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본 연구에서는 DSM-5 진단기준에 속한 외상 사건을 경험한 국내 성인을 대상으로 PTSD 증상과 심리적 디스트레스에 따른 잠재계층을 도출하고, 잠재계층 분류에 시간관의 영향을 확인하고자 하였다. 또한 이것이 성별에 따라 어떠한 차이를 보이는지 확인하고자 하였다. 이를 위해 전국 성인 1,137명을 대상으로 진행된 설문을 사용하였다. 이중 DSM-5 진단기준에 속한 외상 사건을 경험한 860명의 자료를 통해 잠재프로파일분석을 실시하였다. 분석 결과 남성의 경우 3개의 잠재계층이 도출되었으며, 그 형태에 따라 ‘스트레스 저집단’, ‘스트레스 중간집단’, ‘스트레스 고위험집단’으로 명명하였다. 여성의 경우 2개의 잠재계층이 도출되었으며, 그 형태에 따라 ‘스트레스 저집단’, ‘스트레스 고위험집단’으로 명명하였다. 영향요인 분석 결과 남성의 경우 ‘과거부정’, ‘현재쾌락’이 유의미한 변수로 나타났으며, 여성의 경우 ‘과거부정’, ‘현재쾌락’, ‘현재숙명’이 유의미한 변수로 나타났다. 본 연구의 연구결과를 토대로 논의 및 시사점이 제시되었다.
This study aimed to identify subgroups among Korean adults who experienced DSM-5-defined traumatic events that differed by severity of PTSD symptoms and psychological distress, analyze the influence of time perspectives on classification, and explore gender differences in patterns of severity. A total of 1,137 South Korean adults completed the survey. Latent Profile Analysis and regression analysis were performed on data from 860 participants who reported DSM-5-defined traumatic events. In men, a three-class model best fit the data with a ‘mild stress class’, ‘moderate stress class’, and ‘severe stress class’. In women, a two-class model best fit the data with a ‘mild stress class’ and ‘severe stress class’. The predictor analysis showed that ‘Past Negative,’ and ‘Present Hedonistic’ were significant variables for men; while ‘Past Negative,’ and ‘Present Fatalistic’ were significant variables for women. In light of these results, Implications and suggestion are discussed.
강윤경, 김지원, 홍세희 (2019). 산재근로자의 일자리 만족도에 따른 프로파일의 잠재전이분석과 영향요인 검증. 장애와 고용, 29(1), 35-60.
건강보험심사평가원 (2017). 국민관심질병통계.
권도연 (2019). 시간관 치료(time perspective therapy)가 외상 경험자들의 인지 및 정서에 미치는 영향. 중앙대학교 대학원 석사학위논문.
김범준 (2014). 시간관과 행복. 한국심리학회지: 사회 및 성격, 28(1), 49-67.
김지윤, 이동훈, 이덕희 (2018). DSM 진단기준의 충족 여부 및 사건의 직, 간접 경험 여부에 따른 심리적 기능의 차이. 한국심리학회지: 상담 및 심리치료, 30(4), 1125- 1153.
박기쁨, 우상우, 장문선 (2012). 대학생 집단을 통한 단축형 간이정신진단 검사-18 (BSI-18)의 타당화 연구. Korean Journal of Clinical Psychology, 31(2), 507-521.
박희은, 김기호, 이장한 (2017). 한국형 스웨덴 짐바르도 시간관 설문지 타당화 연구. 한국자료분석학회, 19(1), 489-502.
신지영, 이동훈, 이수연, 한윤선 (2015). 대학생이 경험하는 외상사건 유형에 관한 연구. 놀이치료연구, 19(2), 69-95.
심은정 (2016) 성별에 따른 대학생의 불안과 우울의 유병률과 관련 요인. 청소년학연구, 23(12), 663-689.
