재난 피해자의 외상 후 스트레스 반응과 내재화 문제의 관계: 소질-스트레스 모형과 회복탄력성 이론을 바탕으로 한 1년 추적 연구
The Relationship Between Posttraumatic Stress Response and The Internalization of Problems in Disaster Victims: A Yearlong Follow-up Based on The Diathesis-stress Model and Resilience Theory
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초록
본 연구의 목적은 소질-스트레스 모형과 회복탄력성 이론을 활용하여 재난 피해자의 스트레스 반응과 회복탄력성에 영향을 미치는 위험요인과 보호요인을 식별하고, 스트레스 반응과 내재화 문제 및 회복탄력성 간의 종단적인 관계를 조사하는 것이다. 연구 참여자는 2017년과 2018년에 재난 피해자 패널조사에 응답한 20대 이상의 성인 남성 217명과 여성 247명이다. 자료는 SPSS와 AMOS 프로그램을 사용하여 구조방정식 모델링을 통해 분석되었다. 본 연구의 결과는 재난 이전의 정신과 병력, 부상 경험, 재산 피해 정도, 거주지의 변화가 외상 후 스트레스 반응을 유의하게 예측하며 성별, 건강 상태, 사회적 지지가 회복탄력성을 유의하게 예측한다는 것을 보여주었다. 또한, 스트레스 반응과 우울/불안은 서로 밀접한 관련이 있으며 스트레스 반응에서 우울/불안으로 가는 경로는 유의한 것으로 나타났다. 위 관계는 회복탄력성에 의해 조절된다고 제안되었지만 2차 년도에서는 조절되지 않는 것으로 나타났다. 본 연구의 결과는 재난 준비와 초기 대응 단계에서 탄력성을 증진하는 것에 초점을 두는 것이 효과적이지만 회복 단계에서는 스트레스 반응과 내재화 문제를 고려한 평가와 치료적 개입이 효과적일 수 있음을 시사한다. 국내에서 발생하는 재난과 문화적 배경을 고려하여 고위험 집단을 선별하고 중재하기 위한 방안을 논의하였다.
Abstract
The aim of this study was to identify the risk factors and protective factors that impact stress response and resilience, and to examine the longitudinal relationship between stress response, the internalization of problems, and resilience in disaster victims on the basis of the diathesis-stress model and resilience theory. A total of 217 adult men and 247 adult women aged 20 years or older who responded to the 2017 and 2018 disaster victim panel surveys participated in this study. The data was analyzed using structural equation modeling on SPSS and AMOS software. The results obtained showed that pre-disaster psychiatric history, injury history, extent of property damage, and change of residence significantly predicted posttraumatic stress response, and sex, health status, and social support significantly predicted resilience. Furthermore, stress response and depression/anxiety were found to be closely related and the path from stress response to depression/anxiety was found to be significant. It was also suggested that this relationship is moderated by resilience, however this moderation was not observed in the second year. The results of this study suggest that it is effective to focus on promoting resilience in the disaster preparation and initial response phases, but in the recovery phase, evaluation and treatment interventions considering stress response and internalization issues may be effective. Possible measures for screening and intervention among high-risk groups with considerations for disaster-prone areas and cultural backgrounds in Korea were discussed.
