The Korean Journal of Health Psychology
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- P-ISSN1229-070X
- E-ISSN2713-9581
- KCI
The Sequential Mediating Effect of Self-Silencing and Emotion Dysregulation Between Depression and Disordered Eating Behavior
Abstract
The following study was conducted to identify the linkage of the two pathologies by observing the correlation of the high comorbid rate of depression and disordered eating behavior. The study examines whether self-silencing and emotion dysregulation mediated in a sequential manner in the relationship between depression and disordered eating behavior. For this, 266 participants, 20-30% of whom were female, completed Depression scale(CES-D), The Korean Version of Eating Attitude Test-26(KEAT-26), Silencing-The-Self-Scale(STSS), Difficulties in Emotion Regulation Scale(K-DERS). The data collected was then analyzed using SPSS 24.0 and Process Macro 2.16. The results indicate that self-silencing and emotion dysregulation both mediated the relationship between depression and disordered eating behavior. These findings proved self-silencing and emotion dysregulation as mechanisms linking depression and disordered eating behavior. More so, it was also observed that both self-silencing and emotion dysregulation mediated sequentially. The study suggested that in the case of high level of depression, self-silencing behaviors that suppressed both the thoughts and emotions of the participants, may pose difficulty in controlling emotions and in turn lead to disordered eating behavior. The limitations and implications for future work are also discussed.
- keywords
- Disordered Eating Behavior, Depression, Self-Silencing, Emotion Dysregulation, 이상섭식행동, 우울, 자기침묵, 정서조절곤란
Reference
강미선 (2015). 여자 대학생의 내현적 자기애와 자기침묵이 섭식태도에 미치는 영향. 아동가족치료연구, 13, 1-20.
공성숙 (2009). 섭식장애 환자의 섭식장애 증상, 우울, 강박성이 자해행동에 미치는 영향. 대한간호학회지, 39(4), 459-468.
김시연, 백근영, 서영석 (2010). 대인 성적 대상화 경험과 외모에 대한 사회문화적 기준의 내면화가 섭식장애 증상에 미치는 영향. 한국심리학회지: 여성, 15(4), 613-634.
김혜령 (2016). 대학생의 자기비판적, 의존적 우울취약성과 대인관계문제의 관계: 자기침묵의 매개효과. 이화여자대학교 대학원 석사학위 청구논문.
박민수 (2017). 자기침묵, 분노반추, 스트레스 대처방식및 주관적 웰빙 간의 관계. 삼육대학교 대학원 석사학위 청구논문.
박지현, 공성숙 (2018). 섭식장애 환자의 섭식장애 증상과 우울 간의 관계에서 성인애착의 매개효과. Journal of Korean Academy of Psychiatric and Mental Health Nursing, 27(1), 64-73.
신미영 (1997). 대중매체가 여성의 다이어트와 섭식장애에 영향을 미치는 과정. 강원대학교 대학원 석사학위 청구논문.
양지윤 (2006). 애착유형, 자존감, 자기침묵이 관계만족에 미치는 영향: 성인여성 표본을 대상으로. 이화여자대학교 석사학위 청구논문.
오경자, 정현강 (2008). 이상 섭식 행동에 영향을 주는완벽주의 성향과 정서조절 양식에 대한 연구. 한국심리학회지: 건강, 13(1), 41-55.
이민규, 고영택, 이혜경, 황을지, 이영호 (2001). 한국판식사태도검사-26(Eating Attitude Test-26: KEAT-26)의 타당화. 정신신체의학, 9(2), 153-163.
이민규, 이영호, 박세현, 손창호, 정영조, 홍성국, 윤애리 (1998). 한국판 식사태도검사-26(The Eating Attitude Test-26: KEAT-26)의 표준화연구 I: 신뢰도 및 요인분석. 정신신체의학, 6(2), 155-175.
이유주 (2017). 여대생의 자기불일치와 대인관계문제의관계: 자기침묵의 매개효과. 성신여자대학교 일반대학원 석사학위 청구논문.