안현의, 박철옥, 주혜선 (2012). 성별에 따른 외상관련 정서가 PTSD에 미치는 영향: 대학생을 중심으로. 상담학연구, 13(5), 2363- 2378.
윤소정, 김정섭 (2012). 한국형 Zimbardo 시간관 척도 타당화. 교육심리연구, 26(2), 587- 606.
이덕희 (2019). 한국판 단축형 짐바르도 시간관 척도 타당화 연구. 성균관대학교 대학원 석사학위논문.
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.
이동훈, 이수연, 윤기원, 김시형, 최수정 (2017). 성별에 따른 외상사건 경험이 PTSD 증상 및 외상 후 성장과의 관계에 미치는 영향: 반추의 매개효과. 한국심리학회지: 상담 및 심리치료, 29(1), 227-253.
이수림 (2015). 외상 경험 및 인지적 정서조절전략이 외상 후 스트레스장애와 외상 후 성장에 미치는 영향. 인문학논총, 39, 93- 124.
한정숙, 최윤경 (2014). 이혼경험자의 인지적 유연성이 역경 후 성장에 미치는 영향: 시간관의 매개효과. 인지행동치료, 14(2), 217-237.
홍세희 (2019). 잠재계층, 잠재전이, 성장혼합 모형. 연구방법론 집중 워크샵. 서울: 박영사.
Armour, C., Contractor, A., Elhai, J. D., Stringer, M., Lyle, G., Forbes, D., & Richardson, J. D. (2015). Identifying latent profiles of posttraumatic stress and major depression symptoms in Canadian veterans: Exploring differences across profiles in health related functioning.. Psychiatry Research, 228(1), 1-7.
Asparouhov, T., & Muthén, B. (2014). Auxiliary variables in mixture modeling: Three-step approaches using M plus. Structural Equation Modeling: A Multidisciplinary Journal, 21(3), 329-341.
American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Association.
Anagnostopoulos, F., & Griva, F. (2012). Exploring time perspective in Greek young adults: Validation of the Zimbardo Time Perspective Inventory and relationships with mental health indicators. Social Indicators Research, 106(1), 41-59.
Baldensperger, L., Wiedemann, A. U., Wessel, L., Keilholz, U., & Knoll, N. (2018). Social network, autonomy, and adherence correlates of future time perspective in patients with head and neck cancer. Psycho‐Oncology, 27(6), 1545-1552.
Başoğlu, M., Livanou, M., Crnobarić, C., Frančišković, T., Suljić, E., Đurić, D., & Vranešić, M. (2005). Psychiatric and cognitive effects of war in former Yugoslavia: association of lack of redress for trauma and posttraumatic stress reactions. Jama, 294(5), 580-590.
Ben‐Ezra, M., Karatzias, T., Hyland, P., Brewin, C. R., Cloitre, M., Bisson, J. I., ... & Shevlin, M. (2018). Posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) as per ICD‐11 proposals: A population study in Israel.. Depression and Anxiety, 35(3), 264-274.
Blix, I., & Brennen, T. (2011). Mental time travel after trauma: The specificity and temporal distribution of autobiographical memories and future-directed thoughts. Memory, 19(8), 956- 967.
Bonanno, G. A. (2004). Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events?. American Psychologist, 59(1), 20
Boniwell, I., & Zimbardo, P. G. (2004). Balancing time perspective in pursuit of optimal functioning. Positive Psychology in Practice, 12, 141-155.
Breslau, N., Reboussin, B. A., Anthony, J. C., & Storr, C. L. (2005). The structure of posttraumatic stress disorder: latent class analysis in 2 community samples. Archives of General Psychiatry, 62(12), 1343-1351.
Brewin, C. R., Dalgleish, T., & Joseph, S. (1996). A dual representation theory of posttraumatic stress disorder. Psychological Review, 103(4), 670.
Carelli, M. G., Wiberg, B., & Wiberg, M. (2011). Development and construct validation of the Swedish Zimbardo time perspective inventory. European Journal of Psychological Assessment.
