한국사회의 우울증과 자살예방을 위한 동태분석 연구: 청소년층을 중심으로

김정기 ( Kim Jung-ki ),박상만 ( Park Sang-mahn ),김강훈 ( Kim Gang-hoon ) 한국시스템다이내믹스학회 2017 한국시스템다이내믹스 연구 Vol.18 No.1

The purpose of this study is to examine the risk factors directly affecting the suicide of the adolescent and to point out the limitation of existing protection factors. We also seek ways to reduce risk factors and strengthen protection factors. The summary and implications of this study are briefly described as follows. Previous studies have shown that suicide risk factors of the adolescent are largely divided into individual factors, family factors, school factors, social factors respectively. And, most studies have found the answer to suicide risk factors as a protective factor for the prevention of adolescent suicide. However, the previous studies looking at the protection factors are too abstract and tried to find the answer in a one - way relationship between the factors. Therefore, in this study, we provide a comprehensive understanding through the dynamic analysis of the occurrence process of the adolescent suicide in order to prevent the suicide of the adolescent. In particular, it provide a new causal relationship and solution for the prevention of suicide prevention through the application and expansion of psychology, policy, and science and technology. In summary, first, psychological stability of the adolescent is allowed to be brought through the use of positive psychological capital. Second, the establishment of infrastructure to prevent suicide by using science and technology will provide another opportunity to prevent suicide of the adolescent. Third, the establishment of suicide prevention system using science and technology can overcome the limit of budget and manpower. In addition, through objective data analysis and data sharing, we will be able to provide more efficient and effective policy formulation and improvement of relevant laws and institutions.

중학생의 자살과 DAS반응 특성 연구 - 위험요인과 보호요인을 중심으로 -

박치홍,김갑숙 한국미술치료학회 2014 美術治療硏究 Vol.21 No.4

This study investigated the correlation between the DAS test and suicide-related scales to see if the DAS could be used as a tool to predict suicide. The correlation between the characteristics of the DAS drawings and suicidal risk factors and protective factors was investigated with 821 middle school students as the study participants. The risk factors and protective factors were compared. The instruments to measure risk factors included a depression scale, school alienation scale, suicidal thoughts scale. The instruments to measure protective factors included a self-esteem scale, friend support scale, family support scale, teacher support scale, and an additional questionnaire about DAS drawings. Data were analyzed using the SPSS 19.0 program. Cronbach's α was computed to check the internal consistency of the question items. Pearson's correlation coefficient, one way ANOVA, and cross-tabulation were conducted. This study found the following findings. First, risk factors such as depression, school alienation, suicidal thoughts were negatively correlated with the DAS scores. A DAS score of 1 was highly associated with school alienation and suicidal thoughts. In self-image, risk factors were high when the scores were 1 and negative 5. Second, a positive correlation was found between protective factors such as self-esteem, friend support, family support, and teacher support and the participants' DAS scores. In addition, when a DAS emotion contents score was 1, protective factors such as self-esteem, friend support, family support, and teacher support were low. In self-image, protective factors were low when self-image scores were 1 and negative 5. 본 연구의 목적은 DAS와 자살관련 척도와의 관계를 파악하여 자살의 위험을 예측할 수 있는 검사로써의 유용성을 파악하는 것이다. 이를 위해 중학생 821명을 대상으로 자살 위험요인 및 보호요인과 DAS에 나타난 반응특성의 차이를 살펴보았다. 위험요인의 측정도구로는 우울 척도, 학교 따돌림 척도, 자살생각 척도를 사용하였고, 보호요인의 측정도구로는 자기존중감 척도, 친구지지 척도, 가족지지 척도, 교사지지 척도를 사용하였으며, DAS와 그림에 대한 추가 질문지를 사용하였다. 자료 분석은 문항내적 일치도(Cronbach‘s α)에 의한 신뢰도 검증, Pearson‘s 상관분석, 일원변량분석 및 교차분석을 실시하였다. 본 연구결과는 다음과 같다. 첫째, 자살 위험요인과 DAS의 상관관계는 모두 유의미한 부적 상관이 있었으며, DAS 점수에 따른 위험요인의 수준차이는 DAS의 정서내용 점수가 1점일 경우 우울, 학교 따돌림, 자살생각이 높았고, 자기상에서는 1점과 부정 5점인 경우 위험요인이 높았다. 둘째, 자살 보호요인과 DAS의 상관관계에서 보호요인은 모두 유의미한 정적 상관이 있었으며, DAS 점수에 따른 보호요인의 수준차이는 DAS의 정서내용 점수가 1점일 경우 자기존중감, 친구지지, 가족지지, 교사지지가 낮았고, 자기상에서는 1점과 부정 5점의 경우 보호요인이 낮았다.

