본문 바로가기
KERD
논문KCI 등재

대학생의 불확실성에 대한 인내력 부족과 내재화 증상의 관계에서 역기능적 상위인지신념과 경험회피의 순차매개효과

Relationship between Intolerance of Uncertainty and Internalizing Symptoms in Korean College Students: Sequential Mediating Effects of Dysfunctional Metacognitive Beliefs and Experiential Avoidance

0

조회

0

다운로드

1

인용

0

참고문헌

키워드

주제분류심리과학

초록

본 연구의 목적은 대학생을 대상으로 불확실성에 대한 인내력 부족과 내재화 증상의 관계에서 역기능적 상위인지신념과 경험회피의 순차적 매개효과를 검증하여, 공병률이 높은 우울과 불안의 취약성 요인들의 관계를 규명하고 정신건강 개입방안을 모색하는 것이다. 이를 위해 대학생 438명을 대상으로 불확실성에 대한 인내력 부족, 역기능적 상위인지신념, 경험회피, 우울, 불안을 측정하는 자기보고형 설문지를 실시하였고, 자료는 구조방정식 모형을 통해 분석하였다. 본 연구의 결과, 불확실성에 대한 인내력 부족과 내재화 증상의 관계에서 역기능적 상위인지신념과 경험회피는 각각 유의한 매개효과가 있는 것으로 나타났다. 더욱이 불확실성에 대한 인내력 부족과 내재화 증상의 관계에서 역기능적 상위인지신념과 경험회피의 순차적 매개효과가 유의한 것으로 나타났다. 또한, 부분매개모형과 완전매개모형의 적합도 비교에서 완전매개모형이 유의하게 더 적합한 것으로 검증되었다. 이러한 결과는 불확실성에 대한 인내력이 부족할수록 역기능적 상위인지신념과 경험회피가 많아지고, 그로 인해 내재화 증상이 많아지는 것을 시사한다. 본 연구는 초진단적 변인들 간 관계의 단일한 통합 모델을 제시하였고, 정신병리의 공통요인들의 치료 방안에 대해 논의하였다.

Abstract

This study aimed to examine the sequential mediating effects of dysfunctional metacognitive beliefs and experiential avoidance in the relationship between intolerance of uncertainty and internalizing symptoms in college students. In doing so, we sort to elucidate the relationships between vulnerability factors for depression and anxiety, which have a high rate of comorbidity, and to identify potential intervention strategies for mental health. 438 college students completed self-report questionnaires to measure intolerance of uncertainty, dysfunctional metacognitive beliefs, experiential avoidance, anxiety, and depression. The collected data were analyzed using structural equation modeling (SEM) to examine the mediating effects. The results indicated that dysfunctional metacognitive beliefs and experiential avoidance had significant mediating effects in the relationship between intolerance of uncertainty and internalizing symptoms, individually. Moreover, the sequential mediating effect of dysfunctional metacognitive beliefs and experiential avoidance in this relationship was found to be statistically significant. Additionally, a full-mediation model demonstrated a significantly better model fit than a partial-mediation model. The results of this study suggest that intolerance of uncertainty may contribute to the development of internalizing symptoms by increasing dysfunctional metacognition and experiential avoidance. Through an integrated understanding of transdiagnostic variables, we tried to find a treatment plan targeting common factors associated with psychopathology.

참고문헌 (110)

