thoughts, and social support", Psychological Trauma: Theory, Research, Practice, and Policy (2018)
- Calhoun, L. G., "Facilitating posttraumatic growth: A clinician’s guide" (1999), Routledge
- Cao, C., "Patterns of posttraumatic stress disorder symptoms and posttraumatic growth in an epidemiological sample of Chinese earthquake survivors: A latent profile analysis", Frontiers in Psychology, 9 (2018)
- Chopko, B. A., "Posttraumatic growth in relation to the frequency and severity of traumatic experiences among police officers in small to midsize departments", Journal of Interpersonal Violence, 34(6), pp.1247~1260 (2019)
- Collins, L. M., "Latent class and latent transition analysis: With applications in the social, behavioral, and health sciences" (2009), Wiley
- Contractor, A. A., "Typologies of PTSD clusters and reckless", self-destructive behaviors : a latent profile analysis, 2019, pp.272, 682~691
- Costello, E. J., "The prevalence of potentially traumatic events in childhood and adolescence", Journal of Traumatic Stress: Official Publication of The International Society for Traumatic Stress Studies, 15(2), pp.99~112 (2002)
- Curran, P. J., "The robustness of test statistics to nonnormality and specification error in confirmatory factor analysis", Psychological methods, 1(1), pp.16~ (1996)
- de Vries, G. J., "The lifetime prevalence of traumatic events and posttraumatic stress disorder in the Netherlands", Journal of Traumatic Stress: Official Publication of The International Society for Traumatic Stress Studies, 22(4), pp.259~267 (2009)
- Eidhof, M. B., "Complex Posttraumatic Stress Disorder in Patients Exposed to Emotional Neglect and Traumatic Events : Latent Class Analysis", Journal of Traumatic Stress, 32(1), pp.23~31 (2019)
- Field, A., "Discovering statistics using IBM SPSS statistics" (2013), SAGE Publications
- Frazier, P., "Traumatic events among undergraduate students : Prevalence and associated symptoms", Journal of Counseling Psychology, 56(3), pp.450~460 (2009)
- Gabriel, S., "Social surrogate use in those exposed to trauma : I get by with a little help from my(fictional)friends", Journal of Social and Clinical Psychology, 36(1), pp.41~63 (2017)
- Galatzer-Levy, I. R., "636,120 ways to have posttraumatic stress disorder", Perspectives on Psychological Science, 8(6), pp.651~662 (2013)
- Garner, D. M., "Manual for Eating Disorder Inventory(EDI); Plus Manual Supplement" (1984), Psychological Assessment Resources
- Garner, R., "When children and adults do not use learning strategies : Toward a theory of settings", Review of Educational Research, 60(4), pp.517~529 (1990)
- Goar, S. G., "Trauma Exposure, Posttraumatic Stress Disorder and Alcohol Use Disorder among Females in Jos, North Central Nigeria", J Psychiatry, 21(453), pp.2~ (2018)
- Goodman, R., "The use of mindfulness in trauma counseling", Journal of Mental Health Counseling, 34(3), pp.254~268 (2012)
- Gratz, K. L., "Measurement of deliberate self-harm : Preliminary data on the Deliberate Self-Harm Inventory", Journal of Psychopathology and Behavioral Assessment, 23(4), pp.253~263 (2001)
- Hays, R. D., "A short-form measure of loneliness", Journal of Personality Assessment, 51(1), pp.69~81 (1987)
- Hill, K. G., "Early adult outcomes of adolescent binge drinking : person and variable‐centered analyses of binge drinking trajectories", Alcoholism : Clinical and Experimental Research, 24(6), pp.892~901 (2000)
- Hruska, B., "PTSD symptom severity and psychiatric comorbidity in recent motor vehicle accident victims : A latent class analysis", Journal of Anxiety Disorders, 28(7), pp.644~649 (2014)
- Johnson, H., "The development and maintenance of post-traumatic stress disorder(PTSD)in civilian adult survivors of war trauma and torture : A review", Clinical Psychology Review, 28(1), pp.36~47 (2008)
- Joseph, S., "Growth following adversity : Theoretical perspectives and implications for clinical practice", Clinical Psychology Review, 26(8), pp.1041~1053 (2006)
- Kim, M. M., "Assessing trauma, substance abuse, and mental health in a sample of homeless men", Health & Social Work, 35(1), pp.39~48 (2010)
- Kline, A., "Increased risk of alcohol dependency in a cohort of National Guard troops with PTSD : a longitudinal study", Journal of Psychiatric Research, 50, pp.18~25 (2014)
- Kokaliari, E. D., "An exploratory study of the nature and extent of nonsuicidal self-injury among college women", International Journal of Population Research (2014)
- Lowenthal, M. F., "Handbook of Aging and the Social Sciences, 5", pp.432~456 (1976)
- McDiarmid, L., "Posttraumatic growth associated with perceived changes in health values and reduced alcohol use among bereaved college students", Traumatology, 23(4), pp.309~ (2017)
