open access
메뉴
open access
메뉴
ISSN : 1229-0688
본 연구는 우울경향이 있는 대학생을 대상으로 우울감 개선 및 재발 방지를 위한 자애명상 기반 수용전념치료(ACTLM) 프로그램을 개발하고, 그 효과를 알아보기 위해 수행하였다. 본 연구는 ACT의 핵심요소를 토대로 Germer(2009)의 자애명상과 재양육 요소를 통합하여, 총 8회기 프로그램으로 새롭게 구성하였다. 연구대상은 대학생 378명 중 CES-D에서 우울로 판정되고 연구에 동의한 28명이다. 이들은 프로그램의 실험집단과 1회 심리교육의 통제집단으로 무선 할당되었고, 프로그램 전후 실험연구에 참가하였다. 연구 결과, 실험집단은 통제 집단에 비해 사후 자기보고 측정치에서 우울은 감소하고, 자기자비와 수용행동, 마음챙김, 자아존중감 그리고 심리적 안녕감의 자율성과 개인 성장이 증가한 것으로 나타났다. 다음으로 프로그램이 객관적으로도 우울 재발 방지에 도움이 되는지 알아보기 위해, 우울 자극에 따른 부정 정서의 활성화 정도를 뇌전도(EEG)로 측정하였다. 그 결과 실험집단은 통제집단에 비해 우울 자극에 대해 우반구 전두피질 비대칭 활성화가 낮아, 부정 정서의 활성화 증대를 막는 것으로 나타났다. 이러한 결과는 프로그램 개입이 향후 우울의 재발 가능성을 낮출 수 있음을 시사한다. 마지막으로 본 연구의 임상적 의미와 시사점 및 제한점에 대해 논의하였다.
The current study examined if the ACT program designed based on Loving-kindness Mediation(ACTLM) could reduce the level of depression for depressed students and prevent them from the recurrence of depression. ACTLM were consisted of 8 sessions in which Germer(2006)'s Loving-kindness meditation were focused. Three hundreds forty nine students completed the CES-D. Twenty eighty students were selected according to their scores on CES-D. Participants were randomly assigned to the experimental group(ACTLM) or the control group(education). The result of study showed that participants in the experimental group exhibited more decrease in depression and increase in self-compassion, acceptance, mindfulness, self-esteem and personal growth, self-acceptance among Psychological Well-Being than those in the control group. In particular, students in the experiment group showed less activation on right hemisphere than those in the control group when depressive memory stimulated. Findings in this study suggested that ACTLM could be available for intervention of recurrent depression.
김경의, 이금단, 조용래, 채숙희, 이우경 (2008).한국판 자기-자비 척도의 타당화 연구: 대학생을 중심으로. 한국심리학회지: 건강,13(4), 1023-1044.
김명소, 김혜원, 차경호 (2001). 심리적 안녕감의 구성개념분석: 한국 성인 남녀를 대상으로. 한국심리학회지: 사회 및 성격, 15(2),19-40.
문현미 (2006). 심리적 수용 촉진 프로그램의 개발과 효과: 수용-전념 치료 모델을 중심으로. 가톨릭대학교 대학원 박사학위논문.
박성현 (2006). 마음챙김 척도 개발. 가톨릭대학교 박사학위논문.
오세만, 민경준, 박두병 (1999). 병원 불안-우울척도에 관한 표준화 연구. 신경정신의학,38(2), 289-296.
오제은 (2009). 자기사랑노트. 샨티. p.187-196.
이병주 (2008). 우울증과 자존감의 상관관계 분석을 통한 우울증 치유 연구. 총신대학교 박사학위 논문.
전겸구, 최상진, 양병창 (2001). 통합적 한국판 CES-D 개발. 한국심리학회지: 건강, 6, 59- 76.
전병제 (1974). 자아개념 측정 가능성에 관한연구. 연세논총, 11(1), 107-130.
최승원, 제갈은주, 안창일 (2008). 우울증 환자와 정상인의 전두엽 알파파 비대칭 현상연구. 한국심리학회지: 임상, 27(4), 1053-1069.
Block, B. A. (2002). Acceptance or change of private experienceies: a comparative analysis in college students with public speaking anxiety. Unpublished doctoral dissertation, University at Albany State University of New York.
Bockting, C. L. H., Schene, A. H., Spinhoven, P., & Koeter, M. (2005). Preventiong relapse/ recurrence in recurrent depression with cognitive therapy: a randomized controlled trial. Journal of Consulting and Clinical Psychology, 73, 647-657.
Clark, D., Beck, A. T., & Alford, B. A. (1999). Scientific foundations of cognitive theory and therapy of depression. New York: John Wiley.
Cohen, J. (1988). Statistical power analysis for the behavioral sciences(2nd ed.). Hilsdale, NJ: Lawrence Earlbaum Associates.
Folke, F., Parling, T., & Melin, L. (2012). Acceptance and commitment therapy for depression: a preliminary randomized clinical trial for unemployed on long-term sick leave. Cognitive and Behavioral Practice, 10, 1016- 1032.
Germer, C. K. (2009). The mindful path to self-compassion. New York. Guilford.
Gilbert, P., Procter, S. (2006). Compassionate mind training for people with high shame and self-criticism: Overview and pilot study of a group therapy approach. Clinical Psychology & Psychotherapy, 13, 353-379.
