초기 성인의 아동기 부정적 경험과 자살사고 : 우울의 매개효과와 사회생태학적 레질리언스의 조절된 매개효과 = Adverse Childhood Experiences and Suicidal Ideation in Early Adulthood: Focusing on the Mediation Effect of Depression and the Moderated Mediation Effect of Social Ecological Resilience

다국어 초록 (Multilingual Abstract)

Suicide is the leading cause of death in early adulthood among 20-year-olds, such a social problem requires active intervention. To date, most studies on suicidality and related factors have been interested in therapeutic approaches to mental health problems such as depression. However, because suicide is not a behavior that is fixed at a particular point in time but affects the entire life cycle, it is necessary to broaden the discussion of interventions for psychological trauma from a life process perspective. Many previous studies have shown that Adverse Childhood Experiences(ACEs) in early childhood have robust associations with suicidal ideation in adulthood. These effects can be cumulative, with a greater number of ACEs progressively associated with suicidal ideation. Thus, to understand suicidality in early adulthood, it is necessary to confirm the association between adverse childhood experiences, suicidal ideation, and depression. Furthermore, through the application of social-ecological resilience, an attempt was made to propose a social work practice strategy for the prevention of suicidal ideation.
The purpose of this research was to determine whether depression plays a mediating role between adverse childhood experiences and suicidal ideation in impact relationships and to examine whether social-ecological resilience moderated mediating effects. The study model was designed based on SPSS 16.0 and PROCESS v.3.5 for SPSS by Hayes. A total of 309 samples were selected for the study, which consisted of male and female adults aged 18 to 28 years, and data collected through a survey were used for analysis, and IRB approval was obtained for ethical review of the present study.
The main findings of this study are as follows:
First, the ACE score had a strong, graded relationship with suicidal ideation. Compared with those without an ACE, those with at least one ACE were significantly more likely to report suicidal ideation. These findings indicate that for prevention and intervention of suicidal ideation, the discussion of interventions on ACEs should be broadened from a life process perspective. In other words, suicidality intervention should address ACEs and, most importantly, seek policy and practice interventions for prevention. In addition, ACE-informed social work practice should be sought.
Second, depression had a partial mediating effect in the relationship between adverse childhood experiences and suicidal ideation, such that depression and adverse childhood experiences were significantly positively correlated, and depression and suicidal ideation were positively correlated. This implies that ACEs directly influence suicidal ideation but may also lead to an increase in suicidal ideation via the depression pathway.
Third, social ecological resilience moderated the mediation effect of depression between ACEs and suicidal ideation. At all levels of social-ecological resilience (high, mean, low), the moderation effect was significant. The results provide practical implications that, in turn, can be used to prevent or mitigate suicidal ideation in early adulthood by strengthening social-ecological resilience. Thus, it would be useful to apply the social-ecological resilience practice model to intervene the influence of ACEs on suicidal ideation in early adulthood.
Despite these efforts, this study was limited by the inability to consider individual and special circumstances in addition to risk and protective factors identified based on previous studies. Therefore, a more in-depth qualitative analysis of suicidality in early adulthood will be helpful in preparing specific suicide prevention strategies in social work practice.

목차 (Table of Contents)

• Ⅰ. 서 론 1
• 1. 연구의 필요성 1
• 2. 연구문제 6
• Ⅱ. 이론적 배경 7
• 1. 초기 성인의 자살 7
• 1) 자살과 자살사고 7
• 2) 초기 성인의 자살사고 8
• 2. 아동기 부정적 경험과 자살사고 10
• 1) 생애과정 관점의 사회스트레스 이론 10
• (1) 사회스트레스 이론과 아동기 부정적 경험 10
• (2) 생애과정 관점의 아동기 부정적 경험 12
• 2) 아동기 부정적 경험과 초기 성인의 자살사고 13
• (1) 아동기 부정적 경험 13
• (2) 아동기 부정적 경험과 자살사고 15
• 3. 초기 성인의 아동기 부정적 경험과 자살사고의 관련 요인 18
• 1) 초기 성인의 우울 19
• 2) 초기 성인의 아동기 부정적 경험, 자살사고 및 우울 20
• 4. 레질리언스 22
• 1) 레질리언스의 개념 22
• 2) 사회생태학적 관점에서 레질리언스 모델 26
• 3) 사회생태학적 레질리언스의 보호역할 29
• Ⅲ. 연구방법 34
• 1. 연구대상 선정 및 자료수집 35
• 2. 측정도구 35
• 3. 연구모형 37
• 4. 연구분석 39
• Ⅳ. 연구결과 40
• 1. 연구대상자의 일반적 특성 40
• 2. 주요 변수의 기술통계 및 특성 42
• 3. 주요 변수의 상관관계 53
• 4. 초기 성인의 아동기 부정적 경험과 자살사고 관계에서 사회생태학적 레질리언스의 조절효과 검증 55
• 1) 아동기 부정적 경험과 자살사고 관계에서 사회생태학적 레질리언스의 조절효과 55
• 2) 아동기 부정적 경험과 자살사고 관계에서 사회생태학적 레질리언스의 하위요인의 조절효과 57
• 3) 직접적 부정적 경험과 자살사고 관계에서 사회생태학적 레질리언스 및 하위요인의 조절효과 60
• 4) 간접적 부정적 경험과 자살사고 관계에서 사회생태학적 레질리언스와 하위 요인의 조절효과 63
• 5. 초기 성인의 아동기 부정적 경험과 자살사고의 관계에서 우울의 매개효과와 사회생태학적 레질리언스의 조절된 매개효과 67
• 1) 아동기 부정적 경험과 자살사고 관계에서 우울의 매개효과 67
• 2) 아동기 부정적 경험과 자살사고 관계에서 우울의 매개효과에 대한 사회생태학적 레질리언스의 조절된 매개효과 68
• 3) 아동기 부정적 경험과 초기 성인의 자살사고 관계에서 우울의 매개효과에 대한 사회생태학적 하위요인 조절된 매개효과 71
• Ⅴ. 결 론 78
• 1. 분석 결과 및 논의 78
• 2. 논의 및 함의 87
• 3. 연구의 한계 93
• 참고문헌 95
• Abstract 111
• 부록 113