한국사회의 자살예방을 위한 인과지도 분석연구: 노년층을 중심으로

김훈 ( Kim Hoon ) 한국시스템다이내믹스학회 2020 한국시스템다이내믹스 연구 Vol.21 No.4

The purpose of this study is to examine the risk factors directly affecting the suicide of the elderly and to point out the limitation of existing protection factors. We also seek ways to reduce risk factors and strengthen protection factors. The summary and implications of this study are briefly described as follows. Previous studies have shown that suicide risk factors of the elderly are largely divided into social factors, family factors, and individual factors respectfully. And, most studies have found the answer to suicide risk factors as a protective factor for the prevention of elderly suicide. However, the previous studies looking at the protection factors are too abstract and tried to find the answer in a one - way relationship between the factors. Therefore, in this study, we provide a comprehensive understanding through the dynamic analysis of the occurrence process of the elderly suicide in order to prevent the suicide of the elderly. In particular, it provide a new causal relationship and solution for the prevention of suicide prevention through the application and expansion of psychology, policy, and science and technology. In summary, first, psychological stability of the elderly is allowed to be brought through the use of positive psychological capital. Second, the establishment of infrastructure to prevent suicide by using science and technology will provide another opportunity to prevent suicide of the elderly. Third, the establishment of suicide prevention system using science and technology can overcome the limit of budget and manpower. In addition, through objective data analysis and data sharing, we will be able to provide more efficient and effective policy formulation and improvement of relevant laws and institutions.

초등학생의 충동성과 자살행동의 관계에서 보호요인의 조절효과

김현정(Hyun-Jung Kim) 한국산학기술학회 2019 한국산학기술학회논문지 Vol.20 No.2

본 연구의 목적은 초등학교 고학년을 대상으로 충동성과 자살행동(자살계획, 자살시도) 간의 관계에서 보호요인(개인요인, 가족요인, 또래요인, 학교요인)의 조절효과를 검증하는 것이다. 이를 위하여 서울지역 초등학생 5∼6학년 573명을 대상으로 충동성, 자살행동, 보호요인 척도에 대한 설문을 실시하였다. 먼저 자살행동의 실태를 파악하기 위하여 빈도 분석을 하였으며, 변인들의 관계를 알아보기 위하여 상관분석을 실시하였다. 또한 충동성과 자살행동과의 관계에서 보호요인의 조절효과를 알아보기 위해 위계적 회귀분석을 실시하였다. 이를 통한 본 연구의 결과는 다음과 같다. 첫째, 연구대상의 29명(5.1%)은 자살계획을 세워 본 적이 있으며, 17명(3.0%)은 자살시도를 해 본 것으로 나타났다. 또한 자살행동을 보고한 학생은 41명(7.1%)으로 집계되었다. 둘째, 초등학생의 충동성과 보호요인(개인요인, 가정요인, 또래요인, 학교요인)은 모두 유의미한 부적 상관을 보였으며, 충동성과 자살행동은 유의미한 정적 상관이 있는 것으로 나타났다. 셋째, 초등학생의 충동성이 자살행동에 미치는 영향에 보호요인 모두 조절효과가 있는 것으로 나타났다. 즉 충동적인 초등학생이라도 보호요인이 높을수록 낮은 자살행동을 보인다는 것이다. 이렇듯 보호요인은 초등학생의 충동성에 따른 자살행동에 대한 완충제로 작용하기 때문에 이를 강화하기 위한 다차원적인 노력이 필요함에 대하여 논의하였다. This study was to investigate the moderating effect of the protective factors in the relationship between impulsivity and suicide behavior of elementary school students. This study surveyed total 573 elementary school students located in Seoul. They completed survey questionnaires of impulsivity, suicide behavior and protective factors. Collected data was examined using correlation analyses and hierarchical multiple regression analyses. First, a total of 29(5.1%) students reported suicide plan, 17(3.0%) students reported suicide attempts and the rate of suicide behavior was 7.1%(n=41). Second, there was a negative relationship between impulsivity and protective factors and a positive relationship between impulsivity and suicide behavior. Also, it was found that the protective factors(individual factor, family factor, peer factor, school factor) moderated the relationship between impulsivity and suicide behavior of elementary school students. The implications and limitations of this study were discussed.