  1. 김순희, "부정적 및 긍정적 평가에 대한 두려움, 불확실성에 대한 인내력 부족과 사회불안의 관계", 석사, 심리학, pp.2010
  2. 김승재, "대학생의 모 애착이 사회불안에 미치는 영향: 역기능적인 상위인지의 매개효과", 인간이해, 40(1), pp.43~62 (2019), 학생생활상담연구소[DOI]
  3. 김하은, "여성 취업준비생의 불확실성에 대한 인내력 부족과 우울의 관계에서 경험회피의 매개효과", 사회과학연구, 59(1), pp.627~651 (2020), 사회과학연구원[DOI]
  4. 백창준, "내면화된 수치심과 대인관계문제와의 관계에서 역기능적 상위인지와 완벽주의적 자기제시의 직렬 매개효과", 석사, pp.2020
  5. 보건복지부, "2022 자살예방백서" (2022), 보건복지부, 한국생명존중희망재단
  6. 설순호, "걱정과 강박사고에 대한 인지적 평가와 통제방략", 석사, 임상·상담심리학, pp.2004
  7. 유정찬, "불확실성에 대한 인내력과 사회불안의 관계: 경험회피와 사후반추사고의 순차적 매개효과", 복지상담교육연구, 11(2), pp.181~211 (2022), 한국복지상담교육학회
  8. 윤소진, "불확실성에 대한 인내력 부족과 불안 및 우울과의 관계: 걱정과 반추의 공통 요인(반복적 부정적 사고)과 차별 요인의 매개효과를 중심으로", 한국심리학회지: 건강, 24(3), pp.709~734 (2019), 한국건강심리학회[DOI]
  9. 이은지, "20대 대학생의 불확실성에 대한 인내력부족과 우울 간의 관계: 반복적 부정적 사고와 경험회피의 이중매개 효과", 석사, pp.2022
  10. 이정은, "걱정에 대한 부정적 신념과 일반화된 불안증상 간의 관계에서 경험적 회피의 매개효과", Korean Journal of Clinical Psychology, 26(4), pp.939~961 (2007), 한국임상심리학회[DOI]
  11. 전겸구, "통합적 한국판 CES-D 개발", 한국심리학회지 : 건강, 6(1), pp.59~76 (2001)
  12. 조용래, "걱정의 통제 불능성", 위험에 대한 부정적 신념과 시험불안의 관계: 경험 회피의 매개역할, 2008, pp.27(4), 891~909[DOI]
  13. 한덕웅, "건강행동척도의 전국 규준", 한국심리학회지: 건강, 7(1), pp.1~22 (2002), 한국건강심리학회
  14. 허재홍, "한국어판 수용-행동 질문지Ⅱ 신뢰도 및 타당도 연구", 한국심리학회지: 상담 및 심리치료, 21(4), pp.861~878 (2009), 한국상담심리학회
  15. 홍세희, "구조 방정식 모형의 적합도 지수 선정기준과 그 근거", Korean Journal of Clinical Psychology, 19(1), pp.161~177 (2000)
  16. Achenbach, T. M., "The classification of child psychopathology : A review and analysis of empirical efforts", Psychological Bulletin, 85(6), pp.1275~1301 (1978)
  17. Akbari, M., "The transdiagnostic model of worry : The mediating role of experiential avoidance", Personality and Individual Differences, 135, pp.166~172 (2018)
  18. Arnett, J. J., "Emerging adulthood : A theory of development from the late teens through the twenties", American Psychologist, 55(5), pp.469~480 (2000)
  19. Arria, A. M., "Discontinuous college enrollment : Associations with substance use and mental health", Psychiatric Services, 64(2), pp.165~172 (2013)
  20. Auerbach, R. P., "Mental disorders among college students in the World Health Organization world mental health surveys", Psychological Medicine, 46(14), pp.2955~2970 (2016)
  21. Bai, Z., "Acceptance and commitment therapy(ACT)to reduce depression : A systematic review and meta-analysis", Journal of Affective Disorders, 260, pp.728~737 (2020)
  22. Banducci, A. N., "The impact of intolerance of emotional distress and uncertainty on veterans with co-occurring PTSD and substance use disorders", Journal of Anxiety Disorders, 41, pp.73~81 (2016)
  23. Barbosa, L. N. F., "Anxiety and depression and psychoactive substance abuse in university students", SMAD. Revista Eletrônica Saúde Mental Álcool e Drogas, 16(1), pp.1~8 (2020)
  24. Barlow D. H., "Toward a unified treatment for emotional disorders–republished article", Behavior Therapy, 47(6), pp.838~853 (2016)
  25. Barlow, D. H., "Clinical handbook of psychological disorders: A step-by-step treatment manual" (2014), Guilford Publication
  26. Barlow, D. H., "The unified protocol for transdiagnostic treatment of emotional disorders: Client workbook" (2011), Oxford University Press
  27. Barlow, D. H., "The unified protocol for transdiagnostic treatment of emotional disorders: Therapist guide" (2011), Oxford University Press
  28. Bond, F. W., "Preliminary psychometric properties of the Acceptance and Action Questionnaire-Ⅱ : A revised measure of psychological inflexibility and experiential avoidance", Behavior Therapy, 42(4), pp.676~688 (2011)
  29. Boswell, J. F., "An idiographic analysis of change processes in the unified transdiagnostic treatment of depression", Journal of Consulting and Clinical Psychology, 82(6), pp.1060~1071 (2014)
