공황 장애의 인지적 기제로서 임박형 이분법 사고의 작용

황성훈 한국인지행동치료학회 2018 인지행동치료 Vol.18 No.3

인지적 이론은 공황을 신체 감각에 대한 재앙적 오해석의 결과로 설명한다. 본 연구는 공황 장애 환자를 대상으로 이분법 사고가 재앙적 오해석에 해당하는 인지적 증폭 작용을 한다는 가설을 검증하고자 했다. 대학생 표집을 대상으로 한 앞선 연구(황성훈, 이훈진, 2012)에서 이 가설은 입증되지 못한 바 있다. 그 원인이 공황 장애에 특유한 이분법 사고를 측정하지 않았 다는 분석에서, 본 연구는 일반형 이분법 사고 외에도 공황 발작의 응급성을 반영하는 임박 형 이분법 사고 척도를 적용하였다. 정신과 전문의나 임상심리전문가의 DSM-IV에 기초한 임 상 진단에 따라, 공황 장애 환자 21명, 신체형 장애(DSM-5 기준, 신체 증상 장애) 환자 18명, 건강한 통제 집단 20명이 선별되었고, 이들에게 신체 감각 증폭 척도, 이분법 사고 지표 개정 판, 임박형 이분법 사고 지표가 실시되었다. 신체 감각에 대한 예민성에서 예측대로 신체형 장애 집단이 가장 높고, 그 다음이 공황 장애 집단이었으며, 건강한 통제 집단이 가장 낮았 다. 이분법 사고는 일반형과 임박형에 따라서 달랐다. 일반형은 공황 장애 집단과 신체형 장 애 집단이 건강한 통제 집단보다 높되, 두 환자 집단간 차이는 없었다. 반면 임박형 이분법 사고에서는 가정대로 공황 장애 집단이 가장 높아서, 신체형 장애 집단과 변별되었으며, 건강 한 통제 집단이 가장 낮았다. 끝으로 본 연구의 이론적, 임상적 시사점을 제시하였으며, 한계 와 이를 보완하기 위한 미래 연구의 방향을 논의하였다. The cognitive theory explains that panic disorders result from catastrophic misinterpretations on bodily sensations. Following the preceding study (Hwang & Lee, 2012), current study was conducted to test the hypothesis that the dichotomous thinking (DT) works as a cognitive amplifier corresponding to catastrophic misinterpretations in patients with panic disorders. The reason why Hwang and Lee (2012) did not succeed in testing the same hypothesis in college students could be because they did not use measure of DT specific to panic disorder. Upon this analysis, measures for imperative DT reflecting the nature of urgency specific to panic attack was developed and used in addition to measures for general DT. Based upon the clinical diagnoses of psychiatrists or clinical psychologists according to DSM-IV, patients with panic disorder (PD) and with somatoform disorder (SD; each 21 and 18 subjects), and 20 healthy controls (HC) were screened out. To them Somatosensory Amplification Scale (SSAS), Dichotomous Thinking Index, General and Imperative version(DTI-30R, I-DTI each) were administered. As predicted, in the sensitivity to bodily sensation there were significant differences with SD as the highest, PD as second-highest and HC as the lowest. Results concerning DT differed according to the subtype. In the general version of DT the both SD and PD were higher than HC while the two patient groups did not differ from each other. However the imperative DT, as assumed, revealed the significant difference in the descending sequence of PD, SD, and HC. In the end, theoretical and clinical implications of these findings were discussed with the same emphasis on the limitations of present study and directions for future one.

한국판 정서적 불안정성 척도-단축판의 타당화

황성훈 한국임상심리학회 2015 Korean Journal of Clinical Psychology Vol.34 No.3

Affective instability is a construct that has not received sufficient research attention in spite of its close relation with various areas of psychopathology. Through the study, it was attempted to translate and validate in Korean sample the Affective Lability Scale-Short Form (ALS-SF; Oliver & Simons, 2004), a self-report scale measuring affective instability. In Study 523 cyber university students completed the ALS-SF along with the Personality Assessment Inventory-Borderline Features Scale, Bipolar Spectrum Disorder Scale, and Beck Depression Inventory, three measures working as criteria variables for validation. ALS-SF showed significant correlations with all three measures, supporting its convergent validity. In addition, the exploratory factor analysis to examine the internal structure revealed the same 3-factor structure consisting of “Elation/Depression”, “Anxiety/Depression”, and “Anger” factor as in previous studies. As a further research effort, the construct validity of the ASL-SF was investigated against the criterion of everyday life in Study 2. For this purpose, the high and low affective lability (AL) group that were screened from the sample of Study 1 using the ALS-SF (each consisting of 21 subjects) kept mood diaries over two weeks, the standard deviations of which were analyzed as the index of mood variability. In the results, the high AL group showed greater variability in both positive and negative mood than the low AL group, supporting the construct validity of the ALS-SF. The score for the ALS-SF measured at a single point in time can predict the ups and downs of mood over time in everyday life. Finally, the limitations of this study and possible directions for future research were discussed.

