본문 바로가기
KERD
논문KCI 등재

심리적 트라우마의 정보처리: 뇌생리학적 근거와 트라우마 내러티브

Information Processing of Psychological Trauma: Their Neuropathology and Traumatic Narratives

유정
인간환경미래연구원 (Institute of Human, Environment & Future)|2015.04|인간.환경.미래 (Human Beings, Environment and Their Future)|제14호|pp. 29-65|DOI 10.34162/hefins.2015..14.002

0

조회

0

다운로드

17

인용

0

참고문헌

키워드

NarrativeTrauma내러티브트라우마정보처리Control조절Information Processing트라우마 내러티브Trauma Narrative
주제분류철학

초록

본 논문은 심리적 고통인 트라우마에 대해 우리나라 재난생존자의 예를 바탕으로 고찰한다. 외상 후 스트레스에 대한 특징을 진단과 뇌영역으로 살펴보고 외상 후 스트레스가 가지는 어려움을 인지적인 접근을 통해 살펴보았다. 외상 후 스트레스 장애의 경우, 뇌영역 간의 관계 및 활동의 분석과 신경기제에 대한 분석을 상세하게 제시한 후 공포와 관련된 편도체 부분과 기억과 관련된 해마 부분의 뇌의 부위가 트라우마를 경험하지 않은 사람의 그것과 다르다는 사실을 보이고 있다. 나아가 트라우마를 경험한 사람들의 내러티브의 경우, 그 구성이 허술하다는 점에서 트라우마를 경험하지 않은 사람들의 경우와 다르다는 사실을 보임으로써 트라우마 경험자로 하여금 자신의 경험을 기억해내도록 유도하고 그 기억이 보다 구체적이고 시간이나 사건이 순서에 맞게 구조가 정교해지도록 도와야 한다. 즉, 트라우마 기억이 구체화될수록, 트라우마에 대한 감각기억이 언어화될수록, 트라우마 내러티브가 구조화될수록 트라우마 경험자들이 외상 후 스트레스를 해소할 수 있다. 본 논문은 주의 및 집중의 문제를 트라우마의 이중표상체계를 기반으로 생존자들의 내러티브의 특징으로 관찰하였으며 트라우마 생존자의 정보처리 모델을 제안하였다.

Abstract

This article examines the psychological trauma based on an example of the trauma survivors’ experiences. Psychological trauma is described as post-traumatic stress disorder (PTSD). I investigated the diagnostic criteria of PTSD, neuro-pathological mechanisms of PTSD, and difficulties of PTSD through a cognitive approach, and found that trauma survivors have difficulties in attention and control. I suggest that trauma survivors are needed to revise fragmented trauma memories to more concrete, cohesive, and organized ones. This article focuses on the narrative characteristics of trauma survivors based on the dual representation theory. As a result, I propose an information processing model of trauma survivors.

참고문헌 (72)

