Original Article J Sasang Constitut Med 2016;28(3): 중학생에서사상성격검사 (SPQ) 의생리심리적타당화연구 이수진 * ㆍ윤보미 * ㆍ최영

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1 Original Article J Sasang Constitut Med 2016;28(3): 중학생에서사상성격검사 (SPQ) 의생리심리적타당화연구 이수진 * ㆍ윤보미 * ㆍ최영준 * ㆍ최유진 * ㆍ윤여진 ㆍ황보경 ㆍ채한 * 경일대학교안전보건대학심리치료학과, 부산대학교한의학전문대학원양생기능의학부 Abstract Biopsychological Validation of the Sasang Personality Questionnaire in Middle School Students Soo Jin Lee *, Bo Mi Yun *, Young Jun Choi *, Yu Jin Choi *, Yeo Jin Yoon, Bo Kyung Hwang, Han Chae * Dept. of Psychotherapy, School of Nursing and Public Health, Kyungil University, Gyungsan, Korea Division of Longevity and Biofunctional Medicine, School of Korean Medicine, Pusan National University, Busan, Korea Objectives The Sasang Personality Questionnaire (SPQ) measures the Yin-Yang temperament of Sasang typology with proven structural and clinical validity in adults, however it was not examined with teenagers. The purpose of this study was to validate the biopsychological structure of SPQ in middle school students. Methods 681 Korean high school students (356 boys and 325 girls) completed SPQ, Junior version of Temperament and Character Inventory (JTCI), and height and weight measures. The correlation between SPQ and JTCI subscales were examined, and the differences of SPQ and JTCI subscales, Body Mass Index (BMI) and Pondera Index (PI) among high (30%), middle (40%), and low (30%) SPQ total score groups were investigated with Analysis of Variance (ANOVA). The profile analysis was also performed to compare JTCI subscale profiles of three SPQ total score groups. Results The SPQ score was significantly (p<0.001) correlated positively with JTCI Novelty-Seeking and negatively with JTCI Harm-Avoidance. The JTCI Novelty-Seeking score of high SPQ group was significantly (p<0.001) higher than that of low SPQ group, and the JTCI Harm-Avoidance score of low SPQ group was significantly higher than that of high SPQ group. The JTCI subscale profiles for three SPQ groups were significantly different for boys and girls. Significant correlations or differences for the PI and BMI among SPQ groups were not found. Conclusions This study presented that the biopsychological structure of SPQ is robust as shown in adults. The SPQ would be a useful clinical measures of Sasang typology in pediatric patients. Key Words : High school student, Sasang Personality Questionnaire, Junior Temperament and Character Inventory, Body Mass Index, Ponderal Index Received August 23, 2016 Revised September 1, 2016 Accepted September 23, 2016 Corresponding Author Han