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외상적 사건과 자해의 관계에서 부적응적 인지조절의 매개효과와 적응적 인지조절의 조절효과: 성차를 중심으로

The Mediation Effects of Maladaptive Cognitive Emotion Regulation and Moderating Effects of Adaptive Cognitive Emotion Regulation in the link Between Traumatic Life Events and Self-Harm: focused on Gender Difference

이종선|구훈정|우성범
한국임상심리학회 (Korean Clinical Psychology Association)|2015.02|Korean Journal of Clinical Psychology|제34권 제1호|pp. 173-199|DOI 10.15842/kjcp.2015.34.1.009

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참고문헌

키워드

조절효과우울depressionangeranxietyself-harm자해불안외상경험인지정서조절분노다집단 분석Traumatic life eventcognitive emotion regulationmoderation effect
주제분류심리과학

초록

본 연구에서는 대학생 집단을 대상으로 외상적 사건이 부정적 인지정서조절과 우울, 불안, 분노를 거쳐 자해에 어떤 영향을 미치는지 살펴보았다. 또한 적응적 인지정서조절이 우울, 불안, 분노와 어떤 상호작용을 통하여 자해에 영향을 미치는지도 살펴보았다. 이를 위하여 선행연구를 바탕으로 외상적 사건이 부정적 인지정서조절과 우울, 불안, 분노를 이중매개로 하여 자해에 이를 것이라고 가정하였다. 이에 더해 적응적 인지정서조절이 우울, 불안, 분노가 자해에 미치는 영향을 조절할 것이라는 경로모형을 가정하였다. 추가적으로 다집단 분석을 통해서 본 연구에서 가정한 경로모형이 남녀 대학생집단에서 어떤 차이를 보이는지를 검증하고자 하였다. 대학생 415명을 대상으로 연구 참여에 대한 동의서를 받고, 생활사건 체크리스트, 인지적 정서조절 질문지, 병원 불안-우울 척도, 상태특성 분노검사, 자해행동척도를 실시하였다. 결과, 제안된 연구 모형의 적합도가 양호한 것으로 나타났으며, 외상적 사건이 부정적 인지정서조절과 우울, 불안, 분노를 이중으로 매개하여 자해에 이르는 경로가 모두 유의한 것으로 나타났다. 이에 더해 적응적 인지정서조절은 우울, 불안, 분노와 상호작용하여 자해에 영향을 미치는 것이 확인되었다. 즉, 우울, 불안, 분노가 평균이상일 경우 적응적 인지정서조절은 자해 수준을 낮추었다. 또한, 본 연구에서 가정한 모형의 경로에서 남녀 집단에 따른 차별적 양상이 나타났다. 이러한 결과에 기초하여 연구의 의의와 제한점을 논의하였다.

Abstract

The present study, using university students as participants, investigated how traumatic life events affect self-harm by going through the steps of negative cognitive emotion regulation, depression, anxiety, and anger. The study further examined how adaptive cognitive emotion regulation’s interactions with depression, anxiety, and anger, respectively, influence self-harm. Based on previous studies, we hypothesized that traumatic life events would affect self-harm through a dual mediation of negative cognitive emotion regulation and depression, anxiety, and anger. We also hypothesized that cognitive emotional regulation will moderate the effects of depression, anxiety, and anger on self-harm. This study additionally examined gender differences in the hypothetical path model using Multi-Group analysis. A total of 415 university students who signed consent form participated and completed the Life Event Checklist, the Cognitive Emotion Regulation Questionnaire, the Hospitalized Anxiety and Depression Scale, the State-Trait Anger Expression Scale, and the Self-Harm Inventory. The proposed research model showed a very good fit for the data. The paths of how traumatic life events lead to self-harm by dual mediating effects of negative cognitive emotional regulation and depression, anxiety, and anger were significant. In addition, adaptive cognitive emotional regulation was found to affect self-harm by interacting with depression, anxiety, and anger. In other words, when the levels of depression, anxiety, and anger were over average, adaptive cognitive emotional regulation lowered the severity of self-harm. Finally, the hypothetical model presented by the current study showed variation in different gender groups. We further discussed the significance and the limitations of the present study, based on the findings.

