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사회불안장애의 주의개입, 탈개입 및 회피과정: 자극 위협가의 차별적 효과

Attentional bias in social anxiety: Differential effect of threat-induced engagement, disengagement and avoidance

권정혜|구훈정
한국임상심리학회 (Korean Clinical Psychology Association)|2015.08|Korean Journal of Clinical Psychology|제34권 제3호|pp. 707-746|DOI 10.15842/kjcp.2015.34.3.007

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참고문헌

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attentional bias사회불안장애주의편향avoidanceSocial anxiety주의개입주의 탈개입 지연주의 회피engagementdisengagement
주제분류심리과학

초록

본 연구에서는 사회불안장애의 주의편향기제를 이해하기 위해 1) 자극 제시 시간을 초/중/후기 정보처리 단계로 다양화 한 후, 사회불안장애에서 주의편향의 세 요소 즉, 주의개입, 주의 탈개입지연 및 주의회피과정이 어떠한 양상으로 나타나는지 통합적으로 살펴보고, 2) 사회적 위협자극을 고위협자극과 저위협자극으로 나누어 해석편향이 주의편향에 미치는 영향을 함께 살펴보고자 한다. 서울과 충남지역의 K대학교에서 교양과목을 수강하는 대학생 중 사회공포증 척도(SPS)와 사회적 상호작용불안 척도(SIAS)를 실시하여 중등도 이상에 속하는 54명을 일차적으로 선별하고 이들을 DSM-IV를 위한 구조화된 임상 면접(SCID-I)을 통하여 사회불안장애집단과 준사회불안장애집단으로 각각 구분하였다. 정상범위에 속하는 42명은 정상집단으로 선별하였다. 간단한 발표과제를 앞두고 있음을 고지 받은 참가자들은 공간단서과제를 실시하였다: 얼굴자극은 한국인 얼굴표정자극(KUFEC)을 사용하여 분노와 혐오 표정 얼굴을 고위협자극으로 사용하였고, 그 외 분노와 혐오 표정 얼굴과 중성 얼굴을 50%로 몰핑(Morphing)하여 저위협자극으로 사용하였다. 자극제시시간은 80msec, 300msec, 500msec이었다. 실험이 끝난 후 발표과제가 없음을 고지하였다. 분석 결과, 주의편향 양상은 자극가에 따라 차별적 양상을 보였다. 첫째, 사회불안장애집단은 초기에 고위협자극에 대해 촉진된 주의개입편향이 나타나지 않았으나, 중/후기에는 주의 탈개입 지연과 이에 수반되는 주의회피편향이 나타났다. 둘째, 준사회불안장애집단은 고위협자극에 대해서는 촉진된 주의 개입 및 회피 편향이 모두 나타나지 않았다. 셋째, 저위협자극에 대해서는 사회불안장애집단과 준사회불안장애집단이 고위협자극에 대해서 보였던 주의편향과는 다른 양상을 보였다. 사회불안장애집단과 준사회불안장애집단 간 저위협자극의 효과는 주의탈개입지연과 주의회피양상에서 차이를 보였다: 사회불안장애집단은 고위협자극에 대한 주의편향패턴과 동일한 패턴인 300msec에서의 주의 탈개입지연과 500msec에서의 회피양상이 나타나, 저위협자극에 대한 타당화 즉, 해석편향이 일어난 것으로 해석하였다. 반면, 준사회불안장애집단은 300msec에서 나타난 주의 탈개입지연 양상이 500msec까지 지속되어, 저위협자극에 대한 비타당화 과정이 일어난 것으로 해석하였다. 본 연구의 결과를 바탕으로 사회불안장애 특정적인 주의편향기제에 대한 임상적 함의에 대한 논의를 하였다.

Abstract

The present study was designed to elucidate attentional bias in social anxiety using a spatial cueing task and to examine whether attentional biases are differentiated by threat level. The participants were recruited from a larger sample of about 1500 undergraduates completing the Social Phobia Scale and Social Interaction Anxiety Scale. Those who had scores above the moderate level of social anxiety on these scales and agreed to participate were assigned to the social anxiety group and those with scores under the mean to the normal control group. Social anxiety group was divided into clinical social anxiety disorder group and subclinical social anxiety disorder group using the Structured Clinical Interview for DSM-IV. Participants were informed that they would make a speech to a live video camera in which they would be evaluated for their performance. Next, they completed the spatial cueing task which assessed the speed of engagement and disengagement from pictorial cues depicting high-threat, low-threat, or neutral content with three exposure durations (80msec, 300msec, and 500msec). Firstly, clinical social anxiety disorder group did not show initial vigilance toward high-threat pictures at 80msec exposure time, but showed difficulty in disengagement at 300msec, which was followed by avoidance for high-threat pictures at 500msec. Secondly, subclinical social anxiety disorder group did not show any attentional bias both high-threat pictures. Thirdly, the effect of low-threat on disengagement delay and avoidance was different between clinical social anxiety disorder group and subclinical social anxiety disorder group: clinical social anxiety disorder group showed disengagement delay at 300msec and avoidance at 500msec which was same with attentional bias pattern with high-threat pictures due to negative interpretation bias effect for low-threat stimuli, but subclinical social anxiety disorder group showed enhanced disengagement delay 500msec instead of attentional avoidance at 500msec due to threat negation. Implication and future research direction was discussed.

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