한국판 컬럼비아 대학 자살 심각도 척도(C-SSRS)의 타당도 연구: 우울장애 환자를 대상으로.
Validation of the Columbia Suicide Severity Rating Scale in Depression Patients
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초록
컬럼비아 자살 심각도 척도(C-SSRS)는 자살의 위험성을 평가하기 위하여 개발된 임상가 평정 척도로 자살 사고의 심각도, 자살 사고의 강도, 자살 행동, 자살 행동의 치명도의 네 가지 하위 영역으로 구성되어 있다. 본 연구의 목적은 우울장애 집단에서 한국판 C-SSRS의 타당도를 확인하는 것이다. 이를 위해 본 연구에서는 총 100명의 우울장애 환자에게 한국판 C-SSRS를 포함하여 자살 사고와 우울 관련 질문지를 실시하였다. 그 결과, 내적 합치도 계수(cronbach's α)는 .62~.88의 범위로 양호하였다. 한국판 C-SSRS의 구성 타당도 검증을 위해 탐색적 요인분석을 한 결과, 자살 사고의 심각도 영역에서 2개의 하위 요인을 가진 요인구조가 확인되었다. 각 요인에 대해 요인 1은 “자살 의도가 없는 수동적 자살 생각”, 요인 2는 “자살 의도가 있는 적극적 자살 생각”으로 명명하였다. 한국판 C-SSRS의 수렴 및 변별 타당도를 알아보기 위하여 C-SSRS와 타 척도의 상관분석을 해 본 결과, C-SSRS의 자살 사고 심각도 및 강도 영역은 자살 생각 척도(SSI), 백의 우울 척도(BDI), 한국판 해밀턴 우울증 평가 척도(HAM-D)의 자살 사고 문항과 유의한 상관을 보였지만, 백의 우울 척도, 한국판 해밀턴 우울증 평가 척도의 신체 증상 문항과는 유의한 상관을 나타내지 않아 수렴 및 변별 타당도가 입증되었다. 또한, C-SSRS가 자살 시도에 대한 예측 타당도를 가지고 있음이 확인되었다. 본 연구 결과를 바탕으로 연구의 의의와 제한점이 논의되었다.
Abstract
The purpose of this study was to verify the validity of the C-SSRS in depression patients. A total of 100 depression patients participated. C-SSRS, Beck’s Depression Inventory, Scale for suicide ideation was used to measure the depression and suicide risk of depression patient. The result was that internal consistency coefficient was good ranging from 0.62 to 0.88. In order to verify construct validity of the C-SSRS, exploratory factor analysis was conducted, and as a result, a factor structure with two sub-factors was identified in the suicidal ideation severity scale. Correlation analysis between the C-SSRS and other scales was conducted in order to look at convergent validity and discriminant validity of the C-SSRS. The convergent validity and discriminant validity of the C-SSRS were proved and the C-SSRS was verified to have predictive validity for suicide attempts.
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