본문 바로가기
KERD
논문KCI 등재

외상 후 스트레스 장애에 대한 외상 경험과 침습적 반추의 효과: 미래 인지와 성차의 조절된 조절된 매개

The Effects of Trauma and Intrusive Rumination on Posttraumatic Stress Disorder Symptoms: The Moderated Moderated Mediation of Future Prospective Cognition and Gender Difference

0

조회

0

다운로드

4

인용

0

참고문헌

키워드

주제분류심리과학

초록

본 연구의 목적은 대학생의 외상 경험에서 외상 후 스트레스 장애(Posttraumatic Stress Disorder, PTSD) 증상의 관계를 침습적 반추가 매개하는지, 부정적인 미래 인지가 외상에서 PTSD 증상까지의 매개효과를 조절하는지와 더불어 특히 이러한 조절된 매개효과에 성차가 있는지 확인하기 위해 조절된 조절된 매개효과(moderated moderated mediation)를 검증하는 것이다. 이를 위해 전국의 대학생 및 대학원생440명을 대상으로 생활사건 체크리스트, 사건 충격 척도, 사건관련 반추척도, 미래인지 설문지를 사용하여 설문을 실시하였다. 주요 결과는 다음과 같다: 첫째, 외상 경험과 PTSD 증상 간의 관계를 침습적 반추가 매개하는 것으로 나타났고 둘째, 외상에서 침습적 반추를 거쳐PTSD 증상에 이르는 매개효과를 부정적 미래인지가 조절했다. 마지막으로, 조절된 매개효과가 여학생에서만 유의하고 남학생에게는 유의하지 않음으로써, 조절된 조절된 매개효과가 있는 것으로 나타났다. 즉, 여학생의 경우 미래를 부정적으로 인지하는 사람들은 외상 후 침습적 반추를 통해 PTSD 증상에 이르게 되는 반면, 미래를 덜 부정적으로 인지하는 여학생은 동일한 조건에서 PTSD 증상으로부터 보호받을 수 있는 것으로 나타났다. 이 결과를 중심으로 본 연구의 의의와 제한점에 대해 논의하였다.

Abstract

The purpose of the present study was to examine whether intrusive rumination mediated the relationship between trauma and Posttraumatic Stress Disorder (PTSD) symptoms and if negative prospective cognition moderated the mediating effect of intrusive rumination in the relationship between trauma and PTSD symptoms. In particular, we aimed to investigate whether there would be a gender difference in the aforementioned moderated mediation. A total of 440 Korean undergraduate students and graduate students were asked to complete the Life Event Checklist, Impact of the Event Scale-Revised, Event Related Rumination Inventory, and the Prospective Cognition Questionnaire for this research. The main findings were as follows: Firstly, intrusive rumination partially mediated the relationship between trauma and PTSD symptoms. Secondly, negative prospective cognition moderated the mediating effect of trauma on PTSD symptoms via intrusive rumination. Finally, there was a gender difference in the moderating effect, confirming a moderated moderated mediation. More specifically, the moderated mediating effect was observed in female students but not in male students. In conclusion, after trauma, female students who recognize the future negatively are more susceptible to PTSD symptoms through the intrusive rumination, while female students who recognize the future less negatively can be protected from PTSD symptoms under the same condition. Based on these results the implications and limitations of this study are discussed.

참고문헌 (82)

