공황 장애의 인지적 기제로서 임박형 이분법 사고의 작용

황성훈 한국인지행동치료학회 2018 인지행동치료 Vol.18 No.3

인지적 이론은 공황을 신체 감각에 대한 재앙적 오해석의 결과로 설명한다. 본 연구는 공황 장애 환자를 대상으로 이분법 사고가 재앙적 오해석에 해당하는 인지적 증폭 작용을 한다는 가설을 검증하고자 했다. 대학생 표집을 대상으로 한 앞선 연구(황성훈, 이훈진, 2012)에서 이 가설은 입증되지 못한 바 있다. 그 원인이 공황 장애에 특유한 이분법 사고를 측정하지 않았 다는 분석에서, 본 연구는 일반형 이분법 사고 외에도 공황 발작의 응급성을 반영하는 임박 형 이분법 사고 척도를 적용하였다. 정신과 전문의나 임상심리전문가의 DSM-IV에 기초한 임 상 진단에 따라, 공황 장애 환자 21명, 신체형 장애(DSM-5 기준, 신체 증상 장애) 환자 18명, 건강한 통제 집단 20명이 선별되었고, 이들에게 신체 감각 증폭 척도, 이분법 사고 지표 개정 판, 임박형 이분법 사고 지표가 실시되었다. 신체 감각에 대한 예민성에서 예측대로 신체형 장애 집단이 가장 높고, 그 다음이 공황 장애 집단이었으며, 건강한 통제 집단이 가장 낮았 다. 이분법 사고는 일반형과 임박형에 따라서 달랐다. 일반형은 공황 장애 집단과 신체형 장 애 집단이 건강한 통제 집단보다 높되, 두 환자 집단간 차이는 없었다. 반면 임박형 이분법 사고에서는 가정대로 공황 장애 집단이 가장 높아서, 신체형 장애 집단과 변별되었으며, 건강 한 통제 집단이 가장 낮았다. 끝으로 본 연구의 이론적, 임상적 시사점을 제시하였으며, 한계 와 이를 보완하기 위한 미래 연구의 방향을 논의하였다. The cognitive theory explains that panic disorders result from catastrophic misinterpretations on bodily sensations. Following the preceding study (Hwang & Lee, 2012), current study was conducted to test the hypothesis that the dichotomous thinking (DT) works as a cognitive amplifier corresponding to catastrophic misinterpretations in patients with panic disorders. The reason why Hwang and Lee (2012) did not succeed in testing the same hypothesis in college students could be because they did not use measure of DT specific to panic disorder. Upon this analysis, measures for imperative DT reflecting the nature of urgency specific to panic attack was developed and used in addition to measures for general DT. Based upon the clinical diagnoses of psychiatrists or clinical psychologists according to DSM-IV, patients with panic disorder (PD) and with somatoform disorder (SD; each 21 and 18 subjects), and 20 healthy controls (HC) were screened out. To them Somatosensory Amplification Scale (SSAS), Dichotomous Thinking Index, General and Imperative version(DTI-30R, I-DTI each) were administered. As predicted, in the sensitivity to bodily sensation there were significant differences with SD as the highest, PD as second-highest and HC as the lowest. Results concerning DT differed according to the subtype. In the general version of DT the both SD and PD were higher than HC while the two patient groups did not differ from each other. However the imperative DT, as assumed, revealed the significant difference in the descending sequence of PD, SD, and HC. In the end, theoretical and clinical implications of these findings were discussed with the same emphasis on the limitations of present study and directions for future one.

