- ENGLISH
- P-ISSN1229-070X
- E-ISSN2713-9581
- KCI
남녀 대학생 집단에서 불안, 신체점검, 섭식문제 간의 관계: 신체점검 사고와 행동의 매개된 조절효과
Anxiety, Body Checking, and Eating Disorder Related Symptoms in Non-Clinical Group: The Mediated Moderating Effect of Body Checking Cognition and Behavior
황현국 (국립춘천병원)
초록
신체점검은 완벽하지 못하거나 결점이 있는 신체에 대한 주의로서, 섭식장애 발병에 핵심적 역할을한다고 알려져 있다. 본 연구는 비임상집단을 대상으로 불안과 섭식문제 간의 관계에서 신체점검사고와 신체점검행동의 매개된 조절효과를 확인해보고자 하였다. 400명(남자 215명; 여자 183명; 무응답 2명)의 대학생에게 불안검사(STAI), 신체점검인지척도(BCCS), 신체점검행동척도(BCQ), 식사태도검사-26(EAT-26)을 실시하였다. 연구 결과, 첫째, 여자는 남자보다 섭식장애 위험군에 속하는사람의 수가 많았으며, 고위험군이 저위험군보다 더 불안이 높았고, 신체점검 사고와 행동도 더 많이 하는 것으로 나타났다. 둘째, 섭식문제에 대한 심리적 변인들의 설명력을 알아본 결과, 남자의경우 불안과 신체점검행동만 섭식문제를 유의하게 설명해준 반면, 여자의 경우 불안, 신체점검 사고 및 행동 모두 섭식문제에 대한 설명력이 높았다. 셋째, 여자에 대해서만 신체점검 사고와 행동의 매개된 조절효과를 알아본 결과, 신체점검행동에 대해 불안과 신체점검사고의 상호작용이 유의했고, 신체점검행동은 섭식문제에 유의한 정적 영향을 미치고 있었다. 또한 신체점검사고 값에 따른 신체점검행동의 조건부 간접효과를 알아본 결과도 신체점검사고가 낮을수록 이러한 매개효과는증가하는 반면, 신체점검사고가 높을 경우 매개효과가 없음을 확인하였다. 결론적으로 불안과 섭식문제의 관계에서 신체점검행동의 매개효과는 신체점검사고에 의해 조절된다는 것이 여자 대학생들에게서만 확인되었다. 본 결과와 연구의 제한점에 대해 논의하였다.
- keywords
- 불안, 신체점검사고, 신체점검행동, 섭식장애, 매개된 조절효과, anxiety, body checking cognition, body checking behavior, eating disorder, mediated moderating effect
Abstract
Body checking includes any cognition and behavior aimed at gaining information about one’s weight, shape, or size. Body checking can increase body dissatisfaction through selective attention to disliked body parts and is one of the strongest correlates of eating disturbance. This study was performed to identify the mediated-moderating effects of body checking cognition and behavior between anxiety and eating disorder related symptoms in a non-clinical group. 398 college students (215 males, 183 females) completed measures of the State-Trait Anxiety Inventory, the Body Checking Cognition Scale (BCCS, Mountford et al., 2006), the Body Checking Questionnaire (BCQ, Reas et al., 2002), and the EAT-26 (Garner et al., 1982). The results were as follows: first, the risk group for eating disorders had higher STAI, BCCS, and BCQ scores than the non-risk group. Second, a standard multiple regression analysis suggested that anxiety and body checking behavior predict eating disorder severity in males, but all three psychological variables predict eating disorder symptoms in females. Third, the results of standard multiple regression analysis indicated that anxiety was directly and indirectly (mediated by body checking behavior) related to eating disorder symptoms in females. Additionally, the interactions between anxiety and body checking cognition significantly increased the variations in eating disorder symptoms (moderating effect) in females. Lastly, the mediated-moderating effect of body checking cognition and behavior in eating disorder symptoms, which was analysed using SPSS Macro as suggested by Preacher et al. (2007), was confirmed in this study. This mediated-moderation indicates the effect of anxiety on eating disorder symptoms via a mediator (body checking behavior) and differs depending on the levels of the moderator (body checking cognition) in females. The limitations and implications of the study were discussed.
- keywords
- 불안, 신체점검사고, 신체점검행동, 섭식장애, 매개된 조절효과, anxiety, body checking cognition, body checking behavior, eating disorder, mediated moderating effect
참고문헌
건강보험심사평가원 보도 자료(2013년 5월 24일자)
염동문, 이성대 (2014). 매개된 조절모형과 조절된 매개모형을 통한 직장차별이 생활만족도에 미치는 영향에 관한 연구: 직무만족과 자아존중감을 중심으로, 장애와 고용, 24(1), 139-165.