  1. Addis, D. R., "Remembering the past and imagining the future: Common and distinct neural substrates during event construction and elaboration", Neuropsychologia, 45, pp.1363~1377 (2007)
  2. 안현의, "한국판 사건관련 반추 척도(K-ERRI)의 타당화", 인지행동치료, 13(1), pp.149~172 (2013), 한국인지행동치료학회
  3. American Psychiatric Association, "Diagnostic and satistical manual of mental disorders" (2013), American Psychiatric Publishing
  4. Hwallip Bae, "Psychometric Properties of the Life Events Checklist-Korean Version", PSYCHIATRY INVESTIGATION, 5(3), pp.163~167 (2008), 대한신경정신의학회
  5. Berntsen, D., "Pretraumatic stress reactions in soldiers deployed to Afghanistan", Clinical Psychological Science, 3, pp.663~674 (2015)
  6. Berntsen, D., "Splintered memories or vivid landmarks? Qualities and organization of traumatic memories with and without PTSD", Applied Cognitive Psychology, 17, pp.675~683 (2003)
  7. Blackburn, L., "Rumination, resilience, and posttraumatic stress disorder symptom severity among veterans of Iraq and Afghanistan", Journal of Aggression, Maltreatment &Trauma, 25, pp.197~209 (2016)
  8. Blackwell, S. E., "Brightening the day with flashes of positive mental imagery: A case study of an individual with depression", Journal of Clinical Psychology, 73, pp.579~589 (2017)
  9. Blake, D. D., "The development of a clinician-administered PTSD scale", Journal of Traumatic Stress, 8, pp.75~90 (1995)
  10. Borders, A., "Sleep problems may mediate associations between rumination and PTSD and depressive symptoms among OIF", OEF veterans, 2015, pp.7, 76~
  11. Botzung, A., "Experiencing past and future personal events: Functional neuroimaging evidence on the neural bases of mental time travel", Brain and Cognition, 66, pp.202~212 (2008)
  12. Brown, A. D., "Overgeneralized autobiographical memory and future thinking in combat veterans with posttraumatic stress disorder", Journal of Behavior Therapy and Experimental Psychiatry, 44, pp.129~134 (2013)
  13. Cann, A., "Assessing posttraumatic cognitive processes: The event related rumination inventory", Anxiety, Stress, & Coping, 24, pp.137~156 (2011)
  14. Cheung, J., "The impact of appraisals on intrusive memories", Journal of Behavior Therapy and Experimental Psychiatry, 54, pp.108~111 (2016)
  15. 조용래, "한국판 외상 후 인지 검사의 요인구조와 수렴 및 변별타당도: 외상경험 대학생들을 대상으로", 인지행동치료, 12(3), pp.369~391 (2012), 한국인지행동치료학회
  16. Choi, Y. G., "The trauma profiles of Korean adults", Conference Materials of Korean Psychological Association, pp.207~ (2015)
  17. Chuen Y. L. B., "The impact of rumination on internal attention switching", Cognition & Emotion, 26, pp.209~223 (2012)
  18. Clark, D. M., "Anxiety disorders: Why they persist and how to treat them", Behaviour Research and Therapy, 37, pp.S5~S27 (1999)
  19. Cortina, L. M., "Gender and posttraumatic stress: sexual violence as an explanation for women's increased risk", Journal of Abnormal Psychology, 115, pp.753~ (2006)
  20. Cusack, K. J., "Unrecognized trauma and PTSD among public mental health consumers with chronic and severe mental illness", Community Mental Health Journal, 42, pp.487~500 (2006)
  21. D’Argembeau, A., "Understanding autobiographical memory: Theories and approaches", pp.311~330 (2012), Cambridge University Press
  22. Diehle, J., "The Dutch version of the Child Posttraumatic Cognitions Inventory: Validation in a clinical sample and a school sample", European Journal of Psychotraumatology, 6, pp.26362~ (2015)
  23. Ehlers, A., "A cognitive model of posttraumatic stress disorder", Behaviour Research and Therapy, 38, pp.319~345 (2000)
  24. Ehlers, A., "Intrusive re-experiencing in post-traumatic stress disorder: Phenomenology, theory, and therapy", Memory, 12, pp.403~415 (2004)
  25. Ehlers, A., "Maintenance of intrusive memories in posttraumatic stress disorder: A cognitive approach", Behavioural and Cognitive Psychotherapy, 23, pp.217~249 (1995)
  26. Ehring, T., "Do cognitive models help in predicting the severity of posttraumatic stress disorder, phobia, and depression after motor vehicle accidents? A prospective longitudinal study", Journal of Consulting and Clinical Psychology, 76, pp.219~ (2008)
  27. 은헌정, "한국판 사건충격척도 수정판의 신뢰도 및 타당도 연구", 신경정신의학, 44(3), pp.303~310 (2005), 대한신경정신의학회
