다면적 인성검사 II 재구성판(MMPI-2-RF)으로 살펴본 노인 우울장애의 임상적 특성
Clinical Characteristics of Elderly Depression Using MMPI-2-RF
박은희 (한림대학교 성심병원)
전덕인 (한림대학교)
홍나래 (한림대학교)
김근향 (대구대학교)
최지영 (인제대학교 상계백병원)
- 다운로드 수
- 조회수
초록
본 연구에서는 노인 우울장애의 임상적 특성을 확인하기 위하여 143명의 노인 우울장애 집단과142명의 MMPI-2의 노인 표준화 집단을 대상으로 MMPI-2-RF의 척도들을 비교 분석하였다. 집단 간 차이 검증 결과, 정서적/내재화 문제(EID), 의기소침(RCd), 신체증상 호소(RC1), 낮은 긍정정서(RC2), 역기능적 부정 정서(RC7), 신체적 불편감(MLS), 소화기 증상 호소(GIC), 두통 호소(HPC), 인지적 증상 호소(COG), 자살/죽음 사고(SUI), 무력감/무망감(HLP), 자기회의(SFD), 스트레스/걱정(STW), 불안(AXY), 분노 경향성(ANP), 행동 제약 공포(BRF), 다중 특정 공포(MSF), 수줍음(SHY), 관계단절(DSF), 부정적 정서성/신경증(NEGE-r), 내향성/낮은 긍정 정서성(INTR-r) 척도에서 노인 우울장애 집단이 유의미하게 더 높은 점수를 보였다. 반면, 경조증적 상태(RC9) 척도에서는 노인 우울장애 집단이 유의미하게 낮은 것으로 나타났다. 위와 같은 변인들을 대상으로어떠한 변인이 가장 강력하게 두 집단을 구별하여 주는지 살펴보기 위해 로지스틱 회귀 분석을시행하였다. 집단 간 차이를 보인 MMPI-2-RF 변인 중 정서적/내재화 문제(EID), 의기소침(RCd), 경조증적 상태(RC9), 신체적 불편감(MLS), 부정적 정서성/신경증(NEGE-r), 내향성/낮은 긍정적정서성(INTR-r)이 나이, 교육수준을 통제한 이후에도 두 집단을 유의미하게 구별하여 줄 수 있는척도로 확인되었다. 본 연구 결과를 바탕으로 연구의 의의와 제한점이 논의되었다.
- keywords
- Elderly, Depression, MMPI-2-RF, 노인, 우울장애, 다면적 인성검사 II 재구성판
Abstract
The purpose of this study was to investigate the clinical characteristics of elderly depression using MMPI-2-RF. A total of 143 elderly patients with depression and 142 elderly people from MMPI-2 normal population of Korea as controls were used in this study. Our results showed that the followings were significantly higher in the elderly depressed patients compared to normal elderly people: emotional/internalizing dysfunction, demoralization, somatic complaints, low positive emotions, dysfunctional negative emotions, malaise, gastrointestinal complaints, head pain complaints, cognitive complaints, suicidal/death ideation, helplessness/ hopelessness, self-doubt, stress/worry, anxiety, anger proneness, behavior restricting fears, multiple specific fears, shyness, disaffiliativeness, negative emotionality/neuroticism-revised, and the introversion/low positive emotionality revised scale. However hypomanic activation scale was significantly lower in elderly controls. Emotional/internalizing dysfunction, demoralization, hypomanic activation, malaise, negative emotionality/neuroticisim-revised, and introversion/low positive emotionality-revised were proved to be the most significant predictors for distinguishing elderly depressed patients from normal elderly controls. Limitations of this study and directions for future research are also discussed.
- keywords
- Elderly, Depression, MMPI-2-RF, 노인, 우울장애, 다면적 인성검사 II 재구성판
참고문헌
권대훈 (2011). 사회과학 연구를 위한 통계학. 서울 학지사
김재민, 신일선, 윤진상, 이형영 (2001). 지역사회 거주노인의 인지기능에 따른 한국형 노인우울검사의 타당도. 정신의학, 10(2), 126-131.
대한노인정신의학회 (2015). 노인 정신의학. (주)엠엘커뮤니케이션
문경주, 육근영, 한경희, 김지혜 (2015). MMPI-2-RF 척도의 진단적 유용성: 양극성장애, 주요우울장애, 조현병 집단의 비교. 한국심리학회지: 임상, 34(1), 103-125.
