알코올 장애군의 자의식적 부정정서와 자살 행동의 관계
Self-conscious Negative Emotions and Suicidal Behavior among Adults with Alcohol Disorders
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초록
본 연구에서는 알코올 장애군의 자살 행동과 자의식적 부정정서의 관계를 알아보았다. 구체적으로, 수치심, 내부적대감과 같은 자의식적 부정정서가 알코올 장애군의 자살 행동과 관련이 있다고 보고된 인구통계학적 변인과 우울 심각도, 문제음주 심각도, 긍정정서 및 기타 부정정서들을 함께 통제한 후에도 이들의 자살 행동을 유의하게 설명할 것이라는 가설을 검증하였다. 이를 위해 알코올 전문 병원 입원 및 외래완자와 알코올 센터 이용자들을 대상으로 차별적 정서척도(DES-IV), 우울증 선별도구(PHQ-9), 문제음주 선별도구(AUDIT)와 자살 생각 및 자살 시도력을 묻는 자기보고식 질문지를 실시하였다. 전체 연구대상자를 자살 생각 및 시도력이 없는 준거 집단, 자살 생각 집단, 자살 시도 집단의 세 개의 상호배제적인 집단으로 구분하여 다항 로지스틱 중다 회귀분석을 실시하였다. 결과, 알코올 장애군의 자살 생각은 우울증상 심각도가, 이들의 자살 시도는 문제음주 심각도와 자의식적 부정정서 중 내부적대감이 유의하게 설명하였다. 본 연구의 결과는 알코올 장애군의 자살 생각은 우울장애 공병과 높은 관련성이 있을 가능성을 시사하는 동시에 자기 자신을 향한 적대적인 자의식적 정서에 대한 임상적 개입이 이들의 자살 시도 위험을 감소시키는 데에 중요함을 시사한다.
Abstract
The purpose of the study was to examine the role of self-conscious negative emotions in suicidal behaviors among adults with alcohol disorders. Participants were recruited from residental alcohol treatment centers and hospitals. All participants completed self-report questionnaires including the Differential Emotions Scale-IV (DES-IV), Patient Health Questionnaire-9 (PHQ-9), Alcohol Use Disorders Identification Test (AUDIT), and responded to the questions of lifetime history of suicidal ideation and attempt. Multinomial logistic regression indicated that depressive symptoms were significantly associated with lifetime history of suicidal ideation while alcohol-related problems were significantly associated with lifetime history of suicide attempt in a multivariate model including sociodemographic risk factors, psychiatric symptoms, and eleven distinct emotion factors. Among emotion factors, only ‘hostility-inward’ was significantly associated with lifetime history of suicidal attempt. These findings highlight the critical role of self-hate or hostile affect toward the self in suicide attempt in adults with alcohol disorders.
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