걱정의 병리적 진행과정에서 인지적 회피의 매개 특성
The Mediating Character of Cognitive Avoidance in the Pathological Process of Worry
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본 연구의 목적은 범불안장애 인지 모델을 기반으로 걱정의 병리적 진행과정에 개입되는 인지적 회피의 매개효과 특성을 살펴보는 것이다. 구체적으로 각 진행 단계별로 인지적 회피 및 각 하위 요인(사고억제, 사고치환, 주의분산, 위험자극회피, 심상을 사고로 전환)의 매개효과분석을 실시하고 상대적인 매개효과 크기를 비교하였다. 총 1,733명의 대학생에게 불확실성에 대한 인내력 부족, 걱정, 상위걱정, 인지적 회피 척도를 활용하여 설문조사를 실시하였다. 결과는 다음과 같다. 불확실성에 대한 인내력 부족과 걱정, 걱정과 상위걱정이라는 두 진행과정에서 투입한 모든 매개변인들이 통계적으로 유의한 부분매개효과가 나타냈다. 그렇지만 하위 유형들의 상대적 매개효과 크기는 달랐다. 불확실성에 대한 인내력 부족과 걱정 간의 관계에서는 사고억제가 가장 큰 매개효과크기를 나타냈다. 반면에 걱정과 상위걱정 간의 관계에서는 사고억제가 가장 작은 매개효과크기를 나타냈으며, 심상을 사고로 전환이 가장 큰 매개효과 크기를 나타냈다. 이러한 결과는 걱정증상에 대한 효과적인 치료적 개입을 위해서는 걱정의 병리적 진행과정에 따라 차별적으로 나타나는 인지적 회피의 매개 특성에 대한 고려가 필요함을 시사한다.
Abstract
The purpose of this study is to examine the characteristics of the mediating effect of cognitive avoidance involved in the pathological process of worry based on the cognitive model for generalized anxiety disorder. Specifically, a mediating effect analysis of cognitive avoidance and sub-factors (thought suppression, thought substitution, distraction, avoidance of threatening stimuli, conversion into thought) was conducted at each stage of progress, and the relative mediating effect size was compared. A total of 1,733 university students were surveyed on the intolerance of uncertainty, worry, meta-worry, and cognitive avoidance. The results are as follows: All mediators showed statistically significant partial mediation effects in the two relations(intolerance of uncertainty and worry, worry and meta-worry). However, the relative mediating effect size of the subtypes was different. In the relation between the intolerance of uncertainty and worry, thought suppression represented the largest mediation effect. On the other hand, the relation between worry and meta-worry showed that thought suppression was the smallest, and transformation of images into thoughts was the largest. These results suggest that for effective intervention for worry symptoms, it is necessary to consider the mediating characteristics of cognitive avoidance that appear differently according to the pathological progression of anxiety.
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