Chae Division of Longevity and Biofunctional Medicine, School of Korean Medicine, Pusan National University, 30 Jangjeon-dong, Geumjeong-gu, Busan Korea Tel: Fax: han@chaelab.org C The Society of Sasang Constitutional Medicine. All rights reserved. This is an open acess article distributed under the terms of the Creative Commons attribution Non-commercial License ( creativecommons.org/licenses/by-nc/3.0/)

2 SJ Lee et al. 247 Ⅰ. 緖論 사상의학은인간을태양인, 소양인, 태음인, 소음인의네가지유형으로구분하여, 이들이지니는고유한생병리특성을토대로체질별질병에대한감수성과약물에대한반응성을제시하고있다 1,2. 선행연구를통해사상체질별로지니고있는고유한생병리특성 3,4, 유전적특성 5, 심리적특성 6,7, 신체적특성 2 등과함께이의토대가되는기전들이제시되었다 6,7. 또한신경해부학적측면에있어서는태음인과소음인이자율신경반응성 (Autonomic Reactivity) 및시상하부- 뇌하수체-부신축 (Hypothalamic-Pituitary-Adrenal Axis, 이하 HPA axis) 에있어뚜렷한차이를보일것으로제시되었으며 4,8, 생리심리적측면에있어서는소양인과소음인이행동활성시스템 (BAS, Behavioral Activation System) 과행동억제시스템 (BIS, Behavioral Inhibition System) 에있어서상반된특성을지니는것으로제시되었다 최근에개발된사상성격검사 (SPQ, Sasang Personality Questionnaire) 는이러한연구성과를토대로성격의음양적특성을객관적으로측정하는자기보고식평가도구로서 12,13, 행동 (SPQ-B: Sasang Personality Questionnaire-Behavior), 인지 (SPQ-C: Sasang Personality Questionnaire-Cognition) 그리고감정 (SPQ-E: Sasang Personality Questionnaire-Emotionality) 의세가지하위척도를측정한다. SPQ 의생리심리적구조는검사의개발 13, 이론적타당화 12, 확인적요인분석 14 등을통해수차례재확인되었으며, 체질의학임상에있어서의임상적타당화연구를통해서는소양인, 태음인, 소음인간의유의한차이를측정해낼수있음이반복확인되었다 13,15. SPQ 의심리학적연구를통해서는기질및성격검사 (TCI, Temperament and Character Inventory) 와 NEO 성격검사 (NEO Personality Inventory) 15, 마이어스- 브릭스성격검사 (Myers-Briggs Type Indicator) 16, BIS/BAS 12 등과유의한상관성을지니고있음이보고되었으며, 선행연구들을통해사상체질심리특성이그대로반영 되어있음 16 도확인되었다. 예를들면, SPQ 총점은 TCI 자극추구 (NS, Novelty-Seeking) 와정적인상관이있었고 TCI 위험회피 (HA, Harm-Avoidance) 와는부적인상관이있었으며 8, SPQ 총점상위 (30%) 집단은자극추구 (NS) 가높았으며하위 (30%) 집단에서는위험회피 (HA) 가높게나타났다 15,16. SPQ와신체적특성간의비교연구를통해서는, 체격발달과갑상선호르몬의기능을반영하는폰데랄지수 (PI, Ponderal Index), 비만도를반영하는체질량지수 (BMI, Body Mass Index) 8,15,17 및체질별소증을측정하는사상소화기능검사 (SDFI, Sasang Digestive Function Inventory) 18 등과의비교를통해심리적특성이독립적인특성이라는것이확인되었다. 또한단축형건강특성 SF-12(Short Form-12) 와 SPQ-B 는상호유의한상관성을지니고있음도보고되었다 17. 이와같이, SPQ 가다양한측면에서의타당화연구를통해임상적으로매우유용하다는것이확인되어왔으나, 이는 20대에서 70대까지의성인을대상으로진행되어왔을뿐, 아동및청소년을대상으로한타당화연구는부족한것이현실이다 청소년기는급격한심신의성장으로인한많은변화가발생하기에, 사상의학에서의임상경험을토대로한균형적인심신발달을위한통합적이고도인간중심적인관리와관심이요구되나, 이를고려한사상의학연구는활발히진행되지못하여왔다. 기존의사상의학연구도구인사상체질분류검사지 (Questionnaire for Sasang Constitution Classification) 22-24, 사상체질음성분석기 (Phonetic System for Sasang Constitution) 25, 사상체질설문지 (SaSang Constitution Questionnaire) 26, 사상체질진단도구 (Sasang Constitutional Analytic Tool) 27 등은성인만을대상으로개발, 타당화가진행되어왔기에, 소아청소년을대상으로한임상적활용에있어서는한계성을지니고있다. 또한, 소아청소년을대상으로한선행연구는매우부족한데, 초등학생을대상으로한연구는사상체질별체형과기질특성 28, 체질별소증 21, 체질별심리적특성 29 과신체적특성 24, 그리고체성분과식이습관 30 등에대한질적,

