open access
메뉴
open access
메뉴
E-ISSN : 2733-4538
The purpose of this study was to investigate the psychological differences in between panic disorder and non-panic anxiety disorder patients and to explore more effective ways of treating patients with panic disorder. The MMPI and the Rorschach test were administered to 77 patients with panic disorders and 72 patients with non-panic anxiety disorders. The Rorschach was administered, scored and analyzed in accordance with the Comprehensive System developed by Exner(1993). Rorschach variables were classified in terms of five clusters(Capacity for Control and Stress Tolerance, Cognition, Affect, Self-perception, Interpersonal Perception). Various additional qualitative features were also analyzed. The results showed that the two groups of patients shared a similar pattern of self-recognition of symptoms, both groups were weak in managing resources and modulating affect, and each group demonstrated negative self- perceptions. However, some interesting differences emerged in the thought contents, thought processes, and coping strategies of the two groups. Firstly, patients in the panic disorder group showed higher stress due to affective constraints, efforts in cognitive control, and the poor management of resources. Secondly, while patients with non-panic anxiety disorders exhibited greater levels of social anxiety, patients with panic disorder displayed more negative ideas about their physical functioning. This finding illustrates an important point of contrast between the two groups. The non-panic anxiety patients held negative cognitions about their social functioning, but, for the panic disorder patients, the loss of objectivity occurred in relation to their catastrophic and unrealistic cognitions about their physical functioning. A logistic regression analysis indicated that self-awareness of symptoms, negative self-perception, and focusing on physical symptoms were important features discriminating between the two groups. These findings suggest that therapy for panic disorder patients could be more effective if patients are encouraged to adopt a more realistic set of beliefs and can be made more aware of their defensiveness, affective constraint, and excessive focus on physical symptoms.
고은정, 최영희, 박기환, 이정흠 (2000). 공황장애의 임상적 특성. 생물치료정신의학, 6(2), 188-198.
곽은희, 최정훈 (1989). 불안집단의 편파적 인지성향. 한국심리학회지: 임상, 8(1), 42- 51.
김명선, 민성길, 이호영 (1984). 공황장애 환자의 MMPI 및 Rorschach 반응특성. 신경정신의학, 23(4), 405-408.
김정범 (1999). 광장공포증을 동반한 공황장애 환자의 집단 인지-행동 치료 및 6개월 추적연구. 생물치료정신의학, 5(1), 1-10.
김정범 (1999). 공황장애 환자의 개인 인지-행동치료 1례. 계명의대 논문집, 18(1), 146 -155.
김진형, 국윤재, 최성열, 김태헌, 류영수 및 강형원 (2005). MMPI 임상척도와 성격척도를 통해 살펴 본 공황장애 환자의 특성에 대한 연구. 동의신경정신과학회지, 16(1), 129-142.
김영환, 김재환, 김중술, 노명래, 심동균, 염태호 및 오상우 (1989). 다면적인성검사 실시요강. 서울: 한국 가이던스.
김의정, 김영철 (1998). 아이젱크 성격검사와 한국판 성격장애 검사를 이용한 공황장애 환자의 성격특성 및 임상증상과의 관계. 이화의대지, 21(1), 39-46.
김지혜, 안창일 (1991). 자기 초점화 주의가 불안에 미치는 영향. 한국심리학회지: 임상, 10(1), 243-261.
김진영, 이현수, 정인과 (1997). MMPI에서 기태성을 보이지 않는 정신분열병 환자의 특성. 한국심리학회지: 건강, 16(2), 313- 322.
김중술 (1998). 다면적 인성검사(개정판). 서울: 서울대학교 출판부.
박기환, 이범용, 권정혜 (1994). 공황장애의 인지-행동 집단치료 효과와 관련 있는 환자의 성격특성. 한국심리학회지: 임상, 13(1), 159-168.
박현순 (2000). 공황장애: 공황, 그 숨막히는 공포. 서울: 학지사.
박현순, 원호택 (1995). 공황장애의 인지행동적 접근연구 개관: 공황발작 인지모형을 중심으로. 한국심리학회지, 14(1), 33-54.
박현순, 원호택 (1996). 공황장애 환자의 인지특성에 관한 실험연구 Ⅰ. 한국심리학회지: 임상, 15(1), 1-16.
