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RISS 인기검색어
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- 저자 : 정재열(Jaeyeul Jung) (검색결과 3 건)
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정신분열병 환자의 살인행동과 관련된 기질 및 성격 특성
정재열(Jaeyeul Jung),정석훈(Seockhoon Chung),문필성(Pilsung Moon),김창윤(Chang Yoon Kim),홍진표(Jin Pyo Hong) 대한사회정신의학회 2007 사회정신의학 Vol.12 No.2
연구목적: 기질성격검사를 통하여 살인행동을 보인 정신분열병 환자의 인격적 특성을 알아보고자 한다. 방 법: 살인행동을 보인 정신분열병 환자 84명과 살인행동을 보인 적이 없는 정신분열병 환자 100명, 정상대조군 61명을 대상으로 하여 한국판 기질성격검사를 시행하였다. 일원배치분산분석과 t-검증을 통하여 세 군 간의 기질성격검사의 결과를 비교하였다. 구조화된 면담도구인 SCID(Structured Clinical Interview for DSM-Ⅳ)를 이용하여 진단을 하였고, 양성 및 음성 증상척도 (Positive And Negative Syndrome Scale, PANSS)를 측정하였다. 공격성척도는 LHA(Life History of Aggression)를 사용 하였다. 결 과: 새로움추구요인(Novelty seeking)은 살인행동을 보인 정신분열병 환자들(homicidal schizophrenic patients, HS)이 살인행 동을 보인 적 없는 정신분열병 환자들(non-homicidal schizophrenic patients, NHS)보다 더 낮은 것으로 나타났다(p=0.01). 위험회피요인(Harm avoidance, HA)과 자기초월성(Self-transcendence, ST)은 두 정신분열병 환자군(HS, NHS)에서 일반 대조군에 비해 유의미하게 높게 나왔다(p<0.01). 보상의존요인(Reward dependence, RD)과 자기중심성(Self-directedness, SD), 사회협조성(Cooperativeness, C)은 일반대조군에 비해 낮은 점수를 보였다(p<0.01). 양성 및 음성 증상척도의 총합점수와 인구학적 변인의 차이는 보이지 않았다. 결 론: 높은 새로움추구요인(Novelty seeking)은 살인행동을 보인 정신분열병 환자들의 인격적 특성이 아니며 이번 연구를 통해 기존의 연구결과에서처럼 정신분열병 환자들이 일반대조군에 비해 높은 위험회피요인(HA)과 자기초월성(ST)을 보인다는 것을 확인하였다. Objectives:The aim of this study was to assess dimensions of temperament and character in homicidal schizophrenic patients by using the temperament and character inventory(TCI) which was defined based on Cloninger’s biosocial model. Subjects and Methods:Eighty four homicidal schizophrenic patients and 100 non-homicidal schizophrenic patients and 61 normal controls participated in this study. We used the Korean version of the TCI to compare these 3 groups. Diagnostic evaluation was made with Structured Clinical Interview for DSM-Ⅳ(SCID), and symptom evaluation was made with Positive and Negative Syndrome Scale(PANSS), and violent behavior was assessed with Life History of Aggression(LHA). Results:Novelty seeking(NS) was lower in homicidal schizophrenic patients(HS) than non-homicidal schizophrenic patients(NHS)(p=0.01). Harm avoidance(HA) and Self-transcendence(ST) were higher in two schizophrenic patients groups(HS, NHS) than normal control(p<0.01). In two schizophrenic patients groups(HS, NHS) Reward dependence(RD) and Self-directedness(SD) and Cooperativeness(C) were lower than normal control(p<0.01). Conclusion:The author found that higher NS was not a characteristic of homicidal schizophrenic patients comparing with non-homicidal schizophrenic patients. This study replicates the results of previous studies suggesting that schizophrenic patients have high HA and high ST.
