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본 연구에서는 정신건강의학과에 내원한 신경증적 환자 집단을 대상으로 기질 및 아동기 외상 경험이 다차원적 충동성과 어떠한 관련성을 보이는지 살펴보고, 충동성에 대한 기질과 아동기 외상의 설명력이 충동성의 각 차원에 따라 다른지 확인하고자 하였다. 서울 소재 한 대학병원 정신건강의학과에 내원하여 우울 및 불안, 적응장애로 진단 받은 172명을 대상으로 하였으며, 조현병스펙트럼장애와 양극성장애, 지적장애, 치매나 뇌손상이 의심되는 사례는 배제하였다. 참가자에게는 한국판 다차원적 충동성 척도(UPPS-P), 아동기 외상 질문지(CTQ), 기질 및 성격검사(TCI-RS) 설문을 실시하였다. 성별 및 연령을 통제한 편상관분석을 실시하여 다차원적 충동성과 기질 및 아동기 외상경험 간 관계를 살펴보았으며, 이후 위계적 회귀분석을 통해 기질 및 아동기 외상경험이 충동성을 유의하게 설명하는지 확인하였다. 그 결과, TCI의 자극추구 및 위험회피 요인과 아동기 학대 경험은 모두 부정긴급성 및 긍정긴급성 요인과 유의한 정적 상관을 보였으며, 그 외 충동성의 각 차원과 기질 및 아동기 방임 경험 간 연관성은 상이하였다. 위계적 회귀분석 결과, 사회적 민감성을 제외한 모든 기질의 하위요인과 아동기 성 학대 경험이 부정긴급성을 유의하게 설명하였으며, 이와 유사하게 긍정긴급성에 대해서도 감각추구 및 위험회피 요인 및 성 학대 경험이 유의한 예측변인인 것으로 나타났다. 반면에, 계획성 부족 및 지속성 부족, 감각추구 요인의 경우에는 기질의 설명력만 유의하였다. 연구결과를 바탕으로 본 연구의 의의와 한계점을 논의하였다.
The purpose of this study was to investigate the relationship among temperaments, childhood trauma, and multidimensional impulsivity. This study, in particular, examined how the sub-dimensions of temperament and the types of childhood trauma affect according to each dimension of impulsivity. A total of 172 psychiatric patients completed the questionnaires including Korean Temperament and Character Inventory (TCI), Childhood Trauma Questionnaire (CTQ), and UPPS-P Impulsive Behavior scale. Those who diagnosed with schizophrenia spectrum disorder, bipolar disorder, intelligence disability, and neurocognitive disorder were excluded. Childhood physical abuse was significantly correlated with all five dimensions of impulsivity(Positive Urgency, Negative Urgency, Sensation Seeking, Lack of premeditation, Lack of perseverance). The relationship between other types of childhood trauma and impulsivity was distinguished according to the each dimension of impulsivity. After controlling for demographic variables(gender and age), the results of a hierarchical multiple regression analysis showed that both temperaments and childhood sexual abuse were significantly predicted level of Urgency, whereas only temperaments affected the other dimensions of impulsivity. The clinical implications and limitations of our findings were also discussed.
민병배, 오현숙, 이주영 (2007). 기질 및 성격검사 성인용(TCI-RS). 서울: (주) 마음사랑.
유재학, 박지선, 박두흠, 유승호, 하지현 (2009). 한국판 아동기 외상 질문지의 타당화. 한국심리학회지: 건강, 14(3), 563-578.
임선영, 이영호. (2014). 한국판 다차원적 충동성 척도(UPPS-P)의 타당화 연구. Korean Journal of Clinical Psychology, 33(1), 51-71.
황순택, 조혜선, 박미정, 이주영 (2015). 성격장애와 기질 및 성격특질 간의 관계. 한국심리학회지: 사회 및 성격, 29(2), 1-13.
Anckarsäter, H., Stahlberg, O., Larson, T., Hakansson, C., Jutblad, S. B., Niklasson, L., ... & Gillberg, C. (2006). The impact of ADHD and autism spectrum disorders on temperament, character, and personality development. American Journal of Psychiatry, 163, 1239-1244.
