DSM 진단기준과 대인 및 비대인 외상사건에 따른 성인의 PTSD 증상, 심리적 디스트레스, 정서조절곤란의 차이
PTSD symptoms, Psychological Distress, and Emotion Regulation Difficulties based on DSM Criterion and Trauma
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참고문헌
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초록
본 연구에서는 DSM-Ⅳ-TR의 진단기준과 대인 및 비대인외상사건 여부에 따른 심리적 증상의 차이를 파악하고자 하였다. 이를 위해 전국에 거주하는 성인 1,000명을 대상으로 온라인 설문을 통해 사건체크리스트, 사건충격척도, 간이증상척도, 정서조절곤란척도를 사용하여 자료를 수집하였다. 이 가운데 분석이 가능한 651명의 자료를 구조방적식 모형을 통해 분석하였다. 연구결과, 진단기준사건과 비진단기준사건, 대인외상사건과 비대인외상사건 간에는 각각 심리적 증상의 차이가 없는 것으로 나타났다. 진단기준-대인외상사건, 진단기준-비대인외상사건, 비진단기준-대인외상사건, 비진단기준-비대인외상사건으로 나누어 심리적 증상의 차이가 있는지 확인한 결과, 진단기준-비대인외상사건은 비진단기준-비대인외상사건보다 PTSD 증상의 하위요인과 정서조절곤란을 더 많이 유발하는 것으로 나타났고, 진단기준-대인외상사건보다 과각성에서 더 많은 증상을 나타냈다. 비진단기준-대인외상사건은 비진단기준-비대인외상사건보다 PTSD 증상의 하위요인, 심리적 디스트레스, 정서조절곤란 모두에서 더 많은 증상을 유발하는 것으로 나타났고, 진단기준-대인외상사건보다 심리적 디스트레에서 더 많은 증상을 유발하는 것으로 확인되었다. 연구결과를 토대로 논의 및 시사점이 제시되었다.
Abstract
The aim of this study was to distinguish psychological symptoms according to both DSM criterion and the type of trauma experienced. From a sample of 1,000 adults residing in South Korea, 651 statistically relevant samples were extracted. Results did not show significant differences in symptoms between DSM criterion events and non-DSM criterion events. The DSM criterion non-interpersonal trauma group did however display more PTSD symptoms along with more emotion regulation difficulties than the non-DSM criterion non-interpersonal trauma group. Hyperarousal, a subtype of PTSD, was shown to develop more among the DSM criterion non-interpersonal trauma group than the DSM criterion-interpersonal trauma group. Further, the DSM non-criterion interpersonal trauma group displayed more PTSD symptoms, psychological distress, and emotion regulation difficulties than the DSM non-criterion non-interpersonal trauma group. In light of these results, counseling implications and suggestion for further research are discussed.
참고문헌 (125)
- 김보미, "대인관계 외상 경험자들의 사회적 유대감, 정서 조절과 자살 생각의 관계", Korean Journal of Clinical Psychology, 31(3), pp.731~748 (2012), 한국임상심리학회[DOI]
- 김희경, "북한이탈주민의 외상 유형에 따른 복합 PTSD와 PTSD 증상의 차이", 한국심리학회지:일반, 31(4), pp.1003~1022 (2012), 한국심리학회
- 박선정, "대인외상 경험 청소년이 지각한 사회적 지지가 외상 후 성장에 미치는 영항: 적극적 대처의 매개효과", 미래청소년학회지, 12(1), pp.25~47 (2015), 미래를 여는 청소년학회
- 박지은, "외상후 부정적 인지와 외상후 성장의 관계에서 용서의 조절효과: 대인관계 외상 경험자를 중심으로", 인간이해, 37(2), pp.167~185 (2016), 학생생활상담연구소
- 서영석, "한국인이 경험한 외상사건: 종류 및 발생률", 한국심리학회지: 상담 및 심리치료, 24(3), pp.671~701 (2012), 한국상담심리학회[DOI]
- "144초마다 교통사고 1건 하루 12명, 삶을 빼앗기다" (2017), 서울신문[URL]
- 신선영, "삶의 의미와 사회적 지지가 외상 후 성장에 미치는 영향: 성장적 반추를 매개 변인으로", 인간이해, 33(2), pp.217~235 (2012), 학생생활상담연구소
- 송승훈, "한국판 외상 후 성장 척도(K-PTGI)의 신뢰도와 타당도", 석사, 응용심리학, pp.2007
- "성인 4명 중 1명은 평생 한 번 이상 정신질환 앓아" (2017)[URL]
- 윤명숙, "청소년의 대인외상경험과 외상 후 성장의 관계에서 스트레스대처능력의 조절효과 검증", 청소년복지연구, 17(3), pp.239~261 (2015), 한국청소년복지학회
- 은헌정, "한국판 사건충격척도 수정판의 신뢰도 및 타당도 연구", 신경정신의학, 44(3), pp.303~310 (2005), 대한신경정신의학회
- 이미연, "외상유형, 자아 탄력성 및 외상 후 부정적 인지가 외상 후 성장에 미치는 영향", 한국심리학회학술대회 자료집, 2012(1), pp.241~241 (2012)
- 한국사회의 사회 심리적 불안의 원인분석과 대응방안, "이상영", 한국보건사회연구원, ~ (2015)
- 이수림, "외상 유형이 외상후성장 및 지혜에 미치는 영향: 사회적 지지와 대처의 매개효과", 한국심리학회지: 문화 및 사회문제, 19(3), pp.319~341 (2013), 한국문화및사회문제심리학회
- 이수림, "외상 경험 및 인지적 정서조절전략이 외상후스트레스장애와 외상후성장에 미치는 영향", 인문학논총, 39, pp.93~124 (2015), 인문과학연구소
- 이순묵, "구조방정식 모형의 일반화 또는 집단차 연구를 위한 다집단 분석의 관행과 문제점", 사회과학, 43(1), pp.63~112 (2011)
