[논문]정신건강의학과 환자의 절망감과 자살사고의 관계: 수면의 질과 모호함에 대한 해석 편향의 매개효과

윤소미; 김은경; 김대호; 박용천

doi:10.22722/kjpm.2023.31.2.100

정신건강의학과 환자의 절망감과 자살사고의 관계: 수면의 질과 모호함에 대한 해석 편향의 매개효과
Relationship Between Hopelessness and Suicidal Ideation Among Psychiatric Patients: The Mediating Effect of Sleep Quality and Interpretation Bias for Ambiguity 원문보기

정신신체의학 = Korean journal of psychosomatic medicine, v.31 no.2, 2023년, pp.100 - 107

윤소미 (한양대학교 구리병원 정신건강의학과) , 김은경 (한양대학교 구리병원 정신건강의학과) , 김대호 (한양대학교 구리병원 정신건강의학과) , 박용천 (한양대학교 의과대학 정신건강의학교실)

초록
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연구목적 본 연구는 정신건강의학과 환자의 절망감이 자살사고에 미치는 영향에서 수면의 질과 모호함에 대한 해석 편향의 매개효과를 확인하고자 하였다. 방 법 한양대학교 구리병원 정신건강의학과의 외래 환자와 입원 환자를 대상으로 축적된 자료를 사용하였으며, 측정 도구로는 벡 절망 척도(Beck Hopelessness Scale), 피츠버그 수면의 질 척도(Pittsburgh Sleep Quality Index), 모호한 상황에서의 시나리오 척도(Ambiguous/Unambiguous Situations Diary-Extended Version, AUSD-EX), Ultra-Short Suicidal Ideation Scale이 사용되었다. 231명의 자료를 기초로 SPSS 25.0과 SPSS Macro를 사용하여 상관분석과 Bootstrapping 기법을 이용한 회귀분석을 실시하였다. 결 과 연구 결과, 절망감과 자살사고의 관계에서 수면의 질과 모호함에 대한 해석 편향의 이중 매개효과가 유의하게 나타났다. 결 론 본 연구는 절망감이 낮은 수면의 질과 모호함에 대한 해석 편향을 거쳐 자살사고에 순차적으로 영향을 미친다는 점을 확인하였다. 이러한 결과는 정신건강의학과 환자에서 절망감이 자살사고로 이어지는 것을 예방함에 있어 낮은 수면의 질과 모호함에 대한 해석 편향을 개선하는 것이 필요함을 시사한다.

Abstract ▼ AI-Helper

Objectives : This study aimed to examine the mediating effect of sleep quality and interpretation bias for ambiguity in the relationship between hopelessness and suicidal ideation in psychiatric patients. Methods : A total of 231 psychiatric outpatients and inpatients completed the Beck Hopelessness Scale, Pittsburgh Sleep Quality Index, Ambiguous/Unambiguous Situations Diary-Extended Version, and Ultra-Short Suicidal Ideation Scale. Data analysis was conducted using regression analyses and bootstrap sampling. Results : The results of this study showed that hopelessness had a direct effect on suicidal ideation, and that sleep quality and interpretation bias for ambiguity mediated the association between hopelessness and suicidal ideation. Moreover, there was a significant double mediating effect of sleep quality and interpretation bias for ambiguity on the relationship between hopelessness and suicidal ideation. Conclusions : These results suggest that it is important to consider both sleep quality and interpretation bias for ambiguity to prevent hopelessness from leading to suicidal idea. These results suggest that considering both sleep quality and interpretation bias for ambiguity may be important in preventing hopelessness from leading to suicidal ideation.

