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ACOMS+ 및 학술지 리포지터리 설명회

  • 한국과학기술정보연구원(KISTI) 서울분원 대회의실(별관 3층)
  • 2024년 07월 03일(수) 13:30
 

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DSM 진단기준의 충족 여부 및 사건의직, 간접 경험 여부에 따른 심리적 기능의 차이

Differences in psychological functioning associated with a traumatic event based on DSM diagnosis (criterion vs. non-criterion) and types of exposure (direct vs. indirect)

초록

본 연구에서는 일반 성인이 경험한 외상사건의 유형을 DSM 진단기준의 충족 여부와 사건의 직, 간접 경험 여부에 따라 분류하여 심리적 기능의 차이를 파악하고자 하였다. 이를 위해 전국에 거주하는 성인 1,000명을 대상으로 자료를 수집하여 분석이 가능한 828명의 자료를 구조방정식 모형을 통해 분석하였다. 연구결과, 직접경험사건이 간접경험사건보다 PTSD 증상의 하위요인인 과각성, 심리적 디스트레스, 정서조절곤란의 증상이 더 높은 것으로 나타났고, 삶의 만족도는 낮은 것으로 나타났다. 진단기준-직접경험사건은 비진단기준-간접경험사건보다 PTSD 증상의 하위요인인 과각성, 회피, 침습과 심리적 디스트레스, 정서조절곤란을 더 많이 유발하는 것으로 나타났으나, 삶의 만족도에서는 차이가 확인되지 않았다. 또한, 진단기준-직접경험사건은 진단기준-간접경험사건보다 심리적 디스트레스를 더 유발하는 것으로 나타났다. 또 다른 결과에서는 비진단기준-직접경험사건은 비진단기준-간접경험사건보다 PTSD 증상의 하위요인인 과각성, 회피와 심리적 디스트레스, 정서조절곤란을 더 많이 유발하고, 삶의 만족도는 더 낮은 것으로 나타났다. 또한, 비진단기준-직접경험사건은 진단기준-간접경험사건보다 삶의 만족도가 더 낮은 것으로 확인되었다. 연구결과를 토대로 논의 및 시사점을 제시하였다.

keywords
adult, criterion event, non-criterion event, directly experienced event, indirectly experienced event, posttraumatic stress disorder, psychological distress, emotion regulation difficulties, life satisfaction, 성인, 진단 및 비진단기준사건, 직간접경험사건, PTSD 하위요인, 심리적 디스트레스, 정서조절곤란, 삶의 만족도

Abstract

Differences in psychological functioning associated with a traumatic event were examined via structural equation modeling based on two criteria: 1) whether the traumatic event meets DSM criteria (i.e., criterion vs. non-criterion), and 2) types of exposure to a traumatic event (direct vs. indirect). 828 adults participated, and focus was given to four psychological functionings: hyperarousal, psychological distress, emotional regulation difficulties, and life satisfaction. Results indicate that direct traumatic experience shows greater relevance to higher level hyperarousal, psychological distress, emotional regulation difficulties, and lower life satisfaction both in criterion and non-criterion groups. However, when associated with DSM diagnosis, the impact of direct exposure was not clear in terms of life satisfaction. For example, no difference in life satisfaction was identified between criterion direct exposure and non-criterion indirect exposure, while non-criterion direct exposure still showed lower life satisfaction as compared to non-criterion indirect exposure. Implication and future research direction were further discussed.

keywords
adult, criterion event, non-criterion event, directly experienced event, indirectly experienced event, posttraumatic stress disorder, psychological distress, emotion regulation difficulties, life satisfaction, 성인, 진단 및 비진단기준사건, 직간접경험사건, PTSD 하위요인, 심리적 디스트레스, 정서조절곤란, 삶의 만족도

참고문헌

1.

김자혜, 김정규 (2013). 경찰공무원의 외상사건 유형과 PTSD 증상의 관계: 스트레스 대처양식의 조절효과. 한국경찰연구, 12(3), 27- 50.

2.

배병렬 (2007). AMOS 7에 의한 구조방정식모델링: 원리와 실제. 서울: 청람.

3.

배병렬 (2009). Amos 17.0 구조방정식 모델링. 서울: 도서출판 청람

4.

보건복지부 (2017. 4. 13). 2016년 정신질환실태조사. http://www.mohw.go.kr/front_new/jb/sjb030301vw.jsp 에서 자료 얻음.

5.

서영석, 박지수, 조아라 (2015). 대규모 외상사건으로 인한 임상적 장애 및 증상 관련 평가도구 개관. 상담학연구, 16(3), 557- 580.