임무형 지휘가 조직 효과성에 미치는 영향에 관한 연구 - 조직문화의 매개효과를 중심으로 -

황성훈,Hwang, Sung-Hoon 대전대학교 군사연구원 2018 군사학연구 Vol.15 No.-

The purpose of this study is to verify the relationship between mission-oriented Command, organization efficiency, organization culture of 626 field officers in JFMU. Firstly. the study found that decision making in the relationship between mission-oriented command and organization efficiency had negative effect on job satisfaction. Planning and trust lead to positive effect on job satisfaction and organizational commitment and no significance in self decision. Secondly, mission-oriented command may differ depending on the types of organization culture and organization culture has positive effect on job satisfaction and organizational commitment. Thirdly, mission-oriented command has some effect which derives from its impact on organization efficiency that also effects rational culture and rank hierarchy culture. These study results suggest different measures in terms of practice and policy. Firstly. within the military organization, precise communication will lead to job satisfaction without unnecessary overload of communication. Also. we have rationale culture, agreement culture and rank hierarchy culture forming our organization culture. There is a need to apply elements of mission-oriented command depending on the types of organization culture. Secondly, to maximize organization performance through mission-oriented command, we have to strengthen the rationale and rank hierarchy cultures and especially introduce development culture which should be established within the military organization.

불안 민감성에 대한 이요인 이론의 제안과 그 타당화: 공황장애 집단과 신체형 장애 집단을 중심으로

황성훈,이훈진,이수현 한국임상심리학회 2006 Korean Journal of Clinical Psychology Vol.25 No.3

The purpose of this study was to test the hypothesis that the anxiety sensitivity known as a major mechanism of panic disorder may be divided into dual factors, one being somatic sensitivity, the other being catastrophic interpretation. For this purpose, we modified the anxiety sensitivity index-revised(ASI-R) into two-step rating, somatic sensitivity in the first step and cognitive interpretation in the second step, that can reflect the dual factors. In study 1, we compared panic group and somatization group with control group(each 30 subjects) selected from 500 college students. As predicted from dual factor hypothesis, in the first step rating of somatic sensation, the somatization group exceeded the panic group. However in the second rating(catastrophizing), the panic group did not exceed the somatization group. In study 2, panic patients and somatoform disorder patients(each 30 patients) were compared with 30 normal controls. In the somatic sensation factor, the result of study 1 was replicated, and in the catastrophic interpretation factor, the predicted difference was revealed. That is, in the catastrophic interpretation the panic patients were higher than somatoform disorder patients. These findings support the validity of dual factor hypothesis which says that although panic disorder and somatoform disorder share two-factor structure, panic disorder may be dominant in catastrophic interpretation and somatoform disorder may be prominent in somatic sensation. The dual factor theory may build a conceptual bridge between anxiety sensitivity research and Clark's cognitive model of panic disorder. In clinical settings, it will also contribute to the differential diagnosis and therapy of panic disorders.