Chung, H., & Breslau, N. (2008). The latent structure of post-traumatic stress disorder: Tests of invariance by gender and trauma type. Psychological Medicine, 38(4).
Clark, S. L., & Muthén, B. O. (2009). Relating latent class analysis results to variables not included in the analysis. Manuscript submitted for publication. Retrieved fromhttp://www.statmodel.com/papers.shtml
Cole, J. C., Andretta, J. R., & McKay, M. T. (2017). An exploratory examination of the viability and meaningfulness of time attitudes profiles in adults. Personality and Individual Differences, 106, 146-151.
Contractor, A. A., & Weiss, N. H. (2019). Typologies of PTSD clusters and reckless/self-destructive behaviors: A latent profile analysis. Psychiatry Research, 272, 682-691.
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: Official Publication of The International Society for Traumatic Stress Studies, 15(2), 99-112.
Derogatis, L. R. (1977). SCL-90(Revised) Manual I. ClinicalPsychometrics Research Unit, Baltimore, Johns Hopkins University School ofmedicine.
Derogatis, L. R. (2001). Brief Symptom Inventory(BSI)-18. Administration, scoring and proceduresmanual. Minneapolis: NCS Pearson, Inc..
Drake, L., Duncan, E., Sutherland, F., Abernethy, C., & Henry, C. (2008). Time perspective and correlates of wellbeing. Time & Society, 17(1), 47-61.
Dunkel, C. S., & Weber, J. L. (2010). Using three levels of personality to predict time perspective. Current Psychology, 29(2), 95-103.
Ehlers, A., & Clark, D. M. (2000). A cognitive model of posttraumatic stress disorder. Behaviour research and therapy, 38(4), 319-345.
Ehlers, A., Hackmann, A., & Michael, T. (2004). Intrusive re‐experiencing in post‐traumatic stress disorder: Phenomenology, theory, and therapy. Memory, 12(4), 403-415.
Ely, R., & Mercurio, A. (2011). Time perspective and autobiographical memory: Individual and gender differences in experiencing time and remembering the past. Time & Society, 20(3), 375-400.
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.
Feeny, N. C., & Foa, E. B. (2006). Cognitive vulnerability to PTSD. In L. B. Alloy and J. H. Riskind (Eds.), Cognitive Vulnerability to Emotional Disorders (pp. 285-301). Hillsdale, NJ: Lawrence Erlbaum Associates Inc.
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.
Ge, J., Wu, J., Li, K., & Zheng, Y. (2019). Self-compassion and subjective well-being mediates the Impact of mindfulness on balanced time perspective in chinese college students. Frontiers in Psychology, 10, 367.
Greene, B. A., & DeBacker, T. K. (2004). Gender and orientations toward the future: Links to motivation. Educational Psychology Review, 16(2), 91-120.
Gruber, J., Cunningham, W. A., Kirkland, T., & Hay, A. C. (2012). Feeling stuck in the present? Mania proneness and history associated with present-oriented time perspective. Emotion, 12, 13-17.
Guffanti, G., Geronazzo‐Alman, L., Fan, B., Duarte, C. S., Musa, G. J., & Hoven, C. W. (2016). Homogeneity of severe posttraumatic stress disorder symptom profiles in children and adolescents across gender, age, and traumatic experiences related to 9/11. Journal of Traumatic Stress, 29(5), 430-439.
Guina, J., Nahhas, R. W., Kawalec, K., & Farnsworth, S. (2016). Are gender differences in DSM-5 PTSD symptomatology explained by sexual trauma? Journal of Interpersonal Violence, 1-28.
Hayes, S. C., Wilson, K. G., Gifford, E. V., Follette, V. M., & Strosahl, K. (1996). Experiential avoidance and behavioral disorders: A functional dimensional approach to diagnosis and treatment. Journal of Consulting and Clinical Psychology, 64(6), 1152.
