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메뉴본 연구에서는 데이트폭력 피해 경험이 복합 외상후 스트레스를 경유하여 경계선 성격 경향성으로 이어지는 경로에 대해 확인하고자 하였다. 이를 위해, 대인관계적 외상의 한 형태인 데이트폭력 경험이 경계선 성격 경향성 형성에 영향을 미치는 과정에서 복합 외상후 스트레스의 매개효과를 검증하였고, 개인의 회복 자원이 되는 회복탄력성과 사회적 지지의 수준에 따라 달라지는지 조절된 매개효과를 확인하였다. 참가자들은 데이트폭력 경험이 있는 전국의 만 20~39세 미혼 여성 436명으로, 온라인 설문지를 통해 데이트폭력 피해 경험, 복합 외상후 스트레스 수준, 경계선 성격 경향성, 회복탄력성, 사회적 지지의 문항에 응답하였다. 수집된 자료는 다중회귀분석을 통해 데이트폭력 유형별 영향력을 검증하였고, Process Macro 3.1을 활용하여 매개효과, 조절효과, 조절된 매개효과를 분석하였다. 본 연구의 결과는 다음과 같다. 첫째, 측정변인들 중 데이트폭력 피해 경험과 경계선 성격 경향성, 복합 외상후 스트레스 수준에는 정적 상관이 나타났고, 이들은 회복탄력성 및 사회적 지지와는 부적 상관을 보였다. 둘째, 데이트폭력의 유형 중 정서적 폭력만이 복합 외상후 스트레스 및 경계선 성격 경향성을 유의미하게 예측하는 것으로 나타났다. 셋째, 데이트폭력 피해와 경계선 성격 경향성의 관계에서 복합 외상후 스트레스의 완전매개효과를 확인하였다. 넷째, 데이트폭력 피해 경험이 복합 외상후 스트레스로 이어지는 경로에서는 회복탄력성과 사회적 지지의 조절효과가 나타나지 않았으나, 데이트폭력 피해를 완전매개한 복합 외상후 스트레스 수준이 경계선 성격 경향성에 영향을 미치는 과정에서는 조절효과가 있는 것으로 확인되었다. 다섯째, 데이트폭력과 경계선 성격 경향의 관계에서 복합 외상후 스트레스의 간접효과가 회복탄력성과 사회적 지지 수준에 따라 변화되는 조절된 매개효과를 검증하였다. 마지막으로, 본 연구결과를 통해 향후 데이트폭력 피해자들의 상담 및 심리치료 개입 방안에 대해 논의하였고, 후속연구를 위해 본 연구의 제한점 및 한계점을 제시하였다.
The purpose of this study was to investigate the effects of dating violence on individuals with borderline personality tendency through complex posttraumatic stress. In particular, this study examined the moderated mediating effect of complex posttraumatic stress through resilience and social support on the influence of dating violence on borderline personality tendency. For this purpose, 436 unmarried women aged 20-39 years who had experiences of dating violence were measured and analyzed levels of dating violence, complex posttraumatic stress, borderline personality characteristics, resilience, and social support. The results of the analysis were as follows: First, a statistically significant relationship was shown between the variable of dating violence, borderline personality traits, and complex posttraumatic stress levels, and these showed a negative correlation with resilience and social support. Second, among the types of dating violence assessed, only emotional violence significantly predicted complex posttraumatic stress and borderline personality tendency. Third, the full mediation effect of complex posttraumatic stress was confirmed in the relationship between dating violence and borderline personality tendency. Fourth, there was no moderating effect of resilience and social support on the path from dating violence to complex posttraumatic stress. However, it was confirmed that the complex posttraumatic stress level that fully mediated the dating violence had a moderating effect on the borderline personality tendency. Fifth, as a result of verifying the moderated mediating effect, it was further confirmed that when the resilience and the social support levels were high, the effect of dating violence mediated by complex posttraumatic stress on the formation of borderline personality tendency was mitigated. Finally, this study suggested the implications for counseling and psychotherapy interventions for victims of dating violence in the future.
김도연, 이기은, 이종현 (2017). 한국 데이트폭력 실태 및 인식 조사. 한국심리학회 연차학술 대회 심포지움 발표논문, 2017년 8월 18일. 서울: 세종대학교. 미간행.