이분법적 사고가 기분 및 자존감의 강도와 기복에 미치는 영향

황성훈,이훈진 한국심리학회 2011 한국심리학회지 일반 Vol.30 No.4

Dichotomous thinking(DT) refers to the tendency to judge objects, people or events in terms of extremes. The binary conclusions drawn as a result of DT can lead to extreme emotional reactions and mood fluctuations. If DT is applied to evaluation of self, it can bring to unstable self-esteem. This study attempted to investigate the influence of DT on the intensity and variability of affect and self-esteem. The participants were college students assigned to two contrast groups (DT vs normal controls) on the basis of Dichotomous Thinking Index-30 Revised(DTI-30R). They kept mood diary measuring daily life events, affect and self-esteem during 14 days. The means and standard deviations of 14 daily records were compared between groups each as intensity and fluctuation measures. As results, in positive affect DT group did not differ from control group, but in negative affect showed more intensity and variability than control group. In self esteem, DT group was lower than control group and showed more up-and-downs. Therefore the hypothesis that DT causes intensification and fluctuation of mood and self evaluation was supported. Finally, we discussed implications and limitations of this study and present directions for future researches. 이분법적 사고는 경험을 상호배타적인 범주로 평가하는 판단 양식이다. 이분법적 사고에 따른 양극적인 판단은 상황에 대한 정서적 반응을 강렬하게 만들고, 자신에 대한 평가에 적용되면, 자존감의 불안정성을 초래할 수 있다. 본 연구에서는 이분법 사고가 기분 및 자존감의 강도와 기복에 미치는 영향을 알아보고자 했다. 대학생들을 대상으로, 개정된 이분법 사고 척도를 실시하여, 이분법 사고 집단(21명)과 정상 통제 집단(21명)을 선별하였다. 두 집단에게 기분 일기를 통해 14일에 걸쳐 매일 한번씩 생활 사건, 기분, 자존감을 평정하게 했다. 14일간에 걸친 평정의 평균값을 강도의 측정치로, 표준편차 값을 기복의 측정치로 삼아, 두 집단의 차이를 검증하였다. 그 결과, 긍정적 기분의 강도와 기복에서 이분법 사고 집단은 통제 집단과 차이가 없었으나, 부정적 기분에서는 통제 집단에 비해 더 강하게 느끼고, 더 큰 기복을 보였다. 한편 자존감은 이분법 사고 집단이 통제 집단에 비해 더 낮게 설정되어 있되, 더 잦은 부침 현상을 보였다. 따라서 이분법 사고가 극단적인 해석을 통해 부정적 기분과 부정적 자기 평가를 강렬화하고, 동요하게 만든다는 가설이 뒷받침되었다. 끝으로 본 연구의 시사점, 한계, 그리고 향후 연구의 방향을 제시하였다.

이분법적 사고와 MMPI-2로 측정한 정신병리의 관계

황성훈,이훈진 한국임상심리학회 2009 Korean Journal of Clinical Psychology Vol.28 No.1

Dichotomous thinking(DT) refers to the tendency to judge objects, people or events in terms of extremes. DT can have psychopathological consequences. The binary conclusions drawn as a result of DT can lead to extreme reactions and maladaptive patterns of emotions and behaviours. The aim of this study was to explore the relationship between DT and psychopathology using the clinical scales of the revised Minnesota Multiphasic Personality Inventory(MMPI-2). The participants were college students assigned to two contrast groups(DT vs normal controls) on the basis of Dichotomous Thinking Index. The DT group showed lower L, K and higher F, D, Pd, Pa, Pt, Sc, Ma, Si scale scores than the control group. This confirmed the expected relationship between DT and various domains of psychopathology. As predicted, dichotomous thinkers showed elevated MMPI-2 profiles and revealed higher level of intention to participate in psychotherapy. A result of particular importance is that the profile of dichotomous thinkers was characterized by the elevation of each Si and Ma scale(Spike 0, Spike 9) which implies contradictory self images. The correlations between DT and the various MMPI-2 scales were investigated as a preliminary exploration of future researches. A conceptual analysis of the correlations found in the present study suggests that psychopathology of DT may be categorized into five domains: 1) global dysfunction, 2) negative affect, 3) anger and alienation, 4) elation and impulsivity, and 5) disorganization of thought.

