마음챙김에 기반을 둔 정서조절개입이 심리적 건강의 개선에 미치는 효과와 그 변화기제: 정서조절곤란과 마음챙김의 매개역할 = Effects of and Mechanisms of Changes in a Group Mindfulness-Based Emotion Regulation Intervention for Improving Psychological Health: Mediating Roles of Emotion Dysregulation and Mindfulness

다국어 초록 (Multilingual Abstract)

The present study examined the effects of a group mindfulness-based emotion regulation intervention(MBERI) on psychological health in a Korean sample of university students. Moreover, to shed light on the mechanisms of changes in the MBERI, this study proposed both emotion dysregulation and mindfulness as potential mediators of treatment changes on the basis of literature review. Forty-five participants in the MBERI group and 50 those in a psychoeducation group completed the measures of psychological health and proposed mediators at pre-intervention, after session 4, and post-intervention. In addition, participants in the MBERI group completed all of the same scales once again at 1-month follow-up. Compared to the participants in the psychoeducation group, those in the MBERI group demonstrated decreases in depressive symptoms, general negative affect, and emotion dysregulation, as well as increases in psychological well-being, life satisfaction, and mindfulness. Early reductions in emotion dysregulation mediated the short-term effects of the MBERI on depressive symptoms, general negative affects, and psychological well-being, but early increases in mindfulness did not. Short-term reductions in emotion dysregulation were significantly associated with long-term changes in depressive symptoms, psychological well-being, and life satisfaction. In addition, short-term improvements in mindfulness were significantly correlated with long-term changes in life satisfaction. In conclusion, these findings suggest that a group MBERI leads to improvements in university students' psychological health, which are mediated through changes in emotion dysregulation, and that some of its long-term effects may be mediated through short-term improvements in mindfulness.

국문 초록 (Abstract)

본 연구는 일반 대학생들의 심리적 건강의 개선에 대한 마음챙김에 기반을 둔 정서조절개입의 효과를 검증하고, 그 변화 기제를 규명하고자 하였다. 이 변화기제와 관련하여, 선행 연구와 문헌들에 기초하여, 정서조절곤란과 마음챙김을 각각 잠정적인 매개변인들로 상정하였다. 마음챙김 개입집단 45명과 심리교육집단 50명은 개입 전, 4회기 후, 종결 직후에, 그리고 마음챙김 개입집단은 추가로 종결 1개월 후에 여러 가지 자기 보고형 검사들을 작성하였다. 연구 결과, 심리교육에 비해 마음챙김 개입은 우울증상, 전반적인 부적 정서, 심리적 안녕감, 삶의 만족도, 정서조절곤란 및 마음챙김수준을 변화시키는데 더 효과적이었다. 정서조절곤란의 조기 감소는 우울증상, 전반적인 부적 정서 및 심리적 안녕감에 대한 마음챙김 개입의 단기효과를 매개하였으나, 마음챙김의 조기 증가는 그렇지 못하였다. 마음챙김 개입 전후의 정서조절곤란수준의 단기적 감소는 우울증상, 심리적 안녕감 및 삶의 만족도 각각의 장기적 변화와 유의한 상관을 보였다. 마음챙김수준의 단기적 증가는 삶의 만족도의 장기적 변화와 유의한 상관을 보였다. 이 결과들은 마음챙김에 기반을 둔 정서조절개입이 일반 대학생들의 심리적 건강을 증진시키는데 효과적이며, 이런 효과가 정서조절곤란의 개선에 의해 매개된다는 점과, 일부 장기효과가 마음챙김의 단기적 증진에 의해 매개될 수 있음을 시사한다.

참고문헌 (Reference)

1 배재홍, "한국형 마음챙김 명상에 기반한 스트레스 감소 프로그램이 대학생의 정서 반응성에 미치는 영향" 영남대학교 대학원 2007

2 장현갑, "한국형 마음챙김 명상에 기반한 스트레스 감소 프로그램의 개발과 SCL-90-R로 본 효과성 검증" 한국건강심리학회 12 (12): 833-850, 2007

3 이현희, "한국판 정적 정서 및 부적 정서 척도 (Positive Affect and Negative Affect Schedule; PANAS)의 타당화 연구" 한국임상심리학회 22 (22): 935-946, 2003

