본문 바로가기
KERD
논문KCI 등재

아동학대 유형과 우울 증상 양상의 관계: 네트워크 분석

Types of child maltreatment and patterns of depression symptoms: A network analysis

심은정|하혜주
한국청소년정책연구원 (National Youth Policy Institute)|2019.02|한국청소년연구 (Studies on Korean Youth)|제30권 제1호|pp. 251-277|DOI http://dx.doi.org/10.14816/sky.2019.30.1.251

0

조회

0

다운로드

7

인용

0

참고문헌

키워드

아동학대네트워크 분석우울 증상depressive symptomschild maltreatment중심 증상교량 증상network analysescentral symptomsbridge symptoms
주제분류기타사회과학

초록

아동학대 피해경험은 우울의 주요 위험 인자로 알려져 있으나, 아동학대 유형과 세부 우울 증상의 관계에 대해서는 밝혀진 바가 적다. 본 연구는 아동학대의 하위 유형인 학대와 방임에 따른 개별 우울 증상 양상에 차이가 있는지 확인하였다. 이를 위해 한국청소년정책연구원(National Youth Policy Institute)이 실시한 한국아동청소년패널(Korean Children and Youth Panel Survey) 초4패널 3차 연도(초등학교 6학년) 자료를 활용하여 네트워크 분석을 실시하였다. 그중 아동학대 피해경험 척도 점수를 기준으로 선별된 학대피해(n=359) 및 방임피해(n=388)집단을 대상으로 아동학대 피해경험과 우울 네트워크 구조를 추정하였다. 첫째, 두 집단의 우울 증상 네트워크 추정을 통해 우울 증상 중 다른 우울 증상들과 관계가 강한 중심 증상(central symptoms)을 확인한 결과, 학대피해집단의 중심 증상은 “모든 일이 힘듦”, “우울한 기분”, “흥미 저하”였으며, 방임피해집단의 중심 증상은 “우울한 기분”, “흥미 저하”, “외로움”이었다. 둘째, 아동학대 피해문항을 추가한 네트워크 추정을 통해 아동학대 피해경험과 우울 증상을 연결하는 교량 증상(bridge symptoms)을 확인한 결과, 학대피해집단의 교량 증상은 “자살사고”, “무망감”, “흥미 저하”였으며, 방임피해집단의 교량 증상은 “모든 일이 힘듦”, “무망감”, “자살사고”이었다. 본 연구의 결과는 아동학대 피해 유형에 따라 개별 우울 증상 양상에서 차이가 있으며, 학대 피해경험 아동과 청소년의 우울 평가 및 치료에서 이러한 중심 증상과 교량 증상을 고려한 개별화된 치료적 개입이 효율적이고 효과적일 가능성을 시사한다.

Abstract

Child maltreatment is a major risk factor for depression. However, little is known about the relationship between types of child maltreatment and patterns of specific and individual symptoms of depression. This study investigated associations between types of child maltreatment and individual depressive symptoms, making use network analysis. For this purpose, we analyzed the third year data of the elementary school fourth grade panel of the Korean Children and Youth Panel Survey. Two maltreatment groups were formed, based on the Child Maltreatment scale scores: an abuse group (n=359) and a neglect group (n=388). First, to identify the central symptoms of depression which may have connections with other symptoms, the networks of depressive symptoms were estimated. Next, items of child maltreatment were added to the network, to identify bridge symptoms of depression that are directly activated by child maltreatment. The results indicated that while in the abuse group, “feeling everything is an effort,” “depressed mood,” and “loss of interest” were the most central symptoms, “depressed mood,” “loss of interest,” and “loneliness” were central symptoms in the neglect group. The bridge centrality indices indicated that “suicide ideation” was the highest bridge symptom of depression in the abuse group, followed by the symptoms of “hopelessness” and “loss of interest,” and in the neglect group, the symptom “feeling everything is an effort” was the highest, followed by those of “hopelessness,” and “loneliness.” The current results suggest that patterns of depressive symptoms may vary depending on the maltreatment type, and therapeutic interventions that take into consideration these central and bridge symptoms might be more efficient and effective in the assessment and treatment of depression in children/adolescents with experience of maltreatment.

