책임감과 강박증상의 차별적 관련성
The differential relationships between responsibilities and OC symptoms
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강박장애에 대한 인지이론에서 책임감은 강박장애의 발병과 유지에 핵심개념으로 제안되어 왔으나 이를 경험적으로 검증하는 연구들의 결과는 비일관적이다. 본 연구에서는 이의 원인이 강박증상의 다양성과 책임감 개념의 혼동에 있다고 보고 책임감의 개념을 세분화한 뒤 강박증상의 유형에 따라 책임감 신념 및 평가와 어떠한 관련성을 가지는지 질문지 연구를 통해 살펴보았다. 연구 1에서 책임감 신념을 인과적 책임감과 도덕적 책임감, 이행에 대한 책임감과 불이행에 대한 책임감으로 세분화하여 강박증상과의 관계를 살펴본 결과, ‘오염과 관련된 사고 및 청결행동’ 유형은 도덕적, 인과적 책임감 모두와 정적인 상관이 유의하였으나, ‘심성활동에 대한 통제 실패’, ‘확인행동’과 ‘반응성 강박사고’ 유형은 인과적 책임감에서만 정적인 상관이 유의하였고, ‘충동과 행동통제 상실에 대한 걱정’과 ‘자생성 강박사고’ 유형은 도덕적 책임감에서만 부적인 상관이 유의하였다. 강박성향자들, 그 중에서 특히 ‘확인행동’과 ‘반응성 강박사고’ 유형이 불이행에 대해 민감하였으나 불이행 편파를 제거할 정도로까지 책임감이 고양되어 있지는 않았다. 연구 2에서는 책임감 평가와 강박증상의 관계를 살펴 본 후 책임감 신념과 책임감 평가의 관계를 검증하였다. 그 결과, ‘심성활동에 대한 통제 실패’, ‘오염과 관련된 사고 및 청결행동’, ‘확인행동’, ‘반응성 강박사고’ 유형은 책임감 평가와 정적인 상관이 유의하였으나 ‘충동과 행동통제 상실에 대한 걱정’, ‘자생성 강박사고’ 유형에서는 상관이 유의하지 않았다. 특히, 회귀분석을 통해 책임감 신념과의 관계를 살펴본 결과, 책임감 평가에서 중요한 요소는 ‘불이행에 대한 인과적 책임감’이라는 결론을 얻었으며 이 요소가 강박사고로부터 강박행동으로 전환되는 데에 주요한 역할을 하는 것으로 추정되었다. 마지막으로 본 연구의 의의 및 제한점과 앞으로의 연구방향이 논의되었다.
Abstract
This study examines the inflated responsibility in obsessive-compulsive disorder. The concept of responsibility is divided into moral/causal responsibility and commission/omission. In study 1, the relationship between responsibility belief and OC subtypes are examined by using a newly developed responsibility belief questionnaire(RSQ). The results are as follows : ‘being contaminated’ factor is positively correlated with moral or causal responsibility, 'impaired control over mental activities', 'checking behaviors' and 'reactive obsession' are positively correlated with causal responsibility, and 'urges and worries about loss of control over motor behavior' and 'autogenous obsession' are negatively correlated with moral responsibility. And obsessionals, especially 'checking behaviors' and 'reactive obsession' types, are more sensitive to omission than commission. In study 2, the inflated responsibility appraisal in OCD is examined with a semi-idiographic measure(RQ). The result shows that the responsibility appraisal is inflated in ‘being contaminated’, 'impaired control over mental activities', 'checking behaviors' and 'reactive obsession' types, but not in 'urges and worries about loss of control over motor behavior' and 'autogenous obsession'. When regression analysis is conducted, the responsibility appraisal is best predicted by causal responsibility in omission. Implications for theory, measurement and research directions are explored.
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