강박사고와 강박행동의 발현에서 위험회피 기질과 체험회피 시도의 역할

국문 초록 (Abstract)

불안장애는 불안경험을 촉발시키는 위협자극의 종류에 따라서 하위유형으로 구분되고 있지만 불안장애의 기저에는 표면적 차이점을 상쇄하는 본질적 공통점인 회피행동경향성이 존재한다. 그러므로 불안장애를 이해하고 치료하기 위해서는 불안감정이라는 경험요소와 회피행동이라는 통제요소를 모두 고려해야 한다. 이러한 점에 주목한 최근의 연구에서 불안장애의 기질적 취약성을 반영하는 위험회피 기질과 관계적 취약성을 반영하는 체험회피 시도가 걱정증상의 발현에 영향을 미친다는 가설이 경험적으로 검증된 바 있다. 본 연구에서는 선행연구의 제한점을 비판적으로 검토하면서 위험회피 기질과 체험회피 시도가 강박사고 및 강박행동의 발현에 차별적인 역할을 한다는 복수의 가설을 설정한 뒤, 288명의 대학생에게서 수집한 자료를 바탕으로 이를 검증하였다. 연구 결과, 강박사고의 발현에는 위험회피 기질이 직접적 영향을 미치는 것으로 나타났으며, 강박행동의 발현에는 위험회피 기질이 직접적 영향을 미칠 뿐만 아니라 체험회피 시도의 매개를 통하여 간접적 영향을 미치는 것으로 밝혀졌다. 아울러, 강박사고가 강박행동으로 이어지는 과정에서 체험회피 시도가 매개변인으로 작용한다는 것이 입증되었다. 이를 토대로, 본 연구의 결과가 강박증상의 이해와 치료에 시사하는 바를 이론적 및 임상적 관점에서 논의하였고, 본 연구의 함의와 제한점을 언급하였다.

다국어 초록 (Multilingual Abstract)

Anxiety disorders can be classified into various subtypes depending on the nature or kind of threatening stimuli. However, there are essential similarities in the underlying mechanism of all anxiety disorders to offset the differences between the surfaces. The action disposition of anxious emotion is the avoidance. Therefore, clinical issues are not the experiences of anxious emotion per se but the efforts to avoid them. In this context, Yoo and Kwon(2013) proposed that GAD symptoms reflect a combination of the ‘experience component’(i.e., harm avoidance) and the ‘control component’(i.e., experiential avoidance). In present study, the author criticised the limitations of the previous model and respectively investigated the differential roles of harm avoidance and experiential avoidance in the development of OCD symptoms, obsessions and compulsion. In order to evaluate the validities of hypothesized models, cross-sectional data were collected from 288 undergraduate students. The results of this study showed that experiential avoidance did not mediate the relationship between harm avoidance and obsessions but did partially mediate the relationship between harm avoidance and compulsions. And the experiential avoidance partially mediated the relationship between obsessions and compulsions. Based on the findings, the author discussed the implications of present study in theoretical and clinical manner. Finally, the limitations of this study were discussed along with suggestions for further research.

목차 (Table of Contents)

• 요약
• 방법
• 연구참여자
• 측정도구
• 결과
• 위험회피 기질과 강박사고 빈도의 관계에서체험회피 시도의 매개효과 검증
• 위험회피 기질과 강박행동 빈도의 관계에서체험회피 시도의 매개효과 검증
• 강박사고 빈도와 강박행동 빈도의 관계에서체험회피 시도의 매개효과 검증
• 논의
• 참고문헌
• Abstract

참고문헌 (Reference)

1 권석만, "현대 이상심리학" 학지사 2013

2 유성진, "위험회피 기질과 불안증상의 관계에서 체험회피 시도의 매개효과" 한국임상심리학회 32 (32): 217-241, 2013

3 문현미, "심리적 수용 촉진 프로그램의 개발과 효과 : 수용-전념 치료 모델을 중심으로" 가톨릭대학교 대학원 2006

4 유성진, "불안증상의 발현에서 위험회피 기질과 체험회피 시도의 역할 : 불안감내력장애의 개념화" 서울대학교 대학원 2010

5 이숙희, "기질 및 성격검사-성인용(TCI-RS)의 구인타당도: 대학생들의 우울과 불안을 중심으로" 한국임상심리학회 28 (28): 533-548, 2009

