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Korean Journal of Psychology: General

The Mediating Effect of Depressive Symptoms on the Relationship between Anger Suppression and Somatization Symptoms in Nurses

Korean Journal of Psychology: General / Korean Journal of Psychology: General, (P)1229-067X; (E)2734-1127
2018, v.37 no.2, pp.289-305
https://doi.org/10.22257/kjp.2018.06.37.2.289


Abstract

Anger suppression has been associated with depressive and physical symptoms, and this may be particularly true among emotional laborers such as nurses. Nurses may be required to suppress their emotions in their working environments, and they report anger as the most frequently experienced emotion. To this end, the present study investigated the effect of anger suppression on somatization symptoms, as well as the mediating effect of depressive symptoms in a sample of nurses. The Korean version of State Trait Anger Expression Inventory (STAXI-K), Center for Epidemiologic Studies Depression Scale (CES-D), and Symptom Check List 90-Revision (SCL-90-R) were completed by 138 nurses working in university hospitals in Seoul or Cheong-ju for more than 6 months. Analysis using the PROCESS macro indicated that the direct effect of anger suppression on somatization symptoms was not significant, but the indirect effect of depressive symptoms in this relationship was significant. These findings suggest that anger suppression in nurses may not directly lead to somatization symptoms, but may indirectly explain somatization symptoms through depressive symptoms. The results indicate the importance of early detection of depressive symptoms in relation to anger suppression.

keywords
감정노동, 간호사, 분노억제, 우울, 신체화, emotional labor, nurses, anger suppression, depression, somatization

Reference

1.

김광일, 김재환, 원호택 (1984). 간이정신진단검사. 서울: 중앙적성출판사.

2.

김명희, 백지현, 김성민 (2017). 임상간호사의 근무부서에 따른 감정노동 대상자. 글로벌건강과 간호, 7(1), 13-21.

3.

김명희, 이상화, 송주연, 유지형, 윤지향 (2014). 간호사의 감정노동 개념분석. 글로벌 건강과 간호, 4(2), 78-87.

4.

김모아, 이영호 (2013). 분노신념과 분노표현이 불안, 우울, 신체화, 정신병질, 자기애에 미치는 영향. 인간이해, 34(2), 193-213.

5.

김수현, 이원희, 강덕희, 박진희, 민성길, 노재훈 (2006). 일 의료기관 직원들의 지각된 스트레스, 생활습관 및 건강상태 지표. 지역사회간호학회지, 17(3), 407-418.

6.

김정희, 박은옥 (2012). 임상간호사의 직무 스트레스와 자기효능감이 우울에 미치는 영향. 한국직업건강간호학회지, 21(2), 134-144.

7.

김정희, 현미열, 김숙영 (2009). 임상간호사의 직무스트레스, 사회적 지지, 대처전략과 우울. 한국산업간호학회지, 18(2), 219-231.

8.

김종경, 김정희 (2016). 병원 간호사의 감정노동 관련 변인에 관한 메타분석. 기본간호학회지, 23(2), 115-125.

9.

김하자, 김정희 (2011). 임상간호사의 감정노동, 사회적 지지 및 우울 간의 관계. 한국산업간호학회지, 20(3), 308-318.

10.

권석만 (2003). 현대이상심리학. 서울: 학지사.

11.

노진희, 나연경 (2015). 병원간호사의 폭력경험, 감정노동, 직무 스트레스가 우울에 미치는 영향. 한국직업건강간호학회지, 24(3), 153-161.

12.

신미경, 강현임 (2011). 간호사의 감정노동과 직무스트레스가 신체화 증상에 미치는 영향에 관한 분석. 간호행정학회지, 17(2), 158-167.

13.

이미영, 김계하 (2012). 수간호사의 변혁적 리더십이 일반간호사의 심리적 안녕감, 스트레스 및 신체화에 미치는 영향. 간호행정학회지, 18(2), 166-175.

14.

이미옥, 이상복 (2016). 비폭력의사소통 프로그램이 간호사의 의사소통능력, 대인관계 및 분노에 미치는 효과. 한국컴퓨터정보학회논문지, 21(10), 85-89.

15.