김연수 (1995). 정신장애인의 삶의 만족도와 사회적 지지도에 관한 연구. 석사학위논문, 이화여자대학교, 서울.
김에스더, 김정규 (2019). 감사성향이 외상 후 성장에 미치는 영향: 사회적 지지와 자아탄력성의 매개효과. 한국심리학회지: 건강, 24(2), 451-468.
박경은, 유영권 (2017). 데이트폭력 피해여성의 심리내면에 관한 질적연구. 한국심리학회지: 상담 및 심리치료, 29(3), 711-742.
박지원 (1985). 사회적지지 척도 개발을 위한 일 연구. 박사학위논문, 연세대학교, 서울.
서경현 (2003). 음주 동기, 문제음주 및 음주 가족력과 대학생의 데이트 폭력. 한국심리학회지: 사회문제, 9, 61-78.
서경현 (2004). 고등학생과 대학생의 가정폭력 피해와 데이트 폭력간의 관계에 대한 성의 조절효과. 한국심리학회지: 건강, 9, 147-162.
서경현, 김유정, 정구철, 양승애, 김보연 (2010). 데이트폭력에 대한 가부장/비대칭 패러다임과 성-포괄적 모델의 타당성 제고. 한국심리학회지: 건강, 15(4), 781-799.
신우열, 김민규, 김주환 (2009). 회복탄력성 검사 지수의 개발 및 타당도 검증. 한국청소년연구, 20(4), 105-131.
이수림 (2012). 외상 유형이 외상후성장 및 지혜에 미치는 영향: 사회적 지지와 대처의 매개효과. 한국심리학회지: 문화 및 사회문제, 19(3), 319-341.
이아람, 김남재 (2012). 복합외상경험과 경계선 성격특성의 관계에서 자기개념의 중재효과와 매개효과. 한국심리학회지: 여성, 17(2), 227-243.
임채영, 정소영, 이명신 (2010). 대학생의 폭력인식이 데이트폭력행동에 미치는 영향. 한국지역사회복지학회, 35, 147-179.
정선호, 서동기 (2016). 회귀분석을 이용한 매개된 조절효과와 조절된 매개효과 검증 방법. 한국심리학회지: 일반, 35(1), 257- 282.
정지선, 안현의 (2008). 청소년 학교폭력의 복합외상 접근. 한국심리학회지: 상담 및 심리치료, 20(1), 145-160.
홍상환, 김영환 (1998). 경계선 성격장애 척도의 타당화 연구: 대학생을 중심으로. Korean Journal of Clinical Psychology, 17, 259-271.
홍영오, 연성진, 주승희 (2015). 여성 폭력에 대한 연구: 친밀한 관계에서의 폭력을 중심으로. 형사정책연구원 연구총서, 12, 1-491.
Aiken, L. S., & West, S. G. (1991). Multiple regression: testing and interpreting interaction. Newbury Park, CA: Sage.
American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Association.
Arntz, A. (1994). Treatment of borderline personality disorder: A challenge for cognitive-behavioral therapy. Behaviour Research and Therapy, 32, 419-430.
Baron, R. M., & Kenny, D, A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173-1182.
Benight, C., & Bandura, A. (2004). Social cognitive theory of posttraumatic recovery: The role of perceived self-efficacy. Behaviour Research and Therapy, 42, 1129-1148.
Bonanno, G.A., Galea, S., Bucciarelli, A., & Vlahov, D. (2007). What predicts psychological resilience after disaster? The role of demographics, resources, and life stress. Journal of Consulting and Clinical Psychology 75, 671-682.
Boon, S., Steele, K., & Van der Hart, O. (2011). Coping with Trauma-related Dissociation: Skills Training forPatients and Therapists. New York, NY: W. W. Norton & Company.
Campbell, J. C., & Kendall-Tackett, K. A. (2005). Intimate partner violence: Implications for women's physical and mental health. In K. Kendall-Tackett (Eds.), Handbook of women, stress and trauma (pp.123-140). New York, NY: Routledge.