- 이예종, "연령대별 성인의 정신건강이 삶의 질에 미치는 영향 -제5기(2010)국민건강영양조사를 중심으로", 디지털융복합연구, 11(1), pp.321~327 (2013), 한국디지털정책학회
- 전철은, "심리적 피학대 여성의 수치심, 죄책감 및 사회적 지지가 외상후 스트레스장애(PTSD)에 미치는 영향", Korean Journal of Clinical Psychology, 22(4), pp.763~776 (2003), 한국임상심리학회
- 조용래, "정서조절곤란의 평가: 한국판 척도의 심리측정적 속성", Korean Journal of Clinical Psychology, 26(4), pp.1015~1038 (2007), 한국임상심리학회[DOI]
- 조화진, "성인애착과 심리적 디스트레스의 관계: 부적응적 완벽주의와 기본 심리적 욕구 만족의 매개효과", 한국심리학회지: 상담 및 심리치료, 23(2), pp.471~490 (2011), 한국상담심리학회
- 최강록, "한국판 개정판 일생 스트레스 사건 체크리스트의 신뢰도 및 타당도 : 불안 장애 및 우울장애 외래 환자 대상", 석사, pp.2015
- 최은영, "여대생의 아동 청소년기 대인간 외상 경험과 자기역량 손상의 관계에서 내면화된 수치심의 매개효과", 한국심리학회지:여성, 16(3), pp.285~302 (2011), 한국여성심리학회[DOI]
- 홍세희, "구조 방정식 모형의 적합도 지수 선정기준과 그 근거", Korean Journal of Clinical Psychology, 19(1), pp.161~177 (2000)
- 홍세희, "구조방정식 모형의 다양한 확장" (2017), 박영사
- Anders, S. L., "Variations in Criterion A and PTSD prevalence rates and symptoms", Journal of Anxiety Disorders, 25(2), pp.176~184 (2011)
- Anders, S. L., "Beyond criterion A1 : The effects of relational and non-relational traumatic events", Journal of Trauma & Dissociation, 13(2), pp.134~151 (2012)
- Allen, J., "Coping with trauma: Hope through understanding" (2005), America Psychiatric Publishing Inc
- Allen, J. G., "트라우마의 치유" (2010), 학지사
- American Psychiatric Association, "Diagnostic and statistical manual of mental disorders" (1980), American Psychiatric Association
- American Psychiatric Association, "Diagnostic and statistical manual of mental disorders" (1987), American Psychiatric Association
- American Psychiatric Association, "Diagnostic and statistical manual of mental disorders" (2000), American Psychiatric Association
- American Psychiatric Association, "Diagnostic and statistical manual of mental disorders" (2013), American Psychiatric Association
- Avina, C., "Sexual harassment and PTSD: Is sexual harassment diagnosable trauma", Journal of Traumatic Stress, 15(1), pp.69~75 (2002)
- Baumeister, R., "The need to belong : Desire for interpersonal attachments as a fundamental human motivation", Psychological Bulletin, 117(3), pp.497~529 (1995)
- Bedard-Gilligan, M., "The utility of the A1 and A2 criteria in the diagnosis of PTSD", Behaviour Research and Therapy, 46(9), pp.1062~1069 (2008)
- Boals, A., "PTSD symptoms in response to traumatic and nontraumatic events : The role of respondent perception and A2 criterion", Journal of Anxiety Disorders, 23(4), pp.458~462 (2009)
- Bodkin, J. A., "Is PTSD caused by traumatic stress?", Journal of Anxiety Disorders, 21(2), pp.176~182 (2007)
- Bokszczanin, A., "PTSD symptoms in children and adolescents 28 months after a flood : Age and gender differences", Journal of Traumatic Stress, 20(3), pp.347~351 (2007)
- Breslau, N., "Posttraumatic stress disorder : The stressor criterion", The Journal of Nervous and Mental Disease, 175(5), pp.255~264 (1987)
- Breslau, N., "Trauma and posttraumatic stress disorder in the community : The 1996 Detroit Area Survey of Trauma", Archives of General Psychiatry, 55(7), pp.626~632 (1998)
- Briere, J., "Self-awareness, affect regulation, and relatedness : Differential sequels of childhood versus adult victimization experiences", The Journal of Nervous and Mental Disease, 195(6), pp.497~503 (2007)
- Burnam, M. A., "Sexual assault and mental disorders in a community population", Journal of Consulting and Clinical Psychology, 56(6), pp.843~850 (1988)
- Calhoun, L. G., "Facilitating posttraumatic growth: A clinician's guide" (1999), Lawrence Erlbaum Associates