참고문헌 (82)

  1. 공성숙, "섭식장애 환자의 아동기 외상경험이 자해행동에 미치는 영향과 부모 간 갈등의 매개효과 분석", 정신간호학회지, 18(1), pp.31~40 (2009), 정신간호학회
  2. 구훈정, "아동기 정서적 학대경험, 정서강도와 자해의 관계에서 부적응적 인지정서조절과 부정정서의 매개효과", 인지행동치료, 14(2), pp.191~216 (2014), 한국인지행동치료학회
  3. 민경준, "병원 불안-우울 척도에 관한 표준화 연구 : 정상, 불안, 우울 집단간의 비교", 신경정신의학, 38(2), pp.289~296 (1999)
  4. 안현의, "한국판 인지적 정서조절전략 척도(K-CERQ)의 타당화", 상담학연구, 14(3), pp.1773~1794 (2013), 한국상담학회
  5. 이장호, "한국판 상태-특성 분노 표현 척도(STAXI-K) : 대학생 집단", 한국심리학회지 : 건강, 3(1), pp.18~32 (1998)
  6. 이혜림, "청소년의 처벌민감성과 강화민감성이 불안, 우울, 자해행동에 미치는 영향 : 스트레스와 통제가능성 귀인의 역할", 석사, 심리학과 임상심리학전공, pp.2013
  7. 홍세희, "구조방정식 모형의 적합도 지수 선정 기준과 그 근거", 한국심리학회지 : 임상, 19(1), pp.243~264 (2000)
  8. Abramson, L. Y., "Hopelessness depression : A theory-based subtype of depression", Psychological review, 96(2), pp.358~ (1989)
  9. Hwallip Bae, "Psychometric Properties of the Life Events Checklist-Korean Version", PSYCHIATRY INVESTIGATION, 5(3), pp.163~167 (2008), 대한신경정신의학회
  10. Beautrais, A. L., "A Case-Control Study", American Journal of Psychiatry, 153, pp.1009~1014 (1996)
  11. Beck, A. T., "Cognitive therapy of depression" (1979), John Wiley & Sons
  12. Bennum, I., "Depression and Hostility in Self‐Mutilation", Suicide and Life-Threatening Behavior, 13(2), pp.71~84 (1983)
  13. Blake, D. D., "The development of a clinician‐administered PTSD scale", Journal of traumatic stress, 8(1), pp.75~90 (1995)
  14. Briere, J., "Self‐mutilation in clinical and general population samples : Prevalence, correlates, and functions", American Journal of Orthopsychiatry, 68(4), pp.609~620 (1998)
  15. Brown, M. Z., "Reasons for suicide attempts and nonsuicidal self-injury in women with borderline personality disorder", Journal of Abnormal Psychology, 111, pp.198~202 (2002)
  16. Brown, G. K., "Cognitive therapy for the prevention of suicide attempts. A randomized controlled trial", Journal of the American Medical Association, 294, pp.563~570 (2005)
  17. Brown, S. A., "Past and recent deliberate self‐harm : Emotion and coping strategy differences", Journal of Clinical Psychology, 63(9), pp.791~803 (2007)
  18. Busch, K. A., "Clinical features of inpatient suicide", Psychiatric Annals (1993)
  19. Byrne, B. M., "Structural equation modeling with AMOS, EQS, and LISREL : Comparative approaches to testing for the factorial validity of a measuring instrument", International Journal of Testing, 1(1), pp.55~86 (2001)
  20. Campbell-Sills, L., "Handbook of emotion regulation", pp.542~559 (2007), Guilford Press
  21. Carver, C. S., "Assessing coping strategies : a theoretically based approach", Journal of personality and social psychology, 56(2), pp.267~ (1989)
  22. Chapman, A. L., "Exploring the function of deliberate self-harm: Experiential avoidance and borderline personality disorder (BPD)", Symposium presented at the 38th annual meeting of the Association for the Advancement of Behavior Therapy (AABT) (2004)
  23. Chapman, A. L., "Solving the puzzle of deliberate self-harm : The experiential avoidance model", Behaviour research and therapy, 44(3), pp.371~394 (2006)
  24. Connors, R., "Self-injury in trauma survivors : 1. Functions and meanings", American Journal of Orthopsychiatry, 66(2), pp.197~206 (1996)
  25. Donaldson, D., "The role of perfectionism and depressive cognitions in understanding the hopelessness experienced by adolescent suicide attempters", Child Psychiatry and Human Development, 31(2), pp.99~111 (2000)
  26. Earvolino-Ramirez, M., "Resilience : A concept analysis", Nursing Forum, 42(2), pp.73~82 (2007)
  27. Favazza, A. R, "Repetitive self-mutilation", Psychiatric Annals, 22(2), pp.60~63 (1992)
  28. Fawcett, J., "Assessing and treating the patient at risk for suicide", Psychiatric Annals, 23(5), pp.244~255 (1993)
  29. Franklin, J. C., "The functions of nonsuicidal self-injury : Support for cognitive–affective regulation and opponent processes from a novel psychophysiological paradigm", Journal of abnormal psychology, 119(4), pp.850~ (2010)
  30. Garmezy, N., "The study of stress and competence in children : A building block for developmental psychopathology", Child development, 55, pp.97~111 (1984)
