불안장애 및 우울장애에 따른 불안민감성(Anxiety Sensitivity)의 차별성
Differences in Anxiety Sensitivity between Anxiety and Depressive Disorders
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초록
불안민감성(anxiety sensitivity)은 불안관련 증상들을 두려워하는 성향으로 그로 인해 해로운 신체적, 심리적, 또는 사회적 결과를 초래할 것이라는 신념에 기초하고 있다. 이를 측정하는 도구로는 불안민감성 지표(Anxiety Sensitivity Index; ASI)가 가장 널리 사용되고 있으며, 다차원적인 구조를 가정하고 우울 및 불안장애와의 관련성을 밝히고자 하는 연구들도 다수 보고되고 있다. 이에 연구 1에서는 정신과 외래에 내원하여 불안장애 및 우울장애로 진단받은 성인남녀 611명을 대상으로 ASI, BDI 및 BAI를 실시하였다. ASI를 탐색적 요인 분석 및 확인적 요인 분석한 결과, 선행연구에서와 같이 신체적 염려, 사회적 염려, 인지적 염려 요인으로 구성된 위계적 3요인 모형이 가장 적절한 것으로 나타났다. 연구 2에서는 사회불안장애(n=101), 공황장애(n=145), 범불안장애(n=33), 우울장애(n=135)로 진단받고 공존질환이 없는 대상으로 총 430명을 선별하여, 임상집단에 따른 불안민감성의 세 하위 요인 간 차이를 알아보기 위해 변량분석을 실시하였다. 그 결과, 신체적 염려 요인은 공황장애에서, 사회적 염려 요인은 사회불안장애 집단이 다른 세 집단에 비해 유의하게 높은 점수를 나타냈다. 인지적 염려 요인은 범불안장애와 우울장애가 사회불안장애 집단에 비해 유의하게 높은 점수를 나타냈다. 마지막으로 본 연구가 갖는 의의와 제한점을 제시하였다.
Abstract
Anxiety sensitivity is the fear of anxiety-related symptoms, arising from beliefs that the sensation has harmful physical, social, or psychological consequences. To measure anxiety sensitivity, the Anxiety Sensitivity Index(ASI) is commonly used. Several studies have show the relationship between depression and anxiety disorder assuming multidimensional structure. In this study, ASI, BDI, and BAI were administered to 611 adult males and females, who had been -diagnosed with depression and anxiety disorder, upon visiting the psychiatric clinic. Exploratory factor and Confirmatory factor analyses were employed to test competing models, and the results suggested that the hierarchical model(comprising three first-order factors corresponding to physical concern, social concern and cognition concern) provided the best fit to the data. This finding was consistent with the results of previous studies. The current study also investigated(using an ANCOVA) differences with respect to the three factors of anxiety sensitivity in four clinical groups of patients who had been diagnosed either with social anxiety disorder(n=101), panic disorder(n=145), generalized anxiety disorder(n=33) or depressive disorder(n=135) and had been free of comorbidity. Results indicated that physical concern was significantly higher in panic disorder patients compared with the other three groups, and that social concern was significantly higher in social anxiety disorder patients. Further, generalized anxiety disorder patients and depressive disorder patients had more cognitive concern than social anxiety disorder patients. The implications and limitations of this study were also discussed.
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