재난을 경험한 많은 생존자들은 시간의 경과에 따라 원래의 기능을 회복하지만, 어떤 생존자들은 보다 장기적인 심리적 문제들을 발생시킬 수 있다. 본 연구는 이러한 선행연구 결과에 입각하여, 경북지역 지진 생존자들의 장기적인 심리적 문제와 그에 대한 예측 요인을 파악하기 위해 수행되었다. 이를 위해 지진을 경험한 경주 및 포항 지역 거주민 195명을 대상으로 자기보고식 설문 도구를 이용하여 재난 발생 1년10개월, 7개월 후의 외상후 스트레스 및 우울 증상을 측정하고, 인구통계학적 변인과 재난 관련 변인, 개인의 심리적 특성 변인에 관한 자료를 수집하였다. 먼저, 외상후 스트레스 및 우울 증상 고위험군의 비율은 각각 13.85%, 25.64%로 나타났다. 다음으로 위계적 중다회귀분석을 실시한 결과, 외상후 스트레스 증상에 대한 유의미한 예측 요인으로 재난 당시 자신의 신체적 상해 및 생명의 위협 여부와 파국화가 나타났으며, 우울 증상에 대한 유의미한 예측 요인으로 직업 유무, 재난 이전의 심리적 문제, 지각된 사회적 지지 정도, 부정적 정서성, 타인비난, 파국화가 나타났다. 이러한 결과는 지진과 같은 자연재난 생존자들의 장기적인 심리적 문제를 예측하는 데에 있어 개인의 심리적 특성변인이 핵심적인 역할을 담당할 수 있음을 시사한다. 나아가 본 연구는 자연재난 발생 시 장기적인 심리적 문제를 예방 혹은 개선하기 위해어떤 개인에게 주의를 기울이고, 어떤 부분에 초점을 맞춰 개입을 할지 결정하는 데에 기초가 되는 연구라는 점에서 의의를 가진다.
While most disaster survivors recover from the emotional impact of the event over time, some develop long-term psychological problems. Based on extant findings, this study was conducted to identify the long-term psychological symptoms of Gyeongbuk area earthquake survivors and the predictors of such symptoms. Posttraumatic stress and depressive symptoms approximately 1 year following the earthquake, along with demographic variables, disaster-related variables, and, most importantly, individual psychological characteristic variables, were measured with self-report questionnaires in a sample of 195 residents of Gyeongju and Pohang. The proportion of survivors at high risk for posttraumatic stress and depression were 13.85% and 25.64%, respectively. Hierarchical multiple regression analysis revealed that posttraumatic stress symptoms were significantly predicted by physical injury of self, perceived life threat of self, and catastrophizing tendency. For depressive symptoms, employment, prior psychological problems, social support, negative affectivity, other-blame, and catastrophizing tendency were identified as significant predictors. These results suggest the importance of psychological factors in predicting the long-term psychological symptoms of earthquake survivors. Furthermore, the findings highlight the need to examine such predictors when delivering prevention and intervention programs that target long-term psychological symptoms following a disaster such as an earthquake.
대학생 우울성향 집단을 대상으로 미래 사고 과제(future thinking task)로 측정한 긍정적 미래 사고의 부족이 부정적 미래 사고, 우울 및무망감과는 독립적으로 자살사고에 고유한 영향을 미칠 것이라는 가설을 검증하였다. 또한 긍정적 미래 사고의 내용, 구체성 및 범주의 다양성이 자살사고와 어떠한 관련을 맺는지 탐색하고자 하였다. 우울성향 대학생 64명을 대상으로 사전에 우울척도인 CES-D, 벡 절망 척도(K-BHS)와 자살사고 척도(SIQ)에 응답하게 했다. 미래 사고 과제를 실시한 후 본인이 보고한 미래의 긍정적 경험 중 3가지를 골라 구체적으로 적도록 지시하였다. 긍정적 미래 사고의 정도는 부정적 미래 사고와 유의한 정적 상관을 나타냈지만, 우울, 무망감 및 자살사고와는유의한 부적 상관을 보였다. 또한, 긍정적 미래 사고는 부정적 미래 사고, 우울 및 무망감을 통제한 뒤에도 자살사고에 독립적으로 영향을미쳤다. 긍정적 미래 사고의 내용 중 대인관계 영역은 자살사고와 유의한 부적 상관을, 개인내적 영역은 유의한 정적 상관을 나타냈고, 긍정적 미래 사고의 구체성은 자살사고와 유의한 정적 상관을 나타냈지만 우울 정도를 통제한 뒤에는 유의하지 않았다. 본 연구의 이론적∙임상적 함의와 제한점을 논의하였다.
