통증위협 상황에서 반추유형에 따른 주의편향과 회피행동
Differential Effects of Types of Rumination on Attentional Bias and Avoidance Behavior in the Face of Pain-Related Threat
조성근 (충남대학교)
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초록
일반적으로 통증위협을 느낄 경우, 통증 관련 자극에 주의편향을 보이거나 활동을 회피함으로써 부적응적인 결과를 초래하는 것으로 알려져 있다. 손상된 주의이탈 모형에 따르면, 반추유형은 수심과 숙고로 구분된다. 수심의 경우, 주의와 목표활동을 방해하여 부적응적 결과를, 숙고의 경우, 적응적 결과를 초래할 수 있다고 제안했다. 이에 이 연구에서는 반추유형을 조작하여 통증위협 상황에서 주의편향과 회피행동의 변화를 실험적으로 검증하고자 했다. 대전광역시 소재 대학교에 재학 중인 건강한 대학생 남녀 84명을 모집하여 통증위협 수준(고, 저) × 반추유형(수심적 사고, 숙고적 사고)에 따라 4개의 집단 중 하나에 무작위 배정한 후 실험을 실시했다. 실험 결과, 첫째, 첫 고정지속시간의 경우 통증위협, 반추유형, 통증단어유형 간 상호작용이 유의하지 않았다. 둘째, 전반적인 응시시간의 경우 통증위협 수준에 상관없이 수심적 사고 집단은 숙고적 사고 집단보다 통증관련 단어에 비해 중립단어에 응시하는 시간이 더 길었다. 셋째, 회피행동의 경우 통증위협이 높을 때 수심적 사고 집단은 숙고적 사고 집단보다 전기가 흐를 것으로 예상되는 금속 패드에 손을 대는 데 까지 걸린 시간이 더 길었던 반면에, 통증위협이 낮을 때는 집단 간 유의한 차이가 없었다. 이러한 결과는 수심 및 숙고적 사고가 주의편향과 회피행동의 변화에 중요한 요인일 수 있음을 시사한다.
- keywords
- 통증위협, 반추유형, 주의편향, 회피행동, 안구추적, pain threat, types of rumination, attentional bias, avoidance behavior, eye-tracking
Abstract
Generally, it has been known that threat of pain can lead to adverse consequences through bias toward pain-related stimuli or avoidance behavior. According to the impaired-disengagement model, rumination comprises brooding and reflection. The model suggest that brooding would interfere with attention and goal activity, resulting in maladaptive consequences, but reflection would result in adaptive consequences. In this study, we examined the changes in attentional bias and avoidance behavior in the face of pain-related threat by manipulating the types of rumination. A total of 84 college students in Daejeon were recruited and randomly assigned to one of four groups according to the threat of pain (high, low) * types of rumination (brooding, reflection). Results showed that for first fixation duration, there was no significant interaction among pain threats, types of rumination, and types of pain words. For dwell time, regardless of pain threats, the brooding group gazed at neutral words longer than pain-related words, compared to the reflection group. Also, the brooding group took longer to touch the metal pad, which was expected to emit electricity, than the reflection group, when the threat of pain was high, while there was no significant difference between the groups when the threat of pain was low. These results suggest that brooding and reflection may be crucial factors for changes in attentional bias and avoidance behavior.
- keywords
- 통증위협, 반추유형, 주의편향, 회피행동, 안구추적, pain threat, types of rumination, attentional bias, avoidance behavior, eye-tracking
참고문헌
김분옥, 김기성, 신대용, 조성근 (2019). 통증 두려움과회피행동의 관계에 금전동기가 미치는 영향. 스트레스硏究, 27(1), 117-124.
김소정, 김지혜, 윤세창. (2010). 한국판 반추적 반응 척도(K-RRS)의 타당화 연구. Korean Journal of Clinical Psychology, 29(1), 1-19.
김정택, 신동균. (1978). STAI 의 한국표준화에 관한 연구. 최신의학, 21(11), 69-75.
