정서장애 대학생들을 대상으로 한 단일화된 범진단적 치료의 변화기제: 정서조절곤란의 매개가설에 대한 지지 증거
Mechanism of Change in a Unified, Transdiagnostic Treatment for Undergraduate Students with Emotional Disorders: Evidence for the Emotion Dysregulation Mediational Hypothesis
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참고문헌
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초록
본 연구는 정서장애에 대한 단일화된 범진단적 치료의 효과를 설명하는 변화기제를 규명하기 위하여 수행되었다. 선행연구들과 문헌에 기초하여, 사회불안증상, 범불안증상, 공황장애 심각도, 우울증상, 부적 정서, 일상적 기능의 손상 수준 및 주 진단의 임상적 심각도에 대한 단일화된 범진단적 치료의 효과가 정서조절곤란의 감소에 의해 매개될 것이라는 가설을 상정하고 검증하였다. 연구 대상은 DSM-5의 여러 종류의 불안 및 우울장애 중에서 적어도 1가지 이상의 진단을 충족시킨 대학생들이며, 단일화된 범진단적 치료를 제공받은 참가자 44명과 대기통제조건에 속한 참가자 15명이 8주 간격의 사전 및 사후 평가와 3개월 추후 평가를 모두 완성하였다. 부트스트랩핑에 기반한 매개효과 분석 결과, 가설과 일치되게, 사회불안증상 및 주 진단의 임상적 심각도에 대한 단일화된 범진단적 치료의 효과는 정서조절곤란의 감소에 의해 부분 매개되었고, 다섯 가지 다른 결과 측정치에 대한 단일화된 범진단적 치료의 효과는 정서조절곤란의 감소에 의해 완전 매개되었다. 결론적으로, 이러한 결과들은 정서조절곤란의 감소가 여러 종류의 불안장애와 우울장애로 진단된 국내 대학생 내담자들을 대상으로 한 단일화된 범진단적 치료의 효과에 대한 매개변인임을 지지하는 증거를 제공한다.
Abstract
This study was conducted to shed light on the mechanism of change in the unified protocol for transdiagnostic treatment for emotional disorders(UP). Based on previous findings and literature review, we hypothesized that a reduction in emotion dysregulation would act as a mediator of the effects of the UP for social anxiety, generalized anxiety, depression symptoms, panic disorder severity, negative affect, impairment in daily functioning, and clinical severity rating of a principal diagnosis. Thereafter, we examined its mediating effects. Participants were undergraduate students with at least one DSM-5 diagnosis of various anxiety and depressive disorders. Forty-four participants who received individual or group UP treatment and 15 in the wait-list control condition completed outcome assessments at pre- and posttreatment and 3-month follow-up. Consistent with our hypothesis, bootstrapping-based mediational analyses demonstrated that a reduction in emotional dysregulation partially mediated the effects of the UP on social anxiety symptoms and clinical severity rating of a principal diagnosis. In addition, it fully mediated the effects of the UP on generalized anxiety, depression symptoms, panic disorder severity, negative affect, and impairment in daily functioning. In conclusion, these results provide the evidence for reducing emotion dysregulation as a mediator of the effects of the UP for Korean undergraduate students with various anxiety and depressive disorders.
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