ISSN : 1229-067X
본 논문에서는 조현병 음성증상에 대한 최신 구성개념을 소개하고 관련 연구들을 체계적으로 개관한 후, 이러한 구성개념을 지지하는 신경과학적 증거들을 살펴보았다. 또한 음성증상의 평가를 위한 기존 측정 도구들과 최신 도구들을 소개하고, 현재까지 조현병 음성증상 치료에 대한 주요 접근법인 인지치료, 행동치료, 동기강화기법, 약물치료 연구들을 개관하였다. 본 논문에서 개관한 음상증상에 대한 최신 구성개념(즉, 음성증상 2요인 모델)에 기반하여, 동기강화와 표현증진, 자기 효능감 향상이라는 요소들을 포함한 새로운 심리사회적 치료 모델을 제시하였다. 본 연구자들이 새롭게 개발하고 있는 조현병 음성증상을 위한 동기행동활성화 치료는 인지 모델 및 학습 모델을 근거로 행동활성화기법과 동기강화기법을 통합하였고, 이러한 동기행동활성화 치료의 실행가능성 및 예비연구 결과를 보고하였다. 동기행동활성화 치료의 예비연구 결과, 음성증상이 있는 조현병 환자에게 실시하였을 때 만족도가 높았으며, 음성증상 평가척도, 동기 및 자기효능감 척도에서 중간 정도의 효과크기를 나타내었다. 마지막으로 조현병 음성증상에 대한 심리치료의 가능성 및 앞으로의 연구방향에 대해 논의하였다.
This comprehensive review aimed to introduce 1) the latest concept and research findings on negative symptoms of schizophrenia, 2) existing negative symptom assessment tools, and 3) psycho-social approaches to negative symptoms including cognitive therapy, behavior therapy, motivational interviewing and medications. Based on the latest concept of negative symptoms, motivational theories and learning principles outlined in this paper, a novel psychosocial treatment model (i.e., activation of behavior and motivation for negative symptoms, ABM-NS) was proposed. Finally, we presented data from a feasibility and preliminary efficacy trial. The results indicated that the ABM-NS appeared acceptable to individuals with schizophrenia with negative symptoms, with minimal dropouts and high levels of therapy adherence. Implications and future research directions were discussed.
전임홍, 이수영, 선자연, 송선미, 백수연, 이희영, 조혜현, 신경백, 박종석, 박지인, 송윤영, 안석균 (2013). 정신증을 이해하고 전문가가 되기 위한 조현 인지치료. 서울: 학지사.
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