Greco, L. A., Heffner, M., Ritchie, S., Polak, M., & Lynch, S. K. (2005). Maternal adjustment following preterm birth: contribution of experiential avoidance. Behavior Therapy, 36, 177-184.
Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and commitment therapy: model, processes and outcomes. Behaviour Research and Therapy, 44, 1-25.
Hayes, S. C. (2002). Buddhism and acceptance an commitment therapy. Cognitive and Behavioral Practice, 9, 58-66.
Hayes, S. C., Follette, V. M., & Linehan, M. M. (2004). Mindfulness and acceptance, pp1-29. New York: Guilford Press.
Henriques, J. B., & Davidson, R. J. (1991). Left frontal hypoactivation in depression. Journal of abnormal psychology, 100(4), 535-545.
Holahan, C. J., Moos, R. H., Holahan, C. K., Brennan, P. L., & Schutte, K. K. (2005). Stress generation avoidant coping and depressive symptoms: a 10-year model. Journal of Consulting and Clinical Psychology, 73, 658- 666.
IKabat-Zinn. (2006). Coming to our senses. New York. Guilford.
Ingram, R. E. (1984). Toward an informationprocessing analysis of depression. Cognitive Therapy and Research, 8, 443-447.
Ingram, R. E., Miranda, J., & Segal, ZV. (1998). Cognitive vulnerability to depression. New York: Guilford Press.
Jarrett, R. B., Kraft, D., Doyle, J., Foster, B. M., & Silver, P. C. (2001). Preventing recurrent depression using cognitive therapy with and without a continuation phase: a randomized clinical trial. Archives of General Psychiatry, 58(4), 381-395.
Keller, M. B., Lavori, P. W., Mueller, R. M. A., Endicott, J., Coryell. W., & Shea, T. (1992). Time to recovery, chronicity and levels of psychopathology in major depression. Arch Gen Psychiatry, 49: 809-816.
Lau, M. A., Segal, Z. V., & Williams, J. M. G. (2004). Teasdale's differential activation hypothesis: implications for mechanisms of depressive recurrence and suicidal behaviour. Behavior Research and Therapy, 42, 1001-1017.
Neff, K. D. (2003). The development and validation of a scale to measure selfcompassion. Self and Identity, 2(3), 223- 250.
Oquendo, M. A., Kamali, M., Ellis, S. P., Grunebaum, M. F., Malone, K. M., Brodsky, B. S., Sackeim, H. A., & Mann, J. J. (2002) Adequacy of antidepressant treatment after discharge and the occurrence of suicidal acts in major depression. American Journal of Psychiatry, 159, 1746-1751.
Radloff, L. S. (1997). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385-401.
Roemer, L., & Orsillo, S. M. (2007). An open trial of an acceptance-based behavior therapy for generalized anxiety disorder. Behavior Therapy, 6, 67-85.
Rosenberg, M. (1965). Society and the Adolescent Self-Image. Princeton, NJ: Princeton University Press.
Ruiz, F. J. (2010). A review of acceptance and commitment therapy empirical evidence: correlational, experimental psychopathology, component and outcome studies. International Journal of Psychology and Psychological Therapy, 20, 125-162.
Ryff, C. D. (1989). Happiness is everything, or is it? Explorations on the meaning of psychological well-being. Journal of Personality and Social Psychology, 57(6), 1069-1081.
Schaffer, C. E., Davidson, R. J., & Saron, C. (1983). Frontal and parietal electroencephalogram asymmetry in depressed and nondepressed subjects. Biological Psychiatry, 18(7), 753-762.
Segal, V. Z., Williams, G. J. M., & Teasdale, D. J. (2002). 마음챙김 명상에 기초한 인지치 료: 우울증 재발방지를 위한 새로운 치료법. 이우경, 조선미, 황태연 공역. 학지사
Strosahl, K. D., & Robinson, P. J. (2008). The mindfulness and acceptance workbook for depression. New Harbinger.
Sussman, S. (2001). Handbook of program development for health behavior research and practice. Oaks: Sage Publication.
Takahashi, M., Muto, T., Tada, M., & Sugiyama, M. (2002). Acceptance rationale and increasing pain tolerance: acceptance-based and fear-based practice. Japanese Journal of Behavior Therapy, 28, 35-46.
Teasdale, J. D. (1988). Cognitive vulnerability to persistent depression. Cognition & Emotion, 2, 247-274.
Twonhig, M. P., Hayes, S. C., & Masuda, A. (2006). Increasing willigness to experience obsessions: acceptance and commitment therapy as a treatment for obsessive-compulsive disorder. Behavior Therapy, 37, 3-13.
Vittengl, J. R., Clark L. A., Dunn, T. W., & Jarrett, R. B. (2007). Reducing relapse and recurrence in unipolar depression: a comparative met-analysis of cognitive-behavioral therapy's effects. Journal of Consulting and Clinical Psychology, 75(3), 475-488.
Zettle, R. D. (2007). ACT for depression: a clinician's guide to using acceptance and commitment therapy in treating depression. Oakland, CA: New Harnbinger
Zettle, R. D., & Rains, J. C. (1989). Group cognitive and contextual therapies in treatment of depression. Journal of Clinical Psychology, 45, 438-445.
Zigmond, A. S., & Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand, 67(6), 361-370.