본문 바로가기
KERD
논문KCI 등재

대학생을 위한 인지행동치료 기반 우울관리 프로그램의 개발과 효과성 검증

The Development and Effectiveness of Depression Management Program Based on Cognitive Behavioral Therapy Program for College Students

3

조회

0

다운로드

5

인용

0

참고문헌

키워드

초록

이 연구는 우울을 관리하기 위해 사회부과적 완벽주의, 불확실성에 대한 인내력 부족(IU)과 반추에 초점을 둔 프로그램을 개발하고 대학생 집단을 대상으로 적용한 프로그램의 효과를 알아보고자 하였다. 연구에 자발적으로 참여하기를 동의한 대학생 중, 우울(CES-D)의 평균이 16점 이상의 점수를 보고한 사람을 연구 참여자로 선정하였다. 치료집단(n=12)과 대기통제집단(n=12)의 사회부과적 완벽주의(HMPS), 우울(CES-D), IU(IUS), 반추(RDQ)를 측정하였다. 치료집단에 8회기로 구성된 인지행동치료 기반 우울관리 프로그램을 진행하였으며, 치료집단과 대기-통제집단에게 사전, 사후, 추후(6개월)검사를 진행하여 종속변인을 측정하였다. 연구 결과, 치료집단은 치료개입 전에 비해 사후 및 추후에 측정한 종속변인이 유의하게 감소하였지만, 대기-통제집단에서는 유의한 감소가 나타나지 않았다. 이는 개발된 프로그램이 치료집단의 사회부과적 완벽주의, 우울, IU, 반추의 수준을 감소시키고 효과를 6개월 동안 유지하는데 효과가 있었다는 것을 의미한다. 이는 사회부과적 완벽주의, IU와 반추에 대한 개입이 대학생의 우울을 관리하는데 유용하다는 것을 시사한다. 연구결과를 바탕으로이 연구의 의의와 한계점, 및 제언에 대해 논의하였다.

Abstract

This study aimed to investigate the effectiveness of a depression management program based on cognitive behavioral therapy, focusing on Socially Prescribed Perfectionism, Intolerance of Uncertainty, Rumination. According to the criteria over CES-D score 16 or more, the treatment group (n=12) and the waiting-control group (n=12) were selected. The depression management program based on CBT consisting of 8 sessions was conducted for the treatment group. To test the effectiveness of the program, Socially Prescribed Perfectionism (HMPS), Depression (CES-D), Intolerance of Uncertainty(IUS), Rumination(RDQ) were measured at pre, post, and follow-up (6 months) tests. As a result of the study, in the treatment group, the dependent variables measured post and follow-up treatments were significantly decreased compared to pre-test, but there was no significant change in the waiting-control group. It means that the program is effective in reducing the levels of Socially Prescribed Perfectionism, Depression, Intolerance of Uncertainty, and rumination in the treatment group and maintaining the effect for 6 months. It suggests that the intervention for the Socially Prescribed Perfectionism, Intolerance of Uncertainty and rumination is useful for managing Depression in college students. Based on the research results, the limitations, suggestions, and significance of this study were discussed.

참고문헌 (72)