참고문헌 (69)
- 기경희, "회복탄력성 연구 동향과 과제: 회복탄력성 개념과 척도를 중심으로", 초등상담연구, 17(2), pp.157~175 (2018), 한국초등상담교육학회[DOI]
- 김좌겸, "중학생이 지각한 부모의 언어적 학대와 우울 간의 관계: 회복탄력성의 조절효과를 중심으로", 학습자중심교과교육연구, 19(1), pp.703~721 (2019), 학습자중심교과교육학회[DOI]
- 김지선, "자연재난 피해자의 외상 후 스트레스 장애(PTSD) 집단유형에 영향을 미치는 심리사회적요인에 관한 연구", 한국심리학회지: 건강, 24(3), pp.669~693 (2019), 한국건강심리학회[DOI]
- 박하영, "콜센터 상담원의 감정노동이 소진에 미치는 영향: 회복 탄력성과 사회적 지지의 조절효과", 스트레스 硏究, 26(4), pp.340~349 (2018), 대한스트레스학회[DOI]
- 이기은, "데이트폭력 피해가 경계선 성격 경향성에 미치는 영향: 회복탄력성 및 사회적 지지를 통한 복합 외상후 스트레스의 조절된 매개효과", 한국심리학회지: 임상심리 연구와 실제, 6(1), pp.69~96 (2020), 한국임상심리학회[DOI]
- Achenbach, T. M., "Manual for the Child Behavior Checklist and Revised Child Behavior Profile" (1983), University of Vermont, Department of Psychology
- Adams, R. E., "Predictors of PTSD and delayed PTSD after disaster : the impact of exposure and psychosocial resources", The Journal of Nervous and Mental Disease, 194(7), pp.485~493 (2006)
- Alexander, A. C., "Racial differences in posttraumatic stress disorder vulnerability following hurricane katrina among a sample of adult cigarette smokers from new orleans", Journal of Racial and Ethnic Health Disparities, 4(1), pp.94~103 (2017)
- American Psychiatric Association, "Diagnostic and Statistical Manual of Mental Disorders (DSM-5®)" (2013), American Psychiatric Pub
- Awang, Z., "SEM Made Simple" (2015), MPWS Publisher
- Baker, F. A., "A systematic review of the efficacy of creative arts therapies in the treatment of adults with ptsd", Psychological Trauma: Theory, Research, Practice, and Policy, 10(6), pp.643~651 (2018)
- Chan, C. L. W., "Posttraumatic stress disorder symptoms among adult survivors of the 2008 sichuan earthquake in china", Journal of Traumatic Stress, 24(3), pp.295~302 (2011)
- Chen, Y., "Effectiveness rct of a cbt intervention for youths who lost parents in the sichuan, China, earthquake", Psychiatric Services, 65(2), pp.259~262 (2014)
- Cherry, K. E., "Spirituality, humor, and resilience after natural and technological disasters", Journal of Nursing Scholarship, 50(5), pp.492~501 (2018)
- Cosco, T. D., "Operationalising resilience in longitudinal studies : a systematic review of methodological approaches", J Epidemiol Community Health, 71(1), pp.98~104 (2017)
- Deković, M., "Factors associated with traumatic symptoms and internalizing problems among adolescents who experienced a traumatic event", Anxiety, Stress, & Coping, 21(4), pp.377~386 (2008)
- Edmondson, D., "A test of the diathesis-stress model in the emergency department : who develops ptsd after an acute coronary syndrome?", Journal of Psychiatric Research, 53, pp.8~13 (2014)
- Elwood, L. S., "Cognitive vulnerabilities to the development of ptsd : a review of four vulnerabilities and the proposal of an integrative vulnerability model", Clinical Psychology Review, 29(1), pp.87~100 (2009)
- Fava, G. A., "Increasing psychological well‐being and resilience by psychotherapeutic methods", Journal of Personality, 77(6), pp.1903~1934 (2009)
- Fernandez, C. A., "Longitudinal course of disaster-related PTSD among a prospective sample of adult Chilean natural disaster survivors", International Journal of Epidemiology, 46(2), pp.440~452 (2017)
- Fletcher, S. M., "Traditional coping strategies and disaster response : examples from the south pacific region", Journal of Environmental and Public Health, 2013(1), pp.264503~264512 (2013)
- Foy, D. W., "Etiological factors in the development of ptsd in clinical samples of vietnam combat veterans", Journal of Clinical Psychology, 43(1), pp.17~27 (1987)
- Ginzburg, K., "Comorbidity of posttraumatic stress disorder, anxiety and depression: a 20-year longitudinal study of war veterans", Journal of Affective Disorders, 123(1-3), pp.249~257 (2010)
