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외상후 스트레스 장애의 예측요인으로서 정신적 심상의 인지, 정서 및 생리 반응

Cognitive, Emotional, and Physiological Reactions to Mental Imagery as Predictors of Posttraumatic Stress Disorder

최윤경|이재호|이흥표|이홍석
한국임상심리학회 (Korean Clinical Psychology Association)|2018.08|Korean Journal of Clinical Psychology|제37권 제3호|pp. 339-359|DOI https://doi.org/10.15842/kjcp.2018.37.3.007

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참고문헌

키워드

PTSD외상후 스트레스 장애유도 심상암묵연합검사심박변이도자기관련성induced imageryimplicit association testHRVself-relevance
주제분류심리과학

초록

본 연구의 목적은 수정된 외상 회상 패러다임을 사용해서 정신적 심상을 유도한 후 암묵연합검사(implicit association test, IAT)와 심박변이도(heart rate variability, HRV)의 특성을 살펴보고 IAT의 D값과 HRV 측정치들이 PTSD 진단을 예측할 수 있는지를 알아보는 것이었다. 참가자는 모두 240명으로, 대학생(n=71), 지역사회 거주자 중 PTSD가 없는 일반인(n=58), 외상사건을 경험한 일반인(n=29) 및 PTSD 로 진단받은 환자(n=82)로 구성되었다. 본 연구에서는 자기관련외상사건을 회상하거나 부정적 또는 중성적 사건을 상상하도록 함으로써정신적 심상을 조작하였다. 그 결과, PTSD는 부정적 사건에 대한 심상처치조건에서 암묵적 자기-부정 연합의 강화와 관련이 있고 자기관련외상사건에 대한 심상은 높은 LF:HF 비율과 관련이 있었다. 로지스틱 회귀분석 결과, 누적 외상과 PTSD의 회피 및 과각성 증상이 PTSD 진단과 유의한 관계가 있었다. HR과 IAT의 D값을 추가한 후에도 모델은 여전히 유의한 것으로 나타났으며, PTSD 사례의 76.5%를 정확하게 분류하였다. 이 결과는 HRV와 IAT 측정치들이 PTSD 진단의 민감성을 향상시킬 수 있음을 시사한다. 마지막으로, 본 연구의 제한점과후속 연구를 위한 제언이 논의되었다.

Abstract

The purposes of this study were to examine the characteristics of the implicit association test (IAT) and the heart rate variability (HRV) after performing mental imagery using the modified trauma recall paradigm, and to investigate whether IAT and HRV measures could predict posttraumatic stress disorder (PTSD) status. Participants were 71 college students, 58 community residents without PTSD, 29 community residents who have experienced traumatic events, and 82 patients with PTSD, totaling 240 persons. This study manipulated mental imagery by leading participants to recall self-related traumatic events or to imagine negative or neutral events. The results showed that PTSD was associated with enhanced implicit selfnegative associations when negative events were imagined and high LF/HF ratio when self-related traumatic events were recalled. Logistic regression analysis showed that cumulative trauma, avoidance, and hyperarousal symptoms were associated with a PTSD diagnosis. The model remained significant after the addition of heart rate (HR) and the D score of IAT, and correctly classified 76.5% of the cases with PTSD. The results suggest that HRV and IAT measures can increase the sensitivity of PTSD diagnosis. Finally, limitations of this study and suggestions for further research were also discussed.

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