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신체증상 해석편향과 질병불안의 관계에서 죽음태도의 조절효과

Moderation Effects of Death Attitude on Relationship Between Physical Symptom Interpretation Bias and Illness Anxiety

이슬아|오주용
한국건강심리학회 (Korean Health Psychological Association)|2023.07|한국심리학회지: 건강 (Korean Journal of Health Psychology)|제28권 제4호|pp. 841-859|DOI 10.17315/kjhp.2023.28.4.002

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death attitude죽음공포죽음태도fear of death질병불안신체증상 해석편향중립적 죽음수용illness anxietyphysical symptom interpretation biasneutral death acceptance
주제분류심리과학

초록

불편하고 모호한 신체증상을 신체이상이나 질병으로 오해석하는 것은 질병불안의 주된 특징으로 알려져있다. 이러한 신체증상 해석편향은 누구나 경험하는 보편적 현상으로, 경미한 경우에는 건강 관리에 도움이 되는 적응적 신호일 수도 있으나, 과도하면 병리적인 질병불안으로 이어질 수 있다. 신체증상을 치명적인 질병의 증거로 오해석하는 사람들이 질병불안을 경험하는 데에는 죽음을 다루는 태도가 영향을 미칠 수 있다. 죽음에 대한 태도는 죽음공포, 죽음회피, 그리고 도피적, 접근적, 중립적 죽음수용으로 다양하다. 따라서 본 연구에서는 신체증상 해석편향과 질병불안의 관계에서 죽음태도의 조절효과를 검증하였다. 한국리서치 MS 패널 온라인 설문 시스템을 통해 20～70대의 성인 297명을 대상으로 질병불안, 신체증상 해석편향, 죽음태도를 측정하였으며, 회귀 분석과 기울기 분석, Johnson-Nayman 기법을 이용하여 죽음태도의 조절효과를 검증하였다. 연구 결과, 죽음공포와 중립적 죽음수용은 신체증상 해석편향과 질병불안의 관계를 조절하는 것으로 확인되었다. 구체적으로는 죽음공포 수준이 높을 때 신체증상 해석편향과 질병불안 간의 정적 상관관계가 강해지며, 반대로 중립수용 수준이 높을 때 신체증상 해석편향과 질병불안 간의 정적 상관관계가 약해지는 것으로 나타났다. 이러한 결과는 죽음공포와 중립적 죽음수용 수준에 따라 신체증상 해석편향이 질병불안을 증가시키는 정도가 달라질 수 있음을 의미하며, 죽음공포 완화와 중립적 죽음수용 증진을 통해 질병불안이 과도해지지 않도록 예방할 수 있음을 시사한다.

Abstract

Misinterpreting an uncomfortable and ambiguous somatic symptom as a physical problem or illness is known to be a key feature of illness anxiety. This symptom interpretation bias is a universal phenomenon that everyone experiences. In mild cases, it can be an adaptive signal that help us manage our health. However, when it is excessive, it can lead to pathological illness anxiety. Attitude toward death may affect illness anxiety in people who misinterpret somatic symptoms as a fatal illness. There are various death attitudes such as fear of death, death avoidance, and avoidant, approaching, or neutral acceptance of death. The present study examined the moderating effect of death attitude on the relationship between somatic symptom interpretation bias and illness anxiety. A total of 227 adults aged 20 to 70 years were recruited through Korea Research MS Panel online survey system. Illness anxiety, somatic symptom interpretation bias, and death attitudes were measured. Regression analysis, slope analysis, and Johnson-Nayman technique were used to verify the moderating effect of death attitude. As a result, fear of death and neutral death acceptance moderated the relationship between somatic symptom interpretation bias and illness anxiety. The positive correlation between somatic symptom interpretation bias and illness anxiety increased as the level of fear of death increased, whereas the positive correlation between somatic symptom interpretation bias and illness anxiety decreased as the level of neutral acceptance of death increased. These findings suggest that the extent to which somatic symptom interpretation bias exacerbates illness anxiety might vary depending on levels of fear of death and neutral death acceptance. Reducing fear of death and promoting neutral death acceptance might prevent excessive illness anxiety.

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