바로가기메뉴

본문 바로가기 주메뉴 바로가기

The Korean Journal of Health Psychology

  • KOREAN
  • P-ISSN1229-070X
  • E-ISSN2713-9581
  • KCI

The Relationships between Internalized Shame and Suicidal Ideation: Dual Mediating Effects of Anger Suppression and Depression among College Students

The Korean Journal of Health Psychology / The Korean Journal of Health Psychology, (P)1229-070X; (E)2713-9581
2018, v.23 no.1, pp.209-230
https://doi.org/10.17315/kjhp.2018.23.1.011


Abstract

The purpose of this study was to explore the dual mediating effects that are characteristic of anger suppression and the associated effects of depression, in the relationship between internalized shame and suicidal ideation among college students. For this purpose, a comprehensive questionnaire survey was conducted on 422 college students as participants in the study, located in Gyeonggi and Busan, South Korea. The participants therefore completed The Internalized Shame Scale (ISS), State-Trait Anger Expression Inventory (STAXI-K), Korean CES-D, and the Suicidal Ideation Questionnaire (SIQ) for purposes of this study. Chiefly, in order to analyze the dual mediating effects, a structural equation modeling was conducted by the use of the AMOS 18.0 programs. Overall, the results of this study were as follows: First, the associated anger suppression as noted in the participants had a partial mediating effect between internalized shame and the incidence of depression. Second, it was noted that the depression experienced in the participants had a partial mediating effect between internalized shame and suicidal ideation. Third, the incidence of depression had a mediating effect as associated between anger suppression and suicidal ideation. Finally, the effect of internalized shame as experienced by the student participants surveyed had both noted direct and indirect effects on suicidal ideation via the incidence of anger suppression and depression. That is, we are confident to note that a partial dual mediation model fit the data well in this case. These results of this study suggest that anger suppression and depression sequentially mediate the relationship between the idea of internalized shame and suicidal ideation among college students. In conclusion, the noted limitations of this study and suggestions for future studies were discussed.

keywords
내면화된 수치심, 분노억제, 우울, 자살사고, 이중매개효과, Internalized Shame, Anger Suppression, Depression, Suicidal Ideation, Dual Mediating Effects

Reference

1.

강민철, 조현주, 이종선 (2013). 우울, 불안, 수치심, 자살사고에 대한 잠재프로파일분석. 한국심리학회지:상담 및 심리치료, 25(4), 873-896.

2.

고은영 (1997). 분노 표현 방식과 분노 표현의 적절성이 우울에 미치는 영향. 가톨릭대학교 석사학위 청구논문.

3.

김신연, 채규만 (2013). 대학생의 생활스트레스가 자살사고에 미치는 영향: 지각된 사회적 지지와 삶의 의미의 조절효과. 인간이해, 34(1), 1-13.

4.

김영석 (2008). 완벽주의, 수치심, 우울과의 관계. 서강대학교 교육대학원 석사학위 청구논문.

5.

김용태 (2010). 사회-심리적 특성으로서 수치심의 이해와 해결. 상담학연구, 11(1), 59-73.

6.

김태훈 (2016). 한국인들의 수치심에 내재된 유교 문화적 특성 분석. 한국초등도덕교육학회 하계학술발표논문집, 2016, 814-824.

7.

박경 (2004). 부정적 생활스트레스와 우울과의 관계: 문제해결과 완벽주의의 중재효과와 매개효과. 한국심리학회지: 건강, 9(2), 265-283.

8.

박광배 (2000). 다차원척도법. 서울: 교육과학사.

9.

박보람, 양난미 (2012). 대학생의 사회적으로 부과된 완벽주의와 학업적 지연행동의 관계. 한국심리학회지:일반, 31(2), 541-561.

10.

박승일, 이동귀 (2014). 군 초급간부의 직무만족, 직무스트레스, 분노표현, 우울, 무망감이 자살생각에 미치는 영향. 한국심리학회지: 상담 및 심리치료, 26(2), 545-571.

11.

서미순 (2005). 청소년 자살사고에 영향을 미치는 심리사회적 요인들에 관한 연구. 경남대학교 행정대학원 석사학위 청구논문.

12.

송동호, 이홍식, 전여숙, 정유숙 (1996). 청소년 자살기도자의 정신의학적 특성. 신경정신의학, 35(6), 1366-1375.

13.