이은희 (2012). 자기침묵과 정서표현양가성이 결혼만족및 우울에 미치는 영향. 한국상담대학원 석사학위청구논문.
이현지, 하은혜 (2014). 여고생의 정서조절곤란이 폭식행동에 미치는 영향에서 우울증상의 매개효과. 청소년상담연구, 22(1), 227-246.
전겸구, 최상진, 양병창 (2001). 통합적 한국판 CES-D 개발. 한국심리학회지: 건강, 6(1), 59-71.
조용래 (2007). 정서조절곤란의 평가. 한국심리학회지:임상, 26(4), 1015-1038.
조한비 (2015). 여자 청소년의 우울취약성 성격양식이 섭식태도에 미치는 영향: 정서조절곤란의 매개효과 중심으로. 명지대학교 일반대학원 석사학위 청구논문.
최현정 (2018). 변증법행동치료(DBT)의 근거와 한국 보급: 체계적 문헌 고찰. Korean Journal of Clinical Psychology, 37(3), 443-463.
한국건강보험심사평가원 (2016). 의료통계정보질병, 세분류(4단 상병) 통계 2016년 자료. http://opendata.hira.or.kr/op/opc/olap4thDsInfo.do에서 2018. 10. 10 인출.
한지영, 김정민 (2016). 여자 청소년의 정서조절곤란과우울이 섭식태도에 미치는 영향: 신체질량지수(BMI) 집단별 차이를 중심으로. 인지행동치료, 16(4), 469-488.
Abrams, J. A., Hill, A., & Maxwell, M. (2018). Underneath the mask of the strong black woman schema: Disentangling influences of strength and self-silencing on depressive symptoms among US black women. Sex Roles, 1-10. Retrieved from https://doi.org/10.1007/s11199-018-0956-y
Adetunji, O. J., & Olusola, A. I. (2018). Body image:A global health concerns among girls and women in developing countries. European Journal of Physical Education and Sport Science, 11(4), 76-87.
American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Association.
Baek, S. Y., Park, J. Y., Kim, H. S., & Kim, T. H. (2012). Eating attitudes, depression, parent-child interaction, and family function of adolescent girls. Journal of Korean Academy of Psychiatric Mental Health Nursing, 21, 176-187.
Barlow, D. H., Allen, L. B., & Choate, M. L. (2004). Toward a unified treatment for emotional disorders. Behavior therapy, 35(2), 205-230.
Bennett, J., Greene, G., & Schwartz-Barcott, D. (2013). Perceptions of emotional eating behavior. A qualitative study of college students. Appetite, 60(1), 187-192.
Besser, A., Flett, G. L., & Davis, R. A. (2003). Self-criticism, dependency, silencing the self, and loneliness: A test of a mediational mode l. Personality and Individual Differences, 35, 1735-1752.
Bohr, Y., Garfinkel, P. E., Garner, D. M., & Olmsted, M. P. (1982). The eating attitude test:psychometric features and clinical correlates. Psychological Medicine, 12, 871-878.
Brechan, I., & Kvalem, I. L. (2015). Relationship between body dissatisfaction and disordered eating: Mediating role of self-esteem and depression. Eating Behavior, 17, 49-58.
Buchholz, A., Henderson, K. A., Hounsell, A., Wagner, A., Norris, M., & Spettigue, W. (2007). Self-silencing in a clinical sample of female adolescents with eating disorders. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 16(4), 158-163.
Burton, E., Stice, E., Bearman, S. K., & Rohde, P. (2007). Experimental test of the affect regulation theory of bulimic symptoms and substance use:A randomized trial. International Journal of Eating Disorders, 40(1), 27-36.
Chao, S. Y., Liu, H. Y., Wu, C. Y., Jin, S. F., Chu, T. L., Huang, T. S., & Clark, M. J. (2006). The effects of group reminiscence therapy on depression, self esteem, and life satisfaction of elderly nursing home residents. Journal of Nurshing Research, 14, 36-45.
Chng, S. C., & Fassnacht, D. B. (2016). Parental comments: Relationship with gender, body dissatisfaction, and disordered eating in Asian young adults. Body Image, 16, 93-99.
