고통 감내력과 심리장애: 경험적 연구 개관 = Distress Tolerance and Psychological Disorders:A Review of the Empirical Literature

국문 초록 (Abstract)

고통 감내력은 다양한 심리장애의 위험요인으로 주목받고 있는 구성개념이다. 이 개념이 제안된 이후로 많은 양의 경험적 연구들이 실시되었으나, 이러한 연구들을 포괄적으로 개관한 연구는 매우 적었다. 비교적 최근에 수행된 개관연구도 고통 감내력과 다른 유사한 개념들의 관계를 탐색한 연구들이나 다양한 심리장애와의 관계에 대한 연구들을 충분히 검토하지 않았다는 한계를 가지고 있다. 따라서 본 연구에서는 이러한 연구들을 포함하는 좀 더 포괄적인 개관 연구를 실시하고자 했다. 이를 달성하기 위해 우선 고통 감내력의 주요이론들을 살펴보면서 각 이론들의 핵심적인 특징을 비교하였으며, 대표적인 측정도구들의 특징을 구체적으로 살펴보았다. 다음으로는 고통 감내력과 유사한 다른 구성개념들과의 관계 분석 연구들을 검토하면서 고통 감내력이 다른 구성개념들과 어떻게 구별되는지를 확인하였다. 마지막으로 심리장애와 고통 감내력의 관계에 대한 연구들을 검토하면서 심리장애에서 고통 감내력이 수행하는 역할에 대해 살펴보았다. 현재까지 수행된 고통 감내력 연구들의 한계를 살펴보고 향후 연구 방향을 제시하였다

다국어 초록 (Multilingual Abstract)

Distress tolerance is a risk factor to various psychological disorders and numerous empirical studies have focused on evaluating this concept. However, there have been only a few comprehensive reviews of the extant empirical literature studied the concept and most recent literature reviews neither explored the relationships between distress tolerance and other similar constructs, nor included studies examining the role of distress tolerance in the development and maintenance of psychological disorders. This study is conducted to comprehensively examine distress tolerance with the consideration of the previously mentioned issues. In order to achieve this objective, this study reviewed main theories of distress tolerance and compared main arguments of those theories. Further, this study analyzed various measures of distress tolerance and incorporated the studies of the relationships between distress tolerance and other variants in the comparative analyses. This study provides a better understanding of the distress tolerance role in psychological disorders by examining the relationships between distress tolerance and various forms of psychological disorders. In conclusion, this study proposes future directions of the empirical studies on distress tolerance and psychological disorders as discussing the limitations of the previous studies.

참고문헌 (Reference)

1 임선영, "한국판 다차원적 충동성 척도(UPPS-P)의 타당화 연구: 대학생 집단을 대상으로" 한국임상심리학회 33 (33): 51-71, 2014

2 서장원, "한국판 고통 감내력 부족 척도의 타당화 연구: 한국 대학생 집단을 대상으로" 한국임상심리학회 33 (33): 783-798, 2014

3 장하연, "타인의 인정에 대한 과도한 요구 신념과 정서적 고통 감내력이 사회적 수행불안에 미치는 영향" 한국인지행동치료학회 12 (12): 299-313, 2012

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

5 전주리, "정서조급성과 폭식행동의 관계" 서울대학교 2011

6 장하연, "역기능적 신념, 고통수준과 고통감내력이 사회적 수행불안에 미치는 영향 : PASAT-C 과제와 자기보고식 검사를 활용하여" 한림대학교 2012

7 설승원, "불확실성에 대한 인내력 부족과 정서 통제감이 걱정에 영향을 미치는 기제: 문제 해결 지향의 매개효과를 중심으로" 한국임상심리학회 27 (27): 209-235, 2008

8 오영아, "불확실성에 대한 인내력 부족과 걱정의 관계: 경험적 회피의 매개효과 검증" 한국상담심리학회 23 (23): 671-691, 2011

9 김지혜, "불확실성에 대한 인내력 및 지각된 통제력이 걱정에 미치는 영향: 인지적 회피의 매개효과 검증" 한국심리학회 30 (30): 1149-1164, 2011

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

11 이경선, "불안민감성의 사회적 염려차원이 발표상황에 대한 불안반응에 미치는 영향" 한국임상심리학회 25 (25): 187-203, 2006

12 박성아, "경계선 성격장애 성향자의 정서에 대한 두려움과 고통감내력" 서울대학교 2010

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

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

15 Stöber, J., "Worry, problem elaboration and suppression of imagery : The role of concreteness" 36 (36): 751-756, 1998

16 Heaton, R. K., "Wisconsin card sorting test manual" Psychological Assessment Resources 1993

17 Joiner, T., "Why people die by suicide" Harvard University Press 2009

18 Freeston, M. H., "Why do people worry?" 17 (17): 791-802, 1994

19 Sargeant, M. N., "Unique roles of antisocial personality disorder and psychopathic traits in distress tolerance" 120 (120): 987-992, 2011