Hill, K. G., White, H. R., Chung, I. J., Hawkins, J. D., & Catalano, R. F. (2000). Early adult outcomes of adolescent binge drinking: person and variable‐centered analyses of binge drinking trajectories. Alcoholism: Clinical and Experimental Research, 24(6), 892-901.
Holman, E. A., Silver, R. C., Mogle, J. A., & Scott, S. B. (2016). Adversity, time, and well-being: A longitudinal analysis of time perspective in adulthood. Psychology and Aging, 31(6), 640.
Hourani, L., Williams, J., Bray, R., & Kandel, D. (2015). Gender differences in the expression of PTSD symptoms among active duty military personnel. Journal of Anxiety Disorders, 29, 101-108.
Hruska, B., Irish, L. A., Pacella, M. L., Sledjeski, E. M., & Delahanty, D. L. (2014). PTSD symptom severity and psychiatric comorbidity in recent motor vehicle accident victims: A latent class analysis. Journal of anxiety disorders, 28(7), 644-649.
Jongedijk, R. A., van der Aa, N., Haagen, J. F., Boelen, P. A., & Kleber, R. J. (2019). Symptom severity in PTSD and comorbid psychopathology: A latent profile analysis among traumatized veterans. Journal of Anxiety Disorders, 62, 35-44.
Kessler, R. C. (2006). The epidemiology of depression among women. Women and Depression: A Handbook for the Social, Behavioral, and Biomedical Sciences, 22-37.
Košťál, J., Klicperová-Baker, M., Lukavská, K., & Lukavský, J. (2016). Short version of the Zimbardo Time Perspective Inventory (ZTPI- short) with and without the Future-Negative scale, verified on nationally representative samples. Time & Society, 25(2), 169-192.
Lasane, T. P., & O’Donnell, D. A. (2005). Measurement of temporal orientation: A conceptual approach. In A. Strathman & J. Joireman (Eds.), Understanding behavior in the context of time: Theory, research, and application (pp. 11-30). Mahwah, NJ: Lawrence Erlbaum.
Layne, C. M., Warren, J. S., Watson, P. J., & Shalev, A. Y. (2007). Risk, vulnerability, resistance, and resilience: toward an integrative conceptualization of posttraumatic adaptation. In M. Friedman, T. Keane, & P. Resick (Eds.), Handbook of PTSD: Science and practice (pp. 497-520). New York: Guilford Press.
Leach, L. S., Christensen, H., Mackinnon, A. J., Windsor, T. D., & Butterworth, P. (2008). Gender differences in depression and anxiety across the adult lifespan: the role of psychosocial mediators. Social Psychiatry and Psychiatric Epidemiology, 43(12), 983-998.
Lev‐Wiesel, R., & Amir, M. (2000). Posttraumatic stress disorder symptoms, psychological distress, personal resources, and quality of life in four groups of Holocaust child survivors. Family Process, 39(4), 445-459.
Marshall, G. N., Schell, T. L., & Miles, J. N. (2010). All PTSD symptoms are highly associated with general distress: Ramifications for the dysphoria symptom cluster. Journal of Abnormal Psychology, 119(1), 126.
McKay, M. T., Andretta, J. R., & Cole, J. C. (2017). How Individuals Feel About the Past, Present, and Future Bears Little Relation to Alcohol-Related Problems, Anxiety, and Depression: A Person-Centered Analysis in a University Sample. Substance Use & Misuse, 52(6), 734-741.
Montazeri, A., Baradaran, H., Omidvari, S., Azin, S. A., Ebadi, M., Garmaroudi, G., ... & Shariati, M. (2005). Psychological distress among Bam earthquake survivors in Iran: a population-based study. BMC Public Health, 5(1), 4.
Neria, Y., Nandi, A., & Galea, S. (2008). Post-traumatic stress disorder following disasters: A systematic review. Psychological Medicine, 38(4), 467-480.