The present study examined whether positive future thinking would have a significant unique impact on suicidal ideation independently from negative future thinking, depression and hopelessness in depressed college students by using Future Thinking Task. Additionally, the relationships among the content, specificity, category variety of positive future thinking and suicidal ideation were examined. Sixty-four self-reported depressed college students completed the CES-D, Korean version of Beck's hopelessness Scale (K-BHS) and Suicidal Ideation Scale (SIQ) in advance. They were asked to generate future expectancies using a Future Thinking Task, and their capacity to describe positive future expectations specifically was also assessed. Positive future thinking was independently associated with suicidal ideation. In addition, low levels of interpersonal and high levels of intrapersonal future thinking were correlated with suicidal ideation. The specificity of positive future thinking was negatively correlated with suicidal ideation. The results were discussed in terms of theoretical and clinical implications.
본 연구의 목적은 무쾌감성 우울 증상(anhedonic depression)에 효과적으로 개입하기 위한 이론적인 기초를 제공하는 것에 있다. 이에 즐거움 경험의 처리 방식(심상적 대 언어적 처리)이 예기적 긍정 정서와 행동 동기, 무쾌감성 우울 증상 수준에 미치는 영향을 실험 연구를 통해 검증하고자 하였다. 이를 위해 무쾌감성 우울 대상자를 심상적 처리 조건(n=33)과 언어적 처리 조건(n=32)에 무선 배정한 뒤, 행동 활성화를 위한 활동 계획을 세우고 이와 관련된 즐거움 경험을 심상 또는 내적 언어를 통해 처리하도록 하였다. 반복측정 분산분석 결과, 두조건 모두에서 정서와 동기, 무쾌감성 우울 증상이 유의미하게 개선되었으나 심상적 처리 조건에서 긍정 정서와 무쾌감성 우울 수준의 변화 폭이 더 크게 나타났다. 그리고 심상적 처리 과정에서 경험한 긍정 정서는 무쾌감성 우울 증상의 감소를 유의미하게 예측하였다. 본 연구의 결과는 예상하는 동안의 즐거움 경험을 통해 무쾌감성 우울 수준이 감소될 수 있으며, 예기적 즐거움 증진에 있어 심상적 처리가 더욱효과적일 수 있다는 점을 시사한다.
The purpose of this study was to examine the effect of imagery processing on positive affect, behavioral motivation, and anhedonic symptoms. For this purpose, participants with anhedonic symptoms of depression were randomly assigned to one of two conditions, namely, an imagery processing condition (n=33) and a verbal processing condition (n=32). The experiment consisted of activity scheduling and practice designed to induce the pleasure experience regarding that activity in each processing mode. In both conditions, increases in positive affect and behavioral motivation, and a decrease in the level of anhedonic depression were observed. Participants in the imagery processing condition, however, reported greater enhancement in positive affect and anhedonic symptoms than did those in the verbal processing condition. Results indicate that boosting anticipatory pleasure for future events through mental imagery could alleviate anhedonic symptoms of depression, with increases in positive affect and behavioral motivation. In the final section, the implications and limitations of this study as well as suggestions for future research are discussed.
The purpose of this study was to examine the effect of sleep on depression among older adults and to determine which sleep variables best explain depression. The data for this study were from the fourth wave of the Korean Social Life, Health and Aging Project (KSHAP). A hierarchical regression analysis was conducted to determine whether sleep variables, such as sleep latency, sleep quality, and nightmares could predict depression after controlling for demographic and health status variables. The results indicated that, similar to the hypotheses, some sleep variables predict depression, even after controlling other variables (R2=.34, ΔR2=.07, F(20, 543)=14.05, p<.001). Specifically, breathing discomfort (β=.09, p<.05), nightmares (β=.10, p<.05), low sleep quality (β=.12, p<.01), and difficulty of concentration (β=.19, p<.001) predict depression significantly, and their correlations were also significant. These findings suggest that various sleep problems interact with each other. Therefore, increasing general sleep quality would aid in the prevention of depression among older adults by examining the sleep problems in detail.
