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아동기 신체학대와 자살의 관계에서 PTSD 증상, 우울 및 사회적 지지의 영향

The Influence of PTSD Symptoms, Depression and Social Support on the Relationship between Childhood Physical Abuse and Suicide

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초록

본 연구의 목적은 아동기 신체학대의 심각성에 주목하여, 아동기 신체학대, PTSD 증상, 우울, 자살 및 사회적 지지가 포함된 모형을 제시하고, 관련된 변인 간의 유기적인 관계를 알아보는 데 있다. 성인 남녀 222명(남자 80명, 여자 142명)의 일반인을 대상으로 한국판 아동기 외상 질문지, 자살생각 척도, 사회적 지지 척도, 외상 후 스트레스 장애 체크리스트, 병원 불안-우울 척도를 사용하였다. 연구 가설을 검증하기 위해 구조방정식을 사용하여 이중 매개효과, 조절효과 및 조절된 매개효과를 분석하였다. 연구 결과, PTSD 증상 및 우울은 아동기 신체학대와 자살의 관계를 부분 매개하였다. 다음으로 사회적 지지는 아동기 신체학대와 PTSD 증상 간의 관계를 조절하였다. 마지막으로 사회적 지지는 아동기 신체학대, PTSD 증상, 우울 및 자살의 관계에서 조절된 매개효과를 보였다. 본 연구는 일반인의 아동기 신체학대, PTSD 증상, 우울, 자살 및 사회적 지지의 관계를 통합적으로 살펴본 최초의 시도이며, 자살과 PTSD 증상의 보호 요인으로서 사회적 지지의 중요성을 확인한 데 의의가 있다. 하지만, 횡단 자료를 바탕으로 진행되었기에 변인 간의 인과성을 확정 지을 수 없다는 제한점이 있다. 지속적인 사회적 지지를 제공하며 긍정적인 사회적 관계망을 확장하는 것은 아동기 신체학대 피해자의 PTSD 및 자살 예방에 있어 중요한 시사점이라고 할 수 있다.

Abstract

The study presented an integrated model that includes childhood physical abuse, PTSD symptoms, depression, suicidal ideation and social support, and examined the relationships between the variables. Two hundred and twenty two healthy individuals (80 males and 142 females) completed the Childhood Trauma Questionnaire, Scale for Suicidal Ideation, PTSD checklist-5, Hospital Anxiety-Depression Scale and DUKE-UNC Functional Social Support Questionnaire. To test the hypothesized model, this study examined the multiple mediation effect, moderation effect and moderated mediation effect using the structural equation model. The results showed that PTSD symptoms and depression partially mediated the relationship between childhood physical abuse and suicidal ideation. Futhermore, the moderation effect of the social support was significant in the relationship between childhood physical abuse and PTSD symptoms. Finally, the moderated mediation effect of social support was significant in the relationship among childhood physical abuse, PTSD symptoms, depression and suicidal ideation. To our knowledge, this study is the first attempt to examine the relationship of childhood physical abuse, PTSD symptoms, depression, and suicidal ideation. The findings highlight the importance of social support as a protective factor. However, it is difficult to establish causality in the relationships between the variables based on cross-sectional data. Providing ongoing social support and expanding positive social networks are important steps in preventing PTSD and suicide in childhood physical abuse victims.

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