이안생, 윤치근, 이정미 (2012). 병원간호사의 자아탄력성과 사회적 지지가 우울감에 미치는 영향. 한국직업건강간호학회지, 21(1), 46-54.

16.

이원희, 송주은, 김주형, 김희정, 이주미, 김은영 (2009). 간호사의 특성분노 및 분노표현이 직무만족, 조직몰입, 조직성과에 미치는 영향. 간호행정학회지, 15(4), 539-549.

17.

이주일 (2003). 조직 장면에서의 분노, 불안, 우울 정서-정서 간 유발 상황과 대처방식의 차이 및 정서의 조절과 심리적 안녕, 직무효과 간의 관계. 한국심리학회지: 산업 및 조직, 16(3), 19-58.

18.

염영희, 이현숙, 손희숙 (2016). 임상간호사의 감정노동 경험. 임상간호연구, 22(3), 314-326.

19.

오윤정, 최영희 (2015). 융복합 시대의 간호사의 감정노동, 직무스트레스 및 소진이 신체화 증상에 미치는 영향. 디지털융복합연구, 13(10), 415-424.

20.

전겸구 (1999). 분노에 관한 기초 연구. 재활심리연구, 6(1), 173-190.

21.

전겸구, 최상진, 양병창 (2001). 통합적 한국판CES-D 개발. 한국심리학회지: 건강, 6(1), 59-76.

22.

전겸구, 한덕웅, 이장호, Spielberger (1997). 한국판 STAXI 척도 개발: 분노와 혈압. 한국심리학회지: 건강, 2(1), 60-78.

23.

정한용, 박준호, 이소영 (2004). 우울증상과 성별에 따른 신체화 환자의 인지적 특성. 신경정신의학회지, 40, 425-431.

24.

최성일, 김중술, 신민섭, 조맹제 (2001). 분노표현방식과 우울 및 신체화 증상과의 관계. 대한신경정신의학회, 40(3), 425-433.

25.

한진아, 김미진 (2016). 간호사의 분노, 직무스트레스, 사회적 지지에 대한 대인 돌봄행위의 융합적 연구. 한국융합학회논문지, 7(3), 87-98.

26.

Aldao, A., & Nolen-Hoeksema, S. (2010). Specificity of cognitive emotion regulation strategies: A transdiagnostic examination. Behaviour Research and Therapy, 48, 974-983.

27.

Baldacchino, D. R. (2012). Student nurses'personality traits and the nursing profession:Part 1. British Journal of Nursing, 21, 419-425.

28.

Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173-1182.

29.

Beblo, T., Fernando, S., Klocke, S., Griepenstroh, J., Aschenbrenner, S., & Driessen, M. (2012). Increased suppression of negative and positive emotions in major depression. Journal of Affective Disorders, 141, 474-479.

30.

Brotheridge, C. M., & Grandey, A. A. (2002). Emotional labor and burnout: Comparing two perspectives of “people work”. Journal of Vacational Behavior, 60(1), 17-39.

31.

Brotheridge, V. M., & Lee, R. (2003). Development and validation of the emotional labour scale. Journal of Occupational and Organizational Psychology, 76, 365-379.

32.

Cha, N. H. & Sok, S. R. (2014). Depression, self-esteem and anger expression patterns of Korean nursing students. International Nursing Review, 61, 109-115.

33.

Cox, D. L., Van Velsor, P., & Hulgus, J. (2004). Who me, angry? Patterns of anger diversion in women. Health Care For Women International, 25, 872-893.

34.

D'avanzato, C., Joormann, J., Siemer, M., & Gotlib, I. H. (2013). Emotion regulation in depression and anxiety: Examining diagnostic specificity and stability of strategy use. Cognitive Therapy and Research, 37, 968-980.

35.

De Gucht, V., Fischler, B., & Heiser, W. (2003). Job stress, personality, and psychological distress as determinants of somatization and functional somatic syndromes in a population of nurses. Stress and Health, 19, 195-204.

36.

Derogatis, L. R. (1977). SCL-90 Manual-1. Baltimore, MA: John Hopkins University Clinical Psychometrics Research Unit.

37.

Eftekhari, A., Zoellner, L. A., & Vigil, S. A. (2009). Patterns of emotion regulation and psychopathology. Anxiety, Stress & Coping, 22, 571-586.

