국내 아동 청소년 심리 치료 효과 검증 연구의 방법론적 고찰과 메타분석: 학회지 게재 논문을 중심으로(1995-2010)

구훈정,최승미,권정혜 한국임상심리학회 2012 Korean Journal of Clinical Psychology Vol.31 No.1

Child and adolescent psychotherapy has progressed considerably, as reflected in the number of controlled studies. Despite the progress, the methodological soundness and effectiveness of child and adolescent psychotherapy has not been confirmed in Korea. The purpose of the first study was to critically review the youth psychotherapy outcome studies involving treatment of anxiety, depression, ADHD and conduct or addiction-related problems and disorders. Eighty two studies, conducted from 1995 through 2010, were selected. The analysis revealed that many studies failed to use well-standardized procedures to ensure appropriate sample selection, measurement and experimental design. The purpose of the second study was to use mata-analysis to analyze the effects of well-designed children and adolescent psychotherapy that were selected in studies from 1995-2010. The overall mean effect size was .80 indicating that children and adolescent psychotherapy was highly effective overall. When mean effect sizes were compared according to moderator, the effect of therapy type and outcome type were significantly affected. The implications and limitations were discussed.

아동기 정서적 학대경험, 정서강도와 자해의 관계에서 부적응적 인지정서조절과 부정정서의 매개효과

구훈정,조현주,이종선 한국인지행동치료학회 2014 인지행동치료 Vol.14 No.2

본 연구는 대학생 집단을 대상으로 원격 위험요인으로서의 아동기 정서적 학대 경험과 정서강도가 자해에 미치는 심리적 기제를 살펴보기 위한 것이다. 이를 위해 선행연구에 근거하여 부적응적 인지정서조절과 부정정서가 아동기 정서적 학대경험과 정서강도와 자해를 매개한다고 가정하였다. 대학생 415명을 대상으로 연구참여에 대한 동의서를 받고, 부모자녀결합형태 검사, 정서강도 척도, 인지적정서조절 질문지, 병원 불안-우울 척도, 자해척도를 실시하였다. 구조방정식을 적용하여 연구모형과 대안모형의 모형적합도를 비교 검증한 결과, 연구모형이 자료에 적합한 것으로 선택되었다. 연구 모형에 기반하여 결과를 살펴보면 다음과 같다. 첫째, 아동기 부모학대와 자해 사이의 관계는 부적응적 인지정서조절과 우울/불안에 의해 이중으로 매개되거나 우울/불안 단독으로 매개되었다. 둘째, 정서강도의 경우 부적응적 인지정서조절과 우울/불안을 매개로 하여 자해를 영향을 미쳤다. 마지막으로 본 연구 결과의 제한점과 자해관련 후속연구 및 치료적 개입에 대한 제언을 논의하였다. The present study aims to investigate a psychological mechanism by which childhood abuse experiences and affect intensity as distal factors of self-harm behaviors influence self-harm in university students. In doing this, it is hypothesized that maladaptive cognitive emotion regulation and negative affect would mediate the relationships between childhood abuse experience, affect intensity and self-harm. A total of 415 students participated and completed the Parental Boding Instrument, the Affect Intensity Measures, the Cognitive Emotion Regulation Questionaire, the Hospital Anxiety and Depression scale and the Self-Harm Inventory, along with a consent form. Structural equation modelling was used to compare the fit of the research and alternative models, and found that the research model as the best model for the present data. Based on the research model, the results were as follows. Firstly, The relationship between childhood abuse from parents and self-harm was mediated both by maladaptive cognitive emotion regulation and depression/anxiety and only depression/anxiety, respectively. Secondly, Affect intensity influenced self-harm through maladaptive cognitive emotion regulation and depression/anxiety. Limitations, future research and therapeutic implications were discussed.

