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메뉴본 연구의 목적은 강박사고 유형 간에 사고행위융합(Thought-Action Fusion: 이하 TAF), 중화행동, 그리고 사고억제 결함에서 차이를 확인하고자 함이다. 이를 위해 대학생 471명을 대상으로 파두아 강박증상 질문지-워싱턴 주립대학 개정판(PI-WSUR), 사고행위융합 척도(TAFS-R), 침투사고 대처과정 질문지(CITQ), 그리고 사고억제 척도(TSI)를 실시하였으며 연구의 결과는 다음과 같다. 강박사고 고집단이 저집단보다 TAF의 세 요인인 도덕성TAF, 가능성TAF-타인, 그리고 가능성TAF-자기를 모두 더 많이 경험하였고, 사고억제의 세 요인인 침투적 사고, 성공적 억제, 억제시도 중 침투적 사고와 억제시도를 더 높게 경험하였다. 반면에 자생성 강박사고 집단과 반응성 강박사고 집단으로 구분했을 때 TAF, 중화행동, 사고억제 결함의 차이에서는 예상과는 다른 결과가 나왔다. 세부적으로, 자생성 강박사고가 높은 집단이 낮은 집단보다 가능성TAF를 더 높게 경험하였고, 반응성 강박사고가 높은 집단은 낮은 집단보다 도덕성TAF를 더 높게 경험하였다. 다음으로 중화행동에서는 반응성 강박사고 집단(저자생-고반응 집단)이 자생성 강박조건에서 회피적 중화행동을 가장 많이 사용하였고, 자생성 강박사고 집단(고자생-저반응 집단)은 그 다음으로 회피적 중화행동을 많이 사용하였으며, 자생성 강박사고가 높은 집단은 나머지 조건에서 유의미한 중화행동 효과를 나타내지 못했다. 그리고 반응성 강박사고가 높은 집단이 낮은 집단보다 자생성 강박조건에서 직면적 중화행동을 더 많이 사용하였고, 반응성 강박조건에서는 회피와 직면적 중화행동을 모두 더 많이 사용하는 것으로 나타났다. 마지막으로 사고억제에서 침투적 사고는 강박사고 고집단(고자생-고반응 집단)에서 가장 많이 발생하였고, 자생성 혹은 반응성 강박사고가 높으면 각각의 낮은 집단보다 억제시도를 더 많이 경험하였다. 성공적 억제는 자생성 강박사고가 높은 집단이 낮은 집단보다 억제의 어려움을 더 많이 경험하였다. 이러한 결과를 통하여 본 연구의 의의 및 제한점과 향후 연구의 방향에 대해 논의하였다.
The purpose of the study is to confirm the differences in thought-action fusion(TAF), neutralizing actions and deficiency of thought suppression among the types of obsession. To this end, Padua Inventory-Washington State University Revision(PI-WSUR), Thought-Action Fusion Scale-Revised(TAFS-R), Copying for Intrusive Thoughts Questionnaire(CITQ) and Thought Suppression Inventory(TSI) were conducted with 471 college students, and the following are the results of the study. The groups of high obsession experienced more of morality TAF, likelihood-other TAF and likelihood-self TAF, which are the three elements of TAF, than the groups of low obsession. They also experienced more of intrusive thoughts and attempted thought suppression among the three elements of thought suppression, which are intrusive thoughts, successful suppression and attempted thought suppression. When autogenous obsession groups and reactive obsession groups were divided, the results different than expected were obtained in the differences in TAF, neutralizing actions and deficiency of thought suppression. In detail, the groups with high autogenous obsession experienced more of likelihood TAF than the groups with low autogenous obsession. The groups with high reactive obsession experienced more of morality TAF than the groups with low reactive obsession. In regards to neutralizing actions, reactive obsession groups(low autogenous-high reactive groups) used avoidant neutralizing actions the most when it came to autogenous obsessive conditions, and autogenous obsession groups(high autogenous-low reactive groups) came after the reactive obsession groups when using avoidant neutralizing actions. The groups with high autogenous obsession showed no significant effects in the rest of the conditions. The groups with high reactive obsession used more of direct neutralizing actions than the groups with low reactive obsession when it came to autogenous obsessive conditions. With regards to reactive obsessive conditions, they more used both avoidant and direct neutralizing actions. Lastly, intrusive thoughts in thought suppression occurred the most in the groups of high obsession(high autogenous-high reactive groups). If groups had high autogenous obsession or high reactive obsession, they experienced more of attempted thought suppression than the lower groups. When it came to successful suppression, the groups with high autogenous obsession experienced more difficulties in suppression compared to the groups with low autogenous obsession. Based on these results, the meanings and suggestions that the study provides as well as the direction of the future study were discussed.