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살인 행동을 보인 정신분열병 환자에서 MMPI와 SCL-90-R 검사의 특징
강시현(Shi Hyun Kang),정석훈(Seockhoon Chung),정재열(Jaeyeul Jung),정혜윤(Hye Yoon Chung),성명제(Myung-Jae Sung),김민후(Min Hoo Kim),송해철(Hae-Cheol Song),권수희(Soo Hie Kwon),진영식(Young Sik Jin),백상빈(Sang-Bin Baek) 대한사회정신의학회 2005 사회정신의학 Vol.10 No.2
목 적: 공격성은 정신분열병 환자에게 나타나는 심각한 문제 중 하나이다. 공격성의 가장 극단적 형태인 살인 행동을 보인 정신분열병 환자들이 경험하는 주관적인 정신 증상 및 심리 상태의 특성을 알아보고자 본 연구를 시행하였다. 방 법: 살인 행동이 있었던 정신분열병 입원 환자(n=64)를 연구대상으로 하였고 살인 행동은 없었으며 실험군과 나이, 교육 연한, 항정신병 약물 용량을 짝짓기하여 선정한 정신분열병 입원 환자를 대조군(n=75)으로 선정하여 두 군간의 주관적 정신 증상 및 심리상태를 비교 연구하였다. 주관적 상태는 Minnesota Multiphasic Personality Inventory(MMPI)와 Symptom checklist-90-R(SCL-90-R)로 평가하였다. 살인 행동 환자군은 살인 행동 후 정신감정 시점에 검사된 MMPI와 SCL-90-R결과를 얻었다. 결 과: 살인 행동을 보인 환자군은 대조군에 비하여 MMPI와 SCL-90-R검사 모두에서 전반적으로 더 높은 점수를 받았다. MMPI 검사에서 우울증, 히스테리, 반사회성, 편집증, 내향성 척도가 살인 행동군에서 대조군에 비해 유의하게 높았다. SCL-90-R 검사에 서는 강박증, 대인관계 예민성, 불안, 편집증, 정신증 항목에서 살인 행동군에서 통계적으로 유의하게 높은 점수를 보였다. 결 론: 살인 행동을 보인 정신분열병 환자군은 주관적으로 사회적 상황에서 정서적으로 불안정하여 피해의식을 쉽게 느끼고 분노와 정감 조절이 어려울 때 인지적 왜곡에 부합하여 공격적 행동이 유발될 가능성이 있다. Objectives:Violence is a serious problem in some patients with schizophrenia. Homicide is one of the most extreme aggressive behavior. The purpose of this study was to investigate the characteristics of subjective symptomatology and psychological state of schizophrenia with homicidal behavior. Methods:Subjects were schizophrenia patients hospitalized in a mental hospital due to their homicidal behavior (n=64, group 1). Control subjects were schizophrenia patients without homicide also hospitalized in another mental hospital(n=75, group 2). Subjects were matched by age, years of education and dosage of antipsychotics. Minnesota Multiphasic Personality Inventory(MMPI) and Symptom checklist-90-R(SCL-90-R) were used to evaluate the subjective symptomatology. In group 1, the results of MMPI and SCL-90-R had been acquired following the incident that led to hospitalization. Results:Schizophrenia patients with homicide showed overall elevated MMPI clinical scales and SCL-90-R scales. The group with homicidal behavior had significantly higher scores than patients without homicidal behavior on the subscales of depression, hysteria, psychopathic deviance, paranoid, social introversion as assessed by the MMPI. They also had significantly higher scores on the subscales of obsessive-compulsive, interpersonal sensitivity, anxiety, paranoid ideation, psychoticism as assessed by the SCL-90-R. Conclusion:Schizophrenia patients with homicidal behavior did present different clinical subjective pictures : unstable emotion, more paranoid tendency, difficulty with control of anger, more perceptual disturbance. Under those subjective states they had a risk of violent behavior.
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정석훈,이태경,정재열,장정기,장상현,이미경,강시현,정혜윤,유한익,김창윤,홍진표 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.1
Objectives : Recent studies have shown that schizophrenic patients are at increased risk to commit acts of aggression, and aggressive behaviors have severe critical results for the patients and victims. The purpose of the present study is to assess the homicidal behaviors of schizophrenic patients as a extreme case of aggressiveness. Methods : 93 homicidal schizophrenic patients and 93 non-homicidal schizophrenic patients participated in this study. Diagnostic evaluation was made with SCID (Structured Clinical Interview for DSM-IV), and personality trait was evaluated with SIDP (Structured Interview for DSM-IV Personality Disorders). Symptom evaluation was done with PANSS (Positive And Negative Syndrome Scale), and violent behaviors were assessed with LHA (Life History of Aggression) and OAS (Overt Aggression Scale). Results : There were no significant differences in demographic vahables, schizotypal personality trait and antisocial Personality trait between two groups. Mean age at homicidal commitment was 34±8.9 years and 9.8±7.5 years after the onset of illness. The major criminal victims were the parents of the patients (N=49, 53.7%). The aggressiveness was higher in homicidal schizophrenic patients in LHA and OAS scales. There were statistical significances in separate items of the PANSS scale such as excitement (P4), Poor rapport (N3), lack of judgement and insight (G12), disturbance of volition (G13), Poor impulse control (G14) and active social avoidnance (G16), but not in the positive, negative, general subscales and the total scores of the PANSS scale. Conclusion : Excitement and poor impulse control persisted in homicidal schizophrenics, although overt psychotic Symptoms decline after proper treatment. Homicidal behavior can be preventive if proper treatment for excitement and poor impulse control are given.
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