ISSN : 1229-0688
본 연구의 목적은 사회불안장애 청소년을 대상으로 인지적 내용을 다루는 인지행동치료 프로그램과 인지적 내용과 인지적 과정을 모두 다루는 인지행동치료·주의훈련 프로그램의 효과를 비교하는 것이다. 연구대상은 중학교 1학년 여학생 629명에게 KSAS-A와 SASC-R을 실시하여 각각 상위 10%에 중복 해당하는 56명을 1차 선발한 후 이 중 참가를 희망한 지원자 50명을 2차 선발하고 이들을 대상으로 소아정신과 전문의의 진단면접을 실시하여 사회불안장애 48명을 최종 선정하였다. 이들은 각각 인지행동치료(CBT)집단, 인지행동치료․주의훈련(CBT +AT)집단, 통제집단에 16명씩 무선 배정되었으며, 통제집단을 제외한 두 집단은 각각 2개의 소집단으로 나누어 주 1회 총 12회기 프로그램을 실시하였다. 프로그램 사전과 사후에 세 집단을 대상으로 SASC-R, FNE-B, SFA, 교사용 MESSY를 실시하였으며, 통제집단을 제외한 두 집단에게는 행동과제를 추가 실시하였다. 또한 CBT집단과 CBT+AT집단의 경우 프로그램 6회기 종료 후 중간 평가와 프로그램 종료 6개월 후 추후검사를 각각 실시하였다. 수집된 자료는 one-way ANOVA, 대응 t-test, ANCOVA, Scheffé검증을 사용하여 분석하였다. 연구 결과, 첫째, CBT집단과 CBT+AT집단 모두 사전검사에 비해 사후검사와 추후검사에서 각각 사회불안과 자기초점주의가 유의하게 감소한 반면 사회적 기술은 유의한 향상을 나타냈다. 둘째, 사후검사시 CBT집단과 CBT+AT집단은 통제집단에 비해, CBT+AT집단은 CBT집단에 비해 사회불안과 자기초점주의가 유의하게 낮았다. 셋째, 추후검사시 CBT+AT집단은 CBT집단에 비해 사회불안과 자기초점주의가 유의하게 낮았다.
This study aimed to compare the effects of cognitive-behavioral treatment(CBT) and cognitive-behavioral treatment with attention training(CBT+AT) for adolescents with social anxiety disorder. Both programs consisted of 12 weekly sessions, approximately 1.5-2 hours in duration. Pre-, mid-, post-, and follow-up tests were administered to the CBT group, the CBT+AT group, and/or the control group. The collected data was statistically analyzed through one-way ANOVA, paired t-test, ANCOVA, and Scheffé tests. The results of the study were as follows: 1) For the CBT group and the CBT+AT group, a significant decrease in social anxiety and self-focused attention was marked at the post- and follow-up test stages in relation to the pre-test. 2) In comparison with the CBT group, the CBT+AT group showed a significant decrease in social anxiety and self-focused attention at the post- and follow-up test stages.
