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비자살적 자해에 대한 경계선 성격 성향, 통증감내력, 대인관계에서의 정서적 고통의 효과

Effects of Borderline Personality Features, Physical Pain Tolerance and Emotional Distress on Non-Suicidal Self-Injury

이주영|서아현
한국정서행동장애학회 (The Korean Society of Emotional and Behavioral Disorders)|2020.09|정서·행동장애연구 (JOURNAL OF EMOTIONAL & BEHAVIORAL DISORDERS)|제36권 제3호|pp. 63-87|DOI 10.33770/JEBD.36.3.4

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키워드

경계선 성격 성향Borderline Personality Features비자살적 자해(NSSI)통증감내력대인관계에서의 정서적 고통Non-Suicidal Self-Injury(NSSI)Physical Pain ToleranceEmotional Distress

초록

본 연구는 비자살적 자해(Non-Suicidal Self-Injury; NSSI)의 위험이 높은 여자 대학생을 대상으로 경계선 성격 성향, 통증감내력, 대인관계에서의 정서적 고통이 서로 상호작용하여 NSSI로 이어지는 복합적인 기제를 살펴보고자 하였다. 672명의 여자 대학생을 대상으로 PAI-BOR(Personality Assessment Inventory-Borderline Features Scale)을 실시하여 총 94명(경계선 집단 53명, 통제집단 41명)을 선별하였다. 연구대상자들에게 경계선 성격 성향, NSSI, 대인관계에서의 정서적 고통을 자기보고식으로 평가하게 하고, 통증감내력은 통각계 과제를 이용해 측정하였다. 분석 결과, 경계선 집단이 통제 집단보다 대인관계에서 정서적 고통을 더 많이 경험하고 더 심각한 양상의 자해를 보였다. 삼원변량분석에서는 경계선 성격 성향의 주효과와 경계선 성격 성향, 통증감내력, 대인관계에서의 정서적 고통의 삼원상호작용이 유의하여 사후검증을 실시하였다. 대인관계에서 정서적 고통이 높을 경우 통증감내력이 낮을 때 경계선 집단이 통제집단보다 더 많은 NSSI를 보고하였으나, 대인관계에서 정서적 고통이 낮을 경우에는 통증감내력이 높을 때 경계선 집단이 통제집단보다 더 많은 NSSI를 보고하였다. 이러한 결과는 NSSI로 이어지는 성격적 변인, 신체적 변인, 상황적 변인의 상호작용을 지지하는 결과이다. 본 연구의 결과는 NSSI의 기제를 보다 깊이 있게 이해함으로써 위험군을 조기 변별하여 구체적인 예방 및 개입 방안을 계획하는데 유용하게 활용될 것으로 기대된다.

Abstract

This study examined the interaction effect of borderline personality features, physical pain tolerance and emotional distress on non-suicidal self-injury (NSSI). For this purpose, female college students in Seoul were recruited and 92 participants were grouped based on PAI-BOR: borderline group (n=53) and control group (n=41). Borderline personality features, NSSI, and emotional distress were assessed by self-report questionnaires, and physical pain tolerance was assessed by an algometer task. The results of this study were as follows. First, borderline group scored higher than control group in emotional distress and showed more severe self-injury behavior. Second, three-way ANOVA analysis revealed an interaction effect of borderline personality features, physical pain tolerance and emotional distress and post hoc analysis was executed. Borderline group tended to engage in NSSI more than control group when they were under higher emotional distress and had lower physical pain tolerance and when they were under lower emotional distress and higher physical pain tolerance. This study emphasized the interactions between personality features, physical condition, and emotional stress on NSSI. This study demonstrated a possible mechanism of NSSI and suggested early intervention strategy for NSSI.

참고문헌 (81)