3 248 Biopsychological Validation of the Sasang Personality Questionnaire in middle school students 양적연구를통한연구가능성이제시되었을뿐이다. 이에반하여, 소아 10 및중학생 31 에서의체질별 Junior version of Temperament and Character Inventory ( 이하 JTCI) 프로파일분석과고등학생을대상으로한선행타당화연구 19,32,33 의결과를고려한다면, SPQ 는성인뿐아니라소아청소년을포함하는전연령을대상으로한사상의학의임상활용에매우유용하게활용될수있을것이다. 이에, 본연구에서는중학교학생을대상으로한 SPQ 타당화를통해임상적활용범위를확장시키고자하였다. 성인및고등학생을대상으로진행하였던선행생리심리학적연구에서확인되었던것과같이, 중학교학생에있어서도 SPQ 점수는 JTCI 자극추구 (NS) 와는정적인상관관계가, JTCI 위험회피 (HA) 와는부적인상관관계를나타낼것이며, 체질량지수 (BMI) 와폰데랄지수 (PI) 와같은신체적특징과는상호독립적인특성을나타낼것이다. 이와함께, SPQ 총점상위 (30%) 집단은높은자극추구 (NS) 와낮은위험회피 (HA) 점수를지니고있을것이며, SPQ 총점하위 (30%) 집단은낮은자극추구 (NS) 와높은위험회피 (HA) 점수를보일것이다. 중학생에서의 SPQ 타당화는소아청소년에있어서의사상체질별심리적특성을객관적으로측정하고분석할수있는토대를마련할수있을것이며, 임상적으로는체질진단및발달관리에유용한도구로활용할수있을것이다 19, 외하고최종적으로 681 명의데이터를본연구에서의분석대상으로활용하였다. 연구대상자의성별분포는남학생이 356명 (52.28%), 여학생이 325명 (47.72%) 이었으며, 학년에따른분포는 1학년이 193명 (28.34%), 2학년이 233 명 (34.21%), 3 학년이 255명 (37.45%) 이었다. 본연구는경일대학교생명윤리위원회 (IRB) 의사전승인이후에진행하였으며, 연구대상자들은사전에연구참여에대한서면동의서를작성하도록하였다. 2. 연구도구 1) 사상성격검사 (SPQ) 사상성격검사 (SPQ) 37 는사상의학에서의심리적기질을측정하는 14문항의자기보고식검사로, 생리심리적구조와임상적타당화가보고되었다 16,37,38. 각문항은성격적특성을설명하는상반되는두단어로구성되어있는데, 세가지답변중하나를선택하는 3점 Likert 척도로구성되어있다 ( 예, 1= 큰편, 2= 중간편, 3= 작은편 ). SPQ 는음양과유학적인성관을이론적토대로하며, 행동적측면 (SPQ-B), 인지또는의사결정측면 (SPQ-C), 감정적측면 (SPQ-E) 의세가지하위척도로구성되어있다. 본연구에있어서 Cronbach's alpha 로분석한 SPQ-B, SPQ-C, SPQ-E 의내적일치도는각각남자에있어서 0.752, 0.395, 0.551이었으며, 여자에있어서는 0.759, 0.478, 0.421이었다. 2) 청소년용기질및성격검사 (JTCI) Ⅱ. 硏究方法및對象 1. 연구대상및진행본연구에서는, 대구지역중학생 800 명을대상으로사상성격검사 (SPQ), 청소년용기질및성격검사 (JTCI) 를시행하였으며이와함께키와몸무게를수집하였다. 검사에응답한 705명에있어서, 세가지검사모두를시행하지않았거나불성실하게응답한 24명을제 기질및성격검사 (JTCI) 는기질과성격의두차원을측정하는데, 기질은자극에대한자동적인반응을의미하며, 성격은기질을토대로사회문화적학습을통해발달해가는심리적성숙과개인적가치를의미한다. 기질은자극추구 (NS, Novelty Seeking), 위험회피 (HA, Harm-Avoidance), 사회적민감성 (RD, Reward- Dependence), 인내력 (PS, Persistence) 의네가지하위척도로이루어져있으며, 성격차원은자율성 (SD, Self-Directness), 연대감 (CO, Cooperativeness), 자기초월

4 SJ Lee et al. 249 (ST, Self-Transcendence) 의세가지하위척도로이루어져있다 39. 한국판청소년용기질및성격검사 (JTCI) 는 82문항의자기보고식검사로서, 4점 Likert 척도 (0= 전혀그렇지않다, 3= 매우그렇다 ) 로이루어져있는데, 2007년에표준화되어타당성과신뢰성을검증받았다 40. JTCI 의하위척도인 NS, HA, RD, PS, SD, CO, ST의내적일치도는각각 0.76, 0.81, 0.67, 0.67, 0.74, 0.71, 0.66 라고보고되었다 40. 3) 체질량지수 (BMI), 폰데랄지수 (PI) 비만정도를반영하는체질량지수 (BMI) 와체격발달을측정하는폰데랄지수 (Pondera Index, 이하 PI) 의계산을위한키 (m) 와체중 (kg) 측정치는학교생활기록부를통하여수집되었다. BMI 는체중을키의제곱으로나눈값 ( 체중 (kg)/ 키 (m)²) 이며, PI는체중을키의세제곱으로나눈값 ( 체중 (kg)/ 키 (m)³) 이다. 3. 통계분석본연구에있어서연구대상자의성별과학년분포를분석함에있어서는기술통계를사용하였고, SPQ 하위척도에있어서의내적일치도를분석함에있어서는 Cronbach s alpha를사용하였다. 남녀의인구학적특성은 t-test와 χ² 검증을사용하여분석하였으며, 유의한차이를확인하였기에이후분석에서는남녀를구분하여진행하였으며, 이와함께 SPQ 총점을기준으로상위 (30%), 중위 (40%), 하위 (30%) 의세집단을나누어분석에활용하였다. 