참고문헌 (64)

  1. 김광일, "간이 정신진단검사 실시 요강" (1984), 중앙적성출판사
  2. 김세원, "사회적 지지가 학대경험 아동의 적응에 미치는 영향", 석사, 사회복지학, pp.2003
  3. 김주연, "부모의 양육행동과 청소년의 외로움： 또래관계의 질의 매개효과", 아동학회지, 33(1), pp.111~131 (2012), 한국아동학회
  4. 김혜인, "정서적 학대 경험과 성인기 심리적 부적응간의 관계: 정서 인식의 어려움과 정서 표현 억제의 매개효과", 정서·행동장애연구, 28(4), pp.353~380 (2012), 한국정서행동장애학회
  5. 2016 전국아동학대 현황보고서, "보건복지부", 보건복지부 중앙아동보호전문기관, ~ (2017)
  6. 윤혜미, "아동학대유형과 심리사회적 부적응의 관계에 대한 메타분석", 사회복지연구, 48(1), pp.173~206 (2017), 한국사회복지연구회[DOI]
  7. 최미혜, "부모의 방임․학대 양육방식이 청소년기 자녀의 학교적응과 공동체의식에 미치는 영향 연구: 자아인식의 매개효과를 중심으로", 한국청소년연구, 27(2), pp.59~92 (2016), 한국청소년정책연구원[DOI]
  8. 허묘연, "청소년이 지각한 부모 양육행동 척도 개발 연구", 박사, 심리학, pp.2000
  9. Lyn Y. Abramson, "Hopelessness depression: A theory-based subtype of depression.", Psychological Review, 96(2), pp.358~372 (1989), American Psychological Association (APA)[DOI]
  10. American Psychiatric Association, "정신질환의 진단 및 통계편람" (2015), 학지사
  11. Arias, I., "Child maltreatment surveillance; uniform definitions for public health and recommended data elements, version 1.0", Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, ~ (2008)
  12. Cherie Armour, "A network analysis of DSM-5 posttraumatic stress disorder symptoms and correlates in U.S. military veterans", Journal of Anxiety Disorders, 45, pp.49~59 (2017), Elsevier BV[DOI]
  13. Beck, A. T., "Cognitive therapy and the emotional disorders" (1976), International University Press
  14. Beck, A. T., "Cognitive therapy of depression" (1979), The Guilford Press
  15. Stephen P. Borgatti, "Centrality and network flow", Social Networks, 27(1), pp.55~71 (2005), Elsevier BV[DOI]
  16. Denny Borsboom, "A network theory of mental disorders", World Psychiatry, 16(1), pp.5~13 (2017), Wiley[DOI]
  17. Denny Borsboom, "Network Analysis: An Integrative Approach to the Structure of Psychopathology", Annual Review of Clinical Psychology, 9(1), pp.91~121 (2013), Annual Reviews[DOI]
  18. Lynn Boschloo, "A Prospective Study on How Symptoms in a Network Predict the Onset of Depression", Psychotherapy and Psychosomatics, 85(3), pp.183~184 (2016), S. Karger AG[DOI]
  19. David M. Bousha, "Mother–child interactional style in abuse, neglect, and control groups: Naturalistic observations in the home.", Journal of Abnormal Psychology, 93(1), pp.106~114 (1984), American Psychological Association (APA)[DOI]
  20. L. F. Bringmann, "Revealing the dynamic network structure of the Beck Depression Inventory-II", Psychological Medicine, 45(4), pp.747~757 (2015), Cambridge University Press (CUP)[DOI]
  21. JOCELYN BROWN, "Childhood Abuse and Neglect: Specificity of Effects on Adolescent and Young Adult Depression and Suicidality", Journal of the American Academy of Child & Adolescent Psychiatry, 38(12), pp.1490~1496 (1999), Elsevier BV[DOI]
  22. Chen, J., "Extended Bayesian information criteria for model selection with large model spaces", Biometrika, 95, pp.759~771 (2008)[DOI]
  23. Li-Shiun Chen, "Understanding the heterogeneity of depression through the triad of symptoms, course and risk factors: a longitudinal, population-based study", Journal of Affective Disorders, 59(1), pp.1~11 (2000), Elsevier BV[DOI]
  24. correlation analysis for the behavioral sciences, "Applied multiple regression", pp.2003, Cohen, J.
  25. Dante Cicchetti, "Socioemotional, Personality, and Biological Development: Illustrations from a Multilevel Developmental Psychopathology Perspective on Child Maltreatment", Annual Review of Psychology, 67(1), pp.187~211 (2016), Annual Reviews[DOI]
  26. Cicchetti, D., "Developmental psychopathology: Risk, disorder, and adaptation", pp.129~201 (2006), John Wiley & Sons Inc
  27. Giulio Costantini, "State of the aRt personality research: A tutorial on network analysis of personality data in R", Journal of Research in Personality, 54, pp.13~29 (2015), Elsevier BV[DOI]
  28. Angélique O. J. Cramer, "Comorbidity: A network perspective", Behavioral and Brain Sciences, 33(2-3), pp.137~150 (2010), Cambridge University Press (CUP)[DOI]
  29. Margaret C. Cutajar, "Psychopathology in a large cohort of sexually abused children followed up to 43 years", Child Abuse & Neglect, 34(11), pp.813~822 (2010), Elsevier BV[DOI]
  30. Carla Kmett Danielson, "Child Maltreatment in Depressed Adolescents: Differences in Symptomatology Based on History of Abuse", Child Maltreatment, 10(1), pp.37~48 (2016), SAGE Publications[DOI]
  31. S DUBE, "Long-Term Consequences of Childhood Sexual Abuse by Gender of Victim", American Journal of Preventive Medicine, 28(5), pp.430~438 (2005), Elsevier BV[DOI]
  32. Epskamp, S., "Estimating psychological networks and their accuracy : A tutorial paper", Behavior Research Methods, 50(1), pp.195~212 (2018)[DOI]
  33. Sacha Epskamp, "Qgraph: Network visualizations of relationships in psychometric data", Journal of Statistical Software, 48(4) (2012), Foundation for Open Access Statistic[DOI]
  34. Epskamp, S., "Bootnet: Bootstrap methods for various network estimation routines" (2015), R-Package
  35. David M. Fergusson, "Exposure to childhood sexual and physical abuse and adjustment in early adulthood", Child Abuse & Neglect, 32(6), pp.607~619 (2008), Elsevier BV[DOI]
  36. Linton C. Freeman, "Centrality in social networks conceptual clarification", Social Networks, 1(3), pp.215~239 (1978), Elsevier BV[DOI]