  1. 곽현주, "한국 대학생의 우울 관련요인에 대한 메타분석", 청소년학연구, 20(7), pp.75~98 (2013), 한국청소년학회
  2. 김더미, "대학생의 사회부과 완벽주의와 취업불안의 관계: 자기개념 명확성과 불확실성에 대한 인내력 부족의 매개효과", 미래교육학연구, 34(2), pp.133~154 (2021), 교육연구소[DOI]
  3. 김소영, "대학생의 우울 증상에 대한 집단상담 프로그램 효과 메타분석", 청소년학연구, 28(3), pp.309~338 (2021), 한국청소년학회[DOI]
  4. 김유나, "청소년의 물질주의 가치와 심리적 부적응 및 학업성취의 관계에서 기본심리욕구의 매개효과", 한국청소년연구, 28(3), pp.237~268 (2017), 한국청소년정책연구원[DOI]
  5. 김진영, "우울한 기분에 대한 두 가지 내부초점적 반응양식 : 반추적 반응양식과 반성적 반응양식", 석사, 임상·상담심리학, pp.2000
  6. 김태정, "취업준비 대학생의 사회부과 완벽주의와 취업불안의 관계에서 불확실성에 대한 인내력 부족과 사회비교 경향성의 매개효과", 취업진로연구, 10(1), pp.31~53 (2020), 한국취업진로학회[DOI]
  7. 송영주, "대학생의 사회부과적 완벽주의와 진로스트레스: 진로목표불일치의 매개효과 검증", 청소년상담연구, 26(2), pp.269~289 (2018), 한국청소년상담복지개발원[DOI]
  8. 이슬, "한국판 불확실성에 대한 인내력 부족척도 타당화", 석사, pp.2016
  9. 이유림, "정서적 고통의 의미와 우울의 사회적 구성; 20대 ‘명문대’ 여성의 정서적 고통과 우울증 경험에 대한 분석", 석사, pp.2015
  10. 이은희, "남녀 청소년들의 우울에 미치는 학교스트레스, 자아존중감, 부모-자녀 의사소통 및 부모의 내재적 지원의 효과", 한국심리학회지 : 상담 및 심리치료, 12(2), pp.69~84 (2000)
  11. 양도선, "사이버대학생의 다차원적 완벽주의와 학업스트레스의 관계에서 불확실성에 대한 인내력 부족의 매개효과", 교육방법연구, 28(3), pp.421~441 (2016), 한국교육방법학회[DOI]
  12. 전겸구, "한국판 CES-D 개발 연구1", Korean Journal of Clinical Psychology, 11(1), pp.65~76 (1992)
  13. 최문경, "대학졸업에서 첫 직장까지", 직업능력개발연구, 11(3), pp.23~48 (2008), 한국직업능력연구원[DOI]
  14. 최재광, "대학생의 사회부과적 완벽주의가 우울에 미치는 영향: 불확실성에 대한 인내력 부족과 반추적, 반성적 반응양식의 매개효과", 한국심리학회지:학교, 17(2), pp.199~222 (2020), 한국심리학회산하학교심리학회[DOI]
  15. 韓奇娟, "다차원적 완벽성 : 개념, 측정 및 부적응과의 관련성", 박사, 심리학, pp.1994
  16. 한승헌, "한국 청년의 삶의 불안정성(precariousness)과 행복: 불확실성과 통제권한 부재의 매개효과", 한국사회정책, 24(2), pp.87~126 (2017), 한국사회정책학회[DOI]
  17. Abramson, L. Y., "Hopelessness depression : A theory-based subtype of depression", Psychological Review, 96(2), pp.358~ (1989)
  18. American Psychological Association Presidential Task force on Evidence-Based Practice., "Evidence-based practice in psychology", American Psychologist, 61(4), pp.271~285 (2006)
  19. Andersen, S. M., "Anticipating undesired outcomes : The role of outcome certainty in the onset of depressive affect", Journal of Experimental Social Psychology, 23(5), pp.428~443 (1987)
  20. Bardone-Cone, A. M., "Self-oriented and socially prescribed perfectionism dimensions and their associations with disordered eating", Behaviour Research and Therapy, 45(8), pp.1977~1986 (2007)
  21. Beck, A. T., "Thinking and depression : I. Idiosyncratic content and cognitive distortions", Archives of General Psychiatry, 9(4), pp.324~333 (1963)
  22. Beck, A. T., "Thinking and depression : II. Theory and therapy", Archives of General Psychiatry, 10(6), pp.561~571 (1964)
  23. Beck, A. T., "Cognitive therapy of depression" (1979), Guilford Press
  24. Beck. A. T., "Depression : Causes and treatment. University of Pennsylvania Press, Philadelphia Bockting, C. L., Hollon, S. D., Jarrett" (1967), R. B
  25. Kuyken, W., "A lifetime approach to major depressive disorder : The contributions of psychological interventions in preventing relapse and recurrence", Clinical Psychology Review, 41, pp.16~26 (2015)
  26. Buhr, K., "The intolerance of uncertainty scale : Psychometric properties of the English version", Behaviour Research and Therapy, 40(8), pp.931~945 (2002)
  27. Burns, D. D., "The perfectionist’s script for self-defeat", Psychology Today, 14(6), pp.34~51 (1980)
  28. Carleton, R. N., "Fearing the unknown : A short version of the intolerance of uncertainty scale", Journal of Anxiety Disorders, 21(1), pp.105~117 (2007)
  29. Chorpita B. F., "MATCH-ADTC : Modular approach to therapy for children with anxiety, depression, trauma" (2017), or conduct problems. PracticeWise