  1. 권혁진, "비자살적 자해에 영향을 미치는 정서적·인지적 요인의 탐색", 석사, 심리학과 임상·상담심리학전공, pp.2014
  2. 권혁진, "한국판 자해기능 평가지(The Functional Assessment of Self-Mutilation)의 타당화 연구 : 대학생을 중심으로", 한국심리학회지 : 임상심리 연구와실제, 3(1), pp.187~205 (2017)
  3. 김수진, "비자살적 자해의 위험요인과 보호요인 개관", 청소년학연구, 24(9), pp.31~53 (2017), 한국청소년학회[DOI]
  4. 김청송, "불안민감성에 따른 대학생 동통반응에서의 차이", Korean Journal of Clinical Psychology, 22(2), pp.385~397 (2003), 한국임상심리학회
  5. 김초롱, "우울증 환자 집단에서 비자살적자해가 자살시도에 미치는 영향", Korean Journal of Clinical Psychology, 37(4), pp.465~478 (2018), 한국임상심리학회[DOI]
  6. 노상선, "경계선 성격장애 성향자를 위한 자기자비 함양 프로그램의 개발과 효과", Korean Journal of Clinical Psychology, 32(1), pp.97~121 (2013), 한국임상심리학회[DOI]
  7. 안영신, "청소년의 비자살적 자해행동에 관한 연구", 정서·행동장애연구, 33(4), pp.257~281 (2017), 한국정서행동장애학회[DOI]
  8. 양모현, "대학(원)생의 부적응적 정서조절 방략, 음주억제 및 충동성이 음주문제와 음주량에 미치는 영향", Korean Journal of Clinical Psychology, 33(1), pp.157~172 (2014), 한국임상심리학회[DOI]
  9. 전겸구, "개정판 대학생용 생활 스트레스 척도 개발 연구", 한국심리학회지 : 건강, 5(2), pp.316~335 (2000)
  10. 진하영, "성격장애성향의 대인관계 문제: 자기-타인지각 비교", 인간이해, 31(2), pp.211~230 (2010), 학생생활상담연구소
  11. 최혜숙, "통제소재와 자아탄력성, 코티졸 수준에 따른 정서의 효과", 청소년학연구, 23(1), pp.235~255 (2016), 한국청소년학회
  12. 홍상황, "경계선 성격장애 척도의 타당화 연구 : 대학생을 중심으로", Korean Journal of Clinical Psychology, 17(1), pp.259~271 (1998)
  13. Diagnostic and statistical manual of mental disorders, "American Psychiatric Association", American Psychiatric Association, ~ (2013)
  14. Andover, M. S., "Self‐mutilation and symptoms of depression, anxiety, and borderline personality disorder", Suicide and Life-Threatening Behavior, 35(5), pp.581~591 (2005)
  15. Adriana Banozic, "Neuroticism and pain catastrophizing aggravate response to pain in healthy adults: an experimental study", The Korean Journal of Pain, 31(1), pp.16~26 (2018), 대한통증학회
  16. Beauchaine, T. P., "Post-dexamethasone cortisol, self-inflicted injury, and suicidal ideation among depressed adolescent girls", Journal of Abnormal Child Psychology, 43(4), pp.619~632 (2015)
  17. Bernstein, M. J., "Social exclusion and pain sensitivity : why exclusion sometimes hurts and sometimes numbs", Personality and Social Psychology Bulletin, 38(2), pp.185~196 (2012)
  18. Bohus, M., "Pain perception during self-reported distress and calmness in patients with borderline personality disorder and self-mutilating behavior", Psychiatry Research, 95(3), pp.251~260 (2000)
  19. Bracken-Minor, K. L., "Differences in features of non-suicidal self-injury according to borderline personality disorder screening status", Archives of Suicide Research, 18(1), pp.88~103 (2014)
  20. Brain, K. L., "The psychophysiology of repetitive self-mutilation", Archives of Suicide Research, 6(3), pp.199~210 (2002)
  21. Burke, T. A., "Non-suicidal self-injury prospectively predicts interpersonal stressful life events and depressive symptoms among adolescent girls", Psychiatry Research, 228(3), pp.416~424 (2015)
  22. Carpenter, R. W., "The pain paradox: borderline personality disorder features, self-harm history, and the experience of pain", Personality Disorders: Theory, Research, and Treatment, 6(2), pp.141~151 (2015)
  23. Chapman, A. L., "Emotional reactivity to social rejection and negative evaluation among persons with borderline personality features", Journal of Personality Disorders, 28(5), pp.720~733 (2014)
  24. Cloutier, P., "Characteristics and co-occurrence of adolescent non-suicidal self-injury and suicidal behaviours in pediatric emergency crisis services", Journal of Youth and Adolescence, 39(3), pp.259~269 (2010)
  25. Crouch, W., "Deliberate self-harm at an adolescent unit : A qualitative investigation", Clinical Child Psychology and Psychiatry, 9(2), pp.185~204 (2004)
  26. DeCou, C. R., "Dialectical behavior therapy is effective for the treatment of suicidal behavior : A meta-analysis", Behavior Therapy, 50(1), pp.60~72 (2019)
  27. Dougherty, D. M., "Impulsivity and clinical symptoms among adolescents with non-suicidal self-injury with or without attempted suicide", Psychiatry Research, 169(1), pp.22~27 (2009)
  28. Dziobek, I., "Neuronal correlates of altered empathy and social cognition in borderline personality disorder", Neuroimage, 57(2), pp.539~548 (2011)
  29. Franklin, J. C., "Nonsuicidal self-injury and diminished pain perception : The role of emotion dysregulation", Comprehensive Psychiatry, 53(6), pp.691~700 (2012)
  30. Germain, S. A. S., "Aberrant pain perception in direct and indirect non-suicidal self-injury : An empirical test of Joiner's interpersonal theory", Comprehensive Psychiatry, 54(6), pp.694~701 (2013)