- Chard, K. M., "An evaluation of cognitive processing therapy for the treatment of posttraumatic stress disorder related to childhood sexual abuse", Journal of Consulting and Clinical Psychology, 73(5), pp.965~ (2005)
- Chapman, C., "Remission from post-traumatic stress disorder in the general population", Psychological Medicine, 42(8), pp.1695~1703 (2012)
- Charuvastra, A., "Social bonds and posttraumatic stress disorder", Annual Review of Psychology, 59, pp.301~328 (2008)
- Cloitre, M., "Beyond PTSD : Emotion regulation and interpersonal problems as predictors of functional impairment in survivors of childhood abuse", Behavior Therapy, 36(2), pp.119~124 (2005)
- Costello, E. J., "The prevalence of potentially traumatic events in childhood and adolescence", Journal of Traumatic Stress, 15(2), pp.99~112 (2002)
- Cougle, J. R., "Factors associated with chronicity in posttraumatic stress disorder: A prospective analysis of a national sample of women", Psychological Trauma: Theory, Research, Practice, and Policy, 5(1), pp.43~49 (2013)
- Davidson, J. R., "Post-traumatic stress disorder in the community : An epidemiological study", Psychological Medicine, 21(3), pp.713~721 (1991)
- Davis, J. L., "Intimacy dysfunction and trauma symptomatology : Long-term correlates of different types of child abuse", Journal of Traumatic Stress, 14(1), pp.63~80 (2001)
- De Bellis, M. D., "Developmental traumatology part II : Brain development", Biological Psychiatry, 45(10), pp.1271~1284 (1999)
- De, C. M. G., "Post-traumatic stress disorder in an anxiety disorder unit and in a victims support association", L'Encephale, 31(1 Pt 1), pp.76~81 (2005)
- Derogatis, L. R., "The Brief Symptom Inventory (BSI): Administration, scoring and procedures manual-3. 1993" (1993), National Computer Systems
- Derogatis, L. R., "BSI-18: Brief Symptom Inventory 18, Administration. Scoring, and Procedures Manual" (2000), National Computer Systems Pearson, INC
- De Vries, G. J., "The lifetime prevalence of traumatic events and posttraumatic stress disorder in the Netherlands", Journal of Traumatic Stress, 22(4), pp.259~267 (2009)
- Ehring, T., "Emotion regulation difficulties in trauma survivors : The role of trauma type and PTSD symptom severity", Behavior Therapy, 41(4), pp.587~598 (2010)
- Elhai, J. D., "Clinical presentations of posttraumatic stress disorder across trauma populations : A comparison of MMPI-2 profiles of combat veterans and adult survivors of child sexual abuse", The Journal of Nervous and Mental Disease, 188(10), pp.708~713 (2000)
- Ford, J. D., "A randomized clinical trial comparing affect regulation and social problem-solving psychotherapies for mothers with victimization-related PTSD", Behavior Therapy, 42(4), pp.560~578 (2011)
- Frazier, P., "Traumatic events among undergraduate students : Prevalence and associated symptoms", Journal of Counseling Psychology, 56(3), pp.450~460 (2009)
- Freyd, J. J., "Betrayal trauma : Relationship to physical health, psychological distress, and a written disclosure intervention", Journal of Trauma & Dissociation, 6(3), pp.83~04 (2005)
- Galea, S., "Posttraumatic stress disorder in the general population after mass terrorist incidents : Considerations about the nature of exposure", CNS Spectrums, 10(2), pp.107~115 (2005)
- Gersons, B. P., "Post Traumatic Stress Disorder Diagnosis, Management and Treatment", pp.25~35 (2009), CRC Press
