지난 50년간 국내 심리치료무선통제연구에 대한 체계적 평가

제갈은주,장선경,이가영,최기홍 한국임상심리학회 2014 Korean Journal of Clinical Psychology Vol.33 No.4

The aim of study was to evaluate the quality of randomized controlled trials (RCT) of psychotherapy published between 1961 and 2014 in Korea using the Randomized Controlled Trial-Psychotherapy Quality Rating Scale (RCT-PQRS). On-line searches were performed using the key words, “psychotherapy” or “psychological training” through the RISS and KISS. A total of 75 RCTs of psychotherapy were selected as finals, and independently rated by three researchers. Results showed that 65% of the selected 75 studies were published in the Korean Journals of Psychology such as the Korean Journal of Clinical Psychology. Only nine of the 75 studies were rated 24 or above (the cut-off for a “reasonably well done” study), and eight of the nine studies were published in the Korean Journals of Psychology. Overall, the results showed that the quality of RCTs was rated lower than those reported in previous RCT-PQRS studies targeting RCTs conducted in North America and Europe. Finally, the quality of RCTs was similar between studies using active and inactive controls. Even though RCTs reported in the Korean Journals of Psychology appear to be more rigorous than those reported in other Korean Journals, education within psychology is urgent for improving the quality of the psychotherapy RCT methodology and execution in Korea. Future directions, implications and limitations were discussed.

정서 스트룹 과제에서 나타나는 우울증 환자들의 인지편향 현상

제갈은주,안창일 한국심리학회 2012 한국심리학회지 일반 Vol.31 No.1

This study aimed to investigate cognitive bias of depressed patients on negative information in the emotional stroop task. Also by diversifying word presenting conditions and stimulus duration, this research pursued in which condition depressed patients show cognitive bias most likely. The subjects of this study were 13 depressed patients and 13 healthy control participants. In the emotional stroop task, after all the participants were tested pre-exercise session, they performed both supraliminal and subliminal condition session. The results were as follows; firstly, there were significant differences in reaction times between depressed patients group and heathy control group in both conditions: supraliminal and subliminal. Depressed patients reacted more slowly than control group in all words condition, especially to negative words. Secondly, there were significant differences in reaction times between groups in every condition when negative words were presented to them. Finally, the depressed patient also showed slow response when the negative words presented were delayed to show up in supraliminal condition, but there were no differences in the condition of subliminal. 본 연구는 우울증 환자들이 부정적인 정보에 나타내는 인지편향 현상을 정서 스트룹 과제를 통해 확인하기 위해 수행되었다. 또한 정서 스트룹 과제의 단어조건과 단어의 제시시간을 다양화하여, 우울증 환자들이 과제의 어떤 조건에서 인지편향 현상을 가장 크게 나타내는지 밝히고자 하였다. 연구 대상자는 총 26명으로 우울증 현재 삽화(episode)를 보이는 우울증 집단 13명과 정신병력이 없는 정상 집단 13명을 대상으로 정서 스트룹 과제의 역치상 시행과 역치하 시행을 차례로 실시하였다. 실험 결과 우울증 환자들은 정서 스트룹 과제의 모든 단어 조건에서 정상인들보다 유의하게 긴 반응시간을 나타냈으며, 특히 역치상 조건의 부정단어와 중성단어에서 큰 차이를 보였다. 또한 우울증 환자들은 부정단어의 모든 제시시간에서 정상인들보다 유의하게 긴 반응시간을 나타냈는데, 역치상 조건에서는 부정단어의 제시시간이 길어질수록 더 긴 반응시간을 나타냈으며 역치하 조건에서는 이와 같은 현상이 나타나지 않았다. 본 연구를 통해 우울증 환자들이 자극의 정교한 처리가 가능한 역치상 조건에서 부정 자극에 대한 인지편향 현상을 크게 나타내는 것이 확인되었으며, 부정 자극을 정교하게 처리할 수 있는 시간이 길수록 더 큰 인지편향 현상을 나타낸다는 것이 밝혀졌다.

