ISSN : 1229-0688
본 연구는 청소년의 섭식장애와 가족기능과의 상관관계를 알아보고자 하였다. 내담자의 가족기능에 대한 내담자 및, 상담자의 관점 그리고 외부관찰자의 상호작용 관찰을 조사 비교하여 섭식장애와의 연관성에 대해 검토해 보았다. 연구 결과, 가족의 기능에 대한 내담자의 주관적인 평가와 상담자의 평가가 전반적으로 유의미한 상관관계가 있는 것으로 나타났다. 내담자 가족 기능에 대한 상담자의 평가는 외부 관찰자의 상호작용분석을 통한 평가와는 다소 적은 연관성을 나타내 보였다. 반면에 내담자 자신이 평가한 가족의 기능정도와 외부관찰자의 평가는 가장 적은 상관관계를 가지는 것으로 나타났다. 내담자의 전반적인 심리적 부적응 정도와 가족의 역기능 정도는 상담자와 외부평가자 관점 모두에서 정적인 상관관계를 가짐을 보여 주었다. 그러나 내담자의 신체에 대한 부정적인 태도와 가족의 역기능 사이의 상관관계는 분명하게 드러나지 않았다. 폭식증의 경우, 가족기능에 대한 내담자의 주관적인 평가와 상담자의 평가는 내담자의 폭식증 증상의 정도와 상관관계를 보이지 않았다. 그러나 외부관찰자에 의한 상호작용에서는 둘 사이의 상관관계가 나타났다. 즉, 폭식증 내담자 가족의 상호작용이 대인 경계가 부적절하고 감정표현이 격렬하며 가족의 밀착이 약할수록, 내담자는 체중을 줄이고 칼로리를 적게 섭취하려고 하는 반 조정 행동의 경향을 심하게 보였다. 거식증에 있어서는 가족기능에 대한 내담자 평가와 상담자의 평가가 모두 거식증 정도와 정적인 상관관계가 있는 것으로 나타났다. 또 외부관찰자에 의한 상호작용 관찰에서 가족의 밀착이 강하고 갈등회피 경향이 강하며 부정적 감정의 표현이 적을수록 거식증 내담자의 증상은 심하게 나타났다. 본 연구의 결과는 섭식 장애 내담자의 가족 관계가 다양한 관점과 접근 방법을 통해 통합적으로 측정되어져야 함을 시사하며 나아가 섭식장애의 유형에 따른 가족 역동적 관계변인이 상담 및 치료에 고려되어야 함을 제안하고 있다.
In this survey, the relationship between eating disorders and family functioning were examined. At first the views of family functioning are examined how they differ between patients, clinical raters and observers. These different perspectives were related to each other and to the extent of eating disorders. The subjective view of patients agreed with the outsider view of the clinical rater to a high degree. The outside estimate of the clinical rater matched only moderately the estimate of the family interaction by observers. The subjective view of patients towards their families also agreed with the view of the observers of the interaction to a small extent. The assumed connection between the psychological impairment of patients and negative family relationships showed up in all perspectives. The expected connection between the disturbed attitudes of patients to their body and the negative family relationship and/or family interactions is not shown clearly. Neither the bulimic patients nor the family relationships estimated negatively by the clinical rater indicated connections of the bulimic symptoms. During the interaction observation, however, connections could be determined. The following three dimensions of family interaction correlate with the severity of bulimic symptoms: The greater family members exceed interpersonal boundaries, the more violent the emotional expression and the lower the family cohesion, the stronger the tendency for counter measures to be used by the bulimic patients. In the anorectic group the expected connections between the family estimates showed up in evaluations by the patients as well as by the clinical raters and the symptom severity for the anorexia. In the interaction observation the anorexic group showed that the stronger the family cohesion, where conflict is avoided and little negative emotion is expressed, the more severe are the anorexic symptoms shown by the patients.
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