38.

Fiocco, A. J., & Mallya, S. (2015). The importance of cultivating mindfulness for cognitive and emotional well-being in late life. Journal of Evidence-Based Complementary and Alternative Medicine, 20, 35-40.

39.

Frattaroli, J. (2006). Experimental disclosure and its moderators: A meta-analysis. Psychological Bulletin, 132, 823-865.

40.

Geisser, M. E., Casey, K. L., Brucksch, C. B., Ribbens, C. M., Appleton, B. B., & Crofford, L. J. (2003). Perception of noxious and innocuous heat stimulation among healthy women and women with fibromyalgia: Association with mood, somatic focus, and catastrophizing. Pain, 102, 243-250.

41.

Grandey, A. A. (2000). Emotional regulation in the workplace: A new way to conceptualize emotional labor. Journal of Occupational Health Psychology, 5(1), 95-110.

42.

Grandey, A. A., Tam, A. P., & Brauburger, A. L. (2002). Affective states and traits in the workplace: Diary and survey data from young workers. Motivation and Emotion, 26(1), 31-55.

43.

Gross, J. (1998). The emerging field of emotion regulation: An integrative review. Review of General Psychology, 2, 271-299.

44.

Gross, J. J., & Levenson, R. W. (1997). Hiding feelings: The acute effects of inhibiting negative and positive emotion. Journal of Abnormal Psychology, 106(1), 95-103.

45.

Han, A., Won, J., Kim, O., & Lee, S. E. (2015). Anger expression types and interpersonal problems in nurses. Asian Nursing Research, 9, 146-151.

46.

Harris, C. R. (2001). Cardiovascular responses of embarrassment and effects of emotional suppression in a social setting. Journal of Personality and Social Psychology, 81, 886-897.

47.

Harshaw, C. (2015). Interoceptive dysfunction:Toward an integrated framework for understanding somatic and affective disturbance in depression. Psychological Bulletin, 141, 311-363.

48.

Hayes, A. F. (2009). Beyond Baron and Kenny:Statistical mediation analysis in the new millennium. Communication Monographs, 76, 408-420.

49.

Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. New York: The Guilford Press.

50.

Hayes, S. C., Strosahl, K, Wilson, K G., Bissett, R T., Hstrorello, J., & Toarmino, D. (2004). Measuring experiential avoidance: A preliminary test of a working model. The Psychological Record, 54, 553-578.

51.

Hayward, R. M., & Tuckey, M. R. (2011). Emotions in uniform: How nurses regulate emotion at work via emotional boundaries. Human Relations, 64, 1501-1523.

52.

Henderson, A. (2001). Emotional labor and nursing: An under-appreciated aspect of caring work. Nursing Inquiry, 8, 130-138.

53.

Hochschild, A. R. (1983). The managed heart:Commercialization of human feeling. Berkeley, CA:University of California Press.

54.

Jones, S. E., Miller, J. D., & Lynam, D. R. (2011). Personality, antisocial behavior, and aggression: A meta-analytic review. Journal of Criminal Justice, 39, 329-337.

55.

Kellner, R., Hernandez, J., & Pathak, D. (1992). Self-rated anger, somatization and depression. Psychotherapy and Psychosomatics, 57, 102-107.

56.

Kennedy-Moore, E., & Watson, J. C. (2001). How and when does emotional expression help? Review of General Psychology, 5, 187-212.

57.

Kirmayer, L. J., Groleau, D., Looper, K. J., & Dao, M. D. (2004). Explaining medically unexplained symptoms. The Canadian Journal of Psychiatry, 49, 663-672.

58.

Koh, K, B., Kim, D, K., Kim, S, Y., Park, J, K., & Han, M. (2008). The relation between anger management style, mood and somatic symptoms in anxiety disorders and somatoform disorders. Psychiatry Research, 160, 372-379.

59.

Lazarus, R. S. (1991). Emotion and adaptation. New York: Oxford University Press.

60.

Lipowski, Z. J. (1988). Somatization: The concept and its clinical application. American Journal of Psychiatry, 145, 1358-1368.

61.