안소정, 박은희, 홍나래 (2011). MMPI-2로 살펴본 노인우울증의 임상적 특성. 한국심리학회 추계 학술대회.
전은영, 이동혁, 이정림, 김석현 (2013). 우울장애와 불안장애 환자군의 MMPI-2 특성. 상담학연구, 14(1), 555-572.
정선훈, 이은호, 김지혜, 한경희, 문경주 (2013). MMPI-2-RF 척도의 진단적 유용성: 주요우울장애환자들과 양극성 장애 환자들의 감별. 한국심리학회지: 일반, 32(2), 371-394.
정윤경, 박은희, 전덕인, 석정호, 홍나래 (2009). 임상현장에서 MMPI-2 진단적 유용성: 우울증 환자군과정신분열증 환자군의 비교. 한국심리학회지: 임상, 28(2), 339-362.
정인과, 곽동일, 조숙행, 이현수 (1997). 한국형 노인우울검사(Korean Form of Geriatric Depression Scale, KGDS) 표준화 연구. 노인정신의학, 1(1), 61-72.
최정윤, 정진복 (1991). 우울증 환자의 MMPI 프로파일. 한국심리학회지: 임상, 10(1), 34-41.
통계청(2011. 12. 7). 장래인구추계: 2010년～2060년
한경희, 문경주, 이주영, 김지혜 (2011). 다면적 인성검사 2 재구성판 매뉴얼. 마음사랑.
한준수, 이현수, 이성근, 정인과 (1997). 신체질환이 있는 노인 환자의 우울증상. 노인정신의학, 1(1), 100-111.
Alves, V. d. M., Maia, A. C. C., & Nardi, A. E. (2014). Suicide among elderly: a systematic review. MedicalExpress, 1(1), 9-13.
Arbisi, P. A., Ben-Porath, Y. S., & McNulty, J. L. (2003). Empirical correlates of common MMPI-2two-point codes in male psychiatric inpatients. Assessment, 10(3), 237-247.
Archer, R. P., Griffin, R., & Aiduk, R. (1995). MMPI-2 clinical correlates for ten common codes. Journal of Personality Assessment, 65(3), 391-407.
Association, A. P. (1994). Diagnostic and statistical manual of mental disorders, 4th edn Washington. DC: American Psychiatric Association.
Bagby, R. M., Marshall, M. B., Basso, M. R., Nicholson, R. A., Bacchiochi, J., & Miller, L. S. (2005). Distinguishing bipolar depression, major depression, and schizophrenia with the MMPI-2clinical and content scales. Journal of Personality Assessment, 84(1), 89-95.
Barua, A., Ghosh, M. K., Kar, N., & Basilio, M. A. (2012). Chronic co-morbidities associated with depression in elderly. Annals of Tropical Medicine and Public Health, 5(2), 145-148.
Ben-Porath, Y. S., Butcher, J. N., & Graham, J. R. (1991). Contribution of the MMPI-2 content scales to the differential diagnosis of schizophrenia and major depression. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 3(4), 634-640.
Ben-Porath, Y. S., & Tellegen, A. (2008). MMPI-2-RF, Minnesota Multiphasic Personality Inventory-2 Restructured Form: Manual for Administration, Scoring and Interpretation:University of Minnesota Press.
Brown, R. P., Sweeney, J., Loutsch, E., Kocsis, J., & Frances, A. (1984). Involutional melancholia revisited. The American Journal of Psychiatry. 141(1), 24-28
Brown, T. A., Chorpita, B. F., & Barlow, D. H. (1998). Structural relationships among dimensions of the DSM-IVanxiety and mood disorders and dimensions of negative affect, positive affect, and autonomic arousal. Journal of Abnormal Psychology, 107(2), 179-192.
Butcher, J. N., Dahlstrom, W., Graham, J., Tellegen, A., & Kaemmer, B. (1990). Minnesota multiphasic personality inventory2. Manual for Administration and, 8, 491-499.
Chan, A. C.-M. (1996). Clinical validation of the geriatric depression scale (GDS) Chinese version. Journal of Aging and Health, 8(2), 238-253.
Chan, M. F., & Zeng, W. (2009). Investigating factors associated with depression of older women in Macau. Journal of Clinical Nursing, 18(21), 2969-2977.