6 민병배, "기질 및 성격검사 매뉴얼" (주)마음사랑 2007

7 김환, "경험적 회피(Experiential Avoidance)와 회피적 반응의 관계: 행동적 회피, 감추기 및 거리두기를 중심으로" 한국심리학회 26 (26): 225-243, 2007

8 박진미, "경계선 성격장애 성향자의 부적응적 정서조절 : 정서적 회피를 중심으로" 서울대학교 대학원 2006

9 조용래, "걱정의 통제 불능성/위험에 대한 부정적 신념과 시험불안의 관계: 경험 회피의 매개역할" 한국임상심리학회 27 (27): 891-909, 2008

10 이정은, "걱정에 대한 부정적 신념과 일반화된 불안증상 간의 관계에서 경험적 회피의 매개효과" 한국임상심리학회 26 (26): 939-961, 2007

11 민병배, "강박증상과 걱정의 관계" 18 : 59-68, 1999

12 민병배, "강박사고와 걱정 : 침투사고 대처과정 및 관련 성격특성에서의 유사점과 차이점" 서울대학교 대학원 2000

13 이용승, "강박사고 억제의 역설적 효과" 서울대학교 대학원 2000

14 Malcarne, V. L., "Vulnerability to anxiety disorders in childhood and adolescence, In Vulnerability to psychopathology: Risk across the lifespan" The Guilford Press 271-303, 2001

15 Barlow, D. H., "Toward a unified treatment for emotional disorders" 35 (35): 205-230, 2004

16 MacKinnon, R. A., "The psychiatric interview in clinical practice" Saunders 1971

17 Gray, J. A., "The neuropsychology of anxiety" Oxford University Press 1982

18 Borkovec, T. D., "The nature, functions, and origins of worry, In Worrying: Perspectives on theory, assessment and treatment" Wiley 29-50, 1994

19 Baron, R. M., "The moderator-mediator variable distinction in social psychological research : Conceptual, strategic, and statistical considerations" 51 : 1173-1182, 1986

20 Agras, S., "The epidemiology of common fears and phobias" 10 : 151-156, 1969

21 Frijda, N. H., "The emotions" Cambridge University Press 1986

22 Eder, R. A., "The emotional basis of early personality development, In Handbook of personality psychology" Academic Press 209-240, 1997

23 Salkovskis, P. M., "The cognitive approach to anxiety: Threat beliefs, safety-seeking behavior, and the special case of health anxiety and obsessions, In Frontiers of cognitive therapy" The Guilford Press 48-74, 1996

24 Cloninger, C. R., "The Temperament and Character Inventory(TCI): A guide to its development and use" Missouri 1994

25 Battaglia, M., "Temperament dimensions explain the comorbidity of psychiatric disorders" 37 : 292-298, 1996

26 Kagan, J., "Temperament and the reactions to unfamiliarity" 68 : 139-143, 1997

27 Young, J. E., "Schema theapy : A practitioner’s guide" The Guilford Press 2003

28 Ellis, A. & MacLaren, C., "Rational emotive behavior therapy : A therapist's guide" Impact Publishers 1995

29 Siegel, R. D., "Psychophysiological disorders: Embracing pain, In Mindfulness and psychotherapy" The Guilford Press 173-196, 2005

30 Friedman, A. F., "Psychological assessment with MMPI" Lawrence Erlbaum Associates 1989

31 Gabbard, G. O., "Psychodynamic psychiatry in clinical practice" American Psychiatric Press 2000

32 McWilliams, N., "Psychoanalytic diagnosis : Understanding personality structure in the clinical process" The Guilford Press 1994

33 Cloninger, C. R., "Personality disorders, In Comprehensive textbook of psychiatry" Lippincott Williams & Wilkins 1723-1764, 2000

34 Purdon, C., "Obsessive intrusive thoughts in nonclinical subjects. Part I. Content and relation with depressive, anxious and obsesssional symptoms" 31 : 712-720, 1993

35 Sanavio, E., "Obsessions and compulsions : The Padua Inventory" 26 : 169-177, 1988

36 Salkovskis, P. M., "Obsessional-compulsive problem : A cognitive-behavioral analysis" 23 : 571-583, 1985

37 Hayes, S. C., "Measuring experiential avoidance : A preliminary test of a working model" 54 : 553-578, 2004

38 Cloninger, C. R., "Measurement of temperament and character in mood disorders : A model of fundamental states as personality types" 51 : 21-32, 1998