외상적 사건과 자해의 관계에서 부적응적 인지조절의 매개효과와 적응적 인지조절의 조절효과: 성차를 중심으로

구훈정,우성범,이종선 한국임상심리학회 2015 Korean Journal of Clinical Psychology Vol.34 No.1

The present study, using university students as participants, investigated how traumatic life events affect self-harm by going through the steps of negative cognitive emotion regulation, depression, anxiety, and anger. The study further examined how adaptive cognitive emotion regulation’s interactions with depression, anxiety, and anger, respectively, influence self-harm. Based on previous studies, we hypothesized that traumatic life events would affect self-harm through a dual mediation of negative cognitive emotion regulation and depression, anxiety, and anger. We also hypothesized that cognitive emotional regulation will moderate the effects of depression, anxiety, and anger on self-harm. This study additionally examined gender differences in the hypothetical path model using Multi-Group analysis. A total of 415 university students who signed consent form participated and completed the Life Event Checklist, the Cognitive Emotion Regulation Questionnaire, the Hospitalized Anxiety and Depression Scale, the State-Trait Anger Expression Scale, and the Self-Harm Inventory. The proposed research model showed a very good fit for the data. The paths of how traumatic life events lead to self-harm by dual mediating effects of negative cognitive emotional regulation and depression, anxiety, and anger were significant. In addition, adaptive cognitive emotional regulation was found to affect self-harm by interacting with depression, anxiety, and anger. In other words, when the levels of depression, anxiety, and anger were over average, adaptive cognitive emotional regulation lowered the severity of self-harm. Finally, the hypothetical model presented by the current study showed variation in different gender groups. We further discussed the significance and the limitations of the present study, based on the findings.

사회불안이 사회자본형성에 미치는 영향: 온-오프라인 자기불일치와 의사소통유능감의 이중매개효과검증

구훈정,권정혜,양은주 한국심리학회산하학교심리학회 2014 한국심리학회지 학교 Vol.11 No.2

The present study aims to investigate the dual mediating effects of online-offline self-discrepancy and communication competence in relationship between social anxiety and social capital for adolescents. A total of 316 students participated and completed the Social Anxiety and Distress Scale, Self-Discrepancy Scale modified for measuring online and offline self-presentation, Communication Competence Scale, and Social Capital Scale, along with a consent form three times. Structural equation modelling was used to compare the fit of the research and alternative models, and found that the research model as the best model for the present data. Results showed that social anxiety had directly a effect on social capital and indirectly a effect on social capital via online-offline self-discrepancy, which also functions as a mediator between social anxiety and communication competence, and communication competence, which also functions as a mediator between on-offline self-discrepancy and social capital. Limitations, future research and therapeutic implications were discussed. 본 연구는 청소년을 대상으로 사회불안이 사회자본형성에 미치는 영향과 그 심리적 기제를 확인하기 위한 것이다. 이를 위해 선행연구에 근거하여 온-오프라인 자기불일치와 의사소통유능감이 사회불안과 사회자본형성에의 이중으로 매개한다고 가정하였다. 서울과 지방소재 중고등학교에 재학 중인 청소년 316명(남학생 147명, 여학생 169명)을 대상으로 연구 참여에 대한 동의를 받고 총 3차에 걸쳐 사회불안척도, 자기불일치척도, 의사소통유능감척도, 사회자본척도를 실시하였다. 본 연구에서 제안한 연구 모형과 대안 모형의 모형 적합도를 비교 검증한 결과, 연구 모형이 자료에 적합한 것으로 선택되었다. 연구 모형에 기반하여 결과를 살펴보면, 사회불안은 온-오프라인 자기불일치를 부분매개로 하여 의사소통유능감에 영향을 미쳤고, 온-오프라인 자기불일치는 의사소통유능감을 부분매개로 하여 사회자본에 영향을 미쳤다. 결과적으로 사회불안이 온-오프라인 자기불일치와 의사소통유능감을 이중으로 부분매개하여 사회자본형성에 영향을 미치는 이중매개경로가 유의한 것으로 나타났다. 이러한 결과에 기초하여 사회불안 청소년의 온라인 사회공간 활용방안에 대한 교육적 지침에 대한 제언과 더불어 연구의 의의와 제한점을 논의하였다.

한국형 인터넷 중독 자가진단 척도(K-척도)의 진단적 유용성에 대한 연구: DSM-5 인터넷 게임 장애의 진단을 중심으로

구훈정,조성훈,권정혜 한국임상심리학회 2015 Korean Journal of Clinical Psychology Vol.34 No.2

The purpose of this study was to examine the diagnostic ability of K-scale, one of the most popular Internet addiction scale in Korea, as a diagnostic tool for DSM-5 Internet Gaming Disorder (IGD). This study aimed to compare the diagnostic ability of the full version of K-scale with the symptom subscales of K-scale and to establish the optimal cut-off points of the K-scale. A total of 274 adolescents were interviewed with the Diagnostic Interview Schedule for DSM-5 Internet Gaming Disorder and administered questionnaires (K-scale, Brief symptom Inventory, Zukerman-Kuhnman Personality Questionnaire, Parent- Child Communication Scale, and Emotion Modulation Scale). Addictionally, 133 middle school students were administered self-report questionnaires. Results indicated that the symptom subscales of K-scale was more effective in diagnosing IGD than the full version of K-scale. In detail, the diagnostic (60/61 point) cut-off points of symptom K scale, which showed the higher diagnostic accuracy, classifying 60.0% and 88.5% of participants correctly, was used to select the case group. It was demonstrated that the case group was found to be significantly different from the non-case group on the gaming activity patterns and the psycho-social variables, suggesting that the cut-off point can identify IGD group efficiently. The limitations and implications were discussed.

