KISEP Original Articles J Korean Neuropsychiatr Assoc Vol 39, No 4 스트레스반응척도의개발 고경봉 * 박중규 ** 김찬형 * Development of the Stress Response Invento

Size: px

Start display at page:

Download "KISEP Original Articles J Korean Neuropsychiatr Assoc Vol 39, No 4 스트레스반응척도의개발 고경봉 * 박중규 ** 김찬형 * Development of the Stress Response Invento"

불현 진
5 years ago
Views:

1 KISEP Original Articles J Korean Neuropsychiatr Assoc Vol 39, No 4 스트레스반응척도의개발 고경봉 * 박중규 ** 김찬형 * Development of the Stress Response Inventory Kyung Bong Koh, M.D., Ph.D.,* Joong-Kyu Park, Ph.D.,** Chan Hyung Kim, M.D., Ph.D.* 국문초록 연구목적 : 방법 : 결과 : 결론 : 중심단어 Department of Psychiatry, Yonsei University College of Medicine, C.P.O. Box 8044, Seoul Department of Clinical Psychology, Paik Hospital, Inje University, Ilsan Corresponding author 707

2 서론 708

3 방법 1. 척도예비설문의대상및과정 2. 예비척도의대상및과정 3. 통계분석 709

4 결 과 1. 대상자들의사회인구학적특징 2. 스트레스반응척도의요인분석 3. 스트레스반응척도의신뢰도 1) 검사-재검사신뢰도 (Test-retest reliability) 2) 내적일치도 710

5 Table 1. Sociodemographic characteristics of subjects Sex Normal subjectsn215 Control patientsn242 Statistics df p Male N% Female N% Age MeanSD t Duration of education MeanSD t Duration of illnessmonths MeanSD ReligionN Present Absent Marital statusn422 Married Single OccupationN266 Professional Non-professional Income1,000won MeanSD 2, , t Table 2. Factor analysis of Stress Response Inventory and item-total correlations Items Tension* Aggression* Somatization* Anger* Eigenvalueexplained proportion % *Item-total correlationp

6 Table 3. Factor analysis of Stress Response Inventory and item-total correlations Items Depression* Fatigue* Frustration* Eigenvalueexplained proportion % *Item-total correlationp.05 3) 하위척도와척도전체점수간의상관성 (Subscaletotal correlations) 4) 문항-하위척도전체점수간상관성 (Item-total correlations) 4. 스트레스반응척도의타당도 1) 공존타당도 Table 4. Test-retest reliability and internal-consistency Test-retest correlation n62 r* Internal consistency n215 Cronbach's ** Tension Aggression Somatization Anger Depression Fatigue Frustration Total rpearson's correlation coefficient *p.0001, **p.0 2) 변별타당도 712

7 Table 5. Correlation of SRI total scores with total score of GARS, PSQ and SCL-90-R Tension Aggression Somatization Anger Depression Fatigue Frustration Total GARS.46*.39*.41*.47*.53*.47*.45*.54* PSQ.68*.37*.55*.65*.69*.63*.71*.75* SCL-90-R GSI.69*.54*.62*.66*.69*.54*.69*.76* PSDI.58*.30*.48*.55*.58*.42*.59*.62* PST.64*.63*.60*.63*.65*.56*.65*.74* *p.01 GARSGlobal Assessment of Recent Stress Scale, PSQTotal scores of Perceived Stress Questionnaire, GSI Global Severity Index, PSDIPositive Symptom Distress Index, PSTPositive Symptom Total Table 6. SRI scores in each of patient groups and normal group Anxiety disorder N71 Depressive disorder N73 Somatoform disorder N47 Psychosomatic disorder N51 Normal control N215 F df p Tension * * * * Aggression * Somatization * * * Anger * * * Depression * * * Fatigue * * * * Frustration * * * * Total * * * *significantly higher in scores of each subscale than normal controlsp.05scheffe test 5. 사회인구학적변수와스트레스반응척도점수간의관계 713

8 6. 스트레스반응척도의임상적응용 고 찰 714

9 참고문헌 1) Cotton DHG(1990):Stress Management-An Integrated Approach to Therapy. New York, Brunner/Mazel, pp ) Derogatis LR, Coons HL(1993):Self-report measures of stress. In:Handbook of Stress-Theoretical and Clinical Aspects. Ed by Goldberg L and Breznitz S, 2nd ed, New York, The Free Press, pp ) Holmes TH, Rahe RH(1967):The Social Readjustment Rating Scale. J Psychosom Res 11: ) Cannon WB(1929):Bodily Changes in Fear, Hunger, Pain, and Rage:An Account of Recent Resear- 715

