본문 바로가기
KERD
논문KCI 등재

재미 한인노인들의 자살생각 모형 분석: 우울의 매개효과와 연령별 조절효과를 중심으로

An Analysis on the Explanatory Model for Suicidal Ideation among Older Korean Immigrants in the U.S.: Mediating effects of Depression & Moderating effects of Age

0

조회

0

다운로드

7

인용

0

참고문헌

키워드

주제분류사회복지학

초록

본 연구는 한인 노인 이민자들의 신체적, 심리 ․ 정서적, 사회적 위험요인이 직접적으로 또는 우울을 매개로 간접적으로 자살생각에 미치는 영향을 분석하고, 이에 대한 연령의 조절효과를 보고자하는데 그 목적이 있다. 자료 수집은 미국 LA 지역의 복지관과 교회에 다니는 한인 노인(연령≧65) 220명을 대상으로 이루어졌으며, 경로분석과 다 집단 분석을 이용하여 가설 검증을 하였다. 연구결과로는 첫째, 노인의 신체적 기능 문제(IADL)는 우울과 자살생각에 정적(+)인 직접적 영향을 미쳤다. 둘째, 신경증적 성격은 우울과 자살생각에 정적(+)인 직접적인 영향을 미쳤다. 셋째, 사회적 지지만족도는 자살생각에 부적(-)인 직접적 영향을, 문화적 적응은 우울에 부적(-)인 직접적 영향을 미치는 것으로 나타났다. 넷째, 우울은 자살생각에 정적(+)인 영향을 미쳤고, 신체적 기능상태, 문화적 적응, 신경증적 성격은 우울을 매개로 자살생각에 간접적인 영향을 미치는 것으로 나타났다. 다섯째, 우울의 위험요인에 대한 연령별(연소 노인(65-74세), 고령노인(75세 이상)의 조절효과는 신체적 기능, 사회적지지, 신경증적 성격에서 나타났으며, 자살의 위험요인에 대한 연령별 조절효과는 사회적지지와 문화적응에서 나타났다. 본 연구 결과를 바탕으로 한인 노인 이민자를 위한 효과적인 우울증 치료와 자살예방서비스 및 프로그램의 내용을 제언하고, 연령별로 차별적 서비스 제공의 필요성을 시사하고 있다.

Abstract

The purpose of the study is to analyze the direct and indirect effects(via depression) of physiological, psychological, and social risk factors on suicidal ideation among older Korean immigrant in the U.S.. In addition, the study purported to investigate the moderating effects of age on this analytic model. Data were collected from a cross-sectional survey of 220 Korean older immigrants (age 65) ≧ drawn from community senior centers and churches in the Los Angeles County. The statistical analysis was performed by a path analysis with a multi group analysis using AMOS statistical program. The results were fivefold. First, problems in physical functions(IADL) and neurotic personality traits were directly positively associated with depression as well as suicidal ideaion. Second, social support was directly negatively associated with suicidal ideation, whereas acculturation was directly negatively related to depression. Third, depression exerted positive effects on depression, and physical functions, acculturation, and neurotic personality had indirect effects on suicidal ideation via depression. Fourth, age showed significant moderating effects on the relationship between three exogeneous factors (physical functions, social support, and neurotic personality traits) and depression. Sixth, age had significant moderating effects on the relationship between two exogeneous factors (social support and acculturation) and suicidal ideation. These results suggest crucial practical implications for developing and implementing effective treatment for depression as well as age-sensitive suicide prevention programs for older Korean immigrants. Limitations and directions for future research are also discussed.

참고문헌 (69)