- Milligan-Saville, J., "The impact of trauma exposure on the development of PTSD and psychological distress in a volunteer fire service", Psychiatry Research, 270, pp.1110~1115 (2018)
- Minihan, S., "Patterns and predictors of posttraumatic stress disorder in refugees : A latent class analysis", Journal of Affective Disorders, 232, pp.252~259 (2018)
- Mota, N. P., "Trauma exposure, DSM-5 post-traumatic stress disorder, and sexual risk outcomes", American Journal of Preventive Medicine, 56(2), pp.215~223 (2019)
- Muthén, B., "Integrating person‐centered and variable‐centered analyses : Growth mixture modeling with latent trajectory classes", Alcoholism : Clinical and experimental research, 24(6), pp.882~891 (2000)
- Nietlisbach, G., "Social cognition and interpersonal impairments in trauma survivors with PTSD", Journal of Aggression, Maltreatment & Trauma, 18(4), pp.382~402 (2009)
- Nock, M. K., "Prevalence, correlates, and treatment of lifetime suicidal behavior among adolescents : results from the National Comorbidity Survey Replication Adolescent Supplement", JAMA Psychiatry, 70(3), pp.300~310 (2013)
- Nylund, K. L., "Deciding on the number of classes in latent class analysis and growth mixture modeling : A Monte Carlo simulation study", Structural equation modeling : A multidisciplinary Journal, 14(4), pp.535~569 (2007)
- Pastor, D. A., "A latent profile analysis of college students’ achievement goal orientation", Contemporary Educational Psychology, 32(1), pp.8~47 (2007)
- Prins, A., "The primary care PTSD Screen for DSM-5(PC-PTSD-5) : development and evaluation within a veteran primary care sample", Journal of general internal medicine, 31(10), pp.1206~1211 (2016)
- Prins, A, "The primary care PTSD screen (PC-PTSD): development and operating characteristics", Primary care psychiatry, 9(1), pp.9~14 (2003)
- Rahman, A. F., "A latent class analysis of PTSD symptoms among inner city primary care patients", Journal of Psychiatric Research, 98, pp.1~8 (2018)
- Russell, D., "The revised UCLA Loneliness Scale : concurrent and discriminant validity evidence", Journal of Personality and Social Psychology, 39(3), pp.472~ (1980)
- Russell, D., "Developing a measure of loneliness", Journal of Personality Assessment, 42(3), pp.290~294 (1978)
- Ryu, W., "Post-traumatic Stress Disorder and Social Isolation among North Korean Refugee Women in South Korea: The Moderating Role of Formal and Informal Support", Sustainability, 10(4), pp.1246~ (2018)
- Saunders, J. B., "Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption‐II", Addiction, 88(6), pp.791~804 (1993)
- Schoedl, A. F., "The clinical correlates of reported childhood sexual abuse : an association between age at trauma onset and severity of depression and PTSD in adults", Journal of Child Sexual Abuse, 19(2), pp.156~170 (2010)
- Sippel, L. M., "The unique roles of emotional numbing and arousal symptoms in relation to social connectedness among military veterans in residential treatment for PTSD", Psychiatry, 81(3), pp.271~282 (2018)
- Steenkamp, M. M., "Latent classes of PTSD symptoms in Vietnam veterans", Behavior Modification, 36(6), pp.857~874 (2012)
- Smith, N. B., "The role of trauma symptoms in nonsuicidal self-injury", Trauma, Violence, & Abuse, 15(1), pp.41~56 (2014)
- Solomon, Z., "Family functioning, perceived societal support, and combat-related psychopathology : The moderating role of loneliness", Journal of Social and Clinical Psychology, 9(4), pp.456~472 (1990)
- Tedeschi, R. G., "The Posttraumatic Growth Inventory : Measuring the positive legacy of trauma", Journal of Traumatic Stress, 9(3), pp.455~471 (1996)
- Tedeschi, R. G., "Posttraumatic growth: Conceptual foundations and empirical evidence", Psychological Inquiry, 15(1), pp.1~18 (2004)
- Tedeschi, R. G., "The posttraumatic growth inventory : A revision integrating existential and spiritual change", Journal of Traumatic Stress, 30(1), pp.11~18 (2017)
- Townsend, Peter, "Old People in Three Industrial Societies" (1968), Routledge and K. Paul
- Tull, M. T., "Comprehensive guide to post-traumatic stress disorders", pp.803~816 (2016), Springer International Publishing
- Vermunt, J. K., "Latent class modeling with covariates : Two improved three-step approaches", Political analysis, 18(4), pp.450~469 (2010)
- Wang, J., "Structural equation modeling: Applications using Mplus" (2012), Higher Education Press
- "The Life Events Checklist for DSM-5 (LEC-5)" (2013)[URL]
- Weathers, F. W., "The PTSD Checklist (PCL): Reliability, validity, and diagnostic utility", annual convention of the international society for traumatic stress studies, 462 (1993)
- Williams, D., "Hurting to Cope : Self-Injurious Behavior as an Escape from Self-Focus", Undergraduate Review, 6(1), pp.120~129 (2010)
- Zeligman, M., "Loneliness as moderator between trauma and posttraumatic growth", Journal of Counseling & Development, 95(4), pp.435~444 (2017)
