사회공포증 하위유형에 따른 임상적 특징 및 치료효과 비교
Comparison of subtypes of social phobia in clinical characteristics and therapeutic outcome
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초록
본 연구는 사회공포증 환자들을 대상으로 하위유형에 따른 임상적 특징 및 치료 효과에서의 차이를 살펴보았다. 사회공포증으로 진단받은 83명의 환자들을 일반화 유형(51명)과 비일반화 유형(32명)으로 분류하여 임상적 특징에서 어떤 차이가 있는지를 고찰해 본 결과, 일반화 유형은 비일반화 유형에 비해 연령이 더 어렸고, 교육연한이 더 짧았으며, 유병기간이 더 짧았다. 또한 비일반화 유형보다 일반화 유형이 대부분 사회적 상황에서 더 불안을 느꼈고, 자신에 대한 부정적 인지와 소극적 회피행동이 더 많았다. 그러나 신체증상에서는 두 하위유형간에 유의한 차이가 없었다. 일반화 유형은 비일반화 유형보다 회피성 성격장애의 공병 비율이 더 높았으며, 자살시도 경험도 더 많았다. 인지행동집단치료를 마친 환자들의 자료를 검토한 결과, 일반화 유형은 비일반화 유형과 비교해 치료 전에 증상이 전반적으로 더 심했으나, 치료를 통해 비일반화 유형과 유사한 정도의 향상을 보였으며, 두 유형 모두 유의한 치료적 향상을 보였다. 이러한 연구결과에 대해 논의하였으며, 본 연구의 의의와 제한점 및 추후연구의 방향을 제안하였다.
Abstract
The present study investigated the differences between subtypes of social phobia in clinical characteristics and therapeutic outcome. The participants for the present study consisted of 83 social phobic patients who were classified as 51 generalized subtype patients and 32 nongeneralized subtype patients according to DSM-IV criteria. Generalized subtype patients were younger, less educated, and had shorter duration of illness than nongeneralized subtype patients. Also they were more anxious in most social situations, had more negative cognitions toward themselves and more passive avoidant behaviors than nongeneralized subtype patients. However, in somatic symptoms there were no significant differences between two subtypes. Generalized subtype patients were highly comorbid for avoidant personality disorder, were more likely to report past suicide attempts than nongeneralized subtype patients. Although the symptoms of generalized subtype patients were significantly more severe at pretreatment than those of nongeneralized subtype patients, both subtype patients improved to a similar degree over treatment. The implication and the limitations of this study were discussed, and the directions for future research were suggested.
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