20 Linehan, M. M., "Two-year randomized controlled trial and follow-up of dialectical behavior therapy vs therapy by experts for suicidal behaviors and borderline personality disorder" 63 (63): 757-766, 2006

21 Birrell, J., "Toward a definition of intolerance of uncertainty : A review of factor analytical studies of the Intolerance of Uncertainty Scale" 31 (31): 1198-1208, 2011

22 Furnham, A., "Tolerance of ambiguity : A review of the concept, its measurement and applications" 14 (14): 179-199, 1995

23 Hall, K. R. L., "The varying response to pain in psychiatric disorders: A study in abnormal psychology" 27 (27): 48-60, 1954

24 Selye, H., "The stress of life" McGraw Hill 1956

25 Tull, M. T., "The role of experiential avoidance in posttraumatic stress symptoms and symptoms of depression, anxiety, and somatization" 192 (192): 754-761, 2004

26 Gorka, S. M., "The role of distress tolerance in the relationship between depressive symptoms and problematic alcohol use" 26 (26): 621-626, 2012

27 Schmidt, N. B., "The role of anxiety sensitivity in the pathogenesis of panic : prospective evaluation of spontaneous panic attacks during acute stress" 106 (106): 355-364, 1997

28 Simon, N. M., "The relationship of anxiety disorders, anxiety sensitivity and pulmonary dysfunction with dyspnea-related distress and avoidance" 194 (194): 951-957, 2006

29 Daughters, S. B., "The relationship between distress tolerance and antisocial personality disorder among male inner-city treatment seeking substance users" 22 (22): 509-524, 2008

30 Anderson, E. R., "The relationship among social phobia, objective and perceived physiological reactivity, and anxiety sensitivity in an adolescent population" 23 (23): 18-26, 2009

31 Gronwall, D. M., "The psychological effects of concussion" Aukland University Press 1974

32 Fischer, L., "The protective role of testosterone in the development of temporomandibular joint pain" 8 (8): 437-442, 2007

33 Anestis, M. D., "The multifaceted role of distress tolerance in dysregulated eating behaviors" 40 (40): 718-726, 2007

34 Buhr, K., "The intolerance of uncertainty scale : Psychometric properties of the English version" 40 (40): 931-945, 2002

35 Klonsky, E. D., "The functions of deliberate self-injury : A review of the evidence" 27 (27): 226-239, 2007

36 Whiteside, S. P., "The five factor model and impulsivity : Using a structural model of personality to understand impulsivity" 30 (30): 669-689, 2001

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

38 Peterson, R. A., "The anxiety sensitivity index : Construct validity and factor analytic structure" 1 (1): 117-121, 1987

39 Simons, J. S., "The Distress Tolerance Scale : Development and validation of a self-report measure" 29 (29): 83-102, 2005

40 Deacon, B. J., "The Anxiety Sensitivity Index-Revised : Psychometric properties and factor structure in two nonclinical samples" 41 (41): 1427-1449, 2003

41 Bardeen, J. R., "Testing a Hierarchical Model of Distress Tolerance" 35 (35): 495-505, 2013

42 Chapman, A. L., "Solving the puzzle of deliberate self-harm : The experiential avoidance model" 44 (44): 371-394, 2006

43 Linehan, M. M., "Skills training manual for treating borderline personality disorder" Guilford Press 1993

44 Freud, S., "Sigmund Freud Collected Papers 4" Hogarth and Institute of Psycho-Analysis 13-21, 1911

45 Pednekar, J. R., "Role of testosterone on pain threshold in rats" 39 (39): 423-424, 1995

46 Taylor, S., "Robust dimensions of anxiety sensitivity : Development and initial validation of the Anxiety Sensitivity Index-3" 19 (19): 176-188, 2007

47 MacDonald, A., "Revised scale for ambiguity tolerance : Reliability and validity" 26 : 791-198, 1970

48 Frenkel-Brunswik, E., "Review of personality : A biosocial approach to origins and structure" 45 : 348-351, 1948

49 Kane, E. M., "Response to cutaneous pain in mental hospital patients" 77 (77): 52-60, 1971

50 McHugh, R. K., "Refining the measurement of distress intolerance" 43 (43): 641-651, 2012

51 Daughters, S. B., "Psychological distress tolerance and duration of most recent abstinence attempt among residential treatment-seeking substance abusers" 19 (19): 208-211, 2005

52 Schmidt, N. B., "Prospective evaluation of psychological risk factors as predictors of functional impairment during acute stress" 8 (8): 199-212, 1998