- Gold, S. D., "Is life stress more traumatic than traumatic stress?", Journal of Anxiety Disorders, 19(6), pp.687~698 (2005)
- Gratz, K. L., "Multidimensional assessment of emotion regulation and dysregulation : Development, factor structure, and initial validation of the difficulties in emotion regulation scale", Journal of Psychopathology and Behavioral Assessment, 26(1), pp.41~54 (2004)
- Green, B. L., "Outcomes of single versus multiple trauma exposure in a screening sample", Journal of Traumatic Stress, 13(2), pp.271~286 (2000)
- Green, B. L., "Children and disaster : Age, gender, and parental effects on PTSD symptoms", Journal of the American Academy of Child & Adolescent Psychiatry, 30(6), pp.945~951 (1991)
- Hedtke, K. A., "A longitudinal investigation of interpersonal violence in relation to mental health and substance use", Journal of Consulting and Clinical Psychology, 76(4), pp.633~ (2008)
- Horowitz, M., "Impact of Event Scale : A measure of subjective stress", Psychosomatic medicine, 41(3), pp.209~218 (1979)
- Hu, L. T., "Cutoff criteria for fit indexes in covariance structure analysis : Conventional criteria versus new alternatives", Structural equation modeling : a multidisciplinary journal, 6(1), pp.1~55 (1999)
- Joseph, S., "Life‐events and post‐traumatic stress in a sample of English adolescents", Journal of Community & Applied Social Psychology, 10(6), pp.475~482 (2000)
- Kaplan, D., "Structural equation modeling: Foundations and extensions (Vol. 10)" (2008), Sage Publications
- Kasl, S. V., "Some considerations in the study of traumatic stress", Journal of Applied Social Psychology, 20(20), pp.1655~1665 (1990)
- Kazantzis, N., "Predictors of chronic trauma-related symptoms in a community sample of New Zealand motor vehicle accident survivors", Culture, Medicine, and Psychiatry, 36(3), pp.442~464 (2012)
- Kelley, L. P., "A comparison of PTSD symptom patterns in three types of civilian trauma", Journal of Traumatic Stress, 22(3), pp.227~235 (2009)
- Kessler, R. C., "Posttraumatic stress disorder in the National Comorbidity Survey", Archives of General Psychiatry, 52(12), pp.1048~1060 (1995)
- Kilpatrick, D. G., "Risk factors for adolescent substance abuse and dependence : Data from a national sample", Journal of Consulting and Clinical Psychology, 68(1), pp.19~30 (2000)
- Kilpatrick, D. G., "DSM–IV sourcebook, Vol. 4", pp.803~841 (1998), American Psychiatric Press
- Lancaster, S. L., "An examination of the differential effects of the experience of DSM-IV defined traumatic events and life stressors", Journal of Anxiety Disorders, 23(5), pp.711~717 (2009)
- Lapp, L. K., "PTSD in the elderly : The interaction between trauma and aging", International Psychogeriatrics, 23(06), pp.858~868 (2011)
- Lincoln, K. D., "Social support, traumatic events, and depressive symptoms among African Americans", Journal of Marriage and Family, 67(3), pp.754~766 (2005)
- Long, M. E., "Differences in posttraumatic stress disorder diagnostic rates and symptom severity between Criterion A1 and non-Criterion A1 stressors", Journal of Anxiety Disorders, 22(7), pp.1255~1263 (2008)
- Matthiesen, S. B., "Psychiatric distress and symptoms of PTSD among victims of bullying at work", British Journal of Guidance & Counselling, 32(3), pp.335~356 (2004)
- McHugo, G. J., "The assessment of trauma history in women with co-occurring substance abuse and mental disorder and a history of interpersonal violence", The Journal of Behavioral Health Services & Research, 32(2), pp.113~127 (2005)