  31. Garnefski, N., "Relationships between cognitive emotion regulation strategies and depressive symptoms : A comparative study of five specific samples", Personality and Individual differences, 40(8), pp.1659~1669 (2006)
  32. Garnefski, N., "The cognitive emotion regulation questionnaire", European Journal of Psychological Assessment, 23(3), pp.141~149 (2007)
  33. Garnefski, N., "Negative life events, cognitive emotion regulation and emotional problems", Personality and Individual differences, 30(8), pp.1311~1327 (2001)
  34. Gaylin, W., "The rage within" (1984), Simon & Schuster
  35. Gratz, K. L., "Measurement of deliberate self-harm : Preliminary data on the Deliberate Self-Harm Inventory", Journal of Psychopathology and Behavioral Assessment, 23, pp.253~263 (2001)
  36. Gratz, K. L., "Risk factors for deliberate self‐harm among college students", American Journal of Orthopsychiatry, 72(1), pp.128~140 (2002)
  37. Gratz, K. L., "Multidimensional assessment of emotion regulation and dysregulation : Development, factor structure, and initial validation of the Difficulties in Emotion Regulation Scale", Journal of Psychopathology and Behavioral Assessment, 26, pp.41~54 (2004)
  38. Gross, J. J., "Antecedent-and response-focused emotion regulation : divergent consequences for experience, expression, and physiology", Journal of personality and social psychology, 74(1), pp.224~ (1998)
  39. Guerry, J. D., "Longitudinal prediction of adolescent nonsuicidal self-injury : Examination of a cognitive vulnerability-stress model", Journal of Clinical Child and Adolescent Psychology, 39, pp.77~89 (2010)
  40. Haines, J., "Coping and problem solving of self‐mutilators", Journal of Clinical Psychology, 59(10), pp.1097~1106 (2003)
  41. Haines, J., "The psychophysiology of self-mutilation", Journal of Abnormal Psychology, 104, pp.471~489 (1995)
  42. Hawton, K., "Repetition of deliberate self-harm by adolescents : the role of psychological factors", Journal of adolescence, 22(3), pp.369~378 (1999)
  43. Hawton, K., "Deliberate self harm in adolescents : self report survey in schools in England", Bmj, 325(7374), pp.1207~1211 (2002)
  44. Herman, J. L., "Complex PTSD : A syndrome in survivors of prolonged and repeated trauma", Journal of traumatic stress, 5(3), pp.377~391 (1992)
  45. Hilt, L. M., "Longitudinal Study of Nonsuicidal Self-Injury Among Young Adolescents Rates, Correlates, and Preliminary Test of an Interpersonal Model", The Journal of Early Adolescence, 28(3), pp.455~469 (2008)
  46. Kaplan, S. J., "Child and adolescent abuse and neglect research : A review of the past 10 years. Part I : Physical and emotional abuse and neglect", Journal of the American Academy of Child & Adolescent Psychiatry, 38(10), pp.1214~1222 (1999)
  47. Kashdan, T. B., "Social anxiety and positive emotions : A prospective examination of a self-regulatory model with tendencies to suppress or express emotions as a moderating variable", Behavior Therapy, 39(1), pp.1~12 (2008)
  48. Kline, R. B., "Principles and practice of structural equation modeling" (2005), Guilford Press
  49. Klonsky, E. D., "Non‐suicidal self‐injury : An introduction", Journal of clinical psychology, 63(11), pp.1039~1043 (2007)
  50. Klonsky, E. D., "The functions of self-injury in young adults who cut themselves : Clarifying the evidence for affect-regulation", Psychiatry research, 166(2), pp.260~268 (2009)
  51. Lang, P. J., "Emotion, attention, and the startle reflex", Psychological review, 97(3), pp.377~ (1990)
  52. Mennin, D. S., "Delineating components of emotion and its dysregulation in anxiety and mood psychopathology", Behavior Therapy, 38(3), pp.284~302 (2007)
  53. Mikolajczak, M., "Adolescents choosing self-harm as an emotion regulation strategy : The protective role of trait emotional intelligence", British Journal of Clinical Psychology, 48(2), pp.181~193 (2009)
  54. Mitchell, K. J., "Exposure to websites that encourage self-harm and suicide : Prevalence rates and association with actual thoughts of self-harm and thoughts of suicide in the United States", Journal of adolescence, 37(8), pp.1335~1344 (2014)
  55. Murray, C. D., "Body satisfaction, eating disorders and suicide ideation in an Internet sample of self-harmers reporting and not reporting childhood sexual abuse", Psychology, Health and Medicine, 13(1), pp.29~42 (2008)