경기도 119구급대 다중출동체계의 융복합적 분석 - 병원전 심정지 환자를 중심으로 -

황성훈,김종호,김지희 국제차세대융합기술학회 2021 차세대융합기술학회논문지 Vol.5 No.6

본 연구의 목적은 119 구급대를 통한 경기도 내 병원 전 심정지 환자에 대한 다중출동체계의 융복합적 분석을 하고자 함이다. 2017년 7월부터 12월까지 발생한 경기도 내 병원 전 심정지 환자 5,621명 중 명백한 사망 징후가 관찰되어 소생술 유보, 외상성 심정지, 소아 심정지, 헬기 이송 및 구급차 내에서 발생한 심정지, 기록지 누락을 제외한 총 2,650명을 대상으로 구급활동일지 및 심폐정지환자 세부상황표를 분석하였다. 출동대 구성에 따 라 각각 구급차 1대, 구급차 2대 이상, 구급차 1대 & 펌프차 1대, 구급차 2대 & 펌프차 1대 이상으로 구분하였으 며, 구급대 구성에 따라 유자격자 1명, 유자격자 2~3명, 유자격자 4명 이상으로 구분하여 분석하였다. 본 연구에서 출동대 및 구급대 구성에 따른 병원 전 심장정지 환자의 자발순환회복률은 차이가 없었다. 그러나 전문심장소생술 의 수액투여와 에피네프린 투여가 자발순환회복률을 높이기 위한 예측변인이었으며, 이런 전문 응급처치 술기들은 출동대 및 구급대 구성에서 유자격자의 비율이 높을수록 시행률이 높았다. The purpose of the study is to carry out the convergence analysis of out-of-hospital cardiac arrest patients transferred by 119 multi-tiered ambulance service in Gyeonggido. From July to December, 2017, among 5,621 out-of-hospital cardiac arrest patients, 2,650 patients data were analyzed except DNR(don not resuscitate), traumatic cardiac arrest, pediatric cardiac arrest, helicpoter transport case, and cardiac arrest in ambulance. Dispatch consisted of one ambulance, two ambulances, one ambulance plus one pump vehicle, and two ambulances plus one pump vehicle. by each dispatch team, the paramedic certificate holders were classified from one person to four persons. There were no significant difference in return of spontaneous circulation (ROSC) between the dispatch types and certificate. Fluid therapy and epinephrine administration enhanced ROSC. The dispatch type and paramedic certificate were the important factor in advanced life support skills.

월요일 같은 자리-하느님의 노란 카드

황성훈 우리신학연구소 1997 갈라진 시대의 기쁜소식 Vol.- No.313

임무형 지휘가 조직 효과성에 미치는 영향에 관한 연구

황성훈 대전대학교 군사연구원 2006 군사학연구 Vol.15 No.-

The purpose of this study is to verify the relationship between mission-oriented Command, organization efficiency, organization culture of 626 field officers in JFMU. Firstly. the study found that decision making in the relationship between mission-oriented command and organization efficiency had negative effect on job satisfaction. Planning and trust lead to positive effect on job satisfaction and organizational commitment and no significance in self decision. Secondly, missionoriented command may differ depending on the types of organization culture and organization culture has positive effect on job satisfaction and organizational commitment. Thirdly, mission-oriented command has some effect which derives from its impact on organization efficiency that also effects rational culture and rank hierarchy culture. These study results suggest different measures in terms of practice and policy. Firstly. within the military organization, precise communication will lead to job satisfaction without unnecessary overload of communication. Also. we have rationale culture, agreement culture and rank hierarchy culture forming our organization culture. There is a need to apply elements of mission-oriented command depending on the types of organization culture. Secondly, to maximize organization performance through mission-oriented command, we have to strengthen the rationale and rank hierarchy cultures and especially introduce development culture which should be established within the military organization.

불안 민감성에 대한 이요인 이론의 제안과 그 타당화: 공황장애 집단과 신체형 장애 집단을 중심으로

황성훈,이훈진,이수현 한국임상심리학회 2006 Korean Journal of Clinical Psychology Vol.25 No.3

The purpose of this study was to test the hypothesis that the anxiety sensitivity known as a major mechanism of panic disorder may be divided into dual factors, one being somatic sensitivity, the other being catastrophic interpretation. For this purpose, we modified the anxiety sensitivity index-revised(ASI-R) into two-step rating, somatic sensitivity in the first step and cognitive interpretation in the second step, that can reflect the dual factors. In study 1, we compared panic group and somatization group with control group(each 30 subjects) selected from 500 college students. As predicted from dual factor hypothesis, in the first step rating of somatic sensation, the somatization group exceeded the panic group. However in the second rating(catastrophizing), the panic group did not exceed the somatization group. In study 2, panic patients and somatoform disorder patients(each 30 patients) were compared with 30 normal controls. In the somatic sensation factor, the result of study 1 was replicated, and in the catastrophic interpretation factor, the predicted difference was revealed. That is, in the catastrophic interpretation the panic patients were higher than somatoform disorder patients. These findings support the validity of dual factor hypothesis which says that although panic disorder and somatoform disorder share two-factor structure, panic disorder may be dominant in catastrophic interpretation and somatoform disorder may be prominent in somatic sensation. The dual factor theory may build a conceptual bridge between anxiety sensitivity research and Clark's cognitive model of panic disorder. In clinical settings, it will also contribute to the differential diagnosis and therapy of panic disorders.