정서적 불안정성의 배후 기제로서 이분법적 사고

황성훈 한국인지행동치료학회 2018 인지행동치료 Vol.18 No.2

본 연구는 이분법적 사고가 정서적 불안정성과 어떻게 관련되어 있는지를 살피고자 했다. 사고의 이분법이 정서의 지나친 가변성을 초래한다는 가정을 검증하기 위해 정서 자극 평정 과제를 제작해 사용했다. 이분 법 사고 척도-개정판을 200명의 사이버대학생에게 실시해서, 이분법 사고가 높은 집단과 낮은 집단(각 40 명)을 선별하였다. 두 집단은 정서 자극 평정 과제에서 긍정 시나리오와 부정 시나리오, 그리고 이 둘이 혼합된 가상의 시나리오 각각을 읽고 기쁨과 슬픔 차원에서 정서적 반응을 평정했다. 정서 자극 평정 과제의 결과는 기쁨과 슬픔에 관해 반응할 때 (1) 단일 양극 차원에 대한 선호, (2) 한 정서(예컨대, 기쁨)가 반대되는 정서(예컨대, 슬픔)에서 떨어진 거리, (3) 눈금이 없는 척도에 스스로 그려 넣은 눈금의 수 등으로 지표 화되었다. 고 이분법 사고 집단은 정서 평정에서 양극 차원을 선호하고, 기쁨과 슬픔 사이에 더 먼 거리를 설정하며, 눈금의 수가 적을 것이라 예언되었는데, 이는 부분적으로 지지되었다. 단일 양극 차원의 선호에 서는 고저 이분법 사고 집단 간에 유의한 차이가 없었고, 고이분법 사고 집단이 긍정 정서 평정에서 저이 분법 사고 집단에 비해 반대되는 정서로부터의 거리를 오히려 더 짧게 설정하였으며, 고 이분법 집단은 시 나리오의 정서가에 관계없이 더 적은 눈금을 표시하였다. 정서 평정의 차원에서 기쁨과 슬픔의 중간 구분 이 적고, 현재의 기쁨이 잠재적인 슬픔과 근접해 있는 것은 이분법 사고가 정서적 가변성을 초래하는 기제를 설명해준다. 끝으로 임상적 시사점과 함께 본 연구의 한계와 향후 연구의 방향을 논의하였다. I explored whether and how dichotomous thinking (DT) is related to mood variability (MV). Ratings of Emotional Stimulus (RES) task was created in order to understand the connectedness between DT and MV. The high and low DT groups (each consisting of 40 subjects) were screened based on the results of the Dichotomous Thinking Index-30 Revised (DTI-30R; Hwang, 2007) from the population of 200 cyber university students. The two groups completed RES, where they were directed to read fictional scenarios containing positive, negative, or mixed emotional valence, and to rate their emotional response on the dimensions of joy and sadness. The RES was supposed to yield its results mainly in three ways: (a) preference for a single bipolar emotional dimension (i.e., joy and sadness are placed at each end of dimension) over a couple of unipolar ones (i.e., joy and sadness are separately placed to two independent dimensions); (b) distance of one emotion (e.g., joy) from the opposite one (e.g., sadness) on the sadness-joy dimension; (c) number of markings added on the unmarked sadness-joy dimension. It was predicted that DT would be related to a higher preference for bipolar scale, to a longer distance between joy and sadness, and to fewer markings. As results, the predictions turned out to be partly supported: (a) In the preference for a single bipolar scale, there was no significant difference between groups; (b) the high DT group set shorter, not longer, distance between joy and sadness than the low DT group only when rating positive emotion; (c) the high DT group made fewer divisions on sadness-joy dimension regardless of emotional valence. These findings from RES may explicate the mechanism through which DT brings MV as its consequence. In addition to its implications, several limitations and possible directions for future research were discussed.

[特輯]Fuzzy Logic을 이용한 영상분할 알고리듬

황성훈,정호선 한국정보과학회 1992 정보과학회지 Vol.10 No.1

양극성 성향을 지닌 대학생 집단에서 기분 왕복과 이분법 사고의 관계

황성훈 한국임상심리학회 2013 Korean Journal of Clinical Psychology Vol.32 No.4

In this study, we attempted to investigate the role of dichotomous thinking (DT) as the mechanism of mood shuttle, a core symptom of Bipolar Disorder (BD). We examined whether bipolar persons use DT when they evaluate affective stimuli. Bipolar Spectrum Diagnostic Scale (BSDS) and Mood Disorder Questionnaire (MDQ) were administered to 209 cyber university students. From them, a bipolar tendency group (BG, 19 subjects) and a control group (CG, 20 subjects) were screened based upon the scores of two bipolar symptom scales, MDQ and BSDS. Then two groups answered the Dichotomous Thinking-Index Revised (DTI-30R) and responded to the Affective Stimulus Rating Task (ASRT) developed to measure dichotomous judgment style in emotional situations. In the ASRT, subjects read scenarios of various valence (positive/negative/mixed) and rated the dimension of pleasure vs sadness. The BG revealed higher DT than the CG. Also, the BG set shorter distances between a certain affect and the opposite affect (e.g. pleasure vs. sadness) than the CG. When judging emotional situation, the BG marked fewer anchors on the self-anchoring scale than the CG. Overall, the extreme ends on the “sadness-pleasure” dimension were closer to each other, and the dimension had fewer gradations in the BG. The closeness of distance and fewer divisions between contrary affects may act as the mechanism of mood shuttle in BD. Finally, the clinical implications of this study were discussed, and the limitations of the present research with directions for future studies were presented.

