- 권한신청
- P-ISSN1229-0661
- E-ISSN1229-0661
- KCI
PTSD 증상의 조건비율에 근거한한국 성인의 트라우마 경험에 관한 연구
A Study on Trauma Experiences among Korean Adults based on Conditional probability of PTSD symptoms
이동훈 (성균관대학교)
김시형 (성균관대학교 외상심리건강연구소)
- 다운로드 수
- 조회수
초록
본 연구에서는 높은 수준의 PTSD 증상을 유발하는 사건을 탐색하기 위해 외상사건을 DSM-Ⅳ-TR의 진단기준을 충족시키는 ‘진단기준사건’과 ‘생활스트레스 사건’으로 구분하고, 가장 고통스러운 사건 대비 PTSD 고위험군의 비율인 PTSD의 조건비율(conditional probability)을 확인하였다. 이를 위해 전국의 인구센서스 기준에 따라 성별 및 연령비율을 고려하여 표집한 성인 1,000명을 대상으로 외상사건을 조사하였고, 998명의 자료를 분석하였다. 진단기준사건을 살펴보면, ‘16세 이전의 성추행’, ‘기타사고 목격’, ‘16세 이전의 성폭행’, ‘16세 이전의 가정폭력 목격’, ‘재난’, ‘교통사고 겪음’, ‘교통사고 목격’, ‘기타사고 겪음’인 것으로 나타났으며, 생활스트레스 사건은 ‘법적 구속 또는 수감(본인 및 가족)’, ‘부모의 별거나 이혼’, ‘심각한 스트레스를 야기하는 실패나 절망’, ‘가족과의 극심한 갈등 또는 잦은 다툼’인 것으로 나타났다. 마지막으로 인구사회학적 특성 중 연령, 혼인상태, 종교유무가 PTSD 증상수준에 영향을 미치는 것으로 확인되었다. 주요 연구결과를 토대로 논의 및 시사점을 제시하였다.
- keywords
- 성인, 트라우마, PTSD 증상, 조건비율, 진단기준사건, 생활스트레스 사건, adults, trauma, PTSD symptoms, conditional probability, criterion event, life stresssful event
Abstract
In this study, to search for events that cause high levels of PTSD symptoms, traumatic events are classified into ‘criterion events’ that meet DSM-IV-TR criteria and ‘life stresssful events’, conditional probability of PTSD was confirmed. From a sample of 1,000 adults residing in South Korea, 998 statistically relevant samples were extracted. Criterion events include cases of ‘sexual harassment before age 16’, ‘sightings of other accidents’, ‘rape before 16’, ‘domestic violence before 16’, ‘disaster’, ‘traffic accidents’, ‘other accidents’. Life stressful events appeared to be ‘legal arrest or detention(person and family)’, ‘parental separation or divorce’, ‘failure or despair causing serious stress’, ‘extreme conflict with family or frequent quarrels’. Among the demographic characteristics, age, marital status, religion were found to affect PTSD symptoms. The implications and limitations of these results are discussed.
- keywords
- 성인, 트라우마, PTSD 증상, 조건비율, 진단기준사건, 생활스트레스 사건, adults, trauma, PTSD symptoms, conditional probability, criterion event, life stresssful event
참고문헌
김태형, 김임, 이선미, 은헌정, 김동인, 강영수 (1998). 교통사고 후 신체 손상 환자의 외상후 스트레스장애에 대한 연구. 신경정신의학, 37(4), 650-659.
서영석, 조화진, 안하얀, 이정선 (2012a). 청소년들의 외상사건 경험. 한국교육심리연구. 26(3), 787-816.
서영석, 조화진, 안하얀, 이정선 (2012). 한국인이 경험한 외상사건: 종류 및 발생률. 한국심리학회지: 상담 및 심리치료, 24(3), 671-701.
신지영, 이동훈, 이수연, 한윤선 (2015). 대학생이 경험하는 외상사건 유형에 관한 연구. 놀이치료연구, 19(2), 69-95.
은헌정, 권태완, 이선미, 김태형, 최말례, 조수진 (2005). 한국판 사건충격척도 수정판의 신뢰도 및 타당도 연구. 신경정신의학, 44(3), 303-310.
최강록 (2015). 한국판 개정판 일생 스트레스 사건 체크리스트의 신뢰도 및 타당도: 불안 장애 및 우울장애 외래 환자 대상. 한양대학교 대학원 석사학위논문.
YTN (2017. 5. 2). OECD 중 산업재난 1위...‘예고된 참사’ 반복. http://www.ytn.co.kr/_ln/0102_201705021620479532에서 검색.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: Author.