6.

서영석, 조화진, 안하얀, 이정선 (2012). 청소년들의 외상사건 경험. 교육심리연구, 26(3), 78-816.

7.

서울경제 (2017. 4. 12). 우리나라 성인 25%는 정신질환 겪은 적 있다. https://www.sedaily.com/NewsView/1OEM9LVKQO 에서 검색

8.

손승희 (2014). 사회적 사건에 의한 청소년의 간접외상 및 관련요인 연구. 청소년학연구, 21(10), 269-294.

9.

유현경 (2011). 외상 경험자의 자기노출과 소외감에 관한 연구: 우울 집단과의 비교를 중심으로. 이화여자대학교 대학원 석사학위논문.

10.

은헌정, 권태완, 이선미, 김태형, 최말례, 조수진 (2005). 한국판 사건충격척도 수정판의 신뢰도 및 타당도 연구. 신경정신의학, 44(3), 303-310.

11.

이동훈, 김지윤, 이덕희, 강민수 (2018). DSM 진단기준과 대인 및 비대인 외상사건에 따른 성인의 PTSD 증상, 심리적 디스트레스, 정서조절곤란의 차이. 한국심리학회지: 상담 및 심리치료, 30(3), 741-773.

12.

이수아 (2016). 고등학생의 간접 외상 수준에 따른 사회적 관심, 정서표현, 정서인식의 차이: 세월호 사건을 중심으로. 한국교원대학교 교육대학원 석사학위논문.

13.

정의문 (2015). 매체노출이 대학생들에게 미친 간접 외상에 대한 연구-외상관련 부정적 신념과 회복탄력성을 조절변인으로-. 대구대학교 대학원 석사학위논문.

14.

조명한, 차경호 (1998). 삶의 질에 대한 국가 간 비교. 서울: 집문당.

15.

조용래 (2007). 정서조절곤란의 평가. Korean Journal of Clinical Psychology, 26(4), 1015-1038.

16.

최강록 (2015). 한국판 개정판 일생 스트레스 사건 체크리스트의 신뢰도 및 타당도: 불안 장애 및 우울장애 외래 환자 대상. 한양대학교 대학원 석사학위논문.

17.

홍세희 (2000). 구조 방정식 모형의 적합도 지수 선정기준과 그 근거. Korean Journal of Clinical Psychology, 19(1), 161-177.

18.

홍세희 (2017). 구조방정식 모형의 다양한 확장. 서울: 박영사.

19.

홍세희, 황매향, 이은설 (2005). 청소년용 여성 진로장벽 척도의 잠재평균분석. 교육심리연구, 19(4), 1159-1177.

20.

American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Association.

21.

Anders, S. L., Frazier, P. A., & Frankfurt, S. B. (2011). Variations in Criterion A and PTSD rates in a community sample of women. Journal of Anxiety Disorders, 25(2), 176-184.

22.

Anders, S. L., Frazier, P. A., & Shallcross, S. L. (2012). Prevalence and effects of life event exposure among undergraduate and community college students. Journal of Counseling Psychology, 59(3), 449-457.

23.

Avina, C., & O’Donahue, W. (2002). Sexual harassment and PTSD: Is sexual harassment diagnosable trauma. Journal of Traumatic Stress, 15(1), 69-75.

24.

Baschnagel, J. S., Gudmundsdottir, B., Hawk, L. W., & Beck, J. G. (2009). Post-trauma symptoms following indirect exposure to the September 11th terrorist attacks: The predictive role of dispositional coping. Journal of Anxiety Disorders, 23(7), 915-922.

25.

Bedard-Gilligan, M., & Zoellner, L. A. (2008). The utility of the A1 and A2 criteria in the diagnosis of PTSD. Behaviour Research and Therapy, 46(9), 1062-1069.

26.

Besser, A., & Neria, Y. (2009). PTSD symptoms, satisfaction with life, and prejudicial attitudes toward the adversary among Israeli civilians exposed to ongoing missile attacks. Journal of Traumatic Stress, 22(4), 268-275.

27.

Bodkin, J. A., Pope, H. G., Detke, M. J., & Hudson, J. I. (2007). Is PTSD caused by traumatic stress?. Journal of Anxiety Disorders, 21(2), 176-182.

28.

Bokszczanin, A. (2007). PTSD symptoms in children and adolescents 28 months after a flood: Age and gender differences. Journal of Traumatic Stress, 20(3), 347-351.

29.

