북한이탈주민의 외상후스트레스증상과 자살행동의 관계: 사회적 지지와 외로움의 순차매개효과
The Association between Posttraumatic Stress Symptoms and Suicidal Behavior in North Korean Defectors: Social Support and Loneliness as Sequential Mediators
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초록
본 연구는 외상후스트레스증상과 자살행동의 관계에서 사회적 지지와 외로움의 순차매개효과를 알아보기 위해 실시되었다. 이를 위해 199명(남성 43명, 여성 156명)의 북한이탈주민을 대상으로 기초선에서 외상후스트레스증상, 사회적 지지, 외로움, 자살행동에 대한 자기보고식 설문을 실시하였다. 참가자들은 2년 후, 자살행동을 다시 보고하였다. 연구 결과는 다음과 같다. 첫째, 외상후스트레스증상과 자살행동의 정적 관계가 유의하였다. 둘째, 외상후스트레스증상과 자살행동의 관계에서 사회적 지지의 단순 매개효과는 유의하지 않았다. 셋째, 외상후스트레스증상과 자살행동의 관계에서 외로움의 단순 매개효과는 유의하였다. 넷째, 외상후스트레스증상이 사회적 지지와 외로움을 차례로 거쳐 자살행동을 예측하는 순차매개효과가 유의한 것으로 나타났다. 이는 높은 외상후스트레스증상이 낮은 사회적 지지를 예측하고, 낮은 사회적 지지가 높은 외로움을 예측하여, 높은 외로움이 결국 높은 자살행동으로 이어질 수 있음을 의미한다. 본 연구는 외상후스트레스증상과 자살행동의 관계에서 사회적 지지와 외로움을 통합적으로 확인했다는 점에서 의의를 지닌다. 나아가, 북한이탈주민 집단에 개입할 때 대인관계에 초점을 맞춘 치료가 효과적일 수 있음을 시사하는 임상적 함의를 지닌다.
Abstract
This study investigated the sequential mediating effect of social support and loneliness in the relationship between posttraumatic symptoms and suicidal behavior among North Korean defectors. The participants were 199 North Korean defectors (43 males, 156 females) who completed a set of self-report questionnaires that measured posttruamatic symptoms, social support, loneliness, and suicidal behavior at baseline(Time 1). After two years(Time 2), participants reported their suicidal behavior. The relationship between posttraumatic stress symptoms at Time 1 and suicidal behavior at Time 2 was significantly mediated only by loneliness at Time 1, and not by social support at Time 1. Furthermore, social support and loneliness at Time 1 sequentially mediated the association between posttraumatic stress symptoms at Time 1 and suicidal behavior at Time 2. This study contributes to the literature by elucidating the underlying processes that may lead to high suicidality among North Korean defectors focusing on interpersonal factors and highlighting social support and loneliness as potential targets for intervention.
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