신민섭 (1992). 자살기제에 대한 실증적 연구: 자기도피척도의 타당화. 연세대학교 박사학위 청구논문.

14.

심종온, 이영호 (2000). 수치심 경향성, 죄책감 경향성 및 사건귀인이 우울증상에 미치는 영향. 한국심리학회지: 임상, 19(3), 485-499.

15.

조채희 (2011, 4, 11). 대학생 자살 연 230명. 심리상담강화 추진. 연합뉴스. http://www.yonhapnews.co.kr/society/2011/04/11/0703000000AKR20110411103900004.HTML에서 2017, 11, 20 인출.

16.

윤태림 (1986). 한국인의 성격. 서울: 동방도서.

17.

이인숙, 최해림 (2005). 내면화된 수치심 척도(Iss)의 타당화 연구-애착, 과민성 자기애, 외로움과의 관계. 한국심리학회지: 상담 및 심리치료, 17(3), 651-670.

18.

이종은, 최동원, 임정혜 (2013). 중학생의 분노, 우울과 자살생각에 관한 예측모형. 한국학교보건학회지, 26(2), 72-80.

19.

이진, 송미경 (2017). 대학생의 내면화된 수치심과 우울의 관계. 한국심리학회지: 상담 및 심리치료, 29(2), 409-428.

20.

이현지, 김명희 (2007). 대학생의 자아정체감과 무망감, 우울, 자살사고의 관계에 관한 연구. 청소년학연구, 14(3), 243-264.

21.

이혜선, 육성필, 배진화, 안창일 (2008). 이론 및 개관연구: 자살관련행동의 명명과 분류. 한국심리학회지:일반, 27(2), 331-349.

22.

이혜선, 김성연, 박일, 강여정, 이지영, 권정혜 (2012). 대학생의 자살관련생각과 행동의 원인 및 자살을 선택하지 않은 이유. 한국심리학회지: 상담 및 심리치료, 24(3), 703-728.

23.

임혜령, 이영순 (2017). 내면화된 수치심과 분노표현양식의 관계에서 고통감내력의 매개효과. 한국심리학회지: 상담 및 심리치료, 29(1), 159-178.

24.

장혜주, 임지영 (2011). 초등학교 저학년 아동의 분노표현방식 유형에 관한 연구: Q 방법론 적용. Family and Environment Research, 49(4), 11-23.

25.

전겸구, 최상진, 양병창 (2001). 통합적 한국판 Ces-d 개발. 한국심리학회지: 건강, 6(1), 59-76.

26.

정은영, 신희천 (2014). 수치심 경험이 우울에 미치는영향: 자기수용의 조절효과. 상담학연구, 15(1), 183-194.

27.

정해숙, 정남운 (2011). 대학생의 완벽주의와 분노표현양식의 관계에서 내면화된 수치심의 매개효과. 인간이해, 32(2), 89-107.

28.

조성진, 전홍진, 김무진, 김장규, 김선욱, 류인균, 조맹제 (2001). 한국 도시지역 청소년의 우울증상의 유병률과 관련요인에 대한 연구. 신경정신의학, 40(4), 627-639.

29.

조영희, 정남운 (2016). 성인애착, 기본 심리적 욕구 만족, 내면화된 수치심이 분노 표현 방식에 미치는 영향. 한국심리학회지: 상담 및 심리치료, 28(1), 169-190.

30.

조화진, 서영석 (2011). 성인애착과 심리적 디스트레스의 관계: 부적응적 완벽주의와 기본 심리적 욕구만족의 매개효과. 한국심리학회지: 상담 및 심리치료, 23(2), 471-490.

31.

최임정, 심혜숙 (2010). 대학생의 내면화된 수치심과 분노표현양식이 대인관계문제에 미치는 영향. 한국심리학회지: 상담 및 심리치료, 22(2), 479-492.

32.

통계청 (2017). 2016년 사망원인통계. https://kostat.go.kr/portal/korea/kor_nw/2/6/2/index.board?bmode=read&aSeq=363268 에서 2017, 11, 20 인출.

33.

하정희, 안성희 (2008). 대학생들의 자살생각에 영향을 미치는 요인들: 스트레스, 대처방식, 완벽주의, 우울, 충동성의 구조적 관계모형 검증. 한국심리학회지: 상담 및 심리치료, 20(4), 1149-1171.

34.

하은혜, 이선희, 유은승, 김종흔, 강한성, 노정실, 이근석 (2011). 유방암 환자의 화병과 우울증상의 관계. 한국심리학회지: 여성, 16(1), 115-133.