  28. Frans, Ö., "Trauma exposure and post‐traumatic stress disorder in the general population", Acta Psychiatrica Scandinavica, 111, pp.291~299 (2005)
  29. Frazier, P. A., "Perceived control and distress following sexual assault: A longitudinal test of a new model", Journal of Personality and Social Psychology, 84, pp.1257~ (2003)
  30. Frazier, P. A., "Further development of the temporal model of control", Journal of Counseling Psychology, 59, pp.623~ (2012)
  31. Fresco, D. M., "Distinct and overlapping features of rumination and worry: The relationship of cognitive production to negative affective states", Cognitive Therapy and Research, 26, pp.179~188 (2002)
  32. Gabert‐Quillen, C. A., "Posttraumatic stress disorder symptoms mediate the relationship between trauma exposure and smoking status in college students", Stress and Health, 31, pp.78~82 (2015)
  33. Gold, D. B., "Origins of ruminative thought: Trauma, incompleteness, nondisclosure, and suppression", Journal of Applied Social Psychology, 25, pp.1245~1261 (1995)
  34. Hatcher, M. B., "What predicts post‐traumatic stress following spinal cord injury", British Journal of Health Psychology, 14, pp.541~561 (2009)
  35. Hayes, A. F., "Introduction to mediation, moderation, and conditional process analysis: A regression-based approach" (2015), Shinyoungsa
  36. Hayes, A. F., "Partial, conditional, and moderated moderated mediation: Quantification, inference, and interpretation", Communication Monographs, pp.1~37 (2017)
  37. Hintz, S., "Development of a measure of the perceived likelihood of stressful events", Poster presented at the meeting of the International Society for Traumatic Stress Studies (2010)
  38. Horowitz, M., "Impact of event scale: A measure of subjective stress", Psychosomatic Medicine, 41, pp.209~218 (1979)
  39. Janoff-Bulman, R., "Shattered assumptions" (2010), Simon and Schuster
  40. 전선영, "대학생의 반추 하위유형들(몰두와 반성)과 우울 증상 간의 관계: 회피의 매개 효과", 인지행동치료, 13(2), pp.285~306 (2013), 한국인지행동치료학회
  41. Johnson, D. P., "Gender differences in rumination: A meta-analysis", Personality and Individual Differences, 55, pp.367~374 (2013)
  42. Kleim, B., "Reduced specificity in episodic future thinking in posttraumatic stress disorder", Clinical Psychological Science, 2, pp.165~173 (2014)
  43. Kline, R. B., "Principles and practice of structural equation modeling" (2005), Guilford Press
  44. 고옥주, "대학생의 자기자비 수준별 대인간 외상 경험과 친밀감에 대한 두려움 간의 관계: 자기체계 손상의 매개효과", 사회과학연구, 26(3), pp.81~101 (2015), 사회과학연구소[DOI]
  45. 이형권, "조절분석과 조절된 매개분석 및 매개된 조절분석의 오해와 진실", 관광연구, 31(3), pp.213~248 (2016), 대한관광경영학회
  46. 이옥정, "경찰의 직무스트레스 해소 프로그램 적용을 위한 외근 경찰관의 외상후 스트레스 장애(PTSD) 증상 분석", 한국경찰학회보, 12(4), pp.173~203 (2010), 한국경찰학회
  47. 이성진, "가정폭력 피해여성들의 지각된 통제감과 회피 대처가 외상후 스트레스 증상에 미치는 효과", Korean Journal of Clinical Psychology, 28(2), pp.415~436 (2009), 한국임상심리학회
  48. Llera, S. J., "Rethinking the role of worry in generalized anxiety disorder: Evidence supporting a model of emotional contrast avoidance", Behavior Therapy, 45, pp.283~299 (2014)
  49. Markham, A. M., "The relationship between rumination, gender, age, and posttraumatic stress", Modern Psychological Studies, 21, pp.83~87 (2016)
  50. McFarland, C. P., "Event-based prospective memory among veterans: The role of posttraumatic stress disorder symptom severity in executing intentions", Journal of Clinical and Experimental Neuropsychology, 38, pp.251~260 (2016)
  51. Michael, T., "Rumination in posttraumatic stress disorder", Depression and Anxiety, 24, pp.307~317 (2007)
  52. "The 2011 Epidemiological Survey of Mental Disorders among Korean Adults" (2011)[URL]
  53. Miranda, R., "Depression, generalized anxiety disorder, and certainty in pessimistic predictions about the future", Cognitive Therapy and Research, 31, pp.71~82 (2007)
  54. Nolen-Hoeksema, S., "Responses to depression and their effects on the duration of depressive episodes", Journal of Abnormal Psychology, 100, pp.569~582 (1991)
  55. Nolen‐Hoeksema, S., "Mediators of the gender difference in rumination", Psychology of Women Quarterly, 25, pp.37~47 (2001)
  56. Norris, F. H., "Epidemiology of trauma: Frequency and impact of different potentially traumatic events on different demographic groups", Journal of Consulting and Clinical Psychology, 60, pp.409~ (1992)
  57. Norris, F. H., "Sex differences in symptoms of posttraumatic stress: Does culture play a role?", Journal of Traumatic Stress, 14, pp.7~28 (2001)