주제어

표/그림 (6)

표 Table 1. Characteristics of the participants (n=231)
그림 Fig. 1. The double mediation effect of interpretation bias for ambiguity and anxiety in the relationship between sleep quality and depression. *p<0.05; ^†p<0.01; ^‡p<0.001.
표 Table 2. Clinical diagnosis of the participants (n=231)
표 Table 4. Path coeffcient of variables
표 Table 3. Correlations analysis of variables (n=231)
표 Table 5. Indirect effect of Bootstrapping analysis

참고문헌 (37)

Korea Foundation for Suicide Prevention. the report analyzing national suicide mortality from 2013 to 2017. Korea Foundation for Suicide Prevention 2021.
Ministry of Health and Welfare. 13,352 suicide deaths in？2021, a slight increase from last year. Reference for press coverage 2021.
Beck AT, Steer RA, Kovacs M, Garrison B. Hopelessness？and eventual suicide: a 10-year prospective study of patients？hospitalized with suicidal ideation. Am J Psychiatry 1985;142:559-563.

상세보기
Beck AT, Weissman A, Lester D, Trexler L. The measurement of pessimism: the hopelessness scale. J Consult Clin Psychol 1974;42:861865.

상세보기
Abramson LY, Metalsky GI, Alloy LB. Hopelessness depression: A theory-based subtype of depression. Psychological review 1989;96:2:358.

상세보기
Beck AT. Thinking and depression: I. idiosyncratic content and？cognitive distortions. Arch Gen Psychiatry 1963;9:324-335.

상세보기
Forman EM, Berk MS, Henriques GR, Brown GK, Beck？AT. History of multiple suicide attempts as a behavioral marker？of severe psychopathology. American Journal of Psychiatry？2004;161:437-443.

상세보기
Beck AT, Brown G, Steer RA. Prediction of eventual suicide？in psychiatric inpatients by clinical ratings of hopelessness. Journal of Consulting and Clinical Psychology 1989;57:2:309-310.

상세보기
Brown GK, Beck AT, Steer RA, Grisham JR. Risk factors？for suicide in psychiatric outpatients: a 20-year prospective？study. Journal of Consulting and Clinical Psychology 2000;68:371-377.

상세보기
Sjostrom N, Waern M, Hetta J. Nightmares and sleep disturbances in relation to suicidality in suicide attempters. Sleep？2007;30:91-95.

상세보기
Yoshimasu K, Sugahara H, Akamine M, Kondo T, Fujisawa？K, Tokunaga S, Kiyouhara C, Miyashita K, Kubo C. Sleep？disorders and suicidal ideation in Japanese patients visiting a？psychosomatic clinic in a university hospital. Sleep and Biological Rhythms 2006;4:137-143.

상세보기
Kim SH, Park CS, Kim BJ, Lee CS, Cha BS, Lee DY, Seo？JY, Choi JW, Ahn IY, Lee SJ. The Association between Suicidal Ideation, Anxiety, and Sleep Quality Among College Students in a City. Sleep Medicine and Psychophysiology 2017;24:55-61.
Turvey CL, Conwell Y, Jones MP, Phillips C, Simonsick E,？Pearson JL, Wallace R. Risk factors for late-life suicide: a？prospective, community-based study. Am J Geriatr Psychiatry？2002;10:398-406.

상세보기
Starr LR, Davila J. Responding to anxiety with rumination？and hopelessness: mechanism of anxiety-depression symptom？co-occurrence?. Cognitive Therapy and Research 2012;36:321-337.

상세보기
Morin CM, Stone J, Trinkle D, Mercer J, Remsberg S. Dysfunctional beliefs and attitudes about sleep among older adults？with and without insomnia complaints. Psychology and Aging 1993;8:3:463.

상세보기
Lichstein KL, Rosenthal TL. Insomniacs' perceptions of？cognitive versus somatic determinants of sleep disturbance.？Journal of Abnormal Psychology 1980;89:1:105.

상세보기
Dugas MJ, Freeston MH, Ladouceur R, Rheaume J,？Provencher M, & Boisvert JM. Worry themes in primary？GAD, secondary GAD, and other anxiety disorders. Journal of？Anxiety Disorders 1998;12.3:253-261.