- Gordon-Hollingsworth, A. T., "Understanding the impact of natural disasters on psychological outcomes in youth from mainland china : a meta-analysis of risk and protective factors for post-traumatic stress disorder symptoms", Journal of Child & Adolescent Trauma, 11(2), pp.205~226 (2018)
- Gradus, J. L., "Posttraumatic stress disorder and death from suicide", Current Psychiatry Reports, 20(11), pp.98~119 (2018)
- Grant, K. E., "Development of Psychopathology: A Vulnerability-stress Perspective", pp.3~31 (2005), Sage Publications
- Green, B. L., "International Review of Psychiatry, Vol. 2", pp.177~210 (1996), American Psychiatric Pub
- Grubaugh, A. L., "Trauma exposure and posttraumatic stress disorder in adults with severe mental illness : a critical review", Clinical Psychology Review, 31(6), pp.883~899 (2011)
- Guo, J., "Suicidality associated with ptsd, depression, and disaster recovery status among adult survivors 8 years after the 2008 Wenchuan earthquake in china", Psychiatry Research, 253, pp.383~390 (2017)
- Heid, A. R., "Exposure to hurricane sandy, neighborhood collective efficacy, and post-traumatic stress symptoms in older adults", Aging & Mental Health, 21(7), pp.742~750 (2017)
- Hill, Y., "Resilience in sports from a dynamical perspective", Sport, Exercise, and Performance Psychology, 7(4), pp.333~341 (2018)
- Hirani, S., "The intersection of gender and resilience", Journal of Psychiatric and Mental Health Nursing, 23(6-7), pp.455~467 (2016)
- Hwang, W. J., "The effects of four days of intensive mindfulness meditation training (templestay program) on resilience to stress: a randomized controlled trial", Psychology, Health & Medicine, 23(5), pp.497~504 (2018)
- Ingram, R. E., "Development of Psychopathology: A Vulnerability‐Stress Perspective", pp.32~46 (2005), Sage Publications
- Ingram, R. E., "Vulnerability to Psychopathology: Risk Across the Lifespan", pp.3~17 (2010), Guilford Press
- Kar, N., "Cognitive behavioral therapy for the treatment of post-traumatic stress disorder : A review", Neuropsychiatric Disease and Treatment, 7(1), pp.167~181 (2011)
- Kessler, R. C., "Trends in mental illness and suicidality after hurricane katrina", Molecular Psychiatry, 13(4), pp.374~384 (2008)
- Kessler, R. C., "Posttraumatic stress disorder in the national comorbidity survey", Archives of General Psychiatry, 52(12), pp.1048~1060 (1995)
- Kim, J. B., "A review of korean mental health studies related to trauma and disasters", Psychiatry Investigation, 2(2), pp.22~30 (2005)
- Kobayashi, I., "Gender and age interact to predict the development of posttraumatic stress disorder symptoms following a motor vehicle accident", Psychological Trauma: Theory, Research, Practice, and Policy, 11(3), pp.328~336 (2019)
- Kroenke, K., "The PHQ‐9 : validity of a brief depression severity measure", Journal of General Internal Medicine, 16(9), pp.606~613 (2001)
- Lawrence-Wood, E., "Re-experiencing phenomena following a disaster : The long-term predictive role of intrusion symptoms in the development of post-trauma depression and anxiety", Journal of Affective Disorders, 190, pp.278~281 (2016)
- Lee, J. H., "Resilience : a meta‐analytic approach", Journal of Counseling & Development, 91(3), pp.269~279 (2013)
- Liu, J. J., "Advancing resilience : an integrative, multi-system model of resilience", Personality and Individual Differences, 111, pp.111~118 (2017)
- Llenares, I. I., "Volunteerism influences on student resilience and gratitude", Journal of Psychology in Africa, 30(3), pp.211~216 (2020)
- Løvstad, M., "Persons injured in the 2011 terror attacks in Norway-Relationship between post-traumatic stress symptoms, emotional distress, fatigue, sleep, and pain outcomes, and medical and psychosocial factors", Disability and Rehabilitation, 42(22), pp.3126~3134 (2019)