10 ches into the Function of Emotional Excitement. 2nd ed., New York, Appleton 5) Cannon WB(1932):The Wisdom of the Body. 2nd ed., New York, Norton 6) Selye H(1950):The Physiology and Pathology of Exposure to Stress. Montreal, Acta 7) Selye H(1970):The evolution of the stress concept. Am J Cardiology 26: ) Henry JP, Stephens PM(1977):Stress, Health and the Social Environment:A Sociobiologic Approach to Medicine. New York, Springer 9) Kagen AR, Levi L(1974):Health and environment-psychosocial stimuli:a review. Soc Sci Med 8: ) Derogatis LR, Rickels K, Rock AF(1976):The SCL-90 and MMPI-a step in the validation of a new report scale. Br J Psychiatry 128: ) Beck AT, Ward C, Mendelson M, Mock J, Erbaugh J(1961):An inventory for measuring depression. Arch Gen Psychiatry 4: ) Spielberger CD, Gorsuch RC, Lushene RE(1970): Manual for the State-Trait Anxiety Inventory. Palo Alto, CA, Consulting Psychologists Press 13) Lazarus RS(1978):Psychological stress and coping in adaptation and illness. In:Psychosomatic Medicine-Current Trends and Clinical Applications. Ed by Lipowski ZJ, Lipsitt DR, Whybrow PC, New York, Oxford Univ. Press, pp ) Sarason IG, Sarason BR, Potter EH, Antoni MH (1985):Life events, social support and illness. Psychosom Med 47: ) Wilder JF, Pluchik R(1985):Stress and psychiatry. In:Comprehensive Textbook of Psychiatry. Ed by Kaplan HI and Sadock BJ, 4th ed., Baltimore, Williams & Wilkins, pp ) Beck AT(1976):Cognitive therapy and the emotional disorders. New York, Times-Mirror 17) Schwartz R(1982):Cognitive-behavior modification:a conceptual review. Clin Psychol Rev 2: ) Paykel ES, Prusoff BA, Uhlenhuth EH(1971): Scaling of life events. Arch Gen Psychiatry 25: ) 고병학, 송옥헌, 신윤모 (1981): 한국인의생활사건에관한예비적연구. 신경정신의학 20: ) 최태진, 강병조 (1981) : 한국에서의사회재적응평가척도에관한예비적연구. 신경정신의학 20: ) 홍강의, 정도언 (1982) : 사회재적응평가척도제작. 신경정신의학 20: ) Linn MW(1985):A global assessment of recent stress(gars) scale. Int J Psychiatry Med 15: ) 고경봉 (1988): 정신신체장애환자들의스트레스지각. 신경정신의학 27: ) 고경봉, 박중규, 김찬형 (1999): 스트레스반응지각척도의개발. 정신신체의학 7: ) American Psychiatric Association(APA)(1994) : Diagnostic and Statistical Manual of Mental Disorders. 4th ed., Washington DC, Am Psychiatric Assoc 26) 김광일, 김재환, 원호택 (1984): 간이정신진단검사실시요강. 서울, 중앙적성출판사, pp ) 고경봉, 박중규 ( 미발간 ): 한국판최근스트레스의전반적평가척도의타당도및신뢰도 28) Levenstein S, Prantera C, Varvo M, Scribano L, Berto E(1993):Development of the perceived stress questionnaire:a new tool for psychosomatic research. J Psychosom Res 37: ) Fava M(1998):Depression with anger attacks. J Clin Psychiatry 59(suppl 18): ) van Praag(1998):Anxiety and increased aggression as pacemakers of depression. Acta Psychiatr Scan 98(Suppl 393):

11 ABSTRACT J Korean Neuropsychiatr Assoc Vol 39, No 4, July, 2000 Development of the Stress Response Inventory Kyung Bong Koh, M.D., Ph.D., Joong Kyu Park, Ph.D., Chan Hyung Kim, M.D., Ph.D. Department of Psychiatry, Yonsei University College of Medicine, C.P.O. Box 8044, Seoul ObjectiveThe purpose of this study was to develop the stress response inventorysri which includes emotional, somatic, cognitive, and behavioral stress responses, and then to use the scale in clinical pracitice. MethodsFirst, a preliminary survey was conducted for 109 healthy adults to obtain 70 response items. Second, a preliminary questionnaire was completed by 215 healthy subjects. Third, a comparison was made regarding stress responses among 242 patients71 with anxiety disorder, 73 with depressive disorder, 47 with somatoform disorder, and 51 with psychosomatic disorder and 215 healthy subjects. ResultsFactor analysis yielded 7 subscalestension, aggression, somatization, anger, depression, fatigue and frustration. Reliability was computed by administering the SRI to 62 healthy subjects during a 2-week interval. Test-retest reliability for 7 subscales and the total score was significantly high, ranging between Internal consistency was computed, and Cronbach s for 7 subscales ranged between and.97 for the total score. Concurrent validity was computed by correlating the 7 subscales and the total score with the total score of the global assessment of recent stress GARS scale, the perceived stress questionnairepsq, and the symptom checklist-90-revisedscl- 90-R. The correlations were all at significant levels. Discriminant validity was computed by comparing the total score and the 7 subscale scores of the patient and control groups. Significant differences were found for 6 subscales and the total score, with the exception being the aggression subscale. The depressive disorder group was highest in total scores of SRI among 4 patient groups, and showed a significant higher scores in total scores of SRI than each of anxiety disorder and psychosomatic disorder groups. In total scores of SRI, female subjects were significantly higher than male ones, and subjects with lower income were significantly higher than those with higher income. ConclusionsThese results indicate that the SRI is highly reliable and valid, and that it can be utilized as an effective measure of stress for research in stress-related fields. It is suggested that depressive disorder group is more susceptible to stress than any other patient groups. KEY WORDSStress response inventory Reliability Validity Depressive disorder. 717

12 부록 스트레스반응척도

13 (,, )

1. 연구대상 연구방법 2. 측정도구 3. 명상법소개및연구절차 492

1. 연구대상 연구방법 2. 측정도구 3. 명상법소개및연구절차 492 KISEP Original Articles 38 3 1999 J Korean Neuropsychiatr Assoc Vol 38, No 3 명상이정서상태에미치는효과 * 이정호 ** 김영미 ** 최영민 ** The Effect of Meditation on Depression and Anxiety* Jung-Ho Lee, M.D.,** Young-Mee Kim,