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불완전감과 강박행동의 관계에서 체험회피의 매개효과

The Mediational Effect of Experiential Avoidance in the Relationship between Incompleteness and Obsessive-Compulsive Disorder

초록

강박장애의 2차원 모형에 따르면, 강박행동을 유발하는 취약성은 위험회피 차원과 불완전감 차원으로 구분된다. 위험을 회피하려고 반복하는 강박행동과 불완전감을 해소하려고 몰두하는 강박행동이 다르다는 것이다. 불완전감은 어떤 행위를 했을 때 만족스럽지 않은 불충분한 느낌 혹은 기대에 부합하지 않는 미흡한 느낌을 의미한다. 불완전감에 과민한 사람은 완전하지 못하다는 찝찝함과 깔끔하지 못하다는 찜찜함을 해소하려고 시도하는데, 이러한 체험회피는 역설적으로 강박행동의 출현과 지속에 기여할 수 있다. 본 연구에서는 불완전감이 강박행동으로 발현되는 과정을 체험회피가 부분적으로 매개한다는 가설을 설정한 뒤, 102명의 대학생에게서 4주 간격으로 수집한 단기-종단적 자료를 구조방정식 모형으로 분석하였다. 분석 결과, 불완전감이 체험회피의 매개를 통해서 강박행동에 영향을 미치는 간접경로 및 불완전감이 강박행동에 곧바로 영향을 미치는 직접경로를 모두 포함하는 부분매개모형의 적합도가 우수하였다. 이에 비해, 불완전감이 체험회피의 매개를 통해서 강박행동에 영향을 미치는 간접경로만 포함하는 완전매개모형의 적합도 및 불완전감이 체험회피와 강박행동의 원인이고 체험회피와 강박행동은 서로 무관하다고 가정한 공통원인모형의 적합도는 미흡하였다. 따라서 불완전감과 강박행동의 관계를 체험회피가 부분적으로 매개한다는 가설이 지지되었다. 이를 근거로 강박행동의 원인과 치료에 관한 이론적 및 실제적 시사점을 논의하였고, 본 연구의 제한점을 기술하였다.

keywords
incompleteness, experiential avoidance, compulsive behavior, Obsessive-Compulsive Disorder(OCD), 불완전감, 체험회피, 강박행동, 강박장애

Abstract

Summerfeldt(2004) proposed that Obsessive-Compulsive Disorder(OCD) symptoms are provoked by two independent components: harm avoidance and incompleteness. Incompleteness means the troubling and irremediable sense that one’s actions or experiences are not just right. Incompleteness appears to underlie many of the symptoms of OCD. In the present study, the author investigated the mediational effect of experiential avoidance in the relationship between incompleteness and compulsive behaviors. To evaluate the goodness-of-fit of the mediation models, short-term longitudinal data were collected from 102 undergraduate students and analyzed using structural equation modeling method. The results showed that experiential avoidance partially mediated the relationship between incompleteness and compulsive behaviors. This finding suggested that the sense of incompleteness influences compulsive behaviors indirectly as well as directly, through the mediation of experiential avoidance. Based on this finding, the author discussed the theoretical and practical implications of the present study. Finally, the limitations of this study and the suggestions for further research were discussed.

keywords
incompleteness, experiential avoidance, compulsive behavior, Obsessive-Compulsive Disorder(OCD), 불완전감, 체험회피, 강박행동, 강박장애

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