고문 생존자의 외상기억표상의 특성과 외상후 심리적 증상과의 관계
The nature of trauma memory representations and its relationship with posttraumatic psychological symptoms of torture survivors
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본 연구는 고문 생존자 213명의 참여로 외상기억표상의 특성을 탐색하고 외상후스트레스장애 및 우울 증상과의 관련성을 살펴보았다. 참여자는 외상후스트레스장애와 우울 증상에 관한 자기보고형 척도를 완성하였고, 외상기억표상은 자기보고형 외상기억양상질문지(Trauma Memory Quality Questionnaire, TMQQ)로 측정하였다. TMQQ는 이중기억표상 중 감각기반기억표상을 측정하는 것으로 보이며 탐색적 요인분석 결과 두 하위 요인으로 구분되었다. 요인 1은 지금-여기의 감각적 재체험과 관련되어, 이를 해리성 재체험 감각기반기억표상으로 명명하였다. 요인 2는 반복 및 단절성 시각 체험과 관련되어, 파편적 시각체험기억표상으로 명명하였다. 주요 인구통계학적 변인 및 외상 경험 관련 변인을 통제한 위계적 회귀분석을 통해 외상후 심리적 증상과의 관련성을 살펴보았을 때, 해리성 재체험 감각기반기억표상은 외상후스트레스장애 및 우울 증상을 유의미하게 설명하였다. 파편적 시각체험기억표상은 외상후스트레스장애 증상 중 재경험 증상만을 유의미하게 설명하였다. 고문과 같은 심각한 외상 경험은 강한 감각기반기억표상으로 활성화되며, TMQQ는 이를 잘 반영하는 것으로 보인다. 특히 해리성 재체험 감각기반기억표상은 우울을 포함하는 외상후 심리적 증상과 관련이 높으므로 이를 통합하는 치료적 개입이 요구된다.
Abstract
This study explored the nature of trauma memory representations and examined its relationship with posttraumatic psychological symptoms with the participation of 213 torture survivors. Participants completed self-report scales of posttraumatic stress disorder(PTSD) and depressive symptoms, and trauma memory representations were assessed using the self-report Trauma Memory Quality Questionnaire(TMQQ). The TMQQ appeared to assess the sensation-based memory representation, and it was divided into two factors by exploratory factor analysis. The here-and-now sensory reliving quality appeared to reveal the nature of the first factor, the dissociative reliving sensation-based memory representation. The repetitive and broken visual experiences reflected the nature of the second factor, the fragmented visual experience memory representation. In relationship with posttraumatic psychological symptoms, hierarchical regression analyses controlling for demographic variables and variables related to trauma experiences showed that the dissociative reliving sensation-based memory representation explained PTSD and depressive symptoms significantly. The fragmented visual experience memory representation explained PTSD reexperience symptoms only. Severe traumatic experiences such as torture can be activated into predominant sensation-based memory representations, and the TMQQ appears to reflect these qualities well. Since dissociative reliving sensation-based memory representations are related to posttraumatic psychological symptoms, including depression, results of this study suggest the need for therapeutic interventions that target the integration of these memory representations.
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