Negative life stressors and suicide ideation in community dwelling older adults: Compensatory and buffering effects of protective factors

박미진 한국정신건강사회복지학회 2009 정신보건과 사회사업 Vol. No.

This study focuses on older adults' suicide ideations from a protective perspective. The purpose of this study is to identify buffering effects and compensatory effects of protective factors in the relationship between negative life stressors and suicide ideations among community dwelling older adults. In studying suicide it is difficult to identify the reason why people commit suicide, so understanding and identifying suicide ideation is an important key to preventing suicide. The sample consists of 295 older adults in the Busan regions. The measures use suicide ideation questions, negaitve life stressors, self-efficacy, family support, social participation scale. This study runs hierarchical multiple regression for statistical analyses. The major findings are as follows. First, negative life stressors are identified as a risk factor. Second, self-efficacy and social participation have roles with compensatory and buffering effects in between negative life stressors and suicide ideations. Finally, the results are discussed in terms of practical implications for mental health social work in older adults' suicide problems, and are discussed research limitations in this paper.

Development of a Checklist for Predicting Suicidality Based on Risk and Protective Factors: The Gwangju Checklist for Evaluation of Suicidality

Kim Sung-Wan,Park Woo-Young,Kim Honey,Jhon Min,Kim Ju-Wan,Kang Hee-Ju,Kim Seon-Young,Ryu Seunghyoung,Lee Ju-Yeon,Shin Il-Seon,Kim Jae-Min 대한신경정신의학회 2022 PSYCHIATRY INVESTIGATION Vol.19 No.6

Objective The aim of the study was to develop a checklist for mental health clinicians to predict and manage suicidality.Methods A literature review of the risk and protective factors for suicide was conducted to develop a checklist for evaluating suicidality.Results The fixed risk factors included sex (male), age (older individuals), history of childhood adversity, and a family history of suicide. Changeable risk factors included marital status (single), economic status (poverty), physical illness, history of psychiatric hospitalization, and history of suicide attempts. Recent discharge from a mental hospital and a recent history of suicide attempts were also included. Manageable risk factors included depression (history and current), alcohol problems (frequent drinking and alcohol abuse), hopelessness, agitation, impulsivity, impaired reality testing, and command hallucinations. Protective factors included responsibility to family, social support, moral objections to suicide, religiosity, motivation to get treatment, ability to cope with stress, and a healthy lifestyle. A final score was assigned based on the sum of the risk and protective factor scores.Conclusion We believe that the development of this checklist will help mental health clinicians to better assess those at risk for suicidal behavior. Further studies are necessary to validate the checklist.