- McNally, R. J., "Progress and controversy in the study of posttraumatic stress disorder", Annual Review of Psychology, 54(1), pp.229~252 (2003)
- Micale, M. S., "Traumatic pasts: history, psychiatry, and trauma in the modern age, 1870-1930" (2001), Cambridge University Press
- Mol, S. S., "Symptoms of post-traumatic stress disorder after non-traumatic events : Evidence from an open population study", The British Journal of Psychiatry, 186(6), pp.494~499 (2005)
- Morrison, J., "DSM-5® Made Easy: The Clinician's Guide to Diagnosis" (2014), Guilford Publications
- Murphy, M. C., "Stressors on the college campus : A comparison of 1985-1993", Journal of College Student Development, 37(1), pp.20~28 (1996)
- Neria, Y., "Post-traumatic stress disorder following disasters : A systematic review", Psychological Medicine, 38(4), pp.467~480 (2008)
- Norris, F. H., "Epidemiology of trauma : Frequency and impact of different potentially traumatic events on different demographic groups", Journal of consulting and clinical psychology, 60(3), pp.409~418 (1992)
- Norris, F. H., "60, 000 disaster victims speak : Part I. An empirical review of the empirical literature, 1981-2001", Psychiatry : Interpersonal and Biological Processes, 65(3), pp.207~239 (2002)
- O’Brien, L. S., "Traumatic events and mental health" (1998), Cambridge University Press
- Olde, E., "Posttraumatic stress following childbirth : A review", Clinical Psychology Review, 26(1), pp.1~16 (2006)
- Palmieri, P. A., "Confirmatory factor analysis of posttraumatic stress symptoms in sexually harassed women", Journal of Traumatic Stress, 18(6), pp.657~666 (2005)
- Polusny, M. A., "Long-term correlates of child sexual abuse : Theory and review of the empirical literature", Applied and preventive psychology, 4(3), pp.143~166 (1995)
- Rasmussen, A., "Factor structure of PTSD symptoms among west and central African refugees", Journal of Traumatic Stress, 20(3), pp.271~280 (2007)
- Resnick, H. S., "Prevalence of civilian trauma and posttraumatic stress disorder in are presentative national sample of women", Journal of Consulting and Clinical Psychology, 61(6), pp.984~991 (1993)
- Robinson, J. S., "Are traumatic events necessary to elicit symptoms of posttraumatic stress", Psychological Trauma: Theory, Research, Practice, and Policy, 2(2), pp.71~76 (2010)
- Rosen, G. M., "Problems with the post-traumatic stress disorder diagnosis and its future in DSM-V", The British Journal of Psychiatry, 192(1), pp.3~4 (2008)
- Russell, D. W., "Analyzing data from experimental studies : A latent variable structural equation modeling approach", Journal of Counseling Psychology, 45(1), pp.18~29 (1998)
- Schumacher, A. M., "The relationship of two types of trauma exposure to current physical and psychological symptom distress in a community sample of colombian women : Why interpersonal violence deserves more attention", Health Care for Women International, 31(10), pp.946~961 (2010)
- Schumm, J. A., "Cumulative interpersonal traumas and social support as risk and resiliency factors in predicting PTSD and depression among inner‐city women", Journal of Traumatic Stress : Official Publication of The International Society for Traumatic Stress Studies, 19(6), pp.825~883 (2006)
- Scott, M. J., "Post traumatic stress disorder without the trauma", British Journal of Clinical Psychology, 33(1), pp.71~74 (1994)