  58. Olff, M., "Gender differences in posttraumatic stress disorder", Psychological Bulletin, 133, pp.183~ (2007)
  59. Papageorgiou, C., "An empirical test of a clinical metacognitive model of rumination and depression", Cognitive Therapy and Research, 27, pp.261~273 (2003)
  60. Pickett, S. M., "The relationship between subjective sleep disturbance, sleep quality, and emotion regulation difficulties in a sample of college students reporting trauma exposure", Psychological Trauma: Theory, Research, Practice, and Policy, 8, pp.25~ (2016)
  61. Read, J. P., "Trauma and posttraumatic stress symptoms predict alcohol and other drug consequence trajectories in the first year of college", Journal of Consulting and Clinical Psychology, 80, pp.426~ (2012)
  62. Renner, F., "Effects of engaging in repeated mental imagery of future positive events on behavioural activation in individuals with major depressive disorder", Cognitive Therapy and Research, 41, pp.369~380 (2017)
  63. Resnick, H. S., "Prevalence of civilian trauma and posttraumatic stress disorder in arepresentative national sample of women", Journal of Consulting and Clinical Psychology, 61, pp.984~ (1993)
  64. Roley, M. E., "The relationship between rumination, PTSD, and depression symptoms", Journal of Affective Disorders, 180, pp.116~121 (2015)
  65. Scott, J. C., "Prospective memory in Posttraumatic Stress Disorder", Journal of the International Neuropsychological Society, 22, pp.724~734 (2016)
  66. Shin, H. S., "Stress coping and its relationship to adjustment in Korean adolescents", The Korea Journal of Youth Counseling, 9, pp.189~225 (2001)
  67. Simmons, C. A., "A cognitive model to explain gender differences in rate of PTSD diagnosis", Brief Treatment and Crisis Intervention, 5, pp.290~ (2005)
  68. Smith, J. M., "A roadmap to rumination: A review of the definition, assessment, and conceptualization of this multifaceted construct", Clinical Psychology Review, 29, pp.116~128 (2009)
  69. Spasojević, J., "Rumination as a common mechanism relating depressive risk factors to depression", Emotion, 1, pp.25~ (2001)
  70. Speckens, A. E., "Intrusive memories and rumination in patients with post-traumatic stress disorder: A phenomenological comparison", Memory, 15, pp.249~257 (2007)
  71. Stockton, H., "Cognitive processing, rumination, and posttraumatic growth", Journal of Traumatic Stress, 24, pp.85~92 (2011)
  72. Suliman, S., "Cumulative effect of multiple trauma on symptoms of posttraumatic stress disorder, anxiety, and depres sion in adolescents", Comprehensive Psychiatry, 50, pp.121~127 (2009)
  73. Szpunar, K. K., "Episodic future thought: An emerging concept", Perspectives on Psychological Science, 5, pp.142~162 (2010)
  74. Tedeschi, R. G., "Posttraumatic growth:Conceptual foundations and empirical evidence", Psychological Inquiry, 15, pp.1~18 (2004)
  75. Tolin, D. F., "Sex differences in trauma and posttraumatic stress disorder: A quantitative review of 25 years of research", Psychological Bulletin, 132, pp.959~992 (2006)
  76. Ullman, S. E., "Coping, emotion regulation, and self-blame as mediators of sexual abuse and psychological symptoms in adult sexual assault", Journal of Child Sexual Abuse, 23, pp.74~93 (2014)
  77. Vishnevsky, T., "Gender differences in self‐reported posttraumatic growth: A meta‐analysis", Psychology of Women Quarterly, 34, pp.110~120 (2010)
  78. Weiss, D. S., "Cross-cultural assessment of psychological trauma and PTSD", pp.219~238 (2007), Springer US
  79. 양귀화, "외상 후 성장 과정에 대한 분석: 정서조절곤란, 침습적 반추, 의도적 반추의 삼중매개효과와 낙관성의 조절효과", 한국심리학회지: 건강, 19(4), pp.1041~1062 (2014), 한국건강심리학회
  80. 유희정, "아동기 외상이 외상 후 성장에 미치는 영향에서 탄력성과 의도적 반추의 매개효과", 초등상담연구, 14(3), pp.277~296 (2015), 한국초등상담교육학회
  81. Zhen, R., "Understanding the relationship between rainstorm-related experiences and PTSD among Chinese adolescents after rainstorm disaster: The roles of rumination and social support", Frontiers in Psychology, 7, pp.1407~1414 (2016)
  82. Zhou, X., "The relationship between rumination, posttraumatic stress disorder, and posttraumatic growth among Chinese adolescents after earthquake: A longitudinal study", Journal of Affective Disorders, 193, pp.242~248 (2016)

관련 논문AI추천

이 간행물의 다른 논문 (11건)