이유빈, 조성근. (2019). 통증 위협이 회피행동에 미치는영향: 사회적 지지의 조절효과. 스트레스硏究, 27(1), 125-131.
이현희, 김은정, 이민규. (2003). 한국판 정적 정서 및부적 정서 척도(Positive Affect and Negative Affect Schedule; PANAS)의 타당화 연구. Korean Journal of Clinical Psychology, 22(4), 935-946.
이효진. (2011). 자기불일치과 반추, 반성적 정서처리가수치심에 미치는 영향. 가톨릭대학교 대학원 석사학위 청구논문.
진병주, 조성근. (2018). 통증위협과 주의편향 간의 관계에서 자아고갈이 미치는 효과: 안구운동 추적 연구. 한국심리학회지: 건강, 23(4), 963-979.
Adler, A. D., Conklin, L. R., & Strunk, D. R. (2013). Quality of coping skills predicts depressive symptom reactivity over repeated stressors. Journal of Clinical Psychology, 69(12), 1228-1238.
Bastian, B., Jetten, J., Hornsey, M. J., & Leknes, S. (2014). The positive consequences of pain: A biopsychosocial approach. Personality and Social Psychology Review, 18(3), 256-279.
Barber, J. P., & DeRubeis, R. J. (1992). The ways of responding: A scale to assess compensatory skills taught in cognitive therapy. Behavioral Assessment, 14(1), 93-115.
Boston, A., & Sharpe, L. (2005). The role of threat-expectancy in acute pain: Effects on attentional bias, coping strategy effectiveness and response to pain. Pain, 119(1-3), 168-175.
Burwell, R. A., & Shirk, S. R. (2007). Subtypes of rumination in adolescence: Associations between brooding, reflection, depressive symptoms, and coping. Journal of Clinical Child and Adolescent Psychology, 36(1), 56-65.
Crombez, G., Eccleston, C., Van Damme, S., Vlaeyen, J. W., & Karoly, P. (2012). Fear-avoidance model of chronic pain: The next generation. The Clinical Journal of Pain, 28(6), 475-483.
Crombez, G., Van Ryckeghem, D. M., Eccleston, C., & Van Damme, S. (2013). Attentional bias to pain-related information: A meta-analysis. Pain, 154(4), 497-510.
De Vlieger, P., Crombez, G., & Eccleston, C. (2006). Worrying about chronic pain. An examination of worry and problem solving in adults who identify as chronic pain sufferers. Pain, 120(1), 138-144.
Eccleston, C., Crombez, G., Aldrich, S., & Stannard, C. (2001). Worry and chronic pain patients: A description and analysis of individual differences. European Journal of Pain, 5(3), 309-318.
Ehlers, A., & Clark, D. M. (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy, 38(4), 319-345.
Eisma, M. C., Schut, H. A., Stroebe, M. S., van den Bout, J., Stroebe, W., & Boelen, P. A. (2014). Is rumination after bereavement linked with loss avoidance? Evidence from eye-tracking. PloS one, 9(8), e104980.
Erber, R., & Wegner, D. M. (1996). Ruminations on the rebound. Advances in Social Cognition, 9, 73-79.
Fashler, S. R. (2014). More than meets the eye:Visual attention biases in individuals with chronic pain. Journal of Pain Research, 19(7), 557-570.
Foti, D., & Hajcak, G. (2010). State sadness reduces neural sensitivity to nonrewards versus rewards. Neuroreport, 21(2), 143-147.
Gaffiero, D., Elander, J., & Maratos, F. A. (2019). Do individuals with chronic pain show attentional bias to pain-related information? An early stage systematic review of the eye-tracking evidence. Cognitive Psychology Bulletin, 4, 37-45.
García-Blanco, A., Salmerón, L., & Perea, M. (2017). Inhibitory control for emotional and neutral scenes in competition: An eye-tracking study in bipolar disorder. Biological Psychology, 127, 82-88.