  30. Brown, T. A., "Current and lifetime comorbidity of the DSM-IV anxiety and mood disorders in a large clinical sample", Journal of Abnormal Psychology, 110(4), pp.585~599 (2001)
  31. Browne, M. W., "Testing structural equation models", pp.136~162 (1993), Sage
  32. Bruffaerts, R., "Mental health problems in college freshmen : Prevalence and academic functioning", Journal of Affective Disorders, 225, pp.97~103 (2018)
  33. Buhr, K., "The intolerance of uncertainty scale : Psychometric properties of the English version", Behaviour Research and Therapy, 40(8), pp.931~945 (2002)
  34. Bullis, J. R., "The unified protocol for transdiagnostic treatment of emotional disorders : A progress report", The Clinical Psychologist, 68(3), pp.4~11 (2015)
  35. Carleton, R. N., "The intolerance of uncertainty construct in the context of anxiety disorders : Theoretical and practical perspectives", Expert Review of Neurotherapeutics, 12(8), pp.937~947 (2012)
  36. Carleton, R. N., "Fearing the unknown : A short version of the Intolerance of Uncertainty Scale", Journal of Anxiety Disorders, 21(1), pp.105~117 (2007)
  37. Carleton, R. N., "Anxiety sensitivity and intolerance of uncertainty: Requisites of the fundamental fears?", Behaviour Research and Therapy, 45(10), pp.2307~2316 (2007)
  38. Cartwright-Hatton, S., "Beliefs about worry and intrusions : The Meta-Cognitions Questionnaire and its correlates", Journal of Anxiety Disorders, 11(3), pp.279~296 (1997)
  39. Chen, J., "Maladaptive metacognitive beliefs mediated the effect of intolerance of uncertainty on depression", Clinical Psychology & Psychotherapy, 28(6), pp.1525~1534 (2021)
  40. Chorpita, B. F., "Mapping evidence-based treatments for children and adolescents : Application of the distillation and matching model to 615 treatments from 322randomized trials", Journal of Consulting and Clinical Psychology, 77(3), pp.566~579 (2009)
  41. Correa, K. A., "The role of intolerance of uncertainty in current and remitted internalizing and externalizing psychopathology", Journal of Anxiety Disorders, 62, pp.68~76 (2019)
  42. Cotter, J., "Metacognitive beliefs in the at-risk mental state : A systematic review and meta-analysis", Behaviour Research and Therapy, 90, pp.25~31 (2017)
  43. Aisling Daly-Eichenhardt, "Changes in Sleep Problems and Psychological Flexibility following Interdisciplinary Acceptance and Commitment Therapy for Chronic Pain: An Observational Cohort Study", Frontiers in Psychology, 7, pp.1326~ (2016), Frontiers Media SA[DOI]
  44. Dugas, M. J., "Cognitive-behavioral treatment for generalized anxiety disorder: From science to practice" (2007), Routledge
  45. Dugas, M. J., "Generalized anxiety disorder: advances in research and practice" (2004), Guilford Press
  46. Dugas, M. J., "Intolerance of uncertainty and information processing : Evidence of biased recall and interpretations", Cognitive Therapy and Research, 29(1), pp.57~70 (2005)
  47. Dugas, M. J., "Further validation of a cognitive-behavioral model of generalized anxiety disorder : Diagnostic and symptom specificity", Journal of Anxiety Disorders, 19(3), pp.329~343 (2005)
  48. Eisenberg, D., "Mental health in American colleges and universities : Variation across student subgroups and across campuses", The Journal of Nervous and Mental Disease, 201(1), pp.60~67 (2013)
  49. Farchione, T. J., "Unified protocol for transdiagnostic treatment of emotional disorders : A randomized controlled trial", Behavior Therapy, 43(3), pp.666~678 (2012)
  50. Fayazbakhsh, . E., "Effectiveness of acceptance and commitment therapy on intolerance of uncertainty, experiential avoidance, and symptoms of generalized anxiety disorder in individuals with Type II diabetes", International Archieves of Health Science, 6(1), pp.30~35 (2019)