이민규, 이영호, 박세현, 손창호, 정영조, 홍성국, 이병관, 장필립, 윤애리 (1998). 한국판 식사태도검사-26(The Korean Version of Eating Attitudes Test-26) 표준화 연구 I: 신뢰도 및 요인분석. 정신신체의학, 6(2), 155-175.
최진미, 김남재 (2009). 섭식문제가 있는 여대생의 부적응 도식. 한국임상심리학회지: 임상, 28(3), 723-740.
한덕웅, 이창호, 탁진국 (1993). Spielberger 상태-특성불안검사의 표준화. 학생지도연구, 성균관대학교 학생생활연구소, 10(1), 214-222.
Aiken, L. S., & West, S. G. (1991). Multiple regression: Testing and interpreting interactions. Newbury Park, CA: Sage.
Altman, S., & Shankman, S, (2009). What is the association between obsessive-compulsive disorder and eating disorders? Clinical Psychology Review, 29(7), 638-646.
American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders. Fourth-TR Edition (DSM-IV-TR). Washington, D.C.
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders. Fifth Edition (DSM-5). American Psychiatric Association, Washington, D.C.
Appleton, K. M., & McGowan, L. (2006). The relationship between restrained eating and poor psychological health is moderated by pleasure normally associated with eating. Eating Behaviors, 7, 342-347.
Bamford, B. H., Attoe, C., Mounfford, V. A., Morgan, J.F., & Sly, R. (2014). Body checking and avoidance in low and weight restored individuals with anorexia nervosa and non-clinical females. Eating Behaviors, 15, 5-8.
Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical consideration. Journal of Personality and Social Psychology, 51(6), 1173-1182.
Braun, D. L., Sunday, S. R., & Halmi, K. A. (1994). Psychiatric comorbidity in patients with eating disorders. Psychological Medicine, 24, 859-867.
Cash, T. F., & Deagle III, E. A. (1997). The nature and extent of body-image disturbances in anorexia nervosa and bulimia nervosa: a meta-analysis. International Journal of Eating Disorders, 22, 107-125.
de Berardis, D., Carano, A., Gambi, F., Campanella, D., Giannetti, P., Ceci, A., et al. (2007). Alexithymia and its relationships with body checking and body image in a non clinical female sample. Eating Behaviors, 8, 296-304.
Fairburn, C. G., Cooper, Z., & Shafran, R. (2003). Cognitive behaviour therapy for eating disorders:A transdiagnostic theory and treatment. Behaviour Research and Therapy, 41, 509-528.
Fairburn, C. G., & Harrison, P.J. (2003). Eating disorders. Lancet, 361, 407-416.
Garner, D. M., Olmsted, M. P., Bohr, Y., & Garfinkel, P. (1982). The Eating Attitudes Test:Psychometric features and clinical correlates. Psychological Medicine, 12, 871-878.
Godart, N. T., Flament, M. F., Curt, F., Perdereau, F., Lang, F., & Venisee, J. L., & Fermanian, J. (2003). Anxiety disorders in subjects seeking treatment for eating disorders: A DSM-IV controlled study. Psychiatric Research, 117, 245-258.
Godart, N. T., Flament, M. F., Lecrubier, Y., & Jeammet, P. (2000). Anxiety disorders in anorexia nervosa and bulimia nervosa. Co-morbidity and chronology of appearance. European Psychiatry, 15, 38-45.
Hadjistavropoulos, H., & Lawrence, B. (2007). Does anxiety about health influence eating patterns and shape-related body checking among females? Personality and Individual Differences, 43, 319-328.
Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. New York: Guilford Press.
Hrabosky, J. I., Cash, T. F., Veale, D., Neziroglu, F., Soll, E. A., Garner, D. M., et al. (2009). Multidimensional body image comparisons among patients with eating disorders, body dysmorphic disorder, and clinical control.: a multisite study. Body Image, 6, 155-163.
Kaye W. H., Bulik, C. M., Thornton, L., Barbarich N., & Masters K. (2004). Comorbidity of anxiety disordera with anorexia and bulimia nervosa. American Journal of Psychiatry, 161, 2215-2221.
Keel, P. K., Dorer, D. J., Franko, D. L., Jackson, A. C., & Herzog, D.B. (2005). Postremission predictors og relapse in women with eating disorders. American Journal of Psychiatry, 162, 2263-2268.