35.

한덕웅, 전겸구, 이장호 (1997). 한국판 Staxi 척도 개발:분노와 혈압. 한국심리학회지: 건강, 2(1), 60-78.

36.

한주연, 박경 (2011). 대학생의 부적응적 완벽주의와 우울과의 관계에서 수치심과 인지적 정서조절 전략의 매개효과. 청소년학연구, 18(9), 169-188.

37.

한지윤 (2007). 고등학생의 분노표현방식이 우울 및 자기효능감에 미치는 영향. 한국외국어대학교 교육대학원 석사학위 청구논문.

38.

허준수 (2004). 지역사회거주 노인들의 생활만족도에 관한 연구. 노인복지연구, 24, 127-151.

39.

홍세희 (2000). 구조 방정식 모형의 적합도 지수 선정기준과 그 근거. 한국심리학회지: 임상, 19(1), 161-177.

40.

Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010). Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical Psychology Review, 30(2), 217-237.

41.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, 5th edition. Washington. DC: American Psychiatric Association.

42.

Ayyash-Abdo, H. (2002). Adolescent suicide: An ecological approach. Psychology in the Schools, 39(4), 459-475.

43.

Baumeister, R. F. (1990). Suicide as escape from self. Psychological Review, 97(1), 90-113.

44.

Bonner, R. L., & Rich, A. R. (1987). Toward a predictive model of suicidal ideation and behavior:Some preliminary data in college students. Suicide and Life-Threatening Behavior, 17(1), 50-63.

45.

Bradshaw, J. (2005). Healing the shame that binds you: Recovery classics edition. Florida: Health Communications, Inc.

46.

Bryan, C. J., Morrow, C. E., Etienne, N., & Ray-Sannerud, B. (2013). Guilt, shame, and suicidal ideation in a military outpatient clinical sample. Depression and Anxiety, 30(1), 55-60.

47.

Cook, D. R. (1987). Measuring shame: The internalized shame scale. Alcoholism Treatment Quarterly, 4(2), 197-215.

48.

Cook, D. R. (2001). Internalized shame scale:Technical manual. New York: Multi Health System Inc.

49.

Cooper, J., Appleby, L., & Amos, T. (2002). Life events preceding suicide by young people. Social Psychiatry and Psychiatric Epidemiology, 37(6), 271-275.

50.

Daniel, S. S., Goldston, D. B., Erkanli, A., Franklin, J. C., & Mayfield, A. M. (2009). Trait anger, anger expression, and suicide attempts among adolescents and young adults: A prospective study. Journal of Clinical Child & Adolescent Psychology, 38(5), 661-671.

51.

Dumais, A., Lesage, A., Alda, M., Rouleau, G., Dumont, M., Chawky, N., ... Turecki, G. (2005). Risk factors for suicide completion in major depression: A case-control study of impulsive and aggressive behaviors in men. American Journal of Psychiatry, 162(11), 2116-2124.

52.

Fortuna, L. R., Perez, D. J., Canino, G., Sribney, W., & Alegria, M. (2007). Prevalence and correlates of lifetime suicidal ideation and suicide attempts among latino subgroups in the united states. The Journal of Clinical Psychiatry, 68(4), 572-581.

53.

Foster, T. (2003). Suicide note themes and suicide prevention. The International Journal of Psychiatry in Medicine, 33(4), 323-331.

54.

Goldney, R., Winefield, A., Saebel, J., Winefield, H., & Tiggeman, M. (1997). Anger, suicidal ideation, and attempted suicide: A prospective study. Comprehensive Psychiatry, 38(5), 264-268.

55.

Goodwin, R. D., & Hamilton, S. P. (2003). Lifetime comorbidity of antisocial personality disorder and anxiety disorders among adults in the community. Psychiatry Research, 117(2), 159-166.

56.

Goss, K., Gilbert, P., & Allan, S. (1994). An exploration of shame measures—I: The other as shamer scale. Personality and Individual Differences, 17(5), 713-717.

57.

Gross, J. J. (1998). Antecedent-and response-focused emotion regulation: divergent consequences for experience, expression, and physiology. Journal of Personality and Social Psychology, 74(1), 224-237.

58.

Ha, F. I. (1995). Shame in Asian and Western cultures. American Behavioral Scientist, 38(8), 1114-1131.