4 전종희, "한국판 마음챙김 주의 자각 척도의 신뢰도 및 타당도 예비 연구" 한국임상심리학회 26 (26): 201-212, 2007

5 조용래, "한국판 개정된 인지적 및 정서적 마음챙김 척도의 신뢰도와 타당도" 한국임상심리학회 28 (28): 667-693, 2009

6 원두리, "한국판 5요인 마음챙김척도의 타당화 연구" 한국건강심리학회 11 (11): 871-886, 2006

7 정준영, "초기 불교의 sati와 현대심리학의 마음챙김: 마음챙김 구성개념 정립을 위한 제언" 2009

8 김정호, "체계적 마음챙김을 통한 스트레스 관리 : 정서 마음챙김을 중심으로" 6 : 23-58, 2001

9 이우경, "중년기 여성의 스트레스, 마음챙김, 자기-자애, 정서적 안녕감 간의 관계 구조 분석과 마음챙김 증진 프로그램의 효과 연구" 이화여자대학교 대학원 2008

10 김정모, "정서조절을 위한 마음챙김 인지치료"

11 전미애, "정서조절을 위한 MBCT가 임상군 환자들에게 미치는 효과" 한국임상심리학회 30 (30): 113-135, 2011

12 조용래, "정서조절곤란의 평가: 한국판 척도의 심리측정적 속성" 한국임상심리학회 26 (26): 1015-1038, 2007

13 최예종, "정서조절곤란과 수용처치가 대학생의 우울기분 변화에 미치는 효과" 한국임상심리학회 28 (28): 1107-1134, 2009

14 김명소, "심리적 안녕감의 구성개념 분석 : 한국 성인 남녀를 대상으로" 15 : 19-39, 2001

15 박정현, "사람의 내-외적인 모습에 두는 상대적 비중과 행복관과의 관계" 한국사회및성격심리학회 19 (19): 19-31, 2005

16 전미애, "마음챙김에 기초한 인지치료가 대학생의 사고억제에 미치는 효과" 한국건강심리학회 14 (14): 795-813, 2009

17 김정모, "마음챙김에 기초한 인지치료가 일반 대학생의 정서조절에 미치는 효과" 한국임상심리학회 28 (28): 741-759, 2009

18 전미애, "마음챙김에 기초한 인지치료(MBCT)가 청소년 수형자의 공격성과 충동성에 미치는 영향" 한국건강심리학회 16 (16): 63-78, 2011

19 장현갑, "마음챙김 명상, In 2006년 한국임상심리학회 동계연수회 자료집 Ⅰ" 2006

20 이수정, "Trait Meta-Mood Scale의 타당화에 관한 연구 : 정서지능의 하위요인에 대한 탐색" 11 : 95-116, 1997

21 Ryff, C. D., "The structure of psychological well-being revisited" 73 : 549-559, 1995

22 Baron, R. M., "The moderator-mediator variable distinction in social psychology research" 51 : 1173-1182, 1986

23 Gross, J. J., "The emerging field of emotion regulation : An integrative review" 2 : 271-299, 1998

24 Brown, K. W., "The benefits of being present : Mindfulness and its role in psychological well-being" 84 : 822-848, 2003

25 Lau, M. A., "The Toronto Mindfulness Scale : Development and validation" 62 : 1445-1467, 2006

26 Diener, E., "The Satisfaction With Life Scale" 49 : 71-75, 1985

27 Josefsson, T., "Self-reported mindfulness mediates the relation between meditation experience and psychological well-being" 2 : 49-58, 2011

28 Ryan, R. M., "Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being" 55 : 68-78, 2000

29 Carmody, J., "Relationships between mindfulness practice and levels of mindfulness, medical and psychological symptoms and well-being in a mindfulness-based stress reduction program" 31 : 23-33, 2008

30 Lykins, E. B., "Psychological functioning in a sample of long-term practitioners of mindfulness meditation" 23 : 226-241, 2009

31 World Health Organization, "Promoting mental health: Concepts, emerging evidence, and practice. A report of the World Health Organization, Department of Mental Health and Substance Abuse in collaboration with the Victorian Health Promotion Foundation and the University of Melbourne" World Health Organization 2005

32 Gratz, K, L., "Preliminary data on an acceptance-based emotion regulation group intervention for deliberate self-harm among women with borderline personality disorder" 37 : 25-35, 2006

33 Gratz, K. L., "Multidimensional Assessment of emotion regulation and dysregulation : Development, factor structure, and initial validation of the Difficulties in Emotion Regulation Scale" 26 : 41-54, 2004

34 Shapiro, S. L., "Mindfulness-based stress reduction for health care professionals : Results from a randomized trial" 12 : 164-176, 2005

35 Grossman, P., "Mindfulness-based stress reduction and health benefits : A meta-analysis" 57 : 35-43, 2004

36 Ma, S. H., "Mindfulness-based cognitive therapy for depression : Replication and exploration of differential relapse prevention effects" 72 : 31-40, 2004

37 Segal, Z. V., "Mindfulness-based cognitive therapy for depression : A new approach to preventing relapse" Guilford Press 2002