The aim of this study was to examine the efficacy of a gratitude intervention for reducing job seeking stress and improving mental health variables among undergraduate students. Moreover, to shed light on its mechanism of action, we proposed and examined meaning in life as a potential mediator of treatment efficacy, based on literature review. A gratitude intervention was provided to undergraduate students who suffered from job-seeking stress and had agreed to participate in the study. A comparison group was given psycho-education. Both participants in the gratitude intervention (n=17) and in the psychoeducation conditions (n=20) received four-session interventions corresponding to the purpose of each condition. Compared with the participants in the psycho-education condition, those in the gratitude intervention condition demonstrated a decrease in job-seeking anxiety, academic stress, depressive symptoms, and perceived stress, as well as an increase in life satisfaction, mental well-being, and happiness. Moreover, improvement in meaning in life partially mediated the efficacy of the gratitude intervention on perceived stress, life satisfaction, mental well-being, and happiness, and also fully mediated its efficacy on academic stress. These results suggest that gratitude intervention is an efficacious intervention for job-seeking stress and various mental health variables among undergraduate students, and that its efficacy may be mediated through increase in meaning in life. Finally, theoretical and practical implications and limitations of the study’s findings are discussed.
본 연구에서는 정신장애를 경험하는 개인들에서의 기능적 손상을 측정하기 위한 자기보고식 척도로서 기능손상 척도(Disability Scale, DS)를 개발하고 대학생 집단을 대상으로 예비적으로 타당화하고자 하였다. 연구 1에서는 대학생 집단(N=259)을 대상으로 탐색적 요인분석을 실시한 결과, 기능손상 척도의 최근 2주 시점 및 6개월 시점 문항 모두에서 ‘정서적 어려움’, ‘대인관계적 어려움’, ‘자기관리의 어려움’, ‘학업 및 직업적 어려움’ 및 ‘건강과 가족관련 어려움’의 총 5요인이 도출되었다. 연구 2에서는 기능손상 척도의 신뢰도와 타당도에 대한검증을 시행하였으며, 기능손상 척도가 적절한 내적 타당도와 더불어 검사-재검사 신뢰도를 갖추고 있는 것으로 확인되었다. 대학생 집단(N=286)과 임상 집단(N=29)을 대상으로 한 집단 차이 분석에서, 임상 집단은 대학생 집단에 비해 전체 점수가 유의미한 수준으로 더 높은 것으로 나타났다. 또한 기능손상 척도는 기능손상을 측정하는 척도 및 우울과 불안장애 관련 증상을 측정하는 척도들과의 정적인 상관을 보이고 있었다. 마지막으로, 최근 2주 시점과 6개월 시점의 문항들에 대해 각각 확인적 요인분석을 실시한 결과, 연구 1을 통해 도출된5요인 모형의 모형 적합도가 양호한 것으로 나타났다. 이같은 결과를 바탕으로 임상적 함의와 연구의 제한점에 대해 논하였다.
This study aimed to develop the Disability Scale (DS), a scale for assessing functional impairment in individuals with mental disorders, and to preliminarily explore the psychometric properties of the DS in university students. In the first part of the study, exploratory factor analysis on DS in the university student group (N=259) yielded five factors: “mood problems,” “interpersonal problems,” “self-care problems,” “academic and occupational problems,” and “health and family problems,” for both items on the past 2 weeks and items on the past 6 months. In the second part of the study, analyses of reliability and validity of the DS were performed. The DS showed sound internal consistency, 3-week test-retest reliability, and construct validity. In addition, DS scores were significantly higher in the clinical group with anxiety and depressive disorders (N=29), when compared with the university student group (N=286). The DS showed positive associations with the scales for assessing functional impairment and psychological symptoms including depression and anxiety. Confirmatory factor analyses on the five-factor model of the DS resulted in favorable goodness of fit indices for both items on the past 2 weeks and items on the past 6 months. Clinical implications and limitations of this study are also discussed.
This study validated the newly developed Social-Emotional, Evidence-based Developmental Strengths (SEEDS) Questionnaire. The SEEDS Questionnaire is the first questionnaire to comprehensively measure the social-emotional, evidence-based developmental strengths areas that have been found to be the most effective areas for reducing mental health problems in children and adolescents. A total of 1,033 Korean students in elementary through high school completed the SEEDS Questionnaire and validity measures. Factor analysis results supported the SEEDS Questionnaire 13-factor structure. The 3-factor higher-order Cognitive-Behavioral-Interpersonal model was also supported. Reliability and validity of all scale scores were also supported. The SEEDS subscales correlated significantly with externalizing and internalizing symptoms (including anxiety, depression, and anger) and with positive affect. These results highlight the role that the SEEDS Questionnaire may play in not only helping to reduce mental health problems, but also increasing well-being and positive engagement in children and adolescents’ lives. Study limitations and implications for enhancing support services in school and clinical settings via this new assessment are discussed.