  1. 유정, "기름유출지역 어린이의 트라우마 내러티브", 서울내러티브연구소 세미나 발표 (2009)
  2. 유정, "트라우마 생존자의 정보처리 : 내러티브 면담의 응집성과 담화처리 모형", 박사, 인지과학, pp.2011
  3. 이재열, "위험사회론과 한국적 재난", 재난없는 미래로 주관 심포지엄 <위험사회와 재난> 발표논문 (2005)
  4. 이재열, "이중적 위험사회형 재난의 구조-대구지하철 화재사고를 중심으로 한 비교사례연구-", 한국사회학, 38(3), pp.143~176 (2004), 한국사회학회
  5. 최남희, "재난 생존자 경험의 내러티브 분석- 재난 간호를 위한 제언 -", Journal of Korean Academy of Nursing, 35(2), pp.407~418 (2005), 한국간호과학회
  6. 최남희, "트라우마 내러티브 재구성과 회복효과", 피해자학연구, 18(1), pp.285~309 (2010), 한국피해자학회
  7. Alvarez-Conrad, J, "Linguistic Predictors of Trauma Pathology and Physical Health", Applied Cognitive Psychology, 15(7), pp.S159~S170 (2001)
  8. American Psychiatric Association, "Diagnostic and Statistical Manual of Mental Disorder" (2000), American Psychiatric Press
  9. Amir, N, "Relationship between Trauma Narratives and Trauma Pathology", Journal of Traumatic Stress, 11, pp.385~392 (1998)
  10. Berntsen, D, "Splintered Memories or Vivid Landmarks? Qualities and Organization of Traumatic Memories with and without PTSD", Applied Cognitive Psychology, 17, pp.675~693 (2003)
  11. Bremner, J. D, "Does Stress Damage the Brain?" (2005), W.W. Norton &Company
  12. Bremner, J. D, "MRI-based Measurement of Hippocampal Volume in Combat-related Posttraumatic Stress Disorder", American Journal of Psychiatry, 152, pp.973~981 (1995)
  13. Brewin, C. R, "A Dual Representation Theory of Posttraumatic Stress Disorder", Psychological Review, 17, pp.670~686 (1996)
  14. Brewin, C. R, "Psychological Theories of Posttraumatic Stress Disorder", Clinical Psychology Review, 23, pp.339~376 (2003)
  15. Bryant, R. A, "The Acute Stress Disorder Scale : A Tool for Predicting Posttraumatic Stress Disorder", Australian Journal of Emergency Management, 14, pp.9~11 (1999)
  16. Bush, G, "Cognitive and Emotional Influences in Anterior Cingulate Cortex", Trends in Cognitive Science, 4(6), pp.215~222 (2000)
  17. Dalgeish, T, "Cognitive Approaches to Post-Traumatic Stress Disorder : The Evolution of Multirepresentational Theorizing", Psychological Bulletin, 130, pp.228~260 (2004)
  18. De Bellis, M. D, "Hippocampal Volume in Adolescent Onset Alcohol Use Disorders", American Journal of Psychiatry, 57, pp.737~744 (2000)
  19. De Bellis, M. D, "Biologic Findings of Post-traumatic Stress Disorder and Child Maltreatment", Current Psychiatry Reports, 5, pp.108~117 (2003)
  20. DePaulo, B. M, "Cues to Deception", Psychological Bulletin, 129(1), pp.74~118 (2003)
  21. Ehlers, A, "The Nature of Intrusive Memories after Trauma: The Warning Signal Hypothesis", Behaviour Research Therapy, 40, pp.995~1002 (2002)
  22. Ehlers, A, "A Cognitive Model of Posttraumatic Stress Disorder", Behaviour Research and Therapy, 38, pp.319~345 (2000)
  23. Eysenck, M. W, "Cognitive Psychology: A Student’s Handbook" (2000), Federal Emergency Management Agency
  24. Foa, E. B, "Behavioral", Cognitive Conceptualization of Post-Traumatic Stress Disorder, 1989, pp.20, 155~176
  25. Foa, E. B, "Treating the Trauma of Rape: Cognitive-Behavioral Therapy for PTSD" (1998), Guilford Press
  26. Foa, E. B, "Change in Rape Narrative During Exposure Therapy for Posttraumatic Stress Disorder", Journal of Traumatic Stress, 8(4), pp.675~690 (1995)
  27. Gibertson, M. W, "Smaller Hippocampal Volume Predicts Pathological Vulnerability to Psychological Trauma", Nature Neuroscience, 5, pp.1242~1247 (2002)
  28. Graesser, A. C, "Auto Tutor: A Tutor with Dialogue in Natural Language", Behavioral Research Methods, Instruments, and Computer, 36, pp.180~193 (2004)
  29. Gray, M. J, "Complexity of Trauma Narratives as an Index of Fragmented Memory in PTSD: A Critical Analysis", Applied Cognitive Psychology, 15, pp.S171~S186 (2001)
  30. Guvits, T. V, "Magnetic Resonance Imaging Study of Hippocampal Volume in Chronic, Combat-Related Posttraumatic Stress Disorder", Biological Psychiatry, 40(11), pp.1091~1099 (1996)
  31. Halligan, S. L, "Post-Traumatic Stress Disorder Following Assault: The Role of Cognitive Processing, Trauma Memory, and Appraisals", Journal of Consulting Clinical Psychology, 71, pp.419~431 (2003)
  32. Ham, B. J, "Decreased N-Acetyl-Aspartate Levels in Anterior Cingulate and Hippocampus in Subjects with Post-Traumatic Stress Disorder: A Proton Magnetic Resonance Spectroscopy Study", European Journal of Neuroscience, 25(1), pp.324~329 (2007)
  33. Hamner, M. B, "Potential Role of the Anterior Cingulated Cortex in PTSD: Review and Hypothesis", Depress Anxiety, 9(1), pp.1~14 (1999)
  34. Harvey, A. G, "Dissociative Symptoms in Acute Stress Disorder", Journal of Traumatic Stress, 12, pp.673~680 (1999)
  35. Hellawell, S. J, "A Comparison of Flashbacks and Ordinary Autobiographical Memories of Trauma : Content and Language", Behavioral Research and Therapy, 42, pp.1~12 (2004)
  36. Horowitz, M. J, "Essential Papers on Posttraumatic Stress Disorder" (1999), New York University Press
  37. Horowitz, M. J, "Impact of Event Scale: A Measure of Subjective Stress", Psychosomatic Medicine, 41(3), pp.209~218 (1979)
  38. Janoff-Bulman, R, "Shattered Assumptions: Towards a New Psychology of Trauma" (1992), Free Press