  37. Fried, E. I., "Problematic assumptions have slowed down depression research : why symptoms, not syndromes are the way forward", Frontiers in Psychology, 6, pp.309~ (2015)[DOI]
  38. Eiko I. Fried, "From loss to loneliness: The relationship between bereavement and depressive symptoms.", Journal of Abnormal Psychology, 124(2), pp.256~265 (2015), American Psychological Association (APA)[DOI]
  39. Eiko I. Fried, "What are 'good' depression symptoms? Comparing the centrality of DSM and non-DSM symptoms of depression in a network analysis", Journal of Affective Disorders, 189, pp.314~320 (2016), Elsevier BV[DOI]
  40. Eiko I. Fried, "The Impact of Individual Depressive Symptoms on Impairment of Psychosocial Functioning", PLoS ONE, 9(2), pp.e90311~ (2014), Public Library of Science (PLoS)[DOI]
  41. Eiko I. Fried, "Depression is not a consistent syndrome: An investigation of unique symptom patterns in the STAR*D study", Journal of Affective Disorders, 172, pp.96~102 (2015), Elsevier BV[DOI]
  42. E. I. Fried, "Depression is more than the sum score of its parts: individual DSM symptoms have different risk factors", Psychological Medicine, 44(10), pp.2067~2076 (2014), Cambridge University Press (CUP)[DOI]
  43. Eiko I. Fried, "Mental disorders as networks of problems: a review of recent insights", Social Psychiatry and Psychiatric Epidemiology, 52(1), pp.1~10 (2017), Springer Science and Business Media LLC[DOI]
  44. Thomas M. J. Fruchterman, "Graph drawing by force-directed placement", Software: Practice and Experience, 21(11), pp.1129~1164 (1991), Wiley[DOI]
  45. Alexandre Heeren, "Mapping network connectivity among symptoms of social anxiety and comorbid depression in people with social anxiety disorder", Journal of Affective Disorders, 228, pp.75~82 (2018), Elsevier BV[DOI]
  46. Maria Rita Infurna, "Associations between depression and specific childhood experiences of abuse and neglect: A meta-analysis", Journal of Affective Disorders, 190, pp.47~55 (2016), Elsevier BV[DOI]
  47. Isvoranu, A. M., "A network approach to psychosis : Pathways between childhood trauma and psychotic symptoms", Schizophrenia Bulletin, 43(1), pp.187~196 (2016)[DOI]
  48. Jones, P. J., "Networktools: Tools for Identifying Important Nodes in Networks", R Package Version 1.1. 0, ~ (2017)
  49. Vivien Keil, "Social information-processing patterns of maltreated children in two social domains", Journal of Applied Developmental Psychology, 30(1), pp.43~52 (2009), Elsevier BV[DOI]
  50. Kenneth S. Kendler, "Evidence for Multiple Genetic Factors Underlying DSM-IV Criteria for Major Depression", JAMA Psychiatry, 70(6), pp.599~ (2013), American Medical Association (AMA)[DOI]
  51. Jolanda J. Kossakowski, "The application of a network approach to Health-Related Quality of Life (HRQoL): introducing a new method for assessing HRQoL in healthy adults and cancer patients", Quality of Life Research, 25(4), pp.781~792 (2016), Springer Science and Business Media LLC[DOI]
  52. Lauritzen, S. L., "Graphical models" (1996), Clarendon Press
  53. Lindert, J., "Sexual and physical abuse in childhood is associated with depression and anxiety over the life course : Systematic review and meta-analysis", International Journal of Public Health, 59(2), pp.359~372 (2014)[DOI]
  54. V. Lux, "Deconstructing major depression: a validation study of the DSM-IV symptomatic criteria", Psychological Medicine, 40(10), pp.1679~1690 (2010), Cambridge University Press (CUP)[DOI]
  55. Ryan Mills, "Child maltreatment and adolescent mental health problems in a large birth cohort", Child Abuse & Neglect, 37(5), pp.292~302 (2013), Elsevier BV[DOI]
  56. Rosana E. Norman, "The Long-Term Health Consequences of Child Physical Abuse, Emotional Abuse, and Neglect: A Systematic Review and Meta-Analysis", PLoS Medicine, 9(11), pp.e1001349~ (2012), Public Library of Science (PLoS)[DOI]
  57. Tore Opsahl, "Node centrality in weighted networks: Generalizing degree and shortest paths", Social Networks, 32(3), pp.245~251 (2010), Elsevier BV[DOI]
  58. S. D. Østergaard, "The heterogeneity of the depressive syndrome: when numbers get serious", Acta Psychiatrica Scandinavica, 124(6), pp.495~496 (2011), Wiley[DOI]
  59. Mijke Rhemtulla, "Network analysis of substance abuse and dependence symptoms", Drug and Alcohol Dependence, 161, pp.230~237 (2016), Elsevier BV[DOI]
  60. Jana Ross, "A network analysis of DSM-5 posttraumatic stress disorder and functional impairment in UK treatment-seeking veterans", Journal of Anxiety Disorders, 57, pp.7~15 (2018), Elsevier BV[DOI]
  61. Robert Tibshirani, "Regression Shrinkage and Selection Via the Lasso", Journal of the Royal Statistical Society: Series B (Methodological), 58(1), pp.267~288 (1996), Wiley[DOI]
  62. David D. Vachon, "Assessment of the Harmful Psychiatric and Behavioral Effects of Different Forms of Child Maltreatment", JAMA Psychiatry, 72(11), pp.1135~ (2015), American Medical Association (AMA)[DOI]
  63. Claudia van Borkulo, "Association of Symptom Network Structure With the Course of Depression", JAMA Psychiatry, 72(12), pp.1219~ (2015), American Medical Association (AMA)[DOI]
  64. Cathy Spatz Widom, "A Prospective Investigation of Major Depressive Disorder and Comorbidity in Abused and Neglected Children Grown Up", Archives of General Psychiatry, 64(1), pp.49~ (2007), American Medical Association (AMA)[DOI]