자살시도 병사의 위험요인과 보호요인에 관한 개념도 연구

정신영,이동귀,박현주 한국상담학회 2012 상담학연구 Vol.13 No.1

This study explored risk factors and protective factors for soldiers (N = 7) who actually attempted suicide based on their empirical statements and critical nature of attempted suicide using the concept mapping method. The analysis of interview transcripts resulted in 66 core statements for risk factors and 44 ones for protective factors. Using multidimensional modeling and hierarchical cluster analyses, four cluster themes emerged for the risk factors: Severe threats to self-esteem caused from disdain of senior soldier and cadre, extreme distress associated with strictly-controlled military life, pain and frustration from failed efforts to overcome controlled environment, and feelings of isolation and loneliness due to lack of dependable and caring objects. As for the protective factors, three cluster themes appeared: Experiences of being accepted and understood through genuine conversations and interactions, positive self-suggestions and encouragements, and empowerment by external social support resources. Implications of the current study were discussed in terms of its significance in exploring the concept structure of suicide risk factors and protective factors in military through a mixed method of qualitative and quantitative research. 본 연구는 군(軍)에 입대 후 자살시도를 경험한 병사 7명의 진술문을 기초로 개념도 분석 방법(concept mapping method)을 적용하여 병영 내 실제 자살시도자들의 위험요인과 보호요인을 그들의 입장에서 심층적으로 이해하고, 자살시도 경험의 핵심적 본질을 탐색하고자 하였다. 연구 결과, 자살시도병사들의 위험요인 핵심문장은 66개, 보호요인 핵심문장은 44개로 정리되었다. 핵심문장들에 대해 다차원 척도 분석과 군집분석을 실시한 결과 자살시도병사들의 위험요인은 ‘외부적 영향 및 내부적 요인’ 축과 ‘관계 및 통제된 환경’ 축의 2차원으로 구성되었고, 군집은 총 4개로 분류되었다. 각 군집은 ‘선임병 및 간부의 무시, 인격모독에 의한 자존감 저하,’ ‘통제된 군대 생활에 대한 괴로움,’ ‘통제 상황을 벗어나려는 노력의 좌절로 인한 고통,’ ‘의지할 대상이 없어서 느끼는 외로움과 소외’로 명명되었다. 자살시도병사들의 보호요인은 ‘능동성 및 수동성’ 축과 ‘쌍방향성 및 일방향성’ 축의 2차원으로 구성되었고, 군집은 총 3개로 분류되었다. 각 군집은 ‘대화와 소통을 통한 이해 받는 경험,’ ‘한번 해보자는 자기암시,’ ‘사회적 지지를 통한 격려’로 명명되었다. 본 연구는 그동안 접근의 제한성으로 연구 참여가 어려웠던 군대 내 자살에 취약한 고(高) 위험 병사들의 위험요인과 보호요인의 개념적 구조를 연구 참여자의 입장에서 그들만의 독특한 특성을 규명하였다는 데 의의가 있다.

청소년 자살의 보호요인에 관한 델파이 연구: 생물심리사회적 접근을 바탕으로

양모현,박효은,이주영,이동훈 한국상담심리학회 2023 한국심리학회지 상담 및 심리치료 Vol.35 No.3

A Delphi study was conducted to identify practical protective factors for preventing and intervening in adolescent suicidal behavior, guided by the biopsychosocial approach. Three rounds of the Delphi study were conducted with 73 school and Wee center counselors experienced in counseling adolescents with self-harm or suicidal behavior. The study’s results revealed 50 endorsed protective factors including 1 biological factor, 28 psychological factors, and 21 social and environmental factors. Among the biological factors, good sleep was the only factor endorsed. Psychological factors included 7 factors related to perception of the world and oneself, 4 factors related to existential values, 12 factors related to coping ability, and 5 factors related to means of obtaining a sense of security and life value. Social and environmental factors included 10 family-related factors, 6 peer-related factors, and 5 school-related factors. The implications and limitations of the study were discussed. 본 연구는 청소년 자살 행동을 예방 및 완화하는 데 실질적으로 도움이 되는 보호요인을 생물심리사회적 접근에 따라 다각적으로 규명하고자 델파이 연구를 진행하였다. 먼저 문헌고찰 및 학교 상담자의 면담을 통해 63개의 보호 요인을 추출하여 생물, 심리, 사회 및 환경 요인으로 분류하였다. 그다음 자해 및 자살 행동 청소년의 상담 경험이 있는 학교 상담교사 및 Wee센터 치료진 73명을 대상으로 총 3차에 걸친 델파이 연구를 진행하였다. 연구 결과, 생물학적 요인 1개, 심리적 요인 28개, 사회 및 환경적 요인 21개 등 총 50개의 보호요인이 채택되었다. 생물학적 요인으로는 양질의 수면이 유일하게 채택되었다. 심리적 요인은 세상 및 자신에 대한 지각 요인 7개, 실존적 가치 요인 4개, 대처 능력 요인 12개, 안정감 및 가치 확보 수단 요인 5개 등 총 28개 요인이 채택되었다. 사회 및 환경적 요인은 가족 요인 10개, 또래 요인 6개, 학교 요인 5개로 총 21개 요인이 채택되었고, 이는 외부 환경 범주과 개인-환경 상호작용 범주로 분류하였다. 논의에서 본 연구의 함의와 한계를 논의하였다.