- Lowe, S. R., "The impact of pet loss on the perceived social support and psychological distress of hurricane survivors", Journal of Traumatic Stress : Official Publication of The International Society for Traumatic Stress Studies, 22(3), pp.244~247 (2009)
- Masood, A., "Gender differences in resilience and psychological distress of patients with burns", Burns, 42(2), pp.300~306 (2016)
- McKeever, V. M., "A diathesis-stress model of posttraumatic stress disorder : ecological, biological, and residual stress pathways", Review of General Psychology, 7(3), pp.237~250 (2003)
- Morina, N., "Remission from post-traumatic stress disorder in adults : a systematic review and meta-analysis of long term outcome studies", Clinical Psychology Review, 34(3), pp.249~255 (2014)
- Ni, C., "Factors associated with resilience of adult survivors five years after the 2008 sichuan earthquake in china", Plos One, 10(3), pp.e0121033~ (2015)
- Norris, F. H., "60,000 disaster victims speak: part I. an empirical review of the empirical literature, 1981-2001", Psychiatry: Interpersonal and Biological Processes, 65(3), pp.207~239 (2002)
- North, C. S., "Examining a comprehensive model of disaster-related posttraumatic stress disorder in systematically studied survivors of 10 disasters", American Journal of Public Health, 102(10), pp.40~48 (2012)
- Park, J. K., "‘Healed to imagine’ : healing discourse in Korean popular culture and its politics", Culture and Religion, 17(4), pp.375~391 (2016)
- Puetz, T. W., "Effects of pharmacotherapy on combat-related PTSD, anxiety, and depression: a systematic review and meta-regression analysis", Plos One, 10(5), pp.e0126529~ (2015)
- Rodriguez-Llanes, J. M., "Measuring psychological resilience to disasters : are evidence-based indicators an achievable goal?", Environmental Health, 12(1), pp.115~135 (2013)
- Scott, B. G., "Identity distress among youth exposed to natural disasters : associations with level of exposure, posttraumatic stress, and internalizing problems", Identity, 14(4), pp.255~267 (2014)
- Seligman, M. E., "Building resilience", Harvard Business Review, 89(4), pp.100~106 (2011)
- Smith, B. W., "The brief resilience scale : assessing the ability to bounce back", International Journal of Behavioral Medicine, 15(3), pp.194~200 (2008)
- Spitzer, R. L., "A brief measure for assessing generalized anxiety disorder : the GAD-7", Archives of Internal Medicine, 166(10), pp.1092~1097 (2006)
- Stratta, P., "Resilience in adolescence : gender differences two years after the earthquake of L’Aquila", Personality and Individual Differences, 54(3), pp.327~331 (2013)
- 2009 UNISDR Terminology on Disaster Risk Reduction, "United Nations", United Nations International Strategy for Reduction, ~ (2009)
- van Minnen, A., "Changes in comorbid conditions after prolonged exposure for PTSD : a literature review", Current Psychiatry Reports, 17(3), pp.1~16 (2015)
- Waugh, C. E., "A resilience framework for promoting stable remission from depression", Clinical Psychology Review, 41, pp.49~60 (2015)
- Weiss, D. S., "Assessing Psychological Trauma and PTSD: A Handbook for Practitioners", pp.399~411 (1997), Guilford Press
- Wilson, J. T., "Brightening the mind : the impact of practicing gratitude on focus and resilience in learning", Journal of the Scholarship of Teaching and Learning, 16(4), pp.1~13 (2016)
- Wu, Y., "Dynamics and predictors of resilience in Chinese rural children: a follow-up study", Psychology, Health & Medicine, 25(1), pp.1~12 (2019)
- Yeh, C. J., "Asian american families’ collectivistic coping strategies in response to 9", 11, 2006, pp.12(1), 134~148
- Yoon, D. K., "A measurement of community disaster resilience in Korea", Journal of Environmental Planning and Management, 59(3), pp.436~460 (2016)