Anestis, M. D., Bagge, C. L., Tull, M. T., & Joiner, T. E. (2011). Clarifying the role of emotion dysregulation in the interpersonal- psychological theory of suicidal behavior in an undergraduate sample. Journal of psychiatric research, 45, 603-611.
Barratt, E. S. (1959). Anxiety and impulsiveness related to psychomotor efficiency. Perceptual and motor skills, 9, 191-198.
Battle, C. L., Shea, M. T., Johnson, D. M., Yen, S., Zlotnick, C., Zanarini, M. C., ... & McGlashan, T. H. (2004). Childhood maltreatment associated with adult personality disorders: findings from the Collaborative Longitudinal Personality Disorders Study. Journal of Personality Disorders, 18, 193-211.
Berg, J. M., Latzman, R. D., Bliwise, N. G., & Lilienfeld, S. O. (2015). Parsing the heterogeneity of impulsivity: A meta-analytic review of the behavioral implications of the UPPS for psychopathology. Psychological Assessment, 27, 1129.
Berstein, D., Fink, L. (1998). Childhood Trauma Questionnaire: A Retrospective Self-Report. Psychological Corporation, San Antonio, TX
Bozkurt, M., Evren, C., Yilmaz, A., Can, Y., & Cetingok, S. (2013). Aggression and impulsivity in different groups of alcohol and heroin dependent inpatient men. Klinik Psikofarmakoloji Bülteni-Bulletin of Clinical Psychopharmacology, 23, 335-344.
Braquehais, M. D., Oquendo, M. A., Baca-García, E., & Sher, L. (2010). Is impulsivity a link between childhood abuse and suicide?. Comprehensive psychiatry, 51, 121-129.
Carver, C. S., & White, T. L. (1994). Behavioral inhibition, behavioral activation, and affective responses to impending reward and punishment: the BIS/BAS scales. Journal of personality and social psychology, 67, 319.
Celikel, F. C., Kose, S., Cumurcu, B. E., Erkorkmaz, U., Sayar, K., Borckardt, J. J., & Cloninger, C. R. (2009). Cloninger’s temperament and character dimensions of personality in patients with major depressive disorder. Comprehensive psychiatry, 50(6), 556-561.
Ceschi, G., Billieux, J., Hearn, M., Fürst, G., & Van der Linden, M. (2014). Trauma exposure interacts with impulsivity in predicting emotion regulation and depressive mood. European journal of psychotraumatology, 5, 24104.
Claes, L., Islam, M. A., Fagundo, A. B., Jimenez-Murcia, S., Granero, R., Agüera, Z., ... & Fernández-Aranda, F. (2015). The relationship between non-suicidal self-injury and the UPPS-P impulsivity facets in eating disorders and healthy controls. PLoS One,10, e0126083.
Cloninger, C. R., Przybeck, T. R., Svrakic, D. M., & Wetzel, R. D. (1994). The Temperament and Character Inventory (TCI): A guide to its development and use. Center for Psychobiology of Personality, Washington University, 1994.
Cyders, M. A., & Coskunpinar, A. (2012). The relationship between self-report and lab task conceptualizations of impulsivity. Journal of Research in Personality, 45, 121-124.
Daray, F. M., Rojas, S. M., Bridges, A. J., Badour, C. L., Grendas, L., Rodante, D., ... & Rebok, F. (2016). The independent effects of child sexual abuse and impulsivity on lifetime suicide attempts among female patients. Child abuse & neglect, 58, 91-98.
Derefinko, K., DeWall, C. N., Metze, A. V., Walsh, E. C., & Lynam, D. R. (2011). Do different facets of impulsivity predict different types of aggression?. Aggressive behavior, 37, 223-233.
Dick, D. M., Smith, G., Olausson, P., Mitchell, S. H., Leeman, R. F., O’malley, S. S., & Sher, K. (2010). Understanding the construct of impulsivity and its relationship to alcohol use disorders. Addiction biology, 15, 217-226.
Dir, A. L., Karyadi, K., & Cyders, M. A. (2013). The uniqueness of negative urgency as a common risk factor for self-harm behaviors, alcohol consumption, and eating problems. Addictive behaviors, 38, 2158-2162.