[장애인 훈련생을 위한 멘탈 휘트니스 긍정심리 집단 프로그램] 토론

제갈은주(토론자) 한국사회복지학회 2013 한국사회복지학회 학술대회 자료집 Vol.2013 No.11

우울증 환자와 정상인의 전두엽 알파파 비대칭 현상 연구

최승원,제갈은주,안창일 한국임상심리학회 2008 Korean Journal of Clinical Psychology Vol.27 No.4

The aim of this study was to examine the relationship between alpha asymmetry in prefrontal cortex (PFC) electroencephalography (EEG) and depression. We compared the resting baseline PFC alpha activity of a depressed patient group (N = 59) and that of a healthy control group (N = 29). Using one way ANOVAs, significant group effects were found in all asymmetry indexes. The depression group showed relatively low activity in the left PFC. There were no significant effects of episode state or diagnostic subtype. There were no differences in asymmetry indexes between current depressed patients and previously depressed patients. We could not find any differences in asymmetry scores between the major depressive disorder group and the other depression group. These results indicate that PFC EEG asymmetry is a trait marker for depression.

국내 심리치료 무선통제연구: 학회지 및 기간별 분석을 통한 체계적 고찰

이가영,장선경,제갈은주,구훈정,최기홍 한국임상심리학회 2017 Korean Journal of Clinical Psychology Vol.36 No.3

Randomized controlled trial (RCT) is one of the gold standards of evidence for efficacy of psychotherapy that allows causal interpretations between a specific psychotherapeutic approach and outcomes. Thus, results from the RCTs are considered a basis for determining which psychotherapeutic approaches should be delivered to the public. In the current study, we aimed to systematically review psychotherapy RCTs conducted in South Korea and to analyze them according to the journals published in and their publication periods (i.e., 1983-2003, 2004-2006, 2007-2011, and 2012-2015). In addition, we have evaluated the quality of RCTs by employing the Randomized Controlled Trial of Psychotherapy Quality Rating Scale (RCT-PQRS). A total of 91 RCTs were finally selected for the current analysis. Four journals (i.e., Korean Journal of Counseling and Psychotherapy, Korean Journal of Clinical Psychology, Korean Journal of Health Psychology, and Korean Journal of East West Mind Science) were included in the analysis since they published at least five RCTs. The results showed that there were no differences in study characteristics (e.g., sample characteristics, types of psychotherapy) between the research periods whereas RCT quality scores have increased over time. Overall, RCTs published in Korean Psychological Association (KPA) Journals had greater RCT quality scores than those published in non-KPA Journals. In terms of the analysis of published journals, there were significant differences in study characteristics (e.g., sample characteristics, types of control groups, types of psychotherapy) between journals. Several issues and implications are discussed for researchers and policy makers in order to enhance quality of RCTs and to disseminate evidence-based information about efficient psychotherapeutic approaches to the public.

조현병 음성증상의 심리치료에 대한 개관

최혜임,최기홍,제갈은주,송명주 한국심리학회 2014 한국심리학회지 일반 Vol.33 No.4

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. 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.

한국형 우울장애 선별도구의 개발: 예비연구

정수연,김신향,박기호,제갈은주,이승환,최윤영,이원혜,최기홍 한국임상심리학회 2017 Korean Journal of Clinical Psychology Vol.36 No.4

