KISEP Original Articles 39 4 2000 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
서론 708
방법 1. 척도예비설문의대상및과정 2. 예비척도의대상및과정 3. 통계분석 709
결 과 1. 대상자들의사회인구학적특징 2. 스트레스반응척도의요인분석 3. 스트레스반응척도의신뢰도 1) 검사-재검사신뢰도 (Test-retest reliability) 2) 내적일치도 710
Table 1. Sociodemographic characteristics of subjects Sex Normal subjectsn215 Control patientsn242 Statistics df p Male N% 10850.2 11848.8 2.098 1.75 Female N% 10749.8 12451.2 Age MeanSD 41.710.4 39.512.6 t2.02 455.04 Duration of education MeanSD 14.23.0 12.93.6 t4.00 446.0001 Duration of illnessmonths MeanSD ReligionN440 3142 Present 13565.2 17474.7 2 4.69 1.03 Absent 7234.8 5925.3 Marital statusn422 Married 16177.8 15675.6 2 1.54 1.22 Single 4622.2 5927.4 OccupationN266 Professional 5836.2 2725.5 2 3.40 1.07 Non-professional 10263.8 7974.5 Income1,000won MeanSD 2,517704 2,273864 t3.31 445.001 Table 2. Factor analysis of Stress Response Inventory and item-total correlations Items Tension* Aggression* Somatization* Anger* 30..55.68 17..47.67 37..44.67 2..42.68 16..35.62 31..34.63 18..76.68 33..70.73 29..67.66 28..51.56 6..82.62 7..73.68 10..35.49 24..62.62 26..54.58 27..48.69 25..41.65 34..35.56 4..34.59 Eigenvalueexplained proportion % 18.9545.1 2.315.5 1.643.9 1.603.8 *Item-total correlationp.05 711
Table 3. Factor analysis of Stress Response Inventory and item-total correlations Items Depression* Fatigue* Frustration* 38..67.70 22..66.70 35..48.65 39..47.70 15..42.75 23..37.70 5..35.68 19..35.68 12..58.68 14..42.67 36..41.50 1..36.56 13..31.56 8..79.75 9..65.79 20..47.79 11..47.73 3..41.67 32..33.65 Eigenvalueexplained proportion % 1.293.1 1.082.6 1.012.4 *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.69.86 Aggression.82.83 Somatization.87.76 Anger.92.84 Depression.92.90 Fatigue.87.81 Frustration.93.91 Total.96.97 rpearson's correlation coefficient *p.0001, **p.0 2) 변별타당도 712
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 13.4 5.4* 17.2 6.2* 14.8 6.4* 13.1 5.4* 10.4 4.2 26.6 452.0001 Aggression 6.0 3.7 7.2 3.8* 6.1 3.4 5.4 2.6 5.9 2.4 3.4 451.009 Somatization 6.3 2.6* 6.7 3.0* 7.1 3.2* 6.0 2.5 4.9 2.2 12.7 452.0001 Anger 13.5 5.0* 16.4 6.1* 13.8 5.4* 13.0 5.4 11.0 4.2 18.2 452.0001 Depression 17.4 7.6* 23.9 8.5* 18.8 7.9* 15.8 5.4 13.6 5.6 34.1 452.0001 Fatigue 12.6 4.4* 15.7 5.0* 13.9 4.6* 12.0 4.0* 9.5 3.2 39.5 452.0001 Frustration 18.1 7.6* 22.2 8.1* 19.4 7.7* 16.7 7.0* 13.2 5.6 28.6 452.0001 Total 87.131.6* 109.234.8* 94.132.5* 82.027.3 68.523.4 32.0 452.0001 *significantly higher in scores of each subscale than normal controlsp.05scheffe test 5. 사회인구학적변수와스트레스반응척도점수간의관계 713
6. 스트레스반응척도의임상적응용 고 찰 714
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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 0.69.96. Internal consistency was computed, and Cronbach s for 7 subscales ranged between.76.91 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
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