김남재, (2005) 관찰자 관점과 자기제시 동기가 사회불안에 미치는 영향, 한국심리학회지 임상
김은정, (2000) 안전행동의 감소가 사회공포증 집단의 불안과 부정적 사고에 미치는 영향, 한국심리학회지:임상
김정민, (2006) 청소년의 사회불안 감소를 위한 인지행동집단상담 프로그램의 효과, 상담학연구
문혜신 ; 오경자, (2002) 한국판 아동청소년용 사회 불안 척도의 타당화 연구, 한국심리학회지 임상
박기환, (2001) 사회공포증의 인지행동집단치료 효과에 대한 연구, 한국심리학회지:임상
박난숙, (1992) Methyphenidate 치료가 주의력 결핍 과잉활동아의 인지,행동 및 사회,학습,정서적 적응에 미치는 효과,
오경자, (2003) 청소년기 사회불안의 발생과 유지의 심리적 기제 II:6개월 추적 조사, 한국심리학회지:임상
이정윤, (1996) 사회불안증에 대한 인지행동치료와 노출치료의 효과연구.미간행,
조용래, (2000) 사회공포증에 대한 집단인지치료의 효과, 한국심리학회지:임상
조용래 ; 이경선 ; 황경남, (2005) 사회불안장애 청소년에 대한 집단인지행동치료 효과의 예비연구, 한국심리학회지 임상
오경자 ; 강지현 ; 하은혜 ; 송동호, (2004) 우울장애와 불안장애 청소년을 위한 집단 인지행동치료 효과의 예비연구, 한국심리학회지 임상
American Psychiatric Association, (2000) Diagnostic and statistical manual of mental disorders, American Psychiatric Press
Albano, A. M., (1995) Cognitive-behavioral group treatment for social phobia in adolescents: A preliminary study, The Journal of Nervous and Mental Disease
Barrett P. M., (1998) Evaluation of Cognitive -Behavioral Group Treatments for Childhood Anxiety Disorders, Journal of Clinical Child Psychology
Barrett, P. M., (1996) Family treatment of childhood anxiety: A controlled trial, Journal of Consulting and Clinical Psychology
Beck, A. T., (1985) Anxiety disorders and phobias: A cognitive perspective, Basic Books
Beidel D. C., (1995) Social phobia, Guilford Press
Beidel, D. C., (1995) A new inventory to assess childhood social anxiety and phobia: The Social Phobia and Anxiety Inventory for Children, Psychological Assessment
Beidel, D. C., (2000) Behavioral treatment of childhood social phobia, Journal of Consulting and Clinical Psychology
Beidel, D. C., (2001) The treatment of childhood social anxiety disorder, Social Anxiety Disorder
B?els, S. M., (2006) Task concentration training versus applied relaxation, in combination with cognitive therapy, for social phobia patients with fear of blushing, trembling, and sweating, Behavior Research and Therapy
B?els, S. M., (1996) Self-consciousness, self-focused attention, blushing propensity and fear of blushing, Personality and Individual Differences
B?els, S. M., (2004) Attention processes in the maintenance and treatment of social phobia: Hypervigilance, avoidance, and self-focused attention, Clinical Psychology Review
B?els, S. M., (1997) Task concentration training and fear of blushing, Journal of Clinical Psychology and Psychotherapy
B?els, S. M., (2006) Mindfulness and task concentration training for social phobia: A pilot study, Journal of Cognitive Psychotherapy
Cartwright-Hatton, S., (2003) Social anxiety in childhood: the relationship with self and observer rated social skills, Journal of Child Psychology and Psychiatry
Clark, D. M., (1999) Anxiety disorders: Why they persist and how to treat them, Behaviour Research and Therapy
Clark, D. M., (1995) A cognitive model of social phobia, The Guilford Press
Costello, E. J., (2003) Prevalence and development of psychiatric disorders in childhood and adolescence, Archives of General Psychiatry
Dewit, D. J., (1999) Antecedents of the risk of recovery from DSM-III-R social phobia, Psychological Medicine
Essau, C. A., (2002) Course and outcome of anxiety disorders in adolescents, Journal of Anxiety Disorders
Essau, C. A., (1999) Frequency and comorbidity of social phobia and social fears in adolescents, Behavior Research and Therapy
Feske, U., (1995) Cognitive behavioral versus exposure only treatment for social phobia: A meta-analysis, Behavior Therapy
Flanery-Schroeder, E. C., (2000) Group and individual cognitive-behavioral treatment for youth with anxiety disorders: A randomized clinical trial, Cognitive Therapy and Research
Friedberg, R. D., (2002) Clinical practice of cognitive therapy with children and adolescents, the Guilford Press
Gallagher, H. M., (2004) A brief group cognitive -behavioral intervention for social phobia in childhood, Journal of Anxiety Disorders