- Shakespeare-Finch, J., "Trauma type and posttrauma outcomes : Differences between survivors of motor vehicle accidents, sexual assault, and bereavement", Journal of Loss and Trauma, 15(2), pp.69~82 (2010)
- Smart Richman, L., "Reactions to discrimination, stigmatization, ostracism, and other forms of interpersonal rejection : a multimotive model", Psychological review, 116(2), pp.365~383 (2009)
- Smith, H. L., "Is worst-event trauma type related to PTSD symptom presentation and associated features?", Journal of Anxiety Disorders, 38, pp.55~61 (2016)
- Smith, M. Y., "Post‐traumatic stress disorder in cancer : A review", Psycho‐Oncology, 8(6), pp.521~537 (1999)
- Spertus, I. L., "Childhood emotional abuse and neglect as predictors of psychological and physical symptoms in women presenting to a primary care practice", Child Abuse & Neglect, 27(11), pp.1247~1258 (2003)
- Spitzer, C., "Posttraumatic stress disorder following high and low‐magnitude stressors in psychotherapeutic inpatients", Clinical Psychology & Psychotherapy, 7(5), pp.379~384 (2000)
- Stein, D. J., "Efficacy of sertraline in posttraumatic stress disorder secondary to interpersonal trauma or childhood abuse", Annals of Clinical Psychiatry, 18(4), pp.243~249 (2006)
- Taylor, S., "Simple versus complex PTSD : A cluster analytic investigation", Journal of Anxiety Disorders, 20(4), pp.459~472 (2006)
- Tedeschi, R. G., "Posttraumatic growth : Conceptual foundations and empirical evidence", Psychological Inquiry, 15(1), pp.1~18 (2004)
- Tolin, D. F., "Sex differences in trauma and posttraumatic stress disorder : A quantitative review of 25 years of research", Psychological Bulletin, 132(6), pp.959~ (2006)
- Torres, L., "Discrimination, acculturation, acculturative stress, and Latino psychological distress : A moderated mediational model", Cultural Diversity and Ethnic Minority Psychology, 18(1), pp.17~ (2012)
- Tull, M. T., "A preliminary investigation of the relationship between emotion regulation difficulties and posttraumatic stress symptoms", Behavior Therapy, 38(3), pp.303~313 (2007)
- Van der Kolk, B. A., "Disorders of extreme stress : The empirical foundation of a complex adaptation to trauma", Journal of Traumatic Stress, 18(5), pp.389~399 (2005)
- Van Hooff, M., "The stressor Criterion-A1 and PTSD : A matter of opinion?", Journal of Anxiety Disorders, 23(1), pp.77~86 (2009)
- Velezmoro, R., "Online sexual activity : Cross-national comparison between United States and Peruvian college students", Archives of Sexual Behavior, 41(4), pp.1015~1025 (2012)
- Verlinden, E., "What makes a life event traumatic for a child? The predictive values of DSM-Criteria A1 and A2", European Journal of Psychotraumatology, 4(1), pp.20436~ (2013)
- Wang, C. C. D., "Acculturation, attachment, and psychological adjustment of Chinese", Taiwanese international students, 2006, pp.53(4), 422~
- Weiss, D. S., "Assessing Psychological Trauma and PTSD: A Handbook for Practitioners", pp.399~411 (1997), Guilford Press
- West, S. G., "Structural equation modeling: Concepts, issues and applications", pp.56~75 (1995), Sage
- Willard, V. W., "Life stress versus traumatic stress: The impact of life events on psychological functioning in children with and without serious illness", Psychological Trauma: Theory, Research, Practice, and Policy, 8(1), pp.63~ (2016)
- Wolfe, J., "Assessing psychological trauma and PTSD", pp.192~238 (1997), Guilford
