해리 및 과각성이 유사 외상 장면의 침습에 미치는 영향

국문 초록 (Abstract)

본 연구의 목적은 트라우마 필름 패러다임을 사용해서 해리와 과각성이 유사 외상 장면의 침습에 미치는 영향을 알아보는 것이었다. 참가자들은 심각한 외상 경험이 없는 대학생 71명으로, 자료 주도적 처리를 한 실험군(n=34)과 개념적 처리를 한 통제군(n=37)에 무선할당되었다. 각 참가자는 처치 전후에 일련의 자기보고식 질문지를 완성하였고, 트라우마 동영상을 시청한 후 일주일 동안 매일 침습 일지를 작성하였다. 안정기(기저선), 트라우마 동영상 노출기, 및 회복기에 각 5분씩 그들의 심박변이도(heart rate variability, HRV)가 측정되었다. 실험 결과, 동영상 시청 직후 및 이후 일주일 동안 통제군보다 실험군에서 더 많은 침습이 발생하였다. 위계적 회귀분석에서는 동영상 시청 직후 측정한 해리와 과각성, 그리고 안정기의 RMSSD가 일주일 동안의 침습을 유의하게 예측하였고, 심리형 및 신체형 해리, 심장박동, LF-HRV 및 HF-HRV는 통계적으로 유의하지 않은 것으로 나타났다. 마지막으로, 본 연구의 한계점과 향후 연구의 방향이 논의되었다.

다국어 초록 (Multilingual Abstract)

The purpose of the present study was to examine the effects of dissociation and hyperarousal on intrusions of similar trauma scenes. Participants were college students without serious trauma experiences. They were randomly assigned to experimental group(n=34) manipulated with data-driven processing and control group(n=37) manipulated with conceptual processing. All participants were asked to complete a series of self-report questionnaires at pre- and post-treatment, and a daily intrusion diary for one week after viewing the trauma film. Their heart rate variability(HRV) were recorded during baseline, trauma film exposure, and recovery period(for 5 minutes on each period). The results showed that participants in the experimental group had reported intrusions of the film more frequently than did controls both immediately and for a week after exposure to the trauma film. The hierarchical regression results showed that peritraumatic dissociation, hyperarousal and RMSSD on baseline were positively associated with intrusions during 1 week after watching trauma film, but psychological and somatoform dissociation, heart rate, LF-HRV and HF-HRV were not significant. Finally, limitations of this study and suggestions for future study were discussed.

목차 (Table of Contents)

• 요약
• 방법
• 연구대상
• 측정도구
• 실험재료
• 실험절차
• 설계 및 분석
• 결과
• 집단간 사건당시 해리, 각성 및 침습 비교
• 침습에 영향을 미치는 변인
• 논의
• 참고문헌
• Abstract

참고문헌 (Reference)

1 박제민, "한국판 해리경험척도의표준화 연구(I)" 4 : 105-125, 1995

2 남보라, "한국판 외상 후 스트레스 진단 척도의 신뢰도 및 타당도 연구" 한국임상심리학회 29 (29): 147-167, 2010

3 이지민, "인지적 처리양식과 안구운동이 유사외상장면의 침습에 미치는 영향" 한국임상심리학회 33 (33): 365-385, 2014

4 최윤경, "유사외상 상황에서 양측성 안구운동, 심상노출 및 심상재각본이 침습적 기억에 미치는 영향" 한국인지행동치료학회 14 (14): 165-190, 2014

5 주혜선, "외상후 위기 체크리스트: 개발 및 타당화 연구" 한국심리학회 27 (27): 235-257, 2008

6 Foa, E., "The validation of a self-report measure of posttraumatic stress disorder : The Posttraumatic Diagnostic Scale" 9 : 445-451, 1997

7 Yoshizumi, T., "The effect of avoidant tendencies on the intensity of intrusive memories in a community sample of college students" 43 : 1819-1828, 2007

8 한덕웅, "Spielberger의 상태-특성 불안검사 Y형의 개발" 1 : 1-14, 1996

9 Nijenhuis, E. R. S., "Somatoform dissociation : Major symptoms of dissociative disorders" 1 : 7-32, 2000

10 Blanchard, E., "Psychophysiological responses in the diagnosis of posttraumatic stress disorder in Vietnam veterans" 179 : 97-101, 1991

11 Orr, S. P., "Psychophysiological assessment : Clinical applications for PTSD" 61 : 225-240, 2000

12 Pitman, R., "Psychophysiologic assessment of posttraumatic stress disorder imagery in Vietnam combat veterans" 44 : 970-975, 1987

13 Charney, D. S., "Psychobiologic mechanisms of Posttraumatic Stress Disorder" 50 : 294-305, 1993

14 Baldwin, D. V., "Primitive mechanisms of trauma response: An evolutionary perspective on trauma-related disorder" 37 : 1549-1566, 2013

15 Cohen, H., "Power spectral analysis of heart rate variability in posttraumatic stress disorder" 41 : 627-629, 1997

16 Cantor, C., "Posttraumatic stress disorder : Evolutionary perspectives" 43 : 1038-1048, 2009

17 Briere, J., "Peritraumatic and persistent dissociation in the presumed etiology of PTSD" 162 : 2295-2301, 2004

18 Malta, L. S., "Numbing symptoms as predictors of unremitting posttraumatic stress disorder" 23 (23): 223-229, 2009

19 Spielberger, C. D., "Manual for the state-trait anxiety inventory" Consulting Psychologists Press 1970

20 Holmes, E. A., "Intrusive images and"hotspots"of trauma memories in posttraumatic stress disorder : An exploratory investigation of emotions and cognitive themes" 36 : 3-17, 2005

21 Horowitz, M. J., "Impact of Event Scale : A measure of subjective stress" 41 : 209-218, 1979

22 Hauschildt, M., "Heart rate variability in response to affective scenes in posttraumatic stress disorder" 88 : 215-222, 2011

23 Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology, "Heart rate variability : Standards of measurement, physiological interpretation and clinical use" 93 : 1043-1065, 1996

24 Dell, P. F., "Dissociative phenomenology of dissociative identity disorder" 190 : 1-15, 2002

25 American Psychiatric Association, "Diagnostic and statistical manual of mental disorders" American Psychiatric Press 2013

26 Bernstein, E., "Development, reliability and validity of a dissociation scale" 174 : 727-735, 1986

27 Marshall, G. N., "Development and validation of a modified version of the peritraumatic dissociative experiences questionnaire" 14 (14): 123-134, 2002

28 Ehlers, A., "Data-driven versus conceptual processing questionnaire"

29 Cohen, H., "Autonomic dysregulation in panic disorder and in post-traumatic stress disorder : Application of power spectrum analysis of heart rate variability at rest and in response to recollection of trauma or panic attacks" 96 : 1-13, 2000

30 Foa, E., "Arousal, numbing, and intrusion : Symptom structure of PTSD following assault" 152 : 116-120, 1995

31 Ehlers, A., "A cognitive model of posttraumatic stress disorder" 38 : 319-345, 2000