Breslau, N., & Davis, G. C. (1987). Posttraumatic stress disorder: The stressor criterion. The Journal of Nervous and Mental Disease, 175(5), 255-264.

30.

Breslau, N., Kessler, R. C., Chilcoat, H. D., Schultz, L. R., Davis, G. C., & Andreski, P. (1998). Trauma and posttraumatic stress disorder in the community: the 1996 Detroit Area Survey of Trauma. Archives of general psychiatry, 55(7), 626-632.

31.

Brewin, C. R., Andrews, B., & Rose, S. (2000). Fear, helplessness, and horror in posttraumatic stress disorder: Investigating the DSM-IV Criterion A2 in victims of violent crime. Journal of Traumatic Stress, 13(3), 499-509.

32.

Browne, M. W., & Cudeck, R. (1993). Alternative ways of assessing model fit. In K. A. Bollen & J. S. Long (Eds.), Testing structural equation models (pp. 136-162). Newbury Park, CA: Sage.

33.

Burnam, M. A., Stein, I A., Golding, J. M., Siegel, J. M., Sorenson, S. B., Forsythe, A. B., & Telles, C. A. (1988). Sexual assault and mental disorders in a community population. Journal of Consulting and Clinical Psychology, 56(6), 843-850.

34.

Calhoun, L. G., & Tedeschi, R. G. (1999). Facilitating posttraumatic growth: A clinician's guide. Mahwah, NJ: Lawrence Erlbaum Associates.

35.

Chard, K. M. (2005). An evaluation of cognitive processing therapy for the treatment of posttraumatic stress disorder related to childhood sexual abuse. Journal of Consulting and Clinical Psychology, 73(5), 965-971.

36.

Chou, C. P., & Bentler, P. M. (1995). Estimates and tests in structural equation modeling. In R. H. Hoyle (Eds.), Structural equation medeling: Concepts, issues, and applications(pp. 37-54). Thousand Oaks, CA:Sage.

37.

Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd edn.). Hillsdale, NJ: Erlbaum,

38.

Costello, E. J., Erkanli, A., Fairbank, J. A., & Angold, A. (2002). The prevalence of potentially traumatic events in childhood and adolescence. Journal of Traumatic Stress, 15(2), 99-112.

39.

Derogatis, L. R. (1993). The Brief Symptom Inventory (BSI): Administration, scoring and procedures manual-3. 1993. Mineapolis: National Computer Systems.

40.

Derogatis, L. R. (2000). BSI-18: Brief Symptom Inventory 18, Administration. Scoring, and Procedures Manual. Minneapolis, MN, USA: National Computer Systems Pearson, INC.

41.

De Vries, G. J., & Olff, M. (2009). The lifetime prevalence of traumatic events and posttraumatic stress disorder in the Netherlands. Journal of traumatic stress, 22(4), 259-267.

42.

Diener, E. D., Emmons, R. A., Larsen, R. J., & Griffin, S. (1985). The satisfaction with life scale. Journal of personality assessment, 49(1), 71-75.

43.

Diener, E., Suh, E. N., Lucas, R. E., & Smith, H. L. (1999). Subjective well-being: Three decades of progress. Psychological Bulletin, 125(2), 276- 302

44.

Ehring, T., & Quack, D. (2010). Emotion regulation difficulties in trauma survivors:the role of trauma type and PTSD symptom severity. Behavior Therapy, 41(4), 587-598.

45.

Elhai, J. D., Frueh, B. C., Gold, P. B., Gold, S. N., & Hamner, M. B. (2000). Clinical presentations of posttraumatic stress disorder across trauma populations: acomparison of MMPI-2 profiles of combat veterans and adult survivors of childsexual abuse. The Journal of Nervous and Mental Disease, 188(10), 708-713.

46.

Frazier, P., Anders, S., Perera, S., Tomich, P., Tennen, H., Park, C., & Tashiro, T. (2009). Traumatic events among undergraduate students: Prevalence and associated symptoms. Journal of Counseling Psychology, 56(3), 450.

47.

Galea, S., & Resnick, H. (2005). Posttraumatic stress disorder in the general population after mass terrorist incidents: considerations about the nature of exposure. CNS spectrums, 10(2), 107-115.

48.

Galea, S., Vlahov, D., Resnick, H., Ahern, J., Susser, E., Gold, J., ..., & Kilpatrick, D. (2003). Trends of probable post-traumatic stress disorder in New York City after the September 11 terrorist attacks. American Journal of Epidemiology, 158(6), 514-524.

49.