Nugent N. R., Koenen K. C., Bradley B. (2012) Heterogeneity of posttraumatic stress symptoms in a highly traumatized low income, urban, african american sample. Journal of Psychiatric Research, 46(12), 1576-1583.
Nyberg, L., Kim, A. S., Habib, R., Levine, B., & Tulving, E. (2010). Consciousness of subjective time in the brain. Proceedings of the National Academy of Sciences, 107(51), 22356-22359.
Nylund, K. L., Asparouhov, T., & Muthén, B. O. (2007). Deciding on the number of classes in latent class analysis and growth mixture modeling: A Monte Carlo simulation study. Structural Equation Modeling: A Multidisciplinary Journal, 14(4), 535-569.
Otrar, M., Eksi, H., Dilmac, B., & Sikin, A. (2002). The sources of stress, coping, and psychological well- being among Turkic and relative societies’ students in Turkey. EDAM Egitim Danismanligi Ve Arastirmalari Merkezi, 2, 473-506.
Papastamatelou, J., Unger, A., Giotakos, O., & Athanasiadou, F. (2015). Is time perspective a predictor of anxiety and perceived stress? Some preliminary results from Greece. Psychological Studies, 60(4), 468-477.
Place, P. J., Ling, S., & Patihis, L. (2018). Full statistical mediation of the relationship between trauma and depressive symptoms. International Journal of Psychology, 53(2), 142-149.
Rahman, A. F., Manatunga, A., Guo, Y., Peng, L., Warnock, M., Ressler, K. J. & Jovanovic, T. (2018). A latent class analysis of PTSD symptoms among inner city primary care patients. Journal of Psychiatric Research, 98, 1-8.
Resick, P. A., Monson, C. M., & Chard, K. M. (2016). Cognitive processing therapy for PTSD: A comprehensive manual. New York: Guilford Press.
Rosellini, A. J., Coffey, S. F., Tracy, M., & Galea, S. (2014). A person-centered analysis of posttraumatic stress disorder symptoms following a natural disaster: Predictors of latent class membership. Journal of Anxiety Disorders, 28(1), 16-24.
Sailer, U., Rosenberg, P., Al Nima, A., Gamble, A., Gärling, T., Archer, T., & Garcia, D. (2014). A happier and less sinister past, a more hedonistic and less fatalistic present and a more structured future: time perspective and well-being. PeerJ, 2, e303.
Schuch, J. J., Roest, A. M., Nolen, W. A., Penninx, B. W., & De Jonge, P. (2014). Gender differences in major depressive disorder: results from the Netherlands study of depression and anxiety. Journal of Affective Disorders, 156, 156-163.
Sobol-Kwapinska, M., & Jankowski, T. (2016). Positive time: Balanced time perspective and positive orientation. Journal of Happiness Studies, 17(4), 1511-1528.
Steenkamp, M. M., Nickerson, A., Maguen, S., Dickstein, B. D., Nash, W. P., & Litz, B. T. (2012). Latent classes of PTSD symptoms in Vietnam veterans. Behavior Modification, 36(6), 857-874.
Stolarski, M., & Cyniak-Cieciura, M. (2016). Balanced and less traumatized: Balanced time perspective mediates the relationship between temperament and severity of PTSD syndrome in motor vehicle accident survivor sample. Personality and Individual Differences, 101, 456-461.
Stolarski, M., Fieulaine, N., & van Beek, W. (2015). Time perspective theory; Review, research, and application. Cham: Springer International.
Sword, R. M., Sword, R. K., Brunskill, S. R., & Zimbardo, P. G. (2014). Time perspective therapy: A new time-based metaphor therapy for PTSD. Journal of Loss and Trauma, 19(3), 197-201.
T. Zimmermann. (2015). Cancer: Psychosocial aspects. In J. D. Wright (Eds.), International Encyclopedia of the Social & Behavioral Sciences (pp. 73-77). Elsevier: Oxford.