Chung, M. C., Berger, Z., Rudd, H. (2007). Comorbidity and personality traits in patients with different levels of posttraumatic stress disorder following myocardial infarction. Psychiatry Research, 152, 243-252.
Cloitre, M., Courtois, C. A., Charuvastra, A., Carapezza, R., Stolbach, B. C., & Green, B. L. (2011). Treatment of complex PTSD: Results of the ISTSS expert clinician survey on best practices. Journal of Traumatic Stress, 24(6), 615-627.
Cloitre, M., Garvert, D. W., Brewin, C. R., Bryant, R. A., & Maercker, A. (2013). Evidence for proposed ICD-11 PTSD and complex PTSD: A latent profile analysis. European Journal of Psychotraumatology, 4, 20706, doi: http://dx.doi.org/10.3402/ejpt.v4i0.20706.
Cloitre, M., Stolbach, B. C., Herman, J. L., Van der Kolk, B., Pynoos, R., Wang, J., & Petkova, E. (2009). A developmental approach to complex PTSD: Childhood and adult cumulative trauma as predictors of symptom complexity. Journal of Traumatic Stress, 22(5), 399-408.
Coker, A. L., Davis, K. E., Arias, I., Desai, S., Sanderson, M., Brandt, H. M., & Smith, P. H. (2002). Physical and mental health effects of intimate partner violencefor men and women. American Journal of Preventive Medicine, 23, 260-268.
Cornelius, T. L., Shorey, R. C., & Beebe, S. M. (2010). Self-reported communication variables and dating violence: Using Gottman's marital communication conceptualization. Journal of Family Violence, 25(4), 439-448.
Courtois, C. A., & Ford, J. D. (2013). Treating complex trauma: A sequenced relationship-based approach. New York, NY: Guilford.
Dorahy, M. J., Corry, M., Shannon, M., MacSherry, A., Hamilton, G., McRobert, G... Hanna, D. (2009). Complex PTSD, interpersonal trauma and relational consequences: Findings from a treatment-receiving Northern Irish sample. Journal of Affective Disorders, 112, 71-80.
Dorrepaal, E., Thomaes, K., Hoogendoorn, A. W., Veltman, D. J., Draijer, N., & Van Balkom, A. J. (2014). Evidence-based treatment for adult women with child abuse-related complex PTSD: A quantitative review. European Journal of Psycho-Traumatology, 5, 23613. doi: http://dx.doi.org/10.3402/ejpt.v5. 23613.
Dorrepaal, E., Thomaes, K., Smit, J. H., Hoogendoorn, A., Veltman, D. J., van Balkom, A. J, & Draijer, N. (2012). Clinical phenomenology of childhood abuse-related complex PTSD in a population of female patients: Patterns of personality disturbance. Journal of Trauma and Dissociation, 13(3), 271-290.
Dutton. D. G. (2007). The complexities of domestic violence. American Psychologist, 62(7), 708-709.
Dutton, M. A., Green, B., Kaltman, S. I., Roesch, D. M., Zeffiro, T. A., & Krause, E. D. (2006). Intimate partner violence, PTSD, and adverse health outcomes. Journal of Interpersonal Violence, 21, 955-968.
Eshelman, L., & Levendosky, A. A. (2012). Dating violence: Mental health consequences based on type of abuse. Violence and Victims, 27(2), 215-228.
Fauerbach, J. A., Lawrence, J. W., Schmidt Jr., C. W., Munster, A. M., & Costa Jr., P. T. (2000). Personality predictors of injury-related posttraumatic stress disorder. The Journal of Nervous and Mental Disease, 188, 510-517.
Fletcher, D., & Sarkar, M. (2013). Psychological resilience: A review and critique of definitions, concepts, and theory. European Psychologist, 18, 12-23.
Follingstad, D., Wright, S., Lloyd, S., & Sebastian, J. (1991). Sex differences in motivations and effects in dating violence. Family Relations, 40(1), 51-57.
Ford, J. D. (2015). Complex PTSD: Research directions for nosology/assessment, treatment, and public health, European Journal of Psychotraumatology, 6, 27584. doi: http://dx. doi.org/10.3402/ejpt.v6.27584
Ford, J. D., & Courtois, C. A. (2014). Complex PTSD, affect dysregulation, and borderline personality disorder. Borderline Personality Disorder and Emotion Dysregulation, 1:9.