59.

Harburg, E., Blakelock Jr, E. H., & Roeper, P. J. (1979). Resentful and reflective coping with arbitrary authority and blood pressure: Detroit. Psychosomatic Medicine, 41(3), 189-202.

60.

Harwood, D., & Jacoby, R. (2000). Suicidal behaviour among the elderly. In Hawton. K. & Van Heeringen, K. (Eds.), The International Handbook of Suicide and Attempted Suicide (pp. 275-292). New York: John Wiley & Sons, Ltd.

61.

Hawton, K. & Van Heeringen, K. (2009). Suicide. The Lancet, 373(9672), 1372-1381.

62.

Johnson, E. H. (1984). Anger and anxiety as determinants of elevated blood pressure in adolescents: The tampa Study. Doctoral dissertation. University of South Florida, USA.

63.

Joiner, T. E. (2005). Why people die by suicide. Cambridge, MA: Harvard University Press.

64.

Jöreskog, K. G., & Sörbom, D. (1993). LISREL 8:Structural equation modeling with the SIMPLIS command language. Hillsdale, NJ: Erlbaum.

65.

Kaufman, G. (1989). The psychology of shame: Theory and treatment of shame-based syndromes. New York: Springer Publishing Company Inc.

66.

Kim, J., Talbot, N. L., & Cicchetti, D. (2009). Childhood abuse and current interpersonal conflict: The role of shame. Child Abuse &Neglect, 33(6), 362-371.

67.

Kuo, W., Gallo, J. J., & Tien, A. (2001). Incidence of suicide ideation and attempts in adults: The 13-year follow-up of a community sample in baltimore. Psychological Medicine, 31(07), 1181-1191.

68.

Leaviss, J. & Uttley, L. (2015). Psychotherapeutic benefits of compassion-focused therapy: An early systematic review. Psychological medicine, 45(5), 927-945.

69.

Lee, Z. N. (1999). Korean culture and sense of shame. Transcultural Psychiatry, 36(2), 181-194.

70.

Lee, J., Choi, H., Kim, M. J., Park, C. G., & Shin, D. S. (2009). Anger as a predictor of suicidal ideation in middle-school students in Korea:Gender difference in threshold point. Adolescence, 44(174), 433-446.

71.

Lester, D. (1992). Why people kill themselves: A 1990s summary of research findings on suicidal behavior. Illinois: Charles C Thomas, Publisher.

72.

Lester, D. (1997). The role of shame in suicide. Suicide and Life-Threatening Behavior, 27(4), 352-361.

73.

Lester, D. (2000). Shame and suicide: A case study. Death Studies, 24(2), 157-162.

74.

Lester, D., & Miller, C. (1990). Depression and suicidal preoccupation in teenagers. Personality and Individual Differences, 11(4), 421-422.

75.

Lewis, H. B. (1971). Shame and guilt in neurosis. Psychoanalytic Review, 58(3), 419-438.

76.

Lynch, T. R., Cheavens, J., Morse, J. Q., & Rosenthal, M. (2004). A model predicting suicidal ideation and hopelessness in depressed older adults: The impact of emotion inhibition and affect intensity. Aging & Mental Health, 8(6), 486-497.

77.

Newman, L. S., Duff, K. J., & Baumeister, R. F. (1997). A new look at defensive projection:Thought suppression, accessibility, and biased person perception. Journal of Personality and Social Psychology, 72(5), 980-1001.

78.

Van Orden, K. A., Witte, T. K., Cukrowicz, K. C., Braithwaite, S. R., Selby, E. A., & Joiner, T. E. (2010). The interpersonal theory of suicide. Psychological Review, 117(2), 575.

79.

Organization for Economic Cooperation and Development. (2017). Health at a Glance 2017:OECD Indicators. Retrieved from http://dx.doi.org/10.1787/health_glance-2017-en.

80.

Orth, U., Berking, M., & Burkhardt, S. (2006). Self-conscious emotions and depression:Rumination explains why shame but not guilt is maladaptive. Personality & Social Psychology Bulletin, 32(12), 1608-1619.

81.

Painuly, N., Sharan, P., & Mattoo, S. K. (2007). Antecedents, concomitants and consequences of anger attacks in depression. Psychiatry Research, 153(1), 39-45.

82.

Pirkis, J., Burgess, P., & Dunt, D. (2000). Suicidal ideation and suicide attempts among australian adults. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 21(1), 16-25.