American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Association.
Amstadter, A. B., Aggen, S. H., Knudsen, G. P., Reichborn-Kjennerud, T., & Kendler, K. S. (2013). Potentially traumatic event exposure, posttraumatic stress disorder, and Axis I and II comorbidity in a population-based study of Norwegian young adults. Social Psychiatry and Psychiatric Epidemiology, 48(2), 215-223.
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.
Averill, P. M., & Beck, J. G. (2000). Posttraumatic stress disorder in older adults: a conceptual review. Journal of Anxiety Disorders, 14(2), 133-156.
Benjet, C., Bromet, E., Karam, E. G., Kessler, R. C., McLaughlin, K. A., Ruscio, A. M., & Alonso, J. (2016). The epidemiology of traumatic event exposure worldwide: results from the World Mental Health Survey Consortium. Psychological Medicine, 46(2), 327-343.
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.
Breslau, N., & Anthony, J. C. (2007). Gender differences in the sensitivity to post traumatic stress disorder: An epidemiological study of urban young adults. Journal of Abnormal Psychology, 116(3), 607-611.
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.
Briere, J. N., & Scott, C. (2014). Principles of trauma therapy: A guide to symptoms, evaluation, and treatment (DSM-5 update). London: Sage Publications.
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.
Creamer, M., Burgess, P., & McFarlane, A. C. (2001). Post-traumatic stress disorder: findings from the Australian National Survey of Mental Health and Well-being. Psychological Medicine, 31(7), 1237-1247.
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.
Elhai, J. D., & Naifeh, J. A. (2012). The missing link: A call for more rigorous PTSD assessment procedures. Clinical Psychology: Science and Practice, 19(3), 276-282.
Erwin, B. A., Heimberg, R. G., Marx, B. P., & Franklin, M. E. (2006). Traumatic and socially stressful life events among persons with social anxiety disorder. Journal of Anxiety Disorders, 20(7), 896-914.
Frazier, P., Ander, 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), 450-460.
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.
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.
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.
Horowitz, M., Wilner, N., & Alvarez, W. (1979). Impact of Event Scale: A measure of subjective stress. Psychosomatic medicine, 41(3), 209-218.
Johnson, H., & Thompson, A. (2008). The development and maintenance of post-traumatic stress disorder (PTSD) in civilian adult survivors of war trauma and torture: A review. Clinical Psychology Review, 28(1), 36-47.
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.
Kessler, R. C., Sonnega, A., Bromet, E., Hughes, M., & Nelson, C. B. (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry, 52(12), 1048-1060.
Lancaster, S. L., Melka, S. E., & Rodriguez, B. F. (2009). An examination of the differential effects of the experience of DSM-IV defined traumatic events and life stressors. Journal of Anxiety Disorders, 23(5), 711-717.
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.
Luz, M. P., Coutinho, E. S., Berger, W., Mendlowicz, M. V., Vilete, L. M., Mello, M. F., ... & Figueira, I. (2016). Conditional risk for posttraumatic stress disorder in an epidemiological study of a Brazilian urban population. Journal of psychiatric research, 72, 51-57.
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.
Murphy, M. C., & Archer, J. (1996). Stressors on the college campus: A comparison of 1985-1993. Journal of College Student Development, 37(1), 20-28.
Robinson, J. S., & Larson, C. (2010). Are traumatic events necessary to elicit symptoms of posttraumatic stress. Psychological Trauma: Theory, Research, Practice, and Policy, 2(2), 71-76.
Rosen, G. M., Spitzer, R. L., & McHugh, P. R. (2008). Problems with the post-traumatic stress disorder diagnosis and its future in DSM-V. The British Journal of Psychiatry, 192(1), 3-4.
Smith, H. L., Summers, B. J., Dillon, K. H., & Cougle, J. R. (2016). Is worst-event trauma type related to PTSD symptom presentation and associated features?. Journal of Anxiety Disorders, 38, 55-61.
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.
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), 959-992.
Van Hooff, M., McFarlane, A. C., Baur, J., Abraham, M., & Barnes, D. J. (2009). The stressor Criterion-A1 and PTSD: A matter of opinion?. Journal of Anxiety Disorders, 23(1), 77-86.
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.
Wolfe, J., & Kimerling, R. (1997). Gender issues in the assessment of posttraumatic stress disorder. In J. P. Wilson & T. M. Keane (Eds.), Assessing psychological trauma and PTSD (pp. 192-238). New York: Guilford.
- 다운로드 수
- 조회수
- 0KCI 피인용수
- 0WOS 피인용수