박현순, 원호택 (1997). 공황장애 환자의 인지특성에 관한 실험연구 Ⅱ. 한국심리학회지: 임상, 16(2), 15-28.
박현순, 이창인, 김영철, 김종원 (1997). 공황장애 환자의 임상양상에 관한 조사연구. 한국심리학회지: 임상, 16(2), 1-13.
박현진, 이정흠, 최영희 (1999). 공황장애환자의 성격 특성: 대인관계 의존성과 완벽주의. 생물치료 정신의학, 5(2), 127-136.
심진현, 백상빈, 신영철, 오강섭, 노경선, 이시형 (1999). 공황장애 환자의 성격요인과 방어기제의 특성에 관한 연구. 신경정신의학, 38(6), 1315-1323.
심은지, 민성길, 이창호, 김주영, 송원영 (2004). 일본군 위안부 생존자들의 로르샤하 반응 특성. 한국심리학회지: 임상, 23(1), 169-187.
원호택, 박현순, 권석만 (1995). 한국판 공황장애 척도 개발 연구. 한국심리학회지: 임상, 14(1), 95-110.
원호택, 권석만, 박현순, 신현균 (1996). 불안장애 환자가 나타내는 사고내용의 특성. 심리과학, 5(1), 1-12.
이정태, 이성필 (1991). 범불안장애와 공황장애의 증상 비교. 신경정신의학, 30(4), 720-727.
이수진, 송수미, 김재환 (2000). 16세 이전에 가족으로부터 구타당한 경험이 있는 정신과 입원환자의 심리적 특성. 한국심리학회지: 임상, 19(1), 57-67.
이혜선, 김재환 (2000). 외상후 스트레스 장애 환자와 정신분열증 환자의 Rorschach 반응 비교: 남편의 폭력으로 인하여 외상후 스트레스 장애로 진단 받은 여자 환자를 중심으로. 한국심리학회지: 임상, 19(2), 293-303.
정영인, 김명정 (1985). 범불안장애와 공황장애의 임상적 비교 고찰. 신경정신의학, 24(2), 327-334.
최영희, 이정흠 (1998). 공황장애의 인지행동치료. 신경정신의학, 37(4), 603-619.
황성훈, 유희정, 김 환 (2001). ‘불안 민감성’의 개념과 작용에 대한 개관. 한국심리학회지: 임상, 20(1), 195-205.
황성훈, 이수현, 이훈진 (2006). 불안민감성에 대한 이요인 이론의 제안과 그 타당화: 공황장애 집단과 신체형 장애 집단을 중심으로. 한국심리학회지: 임상, 25(3), 781-797.
American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorder(4th). Washington, DC.
Arnt,. A. (2002). Cognitive therapy versus interoceptive exposure as treatment of panic disorder without agoraphobia. Behaviour Research and Therapy. 40, 325-341.
Ball, S. G., Otto, M. W., Pollack, M. H., Uccello, R., & Rosenbaum, J. F. (1995). Differentiating Social Phobia and Panic Disorder: A Test of Core Beliefs. Cognitive Therapy and Research. 19(4), 473-482.
Beck. A. T. (1976). Cognitive therapy and the emotional disorders. New York: International Universities Press.
Belfer, P. L., & Glass, C. R. (1982). Agoraphobic anxiety and fear of fear: A cognitive attentional model. Parer presented at the meeting of the Association for the Advancement of Behavior Therapy. NY.
Boeijen, C. A., Oppen, P., Balkom,, A. L. J. M., & Dyck, R. (2007). Treatment of panic disorder and/or generalized anxiety disorder with a guided self-helf manual. Clinical Case Studies. 6(3), 277-291.
Bulter, G., & Mathews, A. (1983). Cognitive processes in anxiety. Advances in Behaviour Research and Therapy. 5, 51-62.
Carlbring, P., Ekselius, L., & Andersson, G. (2003). Treatment of panic disorder via the Internet: a randomized trial of CBT vs. applied relaxation. Journal of Behavior Therapy and Experimental Paychiatry. 34, 129-140.
Carr, R. E., Lahrer, P. M., Rausch, L. L., & Hochron, S. M. (1993). Anxiety sensitivity and panic attacks in an asthmatic population. Behaviour Research and Therapy. 32(4), 411-418.