Grattan, L. M., Roberts, S., Mahan Jr, W. T., McLaughlin, P. K., Otwell, W. S., & Morris Jr, J. G. (2011). The early psychological impacts of the Deepwater Horizon oil spill on Florida and Alabama communities. Environmental Health Perspectives, 119(6), 838-843.

50.

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.

51.

Green, B. L., Goodman, L. A., Krupnick, J. L., Corcoran, C. B., Petty, R. M., Stockton, P., & Stern, N. M. (2000). Outcomes of single versus multiple trauma exposure in a screening sample. Journal of traumatic stress, 13(2), 271- 286.

52.

Green, B. L., Korol, M., Grace, M. C., Vary, M. G., Leonard, A. C., Gleser, G. C., & Smitson-Cohen, S. (1991). Children and disaster: Age, gender, and parental effects on PTSD symptoms. Journal of the American Academy of Child & Adolescent Psychiatry, 30(6), 945-951.

53.

Green, B. L., & Solomon, S. D. (1992). Mental health effects of natural and human-made disasters. National Emergency Training Center.

54.

Gold, S. D., Marx, B. P., Soler-Baillo, J. M., & Sloan, D. M. (2005). Is life stress more traumatic than traumatic stress. Journal of anxiety disorders, 19(6), 687-698.

55.

Hancock, G. R. (1997). Structural equation modeling methods of hypothesis testing of latent variable means. Measurement and Evaluation in Counseling and Development, 30(2), 91-105.

56.

Herman, J. L. (1992). Trauma and recovery. New York: Basic Books.

57.

Holmes, E. A., Creswell, C., & O’Connor, T. G. (2007). Posttraumatic stress symptoms in London school children following September 11, 2001: An exploratory investigation of peri-traumatic reactions and intrusive imagery. Journal of Behavior Therapy and Experimental Psychiatry, 38(4), 474-490.

58.

Hong, S., Malik, M. L., &Lee, M. K. (2003). Testing configural, metric, scalar, and latent mean invariance across genders in sociotropy and autonomy using a non-Western sample. Educational and psychological measurement, 63(4), 636-654.

59.

Horowitz, M., Wilner, N., & Alvarez, W. (1979). Impact of Event Scale: a measure of subjective stress. Psychosomatic medicine, 41(3), 209-218.

60.

Kelley, L. P., Weathers, F. W., McDevitt-Murphy, M. E., Eakin, D. E., & Flood, A. M. (2009). A comparison of PTSD symptom patterns in three types of civilian trauma. Journal of Traumatic Stress, 22(3), 227-235.

61.

Kelloway, E. K. (1998). Using LISREL for structural equation Modeling. Thousand Oaks: Sage Publications.

62.

Kilpatrick, D. G., Resnick, H. S., Freedy, J. R., Pelcovitz, D., Resick, P., Roth, S., et al. (1998). Posttraumatic stress disorder field trial: Evaluation of the PTSD construct-Criteria A through E. In T. A. Widiger, A. J. Frances, H. A. Pincus, R. Ross, M. B. First, W. Davis, et al. (Eds.), DSM-IV sourcebook (Vol. 4, pp. 803-844). Washington, DC: American Psychiatric Association.

63.

Kristensen, P., Weisæth, L., & Heir, T. (2009). Psychiatric disorders among disaster bereaved: an interview study of individuals directly or not directly exposed to the 2004 tsunami. Depression and anxiety, 26(12), 1127-1133.

64.

Long, M. E., Elhai, J. D., Schweinle, A., Gray, M. J., Grubaugh, A. L., & Frueh, B. C. (2008). Differences in posttraumatic stress disorder diagnostic rates and symptom severity between Criterion A1 and non-Criterion A1 stressors. Journal of anxiety disorders, 22(7), 1255-1263.

65.

Micale, M. S., & Lerner, P. (2001). Traumatic Pasts. Cambridge: Cambridge University Press.

66.

Mol, S. S., Arntz, A., Metsemakers, J. F., Dinant, G. J., Vilters-van Montfort, P. A., & Knottnerus, J. A. (2005). Symptoms of post-traumatic stress disorder after non-traumatic events: evidence from an open population study. The British Journal of Psychiatry, 186(6), 494-499.

67.

Morrison, J. (2014). DSM-5® Made Easy: The Clinician's Guide to Diagnosis. Guilford Publications.

68.

Neria, Y., Nandi, A., & Galea, S. (2008). Post-traumatic stress disorder following disasters: a systematic review. Psychological medicine, 38(4), 467-480.

69.