  1. 김동배, "노인의 사회관계망 특성과 자살생각 관계 : 우울의 매개효과 검증", 한국사회복지조사연구, 24, pp.109~129 (2010), 사회복지연구소
  2. 김대업, "AMOS A to Z" (2008), 학현사
  3. 김태성, "생애사 연구를 통한 노년기 삶의 이해 - 주거노인을 중심으로 -", 노인복지연구, 57(57), pp.381~402 (2012), 한국노인복지학회
  4. 김현경, "노인의 자살생각과 위험요인", 한국보건학회지, 24(1), pp.82~92 (2010)
  5. 문동규, "노인의 자살생각과 관련된 유발변인의 메타회귀분석", 노인복지연구, (55), pp.133~158 (2012), 한국노인복지학회
  6. 박봉길, "노인의 자살생각에 영향을 미치는 우울증을 매개로 한 관련요인 연구", 정신보건과 사회사업, (22), pp.58~90 (2006), 한국정신보건사회복지학회
  7. 안준희, "한인 이민노인의 우울증에 영향을 미치는 요인", 한국노년학, 27(3), pp.597~616 (2007), 한국노년학회
  8. 양옥경, "서울지역 결혼이주여성의 문화적응스트레스에 관한 연구", 한국가족관계학회지, 14(1), pp.137~168 (2009), 한국가족관계학회
  9. 이신영, "독거노인의 친구․이웃과의 사회적 지원과 우울성향", 노인복지연구, (56), pp.137~164 (2012), 한국노인복지학회[DOI]
  10. 장혜경, "노인의 자살생각 유발요인과 사회적 지지의 중재효과 연구", 석사, pp.2007
  11. 정호영, "노인 자살생각에 영향을 미치는 요인에 관한 연구-우울과 스트레스의 매개효과를 중심으로-", 한국노년학, 27(4), pp.789~805 (2007), 한국노년학회
  12. 정태연, "노년기의 외로움 및 생활만족도와 관련된 변인탐색", 한국노년학, 25(1), pp.55~71 (2005), 한국노년학회
  13. 허준수, "노인들의 고독감에 대한 영향요인에 관한 연구: 노인복지관 이용 노인과 비이용 노인을 중심으로", 노인복지연구, (53), pp.74~95 (2011), 한국노인복지학회
  14. Alexopoulos, G. S, "Clinical determinants of suicidal ideation and behavior in geriatric depression", Arch General Psychiatry, 56, pp.1048~1053 (1999)
  15. Awata, S, "Factors associated with suicidal ideation in an elderly urban Japanese population: A community-based, cross-sectional study", Psychiatry & Clinical Neurosciences, 59, pp.327~336 (2005)
  16. Barnow, S, "Epidemiology and psychiatric morbidity of suicidal ideation among the elderly", The Journal of Crisis Intervention and Suicide Prevention, 21(4), pp.171~180 (2000)
  17. Beck, A. T, "Assessment of suicidal intention: The Scale for Suicide Ideation", Journal of Consulting and Clinical Psychology, 47, pp.343~352 (1979)
  18. Beevers, C. G, "Perfectionism, cognitive bias, and hopelessness as prospective predictors of suicidal ideation", Suicide and Life-Threatening Behavior, 34, pp.126~137 (2004)
  19. A. M. Padilla, "Acculturation as varieties of adaptation, In Acculturation: Theory, models, and some new findings", pp.9~25 (1986), Westview
  20. Brown, S. L, "The Interplay Among Risk Factors for Suicidal Ideation and Suicide: The Role of Depression, Poor Health, and Loved Ones' Messages of Support and Criticism", American Journal of Community Psychology, 32(1-2), pp.131~141 (2003)
  21. Chi, I, "Social support and depression among elderly Chinese people in Hong Kong", International Journal of Aging and Human Development, 52(3), pp.231~252 (2001)
  22. 최연희, "재가 노인의 우울에 따른 자살생각과 관련요인", 한국노년학, 28(2), pp.345~355 (2008), 한국노년학회
  23. Cloninger, C. R, "Personality and psychopathology" (1999), American Psychiatric Association Press
  24. Conwell, Y, "Risk factors for suicide in later life", Biol Psychiatry, 52, pp.193~204 (2002)
  25. Costa, P. T, "Personality assessment in psychosomatic medicine, In Advances in psychosomatic medicine", pp.71~82 (1987), Karger
  26. Donnelly, P. L, "patient health questionnaire (PHQ-9K) to screen for depressive disorders among immigrant Korean American elderly", Journal of Cultural Diversity, 15(1), pp.24~29 (2008)
  27. Duberstein, P. R, "Age differences in the personality characteristics of suicide completers: Preliminary findings from a psychological autopsy study", Psychiatry, 57(3), pp.213~224 (1994)
  28. Duberstein, P. R, "Age and suicidal ideation in older depressed inpatients", American Journal of Geriatric Psychiatry, 7, pp.289~296 (1999)
  29. Eysenck, H. J, "The manual of the Eysenck Personality Questionnair" (1975), Hodder & Stoughton
  30. Eysenck, S. B. G, "Cross-cultural study on the characteristics of personality dimensions: Korean and English", Korean Journal of Psychology, 5, pp.51~66 (1985)
  31. Fillenbaum, G. G, "Screening the elderly: A brief instrumental ADL measure", Journal of American Geriatric Society, 33, pp.698~706 (1985)
  32. Goldney, R. D, "Suicidal ideation in a random community sample: attributable risk due to depression and psychological and traumatic events", Australian and New Zealand Journal of Psychiatry, 34, pp.98~106 (2000)
  33. Graves, T. D, "Psychological acculturation in a tri-ethnic community", Southwestern Journal of Anthropology, 23, pp.337~350 (1967)
  34. Gunderson, J. G, "Personality and vulnerability to affective disorders, In Personality and psychopathology" (1999), American Psychiatric Association Press
  35. Harwood, D, "Psychiatric disorder and personality factors associated with suicide in older people: A descriptive and case controlled study", International Journal of Geriatric Psychiatry, 16, pp.155~165 (2001)
  36. Jha, A, "Depression and suicidality in Asian Indian students", Dissertation Abstracts International, 62(03), pp.1311~ (2001)