Duijsens, I. J., Spinhoven, P., Goekoop, J. G., Spermon, T., & Eurelings-Bontekoe, E. H. (2000). The Dutch temperament and character inventory (TCI): dimensional structure, reliability and validity in a normal and psychiatric outpatient sample. Personality and Individual Differences, 28(3), 487-499.
Egeland, B., Jacobvitz, D., & Sroufe, L. A. (1988). Breaking the cycle of abuse. Child development, 1080-1088.
Eysenck, S. B., Pearson, P. R., Easting, G., & Allsopp, J. F. (1985). Age norms for impulsiveness, venturesomeness and empathy in adults. Personality and individual differences, 6, 613-619.
Faraone, S. V., Kunwar, A., Adamson, J., & Biederman, J. (2009). Personality traits among ADHD adults: implications of late-onset and subthreshold diagnoses. Psychological medicine, 39, 685-693.
Favaro, A., Santonastaso, P., Monteleone, P., Bellodi, L., Mauri, M., Rotondo, A., ... & Maj, M. (2008). Self-injurious behavior and attempted suicide in purging bulimia nervosa: associations with psychiatric comorbidity. Journal of Affective Disorders, 105, 285-289.
Foulds, J. A., Boden, J. M., Newton‐Howes, G. M., Mulder, R. T., & Horwood, L. J. (2017). The role of novelty seeking as a predictor of substance use disorder outcomes in early adulthood. Addiction, 112, 1629-1637.
Gaher, R. M., Hofman, N. L., Simons, J. S., & Hunsaker, R. (2013). Emotion regulation deficits as mediators between trauma exposure and borderline symptoms. Cognitive therapy and research, 37, 466-475.
Goth, K., Cloninger, C. R., & Schmeck, K. (2003). Das Temperament und Charakter Inventar Kurzversion für Erwachsene-TCI R Kurz.. Klinik für Psychiatrie und Psychotherapie des Kindes-und Jugendalters der JW Goethe- Universität Frankfurt.
Gross, J. J., & Muñoz, R. F. (1995). Emotion regulation and mental health. Clinical psychology: Science and practice, 2, 151-164.
Hariri, A. R., & Holmes, A. (2006). Genetics of emotional regulation: the role of the serotonin transporter in neural function. Trends in cognitive sciences, 10, 182-191.
Hayes, S. C., Wilson, K. G., Gifford, E. V., Follette, V. M., & Strosahl, K. (1996). Experiential avoidance and behavioral disorders: A functional dimensional approach to diagnosis and treatment. Journal of consulting and clinical psychology, 64, 1152.
Howard, R., Karatzias, T., Power, K., & Mahoney, A. (2017). Posttraumatic stress disorder (PTSD) symptoms mediate the relationship between substance misuse and violent offending among female prisoners. Social psychiatry and psychiatric epidemiology, 52, 21-25.
Islam, M. A., Fagundo, A. B., Arcelus, J., Agüera, Z., Jiménez-Murcia, S., Fernández-Real, J. M., ... & Casanueva, F. F. (2015). Olfaction in eating disorders and abnormal eating behavior: a systematic review. Frontiers in psychology, 6, 1431.
Jaworska, N., Berrigan, L., Fisher, D., Ahmed, A. G., Gray, J., Bradford, J., ... & Knott, V. (2012). A pilot study of electrocortical activity in dysfunctional anger: decreased frontocortical activation, impaired attention control, and diminished behavioral inhibition. Aggressive behavior, 38, 469-480.
John, O. P., & Gross, J. J. (2004). Healthy and unhealthy emotion regulation: Personality processes, individual differences, and life span development. Journal of personality, 72, 1301-1334.
Johnson, S. L., Tharp, J. A., Peckham, A. D., Carver, C. S., & Haase, C. M. (2017). A path model of different forms of impulsivity with externalizing and internalizing psychopathology: Towards greater specificity. British Journal of Clinical Psychology, 56(3), 235-252.
Karyadi, K. A., & King, K. M. (2011). Urgency and negative emotions: Evidence for moderation on negative alcohol consequences. Personality and Individual Differences, 51, 635-640.