Koster, E. H., De Lissnyder, E., Derakshan, N., & De Raedt, R. (2011). Understanding depressive rumination from a cognitive science perspective:The impaired disengagement hypothesis. Clinical Psychology Review, 31(1), 138-145.
Lautenbacher, S., Huber, C., Schöfer, D., Kunz, M., Parthum, A., Weber, P. G., Roman, C., Griessinger, N., & Sittl, R. (2010). Attentional and emotional mechanisms related to pain as predictors of chronic postoperative pain: A comparison with other psychological and physiological predictors. Pain, 151(3), 722-731.
Leeuw, M., Goossens, M. E., Linton, S. J., Crombez, G., Boersma, K., & Vlaeyen, J. W. (2007). The fear-avoidance model of musculoskeletal pain:Current state of scientific evidence. Journal of Behavioral Medicine, 30(1), 77-94.
Lyubomirsky, S., & Nolen-Hoeksema, S. (1993). Self-perpetuating properties of dysphoric rumination. Journal of Personality and Social Psychology, 65(2), 339.
Lyubomirsky, S., & Nolen-Hoeksema, S. (1995). Effects of self-focused rumination on negative thinking and interpersonal problem solving. Journal of Personality and Social Psychology, 69(1), 176-190.
Lyubomirsky, S., & Tucker, K. L. (1998). Implications of individual differences in subjective happiness for perceiving, interpreting, and thinking about life events. Motivation and Emotion, 22(2), 155-186.
Marroquín, B. M., Fontes, M., Scilletta, A., & Miranda, R. (2010). Ruminative subtypes and coping responses: Active and passive pathways to depressive symptoms. Cognition and Emotion, 24(8), 1446-1455.
Mauss, I., Bunge, S., & Gross, J. (2007). Automatic emotion regulation. Social and Personality Psychology Compass, 1(1), 146-167.
Michael, T., Halligan, S. L., Clark, D. M., & Ehlers, A. (2007). Rumination in posttraumatic stress disorder. Depression and Anxiety, 24(5), 307-317.
Mogg, K., Bradley, B., Miles, F., & Dixon, R. (2004). Brief report time course of attentional bias for threat scenes: testing the vigilance‐avoidance hypothesis. Cognition and Emotion, 18(5), 689-700.
Nijs, J., Van de Putte, K., Louckx, F., Truijen, S., & De Meirleir, K. (2008). Exercise performance and chronic pain in chronic fatigue syndrome: The role of pain catastrophizing. Pain Medicine, 9(8), 1164-1172.
Nolen-Hoeksema, S., & Morrow, J. (1991). A prospective study of depression and posttraumatic stress symptoms after a natural disaster: The 1989 Loma Prieta Earthquake. Journal of Personality and Social Psychology, 61(3), 115-121.
Nolen-Hoeksema, S., & Morrow, J. (1993). Effects of rumination and distraction on naturally occurring depressed mood. Cognition and Emotion, 7(6), 561-570.
Notebaert, L., Tilbrook, M., Clarke, P. J., & MacLeod, C. (2017). When a bad bias can be good:Anxiety-linked attentional bias to threat in contexts where dangers can be avoided. Clinical Psychological Science, 5(3), 485-496.
Olatunji, B. O., Armstrong, T., McHugo, M., & Zald, D. H. (2013). Heightened attentional capture by threat in veterans with PTSD. Journal of Abnormal Psychology, 122(2), 397-405.
Pierce, W. D., & Cheney, C. D. (2008). Behavior analysis and learning, (4th ed.) New York, NY, US: Psychology Press.
Roelofs, J., Peters, M. L., Zeegers, M. P., & Vlaeyen, J. W. (2002). The modified Stroop paradigm as a measure of selective attention towards pain related stimuli among chronic pain patients: a meta‐analysis. European Journal of Pain, 6(4), 273-281.
Schoth, D. E., Nunes, V. D., & Liossi, C. (2012). Attentional bias towards pain-related information in chronic pain; A meta-analysis of visual-probe investigations. Clinical Psychology Review, 32(1), 13-25.