  37. Joiner, T. E, "Why People Die by Suicide" (2005), Harvard University Press
  38. Kim, H. S, "Risks factors for suicide attempts among Korean adolescent", Child Psychiatry and Human Development, 39, pp.221~235 (2008)
  39. Kim, O, "Medication effect of social support between ethnic attachment and loneliness in older Korean Immigrants", Research in Nursing & Health, 22, pp.169~175 (1999)
  40. Kim, O, "Predictors of loneliness in elderly Korean women living in the United States of America", Journal of Advanced Nursing, 29, pp.1082~1088 (1999)
  41. Lam, R, "Factors related to depressive symptoms in an elderly Chinese American Sample", Clinical Gerontologist, 17(4), pp.57~69 (1997)
  42. LaFromboise, T, "Psychological impact of biculturalism: Evidence and theory", Psychological Bulletin, 114, pp.395~412 (1993)
  43. Lee, M. S, "Social support and depression among elderly Korean immigrants in the United States", International Journal of Aging and Human Development, 42, pp.313~327 (1996)
  44. Leong, F. T. L, "Suicide among Asian Americans: What do we know? what do we need to know?", Death Studies, 31(5), pp.417~434 (2007)
  45. McIntosh, J. L, "Older Adults: The Next Suicide Epidemic?", Suicide and Life- Threatening Behavior, 22(3), pp.322~332 (1992)
  46. Mui, A. C, "Acculturation stress and depression among Asian immigrant elders", Social Work, 51, pp.243~255 (2006)
  47. Neugarten, B. L, "Age Groups in American Society and the Rise of the Young-Old", The ANNALS of the American Academy of Political and Social Science, 415, pp.187~198 (1974)
  48. Oldehinkel, A. J, "Functional disability and neuroticisim as predictors of late-life depression", American Journal of Geriatric Psychiatry, 9, pp.241~248 (2001)
  49. "Older America's mental health week" (2005)[URL]
  50. Park, K. B, "College goal and suicidal ideation among high school students", Korean Journal of Clinical Psychology, 9(1), pp.20~32 (1990)
  51. Pfeiffer E, "A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients", Journal of American Geriatrics Soc, 23, pp.433~441 (1975)
  52. Ponizovsky, A, "Suicidal ideation and suicidal attempts among immigrant adolescents from the former Soviet Union to Israel", Journal of the American Academy of Child and Adolescent Psychiatry, 38(11), pp.1433~1441 (1999)
  53. Radloff, L. F, "The CES-D scale: a self-report depression scale for research in the general public", Applied Psychology Measures, 1, pp.385~401 (1977)
  54. Raue, P. J, "Suicidal ideation among elderly homecare patients", International Journal of Geriatric Psychiatry, 22(1), pp.32~37 (2007)
  55. Sarason, I. G, "Assessing social support: The social support questionnaire", Journal of Person. Society. Psychology, 44, pp.127~139 (1983)
  56. Skoog, I, "Suicidal feelings in a population sample of nondemented 85-year-olds", American Journal of Psychiatry, 153, pp.1015~1020 (1996)
  57. Steunenberg, B, "Personality and the onset of depression in late life", Journal of Affective Disorders, 92, pp.243~251 (2006)
  58. Steunenberg, B, "Personality predicts recurrence of late-life depression", Journal of Affective Disorder, 123(1-3), pp.164~172 (2010)
  59. Suinn, R. M, "The Suinn-Lew Asian Self-Identity Acculturation Scale: An initial report", Educational and Psychological Measurement, 47, pp.401~407 (1987)
  60. Trinh, N. H, "Handbook of Mental Health and Acculturation in Asian American families" (2009), Humana Press
  61. Tsoh, J, "Attempted suicide in elderly Chinese persons: a multi-group, controlled study", American Journal of Geriatric Psychiatry, 13, pp.562~571 (2005)
  62. "Death Rates from Suicide by Selected Characteristics" (2009)[URL]
  63. Van Heeringen, K, "Pathways to suicide: An integrative approach, In The international handbook of suicide and attempted suicide" (2000), Wiley
  64. Waern, M, "Predictors of suicide in the old elderly", Gerontology, 49, pp.328~334 (2003)
  65. Wasserman, D, "Stress-vulnerability model and development of the suicidal process from suicidal ideation to suicide, In suicide: un unnecessary Death" (2001), Martin Dunitz
  66. Wong, Y. J, "Asian Americans' family cohesion and suicide ideation: Moderating and mediating effects", American Journal of Orthopsychiatry, 82(3), pp.309~318 (2012)
  67. Yang, S. M, "Relative effects of depression on suicide ideation of the rural elderly", Journal of Welfare for the Aged, 32, pp.377~396 (2006)
  68. Yip, P. S. F, "Suicide in Hong Kong: epidemiological profile and burden analysis, 1981 to 2001", Hong Kong Medical Journal, 9, pp.419~426 (1981)
  69. Yip, P, "A prevalence study of suicide ideation among older adults in Hong Kong SAR", International Journal of Geriatric Psychiatry, 18, pp.1056~1062 (2003)

관련 논문AI추천

이 간행물의 다른 논문 (11건)