김정인 (2005). 사고행동융합(Thought-Action Fusion)과 통제방략이 강박증상에 미치는 영향. 중앙대학교 석사학위 논문.
김지현, 이종환, 곽호완, 장문선, 구본훈 (2016). 강박성향군의 강박사고 위협자극에 대한 억제기능. 한국심리학회지: 건강, 21(1), 107-128.
민병배 (2000). 강박사고와 걱정: 침투사고 대처과정 및 관련 성격특성에서의 유사점과 차이점. 서울대학교 박사학위 논문.
보건복지부 (2017). 2017년 정신질환실태 역학조사. 서울: 삼성서울병원.
설순호 (2004). 걱정과 강박사고에 대한 인지적 평가와 통제방략. 서울대학교 석사학위 논문.
이미소 (2014). 자생성 및 반응성 강박사고에 대한 대처방략의 차별적 효과. 서울대학교 석사학위 논문.
이선영 (2011). 한국판 사고억제 척도(Thought Suppression Inventory: TSI)의 타당화 연구-일반 성인을 대상으로. Korean Journal of Clinical Psychology, 30(4), 889-906
이순희 (2000). 도덕적, 인과적 책임감 및 불이행에 대한 책임감과 강박증상과의 관계. 서울대학교 석사학위 논문.
이용승, 원호택 (1999). 사고 억제(Thought Suppression)와 통제 방략에서의 개인차에 관한 연구. Korean Journal of Clinical Psychology, 18(1), 37-58.
이용승, 원호택 (2000). 통제 방략의 차이에 따른 침투사고 통제에 관한 연구. Korean Journal of Clinical Psychology, 19 (4), 681-696.
이한주 (1999). 자생성 강박사고와 반응성 강박사고에 대한 평가와 통제방략의 차이. 서울대학교 석사학위 논문.
이한주, 신민섭, 김중술, 권준수 (2002). 자생성 강박사고와 반응성 강박사고: 임상집단 연구. Korean Journal of Clinical Psychology, 21(1), 57-74.
전미애, 김정모 (2009). 마음챙김에 기초한 인지치료가 대학생의 사고억제에 미치는 효과. 한국심리학회지: 건강, 14(4), 795-813.
정선미 (2002). 걱정 및 사고-행동 융합과 두 가지 유형의 강박사고와의 관계: 자생성 강박사고와 반응성 강박사고. 연세대학교 석사학위 논문.
Abramowitz, J. S., Whiteside, S., Lynam, D., & Kalsy, S. (2003). Is thought-action fusion specific to obsessive-compulsive disorder?: A mediating role of negative affect. Behaviour Research and Therapy, 41, 1069-1079.
American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorder (5th ed.). Washington, DC: Auther.
Bannon, S., Gonsalvez, C. J., Croft., R. J., & Boyce, P. M. (2002). Response inhibition deficits in obsessive-compulsive disorder. Psychiatry Research, 110(2), 165-174.
Bouvard, M., Fournet, N., Denis, A., Sixdenier, A., & Clark, D. (2017). Intrusive thoughts in patients with obsessive compulsive disorder and non-clinical participants: a comparison using the International Intrusive Thought Interview Schedule. Cognitive Behaviour Therapy, 46(4), 287-299.