측두엽 간질과 우울의 관계

황성훈,함웅 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.4

Objectives : Regarding the relationship between the laterality of seizure focus and depression in temporal lobe epilepsy (TLE), previous studies reported inconsistent results. The role of frontal function as moderating variable between laterality and depres-sion had been proposed. We attempted to replicate functional involvement of frontal lobe (FIFL) and, as an effort to extend previous findings, to test the functional involvement of parietal lobe (FIPL) to prove the hypothesis derived from Heller's Valen-cearousal theory of emotion. Methods : In study 1, Patients with TLE (right 19, left 17) performed MMPI-D as a depression measure, Wisconsin Card Sorting Test (WCST) as a frontal function measure, and block design (BD) as a parietal function measure in the course of pre-operation assessment. Multiple regression model of depression which includes the interaction terms both between laterality and WCST and between laterality and BD were tested, In study 2, Patients underwent anterior temporal lobectomy (ATL ; right 20, left 25) were assessed and analyzed in the same way as study 1. Results : In study 1, contrary to the FIFL and FIPL prediction, interaction of laterality with WCST or BD were not significant. In study 2, the interaction with frontal function was significant, Consistent with FLFL prediction, depression came to be evident when seizure focus was lateralized to the left side and simultaneously frontal function declined. But the interaction with BD remained insignificant, which suggests the invalidity of FIPL hypothesis. Conclusion : We replicated the FIFL hypothesis in the depression of ATL patients. The relation of depression with frontal function was more evident in post rather than pre operation sample. This pattern may be due to the inter-hemispheric interference of frontal functions in pre-operation sample and to the release-of-function phenomenon in post-operation sample. On the other hand, we did not succeed in confirming the role of pahetal function in depression. Intactness of the parietal function in TLE was considered as the main cause of the negative finding.

사고사례 분석을 통한 건설현장 추락재해 위험성 평가에 관한 연구

황성훈,강성원,신윤석 한국산학기술학회 2022 한국산학기술학회논문지 Vol.23 No.12

건설공사는 정해진 예산 및 기간 내에 마무리해야 하기 때문에 공기가 부족한 경우 무리한 공사가 진행되고는한다. 산업안전보건공단의 연도별 산업재해 지표에 따르면, 건설업 산업재해자 수는 전 산업 중 두 번째로 높은 비중을차지하나, 사망자 수는 가장 많이 발생하고 있다. 그 중, 추락재해로 인한 사망자수가 가장 많은 것으로 나타났다. 이에건설현장의 지속적인 안전관리를 위해 추락 사고사례를 통해 원인을 심층 분석하여 대책수립 및 예방기법 제시가 필요하다. 본 연구는 건설현장의 추락재해 사고사례 분석을 통한 기인물별 위험성 평가 및 예방기법을 제시하고자 한다. 추락재해 사고사례 데이터를 기반으로 빈도, 심도를 정량적 분석하였고, 종합적으로 기인물별 추락재해 위험성을 평가하였다. 우선, 기인물별 추락사고 발생빈도지수는 사다리(40.20%), 비계(25.67%), 작업발판(19.18%)로 나타났다. 기인물별 추락사고 재해심도는 지붕(3.721), 개구부(3.648), 사다리(3.567)순으로 나타났다. 최종적으로 빈도와 심도를 종합적으로고려하여 추락재해위험 우선순위는 사다리(1.428), 비계(0.914), 작업발판(0.675)순으로 도출되었다. 따라서 추락재해를 저감시키기 위해서는 빈도와 심도를 모두 고려하여 사고 예방을 위한 대책을 수립해야 할 것이며, 사망사고와 같이중대재해로 직결되는 작업들은 우선적으로 특별관리가 필요할 것이라 사료된다. 또한, 본 연구의 결과는 추락재해에 관한 안전관리 제도 개선 및 재해 예방을 위한 기초자료로 활용되기를 기대한다. Because construction work must be completed within a set budget and period, excessive construction is often carried out when air is insufficient. According to the Korea Occupational Safety and Health Agency's annual industrial accident index, the number of industrial accidents in the construction industry accounts for the second highest proportion among all industries, but the death toll is the highest. Among them, the death toll from the crash was the highest. Therefore, for continuous safety management of construction sites, it is necessary to establish countermeasures and present prevention techniques by analyzing the cause in-depth through falling accident cases. This presents present risk assessment and prevention techniques for each contributor through the analysis of cases of fall accidents at construction sites. The frequency and depth were analyzed quantitatively based on the case data of crash accidents, and the risk of the crash accidents by characteristics was evaluated comprehensively. First of all, the frequency index of fall accidents by attribution was found to be ladder (40.20%), scaffolding (25.67%), and work scaffolding (19.18%). The depth of the crash accident by characteristic was in the order of roof (3.721), opening (3.648), and ladder (3.567). Finally, considering the frequency and depth comprehensively, the priority of the risk of falling accidents was derived in the order of ladder (1.428), scaffolding (0.914), and work scaffolding (0.675). Therefore, to reduce falling accidents, measures to prevent accidents should be established in consideration of both frequency and depth, and special management is needed first for tasks directly related to serious accidents, such as death accidents. In addition, the results of this study are expected to be used as basic data for improving the safety management system for falling disasters and preventing disasters.