Cheng, S.-T., & Chan, A. C. (2007). Withdrawal, apathy and lack of vigor in late life depression:Factorial validity and relationship to diagnosis. Aging and Mental Health, 11(5), 532-537.
Cheng, T. A. (1989). Symptomatology of minor psychiatric morbidity: a crosscultural comparison. Psychological Medicine, 19(3), 697-708.
Cohen, J. (2013). Statistical power analysis for the behavioral sciences: Routledge Academic.
Covinsky, K. E., Cenzer,I. S., Yaffe, K., O'Brien, S., & Blazer, D. G. (2014). Dysphoria and anhedonia as risk factors for disability or death in older persons: implications for the assessment of geriatric depression. The American Journal of Geriatric Psychiatry, 22(6), 606-613.
Dunn, V. K., & Sacco, W. P. (1989). Psychometric evaluation of the Geriatric Depression Scale and the Zung Self-Rating Depression Scale using an elderly community sample. Psychology and Aging, 4(1), 125-126.
Elderkin-Thompson, V., Mintz, J., Haroon, E., Lavretsky, H., & Kumar, A. (2007). Executive dysfunction and memory in older patients with major and minor depression. Archives of Clinical Neuropsychology, 22(2), 261-270.
Ertan, T., & Eker, E. (2000). Reliability, validity, and factor structure of the geriatric depression scale in Turkish elderly: are there different factor structures for different cultures? International Psychogeriatrics, 12(02), 163-172.
Forbey, J. D., & Ben-Porath, Y. S. (2007). A comparison of the MMPI-2 restructured clinical (RC) and clinical scales in a substance abuse treatment sample. Psychological Services, 4(1), 46-58.
Fry, P. (1989). Mediators of perceptions of stress among community-based elders. Psychological Reports, 65(1), 307-314.
George, L. K. (1989). Stress, social support, and depression over the life-course.
Graham, J. R. (1990). MMPI-2: Assessing personality and psychopathology: Oxford University Press New York.
Gurland, B. J. (1976). The comparative frequency of depression in various adult age groups. Journal of Gerontology, 31(3), 283-292.
Haber, J. C., & Baum, L. J. (2014). Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF) Scales as predictors of psychiatric diagnoses. South African Journal of Psychology, 44(4), 439-453.
Handel, R. W., & Archer, R. P. (2008). An investigation of the psychometric properties of the MMPI2 Restructured Clinical (RC) scales with mental health inpatients. Journal of Personality Assessment, 90(3), 239-249.
Herrmann, L. L., Goodwin, G. M., & Ebmeier, K. P. (2007). The cognitive neuropsychology of depression in the elderly. Psychological Medicine, 37(12), 1693-1702.
Husain, M. M., Rush, A. J., Sackeim, H. A., Wisniewski, S. R., McClintock, S. M., Craven, N., & Hauger, R. (2005). Age-related characteristics of depression: a preliminary STAR* D report. The American Journal of Geriatric Psychiatry, 13(10), 852-860.
Husaini, B. A., Moore, S. T., Castor, R. S., Neser, W., Griffin, D., Linn, J. G., & Whitten-stovall, R. (1991). Social density, stressors, and depression:Gender differences among the black elderly. Journal of Gerontology, 46(5), 236-242.
Jacoby, R., Oppenheimer, C., Dening, T., & Thomas, A. (2008). Oxford Textbook of old age psychiatry. Tijdschrift voor Psychiatrie, 50(12), 807-808.
Li, D., Li, X., Liu, W., Qiu, S., & Zeng, W. (2003). The depressive states of the aged population in the elderly centers of Macau. Macau Journal of Nursing, 2(1), 21-23.
Ludvigsson, M., Milberg, A., Marcusson, J., & Wressle, E. (2014). Normal aging or depression? A qualitative study on the differences between subsyndromal depression and depression in very old people. The Gerontologist, Advance online publication. doi:10.1093/geront/gnt162
Mehrotra, S. (2014). Late Life Depression-An Overview. Annals of Geriatric Education and Medical Sciences, 1(1), 16-19.
