E-ISSN : 2733-4538
The current study was conducted to examine the applicability of the complete mental health model proposed by Keyes for explaining the relationship between mental health and suicidal behavior in the elderly. We examined the unique contribution of mental well-being to the prediction of suicidal behavior and the differences of categorical mental health diagnoses in terms of suicidal behavior. A total of 2,034 elderly people aged 65 years and over participated in this study. Hierarchical multiple regression analyses showed that mental well-being was a significant predictor of suicidal behavior after controlling for education, living arrangement, poverty, physical illness, and depressive symptoms. In addition, education, poverty, physical illness, and depression each contributed significantly to suicidal behavior after controlling for all other relevant predictors, and depression was the strongest predictor of suicidal behavior. While poverty and depression were significant predictors of suicidal behavior in men, mental well-being, physical illness, and depression were significant predictors of suicidal behavior in women. Next, comparisons of three categorical mental health diagnoses based on mental well-being indicated that the languishing group was more vulnerable to suicidal behavior than the moderately mentally healthy group, who in turn was more vulnerable to suicidal behavior than the flourishing group. Comparisons of five categorical mental health diagnoses based on the combination of mental well-being and depression indicated that the languishing and depression group was the most vulnerable to suicidal behavior and the complete mental health group was the least vulnerable to suicidal behavior of all groups. In conclusion, these results suggest that mental well-being may act as a protective factor for alleviating suicidal behavior, and provide support for the applicability of the complete mental health model for explaining the relationship between mental health and suicidal behavior in the elderly.
김동현 (2013). 강원도의 사회.문화.경제적특성에 따른 자살의 특징과 예방사업의방향. 강원도 자살예방 정책토론회 “자살없는 강원도를 위하여!”, 6월 25일. 강원도: 강원대학교병원 암.노인보건센터.
김선영, 정미영, 김경나 (2014). 한국 성인의연령계층별 자살생각 관련 요인: 국민건강영양조사 제5기 3차(2012) 자료를 이용하여. 보건교육.건강증진학회지, 31(2), 1-14.
김영주 (2009). 남녀별 독거노인과 동거노인의건강습관, 스트레스, 우울, 자살생각 비교. 기본간호학회지, 16(3), 333-344.
김형수 (2002). 한국노인의 자살생각과 관련요인 연구. 한국노년학, 22(1), 159-172.
김효창, 손영미 (2006). 노인 자살의 특성과 자살유형에 관한 연구. 한국심리학회지: 사회문제, 12(2), 1-19.
보건복지부 (2015). 2015년 정신건강사업 안내. 서울: 보건복지부.
성태제 (2010). 현대 기초통계학의 이해와 적용<개정5판>. 파주: 교육문화사.
신기섭 (2014, 10, 21). 한국 자살률, 도-농 격차 최대 5배. 한겨레. http://www.hani.co.kr에서 2015, 1, 31 인출.
신서연 (2011). 한국어판 단축형 the Center for Epidemiologic Studies Depression Scale (CES-D)들의 타당성 연구. 서울대학교 대학원 석사학위 논문.
안준희, 전미애 (2009). 노인의 자살 생각에 영향을 미치는 선행요인에 관한 연구: 스트레스 소질 모델(Stress-diathesis Model)을 중심으로. 한국노인학, 29(2). 489-511.
임영진, 고영건, 신희천, 조용래 (2010). 한국인의 정신건강. 2010 한국심리학회 연차학술대회 논문집, 233-257.
임영진, 고영건, 신희천, 조용래 (2012). 정신적웰빙 척도(MHC-SF)의 한국어판 타당화 연구. 한국심리학회지: 일반, 31(2), 369-386.
정은숙 (2005). 노인자살의 위험요인과 보호요인에 관한 연구. 아주대학교 교육대학원 석사학위논문.
조맹제, 김계희 (1993). 주요우울증환자 예비평가에서 the Center for Epidemiologic Studies Depression Scale(CES-D)진단적 타당성 연구. 신경정신의학, 32(3), 381-399.
