비자살적 자해 회복 척도 개발 및 타당화 = Development and Validation of Nonsuicidal Self-Injury Recovery Scale

다국어 초록 (Multilingual Abstract)

The goal of this study was to develop and validate a measure of self-rated recovery scale about nonsuicidal self-injury for Korean adults. Nonsuicidal self-injury(NSSI), defined as the direct and deliberate bodily harm repeated in the absence of suicidal intent, and for purposes not socially sanctioned. Researchers have been attempting to understand what factors may help them recover from this addictive behavior. However, existing measurements about self-injury tend to focus on current status and motivations regarding self-injurious behaviors and thoughts. The current study describes the development of a self-report measure of nonsuicidal self-injury recovery, which was designed to build upon existing measures.
To develop this measure, the constructs were derived from experiences reported by Koreans recovering from nonsuicidal self-injury, including the search for meaning in life and growth, recovery from negative self-image, the development of alternative coping strategies and resilience, recovery of belief in interpersonal relationships, and the rediscovery of meaning in NSSI. Through literature reviews, open questionnaires, FGI on NSSI adults, and expert interviews, the 5-factor construct was derived, and 128 questions were selected. An exploratory factor analysis(EFA) of the preliminary survey results from 300 NSSI experienced adults in Korea suggested 24 questions of a 3-factor construct, and these factors were labeled recovery of self-efficacy, recovery of belief in interpersonal relationships, and rediscovering the meaning of NSSI. Then, confirmatory factor analysis was performed on 300 NSSI adults in Korea to confirm the structure identified in the EFA, with 24 items forming 3 latent factors.
A range of measures was completed for validation purposes. First, convergence validity was examined using NSSI-TTM, and a significant positive correlation indicated that the current scale measured NSSI recovery. Also, significant negative correlations with difficulties in emotion regulation and interpersonal needs were confirmed. Second, the current scale demonstrated moderate-sized correlations with measures of optimism, self-esteem, and resilience, which offer criterion-related validity. Third, significant group differences were observed across all NSSi Recovery subscales, differentiating people with a level of NSSI recovery, suicidal self-injury history, and addictive NSSI. Fourth, the incremental validity of the current scale was explored in a series of multivariate hierarchical regressions. The NSSI Recovery Scale predicted likelihood of future NSSI, past month urges, and level of NSSI recovery, whilst controlling for NSSI-TTM and RESST. In addition, the internal consistency was confirmed using split half reliability. Based on these results, the NSSI Recovery Scale demonstrates strong reliability and validity, suggesting its usefulness as a measure of recovery from NSSI. Finally, the implications and limitations of this study were discussed.

목차 (Table of Contents)

• Ⅰ. 서 론 1
• 1. 연구의 필요성과 목적 1
• 2. 연구문제 7
• 3. 용어의 정의 8
• Ⅱ. 이론적 배경 10
• 1. 비자살적 자해 10
• 2. 비자살적 자해 회복 15
• 3. 비자살적 자해 회복 관련 척도 29
• 4. 비자살적 자해 회복 척도의 구성요소 36
• 5. 비자살적 자해 회복과 관련된 심리적 특성 39
• Ⅲ. 연구1. 비자살적 자해 회복 척도의 개발 43
• 1. 비자살적 자해 회복 척도의 개발 절차 43
• 2. 구성요소 추출 및 기초 예비문항 작성 44
• 3. 최종 예비 문항 선정을 위한 검토 58
• 4. 최종문항 선정 88
• 5. 논의 111
• Ⅳ. 연구2. 비자살적 자해 회복 척도의 타당성 검증 119
• 1. 연구대상 및 절차 119
• 2. 측정도구 122
• 3. 자료 분석 126
• 4. 결과 127
• 5. 논의 143
• Ⅴ. 종합논의 149
• 참고문헌 157
• 국문초록 178
• 부 록 180