불면증에 대한 스트레스와 인지과정의 통합 모형 검증
Verification of the Integrated Model of Insomnia Including Cognitive Process and Stress
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본 연구는 기존의 불면증 유지와 악화를 설명하는 인지모델에 불면증의 유발을 설명하는 ‘스트레스’를 통합함으로써 불면증 모형을 확장시키고자 하였다. 즉 스트레스와 수면에 대한 비합리적 신념에 의해 촉발된 사고억제는 오히려 인지적 각성을 일으켜서 불면증에 기여할 것이라는 가설을 검증하고자 하였다. 연구 대상자는 20대∼50대의 일반인으로 직장인, 학생, 주부 등 다양한 직업군이 포함되었으며, 성별은 남자가 183명(43.3%), 여자가 240명(56.7%)으로 총 423명의 자료가 분석에 사용되었다. 설문지는 수면에 대한 역기능적 신념 및 태도를 측정하는 한국판 DBAS-16, 일상생활 속의 스트레스를 측정하는 DHS-Revised, 일반적 사고억제 경향을 측정하는 WBSI, 수면 전 각성을 측정하는 PSAS, 불면증 심각성을 측정하는 ISI로 구성되었다. 본 연구에서 제안한 불면증의 통합 모형을 검증하기 위해 구조방정식 모형 분석을 실시하였으며, 선행연구들에 의해 제안될 수 있는 대안모형과의 비교를 통해 가장 적합한 모형을 선정하고자 하였다. 연구 결과 스트레스와 불면증의 인지모델을 통합한 완전매개모형이 타당했으며, 스트레스와 수면에 대한 비합리적인 신념이 사고억제, 인지적 각성을 거쳐 불면증으로 가는 경로가 유의미한 것으로 나타났다. 이러한 결과에 기초하여 연구의 의의와 제한점이 논의되었다.
Abstract
The purposes of this study were to prove the validity of the integrated model of insomnia including cognitive process and stress, and to examine the mediating effects of thought suppression on the relationships of stress, dysfunctional beliefs and attitudes about sleep, cognitive arousal and insomnia. The study included 423 subjects from the general population aged 20-59(males=183, females=240). For this study, DBAS- 16(Dysfunctional Beliefs and Attitudes about Sleep Scale-16), DHS-Revised(The Daily Hassle Scale-Revised Version), WBSI(White Bear Suppression Inventory), PSAS(Pre-Sleep Arousal Scale), and ISI(Insomnia Severity Index) were carried out. The data were statistically analyzed using structural equation modeling(SEM). The results of the study validated the integrated model of insomnia including stress and cognitive process. This study also showed that thought suppression had a significant role in the cognitive process contributing to insomnia. The specific results of the study were as follows. The mediating effect of thought suppression was significant on 1) the path from stress to insomnia via cognitive arousal, and 2) the path from dysfunctional beliefs about sleep to insomnia via cognitive arousal.
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