  31. Gratz, K. L., "Measurement of deliberate self-harm : preliminary data on the deliberate self-harm inventory", Journal of Psychopathology and Behavioral Assessment, 23(4), pp.253~263 (2001)
  32. Gratz, K. L., "Risk factors for and functions of deliberate self‐harm : An empirical and conceptual review", Clinical Psychology : Science and Practice, 10(2), pp.192~205 (2003)
  33. Gratz, K. L., "An experimental investigation of emotional willingness and physical pain tolerance in deliberate self-harm : The moderating role of interpersonal distress", Comprehensive Psychiatry, 52(1), pp.63~74 (2011)
  34. Chloe A. Hamza, "Nonsuicidal Self-Injury and Suicidal Behavior: A Latent Class Analysis among Young Adults", PLoS ONE, 8(3), pp.e59955~ (2013), Public Library of Science (PLoS)[DOI]
  35. Haines, J., "The psychophysiology of self-mutilation", Journal of Abnormal Psychology, 104(3), pp.471~ (1995)
  36. Hooley, J. M., "Pain perception and nonsuicidal self-injury: A laboratory investigation", Personality Disorders:Theory, Research, and Treatment, 1(3), pp.170~179 (2010)
  37. Jacobson, C. M., "Psychiatric impairment among adolescents engaging in different types of deliberate self-harm", Journal of Clinical Child & Adolescent Psychology, 37(2), pp.363~375 (2008)
  38. Jeung, H., "Impairments of interpersonal functioning : Empathy and intimacy in borderline personality disorder", Psychopathology, 47(4), pp.220~234 (2014)
  39. Joiner, T., "Why people die by suicide" (2007), Harvard University Press
  40. Kerr, P., "Features of psychopathology in self-injuring female college students", Journal of Mental Health Counseling, 32(4), pp.290~308 (2010)
  41. Kirtley, O. J., "Pain and self-harm : A systematic review", Journal of Affective Disorders, 203, pp.347~363 (2016)
  42. Klonsky, E. D., "The relationship between nonsuicidal self-injury and attempted suicide : Converging evidence from four samples", Journal of Abnormal Psychology, 122(1), pp.231~237 (2013)
  43. Klonsky, E. D., "Identifying clinically distinct subgroups of self-injurers among young adults : a latent class analysis", Journal of Consulting and Clinical Psychology, 76(1), pp.22~27 (2008)
  44. Klonsky, E. D., "Nonsuicidal self-injury : what we know, and what we need to know", The Canadian Journal of Psychiatry, 59(11), pp.565~568 (2014)
  45. Kluetsch, R. C., "Alterations in default mode network connectivity during pain processing in borderline personality disorder", Archives of General Psychiatry, 69(10), pp.993~1002 (2012)
  46. Koenig, J., "Psychobiological response to pain in female adolescents with nonsuicidal self-injury", Journal of Psychiatry & Neuroscience : JPN, 42(3), pp.189~199 (2017)
  47. Koenig, J., "A meta-analysis on pain sensitivity in self-injury", Psychological Medicine, 46(8), pp.1597~1612 (2016)
  48. Laye-Gindhu, A., "Nonsuicidal self-harm among community adolescents : Understanding the"whats"and"whys"of self-harm", Journal of Youth and Adolescence, 34(5), pp.447~457 (2005)
  49. Lazarus, S. A., "Interpersonal functioning in borderline personality disorder : A systematic review of behavioral and laboratory-based assessments", Clinical Psychology Review, 34(3), pp.193~205 (2014)
  50. Lazarus, R. S., "Stress and adaptational outcomes : The problem of confounded measures", American Psychologist, 40, pp.770~785 (1985)[DOI]
  51. Linehan, M., "Cognitive-behavioral treatment of borderline personality disorder" (1993), The Guilford Press
  52. Lloyd, E. E., "Self-mutilation in a community sample of adolescents: Descriptive characteristics and provisional prevalence rates", Annual Meeting of the Society for Behavioral Medicine (1997)
  53. Lofthouse, N., "Self-injury in Youth: The Essential Guide to Assessment and Intervention", pp.59~78 (2009)
  54. Ludäscher, P., "Pain perception in female adolescents with borderline personality disorder", European Child & Adolescent Psychiatry, 24(3), pp.351~357 (2015)
  55. McCown, W., "Borderline personality disorder and laboratory-induced cold pressor pain : Evidence of stress-induced analgesia", Journal of Psychopathology and Behavioral Assessment, 15(2), pp.87~95 (1993)
  56. Miranda, R., "Longitudinal follow‐up study of adolescents who report a suicide attempt : Aspects of suicidal behavior that increase risk of a future attempt", Depression and Anxiety, 31(1), pp.19~26 (2014)