Liu, L., Cohen, S., Schulz, M. S., & Waldinger, R. J. (2011). Sources of somatization: Exploring the roles of insecurity in relationships and styles of anger experience and expression. Social Science & Medicine, 73, 1436-1443.

62.

Martin, R., Wan, C. K., David, J. P., Wegner, E. L., Olson, B. D., & Watson, D. (1999). Style of anger expression: Relation to expressivity, personality, and health. Personality and Social Psychology Bulletin, 25, 1196-1207.

63.

Mazaheri, M. (2015). Difficulties in emotion regulation and mindfulness in psychological and somatic symptoms of functional gastrointestinal disorders. Iranian Journal of Psychiatry and Behavioral Sciences, 9, e954.

64.

Menchetti, M., Cevenini, N., De Ronchi, D., Quarteson, R., & Berardi, D. (2006). Depression and frequent attendance in elderly primary care patients. General Hospital Psychiatry, 28, 119-124.

65.

Mezzich, J. E., Lin, K., & Hughes, C. C. (2000). Acute and transient psychotic disorders and culture-bound syndromes. Baltimore, MD:Lippincott Williams & Wilkins.

66.

Moura, K., Troth, A. C., & Jordan, P. J. (2015). Crossing the impropriety threshold: A study of experiences of excessive anger. New Ways of Studying Emotions in Organisations, 11, 369-395.

67.

Ohayon, M. M. (2004). Specific characteristics of the pain/depression association in the general population. Journal of Clinical Psychiatry, 65, 5-9.

68.

Özyesil, Z. (2012). Five factor personality trait as predictor of trait anger and anger expression. Egitim Ve Bilim, 37, 322-332.

69.

Park, S. C., Sakong, J., Koo, B. H., Kim, J. M., Jun, T. Y., Lee, M. S., ... Park, Y. C. (2016). Clinical significance of the number of depressive symptoms in major depressive disorder: Results from the CRESCEND study. Journal of Korean Medical Science, 31, 617-622.

70.

Preacher, K. J. & Hayes, A. F. (2004). SPSS and SAS procedures for estimating indirect effects in simple mediation models. Behavior Research Methods, Instruments, & Computers, 36, 717-731.

71.

Radloff, L. S. (1977). The CES-D scale a self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385-401.

72.

Sayer, K., Kirmayer, L. J., & Taillerfer, S. (2003). Predictors of somatic symptoms in depressive disorder. General Hospital Psychiatry, 25, 108-114.

73.

Schatzberg, A. F. (2004). The relationship of chronic pain and depression. Journal of Clinical Psychiatry, 65, 3-4.

74.

Shin, J. M., & Cho, S. H. (2014). The effects of emotional clarity on anger expression attitude:The mediating effects of anger rumination. Journal of Human Understanding and Counseling, 35(1), 129-148.

75.

Smith, P. (1992). The emotional labour of nursing. London: Macmillan.

76.

Spielberger, C. D., Krasner, S. S., & Solomon, E. P. (1988). The experience, expression, and control of anger. In M. P. Janisse (Ed.). Health psychology: Individual differences and stress (pp.89-108). New York: Springer-Verlag.

77.

Vaccarino, A. L., Sills, T. L., Evans, K. R., & Kalali, A. H. (2009). Multiple pain complaints in patients with major depressive disorder. Psychosomatic Journal, 71, 159-162.

78.

Wearden, A. J., Lamberton, N., Crook, N., & Walsh, V. (2005). Adult attachment, alexithymia, and symptom reporting: An extension to the four category model of attachment. Journal of Psychosomatic Research, 58, 279-288.

79.

Welsh, D. (2009). Predictors of depressive symptoms in female medical-surgical hospital nurses. Issues in Mental Health Nursing, 30, 320-326.

80.

Yenilmez, Y., Erten, E., Fistikci, N., Saatciog lu, O., & Kivrak, Y. (2013). Anger Expression and impulsivity in conversion disorder. European Psychiatry, 28 Supplement 1 Abstracts of the 21th European Congress of Psychiatry, 1.

81.

Yoon, S. L., & Kim, J. H. (2013). Job-related stress, emotional labor, and depressive symptoms among Korean nurses. Journal of Nursing Scholarship, 45, 169-176.

Korean Journal of Psychology: General