Moras, K., & Barlow, D. H. (1992). Dimensional approaches to diagnosis and the problem of anxiety and depression. In Anke (Ed);Fiegenbaum, Wolfgang (Ed); Florin, Irmela (Ed);Margraf, Jürgen (Ed), Perspective and promises of clinical psychology(pp. 23-37). New York, NY, US: Plenum Press
Paterniti, S., Verdier-Taillefer, M,-H., Dufouil, C., & Alperovitch, A. (2002). Depressive symptoms and cognitive decline in elderly people Longitudinal study. The British Journal of Psychiatry, 181(5), 406-410.
Rodin, G., & Voshart, K. (1986). Depression in the medically ill: an overview. Am J Psychiatry, 143(6), 696-705.
Rogers, A., Rogers, R. G., & Belanger, A. (1990). Longer life but worse health? Measurement and dynamics. The Gerontologist, 30(5), 640-649.
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2000). Comprehensive textbook of psychiatry 7th ed. Philadelphia: Williams and wilkins.
Sadock, B. J. (2000). Kaplan & Sadock's Comprehensive Textbook of Psychiatry (2Volume Set): Lippincott Williams & Wilkins.
Saz, P., & Dewey, M. E. (2001). Depression, depressive symptoms and mortality in persons aged 65 and over living in the community: a systematic review of the literature. International Journal of Geriatric Psychiatry, 16(6), 622-630.
Schulz, R., Drayer, R. A., & Rollman, B. L. (2002). Depression as a risk factor for non-suicide mortality in the elderly. Biological psychiatry, 52(3), 205-225.
Sellbom, M., Bagby, R. M., Kushner, S., Quilty, L. C., & Ayearst, L. E. (2011). Diagnostic construct validity of MMPI-2 restructured form (MMPI-2-RF) scale scores. Assessment, 19, 176-186.
Sellbom, M., & Ben-Porath, Y. S. (2005). Mapping the MMPI2 Restructured Clinical scales onto normal personality traits: Evidence of construct validity. Journal of Personality Assessment, 85(2), 179-187.
Sellbom, M., Ben-Porath, Y. S., & Bagby, R. M. (2008). On the hierarchical structure of mood and anxiety disorders: confirmatory evidence and elaboration of a model of temperament markers. Journal of Abnormal Psychology, 117(3), 576-590.
Sellbom, M., Graham, J. R., & Schenk, P. W. (2005). Symptom correlates of MMPI-2 scales and code types in a private-practice setting. Journal of Personality Assessment, 84(2), 163-171.
Seo, J., Kim, M., & Kim, J. (2006). Discriminating power of depression of elderly women by arthralgia, physical function and physical self-efficacy. J Korean Acad Psychiatr Ment Health Nurs, 15(3), 237-245.
Sheline, Y. I., Barch, D. M., Garcia, K., Gersing, K., Pieper, C., Welsh-Bohmer, K., & Doraiswamy, P. M. (2006). Cognitive function in late life depression: relationships to depression severity, cerebrovascular risk factors and processing speed. Biological Psychiatry, 60(1), 58-65.
Simms, L. J., Casillas, A., Clark, L. A., Watson, D., & Doebbeling, B. N. (2005). Psychometric evaluation of the restructured clinical scales of the MMPI-2. Psychological Assessment, 17(3), 345-358.
Strohle, A. (2009). Physical activity, exercise, depression and anxiety disorders. Journal of Neural Transmission, 116(6), 777-784.
Tellegen, A. (2003). The MMPI-2 restructured clinical (RC) scales: Development, validation, and interpretation: University of Minnesota Press.
Teng, E., Lu, P. H., & Cummings, J. L. (2007). Neuropsychiatric symptoms are associated with progression from mild cognitive impairment to Alzheimer's disease. Dementia and geriatric cognitive disorders, 24(4), 253-259.
Waern, M., Rubenowitz, E., & Wilhelmson, K. (2003). Predictors of suicide in the old elderly. Gerontology, 49(5), 328-334.
Wygant, D. B., Boutacoff, L. I., Arbisi, P. A.,Ben-Porath, Y. S., Kelly, P. H., & Rupp, W. M. (2007). Examination of the MMPI-2restructured clinical (RC) scales in a sample of bariatric surgery candidates. Journal of Clinical Psychology in Medical Settings, 14(3), 197-205.
Yesavage, J. A., Brink, T., Rose, T. L., Lum, O., Huang, V., Adey, M., & Leirer, V. O. (1983). Development and validation of a geriatric depression screening scale: a preliminary report. Journal of Psychiatric Research, 17(1), 37-49.
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