  56. Nock, M. K., "Why do people hurt themselves? New insights into the nature and functions of self-injury", Current directions in psychological science, 18(2), pp.78~83 (2009)
  57. Nock, M. K., "Contextual features and behavioral functions of self-mutilation among adolescents", Journal of abnormal psychology, 114(1), pp.140~ (2005)
  58. Nolen-Hoeksema, S., "Rethinking rumination", Perspectives on psychological science, 3(5), pp.400~424 (2008)
  59. Paivio, S., "Alexithymia as a mediator between childhood trauma and self-injurious behaviors", Child Abuse and Neglect, 28, pp.339~354 (2004)
  60. Plutchik, R., "The measurement of suicidality, aggressivity and impulsivity", Progress in Neuro-Psychopharmacology and Biological Psychiatry, 13(Suppl), pp.23~34 (1989)
  61. Riggs, D. S., "Anger and post traumatic stress disorder in female crime victims", Journal of Traumatic Stress, 5(4), pp.613~625 (1992)
  62. Ross, S., "A study of the frequency of self-mutilation in a community sample of adolescents", Journal of Youth and Adolescence, 31(1), pp.67~77 (2002)
  63. Roy, A., "Low resilience in suicide attempters", Archives of Suicide Research, 11(3), pp.265~269 (2007)
  64. Russ, M. J., "Pain perception in self-injurious patients with borderline personality disorder", Biological Psychiatry, 32(6), pp.501~511 (1992)
  65. Rutter, M., "Resilience in the face of adversity", British journal of psychiatry, 147(1), pp.598~611 (1985)
  66. Saldias, A., "The Mediatory Role of Maladaptive Schema Modes Between Parental Care and Non-Suicidal Self-Injury", Cognitive behaviour therapy, 42(3), pp.244~257 (2013)
  67. Sansone, R. A., "The Self-Harm Inventory(SHI) : development of a scale for identifying self-destructive behaviors and borderline personality disorder", Journal of Clinical Psychology, 54(7), pp.973~983 (1998)
  68. Schut, H. A., "Intervention for the bereaved : Gender differences in the efficacy of two counselling programmes", British Journal of Clinical Psychology, 36(1), pp.63~72 (1997)
  69. Shalev, A. Y., "Prospective study of posttraumatic stress disorder and depression following trauma", American Journal of Psychiatry, 155(5), pp.630~637 (1998)
  70. Simeon, D., "Self-mutilation in personality disorders : Psychological and biological correlates", The American journal of psychiatry, 149(2), pp.221~226 (1992)
  71. Skegg, K., "Self-harm", The Lancet, 366(9495), pp.1471~1483 (2005)
  72. Slee, N., "Cognitive-behavioral therapy for deliberate self-harm. Crisis", The Journal of Crisis Intervention and Suicide Prevention, 28(4), pp.175~182 (2007)
  73. Slee, N., "Outcomes of a randomized controlled trial of a cognitive behavioral intervention for Deliberate Self-Harm patients", British Journal of Psychiatry, 192, pp.202~211 (2008)
  74. Slee, N., "Emotion regulation as mediator of treatment outcome in therapy for deliberate self‐harm", Clinical psychology & psychotherapy, 15(4), pp.205~216 (2008)
  75. Spielberger, C. D., "State-trait anger expression inventory: Professional manual" (1988), Psychological Assessment Resources
  76. Stirling, J., "Understanding the behavioral and emotional consequences of child abuse", Pediatrics, 122(3), pp.667~673 (2008)
  77. Tyrer, P., "Randomized controlled trial of brief cognitive behaviour therapy versus treatment as usual in recurrent deliberate self-harm : the POPMACT study", Psychological Medicine, 33, pp.969~976 (2003)
  78. Van der Kolk, B. A., "Childhood origins of self-destructive behavior", American journal of Psychiatry, 148(12), pp.1665~1671 (1991)
  79. Whitlock, J., "Self-injurious behaviors in a college population", Pediatrics, 117(6), pp.1939~1948 (2006)
  80. ilkens, J., "Self-mutilation in female remanded prisoners : I. An indicator of severe psychopathology", Criminal Behaviour and Mental Health, 1, pp.247~267 (1991)
  81. Zigmond, A. S., "The hospital anxiety and depression scale", Acta psychiatrica scandinavica, 67(6), pp.361~370 (1983)
  82. Zoroglu, S. S., "Suicide attempt and self‐mutilation among Turkish high school students in relation with abuse, neglect and dissociation", Psychiatry and Clinical Neurosciences, 57(1), pp.119~126 (2003)

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