53 Buckner, J. D., "Problematic alcohol and cannabis use among young adults : The roles of depression and discomfort and distress tolerance" 32 (32): 1957-1963, 2007

54 Mennin, D. S., "Preliminary evidence for an emotion dysregulation model of generalized anxiety disorder" 43 (43): 1281-1310, 2005

55 Nock, M. K., "Physiological arousal, distress tolerance, and social problem-solving deficits among adolescent self-injurers" 76 (76): 28-38, 2008

56 Wegner, D. M., "Paradoxical effects of thought suppression" 53 (53): 5-13, 1987

57 Asmundson, G. J., "Pain:psychological perspectives" Psychology Press 35-57, 2004

58 Woodrow, K. M., "Pain tolerance : Differences according to age, sex and race" 34 (34): 548-556, 1972

59 Hooley, J. M., "Pain perception and nonsuicidal self-injury: A laboratory investigation" 1 (1): 170-179, 2010

60 Gratz, K. L., "Multidimensional assessment of emotion regulation and dysregulation : Development, factor structure, and initial validation of the difficulties in emotion regulation scale" 26 (26): 41-54, 2004

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

62 Norton, R. W., "Measurement of ambiguity tolerance" 39 (39): 607-619, 1975

63 Rydel, S. T., "Measurement and come correlates of need-cognition" 19 (19): 139-165, 1966

64 Lim, Y. J., "Korean Anxiety Sensitivity Index-Revised : Its factor structure, reliability, and validity in clinical and nonclinical samples" 24 (24): 331-341, 2007

65 임영진, "Korean Anxiety Sensitivity Index-3: Its Factor Structure, Reliability, and Validity in Non-Clinical Samples" 대한신경정신의학회 9 (9): 45-53, 2012

66 Harrington, N., "It’s too difficult!Frustration intolerance beliefs and procrastination" 39 (39): 873-883, 2005

67 Quinn, E. P., "Is task persistence related to smoking and substance abuse? The application of learned industriousness theory to addictive behaviors" 4 (4): 186-190, 1996

68 Tolin, D. F., "Intolerance of uncertainty in obsessive-compulsive disorder" 17 (17): 233-242, 2003

69 Dugas, M. J., "Intolerance of uncertainty and worry : Investigating specificity in a nonclinical sample" 25 (25): 551-558, 2001

70 Boelen, P. A., "Intolerance of uncertainty and social anxiety" 23 (23): 130-135, 2009

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

72 Grenier, S., "Intolerance of uncertainty and intolerance of ambiguity : Similarities and differences" 39 (39): 593-600, 2005

73 Frenkel-Brunswik, E., "Intolerance of ambiguity as an emotional and perceptual personality variable" 18 (18): 108-143, 1949

74 Bornovalova, M. A., "Initial RCT of a distress tolerance treatment for individuals with substance use disorders" 122 (122): 70-76, 2012

75 Matthews, K. A., "Influences of sex and age on cardiovascular responses during stress" 50 (50): 46-56, 1988

76 Gross, J. J., "Individual differences in two emotion regulation processes : Implications for affect, relationships, and well-being" 85 (85): 348-362, 2003

77 Gross, J. J., "Hiding feelings: The acute effects of inhibiting negative and positive emotion" 106 (106): 95-103, 1997

78 Gross, J. J., "Handbook of emotion regulation" The Guilford Press 3-24, 2007

79 Cougle, J. R., "Exploring the unique and interactive roles of distress tolerance and negative urgency in obsessions" 52 (52): 515-520, 2012

80 Timpano, K. R., "Exploration of anxiety sensitivity and distress tolerance as vulnerability factors for hoarding behaviors" 26 (26): 343-353, 2009

81 Chawla, N., "Experiential avoidance as a functional dimensional approach to psychopathology : An empirical review" 63 (63): 871-890, 2007

82 Hocking, C., "Evaluation of cognitive performance in the heat by functional brain imaging and psychometric testing" 128 (128): 719-734, 2001

83 O'Connor, P., "Ethnocentrism," intolerance of ambiguity," and abstract reasoning ability" 47 (47): 526-530, 1952

84 Hambrook, D., "Emotional expression, self‐silencing, and distress tolerance in anorexia nervosa and chronic fatigue syndrome" 50 (50): 310-325, 2011

85 Kalat, J., "Emotion" Cengage Learning 2011

86 Neufeld, R. W., "Effects of perceived efficacy of a prophylactic controlling mechanism on self-control under pain stimulation" 9 (9): 224-232, 1977

87 Eisenberger, R., "Effects of conceptual task difficulty on generalized persistence" 93 (93): 285-298, 1980

88 Trafton, J. A., "Distress tolerance: Theory, research, and clinical applications" The Guilford Press 80-102, 2011

89 Zvolensky, M. J., "Distress tolerance: Theory, research, and clinical applications" The Guilford Press 3-27, 2011

90 Brown, R. A., "Distress tolerance treatment for early-lapse smokers : Rationale, program description, and preliminary findings" 32 (32): 302-332, 2008