Keel, P. K., Klump, K. L., McGue, M., Lacono, W. G. (2005). Shared transmission of eating disorder and anxiety disorder. International Journal of Eating Disorders, 38, 99-105.
Lydecker, J. A., Cotter, E. W., & Mazzeo, S. E. (2014). Body checking and body image avoidance:Construct validity and norms for college women. Eating Behaviors, 15, 13-16.
Miller, J. L., Scmidt, L .A., Vaillancourt, T., McDougall, P., & Laliberte, M. (2006). Neuroticism and introversion: a risky combination for disorderde eating among a non-clinical sample of undergraduate women. Eating Behaviors, 7, 69-78.
Miller, J. L., Vaillancourt, T., & Hanna, S. E. (2009). The measurement of "eating-disorder-thoughts"and "eating-disorder-behaviors": Implications for assessment and detection of eating disorders in epidemiological studies. Eating Behaviors, 10, 89-96.
Mountford, V., Hasse, A. M., & Waller, G. (2006). Body checking in eating disorders: Association between cognitions and behaviors. International Journal of Eating Disorders, 39, 708-715.
Pallister, E., & Waller, G. (2008). Anxiety in the eating disorders: understanding the overlap. Clinical Psychology Review, 28, 366-386.
Polivy, J., & Herman, C. P. (2003). Causes of eating disorders. American Review of Psychology, 53, 187-213.
Preacher, K. J., Rucker, D. D., & Hayes, A. F. (2007). Addressing moderated mediation hypotheses:theory, methods, and prescriptions. Multivariate Behavioral Research, 42(1), 185-227.
Reas, D. L., Grilo, C. M., Masheb, R. M., & Wilson, T. G. (2005). Body checking and avoidance in overweight patients with binge eating disorder. International Journal of Eating Disorders, 37, 342-346.
Reas, D. L., Whisenhunt, B. L., Netemeyer, R., & Williamson, D. A. (2002). Development of the body checking questionnaire: A self report measure of body checking behaviors. International Journal of Eating Disorders, 31, 324-333.
Rosen, J. C. (1987). Cognitive body image therapy. In Garner, D. M., & Garfinkel, P. E.(Eds.), Handbook of treatment for eating disorders. pp.188-201, New York; The Guilford Press.
Rosen, J. C. (1995). the nature of body dysmorphic disorder and treatment with cognitive behavior therapy. Cognitive and Behavioral Practice, 2, 143-166.
Schwalberg, M. D., Barlow, D. H., Algar, S. A., & Howard, L. J. (1992). Comparison of bulimics, obese binge eaters, social phobias, and individuals with panic disorder on comorbidity across DSM-III-R anxiety disorders. Journal of Abnormal Psychology, 101, 675-681.
Serpell, L., Livingstone, A., Neiderman, M., & Lask, B. (2002). Anorexia Nervosa: Obsessivecompulsive disorder, obsessive-compulsive personality disorder, or neither? Clinical Psychology Review, 22, 647-669.
Shafran, R., Fairburn, C. G., Robinson, P., & Lask, B. (2004). Body checking and its avoidance in eating disorders. International Journal of Eating Disorders, 35, 93-101.
Shafran, R., Lee, M., Payne, E., & Fairburn, C. G. (2007). An experimental analysis of body checking. Behaviour Research and Therapy, 45, 113-121.
Smeets, E., Tiggemann, M., Kemps, E., Mills, J. S., Hollitt, S., Roefs, A., & Jansen, A. (2011). Body checking induces an attentional bias for body-related cues. International Journal of Eating Disorders, 44(1), 50-57.
Veale, D., & Riley, S. (2001). Mirror, mirror on the wall, who is the ugliest of them all? The psychopathology of mirror gazing in body dysmorphic disorder. Behavioral Research and Therapy, 39, 1381-1393.
Waker, D. C., Anderson, D. A., & Hildebrandt, T. (2009). Body checking behaviors in men. Body Image, 6, 164-170.
Waller, G., Sines, J., Meyer, C., & Mountford, V. (2008). Body checking in eating disorders:Association with narcissistic characteristics. Eating behaviors, 9, 163-169.
Weltzin, T. E., Bulik, C. M., McConaha, C. W., & Kaye, W. H. (1995). Laxative withdrawal and anxiety in bulimia nervosa. International Journal of Eating Disorders, 17, 141-146.
- 다운로드 수
- 조회수
- 0KCI 피인용수
- 0WOS 피인용수