관련 논문AI추천

아동학대 및 가정폭력의 중복발생이 아동의 우울궤적에 미치는 영향 연구김기현, 최진영한국사회복지연구회 · 사회복지연구2019 · 제50권 제1호청소년 우울증상과 학교적응의 상호관계: 학대방임적 양육에 따른 다집단 분석김민정한국학교사회복지학회 · 학교사회복지2019 · 제46호청소년이 경험한 부정적 생애경험 유형과 우울·불안 간 관계 : 잠재계층분석(LCA)을 중심으로최성수한국국회학회 · 한국과 세계2025 · 제7권 제5호학대 피해경험이 심리사회적 발달에 미치는 영향: 성향점수매칭분석심은정, 하혜주한국청소년정책연구원 · 한국청소년연구2020 · 제31권 제4호중학생이 경험한 학대와 방임이 학교 내 대인관계에 미치는 영향 경로김서현, 임혜림, 정익중한국청소년정책연구원 · 한국청소년연구2014 · 제25권 제4호청소년 우울의 발달궤적 유형과 예측요인에 대한 단기 종단연구임향, 최승원한국심리학회 · 한국심리학회지:일반2016 · 제35권 제3호

이 간행물의 다른 논문 (10건)

청소년의 창의적 체험활동이 진로성숙도에 미치는 동시 및 지연효과 연구원정은, 정혜원pp. 5-37청소년 해외봉사단 활동이 봉사단원 개인역량에 미치는 효과에 대한 연구: WFK IT봉사단과 일반 대학생 간 비교를 중심으로이수연, 이희진, 권구순pp. 39-65대학생의 내재적 자기애가 사회적 불안감에 미치는 영향: 사회적 지지의 조절효과를 중심으로백지민, 임정하pp. 67-94지각된 부모의 심리적 통제, 완벽주의적 자기제시, 우울, 공격성 간의 구조적 관계모형 검증하정희, 주리애pp. 95-123중학생의 방과후 생활시간 활용양상의 잠재전이유형과 학습자특성에 관한 연구하여진pp. 125-153
원문 보기