91 Corstorphine, E., "Distress tolerance in the eating disorders" 8 (8): 91-97, 2007

92 Daughters, S. B., "Distress tolerance as a predictor of early treatment dropout in a residential substance abuse treatment facility" 114 (114): 729-734, 2005

93 Leyro, T. M., "Distress tolerance and psychopathological symptoms and disorders : A review of the empirical literature among adults" 136 (136): 576-600, 2010

94 Brown, R. A., "Distress tolerance and early smoking lapse" 25 (25): 713-733, 2005

95 Richards, J. M., "Distress Tolerance: Theory, research, and clinical applications" The Guilford Press 171-197, 2011

96 Schmidt, N. B., "Discomfort intolerance : Development of a construct and measure relevant to panic disorder" 20 (20): 263-280, 2006

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

98 Klonsky, E. D., "Deliberate self-harm in a nonclinical population : Prevalence and psychological correlates" 160 (160): 1501-1508, 2003

99 Ellis, A., "Conquering low frustration tolerance" Institute for Rational Living 1978

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

101 Vujanovic, A. A., "Cognitive-affective characteristics of smokers with and without posttraumatic stress disorder and panic psychopathology" 35 (35): 419-425, 2010

102 Anestis, M. D., "Clarifying the role of emotion dysregulation in the interpersonalpsychological theory of suicidal behavior in an undergraduate sample" 45 (45): 603-611, 2011

103 Kernberg, O., "Borderline personality organization" 15 (15): 641-685, 1967

104 Kozak, A. T., "Beyond alcohol and drug addiction. Does the negative trait of low distress tolerance have an association with overeating?" 57 (57): 578-581, 2011

105 Anestis, M. D., "Behaviorally-indexed distress tolerance and suicidality" 46 (46): 703-707, 2012

106 Barkley, R. A., "Attention-deficit/hyperactivity disorder, self-regulation, and time : Toward a more comprehensive theory" 18 : 271-279, 1997

107 Dennhardt, A. A., "Associations between depression, distress tolerance, delay discounting, and alcoholrelated problems in European American and African American college students" 25 (25): 595-604, 2011

108 Reiss, S., "Anxiety sensitivity, anxiety frequency and the prediction of fearfulness" 24 (24): 1-8, 1986

109 Peterson, R. A., "Anxiety Sensitivity Index revised manual" International Diagnostic Systems Publishing Corporation 1992

110 Gratz, K. L., "An experimental investigation of emotional willingness and physical pain tolerance in deliberate self-harm : The moderating role of interpersonal distress" 52 (52): 63-74, 2011

111 Gratz, K. L., "An experimental investigation of emotion dysregulation in borderline personality disorder" 115 (115): 850-855, 2006

112 McHugh, R. K., "An examination of the association of distress intolerance and emotion regulation with avoidance" 37 (37): 363-367, 2013

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

114 Goodman, A., "Addiction : Definition and implications" 85 (85): 1403-1408, 1990

115 Hayes, S. C., "Acceptance and Commitment Therapy: An experiential approach to behavior change" Guilford Press 1999

116 Hines, E. A., "A standard stimulus for measuring vasomotor reactions : Its application in the study of hypertension" 7 : 332-335, 1932

117 Kirton, M. J., "A reanalysis of two scales of tolerance of ambiguity" 45 (45): 407-414, 1981

118 McHugh, R. K., "A novel method for assessing distress intolerance : Adaptation of a measure of willingness to pay" 42 (42): 440-446, 2011

119 Bornovalova, M. A., "A multimodal assessment of the relationship between emotion dysregulation and borderline personality disorder among inner-city substance users in residential treatment" 42 (42): 717-726, 2008

120 Lejuez, C. W., "A modified computer version of the Paced Auditory Serial Addition Task(PASAT)as a laboratory-based stressor" 26 (26): 290-293, 2003

121 Ocañez, K. L., "A meta‐analytic review of the association between anxiety sensitivity and pain" 27 (27): 760-767, 2010

122 Gentes, E. L., "A meta-analysis of the relation of intolerance of uncertainty to symptoms of generalized anxiety disorder, major depressive disorder, and obsessive-compulsive disorder" 31 (31): 923-933, 2011

123 Hancock, P. A., "A meta-analysis of performance response under thermal stressors" 49 (49): 851-877, 2007

124 Tombaugh, T. N., "A comprehensive review of the paced auditory serial addition test(PASAT)" 21 (21): 53-76, 2006

125 Ehrlich, D., ""Intolerance of ambiguity, "Walk's A scale : Historical comment" 17 (17): 591-594, 1965