Burns, G. L., Keortge, S. G., Formea, G. M., & Sternberger, L. G. (1996). Revision of the Padua Inventory of obsessive compulsive disorder symptoms: distinctions between worry, obsessions, and compulsions. Behaviour Research and Therapy, 34(2), 163-173.
Claridge, G., McCreery, C., Mason, O., Bentall, R., Boyle, G., Slade, P., & Popplewell, D. (1996). The factor structure of schizotypal traits: A large replication study. British Journal of Clinical Psychology, 35(1), 103-115.
Einstein, D. A., & Menzies, R. G. (2004). The presence of magical thinking in obsessive compulsive disorder. Behaviour Research and Therapy, 42(5), 539-550.
Koster, E. H. W., Soetens, B., Braet, C., & Raedt, R. E. (2008). How to control a white bear? Individual differences involved in self-perceived and actual thought-suppression ability. Cognition and Emotion, 22(6), 1068-1080.
Lee, H. J., & Kwon, S. M. (2003). Two different types of obsession: autogenous obsessions and reactive obsessions. Behaviour Research and Therapy, 41(1), 11-29.
Lee, H. J., & Telch, M. J. (2005). Autogenous/ reactive obsessions and their relationship with OCD symptoms and schizotypal personality features. Journal of Anxiety Disorders, 19(7), 793-805.
Lee, H, J., & Telch, M. J. (2010). Differences in latent inhibition as a function of the autogenous-reactive OCD subtype. Behaviour Research and Therapy, 48(7), 571-579.
Lee, H. J., Cougle, J. R., & Telch, M. J. (2005). Thought-action fusion and its relationship to schizotypy and OCD symptom. Behaviour Research and Therapy, 43(1), 29-41.
Lee, H. J., Yost, B. P., & Telch, M. J. (2009). Differential performance on the go/no-go task as a function of the autogenous-reactive taxonomy of obsessions: Finding from a non-treatment seeking sample. Behaviour Research and Therapy, 47(4), 294-300.
Mckay, D., Abramowitz, J. S., & Taylor, S. (2008). Conceptualizing subtypes of obsessive- compulsive disorder. In Abramowitz, J. S., Mckay, D., & Taylor, S (Eds.), Obsessive- compulsive disorder: subtypes and spectrum conditions (pp. 127-138). New York: Elsevier.
Mouldin, R., Jyrios, M., Doron, G., & Nedeljkovic, M. (2017). Autogenous and reactive obsession: Further evidence for a two-factor model of obsessions. Journal of Anxiety disorders, 21(5), 677-690.
Muris, P., Meesters, C., Rassin, E., Merckelbach, H., & Campbell, J. (2001). Thought-action fusion and anxiety disorders symptoms in normal adolescents. Behaviour Research and Therapy, 39(7), 843-852.
Penadés, R., Catalán, R., Rubia, K., Andrés, S., Salamero, M., & Gastó, C. (2007). Impaired response inhibition in obsessive compulsive disorder. European Psychiatry, 22(6), 404-410.
Posner, M. I., & Snyder, C. R. R. (1975). Attention and cognitive control. In Solso, R. L (Ed.), Information processing and cognition: The Loyola symposium (pp. 55-85). Hillsdale, NJ: Erlbaum.
Rassin, E. (2003). The white Bear Suppression Inventory(WBSI) focuses on failing suppression attempts. European Journal of Personality, 17(4), 285-298.
Rassin, E., Diepstraten, P., Merckelbach, H., & Muris, P. (2001). Thought-action fusion and thought suppression in obsessive-compulsive disorder. Behaviour Research and Therapy, 39(7), 757-764.
Rassin, E., Merckelbach, H., Muris, P., & Schmidt, H. (2001). The thought-action fusion scale: Further evidence for its reliability and validity. Behaviour Research and Therapy, 39(5), 537-544.
Rassin, E., Merckelbach, H., Muris, P., & Spaan, V. (1999). Thought-action fusion as a causal factor in the development of intrusions. Behaviour Research and Therapy, 37(3), 231-237.