  51. Fisher, P. L., "Anxiety and depression in people with epilepsy : The contribution of metacognitive beliefs", Seizure, 50, pp.153~159 (2017)
  52. Flavell, J. H., "Metacognition and cognitive monitoring : A new area of cognitive–developmental inquiry", American Psychologist, 34(10), pp.906~911 (1979)
  53. Freeston, M. H., "Why do people worry?", Personality and Individual Differences, 17(6), pp.791~802 (1994)
  54. Goldstone, E., "Modelling the emergence of hallucinations : Early acquired vulnerabilities, proximal life stressors and maladaptive psychological processes", Social Psychiatry and Psychiatric Epidemiology, 47(9), pp.1367~1380 (2012)
  55. Hankin, B. L., "Developmental origins of cognitive vulnerabilities to depression : Review of processes contributing to stability and change across time", Journal of Clinical Psychology, 65(12), pp.1327~1338 (2009)
  56. Harvey, A. G., "Cognitive behavioural processes across psychological disorders: A transdiagnostic approach to research and treatment" (2004), Oxford University Press
  57. Hawley, S. R., "Concerns of college students during the COVID-19 pandemic : Thematic perspectives from the United States, Asia, and Europe", Journal of Applied Learning and Teaching, 4(1), pp.11~20 (2021)
  58. Hayes, S. C., "Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies", Behavior Therapy, 35(4), pp.639~665 (2004)
  59. Hayes, S. C., "Acceptance and commitment therapy as a unified model of behavior change", The Counseling Psychologist, 40(7), pp.976~1002 (2012)
  60. Hayes, S. C., "Acceptance and commitment therapy: An experiential approach to behavior change" (1999), Guilford Press
  61. Hayes, S. C., "Measuring experiential avoidance : A preliminary test of a working model", The Psychological Record, 54(4), pp.553~578 (2004)
  62. Hayes, S. C., "Experiential avoidance and behavioral disorders : A functional dimensional approach to diagnosis and treatment", Journal of Consulting and Clinical Psychology, 64(6), pp.1152~1168 (1996)
  63. Herringa, R. J., "Childhood maltreatment is associated with altered fear circuitry and increased internalizing symptoms by late adolescence", Proceedings of the National Academy of Sciences, 110(47), pp.19119~19124 (2013)
  64. Hettema, J. M., "A populationbased twin study of the relationship between neuroticism and internalizing disorders", American journal of Psychiatry, 163(5), pp.857~864 (2006)
  65. Heumann, E., "Anxiety and depressive symptoms of German university students 20 months after the COVID-19 outbreak–A cross-sectional study", Journal of Affective Disorders, 320, pp.568~575 (2023)
  66. Hjemdal, O., "Automatic thoughts and meta-cognition as predictors of depressive or anxious symptoms : A prospective study of two trajectories", Scandinavian journal of psychology, 54(2), pp.59~65 (2013)
  67. Hofmann, S. G., "The efficacy of cognitive behavioral therapy : A review of meta-analyses", Cognitive Therapy and Research, 36(5), pp.427~440 (2012)
  68. Nasrin Alsadat Hosseini Ramaghani, "The mediating role of the metacognition, time perspectives and experiential avoidance on the relationship between childhood trauma and post-traumatic stress disorder symptoms", European Journal of Psychotraumatology, 10(1), pp.1648173~ (2019), Informa UK Limited[DOI]
  69. Yeen Huang, "Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 outbreak in China: a web-based cross-sectional survey", Psychiatry Research, 288, pp.112954~ (2020), Elsevier BV[DOI]
  70. Christopher Hunt, "Intolerance of uncertainty prospectively predicts the transdiagnostic severity of emotional psychopathology: Evidence from a Veteran sample", Journal of Anxiety Disorders, 86, pp.102530~ (2022), Elsevier BV[DOI]