군인의 자살보호요인과 자살위험요인에 대한 메타분석

권명훈,김완일 한국청소년학회 2019 청소년학연구 Vol.26 No.12

본 연구는 군인의 자살에 영향을 미치는 보호요인과 위험요인에 대한 메타분석을 통해 각각의 효과크기를 알아보고자 하였다. 1999년부터 2019년까지 군인을 대상으로 한 자살연구 중 자살과의 상관계수 r값을 표시하는 연구 38편을 선정하여 메타분석을 실시하였다. 그 결과, 첫째 자살에 영향을 미치는 보효요인으로 14개의 요인이 검출되었으며, 위험요인으로 25개의 요인이 검출되었다. 둘째, 보호요인 하위요인 중 자존감, 탄력성, 건강, 삶의 의미, 긍정 순으로 큰 효과크기가 나타났다. 셋째, 위험요인 하위요인 중 탈영이 가장 큰 효과크기를 가진 것으로 나타났고, 그 다음으로 자살과거력과 우울이 나타났다. 동질성 검증결과, 각각의 자살연구들은 이질적으로 확인 되었으며, 출판편향은 없는 것으로 나타났다. 본 연구를 통해 군인의 자살에 영향을 미치는 각 요인들을 확인할 뿐 아니라 그 효과크기를 비교할 수 있었다. 이러한 연구결과에 기초하여 연구의 제한점 및 추후연구를 위한 제언을 제시하였다. The purpose of this study was to identify the size of each effect through meta-analysis of the protective and risk factors affecting soldier’s suicide. The meta-analysis was conducted from 1999 to 2019 by selecting 38 studies showing the correlation coefficient r values with suicide about soldier. The results of this study were as follow : First, the variables related to suicide among korea soldier were classified into 14 variables of protective factors and 25 variables of risk factors. Second, the most influential protective factor variable was self-esteem. And it was followed by resilience, health, meaning of life, optimism. Third, the most influential risk factor variable was desertion. And it was followed by suicide history, depression. Equivalence test results show that each suicide study is heterogeneous effect size and has no publishing bias. Through this study, we were able to compare the size of effects as well as identify each factor that affected soldiers' suicide. Based on this study finding, the limitations of this study and directions for future study ar discussed.

노인의 보호요인이 위험요인과 자살생각에 미치는 영향

서인균(In-Kyun Seo),정유선(You-Seon Jung) 한국보건복지학회 2010 보건과 복지 Vol.12 No.-

The present paper is designed to investigate protection factors that may be used to mitigate the impulse of the elderly to commit suicide. Community environments are set forth as protection factors here in an attempt to examine the effects of social support and concern of the community for the elderly that are deemed to be an effective bumper against impulse to suicide. On the other hand, self-respect, depression and stress are set forth as risk factors. This study is believed to contribute to working out measures to prevent suicide by analyzing the paths that can lead to the idea of suicide through mediation of risk factors by protection factors that have a bumper effect. Following conclusion could be drawn from the present study that attempted to analyze the effects of protection factors that mediate risk factors for the elderly on their suicidal Ideation. The higher the support by family members is, the higher their self-respect gets and the less their stress and depression become, resulting in their less suicidal Ideation The higher support by friends old persons receive, the less their stress and depression become, leading to the less suicidal Ideation. The higher support by others the elderly get, the stronger their impulse to suicide and the higher their stress become, intensifying their suicidal Ideation. The better the living conditions of the elderly are, the higher their self-respect and the lower their stress get, causing less suicidal Ideation. The higher their self-respect and the lower their depression get, leading to lower suicidal Ideation. The implications of this study could be summed up as follows: First, the measures for spiritual and physical support should be worked out to prevent dissolution of family and to encourage peer activities. Second, counselling programs for peers and neighbors should be prepared to prevent suicide of the elderly. Third, the facilities for convenient use and welfare of the elderly should be expanded, since the outcomes of this study reveal that the better the living environment surrounding the elderly is, the higher their self-respect and the lower their stress get resulting in their lower impulse to suicide. Fourth, the policy to support regional senior festivals and plans of preferential treatment for the elderly should be introduced or expanded, since it becomes obvious that the higher the concern for the elderly is, the higher their self-respect becomes and the lower their depression and, consequently, their impulse to suicide get. Fifth, the psychological health center for the elderly should be established to ensure overall management and treatment of self-respect, stress and depression of the elderly.