  30. Dugas, M. J., "Intolerance of uncertainty and worry : Investigating specificity in a nonclinical sample", Cognitive Therapy and Research, 25(5), pp.551~558 (2001)
  31. Dugas, M. J., "Group cognitive-behavioral therapy for generalized anxiety disorder : Treatment outcome and long-term follow-up", Journal of Consulting and Clinical Psychology, 71(4), pp.821~825 (2003)
  32. Dugas, M. J., "Brief report : Intolerance of uncertainty, worry, and depression", Cognitive Therapy and Research, 28(6), pp.835~842 (2004)
  33. Ehring, T., "Repetitive negative thinking as a transdiagnostic process", International Journal of Cognitive Therapy, 1(3), pp.192~205 (2008)
  34. Flett, G. L., "Perfectionism and learned resourcefulness in depression and self-esteem", Personality and Individual Differences, 12(1), pp.61~68 (1991)
  35. Geschwind, N., "Efficacy of mindfulness-based cognitive therapy in relation to prior history of depression : Randomised controlled trial", The British Journal of Psychiatry, 201(4), pp.320~325 (2012)
  36. Handley, A. K., "A randomised controlled trial of group cognitive behavioural therapy for perfectionism", Behaviour Research and Therapy, 68, pp.37~47 (2015)
  37. Harvey, A. G., "Sleep disturbance as transdiagnostic : Consideration of neurobiological mechanisms", Clinical Psychology Review, 31(2), pp.225~235 (2011)
  38. Hewitt, P. L., "Perfectionism in the self and social contexts : Conceptualization, assessment, and association with psychopathology", Journal of Personality and Social Psychology, 60(3), pp.456~470 (1991)
  39. Hvenegaard, M., "Group rumination-focused cognitive-behavioural therapy(CBT)v. group CBT for depression : Phase II trial", Psychological Medicine, 50(1), pp.11~19 (2020)
  40. Kanter, J. W., "Behavioral" (2009), Distinctive features. Routledge
  41. Lee, Y., "Structural equation modeling and the effect of perceived academic inferiority, socially prescribed perfectionism, and parents’ forced social comparison on adolescents’ depression and aggression", Children and Youth Services Review, 108, pp.104649~ (2020)
  42. Lewinsohn, P. M., "Group therapy for depression : The coping with depression course. International Journal of Mental Health, 13(3-4)", 8-3, 3 (1984)
  43. McEvoy, P. M., "The search for universal transdiagnostic and trans-therapy change processes : Evidence for intolerance of uncertainty", Journal of Anxiety Disorders, 41, pp.96~107 (2016)
  44. McEvoy, P. M., "The impact of methodological and measurement factors on transdiagnostic associations with intolerance of uncertainty : A meta-analysis", Clinical Psychology Review, 73, pp.101778~ (2019)
  45. McEvoy, P. M., "Efficacy of transdiagnostic treatments : A review of published outcome studies and future research directions", Journal of Cognitive Psychotherapy, 23(1), pp.20~33 (2009)
  46. McLaughlin, K. A., "Rumination as a transdiagnostic factor in depression and anxiety", Behaviour Research and Therapy, 49(3), pp.186~193 (2011)
  47. Michalak, J., "Rumination as a predictor of relapse in mindfulness-based cognitive therapy for depression. Psychology and Psychotherapy : Theory", Research and Practice, 84(2), pp.230~236 (2011)
  48. Miranda, R., "Cognitive content-specificity in future expectancies : Role of hopelessness and intolerance of uncertainty in depression and GAD symptoms", Behaviour Research and Therapy, 46(10), pp.1151~1159 (2008)
  49. Miranda, R., "Cognitive content-specificity in future expectancies : Role of hopelessness and intolerance of uncertainty in depression and GAD symptoms", Behaviour Research and Therapy, 46(10), pp.1151~1159 (2008)