본연구에서는 SPQ 와 JTCI, BMI, PI 사이의상관관계는 Pearson s correlation 을사용하여분석하였다. SPQ 총점을기준으로한세집단간의 SPQ, JTCI, BMI 및 PI 차이를비교함에있어서는분산분석 (ANOVA) 을사용하였으며, Levene s 동질성검정결과에따라사후검정에 Bonferroni 혹은 Dunnett s T3 를사용하였다. 또한 SPQ 상중하그룹간의 TCI 프로파일의차이를비교함에있어서는프로파일분석 (profile analysis) 을사용하였으며, 이를위해 parallelism 와 flatness 분석을실시하였다. 통계분석프로그램으로는 IMB SPSS 20.0(IBM, Armonk, NY) 을사용하였으며, 기술통계의결과에는빈도 (%) 또는평균 ± 표준편차를사용하였으며, 통계적유의수준으로는 p<0.05, p<0.01, p<0.001을사용하였다. Ⅲ. 硏究結果 본연구에서의분석은남학생 365명 (52.28%) 과여학생 325 명 (47.72%) 을대상으로하였으며, 성별및학년분포는 Table 1에제시하였다. 남녀간학년분포에있어서유의한차이는확인할수없었다 (χ²=0.491, df=2, p=0.782). 본연구에서는선행연구에서 JTCI, SPQ 및신체적특성이성별로차이가났었음을고려하여, 통계분석에있어남녀를나누어진행하였다. 1. 남학생남학생에있어서, SPQ, SPQ-B, SPQ-C, SPQ-E의 Cronbach's alpha는각각 0.712, 0.752, 0.395, 0.551이었다. SPQ 총점을기준으로상위 (30%, 32), 중위 (40%, Table 1. Demographic Features of the Participants as Frequency (%) Grade Boy Girl Total 1st 100(51.81) 93(48.19) 193(100) χ²=0.491, df=2, p= nd 126(54.08) 107(45.92) 233(100) 3rd 130(50.98) 125(49.02) 255(100) Total 356(52.28) 325(47.72) 681(100)

5 250 Biopsychological Validation of the Sasang Personality Questionnaire in middle school students Table 2. SPQ and JTCI Subscales Score, BMI and PI of High, Middle and Low SPQ Score Groups in Male Middle School Students High SPQ ( 32) Middle SPQ (28-31) Low SPQ ( 27) Total ANOVA Post-hoc analysis n (%) 101 (28.37) 136 (38.20) 119 (33.43) 356 (100) SPQ *** 34.25± ± ± ±4.3 SPQ-B *** 13.29± ± ± ±2.42 F= , df=2,353, p<0.001 high>middle>low SPQ-C *** 12.02± ± ± ±1.73 F= , df=2,353, p<0.001 high>middle>low SPQ-E *** 8.94± ± ± ±1.78 F=84.687, df=2,353, p<0.001 high>middle>low JTCI NS *** 21.76± ± ± ±5.62 F=36.759, df=2,353, p<0.001 high>middle>low HA *** 17.86± ± ± ±6.21 F=9.714, df=2,353, p<0.001 high, middle<low RD ** 16.68± ± ± ±3.62 F=6.692, df=2,353, p<0.01 high, middle>low PS 14± ± ± ±3.18 F=0.434, df=2,353, p=0.648 SD 24.18± ± ± ±5.24 F=2.993, df=2,353, p=0.051 CO 26.67± ± ± ±5.09 C=0.189, df=2,353, p=0.828 ST 18.43± ± ± ±4.56 F=1.114, df=2,353, p=0.329 BMI 20.98± ± ± ±3.88 F=1.387, df=2,353, p=0.251 PI 12.66± ± ± ±2.32 F=1.38, df=2,353, p=0.253 *** p<0.001; ** p<0.01; SPQ, Sasang Personality Questionnaire; SPQ-B, SPQ Behavior; SPQ-C, SPQ-Cognition; SPQ-E, SPQ-Emotionality; JTCI, Junior version of Temperament and Character Inventory; NS, Novelty-Seeking; HA, Harm-Avoidance; RD, Reward-Dependence; PS, Persistence; SD, Self-Directedness; CO, Cooperativeness; ST, Self-Transcendence; BMI, Body Mass Index; PI, Ponderal Index The JTCI subscale profile of the high, middle and low SPQ score groups were significantly different (flatness with Greenhouse-Geisser correction, df=5.880, F=10.25, p<.001; parallelism with Greenhouse- Geisser correction, df=2.940, F=309.16, p<.001). Data shown as mean and standard errors. Figure 1. JTCI subscale profile of high, middle and low SPQ score groups in male middle school students ), 하위 (30%, 27) 의세그룹으로나누었으며, 이들세그룹의 SPQ, JTCI, BMI, PI 점수를 ANOVA를사용하여비교하였다 (Table 2). SPQ 하위척도에있어서, 세그룹간에유의한차이를확인할수있었으며, JTCI 자극추구 (NS) 와위험회피 (HA) 에있어서도 SPQ 상위, 중위, 하위그룹간유의한 (p<0.001) 차이를확인할수있었다. JTCI 자극추구 (NS) 점수 (21.76±5.47, 18.38±4.94, 15.82±5.02) 는상위 > 중위 > 하위순으로낮아지고있었으며, JTCI 위험회피 (HA) 점수 (17.86±6.16, 19.05±5.71, 21.37±6.36) 는상위 < 중위 < 하위순으로높아지고있었다. 체질량지수와폰데랄지수로측정한신체적특성에있어서는 SPQ 상위, 중위, 하위그룹간유의한차이를확인할수없었다 (Table 2). SPQ 상위, 중위, 하위그룹의 JTCI 하위척도프로파일이서로다른지프로파일분석을사용하여확인한결과 (Figure 1), 세그룹이서류유의한 (flatness with Greenhouse-Geisser correction, df=5.880, F=10.25, p<0.001; parallelism with Greenhouse-Geisser correction, df=2.940, F=309.16, p<0.001) 차이를지니고있음을확인할수

6 SJ Lee et al. 251 Table 3. SPQ and JTCI Subscales Score, BMI and PI of High, Middle and Low SPQ Score Groups in Female Middle School Students High SPQ ( 31) Middle SPQ (27-30) Low SPQ ( 26) Total ANOVA Post-hoc analysis n (%) 101 (31.08) 121 (37.23) 103 (31.69) 325 (100) SPQ *** 33.18± ± ± ±4.2 SPQ-B *** 13.17± ± ± ±2.44 F= , df=2,322, p<0.001 high>middle>low SPQ-C *** 11.28± ± ± ±1.89 F=101.13, df=2,322, p<0.001 high>middle>low SPQ-E *** 8.73± ± ± ±1.69 F=63.63, df=2,322, p<0.001 high>middle>low JTCI NS *** 20.68± ± ± ±5.52 F=23.637, df=2,322, p<0.001 high>middle>low HA *** 17.14± ± ± ±6.6 F=19.334, df=2,322, p<0.001 high<middle<low RD *** 19.13± ± ± ±4.05 F=7.138, df=2,322, p<0.001 high>middle, low PS 14.64± ± ± ±3.43 F=1.134, df=2,322, p=0.323 SD ** 24.39± ± ± ±6.18 F=6.421, df=2,322, p=0.002 high, middle>low CO 27.41± ± ± ±5.33 F=0.266, df=2,322, p=0.767 ST ** 18.82± ± ± ±4.46 F=4.831, df=2,322, p=0.009 high>low BMI 20.62± ± ± ±3.3 F=1.288, df=2,321, p=0.277 PI 13.02± ± ± ±2.1 F=1.747, df=2,321, p=0.176 *** p<0.001; ** p<0.01; SPQ, Sasang Personality Questionnaire; SPQ-B, SPQ Behavior; SPQ-C, SPQ-Cognition; SPQ-E, SPQ-Emotionality; JTCI, Junior version of Temperament and Character Inventory; NS, Novelty-Seeking; HA, Harm-Avoidance; RD, Reward-Dependence; PS, Persistence; SD, Self-Directedness; CO, Cooperativeness; ST, Self-Transcendence; BMI, Body Mass Index; PI, Ponderal Index 관 (r=-0.249, p<0.001) 을지니고있음을확인할수있었다. 또한, SPQ 총점은체질량지수 (r=-0.115, p<0.05) 및폰데랄지수 (r=-0.110, p<0.05) 와미약한상관성을보이는것을확인할수있었다. 2. 