  57. Morey, L. C., "Personality assessment inventory", Personality Assessment, 2, pp.181~228 (1991)
  58. Muraven, M., "Self-control as a limited resource : Regulatory depletion patterns", Journal of Personality and Social Psychology, 74(3), pp.774~789 (1998)
  59. Nock, M. K., "Self-injury", Annual Review of Clinical Psychology, 6, pp.339~363 (2010)
  60. Nock, M. K., "Nonsuicidal self-injury: Definition and classification (Vol. xiii)" (2009), American Psychological Association
  61. Nock, M. K., "A functional approach to the assessment of self-mutilative behavior", Journal of Consulting and Clinical Psychology, 72(5), pp.885~890 (2004)
  62. Oosterman, J. M., "The influence of executive functioning on facial and subjective pain responses in older adults", Behavioural Neurology (2016)[DOI]
  63. Giburm Park, "Reliability and Usefulness of the Pressure Pain Th reshold Measurement in Patients with Myofascial Pain", Annals of Rehabilitation Medicine, 35(3), pp.412~417 (2011), 대한재활의학회
  64. Reitz, S., "Incision and stress regulation in borderline personality disorder : Neurobiological mechanisms of self-injurious behaviour", The British Journal of Psychiatry, 207(2), pp.165~172 (2015)
  65. Sansone, R. A., "The borderline personality disorder and its paradoxical association with pain", Emergency Medicine Reports, 36(12), pp.1~16 (2015)
  66. Sansone, R. A., "Childhood trauma, borderline personality, and eating disorders : A developmental cascade", Eating Disorders, 15(4), pp.333~346 (2007)
  67. Schmahl, C., "Hippocampus and amygdala volumes in patients with borderline personality disorder with or without posttraumatic stress disorder", Journal of Psychiatry & Neuroscience, 34(4), pp.289~295 (2009)
  68. Schmahl, C., "Neural correlates of antinociception in borderline personality disorder", Archives of General Psychiatry, 63(6), pp.659~666 (2006)
  69. Proposal to the DSM-V childhood disorder and mood disorder work groups to include non-suicidal self-injury (NSSI) as a DSM-V disorder, "Shaffer, D.", American Psychiatric Association, ~ (2009)
  70. Skegg, K., "Self-harm", The Lancet, 366(9495), pp.1471~1483 (2005)
  71. Somma, A., "Borderline personality disorder features, emotion dysregulation and non‐suicidal self‐injury : Preliminary findings in a sample of community‐dwelling Italian adolescents", Personality and Mental Health, 11(1), pp.23~32 (2017)
  72. Victoria E. Stead, "Longitudinal associations between non-suicidal self-injury and borderline personality disorder in adolescents: a literature review", Borderline Personality Disorder and Emotion Dysregulation, 6(1) (2019), Springer Science and Business Media LLC[DOI]
  73. Trull, T. J., "Borderline personality disorder features in nonclinical young adults : 1. identification and validation", Psychological Assessment, 7(1), pp.33~41 (1995)
  74. Turner, B. J., "Non-suicidal self-injury with and without borderline personality disorder : Differences in self-injury and diagnostic comorbidity", Psychiatry Research, 230(1), pp.28~35 (2015)
  75. Welch, S. S., "Emotional responses to self-injury imagery among adults with borderline personality disorder", Journal of Consulting and Clinical Psychology, 76(1), pp.45~51 (2008)
  76. Williams, F., "Emotion regulation, coping and alcohol use as moderators in the relationship between non-suicidal self-injury and psychological distress", Prevention Science, 11(1), pp.33~41 (2010)
  77. Whitlock, J., "Self-injurious behaviors in a college population", Pediatrics, 117(6), pp.1939~1948 (2006)
  78. Wilkinson, P., "Clinical and psychosocial predictors of suicide attempts and nonsuicidal self-injury in the Adolescent Depression Antidepressants and Psychotherapy Trial(ADAPT)", American Journal of Psychiatry, 168(5), pp.495~501 (2011)
  79. Willoughby, S. G., "The effect of laboratory-induced depressed mood state on responses to pain", Behavioral Medicine, 28(1), pp.23~31 (2002)
  80. You, J., "Exploring the reciprocal relations between nonsuicidal self-injury, negative emotions and relationship problems in Chinese adolescents : A longitudinal cross-lag study", Journal of Abnormal Child Psychology, 40(5), pp.829~836 (2012)
  81. Zanarini, M. C., "The longitudinal course of borderline psychopathology : 6-year prospective follow-up of the phenomenology of borderline personality disorder", American Journal of Psychiatry, 160(2), pp.274~283 (2003)

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