Chambless, D. L., Beck, A. T., Gracely, E. J., & Grisham, J. R. (2000). Relationship of cognitions to fear of somatic symptoms: A test of the cognitive theory of panic. Depression and Anxiety. 11, 1-9.
Cho, Y., Smits, J. A. J., Powers, M. B., & Telch, M. J. (2007). Do changes in panic appraisal predict improvement in clinical status following cognitive-behavioral treatment of panic disorder? Cognitive Therapy and Research. 31, 695-707.
Clark, D. M. (1986). A cognitive approach to panic. Behaviour Research and Therapy. 24, 461-470.
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Lawrence Earlbaum Associates.
Donnell, D. L., & McNally, R. J. (1990). Anxiety sensitivity and panic attacks in nonclinical population. Behaviour Research and Therapy. 28, 83-85.
Exner, J. E. (1993). The Rorschach: A comprehensive system, Volume1. 3rd addition. New York: John willy & Sons.
Friedman, A. F., Webb, J. T., & Lewak, R. L. (1989). Psychological Assessment with the MMPI. New Jersey: Lawrence Erlbaum Associates, Publishers.
Furer, P., Walker, J. R., Chartier, M. J., & Stein, M. B. (1997). Hypochondriacal concerns and somatization in panic disorder. Depression and Anxiety. 6, 78-85.
Hiller, W., Leibbrand, R., Rief, W., & Fichter, M. M. (2005). Differentiating hypochondriasis from panic disorder. Anxiety disorders. 19, 29-49.
Jack, M. S., Heimberg, M. A., & Mennin, D. S. (1999). Situational panic attacks: Impact on distress and impairment among patients with social phobia. Depression and anxiety. 10, 112-118.
Labrecque, J., Marchand, A., Dugas, M. J., Letarte, A. (2007). Efficacy of cognitive -behavioral therapy for comorbid panic disorder with agoraphobia and generalized anxiety disorder. Behavior Modification. 31(5), 616-637.
Ludewig, S., Ludewig, K., Geyer, M. A., Hell, D., & Vollenweider, F. X. (2002). Prepulse inhibition deficits in patients with panic disorder. Depression and anxiety. 15, 55-60
McNally, R. J. (1990). Psychological approaches to panic disorder: A review.
Menard, S. (2002). Applied logistic regression analysis. Sage university paper series on quantitative applications in the social science. Thousand Oaks, CA: Sage.
Rachman, S. (1986). Special review: A. T. Beck, and G, Emery, with R. L. Greenberg: Anxiety disorders and phobias: A cognitive perspective. New York: Basic Books(1985). Behaviour Research and Therapy. 24(1), 95-96.
Rosnow, R. L., & Rosenthal, R. (1996). Computing contrasts, effect sizes, and counternulls on other people's published data: General procedures for research consumers. Pyschological Methods, 1, 331-340.
Rosenberg, N. K., & Anderson, R. (1990). Rorschach-profile in panic disorder. Scandinavian Journal of Psychology. 31, 99-109.
Roth, W. T., Gomilla, A., Meuret, A., Alpers, G. W., Handke, E. M., & Wilhelm, F. H. (2002). High altitudes, anxiety, and panic attacks: Is there a relationship?. Depression and Anxiety. 16, 51-58.
Sarason, E. G. (1975). Anxiety and self-preoccupation. In I. G. Sarason & C. D. Spielberger (Eds), Stress and anxiety (vol, 2), New York: Hemisphere.
Smits, J. A. J., & Zvolensky, M. J. (2006). Emotional vulnerability as a function of physical activity among individuals with panic disorders. Depression and Anxiety. 23, 102-106.
Sokol, L., Beck, A. T., Greenberg, R. L., Wright, F. D., & Berchik, R. J. (1989). Cognitive therapy of panic disorder: A nonpharmachological alternative. Journal of Nervous and Mental Disease. 177, 711-716.
Tull, M. T., Stipelman, B. A., Pedneault, K., & Gratz, K. L. (2008). An examination of recent non-clinical panic attacks, panic disorder, anxiety sensitivity, and emotion regulation difficulties in the prediction of generalized anxiety disorder in an analogue sample. Journal of anxiety disorders. 913, 1-8.
Weiner, I. B. (1998). Principles of Rorschach Interpretation. Lawrence Erlbaum Associates, Inc.