상세보기
Lee JI, Kwon JH. The effects of worry and emotional regulation on sleep and fatigue. Korean Journal of Clinical Psychology 2008;27:1:1-14.

상세보기
Riemann D, Voderholzer U. Primary insomnia: a risk factor？to develop depression? Journal of Affective Disorders 2003;76:255-259.

상세보기
Tsuno N, Besset A, Ritchie K. Sleep and depression. J Clin？Psychiatry 2005;66:1254-1269.

상세보기
Alfano CA, Zakem AH, Costa NM, Taylor LK, Weems CF.？Sleep problems and their relation to cognitive factors, anxiety,？and depressive symptoms in children and adolescents. Depression and Anxiety 2009:26:503-512.

상세보기
Beard C, Amir N. A multi-session interpretation modification program: changes in interpretation and social anxiety？symptoms. Behaviour Research and Therapy 2008:46:1135-1141.

상세보기
Harvey AG, Watkins E, Mansell W. Cognitive behavioural？processes across psychological disorders: a transdiagnostic？approach to research and treatment. Oxford: Oxford University？Press: USA;2004. p.135-144.
Ree MJ, Pollitt A, Harvey AG. An investigation of interpretive bias in insomnia: an analog study comparing normal and？poor sleepers. Sleep 2006:29:1359-1362.

상세보기
Jollant F, Lawrence NL, Olie E, Guillaume S, Courtet P.？The suicidal mind and brain: a review of neuropsychological？and neuroimaging studies. The World Journal of Biological？Psychiatry 2011;12:5:319-339.

상세보기
Barzilay S, Apter A. Psychological models of suicide. Archives of Suicide Research 2014;18:4:295-312.

상세보기
Beevers CG, Miller IW. Perfectionism, cognitive bias, and？hopelessness as prospective predictors of suicidal ideation. Suicide and Life-Threatening Behavior 2004;34:26-137.
Lee SJ, Jang MS, Kwak HW. Study of emotion processing？with suicide ideation tendency group. The Korean Journal of？Counseling and Psychotherapy 2013;25:603-620.
Cha CB, Najmi S, Park JM, Finn CT, Nock MK. Attentional bias toward suicide-related stimuli predicts suicidal behavior. Journal of Abnormal Psychology 2010;119:616.

상세보기
Beck AT, Weissman A, Lester D, Trexler L. The measurement of pessimism: the hopelessness scale. J Consult Clin Psychol 1974;42:861865.

상세보기
Buysse DJ, Reynolds III CF, Monk TH, Berman SR, Kupfer DJ. The pittsburgh sleep quality index: a new instrument？for psychiatric practice and research. Psychiatry Research？1989:28:193-213.

상세보기
Davey GCL, Hampton J, Farrell J, Davidson S. Some characteristics of worrying: Evidence for worrying and anxiety？states as separate constructs. Personality and Individual Differences 1992;13:133-147.

상세보기
Nugent WR. (The development and psychometric study of？an ultra-short-form suicidal ideation measure. Best Practices？in Mental Health 2005;1:2:1-18.
Hayes AF. Introduction to mediation, moderation, and conditional process analysis: a regression-based approach. New？York, NY: Guilford Press;2013.
Pavlova MK, Latreille V. Sleep disorders. The American？Journal of Medicine 2019;132:292-299.

상세보기
Espie CA, Emsley R, Kyle SD, Gordon C, Drake CL, Siriwardena AN, Cape J, Ong JC, Sheaves B, Foster R, Freeman D, Font JC, Marsden A, Luik AI. Effect of digital cognitive behavioral therapy for insomnia on health, psychological？well-being, and sleep-related quality of life: a randomized？clinical trial. JAMA Psychiatry 2019;76:21-30.

상세보기
Mathews A, Mackintosh B. Induced emotional interpretation？bias and anxiety. Journal of Abnormal Psychology 2000;109:602-615.

상세보기

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