사회불안장애의 주의개입, 탈개입 및 회피과정: 자극 위협가의 차별적 효과

구훈정,권정혜 한국임상심리학회 2015 Korean Journal of Clinical Psychology Vol.34 No.3

The present study was designed to elucidate attentional bias in social anxiety using a spatial cueing task and to examine whether attentional biases are differentiated by threat level. The participants were recruited from a larger sample of about 1500 undergraduates completing the Social Phobia Scale and Social Interaction Anxiety Scale. Those who had scores above the moderate level of social anxiety on these scales and agreed to participate were assigned to the social anxiety group and those with scores under the mean to the normal control group. Social anxiety group was divided into clinical social anxiety disorder group and subclinical social anxiety disorder group using the Structured Clinical Interview for DSM-IV. Participants were informed that they would make a speech to a live video camera in which they would be evaluated for their performance. Next, they completed the spatial cueing task which assessed the speed of engagement and disengagement from pictorial cues depicting high-threat, low-threat, or neutral content with three exposure durations (80msec, 300msec, and 500msec). Firstly, clinical social anxiety disorder group did not show initial vigilance toward high-threat pictures at 80msec exposure time, but showed difficulty in disengagement at 300msec, which was followed by avoidance for high-threat pictures at 500msec. Secondly, subclinical social anxiety disorder group did not show any attentional bias both high-threat pictures. Thirdly, the effect of low-threat on disengagement delay and avoidance was different between clinical social anxiety disorder group and subclinical social anxiety disorder group: clinical social anxiety disorder group showed disengagement delay at 300msec and avoidance at 500msec which was same with attentional bias pattern with high-threat pictures due to negative interpretation bias effect for low-threat stimuli, but subclinical social anxiety disorder group showed enhanced disengagement delay 500msec instead of attentional avoidance at 500msec due to threat negation. Implication and future research direction was discussed.

사회불안 상황과 관련된 미묘한 회피 빈도 검증 척도(SAFE)의 한국판 타당화 연구: 일반 대학생을 대상으로

구훈정,양은주,권정혜 한국임상심리학회 2012 Korean Journal of Clinical Psychology Vol.31 No.3

The present study examined the psychometric properties of the Korean version of the Subtle Avoidance Frequency Examination (SAFE). The Korean versions of SAFE, SIAS, SPS, FNE, CSAQ, SFA, DBT, CSI, and BDI were administered to 328 undergraduate and graduate students. Exploratory factor analysis yielded a three factor structure-“subtle safety behavior” “behavior aimed at avoiding or concealing physical symptoms” and “active safety behavior”. In addition, the results showed relatively high internal consistency, and adequate test-retest reliability over a 2 or 3 week period. The Korean version of SAFE was found to have appropriate construct validity with significant positive correlations with social anxiety, dysfunctional self-belief, self-focused attention, and avoidant coping strategy, but no correlation with problem-solving coping or support-seeking coping. Among the three factors, factor 1 was highly correlated with social anxiety-related measure, which suggests that factor 1 reflects the dysfunctional aspect of safety behavior. Factor 2 was found to reflect the traits of somatic symptom-related safety behavior. Finally, the implications and limitations of the present study and suggestions for future research were discussed.