  39. Kim, M. J, "Disrupted White Matter Tract Integrity of Anterior Cingulated in Trauma Survivors", NeuroReport, 16(10), pp.1049~1053 (2005)
  40. Kakava, C, "The Handbook of Discourse Analysis" (2001), Blackwell
  41. Kim, S. J, "Asymmetrically Altered Integrity of Cingulum Bundle in Posttraumatic Stress Disorder", Neuropsychobiology, 54, pp.120~125 (2006)
  42. Klein, I, "Trauma History and Personal Narratives: Some Clues to Coping among Survivors of Child Abuse", Child Abuse & Neglect, 20(1), pp.45~54 (1996)
  43. Liberzon, I, "Brain Activation in PTSD in Response to Trauma-related Stimuli", Biological Psychiatry, 45(7), pp.817~826 (1999)
  44. MacDonald, A. W, "Dissociating the Role of the Dorsolateral Prefrontal and Anterior Cingulate Cortex in Cognitive Control", Science, 288(5472), pp.1835~1838 (2000)
  45. Manne, S, "Language Use and Post-Traumatic Stress Symptomatology in Parents of Pediatric Cancer Survivors", Journal of Applied Social Psychology, 32(3), pp.608~629 (2002)
  46. McEwan, B. S, "Stress Effects on Morphology and Function of the Hippocampus", Annals of the New York Academy of Sciences, 821, pp.271~284 (1997)
  47. Murray, J. D, "Dissociation and Post-Traumatic Stress Disorder: Two Prospective Studies of Road Traffic Accident Survivors", British Journal of Psychiatry, 180, pp.363~368 (2002)
  48. Murray, J. D, "Forward Inferences in Narrative Text", Journal of Memory and Language, 32, pp.464~473 (1993)
  49. Nutt, D. J, "Structural and Functional Brain Changes in Posttraumatic Stress Disorder", Journal of Clinical Psychiatry, 65, pp.S11~S17 (2004)
  50. O’Kearney, R, "Trauma Narratives in Posttraumatic Stress Disorder:A Review", Journal of Traumatic Stress, 19(1), pp.81~93 (2006)
  51. Pissiota, A, "Neurofunctional Correlates of Posttraumatic Stress Disorder: A PET Symptom Provocation Study", European Archives of Psychiatry and Clinical Neuroscience, 252(2), pp.68~75 (2002)
  52. Pitman, R. K, "Hippocampal Diminution in PTSD: More(or less?) than Meet the Eye", Hippocampus, 11, pp.73~74 (2001)
  53. Pitman, R. K, "Investigating the Pathogenesis of Posttraumatic Stress Disorder with Neuroimaging", Journal of Clinical Psychiatry, 62(Supplement 17), pp.47~54 (2001)
  54. Porter, S, "Is Traumatic Memory Special? A Comparison of Traumatic Memory Characteristics with Memory for Other Emotional Life Experiences", Applied Cognitive Psychology, 15, pp.S101~S117 (2001)
  55. Protopopescu, X, "Differential Time Courses and Specificity of Amygdala Acitivity in Posttraumatic Stress Disorder Subjects and Normal Control Subjects", Biological Psychiatry, 57, pp.464~473 (2005)
  56. Rauch, S. L, "A Symptom Provocation Study of Posttraumatic Stress Disorder Using Positron Emission Tomography and Script-driven Imagery", Archives of General Psychiatry, 53(5), pp.380~387 (1996)
  57. Reisberg, D, "Memory and Emotion" (2004), University Press
  58. Robinson, J. A, "Autobiographical Memory: Theoretical and Applied Perspectives" (1998), Erlbaum
  59. Rubin, D. C, "Reliving, Emotions, and Fragmentation in the Autobiographical Memories of Veterans Diagnosed with PTSD", Applied Cognitive Psychology, 18, pp.17~35 (2004)
  60. Shin, L. M, "Regional Cerebral Blood Flow during Script-driven Imagery in Childhood Sexual Abuse-Related PTSD : A PET Investigation", American Journal of Psychiatry, 156(4), pp.575~584 (1999)
  61. Shin, L. M, "An fMRI Study of Anterior Cingulated Function in Posttraumatic Stress Disorder", Biological Psychiatry, 50(12), pp.932~942 (2001)
  62. Shobe, K, "Is Traumatic Memory Special?", Current Directions in Psychological Science, 6, pp.70~74 (1997)
  63. Stein, M. B, "Hippocampal Volume in Women Victimized by Childhood Sexual Abuse", Psychological Medicine, 27(4), pp.951~959 (1997)
  64. Taylor, S. E, "Biobehavioral Responses to Stress in Females : Tend-and-Befriend, not Fight-or-Flight", Psychological Review, 107, pp.411~429 (2000)
  65. Vastering, J. J, "Neuropsychology of PTSD: Biological, Cognitive, and Clinical Perspecitives" (2005), Guilford Press
  66. van der Kolk, B. A, "Dissociation and the Fragmentary Nature of Traumatic Memories: Overview and Exploratory Study", Journal of Traumatic Stress, 8, pp.505~525 (1995)
  67. van Minnen, A, "Changes in PTSD Patients’Narratives during Prolonged Exposure Therapy: A Replication and Extension", Journal of Traumatic Stress, 15(3), pp.255~258 (2002)
  68. Vastering, J. J, "Neuropsychology of PTSD: Biological, Cognitive, and Clinical Perspectives" (2005), Guilford Press
  69. Villarreal, G, "Brain Imaging in Posttrauamtic Stress Disorder", Seminar of Clinical Neuropsychiatry, 6(2), pp.131~145 (2001)
  70. Winter, H, "Hippocampal Volume in Adult Bum Patients with and without Posttraumatic Stress Disorder", American Journal of Psychiatry, 161, pp.2194~2200 (2004)
  71. Young, K. E, "Cognitive and Emotional Processing in Women with Posttraumatic Stress Disorder for Child Sexual Abuse", 박사, pp.2000
  72. Zoellner, L. A, "Peritraumatic Dissociative Experiences, Trauma Narrative, and Trauma Pathology", Journal of Traumatic Stress, 15(1), pp.49~57 (2002)