여학생 The JTCI subscale profile of the high, middle and low SPQ score groups were significantly different (flatness with Greenhouse-Geisser correction, df=5.286, F=11.25, p<.001; parallelism with Greenhouse- Geisser correction, df=2.643, F=229.33, p<.001). Data shown as mean and standard errors. Figure 2. JTCI subscales of high, middle and low SPQ score groups in female middle school students 있었다. SPQ와 JTCI, BMI, PI간의상관성을분석한결과 (Table 4), SPQ 총점은 JTCI 자극추구 (NS) 와정적상관 (r=0.453, p<0.001) 을, JTCI 위험회피 (HA) 와는부적상 여학생에있어서, SPQ, SPQ-B, SPQ-C, SPQ-E의 Cronbach's alpha는각각 0.680, 0.759, 0.478, 0.421이었다. SPQ 총점을기준으로상위 (30%, 31), 중위 (40%, 27-30), 하위 (30%, 26) 의세그룹으로나누었으며, 이들세그룹의 SPQ, JTCI, BMI, PI 점수를 ANOVA를사용하여비교하였다 (Table 3). SPQ 하위척도에있어서, 세그룹간에유의한차이를확인할수있었으며, JTCI 자극추구 (NS) 와위험회피 (HA) 에있어서도 SPQ 상위, 중위, 하위그룹간유의한 (p<0.001) 차이를확인할수있었다. JTCI 자극추구

7 252 Biopsychological Validation of the Sasang Personality Questionnaire in middle school students Table 4. Correlation Coefficient between Subscales of SPQ and JTCI, BMI and PI in Male Middle School Students SPQ JTCI BMI PI SPQ_B SPQ_C SPQ_E NS HA RD PS SD CO ST SPQ.808 ***.701 ***.632 ***.453 *** ***.218 *** * * * SPQ-B.369 ***.230 ***.240 *** ***.275 ***.295 ***.344 ***.145 **.124 * *** *** SPQ-C.216 ***.285 *** ***.129 * * SPQ-E.489 *** *** *** *** Bold represents more than 0.3. *** p<0.001; ** p<0.01; * p<0.05; Bold represent bigger than 0.3; SPQ, Sasang Personality Questionnaire; SPQ-B, SPQ Behavior; SPQ-C, SPQ-Cognition; SPQ-E, SPQ-Emotionality; JTCI, Junior version of Temperament and Character Inventory; NS, Novelty-Seeking; HA, Harm-Avoidance; RD, Reward-Dependence; PS, Persistence; SD, Self-Directedness; CO, Cooperativeness; ST, Self-Transcendence; BMI, Body Mass Index; PI, Ponderal Index Table 5. Correlation Coefficient between Subscales of SPQ and JTCI, BMI and PI in Female Middle School Students SPQ JTCI BMI PI SPQ_B SPQ_C SPQ_E NS HA RD PS SD CO ST SPQ.764 ***.694 ***.607 *** 402 *** ***.226 *** *** SPQ-B.256 ***.168 ** ***.390 ***.362 ***.435 ***.207 ***.281 *** SPQ-C.237 ***.361 *** *** ** *.102 SPQ-E.500 *** *** ** *** Bold represents more than 0.3. *** p<0.001; ** p<0.01; * p<0.05; Bold represent bigger than 0.3; SPQ, Sasang Personality Questionnaire; SPQ-B, SPQ Behavior; SPQ-C, SPQ-Cognition; SPQ-E, SPQ-Emotionality; JTCI, Junior version of Temperament and Character Inventory; NS, Novelty-Seeking; HA, Harm-Avoidance; RD, Reward-Dependence; PS, Persistence; SD, Self-Directedness; CO, Cooperativeness; ST, Self-Transcendence; BMI, Body Mass Index; PI, Ponderal Index (NS) 점수 (20.68±5.51, 18±4.87, 15.71±5.17) 는상위 > 중위 > 하위순으로낮아지고있었으며, JTCI 위험회피 (HA) 점수 (17.14±6.83, 19.99±6.12, 22.59±5.81) 는상위 < 중위 < 하위순으로높아지고있었다. 