편집증에서 이분법적 사고의 작용

황성훈,이훈진 한국임상심리학회 2009 Korean Journal of Clinical Psychology Vol.28 No.4

This study aimed to investigate the role of dichotomous thinking (DT) as a major vulnerability in paranoia, testing the hypotheses that paranoid persons may use more DT and that paranoid symptoms may result from the dichotomous interpretation of interpersonal life events. When measured via the Dichotomous Thinking Index, the paranoid group (69 college students screened with Paranoia Scale) used DT more than control group (67 college students screened with Paranoia Scale) did. There was a larger difference between the groups on the ‘social splitting’ subscale, which divides persons into my side vs. your side, friend vs. enemy. We subsequently analyzed the whole sample (338 persons) by means of multiple regressions calculated with the paranoia score as a dependent measure and with each DT and life event as independent variables. The results showed DT interacted with interpersonal life events (such as criticism, and refusal) to predict the paranoid symptoms. However, non-interpersonal events (such as financial difficulty, and disease) didn't interact with DT in predicting paranoia. That is, the results showed the pathological functioning of DT in paranoia is confirmed but confined to the domain of interpersonal relationships. These results support the hypothesis that DT plays a role as cognitive vulnerability in paranoia. Finally, we discuss implications and limitations of this study and present directions for future researches.

임무형 지휘가 조직 효과성에 미치는 영향에 관한 연구

황성훈 대전대학교 군사연구원 2006 군사학연구 Vol.15 No.-

The purpose of this study is to verify the relationship between mission-oriented Command, organization efficiency, organization culture of 626 field officers in JFMU. Firstly. the study found that decision making in the relationship between mission-oriented command and organization efficiency had negative effect on job satisfaction. Planning and trust lead to positive effect on job satisfaction and organizational commitment and no significance in self decision. Secondly, missionoriented command may differ depending on the types of organization culture and organization culture has positive effect on job satisfaction and organizational commitment. Thirdly, mission-oriented command has some effect which derives from its impact on organization efficiency that also effects rational culture and rank hierarchy culture. These study results suggest different measures in terms of practice and policy. Firstly. within the military organization, precise communication will lead to job satisfaction without unnecessary overload of communication. Also. we have rationale culture, agreement culture and rank hierarchy culture forming our organization culture. There is a need to apply elements of mission-oriented command depending on the types of organization culture. Secondly, to maximize organization performance through mission-oriented command, we have to strengthen the rationale and rank hierarchy cultures and especially introduce development culture which should be established within the military organization.

측두엽 간질과 우울의 관계

황성훈,함웅 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.4

Objectives : Regarding the relationship between the laterality of seizure focus and depression in temporal lobe epilepsy (TLE), previous studies reported inconsistent results. The role of frontal function as moderating variable between laterality and depres-sion had been proposed. We attempted to replicate functional involvement of frontal lobe (FIFL) and, as an effort to extend previous findings, to test the functional involvement of parietal lobe (FIPL) to prove the hypothesis derived from Heller's Valen-cearousal theory of emotion. Methods : In study 1, Patients with TLE (right 19, left 17) performed MMPI-D as a depression measure, Wisconsin Card Sorting Test (WCST) as a frontal function measure, and block design (BD) as a parietal function measure in the course of pre-operation assessment. Multiple regression model of depression which includes the interaction terms both between laterality and WCST and between laterality and BD were tested, In study 2, Patients underwent anterior temporal lobectomy (ATL ; right 20, left 25) were assessed and analyzed in the same way as study 1. Results : In study 1, contrary to the FIFL and FIPL prediction, interaction of laterality with WCST or BD were not significant. In study 2, the interaction with frontal function was significant, Consistent with FLFL prediction, depression came to be evident when seizure focus was lateralized to the left side and simultaneously frontal function declined. But the interaction with BD remained insignificant, which suggests the invalidity of FIPL hypothesis. Conclusion : We replicated the FIFL hypothesis in the depression of ATL patients. The relation of depression with frontal function was more evident in post rather than pre operation sample. This pattern may be due to the inter-hemispheric interference of frontal functions in pre-operation sample and to the release-of-function phenomenon in post-operation sample. On the other hand, we did not succeed in confirming the role of pahetal function in depression. Intactness of the parietal function in TLE was considered as the main cause of the negative finding.