  50. Moffitt, T. E., "How common are common mental disorders? Evidence that lifetime prevalence rates are doubled by prospective versus retrospective ascertainment", Psychological Medicine, 40(6), pp.899~909 (2010)
  51. Newby, J., "Neuroticism and perfectionism as predictors of social anxiety", Personality and Individual Differences, 106, pp.263~267 (2017)
  52. Nolen-Hoeksema, S., "Responses to depression and their effects on the duration of depressive episodes", Journal of Abnormal Psychology, 100(4), pp.569~582 (1991)
  53. Nolen-Hoeksema, S., "The role of rumination in depressive disorders and mixed anxiety", depressive symptoms, 2000, pp.109(3), 504~511
  54. Oglesby, M. E., "Randomized control trial investigating the efficacy of a computer-based intolerance of uncertainty intervention", Behaviour Research and Therapy, 95, pp.50~57 (2017)
  55. 박준혁, "한국의 우울증 역학에 대한 고찰", 대한의사협회지, 54(4), pp.362~369 (2011), 대한의사협회
  56. Reuther, E. T., "Intolerance of uncertainty as a mediator of the relationship between perfectionism and obsessive-compulsive symptom severity", Depression and Anxiety, 30(8), pp.773~777 (2013)
  57. Safran, J., "Interpersonal process in cognitive therapy. New" (1996), Jason Aronson
  58. Segal, Z. V., "Differential cognitive response to a mood challenge following successful cognitive therapy or pharmacotherapy for unipolar depression", Journal of Abnormal Psychology, 108(1), pp.3~10 (1999)
  59. Segal, Z. V., "Mindfulness-based cognitive therapy for depression : A new approach to preventing relapse" (2002), Guilford Press
  60. Shafran, R., "Clinical perfectionism : A cognitive–behavioural analysis", Behaviour Research and Therapy, 40(7), pp.773~791 (2002)
  61. Smith, M. M., "The existential model of perfectionism and depressive symptoms : Testing a moderated mediation model in community adults using a one-month two-wave longitudinal design", Personality and Individual Differences, 157, pp.101778~ (2020)
  62. Talkovsky, A. M., "Intolerance of uncertainty and transdiagnostic group cognitive behavioral therapy for anxiety", Journal of Anxiety Disorders, 41, pp.108~114 (2016)
  63. Talkovsky, A. M., "Negative affect and intolerance of uncertainty as potential mediators of change in comorbid depression in transdiagnostic CBT for anxiety", Journal of Affective Disorders, 236, pp.259~265 (2018)
  64. Teasdale, J. D., "Cognitive vulnerability to persistent depression", Cognition & Emotion, 2(3), pp.247~274 (1988)
  65. Teasdale, J. D., "Affect cognition" (1995), and change : Re-modelling depressive thought. Psychology Press
  66. Torpey, D. C., "Chronic depression : Update on classification and treatment", Current Psychiatry Reports, 10(6), pp.458~464 (2008)
  67. Watkins, E. R., "Constructive and unconstructive repetitive thought", Psychological Bulletin, 134(2), pp.163~206 (2008)
  68. Watkins, E. R., "Rumination-focused cognitive –behavioural therapy for residual depression : Phase II randomised controlled trial", The British Journal of Psychiatry, 199(4), pp.317~322 (2011)
  69. Wright, J. H., "Learning cognitive-behavior" (2005), An illustrated guide. American Psychiatric Press
  70. Yalom, I. D., "The theory and practice of group psychotherapy(5th ed). New" (2005), Basic Books
  71. Yook, K., "Intolerance of uncertainty, worry, and rumination in major depressive disorder and generalized anxiety disorder", Journal of Anxiety Disorders, 24(6), pp.623~628 (2010)
  72. Zeiss, A. M., "Nonspecific improvement effects in depression using interpersonal skills training, pleasant activity schedules, or cognitive training", Journal of Consulting and Clinical Psychology, 47(3), pp.427~439 (1979)

관련 논문AI추천

이 간행물의 다른 논문 (9건)