Social anxiety disorder (SAD) is defined as severe fear or anxiety in one or more social situations. Although knowing the specifiers of SAD could further improve our understanding of heterogeneity in the disorder, currently available psychometric instruments are insufficient to assess situationally defined social anxiety dimensions individually. Given this situation, the Social Anxiety Questionnaire (SAQ) has been developed to measure five anxiety-provoking situations for adults. The aim of this study was to examine the reliability and validity of the Korean version of the SAQ. A total of 564 undergraduate students participated in this study. A total of 302 samples were used for exploratory factor analysis, and a total of 262 samples were used for confirmatory factor analysis. The mean age of the participants was 20.33 years, and measures of anxiety, fear of negative evaluation, and depression were analyzed. Exploratory factor analysis yielded five factors: (1) interactions with strangers, (2) speaking in public/talking with people in authority, (3) interactions with the opposite sex, (4) criticism and embarrassment, and (5) assertive expression of annoyance, disgust, or displeasure. Confirmatory factor analysis also supported the construct validity of the questionnaire. The Korean version of the SAQ showed good internal consistency, test-retest reliability, criterion validity, and convergent validity. To futher accurately understand social anxiety disorder, it is necessary to determine how the level of anxiety of each individual differs in various circumstances. In this respect, the Korean version of the SAQ is expected to be utilized as a useful tool for clinical research.
The Korean Version of Barkley Deficits in Executive Functioning Scale (K-BDEFS) was designed to evaluate daily executive functioning in adults with attention-deficit/hyperactivity disorder. The original Barkley Deficit in Executive Functioning Scale (BDEFS) and the K-BDEFS have demonstrated satisfactory reliability and validity. This study examined the reliability and validity of the K-BDEFS Short-Form (K-BDEFS-SF) in South Korea. A total of 1,016 community-dwelling general adults in 4-four different areas in South Korea participated. The internal consistency and the item-total correlations were favorable. The Korean version of Adult ADHD Self-Report Scale, Korean version of the Beck Depression Inventory, Korean version of Beck Anxiety Inventory were used to assess the concurrent and discriminant validity. The K-BDEFS-SF demonstrated successful reliability and validity. A confirmatory factor analysis supported the five factor model of the K-BDEFS-SF as presented in the original version of the BDEFS-SF. Overall, this study supports the use of the K-BDEFS-SF to assess deficits in executive functioning in community-dwelling populations of Korean adults.
디스트레스(distress)는 암환자가 정신적으로 겪는 고통으로, 암 치료에 효과적으로 대처할 수 있는 능력을 방해하는 불쾌한 경험이다. 암환자의 디스트레스는 슬픔, 두려움과 같이 일반적으로 느낄 수 있는 정상적인 감정 반응부터 우울, 불안, 공황, 사회적 고립, 실존적 위기와같이 심리사회적 기능을 손상하는 병적인 상태까지 다양하게 나타날 수 있다. 암환자의 35–45%가 임상적으로 유의한 수준의 디스트레스를 겪는 것으로 보고되고 있으며, 암 치료가 종결된 후에도 디스트레스는 지속되기도 한다. 국내 암경험자 174만 명 시대에 암생존율은 10 년 전에 비해 1.3배 증가하였고 계속해서 상승하는 추세인데, 이들의 심리적 어려움에 대한 관심과 심리학적 개입에 대한 사회적 요구가 점차 증가하고 있음에도 불구하고, 통합적 암 관리에서 디스트레스 관리는 요원하며 임상심리학자의 개입은 부족한 실정이다. 본 연구는 1) 암환자의 디스트레스의 개념, 2) 디스트레스 관리의 기본 모델 및 원칙, 3) 디스트레스 선별 및 평가 도구, 그리고 4) 디스트레스 관리와 관련하여 국내 연구 및 임상 적용 현황을 고찰하였다. 더불어 종양학 현장에서 임상심리학자들의 역할과 임상가와 연구자가 나아갈 방향에 대해 논의하였다.
Distress is an unpleasant emotional experience that may interfere with the ability to cope effectively with cancer. Distress can range from normal emotional responses, such as sadness and fear, to psychopathological states that damage psychosocial functioning, such as depression, anxiety, panic, social withdrawal, and existential crisis. It is reported that approximately 35– 45% of cancer patients experience clinically significant levels of distress, and the distress continues after treatment. Currently, about 1.74 million cancer patients and survivors live in Korea. Over the past 10 years, the survival rate has increased by 1.3 times and will most likely continue to increase. Although interest in cancer patients’ psychological difficulties and awareness of the need for psychological interventions are increasing, rarely is distress management provided by clinical psychologists in integrative cancer care systems. This comprehensive review aimed to explore 1) the concept of distress in cancer patients, 2) the basic model and principles of distress management, 3) available distress screening and assessment tools, and 4) current status of distress management and its clinical applications in Korea. Further, we discussed the roles of clinical psychologists and researchers in oncological settings in optimizing distress management in cancer patients.
