재난피해자 정신질환 발병에 영향을 미치는 이차 스트레스 요인
The secondary stress factors influencing the onset of mental disorders following a disaster
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본 연구의 목적은 재난 후 정신질환 발병에 어떠한 이차 스트레스 요인들이 보다 큰 위험요소로 작용하는지 검토하는 것이다. 이를 위해 국립재난안전연구원의 재난피해자 삶의 변화 추적조사 데이터를 활용하여 2012년부터 2017년까지 재난피해자 중에서 재난 전 3개월 간 어떠한 정신질환도 없었던 이들의 데이터를 분석하였다(n=1390). 재난 후 정신질환 발병 집단(n=156)과 아닌 집단(n=1234)으로 구분하고 로지스틱 회귀분석을 실시하여 인구통계학적 요인, 재난 특성, 일차 스트레스 요인, 이차 스트레스 요인들이 재난 후 정신질환 발병을 예측하는지 확인하였다. 그 결과, 여성, 높은 연령, 사회재난 경험, 가구의 현재 월수입이 낮은 경우, 재난으로 상해나 질병 피해를 입었을 경우에 재난 후 정신질환 발병 확률이 높았다. 이차 스트레스 요인 중에서는 재난으로 인해 이웃, 지자체, 정부와 갈등이 있었던 경우, 구호 서비스나 복구과정에서 제공받은 정보가 신뢰롭지 않았을 경우, 국가의 의료지원이 충분치 않았던 경우, 재난 후 총 자산이 감소한 경우에 재난 후 정신질환 발병 확률이 높았다. 이를 통해 당장의 가시적인 피해에만 주목할 것이 아니라 재난 피해자들을 둘러싼 사회·문화적 환경에 내재되어 있던 취약성, 새롭게 발생한 스트레스 요인들을 최소화하는 제도적 방안이 필요함을 제안하였다.
Abstract
This study aimed to examine which secondary stress factors served as greater risk factors for the onset of mental disorders following a disaster. For this purpose, disaster victim follow-up data from the National Disaster Management Research Institute, obtained between 2012 and 2017, were used to analyze data of victims who showed no symptoms of mental illness for a period of three months prior to the disaster (n=1390). The participants were divided into two groups: those that developed a mental disorder after a disaster (n=156) and those that did not (n=1234). Logistic regression analysis was then performed to determine whether demographic factors, disaster-related factors, psychological factors, primary stress factors, and secondary stress factors predicted the onset of mental disorder following a disaster. The results showed that the risk of developing a mental disorder following a disaster was higher among women, older age, lower monthly income, victims of a social disaster, victims who suffered an injury or disease due to the disaster, and victims who were experiencing high levels of depression and post traumatic stress symptoms at the time of the study. Among secondary stress factors, the risk of developing a mental disorder following a disaster was higher among victims who experienced conflict with neighbors, local and national governments, when the disaster relief service or information provided during the recovery process was unreliable, when the government delivered inadequate medical support, and a decrease in asset. These results suggested that secondary stress management should be included as important factors for consideration in the mental health coping strategies of victims of disasters.
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