Rassin, E., Muris, P., Schmidt, H., & Merckelbach, H. (2000). Relationships between thought- action fusion, thought suppression, and obsessive-compulsive symptoms: A structural equation modeling approach. Behaviour Research and Therapy, 38(9), 889-897.
Rachman, S. (1971). Obsessional ruminations. Behaviour Research and Therapy, 9(3), 225-238.
Rachman, S. (1993). Obsessions, responsibility, and guilt. Behaviour Research and Therapy, 31(2), 149-154.
Rachman, S. (1997). A cognitive theory of obsessions. Behaviour Research and Therapy, 35(9), 793-802.
Rachman, S. (1998). A cognitive theory of obsessions: elaborations. Behaviour Research and Therapy, 36(4), 385-401.
Rachman, S. (2002). A cognitive theory of compulsive checking. Behavior Research and Therapy, 40(6), 625-639.
Rachman, S., Thordarson, D. S., Shafran, R., & Woody, S. R. (1995). Perceived responsibility: Structure and significance. Behaviour Research and Therapy, 33(7), 779-784.
Salkovskis, P. M. (1985). Obsessional-compulsive problems: A cognitive-behavioral analysis. Behaviour Research and Therapy, 23(5), 571-583.
Salkovskis, P. M. (1989). Cognitive-behavioral factors and the persistence of intrusive thoughts in obsessional problems. Behaviour Research and Therapy, 27(6), 677-682.
Salkovskis, P. M., & Harrison, J. (1984). Abnormal and normal obsessions-A replication. Behavior Research and Therapy, 22(5), 549-552.
Shafran, R., & Rachman, S. (2004). Thought-action fusion: a review. Journal of Behavior Therapy and Experimental Psychiatry, 35(2), 87-107.
Shafran, R., Thordarson, D. S., & Rachman, S. (1996). Thought-Action Fusion in Obsessive Compulsive Disorder. Journal of Anxiety Disorders, 10(5), 379-391.
Silva, S., Janeiro, L., Brás, M., Carmo, C., Martins, A. T., & Jiménez-Ros A. (2018). Paradoxical Effects of Worrisome Thoughts Suppression: the Influence of Depressive Mood. Current Psychology, 37(1), 98-106.
Smári, J., Birgisdóttir, A. B., & Brynjólfsdóttir, B. (1995). Obsessive-compulsive symptoms and suppression of personally relevant unwanted thoughts. Personality and Individual Differences, 18(5), 621-625.
Sobin, C., Blundell, M. L., Weiller, F., Gavigan, C., Haiman, C., & Karayiorgou, M. (2000). Evidence of a schizotypy subtype in OCD. Journal of Psychiatric Research, 34(1), 15-24.
Thimm, J. C., Wang, C., Waterloo, K., Eisemann, M., & Halvorsen, M. (2017). Coping, thought suppression, and perceived stress in currently depressed, previously depressed, and never depressed individuals. Clinical Psychology Psychotherapy, 25(3), 401-407.
Tolin, D. F., Abramowitz, J. S., Przeworski, A., & Foa, E. B. (2002). Thought suppression in obsessive-compulsive disorder. Behaviour Research and Therapy, 40(11), 1255-1274.
Wegner, D. M., Erber, R., & Zanakos, S. (1993). Ironic processes in the mental control of mood and mood-related thought. Journal of Personality and Social Psychology, 65(6), 1093-1104.
Wegner, D. M., & Wenzlaff, R. M. (1996). Mental control. In Higgins, E. T. & Kruglanski, A. W (Eds.), Social Psycology: Handbook of basic principles (pp, 462-492). New York: Guilford Press.
Wegner, D. M., & Zanakos, S. (1994). Chronic thought suppression. Journal of Personality, 62(4), 615-640.
Wegner, D. M., Schneider, D. J., Carter, S. III., & White T. L. (1987). Paradoxical Effects of Thought Suppression. Journal of Personality and Social Psychology, 53(1), 5-13.