우울장애를 선별하는 신뢰롭고 타당한 선별도구를 개발하는 것은 잠재적인 위험군이나 발병 초기단계 있는 사람에게 최적의 치료를 제공하기 위한 가장 첫 번째 과제이다. 이는 현대 정신건강 정책이 정신질환의 예방과 조기개입을 강조하는 흐름과도 일치한다. 현재까지 우울장애를 선별하는 다수의 도구들이 개발되어 왔으나, 해외 저작권 지불의 문제를 해결하고, 우울의 하위영역은 물론 자살위험과 조증, 불안 및 신체증상을 포괄하며, 국가 연구 프로젝트와 병원 및 다양한 임상현장에서 활용할 수 있는 간결한 형태의 한국형 우울장애 선별도구를 개발하는 것이 과제로 남아있다. 본 연구에서는 현재까지 개발된 우울장애 선별도구를 체계적으로 개관하여 각 선별도구의 강점과약점을 분석하였으며 이를 바탕으로 새롭게 개발할 한국형 우울장애 선별도구(Korean Screening Tool for Depressive Disorders, K-DEP) 의 이론적 기초를 요약하였다. 임상심리, 정신의학, 심리측정 전문가 그룹으로 구성된 다학제 연구팀과 전문가 자문위원회와 함께 한국형우울장애 선별도구를 개발하는 과정을 요약하였으며, 이 과정에서 개발된 총 383문항의 예비 문항을 소개하고, 153명의 참여자에게 실시한 예비 분석결과를 제시하였다. 마지막으로 앞으로 실시될 한국형 우울장애 선별도구 개발 프로젝트의 차기 단계 과정과 고려사항들을논의하였다.

국내 우울증 평가도구 타당화 연구의 체계적 고찰-진단적 타당성을 중점으로 : 한국형 우울 선별 도구 개발을 위한 예비 연구

정수연,김신향,박기호,제갈은주,이원혜,최윤영,이승환,최기홍,Jung, Sooyun,Kim, Shin-Hyang,Park, Kiho,Jaekal, Eunju,Lee, Won-Hye,Choi, Younyoung,Lee, Seung-Hwan,Choi, Kee-Hong 대한불안의학회 2017 대한불안의학회지 Vol.13 No.2

Reliable and valid diagnostic screening tools in the primary care setting enable accurate estimation of depression in individuals at risk or in need of treatment, and provide patients with an opportunity to receive optimal treatments. Although there have been extensive studies on screening tools for depression used in domestic mental health settings, there is little consideration and lack of a thorough review of the diagnostic validity of screening tools. In the current review, we selected 13 representative screening tools for depression which were evaluated in a total of 19 validation studies conducted in Korea. We summarized DSM-5 target domains, diagnostic indices, sensitivity, specificity, cut-off scores, and diagnostic validity information for each tool. Finally, the depression measurement expert group was constituted to evaluate the current status of screening tools for depression, and their recommendations for a new screening tool were summarized. This study was conducted as part of the Mental Health Technology Development project to develop the Korean screening tool for depression (K-DEP).

한국형 불안 선별도구 개발: 현행 불안평가 도구 개관 및 예비문항 개발

김신향,정수연,박기호,제갈은주,이승환,최윤영,이원혜,최기홍 한국임상심리학회 2016 Korean Journal of Clinical Psychology Vol.35 No.3

The Ministry for Health & Welfare Affairs has marked a major milestone in a new mental health paradigm emphasizing the importance of preventative and early interventions. In this context, the development of a reliable and valid screening tool for mental disorders has become a high priority. A consensus has recently emerged among experts that there is a paucity of screening tools available for anxiety disorders and none of them is sufficient in its sensitivity and specificity. The development of new screening approaches for anxiety disorders was therefore recommended. In the current study, the multi-disciplinary research team comprised of clinical psychologists, psychiatrists and psychometricians, conducted a systematic review of existing screening tools for anxiety disorders to analyze strengths and limitations of the tools and to summarize the background and rationale for development of the new Korean screening tool for anxiety disorders (K-ANX). The K-ANX aims to cover recent diagnostic criteria from the DSM-5 and RDoC in a concise manner with sufficient diagnostic sensitivity and specificity. We also summarize the sub-domains of anxiety disorders and develop 273 preliminary item pools of the K-ANX. A preliminary study using the K-ANX was then conducted with 150 individuals whice showed that it demonstrates high concurrent validity with the BAI. Finally, the directions for the validation of the final K-ANX project were discussed.