Ford, J. D., Steinberg, K. L., & Zhang, W. (2011). A randomized clinical trial comparing affect regulation and social problem-solving psychotherapies for mothers with victimization- related PTSD. Behavior Therapy, 42(4), 560- 578.
Ford, J. D., Stockton, P., Kaltman, S., & Green, B. L. (2006). Disorders of extreme stress (DESNOS) symptoms are associated with type and severity of interpersonal trauma exposure in a sample of healthy young women. Journal of Interpersonal Violence, 21, 1399-1416.
Grossman, R., Yehuda, R., New, A., Schmeidler, J., Silverman, J., Mitropoulou, V... Siever, L. (2003). Dexamethasone suppression test findings in subjects with personality disorders: Associations with posttraumatic stress disorder and major depression. American Journal of Psychiatry, 160(7), 1291-1298.
Harned, M. S., Rizvi, S. L., & Linehan, M. M. (2010). Impact of co-occurring posttraumatic stress disorder on suicidal women with borderline personality disorder. American Journal of Psychiatry, 167(10), 1210-1217.
Hayes, A. F. (2017). Introduction to mediation, mederation, and conditional process analysis, a regression-based approach (2nd Ed). New York, NY: Guilford.
Herman, J. L. (1992). Complex PTSD: A syndrome in survivors of prolonged and repeated trauma. Journal of Traumatic Stress, 5(3), 377-391.
Kaura, S. A., & Lohman, B. J. (2009). Does acceptability of violence impact the relationship between satisfaction, victimization, and commitment levels in emerging adult dating relationships? Journal of Family Violence, 24(6), 349-359.
Laffaye, C., Cavella, S., Drescher, K., & Rosen, C. (2008). Relationships among PTSD symptoms, social support, and support source in veterans with chronic PTSD. Journal of Traumatic Stress, 21, 394-401.
Linley, P. A., Alex, J., & Joseph, S. (2004). Positive change following and adversity: A review. Journal of Traumatic Stress, 17(1), 11-21.
Manganello, J. A. (2008). Teens, dating violence, and media use: A review of the literature and conceptual for future research. Trauma, Violence, & Abuse, 9(1), 3-18.
Mason, S. M., Flint, A. J., Roberts, A. L., Agnew-Blais, J., Koenen, K. C., & Rich-Edwards, J. W. (2014). Posttraumatic stress disorder symptoms and food addiction in women by timing and type of trauma exposure. JAMA Psychiatry, 71(11), 1271-1278.
Mauricio, A. M., Tein, J. Y., & Lopez, F. G. (2007). Borderline and antisocial personality scores as mediators between attachment and intimate partner violence. Violence and Victims, 22(2), 139-157.
Moore, S. A., Varra, A. A., Michael, S. T., & Simpson, T. L. (2010). Stress-related growth, positive reframing, and emotional processing inthe prediction of post-trauma functioningamong veterans in mental health treatment. Psychological Trauma: Theory, Research, Practice,and Policy, 2(2), 93-96.
Morey, L. C. (1991). Personality Assessment Inventory: Professional manual. Odessa, FL: Psychological Assessment Resources.
Nishi, D., Matsuoka, Y., & Kim, Y. (2010). Research Posttraumatic growth, posttraumatic stress disorder and resilience of motor vehicle accident survivors. Biopsychosocial Medicine, 4(1), 7.
O'Keefe, M. (1997). Predictors of dating violence among high school students. Journal of Interpersonal Violence, 12(4), 546-568.
O'Keefe, M. (2005). Teen dating violence: A review of risk factors and prevention efforts. National Electronic Network on Violence Against Women, 1, 1-5.
Pelcovitz, D., Kolk, B. A., Roth, S., Mandel, F., Kaplan, S., & Resick, P. (1997). Complex PTSD in victims exposed to sexual and physical abuse: Results from the DSM-IV feild trial for possttraumatic stress disorder. Journal of Traumatic Stress, 10, 539-556.