체질량지수와폰데랄지수로측정한신체적특성에있어서는 SPQ 상위, 중위, 하위그룹간유의한차이를확인할수없었다 (Table 3). SPQ 상위, 중위, 하위그룹의 JTCI 하위척도프로파일이서로다른지프로파일분석을사용하여확인한결과 (Figure 2), 세그룹이서로유의한 (flatness with Greenhouse-Geisser correction, df=5.286, F=11.25, p<0.001; parallelism with Greenhouse-Geisser correction, df=2.643, F=229.33, p<0.001) 차이를지니고있음을확인할수있었다. SPQ와 JTCI, BMI, PI간의상관성을분석한결과 (Table 5), SPQ 총점은 JTCI 자극추구 (NS) 와정적상관 (r=0.402, p<0.001) 을, JTCI 위험회피 (HA) 와는부적상 관 (r=-0.350, p<0.001) 을지니고있음을확인할수있었다. 반면에 SPQ 총점은체질량지수 (r=0.019, n.s.) 및폰데랄지수 (r=0.003, n.s.) 와유의한상관성을확인할수없었다. Ⅳ. 論意및結論 사상성격검사 (SPQ) 는사상체질그룹간의기질적특성을안정적으로측정하는검사도구로, 성인및고등학생에있어서의타당화가진행되었다 17,33. 본연구에서는소아청소년에있어서의활용을위하여중학생을대상으로한생리심리적구조의타당화연구를진행하였는데, 이시기는급격한심신의성장과변화가이루어지는기간으로균형적심신발달과인격적성숙을위한관리가요구된다 19. 연구결과를분석한결과, SPQ 가중학생에있어서

8 SJ Lee et al. 253 도성별과무관하게성인 6-8,10,11,15-17,41 및고등학생 19,33,42 과중학생 20 을대상으로한선행연구와동일한생리심리적구조를지니는것을확인할수있었다. 소양인의심리적특성으로대표되는 SPQ 상위그룹은높은 JTCI 자극추구 (NS) 점수를보였으며, 소음인의심리적특성으로제시되는 SPQ 하위그룹은높은 JTCI 위험회피 (HA) 점수를지니고있었다. 이와함께음양기질을반영 12 하는 SPQ 총점은 JTCI 자극추구 (NS) 와정적상관을, 위험회피 (HA) 와부적상관을보이는것을확인할수있었는데, 이는 SPQ 가외부환경자극에대한자동적인반응을결정하는기질적특성을측정함을재확인하는것이라하겠다. 본연구에있어서흥미로운점은, 음양기질에있어서정서적측면을측정하는 SPQ-E 가성별과상관없이자극추구 (NS) 와높은정적상관을, 인내력 (PS) 및자율성 (SD), 연대감 (CO) 과는약한부적상관을보이지만, 위험회피 (HA) 와는유의한상관성을보이지않고있었다 (Table 4, 5). 이는감정의다이내믹한변화 12,37 를의미하는 SPQ-E 가, 충동적이며, 마음이쉽게변하며, 성질이급하고, 화를잘내는특성을강하게지니며, 인성훈련이부족하여감정의발현을조정할수없기에상황논리에쉽게흔들리고, 타인에적대적이며너그럽지못하는것을의미한다하겠다 39,40. 이와함께, SPQ-E 가서양심리학에있어서위험회피 (HA) 의중요한특성으로제시되는예기불안 (anxiety), 불확실성과낯선상황에대한두려움, 긴장으로인한쉽게지침등과같은부정적정서 (negative emotionality) 또는정서적불안정 (emotional instability) 과는무관하다는것을재확인하는것이라하겠다 12,39. SPQ와청소년의문제행동 (problem behavior) 간의상관성을연구한선행연구에서는 SPQ-E 와문제행동총점이정적상관을지니고있음이확인되었는데 19, 본연구에서의 SPQ-E 와 JTCI 자율성 (SD) 및연대감 (CO) 간의부적상관을고려한다면, 동양에서의인성교육 ( 人性敎育, character development) 에서정적 ( 靜的 ) 인정서를강조하는것 (SPQ-E 점수를낮춤 ) 은 JTCI 성격 (character) 차원에서정신적건강을위하여강조 되고있는자율적인간으로서사회와의교감을증진시키는교육으로재해석될수있을것이다 9,12,39. 청소년은소아에서성인이되는과정에서급격한신체적발달과심리적성숙을경험하고평생동안의건강수준이결정되는중요한시기인만큼, 각개인이가지는고유한질병취약성 18 과신체적특성 8, 건강수준특성 43, 기질및인격적성숙 에있어, 사상성격검사 (SPQ) 와한의학적임상술기를활용하여청소년의정상적인심신발달을위한적절한조기스크리닝 19,34 과환아교육 35 및인성교육 39, 영양과신체발달의관리 24,30, 치료적개입 44 방안을개발할필요가있을것이다. 이와함께, 신체적측면에있어서음양기질의행동적측면을측정하는 SPQ-B 가, 여자에서는유의한상관관계가없었음에도불구하고, 남자에있어서만 BMI(r=-0.205, p<0.001) 및 PI(r=-0.207, p<0.001) 와미약하나유의한부적상관이나타났다. 이는 SPQ와 BMI 및 PI간의상관이일부특성에있어서만확인될수있음을의미하는것으로사료되는데, 활동적인양 ( 陽 ) 적성격을지니는남자중학생에있어서비만도가낮고작은체격을지닐경향성이높음을의미한다하겠다. 사상체질별신체특성에있어서, SPQ 총점과체질량지수 (BMI) 나폰데랄지수 (PI) 간에일반화할수있는상관성은없는것으로재확인되었는데, 이러한결과는심리적특성과신체적특성이서로독립적인것을의미하는것이다. 본연구에서확인된것처럼체질별심리특성은기질로서선천적으로결정되는데, 이와다르게체질별신체특성은후천적성장과정을통해나타나는것일수도있음을의미한다하겠다. 동의수세보원 1 에서도태음인이길고크다 ( 張大 ) 고기술되어있을뿐비만 ( 肥滿 ) 하다고기술되지않고있으나, 선행연구 2 에서사상체질별체형을비만과관련된체질량지수 (BMI) 를사용하여분석하는과정에서태음인이단순히뚱뚱한것이라고오해되었을수있다고보고되기도하였다 8,12,45. 본연구에서의결과를일반화함에있어다음과같은제한점이있을수있겠다. 첫째, 본연구에서는대구지역의중학생들을대상으로만표집을진행하였는