39 Barlow, D. H., "Mastery of your anxiety and panic" Graywind 1989

40 Mowrer, O. H., "Learning theory and personality dynamics" Ronald 1950

41 Wegner, D. M., "Ironic processes of mental control" 101 : 34-52, 1994

42 Dugas, M. J., "Intolerance of uncertainty and problem orientation in worry" 21 : 593-606, 1997

43 Safran, J. D., "Interpersonal process in cognitive therapy" Basic Books 1990

44 Hayes, S. C., "Get out of your mind and into your life : The new acceptance and commitment therapy" New Harbinger Publications 2005

45 Barlow, D. H., "Essentials of abnormal psychology" Wadsworth 2004

46 Feldner, M. T., "Emotional avoidance : An experimental test of individual differences and response suppression using biological challenge" 41 (41): 403-411, 2003

47 Fruzzetti, A. E., "Emotion regulation, In Cognitive behavior therapy: Applying empirically supported techniques in your practice" John Wiley & Sons 152-159, 2003

48 Sloan, D. M., "Emotion regulation in action : Emotional reactivity in experiential avoidance" 42 : 1257-1270, 2004

49 Meyer, T. J., "Development and validation of the Penn State Worry Questionnaire" 28 (28): 487-495, 1990

50 Richter, J., "Depressive mood and personality in terms of temperament and character among the normal population and depressive inpatients" 35 : 917-927, 2003

51 Beck, A. T., "Cognitive therapy of personality disorders" The Guilford Press 2004

52 Wells, A., "Cognitive therapy of anxiety disorders : A practice manual and conceptual guide" John Wiley 1997

53 Linehan, M. M., "Cognitive behavioral treatment of borderline personality disorder" The Guilford Press 1993

54 Obsessive Compulsive Cognition Working Group, "Cognitive assessment of obsessive-compulsive disorder" 35 : 667-681, 1997

55 Rachman, S., "Cognitive and behavioral features of obsessive compulsive disorder, In Obsessive-compulsive disorder: Theory, research, and treatment" The Guilford Press 51-78, 1998

56 Davey, G. C. L., "Catastrophic worrying : Personal inadequacy and a perseverate iterative styles as features of the catastrophising process" 107 : 576-586, 1998

57 Waelder, R., "Basic theory of psychoanalysis" International Universities Press 1960

58 Zvolensky, M. J., "Anxiety sensitivity dimensions in the prediction of body vigilance and attentional-based coping strategies" 26 : 449-460, 2002

59 Germer, C. K., "Anxiety disorders: Befriending fear, In Mindfulness and psychotherapy" The Guilford Press 152-172, 2005

60 Beck, A. T., "Anxiety disorders and phobias : A cognitive perspectives" Basic Books 1985

61 Barlow, D. H., "Anxiety and its disorders: The nature and treatment of anxiety and panic" The Guilford Press 2002

62 Butler, G., "Anticipatory anxiety and risk perception" 11 : 551-565, 1987

63 Strosahl, K. D., "An ACT primer: Core therapy processes, intervention strategies, and therapist competencies, In A practical guide to acceptance and commitment therapy" Springer 31-58, 2004

64 Bradley, S. J., "Affect regulation and the development of psychopathology" The Guilford Press 2000

65 Eifert, G. H., "Acceptance and commitment therapy for anxiety disorders" New Harbinger Publications 2005

66 Hayes, S. C., "Acceptance and commitment therapy and the new behavior therapies: Mindfulness, acceptance, and relationship, In Mindfulness and acceptance: Expanding the cognitive-behavioral tradition" The Guilford Press 1-29, 2004

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

68 Cloninger, C. R., "A systematic method for clinical description and classification of personality variants : A proposal" 44 : 573-587, 1987

69 Wells, A., "A short form of the meta-cognitions questionnaire : Properties of the MCQ-30" 42 : 385-396, 2004

70 Goldstein, A. J., "A reanalysis of agoraphobia" 9 : 47-59, 1978

71 Clark, D. M., "A cognitive model of social phobia, In Social phobia: Diagnosis, assessment, and treatment" The Guilford Press 69-93, 1995

72 Clark, D. M., "A cognitive approach to panic" 24 : 461-470, 1986

73 Ciarrochi, J. V., "A CBT practitioner's guide to ACT : How to bridge the gap between cognitive behavioral therapy and acceptance and commitment therapy" New Harbinger Publications 2008