38 Carmody, J., "Mindfulness, spirituality, and health-related symptoms" 64 : 393-403, 2008

39 Baer, R. A., "Mindfulness training as a clinical intervention : A conceptual and empirical review" 10 : 125-143, 2003

40 Roemer, L., "Mindfulness and emotion regulation difficulties in generalized anxiety disorder : Preliminary evidence for independent and overlapping contributions" 40 : 142-154, 2009

41 Feldman, G., "Mindfulness and emotion regulation : The development and initial validation of the Cognitive and Affective Mindfulness Scale-Revised(CAMS-R)" 29 : 177-190, 2007

42 Brown, K. W., "Mindfulness : Theoretical foundations and evidence for its salutary effects" 18 : 211-237, 2007

43 Bishop, S. R., "Mindfulness : A proposed operational definition" 11 : 230-240, 2004

44 Teasdale, J. D., "Metacognitive awareness and prevention of relapse in depression : Empirical evidence" 70 : 275-287, 2002

45 Kraemer, H. C., "Mediators and moderators of treatment effects in randomized clinical trials" 59 : 877-883, 2002

46 Shapiro, S. L., "Mechanisms of mindfulness" 62 : 373-386, 2006

47 Shahar, B., "Mechanisms of change in mindfulness-based cognitive therapy for depression : Preliminary evidence from a randomized controlled trial" 3 : 402-418, 2010

48 Smits, J. A. J., "Mechanism of change in cognitive-behavioral treatment of panic disorder : Evidence for the fear of fear mediational hypothesis" 72 : 646-652, 2004

49 DeRubeis, R. J., "How does cognitive therapy work? Cognitive change and symptom change in cognitive therapy and pharmacotherapy for depression" 58 : 862-869, 1990

50 Ryff, C. D., "Happiness is everything, or is it? Explorations on the meaning of psychological well-being" 57 : 1069-1081, 1989

51 Kabat-Zinn, J., "Full catastrophe living : Using the wisdom of your mind to face stress, pain, and illness" Dell Publishing 1990

52 Cicchetti, D., "Emotions and emotion regulation in developmental psychopathology" 7 : 1-10, 1995

53 Salovey, P., "Emotional attention, clarity, and repair: Exploring emotional intelligence using the trait meta-mood scale, In Emotion, disclosure, and health" APA Books 125-154, 1995

54 Gratz, K, L., "Emotion regulation as a mechanism of change in acceptance- and mindfulness-based treatments, In Assessing mindfulness and acceptance: Illuminating the processes of change" New Harbinger Publications 2010

55 Gross, J. J., "Emotion regulation and mental health" 2 : 151-164, 1995

56 Watson, D., "Development and validation of brief measure of positive and negative affect : The PANAS scales" 54 : 1063-1070, 1988

57 Tull, M. T., "Development and initial examination of a brief intervention for heightened anxiety sensitivity among heroin users" 31 : 220-242, 2007

58 Shapiro, S. L., "Cultivating mindfulness : Effects on well-being" 64 : 840-862, 2008

59 Linehan, M. M., "Cognitive-behavioral treatment for borderline personality disorder" Guilford Press 1993

60 Beck, A. T., "Cognitive therapy of depression" Guilford Press 1979

61 Hayes, A. M., "Clarifying the construct of mindfulness in the context of emotion regulation and the process of change in therapy" 11 : 255-262, 2004

62 Ehring, T., "Characteristics of emotion regulation in recovered depressed versus never depressed individuals" 44 : 1574-1584, 2008

63 이영호, "BDI, SDS, MMPI-D 척도의 신뢰도 및 타당도에 대한 연구" 10 : 98-113, 1991

64 Sobel, M. E., "Asymptotic confidence intervals for indirect effects in structural equation models, In Sociological methodology" Jossey-Bass 290-312, 1982

65 Kabat-Zinn, J., "An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation : Theoretical considerations and preliminary results" 4 : 33-47, 1982

66 Beck, A. T., "An inventory for measuring depression" 4 : 561-571, 1961

67 Carmody, J., "An empirical study of the mechanisms of mindfulness in a mindfulness-based stress reduction program" 65 : 613-626, 2009

68 Roemer, L., "An acceptance-based behavior therapy for generalized anxiety disorder, In Acceptance and mindfulness- based approaches to anxiety: Conceptualization and treatment" Springer 213-240, 2005

69 Davidson, R. J., "Affective style, psychopathology, and resilience : Brain mechanisms and plasticity" 55 : 1196-1214, 2000

70 Hayes, S. C., "Acceptance and commitment therapy : An experiential approach to behavior change" Guilford Press 1999

71 Leahey, T. M., "A cognitive-behavioral mindfulness group therapy intervention for the treatment of binge eating in bariatric surgery patients" 15 : 364-375, 2008