9 254 Biopsychological Validation of the Sasang Personality Questionnaire in middle school students 데, 후속연구를통해전국적인샘플링을거쳐상위, 중위및하위그룹을결정하는남녀별기준점 (cut-off) 을보다정밀하게설정할필요가있을것이다 17. 둘째, 본연구에서사용한 SPQ-C 의내적일치도가기존연구에비교해볼때낮은것을확인할수있었는데, 이는설문이성인을대상으로개발되고타당화되었기에청소년들이응답함에있어이해의어려움이있었을가능성이있다. 이에후속연구를통해 SPQ 를연령에구애받지않도록소아청소년버전을별도로개발하거나문항을수정할필요가있을것이다. 셋째, 본연구에서는체질별정신생물학적특징에성차가있다는선행연구 1,6,17 를고려하여남녀를나누어분석을진행하였는데, 추후연구를통해성차와관련된문항에대한분석을진행하여보다정밀한측정이가능하도록하여야할것이다. 본연구에서는대구지역의중학생 681명을대상으로사상성격검사 (SPQ) 가지닌정신생물학적인타당성을 JTCI, BMI, PI를사용하여분석함으로써, 성인뿐만아니라중고등학교청소년의기질도신뢰롭게측정할수있다는것을확인하였다. 이를통해선행연구에서성인및고등학생들이보인생리심리적특성들이중학생에있어서도동일하게나타나는것을확인할수있었으며, 사상성격검사 (SPQ) 가인간의전생애발달 (life-span development) 동안안정적으로유지되는생리심리학적특성 (Psychobiological traits) 을측정하는것임을재확인할수있었다 46,47. 이를토대로사상체질별로고유한생병리기전과맞춤치료의임상효과를보다명료히분석할수있을것이며, 중고등학교에서의정신건강관리 19,34,36 및소아청소년과에서의객관적인체질병증진단, 치료, 재활에유용한도구로활용할수있을것이다. Ⅴ. Acknowledgement This work was supported by a 2-Year Research Grant of Pusan National University. Ⅵ. References 1. Lee JM. Longevity and life preservation in Eastern Medicine. Seoul, Korea: Jae Ma Lee; Chae H, Lyoo IK, Lee SJ, Cho S, Bae H, Hong M, et al. An alternative way to individualized medicine: psychological and physical traits of Sasang typology. J Altern Complement Med. 2003;9: Lee S, Chae H. Study on Sasang Typology Based on the Type-Specific Characteristics with Type-Specific Pathophysiological Symptom and Temperament. Korean J Orient Physiol Pathol. 2014;28: Han YR, Lee HB, Han SY, Kim BJ, Lee SJ, Chae H. Systematic review of type-specific pathophysiological symptoms of Sasang typology. Integr Med Res. 2016;5: Sohn K, Jeong A, Yoon M, Lee S, Hwang S, Chae H. Genetic Characteristics of Sasang Typology: A Systematic Review. J Acupunct Meridian Stud. 2012; Chae H, Park SH, Lee SJ, Koh KC. Sasang typology from a personality perspective. J Korean Oriental Med. 2004;25: Chae H, Park SH, Lee SJ, Kim M-g, Wedding D, Kwon Y-K. Psychological profile of sasang typology: a systematic review. Evid Based Complement Alternat Med. 2009;6: Chae H, Kown Y. Best-fit index for describing physical perspectives in Sasang typology. Integr Med Res. 2015;4: Lee SJ, Kim SH, Lim N, Ahn MY, Chae H. Study on the difference of BIS/BAS scale between Sasang types. Evid Based Complement Alternat Med. 2015;805819: Lee SJ, Park SH, Chae H. Temperament profiles of Sasang typology in a child clinical sample. Integr Med

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