사회불안장애에 대한 노출 및 비디오 피드백과 이미지 재구성법의 효과 비교 예비 연구 = Exposure and video feedback vs. imagery rescripting, which is the better intervention for social anxiety disorder?: A pilot study

다국어 초록 (Multilingual Abstract)

This study was conducted as a pilot study to compare the effects of exposure plus video feedback (VF; n=10) and imagery rescripting (IR; n=12) among participants who were diagnosed with a social anxiety disorder (SAD). The subjects consisted of 22 people diagnosed with SAD through a structured interview. The vividness, distress, and frequency of negative self-imagery (NSI) and those of negative past memory (NPM) were addressed before and after therapy. In addition, social anxiety symptoms (social interaction anxiety scale, social phobia scale, brief-fear of negative evaluation scale, social avoidance and distress scale), judgmental bias (subjective probability/cost questionnaire), and core belief were also measured before and after the treatment. The results of this study were as follows: 1) There were no significant interaction effects of vividness, distress, and frequency of NSI reduction between the two groups. However, the main effects of time were significant. 2) There were no significant interaction effects on vividness and distress of NPM reduction between the two groups, but the main effects of time were significant. In the case of frequency of NPM, both the interaction and the main effect of time were not significant. 3) There were no significant interaction effects of social anxiety symptom reduction, but the main effects of time were significant. In the fear of negative evaluation scale, the IR group showed a significant decrease, but the VF group showed no significant changes on the within-group comparisons. 4) There were no significant interaction effects of decreasing judgmental bias, but the main effects of time were significant. In the case of cost bias, the IR group showed a significant change in the within-group comparison, but the VF group was not significant. 5) There was no significant interaction effect of core belief reduction, but the main effect of time was significant. 6) On all social anxiety scales, the VF group showed medium to large effect sizes, and the IR group showed large effect sizes. The implications and limitation of this study were discussed, and suggestions for future research were suggested.

국문 초록 (Abstract)

본 연구는 사회불안장애 진단을 받은 참가자들을 대상으로 노출 및 비디오 피드백과 이미지 재구성법을 시행하고 치료 효과를 비교하기 위한 예비연구로 진행되었다. 연구대상은 구조화된 면접을 통해 사회불안장애로 진단된 22명의 사람들로 선발하였다. 부정적 자기상과 부정적인 과거 기억의 생생함, 고통, 빈도를 측정하였으며, 사회적 상호작용 불안 척도, 사회공포증 척도, 부정적 평가에 대한 두려움 척도, 사회적 회피 및 불편 척도, 주관적 가능성/손실 평정 척도, 핵심 신념을 치료 전, 후에 측정하였다. 노출 및 비디오 피드백과 이미지 재구성법의 집단 간 차이를 비교한 결과, 1) 부정적 자기상의 생생함, 고통 및 빈도 감소의 유의한 상호작용 효과는 나타나지 않았으나, 시간에 따른 주효과는 유의한 것으로 나타났다. 2) 부정적인 과거 기억의 생생함과 고통 감소의 유의한 상호작용 효과는 나타나지 않았으나, 시간 주효과는 유의한 것으로 나타났다. 부정적 과거 기억 빈도의 경우에는 상호작용과 시간 주효과 모두 유의하지 않았다. 3) 사회불안 증상 감소의 유의한 상호작용 효과는 나타나지 않았으나, 시간에 따른 주효과는 유의하였다. 사회불안 척도 중 부정적 평가에 대한 두려움 척도에서는 이미지 재구성법 집단 내 변화는 유의하였으나, 노출 및 비디오 피드백 집단 내 변화는 유의하지 않았다. 4) 판단 편향 감소의 유의한 상호작용 효과는 나타나지 않았으나, 시간에 따른 주효과는 유의하였다. 손실 편향의 경우 이미지 재구성법 집단 내 변화는 유의하였으나, 노출 및 비디오 피드백 집단 내 변화는 유의하지 않았다. 5) 핵심 신념 감소의 유의한 상호작용 효과는 나타나지 않았으나, 시간에 따른 주효과는 유의하였다. 6) 사회불안과 관련된 모든 척도 점수에서 노출 및 비디오 피드백 집단은 중간~큰 효과크기로 감소되는 양상이었고, 이미지 재구성법은 모두 큰 효과크기로 감소하는 양상이었다. 이 결과에 대한 시사점을 논의하고 본 연구의 제한점과 추후 연구에 대한 제언을 제시하였다.

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