Sharpe, L. (2014). Attentional biases in pain: More complex than originally thought? Pain, 155(3), 439-440.
Sharpe, L., Ianiello, M., Dear, B. F., Perry, K. N., Refshauge, K., & Nicholas, M. K. (2012). Is there a potential role for attention bias modification in pain patients? Results of 2 randomised, controlled trials. Pain, 153(3), 722-731.
Sharpe, L., Johnson, A., & Dear, B. F. (2015). Attention bias modification and its impact on experimental pain outcomes: Comparison of training with words versus faces in pain. European Journal of Pain, 19(9), 1248-1257.
Spielberger, C. D., Gorsuch, R. L., & Lushene, R. E. (1970). Manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press.
Stroebe, M., Boelen, P. A., Van Den Hout, M., Stroebe, W., Salemink, E., & Van Den Bout, J. (2007). Ruminative coping as avoidance. European Archives of Psychiatry and Clinical Neuroscience, 257(8), 462-472.
Sullivan, M. J., Sullivan, M. E., & Adams, H. M. (2002). Stage of chronicity and cognitive correlates of pain-related disability. Cognitive Behaviour Therapy, 31(3), 111-118.
Sullivan, M. J., Thorn, B., Haythornthwaite, J. A., Keefe, F., Martin, M., Bradley, L. A., & Lefebvre, J. C. (2001). Theoretical perspectives on the relation between catastrophizing and pain. The Clinical Journal of Pain, 17(1), 52-64.
Szasz, P. L. (2011). The role of irrational beliefs, brooding and reflective pondering in predicting distress. Journal of Cognitive and Behavioral Psychotherapies, 11(1), 43-55.
Tripp, D. A. (2001). Pain catastrophizing in athletic individuals: Scale validation and clinical application.
Treynor, W., Gonzalez, R., & Nolen-Hoeksema, S. (2003). Rumination reconsidered: A psychometric analysis. Cognitive Therapy and Research, 27(3), 247-259.
Trull, T. J., & Ebner-Priemer, U. W. (2009). Using experience sampling methods/ecological momentary assessment (ESM/EMA) in clinical assessment and clinical research: Introduction to the special section. Psychological Assessment, 21(4), 457-462.
Turner, J. A., Holtzman, S., & Mancl, L. (2007). Mediators, moderators, and predictors of therapeutic change in cognitive behavioral therapy for chronic pain. Pain, 127(3), 276-286.
Vervoort, T., Trost, Z., Prkachin, K. M., & Mueller, S. C. (2013). Attentional processing of other’s facial display of pain: An eye tracking study. Pain, 154(6), 836-844.
Vlaeyen, J. W., & Linton, S. J. (2000). Fearavoidance and its consequences in chronic musculoskeletal pain: A state of the art. Pain, 85(3), 317-332.
Watkins, E., Scott, J., Wingrove, J., Rimes, K., Bathurst, N., Steiner, H., Kennell-Webb S., Moulds M., & Malliaris, Y. (2007). Ruminationfocused cognitive behaviour therapy for residual depression: A case series. Behaviour Research and Therapy, 45(9), 2144-2154.
Watkins, E., & Teasdale, J. D. (2001). Rumination and overgeneral memory in depression: Effects of self-focus and analytic thinking. Journal of Abnormal Psychology, 110(2), 353-357.
Watkins, E., & Teasdale, J. D. (2004). Adaptive and maladaptive self-focus in depression. Journal of Affective Disorders, 82(1), 1-8.
Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54(6), 1063-1070.
Wenzlaff, R. M., & Wegner, D. M. (2000). Thought suppression. Annual Review of Psychology, 51(1), 59-91.
Yang, Z., Jackson, T., Gao, X., & Chen, H. (2012). Identifying selective visual attention biases related to fear of pain by tracking eye movements within a dot-probe paradigm. Pain, 153(8), 1742-1748.
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