  71. Huntley, C. D., "Examining the role of positive and negative metacognitive beliefs in depression", Scandinavian Journal of Psychology, 57(5), pp.446~452 (2016)
  72. Kendler, K. S., "Major depression and generalised anxiety disorder: same genes, (partly)different environments–revisited", British Journal of Psychiatry, 168(S30), pp.68~75 (1996)
  73. Kessler, R. C., "Lifetime prevalence and ageof-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication", Archives of General Psychiatry, 62(6), pp.593~602 (2005)
  74. Kranzler, A., "Emotional dysregulation, internalizing symptoms, and self-injurious and suicidal behavior : Structural equation modeling analysis", Death studies, 40(6), pp.358~366 (2016)
  75. Lamers, F., "Comorbidity patterns of anxiety and depressive disorders in a large cohort study : The Netherlands Study of Depression and Anxiety(NESDA)", The Journal of Clinical Psychiatry, 72(3), pp.341~348 (2011)
  76. Mahoney, A. E. J., "A transdiagnostic examination of intolerance of uncertainty across anxiety and depressive disorders", Cognitive Behaviour Therapy, 41(3), pp.212~222 (2012)
  77. McEvoy, P. M., "To be sure, to be sure : Intolerance of uncertainty mediates symptoms of various anxiety disorders and depression", Behavior Therapy, 43(3), pp.533~545 (2012)
  78. McEvoy, P. M., "Intolerance of uncertainty and negative metacognitive beliefs as transdiagnostic mediators of repetitive negative thinking in a clinical sample with anxiety disorders", Journal of Anxiety Disorders, 27(2), pp.216~224 (2013)
  79. McHugh, R. K., "The dissemination and implementation of evidencebased psychological treatments. A review of current efforts", American Psychologist, 65(2), pp.73~84 (2010)
  80. McLaughlin, K. A., "Interpersonal stress generation as a mechanism linking rumination to internalizing symptoms in early adolescents", Journal of Clinical Child &Adolescent Psychology, 41(5), pp.584~597 (2012)
  81. Mortier, P., "Suicidal thoughts and behaviors among first-year college students : Results from the WMH-ICS project", Journal of the American Academy of Child & Adolescent Psychiatry, 57(4), pp.263~273 (2018)
  82. Nordahl, H., "Explaining depression symptoms in patients with social anxiety disorder: Do maladaptive metacognitive beliefs play a role?", Clinical Psychology & Psychotherapy, 25(3), pp.457~464 (2018)
  83. Nicoline Normann, "The Efficacy of Metacognitive Therapy: A Systematic Review and Meta-Analysis", Frontiers in Psychology, 9, pp.2211~ (2018), Frontiers Media SA[DOI]
  84. Nyer, M., "Relationship between sleep disturbance and depression, anxiety, and functioning in college students", Depression and Anxiety, 30(9), pp.873~880 (2013)
  85. Shani Ofrat, "How research on the meta-structure of psychopathology aids in understanding biological correlates of mood and anxiety disorders", Biology of Mood & Anxiety Disorders, 2(1), pp.13~ (2012), Springer Science and Business Media LLC[DOI]
  86. Pirbaglou, M., "Perfectionism, anxiety, and depressive distress : Evidence for the mediating role of negative automatic thoughts and anxiety sensitivity", Journal of American College Health, 61(8), pp.477~483 (2013)
  87. Radloff, L. S., "The CES-D scale a self-report depression scale for research in the general population", Applied Psychological Measurement, 1(3), pp.385~401 (1977)
  88. Raftery, A. E., "Bayesian model selection in social research", Sociological Methodology, 25, pp.111~163 (1995)
  89. Ruggiero, G. M., "Irrational and metacognitive beliefs mediate the relationship between content beliefs and GAD symptoms : A study on a normal population", Journal of Rational-Emotive & Cognitive-Behavior Therapy, 35(3), pp.240~253 (2017)
  90. Francisco J. Ruiz, "Comparing Cognitive, Metacognitive, and Acceptance and Commitment Therapy Models of Depression: a Longitudinal Study Survey", The Spanish Journal of Psychology, 18, pp.E39~ (2015), Cambridge University Press (CUP)[DOI]