통계청 (2014). 2014 고령자통계. http://kostat.go.kr에서 2015, 1, 23 인출
한삼성, 강성욱, 정성화 (2012). 독거노인과 부부노인의 우울감 및 자살생각 경험. 보건의료산업학회지, 6(3), 29-38.
Bates, M. J., & Bowles, S. V. (2011). Review of well-being in the context of suicide prevention and resilience. Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury Silver Spring MD.
Batterham, P. J., & Christensen, H. (2012). Longitudinal risk profiling for suicidal thoughts and behaviours in a community cohort using decision trees. Journal of Affective Disorders, 142(1), 306-314.
Ciulla, L., Nogueira, E. L., da Silva Filho, I. G., Tres, G. L., Engroff, P., Ciulla, V., & Neto, A. C. (2014). Suicide risk in the elderly: Data from Brazilian public health care program. Journal of Affective Disorders, 152, 513-516.
Conwell, Y., Duberstein, P. R., & Caine, E. D.(2002). Risk factors for suicide in later life. Biological Psychiatry, 52(3), 193-204.
Holm, A. L., & Severinsson, E. (2015). Mapping psychosocial risk and protective factors in suicidal older persons-A systematic review. Open Journal of Nursing, 5(3), 260-275.
Keyes, C. L. M. (2002). The mental health continuum: From languishing to flourishing in life. Journal of Health and Social Behavior, 43, 207-222.
Keyes, C. L. M. (2003). Complete mental health:An agenda for the 21st century. In: C. L .M. Keyes & J. Haidt (Eds.), Flourishing: Positive psychology and the life well-lived (pp. 293.312). Washington, DC: American Psychological Association.
Keyes, C. L. M. (2005). Mental illness and/or mental health? Investigating axioms of the complete state model of health. Journal of Consulting and Clinical Psychology, 73, 539-548.
Keyes, C. L. M. (2006). Mental health in adolescence: Is America's youth flourishing?. American Journal of Orthopsychiatry, 76(3), 395.
Keyes, C. L. M., Eisenberg, D., Perry, G. S., Dube, S. R., Kroenke, K., & Dhingra, S. S.(2012). The relationship of level of positive mental health with current mental disorders in predicting suicidal behavior and academic impairment in college students. Journal of American College Health, 60(2), 126-133.
Keyes, C. L. M., Wissing, M., Potgieter, J. P., Temane, M., Kruger, A., & van Rooy, S.(2008). Evaluation of the mental health continuum.short form (MHC-SF) in setswana .speaking South Africans. Clinical Psychology & Psychotherapy, 15(3), 181-192.
Lim, Y. J., Ko, Y. G., Shin, H. C., & Cho, Y.(2013). Prevalence and correlates of complete mental health in the South Korean adult population. Mental Well-Being (pp. 91-109). Netherlands: Springer.
Osman, A., Bagge, C. L., Gutierrez, P. M., Konick, L. C., Kopper, B. A., & Barrios, F. X. (2001). The Suicidal Behaviors Questionnaire-Revised (SBQ-R): Validation with clinical and nonclinical samples. Assessment, 8(4), 443-454.
Purcell, B., Heisel, M. J., Speice, J., Franus, N., Conwell, Y., & Duberstein, P. R. (2012). Family connectedness moderates the association between living alone and suicide ideation in a clinical sample of adults 50 years and older. The American Journal of Geriatric Psychiatry, 20(8), 717-723.
Westerhof, G. J., & Keyes, C. L. M. (2010). Mental illness and mental health: The two continua model across the lifespan. Journal of Adult Development, 17(2), 110-119.
World Health Organization (2005). Promoting mental health: Concepts, emerging evidence, and practice. Geneva, Switzerland: World Health Organization.
World Health Organization (2014). Preventing suicide: A global imperative. Geneva, Switzerland:World Health Organization.