Rasmussen, A., Smith, H., & Keller, A. S. (2007). Factor structure of PTSD symptoms among west and central African refugees. Journal of Traumatic Stress, 20(3), 271-280.

70.

Rubonis, A. V., & Bickman, L. (1991). Psychological impairment in the wake of disaster: The disaster-psychopathology relationship. Psychological bulletin, 109(3), 384-399.

71.

Russell, D. W., Kahn, J. H., Spoth, R, & Altmaier, E. M. (1998). Analyzing data from experimental studies: A latent variable structural equation modeling approach. Journal of Counseling Psychology, 45(1), 18-29.

72.

Schlenger, W. E., Caddell, J. M., Ebert, L., Jordan, B. K., Rourke, K. M., Wilson, D., ..., & Kulka, R. A. (2002). Psychological reactions to terrorist attacks: findings from the National Study of Americans' Reactions to September 11. Jama, 288(5), 581-588.

73.

Silver, R. C., Holman, E. A., McIntosh, D. N., Poulin, M., & Gil-Rivas, V. (2002). Nationwide Longitudinal study of psychological responses to September 11. Journal of the American Medical Association, 288(10), 1235- 1244.

74.

Smith, D. W., Christiansen, E. H., Vincent, R., & Hann, N. E. (1999). Population effects of the bombing of Oklahoma City. The Journal of the Oklahoma State Medical Association, 92(4), 193-198.

75.

Spitzer, C., Abraham, G., Reschke, K., Michels, F., Siebel, U., & Freyberger, H. J. (2000). Posttraumatic stress disorder following high and low‐magnitude stressors in psychotherapeutic inpatients. Clinical Psychology & Psychotherapy, 7(5), 379-384.

76.

Staudinger, U. M., Fleeson, W., & Baltes, P. B. (1999). Predictors of subjective physical health and global well-being: Similarities between the United States and Germany. Journal of Personality and Social Psychology, 76(2), 305-319.

77.

Suvak, M., Maguen, S., Litz, B. T., Silver, R. C., & Holman, E. A. (2008). Indirect exposure to the September 11 terrorist attacks: does symptom structure resemble PTSD?. Journal of traumatic stress, 21(1), 30-39.

78.

Tedeschi, R. G., & Calhoun, L. G. (2004). Posttraumatic growth: Conceptual foundations and empirical evidence. Psychological Inquiry, 15(1), 1-18.

79.

Tolin, D. F., & Foa, E. B. (2006). Sex differences in trauma and posttraumatic stress disorder: a quantitative review of 25 years of research. Psychological bulletin, 132(6), 959.

80.

Torres, L., Driscoll, M. W., & Voell, M. (2012). Discrimination, acculturation, acculturative stress, and Latino psychological distress: A moderated mediational model. Cultural Diversity and Ethnic Minority Psychology, 18(1), 17.

81.

Tull, M. T., Barrett, H. M., McMillan, E. S., & Roemer, L. (2007). A preliminary investigation of the relationship between emotion regulation difficulties and posttraumatic stress symptoms. Behavior Therapy, 38(3), 303-313.

82.

Velezmoro, R., Negy, C., & Livia, J. (2012). Online sexual activity: Cross-national comparison between United States and Peruvian college students. Archives of Sexual Behavior, 41(4), 1015-1025.

83.

Wang, C. C. D., & Mallinckrodt, B. (2006). Acculturation, attachment, and psychosocial adjustment of Chinese/Taiwanese international students. Journal of Counseling Psychology, 53(4), 422.

84.

Weathers, F. W., & Keane, T. M. (2007). The Criterion A problem revisited: Controversies and challenges in defining and measuring psychological trauma. Journal of traumatic stress, 20(2), 107-121.

85.

Weiss, D. S., & Marmar, C. R. (1997). The impact of event scale-revised. In J. P. Wilson & T. M. Keane (Eds.), Assessing psychological trauma and PTSD: A Handbook for Practitioners (pp. 399-411). New York: Guilford Press.

86.

Willard, V. W., Long, A., & Phipps, S. (2016). Life stress versus traumatic stress: The impact of life events on psychological functioning in children with and without serious illness. Psychological Trauma: Theory, Research, Practice, and Policy, 8(1), 63.

87.

Wolfe, J., Kimerling, R., Brown, P. J., Chrestman, K. R., & Levin, K. (1996). Psychometric review of the life stressor Checklist-Revised. In B. H. Stamm(Ed.), Measurement of stress, trauma, and adaptation. Lutherville, MD: Sidran Press.

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