  91. Russell, D. W., "Analyzing data from experimental studies : A latent variable structural equation modeling approach", Journal of Counseling Psychology, 45(1), pp.18~29 (1998)
  92. Schmits, E., "Changes in alcohol use during the COVID-19 pandemic : Impact of the lockdown conditions and mental health factors", International Journal of Mental Health and Addiction, 20(2), pp.1147~1158 (2021)
  93. Mary O. Shapiro, "Prospective associations between intolerance of uncertainty and psychopathology", Personality and Individual Differences, 166, pp.110210~ (2020), Elsevier BV[DOI]
  94. Shihata, S., "Pathways from uncertainty to anxiety : An evaluation of a hierarchical model of trait and disorder-specifc intolerance of uncertainty on anxiety disorder symptoms", Journal of Anxiety Disorders, 45, pp.72~79 (2017)
  95. Spada, M. M., "Measuring metacognitions associated with emotional distress : Factor structure and predictive validity of the metacognitions questionnaire 30", Personality and Individdual Differerences, 45(3), pp.238~242 (2008)
  96. Spielberger, C. D., "Manual for the State-Trait Anxiety Inventory: STAI (Form Y)" (1983), Consulting Psychologists Press
  97. Spinhoven, P., "A longitudinal study of experiential avoidance in emotional disorders", Behavior Therapy, 45(6), pp.840~850 (2014)
  98. Spinhoven, P., "Experiential avoidance and bordering psychological constructs as predictors of the onset, relapse and maintenance of anxiety disorders: One or many?", Cognitive Therapy and Research, 41(6), pp.867~880 (2017)
  99. Steele, S. J., "Efficacy of the Unified Protocol for transdiagnostic treatment of comorbid psychopathology accompanying emotional disorders compared to treatments targeting single disorders", Journal of Psychiatric Research, 104, pp.211~216 (2018)
  100. Sun, X., "Dysfunctional metacognition across psychopathologies : A meta-analytic review", European Psychiatry, 45, pp.139~153 (2017)
  101. Swain, J., "Acceptance and commitment therapy in the treatment of anxiety : A systematic review", Clinical Psychology Review, 33(8), pp.965~978 (2013)
  102. van der Heiden, C., "A hierarchical model for the relationships between general and specific vulnerability factors and symptom levels of generalized anxiety disorder", Journal of Anxiety Disorders, 24(2), pp.284~289 (2010)
  103. Wang, C., "Anxiety, depression, and stress prevalence among college students during the COVID-19 pandemic : A systematic review and meta-analysis", Journal of American college health, 1, pp.1~8 (2021)
  104. Wells, A., "Emotional disorders and metacognition: Innovative cognitive therapy" (2000), Wiley
  105. Wells, A., "Metacognitive therapy for anxiety and depression" (2009), Guilford Press
  106. Wells, A., "A short form of the metacognitions questionnaire : Properties of the MCQ-30", Behaviour Research and Therapy, 42(4), pp.385~396 (2004)
  107. Wells, A., "Modelling cognition in emotional disorder: The S-REF model", Behaviour Research and Therapy, 34, pp.881~888 (1996)
  108. Wilamowska, Z. A., "Conceptual background, development, and preliminary data from the unified protocol for transdiagnostic treatment of emotional disorders", Depression and Anxiety, 27(10), pp.882~890 (2010)
  109. Yilmaz, A. E., "The temporal precedence of metacognition in the development of anxiety and depression symptoms in the context of life-stress : A prospective study", Journal of Anxiety Disorders, 25(3), pp.389~396 (2011)
  110. Yook, K., "Intolerance of uncertainty, worry, and rumination in major depressive disorder and generalized anxiety disorder", Journal of Anxiety Disorders, 24(6), pp.623~628 (2010)

관련 논문AI추천

이 간행물의 다른 논문 (4건)