Tarrier, N., & Gregg, L. (2004). Suicide risk in civilian PTSD patients. Social Psychiatry and Psychiatric Epidemiology, 39(8), 655-661
Tay, A. K., Rees, S., Steel, Z., Tam, N., Soares, Z., Soares, C., & Silove, D. M. (2016). Six-year trajectories of post-traumatic stress and severe psychological distress symptoms and associations with timing of trauma exposure, ongoing adversity and sense of injustice: a latent transition analysis of a community cohort in conflict-affected Timor- Leste. BMJ open, 6(2), e010205.
Torres, L., Miller, M. J., & Moore, K. M. (2013). Factorial invariance of the Brief Symptom Inventory-18 (BSI-18) for adults of Mexican descent across nativity status, language format, and gender. Psychological Assessment, 25(1), 300.
Usunier, J. C., & Valette-Florence, P. (2007). The time styles scale: A review of developments and replications over 15 years. Time & Society, 16(2-3), 333-366.
van Beek, W., Berghuis, H., Kerkhof, A., & Beekman, A. (2010). Time perspective, personality, and psychopathology: Zimbardo’s time perspective inventory in psychiatry. Time & Society, 20, 364-74.
Vermunt, J. K. (2010). Latent class modeling with covariates: Two improved three-step approaches. Political Analysis, 18(4), 450-469.
Vermunt, J. K., & Magidson, J. (2002). Latent class cluster analysis. In J. Hagenaars, & A. McCutcheon (Eds.), Applied latent class analysis. (pp. 89-106). Cambridge: Cambridge University Press.
Wang, W. R., Wang, W. L., Wang, S. C., Tsai, Y. C., Lai, C. H., & Yeh, J. W. (2012). Effects of Al addition on the microstructure and mechanical property of AlxCoCrFeNi high-entropy alloys. Intermetallics, 26, 44-51.
Weathers, F. W., Blake, D. D., Schnurr, P. P., Kaloupek, D. G., Marx, B. P., & Keane, T. M. (2013). The life events checklist for DSM-5 (LEC-5). Instrument available from the National Center for PTSD.
Weathers, F. W., Litz, B. T., Herman, D. S., Huska, J. A., & Keane, T. M. (1993). The PTSD Checklist (PCL): Reliability, validity, and diagnostic utility. In annual convention of the international society for traumatic stress studies, San Antonio, TX (Vol. 462).
Webster, J. D., & Ma, X. (2013). A balanced time perspective in adulthood: Well-being and developmental effects. Canadian Journal on Aging/La Revue canadienne du vieillissement, 32(4), 433-442.
Zhang, J. W., Howell, R. T., & Stolarski, M. (2013). Comparing three methods to measure a balanced time perspective: The relationship between a balanced time perspective and subjective well-being. Journal of Happiness Studies, 14(1), 169-184.
Zimbardo, P. G., & Boyd, J. N. (1999). Putting time in perspective: A valid, reliable individual difference metric. Journal of Personality and Social Psychology, 77, 1271-1288.
Zimbardo, P., & Boyd, J. (2008). The time paradox: The new psychology of time that will change your life. Simon and Schuster.
Zimbardo, P. G., & Boyd, J. N. (2015). Putting time in perspective: A valid, reliable individual-differences metric. In Time perspective theory; review, research and application (pp. 17-55). Springer, Cham.
Zimbardo, P., Sword, R., & Sword, R. (2012). The time cure: Overcoming PTSD with the new psychology of time perspective therapy. John Wiley & Sons.
Zlomuzica, A., Woud, M. L., Machulska, A., Kleimt, K., Dietrich, L., Wolf, O. T., ... & Margraf, J. (2018). Deficits in episodic memory and mental time travel in patients with post-traumatic stress disorder. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 83, 42-54.