관련 논문AI추천

외상 후 스트레스 장애의 인지-기억 체계안현의, 주혜선, 한민희한국상담심리학회 · 한국심리학회지: 상담 및 심리치료2013 · 제25권 제1호외상 후 스트레스 장애와 관련된 자서전적 외상 기억의 조직화 특성안현의, 주혜선한국심리학회 · 한국심리학회지:일반2012 · 제31권 제1호트라우마에 대한 이야기치료적 개입의 신경과학적 관점 해석과 함의서진희, 조은숙, 최연실한국가족치료학회 · 가족과 가족치료2021 · 제29권 제1호PTSD에 대한 마음챙김 명상의 적용가능성윤병수한국정서행동장애학회 · 정서·행동장애연구2020 · 제36권 제3호외상후스트레스장애와 인지기능: 문헌 고찰윤지애, 최경숙, 한유리대한신경정신의학회 · 신경정신의학2020 · 제59권 제4호뇌과학 분야 기능적 연결체학의 발전 : 외상후스트레스장애를 중심으로류인균, 박신원, 정현석대한생물정신의학회 · 생물정신의학2015 · 제22권 제3호

이 간행물의 다른 논문 (3건)

고통에 대해 어떻게 말할 것인가?: 고통 받는 이를 위한 철학 상담의 가능성김선희pp. 3-28아리스토텔레스 행복관에 대한 몇 가지 오해에 대한 해명: 아리스토텔레스와 칸트 윤리학의 온당한 비교를 위하여이영환pp. 67-98파르메니데스의 단편 2에 등장하는 양상문의 역할강성훈pp. 99-131
원문 보기