Kim, J., Talbot, N. L., & Cicchetti, D. (2009). Childhood abuse and current interpersonal conflict: The role of shame. Child Abuse & Neglect, 33, 362-371.
Latzman, R. D., Chan, W. Y., & Shishido, Y. (2013). Impulsivity moderates the association between racial discrimination and alcohol problems. Addictive behaviors, 38, 2898-2904.
Liu, R. T. (2018). Childhood maltreatment and impulsivity: a meta-analysis and recommendations for future study. Journal of abnormal child psychology, 1-23.
Lynam, D. R., Miller, J. D., Miller, D. J., Bornovalova, M. A., & Lejuez, C. W. (2011). Testing the relations between impulsivity-r elated traits, suicidality, and nonsuicidal self-injury: A test of the incremental validity of the UPPS model. Personality disorders: Theory, research, and treatment,2, 151.
Madden, G. J., & Johnson, P. S. (2010). A delay-discounting primer. In Madden, G. J. & Bickel, W. K. (Eds.). Impulsivity: The behavioral and neurological science of discounting (pp. 14-37). Washington, DC. American Psychological Association.
Magid, V., & Colder, C. R. (2007). The UPPS Impulsive Behavior Scale: Factor structure and associations with college drinking. Personality and Individual Differences, 43, 1927-1937.
Mendle, J., Leve, L. D., Van Ryzin, M., Natsuaki, M. N., & Ge, X. (2011). Associations between early life stress, child maltreatment, and pubertal development among girls in foster care Journal of Research on Adolescence, 21, 871-880.
Mennin, D. S., Heimberg, R. G., Turk, C. L., & Fresco, D. M. (2002). Applying an emotion regulation framework to integrative approaches to generalized anxiety disorder. Clinical Psychology: Science and Practice, 9, 85-90.
Mirhashem, R., Allen, H. C., Adams, Z. W., van Stolk-Cooke, K., Legrand, A., & Price, M. (2017). The intervening role of urgency on the association between childhood maltreatment, PTSD, and substance-related problems. Addictive behaviors, 69, 98-103.
Nisenbaum, R., Links, P. S., Eynan, R., & Heisel, M. J. (2010). Variability and predictors of negative mood intensity in patients with borderline personality disorder and recurrent suicidal behavior: Multilevel analyses applied to experience sampling methodology. Journal of Abnormal Psychology, 119, 433.
Netter, P., Hennig, J., & Roed, I. S. (1996). Serotonin and dopamine as mediators of sensation seeking behavior. Neuropsychobiology, 34, 155-165.
Palmer, R. H., Knopik, V. S., Rhee, S. H., Hopfer, C. J., Corley, R. C., Young, S. E., ... & Hewitt, J. K. (2013). Prospective effects of adolescent indicators of behavioral disinhibition on DSM-IV alcohol, tobacco, and illicit drug dependence in young adulthood. Addictive behaviors, 38, 2415-2421.
Reynolds, B., Ortengren, A., Richards, J. B., & de Wit, H. (2006). Dimensions of impulsive behavior: Personality and behavioral measures. Personality and individual differences, 40, 305-315.
Pai, N. B., Vella, S. & Dawes, K. (2018). The Clinical Assessment of Impulsivity. Archives of Medicine and Health Sciences, 6(1), 95-98.
Pearson, C. M., Zapolski, T. C., & Smith, G. T. (2015). A longitudinal test of impulsivity and depression pathways to early binge eating onset. International Journal of Eating Disorders, 48(2), 230-237.
Pierò, A. (2010). Personality correlates of impulsivity in subjects with generalized anxiety disorders. Comprehensive psychiatry, 51, 538-545.
Romans, S. E., Martin, J. M., Gendall, K., & Herbison, G. P. (2003). Age of menarche: the role of some psychosocial factors .Psychological medicine, 33, 933-939.
Schaefer, J. D., Moffitt, T. E., Arseneault, L., Danese, A., Fisher, H. L., Houts, R., … Caspi, A., 2018. Adolescent victimization and early-adult psychopathology: approaching causal inference using a longitudinal twin study to rule out noncausal explanations. Clin. Psychol. Sci. 6, 352371.