Crothers, M. (2011). The effects of mutuality patterns on depression, loneliness, shame, Silencingthe-self, relationship satisfaction, and attitudes towards counseling. Doctoral dissertation, University of Nebraska - Lincoln, Nebraska, USA.
Garner, D. M., Olmsted, M. P., Bohr, Y., & Garfinkel, P. E. (1982). The eating attitudes test:psychometric features and clinical correlates. Psychological Medicine, 12(4), 871-878.
Gilligan, C. (1988). Adolescent development reconsidered. In C. Gilligan, J. Ward, & A. J. Tayler (Eds.), Mapping the Moral Domain. (pp. 2-4). Boston: Harvard University Press.
Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of Psychopathology and Behavioral Assessment, 26(1), 41-54.
Harrington, E. F., Crowther, J. H., & Shipherd, J. C. (2010). Trauma, binge eating, and the “strong Black woman”. Journal of Consulting and Clinical Psychology, 78(4), 469-479.
Hayes, A. F. (2015). Process macro를 이용한 매개분석․조절분석 및 조절된 매개분석. (이형권 역). 서울: 신영사. (원전은 2013에 출판)
Heatherton, T. F., & Baumeister, R. F. (1991). Binge eating as escape from self-awareness. Psychological Bulletin, 110(1), 86-108.
Jack, D. C. (1991). Silencing the self: Women and depression. Cambridge: Harvard University Press.
Jack, D. C. (2011). Reflections on the Silencing the Self Scale and its origins. Psychology of Women Quarterly, 35(3), 523–529.
Jack, D. C., & Ali, A. (2010). Silencing the self across cultures: Depression and gender in the social world. Oxford: Oxford University Press.
Jack, D. C., & Dill, D. (1992). The Silencing the Self Scale: Schemas of intimacy associated with depression in women. Psychology of Women Quarterly, 16(1), 97-106.
Joormann, J., & Stanton, C. H. (2016). Examining emotion regulation in depression: A review and future directions. Behaviour Research and Therapy, 86, 35–49.
Kline, R. B. (2011). Principles and practice of structural equation modeling (3rd ed.). New York: Guilford.
Linehan, M. (1993). Cognitive-behavioral treatment for borderline personality disorder. New York:Guilford Press.
Little, K. C., Welsh, D. P., Darling, N., & Holmes, R. M. (2011). “I can’t talk about it:” Sexuality and self-silencing as interactive predictors of depressive symptoms in adolescent dating couples. Journal of Adolescence, 34(4), 789-794.
Locker, T. K., Heesacker, M., & Baker, J. O. (2012). Gender similarities in the relationship between psychological aspects of disordered eating and self-silencing. Psychology of Men & Masculinity, 13(1), 89-105.
Markey, M. A., & Vander Wal, J. S. (2007). The role of emotional intelligence and negative affect in bulimic symptomatology. Comprehensive Psychiatry, 48(5), 458-464.
Morrison, T. G., & Sheahan, E. E. (2009). Gender-related discourses as mediators in the association between internalization of the thin-body ideal and indicants of body dissatisfaction and disordered eating. Psychology of Women Quarterly, 33(4), 374-383.
Nagata, J. M., Garber, A. K., Tabler, J. L., Murray, S. B., & Bibbins-Domingo, K. (2018). Prevalence and correlates of disordered eating behaviors among young adults with overweight or obesity. Journal of General Internal Medicine, 33(8), 1337-1343.
Norwood, S. J., Bowker, A., Buchholz, A., Henderson, K. A., Goldfield, G., & Flament, M. F. (2011). Self-silencing and anger regulation as predictors of disordered eating among adolescent females. Eating Behaviors, 12(2), 112-118.
Oldershaw, A., Lavender, T., & Schmidt, U. (2018). Are socio-emotional and neurocognitive functioning predictors of therapeutic outcomes for adults with anorexia nervosa?. European Eating Disorders Review, 26(4), 346-359.