Pietrzak, R. H., Johnson, D. C., Goldstein, M. B., Malley, J. C., Rivers, A. J., Morgan, C. A., & Southwick, S. M. (2009a). Psychosocial buffers of traumatic stress, depressive symptoms, and psychosocial difficulties in veterans of Operations Enduring Freedom and Iraqi Freedom: The role of resilience, unit support, and postdeployment social support. Journal of Special Operations Medicine 9, 74-78.
Prati, G., & Pietrantoni, L. (2009). Optimism, social support and coping strategies as factors contributing to posttraumatic growth: A meta-analysis. Journal of Loss and Trauma, 14, 364-388.
Rademaker, A. R., van Preacher, K. J., Rucker, D. D., & Hayes, A. F. (2007). Addressing moderated mediation hypothesis: Theory, methods, and prescriptions. Multivariate Behavioral Research, 42(1), 185-227.
Sabina, C., & Straus, M. A. (2008). Polyvictimization by dating partners and mental health among U.S. college students. Violence and Victims, 23(6), 667-682.
Straus, M. A., Hamby, S. L., Boney-McCoy, S., & Sugarman, D. B. (1996). The revised Conflict Tactics Scales (CTS2): Development and preliminary psychometric data. Journal of Family Issues, 17(3), 283-316.
Street, A. E., & Arias, I. (2001). Psychological abuse and posttraumatic stress disorder in battered women: Examining the roles of shame and guilt. Victim Violation 16, 65-78.
Sugarman, D. B., & Hotaling, G. T. (1989). Dating violence: Prevalence, context, and risk markers. In M. A. Pirog-Good & J. E. Stets (Eds.). Violence in dating relationships: Emerging social issues (pp.3-32). New York, NY: Praeger Publishers.
Taylor, S., Asmundson, G. J. G., & Carleton, R. V. (2006). Simple versus complex PTSD: A cluster analytic investigation. Journal of Anxiety Disorders, 20, 459-472.
Tedeschi, R. G., & Calhoun, L. G. (2004). Posttraumatic growth: Conceptual foundations and empirical evidence. Psychological Inquiry, 15(1), 1-18.
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, 389-399.
Van Dijke, A., Ford, J. D., Van der Hart, O., Van Son, M. J., Van der Heijden, P. G., & Buhring, M. (2011). Childhood traumatization by primary caretaker and affect dysregulation in patients with borderline personality disorder and somatoform disorder. European Journal of Psychotraumatology, 2, 5628. doi: http://dx.doi. org/10.3402/ejpt.v2i0.5628.
Walker, L. E. (2012). Battered women syndrome and self-defense. Notre Dame Journal of Law, Ethics and Public Policy, 6(2), 321-334.
WHO. (2010). Preventing intimate partner and sexual violence against women: Taking action and generationg evidence. Geneva: World Health Organization. Available at: https:// www.who.int/reproductivehealth/publications/violence/9789241564007/en/www.who.int/reproductivehealth/publications/violence/9789241564007/en
WHO. (2020). International classification of diseases for mortality and morbidity statistics (10th Revision, Clinical Modification).
Wilson, J. P., Drozdek, B., & Turkovic, S. (2006). Posttraumatic shame and guilt. Trauma, Violence & Abuse 7, 122-141.
Wingenfeld, K., Schaffrath, C., Rullkoetter, N., Mensebach, C., Schlosser, N., Beblo, T... Meyer, B. (2011). Associations of childhood trauma, trauma in adulthood and previous-year stress with psychopathology in patients with major depression and borderline personality disorder. Child Abuse & Neglect, 35, 647-654.
Witte, T. H. & Kendra, R. (2010). Risk recognition and intimate partner violence. Journal of Interpersonal Violence, 25(12), 2199-2216.
Zanarini, M. C., Yong, L., Frankenburg. F. R., Hennen, J., Reich, D. B., Marino, M. F., & Vujanoavic, A. A, (2002). Severity of reported childhood sexual abuse and its relationship to severity of borderline psychopathology and psychosocial impairment among borderline inaptients. Journal of Nervous and Mental Disease, 190(6), 381-387.
Zoellner, T., & Maercker, A. (2006). Posttraumatic in clinical psychology: A critical review and introduction of a two component model. Clinical Psychology Review, 26(5), 626-653.