Settles, R. E., Fischer, S., Cyders, M. A., Combs, J. L., Gunn, R. L., & Smith, G. T. (2012). Negative urgency: A personality predictor of externalizing behavior characterized by neuroticism, low scientiousness, and disagreeableness. Journal of abnormal psychology, 121, 160.
Sher, K. J., Bartholow, B. D., & Wood, M. D. (2000). Personality and substance use disorders: a prospective study. Journal of consulting and clinical psychology, 68, 818.
Shipman, K., Edwards, A., Brown, A., Swisher, L., & Jennings, E. (2005). Managing emotion in a maltreating context: A pilot study examining child neglect. Child abuse & neglect, 29, 1015-1029.
Smith, A. R., Chein, J., & Steinberg, L. (2013). Impact of socio-emotional context, brain development, and pubertal maturation on adolescent risk-taking. Hormones and behavior, 64, 323-332.
Smith G. T., Fischer S., Cyders, M. A., Annus, A. M., Spillane, N. S., McCarthy, D. M., et al. (2007). On the validity and utility of discriminating among impulsivity-like traits. Assessment, 14, 155-70.
Steinberg, L. (2008). A social neuroscience perspective on adolescent risk-taking. Developmental review, 28, 78-106.
Steinberg, L., Graham, S., O’Brien, L., Woolard, J., Cauffman, E., & Banich, M. (2009). Age differences in future orientation and delay discounting. Child development, 80, 28-44.
Swogger, M. T., You, S., Cashman-Brown, S., & Conner, K. R. (2011). Childhood physical abuse, aggression, and suicide attempts among criminal offenders. Psychiatry research, 185, 363-367.
Turner, P. K., Runtz, M. G., & Galambos, N. L. (1999). Sexual abuse, pubertal timing, and subjective age in adolescent girls: A research note. Journal of Reproductive and Infant Psychology, 17, 111-118.
Van Der Kolk, B. A., Roth, S., Pelcovitz, D., Sunday, S., Spinazzola, J., 2005. Disorders of extreme stress: The empirical foundation of a complex adaptation to trauma. Journal of Traumatic Stress. 18, 389399.
Verdejo-García, A., Lawrence, A. J., & Clark, L. (2008). Impulsivity as a vulnerability marker for substance-use disorders: review of findings from high-risk research, problem gamblers and genetic association studies. Neuroscience & Biobehavioral Reviews, 32, 777-810.
Wardell, J. D., Strang, N. M., & Hendershot, C. S. (2016). Negative urgency mediates the relationship between childhood maltreatment and problems with alcohol and cannabis in late adolescence. Addictive behaviors, 56, 1-7.
Weiss, N. H., Tull, M. T., Viana, A. G., Anestis, M. D., & Gratz, K. L. (2012). Impulsive behaviors as an emotion regulation strategy: Examining associations between PTSD, emotion dysregulation, and impulsive behaviors among substance dependent inpatients. Journal of anxiety disorders, 26, 453-458.
Willcutt, E. G., Betjemann, R. S., McGrath, L. M., Chhabildas, N. A., Olson, R. K., DeFries, J. C., & Pennington, B. F. (2010). Etiology and neuropsychology of comorbidity between RD and ADHD: The case for multiple-deficit models .Cortex, 46, 1345-1361.
Wise, L. A., Palmer, J. R., Rothman, E. F., & Rosenberg, L. (2009). Childhood abuse and early menarche: findings from the black women’s health study. American Journal of Public Health, 99, S460-S466.
Whiteside, S. P., Lynam, D. R., Miller, J. D., & Reynolds, S. K. (2005). Validation of the UPPS impulsive behaviour scale: a four‐factor model of impulsivity. European Journal of Personality: Published for the European Association of Personality Psychology, 19, 559-574.
Zaninotto, L., Solmi, M., Toffanin, T., Veronese, N., Cloninger, C. R., & Correll, C. U. (2016). A meta-analysis of temperament and character dimensions in patients with mood disorders: Comparison to healthy controls and unaffected siblings. Journal of Affective Disorders, 194, 84-97.