Ginsburg, G. S., (1998) Social anxiety in children with anxiety disorders: Relation with social and emotional functioning, Journal of Abnormal Child Psychology
Hayward, C., (2000) Cognitive -behavioral group therapy for social phobia in female adolescents: Results of a pilot trial, Journal of the American Academy of Child and Adolesce
Heimberg, R. G., (2002) Cognitive -behavioral group therapy for social phobia: Basic mechanisms and clinical strategies, Guilford Press
Hofmann, S. G., (2006) Recent advances in the treatment of social phobia: Introduction to the special issue, Journal of Cognitive Psychotherapy
Inderbitzen, H. M., (1997) The role of social anxiety in adolescent peer relations: Differences among sociometric status groups and rejected subgroups, Journal of Clinical Child Psychology
Kendall, P. C., (1996) Long-term follow-up of a cognitive -behavioral therapy for anxiety-disordered youth, Journal of Consulting and Clinical Psychology
Kendall, P. C., (1997) Therapy for youths with anxiety disorders: A second randomized clinical trial, Journal of Consulting and Clinical Psychology
King, N., (1997) The nature and treatment of social phobia in youth, Counselling Psychology Quarterly
Klein, R. G., (1991) Parent-child agreement in clinical assessment of anxiety and other psychopathology: A review, Journal of Anxiety Disorders
La Greca, A. M., (1993) Social anxiety scale for children-revised: Factor structure and concurrent validity, Journal of Clinical Child Psychology
Masia, C. L., (2001) School-based behavioral treatment for social anxiety disorder in adolescents: Results of a pilot study, Journal of the American Academy of Child and Adolescent Psychiatry
Matson, J. L., (1983) Development of rating scale to measure social skills in children: The Matson evaluation of social skills with youngsters, Behavior Research and Therapy
Morris, T. L., (2004) Social development, Guilford Press
Mulkens, S., (1999) Attentional focus and fear of blushing: A case study, Behavioural and Cognitive Psychotherapy
Mulkens, S., (2001) Fear of blushing: Effects of task concentration training versus exposure in vivo on fear and psychology, Journal of Anxiety Disorders
Muris, P., (2000) Threat perception bias in nonreferred, socially anxious children, Journal of Clinical Child Psychology
Rapee, R. M., (1997) A cognitive-behavioral model of anxiety in social phobia, Behaviour Research and Therapy
Spence, S. H., (1999) Social skills, social outcomes, and cognitive features of childhood social phobia, Journal of Abnormal Psychology
Spence, S. H., (2000) The treatment of childhood social phobia: The effectiveness of a social skills training-based, cognitive -behavioral intervention, with and without parental involvement, Journal of Child Psycho
Stein, M. B., (2001) Bringing up bashful baby: Developmental pathways to social phobia, The Psychiatric Clinics of North America
Stein, M. B., (2001) Social anxiety disorder and the risk of depression, Archives of General Psychiatry
Turner, S. M., (1994) A multicomponent behavioral treatment for social phobia: Social effectiveness therapy, Behavior Research and Therapy
Van Ameringen, M., (2003) The impact of anxiety disorders on educational achievement, Journal of Anxiety Disorders
Wells, A., (1997) Social phobia: A cognitive approach, Wiley
Wells, A., (1998) Social phobia: Effects of external attention on anxiety, negative beliefs, and perspective taking, Behavior Therapy
Wittchen, H. U., (2001) Epidemiology, patterns of comorbidity, and associated disabilities of social phobia, The Psychiatric Clinics of North America
Wittchen, H. U., (1998) Prevalence of mental disorders and psychosocial impairments in adolescents and young adults, Psychological Medicine
Wittchen, H. U., (1999) Social fears and social phobia in a community sample of adolescents and young adults: Prevalence, risk factors and co-morbidity, Psychological Medicine
Woody, S. R., (1997) Self-focused attention in the treatment of social phobia, Behavior Research and Therapy