83.

Radloff, L. S. (1977). The CES-D scale a self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3), 385-401.

84.

Reynolds, W. M. (1987). Suicidal ideation questionnaire (SIQ). Florida: Psychological Assessment Resources.

85.

Russell, D. W., Kahn, J. H., Spoth, R., & Altmaier, E. M. (1998). Analyzing data from experimental studies: A latent variable structural equation modeling approach. Journal of Counseling Psychology, 45(1), 18-29.

86.

Seligman, M. (1975). Helplessness: On depression, development, and death. A series of books in psychology. New York: WH Freeman/Times Books/Henry Holt & Co.

87.

Seligman, M. E. P., Walker, E. F., & Rosenhan, D. L. (2001). Abnormal Psychology. New York: Norton.

88.

Shneidman, E. S. (1984). Aphorisms of suicide and some implications for psychotherapy. American Journal of Psychotherapy, 38(3), 319-328.

89.

Shrout, P. E. & Bolger, N. (2002). Mediation in experimental and nonexperimental studies: New procedures and recommendations. Psychological Methods, 7(4), 422-445.

90.

Soloff, P. H., Lynch, K. G., Kelly, T. M., Malone, K. M., & Mann, J. J. (2000). Characteristics of suicide attempts of patients with major depressive episode and borderline personality disorder: A comparative study. American Journal of Psychiatry, 157(4), 601-608.

91.

Solomon, E. P. (1987). An examination of personality characteristics and coping mechanisms identified as Risk Factors for cancer. Doctoral dissertation. University of South Florida, USA.

92.

Spielberger, C. D. (1985). Assessment of state and trait anxiety: Conceptual and methodological issues. Southern Psychologist, 2(4), 6-16.

93.

Spielberger, C. D., Krasner, S. S., & Solomon, E. P. (1988). The experience, expression, and control of anger. In Janisse, M. P. (Ed.), Health psychology:Individual differences, stress, and health psychology (pp. 89-108). New York: Springer-Verlag.

94.

Tangney, J. P., Wagner, P., Fletcher, C., & Gramzow, R. (1992). Shamed into anger? the relation of shame and guilt to anger and self-reported aggression. Journal of Personality and Social Psychology, 62(4), 669-675.

95.

Wang, M., Richard Lightsey, O., Pietruszka, T., Uruk, A. C., & Wells, A. G. (2007). Purpose in life and reasons for living as mediators of the relationship between stress, coping, and suicidal behavior. The Journal of Positive Psychology, 2(3), 195-204.

96.

Wegner, D. M., & Erber, R. (1992). The hyperaccessibility of suppressed thoughts. Journal of Personality and Social Psychology, 63(6), 903-912.

97.

Wegner, D. M., Schneider, D. J., Carter, S. R., & White, T. L. (1987). Paradoxical effects of thought suppression. Journal of Personality and Social Psychology, 53(1), 5-13.

98.

White, J. L. (1989). The troubled adolescent. New York: Pergamon Press.

99.

Wiklander, M., Samuelsson, M., & Åsberg, M. (2003). Shame reactions after suicide attempt. Scandinavian Journal of Caring Sciences, 17(3), 293-300.

100.

Wiklander, M., Samuelsson, M., Jokinen, J., Nilsonne, Å., Wilczek, A., Rylander, G., & Åsberg, M. (2012). Shame-proneness in attempted suicide patients. BMC Psychiatry, 12(1), 50-58.

101.

Wong, T., & Tsai, J. (2007). Cultural models of shame and guilt. In Tracy, J. L., Robins, R. W., & Tangney, J. P. (Eds.), The self-conscious emotions: Theory and research (pp. 209-223). New York: Guilford Press.

102.

Wong, Y. J., Kim, B. S., Nguyen, C. P., Cheng, J. K. Y., & Saw, A. (2014). The Interpersonal Shame Inventory for Asian Americans: Scale development and psychometric properties. Journal of Counseling Psychology, 61(1), 119-132.

103.

Yang, S., & Rosenblatt, P. C. (2001). Shame in Korean families. Journal of Comparative Family Studies, 32(3), 361-375.

104.

Zane, N., & Ku, H. (2014). Effects of ethnic match, gender match, acculturation, cultural identity, and face concern on self-disclosure in counseling for Asian Americans. Asian American Journal of Psychology, 5(1), 66-74.

The Korean Journal of Health Psychology