Patterson, R. E., Wang, K. T., & Slaney, R. B. (2012). Multidimensional perfectionism, depression and relational health in women with eating disturbances. Eating Behaviors, 13(3), 226-232.
Racine, S. E., & Wildes, J. E. (2013). Emotion dysregulation and symptoms of anorexia nervosa:The unique roles of lack of emotional awareness and impulse control difficulties when upset. International Journal of Eating Disorders, 46(7), 713-720.
Racine, S. E., & Wildes, J. E. (2015). Emotion dysregulation and anorexia nervosa: An exploration of the role of childhood abuse. International Journal of Eating Disorders, 48(1), 55-58.
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.
Rommel, D., Nandrino, J. L., Ducro, C., Andrieux, S., Delecourt, F., & Antoine, P. (2012). Impact of emotional awareness and parental bonding on emotional eating in obese women. Appetite, 59(1), 21-26. doi: http://dx.doi.org/10.1016/j.appet. 2012.03.006
Schore, J. R., & Schore, A. N. (2008). Modern attachment theory: The central role of affect regulation in development and treatment. Clinical Social Work Journal, 36(1), 9-20.
Shateri, L., Arani, A. M., Shamsipour, H., Mousavi, E., & Saleck, L. (2018). The Relationship between Emotion Regulation and Intuitive Eating in Young Women. World Family Medicine, 16(2), 179-186.
Shouse, S. H. (2009). Self-silencing, eating behavios, and relationship satisfaction in African-American and White college women. Doctoral dissertation, University of Missouri-Kansas City, Missouri, USA.
Sim, L., & Zeman, J. (2006). The contribution of emotion regulation to body dissatisfaction and disordered eating in early adolescent girls. Journal of Youth and Adolescence, 35(2), 207-216.
Spinazzola, J., Wilson, H. W., & Stocking, V. B. (2002). Dimensions of silencing and resistance in adolescent girls: Development of a narrative method for research and prevention. In L. H. Collins, M. R. Dunlap, & J. C. Chrisler (Eds.), Charting a new course for feminist psychology (pp. 111-138). Westport, CT: Praeger Pub/Greenwood Pub Group.
Stice, E. (2001). A prospective test of the dualpathway model of bulimic pathology: mediating effects of dieting and negative affect. Journal of Abnormal Psychology, 110(1), 124-135.
Striegel-Moore, R. H., Silberstein, L. R., & Rodin, J. (1993). The social self in bulimia nervosa: public self-consciousness, social anxiety, and perceived fraudulence. Journal of Abnormal Psychology, 102, 297-303.
Swanson, S. A., Crow, S. J., Le Grange, D., Swendsen, J., & Merikangas, K. R. (2011). Prevalence and correlates of eating disorders in adolescents: Results from the National Comorbidity Survey Replication Adolescent Supplement. Archives of General Psychiatry, 68(7), 714–723.
Tan, J., & Carfagnini, B. (2008). Self-silencing, anger and depressive symptoms in women: Implications for prevention and intervention. Journal of Prevention & Intervention in the Community, 35(2), 5-18.
Thapliyal, P., Hay, P., & Conti, J. (2018). Role of gender in the treatment experiences of people with an eating disorder: A metasynthesis. Journal of Eating Disorders, 6, 18. Retrieved from https://doi.org/10.1186/s40337-018-0207-1
Tiggemann, M., & Kuring, J. K. (2004). The role of body objectification in disordered eating and depressed mood. British Journal of Clinical Psychology, 43(3), 299-311.
Yan, C. L., Chang, J. C., Weng, S. C., Yeh, M. K., & Yeh, C. B. (2018). The pre-existing depressive disorders, substance use disorders predicted the suicidal death of the patients with eating disorders: A preliminary result of National Health Insurance Research databases in a Chinese population. Neuropsychiatry(London), 8(5), 1622-1629.
Zaitsoff, S. L., Geller, J., & Srikameswaran S. (2002). Sliencing the self and suppressed anger:Relationship to eating disorder symptoms in adolescent females. European Eating Disorders Review, 10, 51-60.
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