소방대원들의 외상 후 스트레스 증상에 미치는인구통계, 직무특성 및 심리사회 요인들

구훈정,이종선 한국심리학회 2016 한국심리학회지 일반 Vol.35 No.1

본 연구의 목적은 소방대원들의 외상 후 스트레스 증상과 관련된 인구통계, 직무특성 및 심리사회 요인들을 살펴보고, 완전 PTSD와 부분 PTSD를 설명하는 유의한 변인들이 있는지 알아보았다. 강원도 7개 지역 내 소방서에 근무하는 소방대원 및 119 구급대원 634명이 연구에 참여하여, 자기보고 질문지인 생활사건 체크리스트, 사건충격척도, 속박감 척도, 사건관련 반추 및 정서조절척도에 응답하였다. 이 중 연구에 동의하지 않거나 극단치를 포함하여 응답이 불성실한 96명의 자료를 제외하고 총 538명의 자료가 최종 분석에 포함되었다. 연구 결과, 종교, 충격현장 노출 빈도, 스트레스 관리 그리고 사건관련 침습적 반추 및 속박감이 PTSD 증상과 유의한 관련성이 있는 것으로 나타났다. 한편, 다항 로지스틱 분석에서, 완전 PTSD를 설명하는 유의한 변인은 사건관련 침습적 반추가 그리고 부분 PTSD를 설명하는 유의한 변인은 종교로 나타났다. 본 연구 결과를 바탕으로 연구의 의의와 제한점이 논의되었다. The aim of the present study was to investigate whether demographic, job characteristic and psychosocial factors are related to posttraumatic symptoms in firefighters, and to explore significant factors accounting for full Posttraumatic Stress Disorder(PSTD) and partial PTSD. Six hundred and thirty four firefighters and 119 rescue workers in 7 areas within Kangwon-do participated by completing a series of self-report questionnaires including the Impact of the Event-Scale-Revised, the Entrapment Scale, the Event-Related Rumination Inventory and the Emotion Regulation Questionnaire. Ninety six of the responders were excluded due to not completing the consent form and missing data; 539 participants were included in the final analysis. Results showed that religion, exposure frequency to traumatic scene and stress management, intrusive rumination, and entrapment were significantly associated to PTSD symptoms. In a multimodal logistic regression analysis, event-related intrusive rumination was a significant factor related to full PTSD while religion appeared to be significantly associated with partial PTSD. The implications and limitations of the study as well as future directions are discussed.

Risk and Protective Factors of Internet Addiction: A Meta-Analysis of Empirical Studies in Korea

구훈정,권정혜 연세대학교의과대학 2014 Yonsei medical journal Vol.55 No.6

Purpose: A meta-analysis of empirical studies performed in Korea was conducted to systematically investigate the associations between the indices of Internet addiction(IA) and psychosocial variables. Materials and Methods: Systematic literaturesearches were carried out using the Korean Studies Information Service System,Research Information Sharing Service, Science Direct, Google Scholar, and references in review articles. The key words were Internet addiction, (Internet) game addiction, and pathological, problematic, and excessive Internet use. Only original research papers using Korean samples published from 1999 to 2012 and officially reviewed by peers were included for analysis. Ninety-five studies meetingthe inclusion criteria were identified. Results: The magnitude of the overall effectsize of the intrapersonal variables associated with internet addiction was significantlyhigher than that of interpersonal variables. Specifically, IA demonstrated a medium to strong association with “escape from self” and “self-identity” as self-related variables. “Attention problem”, “self-control”, and “emotional regulation” as control and regulation-relation variables; “addiction and absorption traits” as temperament variables; “anger” and “aggression” as emotion and mood and variables;“negative stress coping” as coping variables were also associated with comparablylarger effect sizes. Contrary to our expectation, the magnitude of the correlationsbetween relational ability and quality, parental relationships and family functionality, and IA were found to be small. The strength of the association betweenIA and the risk and protective factors was found to be higher in younger age groups. Conclusion: The findings highlight a need for closer examination of psychosocialfactors, especially intrapersonal variables when assessing high-risk individualsand designing intervention strategies for both general IA and Internet game addiction.

아동 색 선로 검사의 표준화 연구

구훈정(Hoon Jung Koo),신민섭(Min Sup Shin) 대한소아청소년정신의학회 2008 소아청소년정신의학 Vol.19 No.1

Objectives : This study was conducted in order to examine the reliability and validity of the Childrens Color Trails Test (CCTT). The objective of the study was also to provide the Korean normative data for the CCTT. Methods : Normative samples consisted of 766 children and adolescents living in Seoul and aged from 5 to 15 years. Eighty children who were diagnosed with ADHD, based on the DSM-IV criterion, were recruited from Seoul National University Childrens Hospital. Among them, 46 ADHD children were receiving medication, while 34 children were drug-free. Results : The scores of the CCTT were significantly correlated with those of the Stroop test. Three factors were extracted through factor analysis-visual tracking and cognitive flexibility, distractibility and susceptibility to interference, and simple attention and impulsivity. The completion time of the CCTT for all children tended to decrease as age increased. There were significant differences in the CCTT scores between the ADHD group receiving medication, the ADHD-drug free group and the normal groups. The CCTT also showed sound test-retest reliability. These results confirmed the reliability and validity of the CCTT. Finally, we provided the Korean normative data for the CCTT. Conclusion : These results suggest that the CCTT is a reliable and valid test, which can be used to assess frontal function related to child psychiatric disorders in Korean children.