정서적 불안정성의 배후 기제로서 이분법적 사고

황성훈 한국인지행동치료학회 2018 인지행동치료 Vol.18 No.2

본 연구는 이분법적 사고가 정서적 불안정성과 어떻게 관련되어 있는지를 살피고자 했다. 사고의 이분법이 정서의 지나친 가변성을 초래한다는 가정을 검증하기 위해 정서 자극 평정 과제를 제작해 사용했다. 이분 법 사고 척도-개정판을 200명의 사이버대학생에게 실시해서, 이분법 사고가 높은 집단과 낮은 집단(각 40 명)을 선별하였다. 두 집단은 정서 자극 평정 과제에서 긍정 시나리오와 부정 시나리오, 그리고 이 둘이 혼합된 가상의 시나리오 각각을 읽고 기쁨과 슬픔 차원에서 정서적 반응을 평정했다. 정서 자극 평정 과제의 결과는 기쁨과 슬픔에 관해 반응할 때 (1) 단일 양극 차원에 대한 선호, (2) 한 정서(예컨대, 기쁨)가 반대되는 정서(예컨대, 슬픔)에서 떨어진 거리, (3) 눈금이 없는 척도에 스스로 그려 넣은 눈금의 수 등으로 지표 화되었다. 고 이분법 사고 집단은 정서 평정에서 양극 차원을 선호하고, 기쁨과 슬픔 사이에 더 먼 거리를 설정하며, 눈금의 수가 적을 것이라 예언되었는데, 이는 부분적으로 지지되었다. 단일 양극 차원의 선호에 서는 고저 이분법 사고 집단 간에 유의한 차이가 없었고, 고이분법 사고 집단이 긍정 정서 평정에서 저이 분법 사고 집단에 비해 반대되는 정서로부터의 거리를 오히려 더 짧게 설정하였으며, 고 이분법 집단은 시 나리오의 정서가에 관계없이 더 적은 눈금을 표시하였다. 정서 평정의 차원에서 기쁨과 슬픔의 중간 구분 이 적고, 현재의 기쁨이 잠재적인 슬픔과 근접해 있는 것은 이분법 사고가 정서적 가변성을 초래하는 기제를 설명해준다. 끝으로 임상적 시사점과 함께 본 연구의 한계와 향후 연구의 방향을 논의하였다. I explored whether and how dichotomous thinking (DT) is related to mood variability (MV). Ratings of Emotional Stimulus (RES) task was created in order to understand the connectedness between DT and MV. The high and low DT groups (each consisting of 40 subjects) were screened based on the results of the Dichotomous Thinking Index-30 Revised (DTI-30R; Hwang, 2007) from the population of 200 cyber university students. The two groups completed RES, where they were directed to read fictional scenarios containing positive, negative, or mixed emotional valence, and to rate their emotional response on the dimensions of joy and sadness. The RES was supposed to yield its results mainly in three ways: (a) preference for a single bipolar emotional dimension (i.e., joy and sadness are placed at each end of dimension) over a couple of unipolar ones (i.e., joy and sadness are separately placed to two independent dimensions); (b) distance of one emotion (e.g., joy) from the opposite one (e.g., sadness) on the sadness-joy dimension; (c) number of markings added on the unmarked sadness-joy dimension. It was predicted that DT would be related to a higher preference for bipolar scale, to a longer distance between joy and sadness, and to fewer markings. As results, the predictions turned out to be partly supported: (a) In the preference for a single bipolar scale, there was no significant difference between groups; (b) the high DT group set shorter, not longer, distance between joy and sadness than the low DT group only when rating positive emotion; (c) the high DT group made fewer divisions on sadness-joy dimension regardless of emotional valence. These findings from RES may explicate the mechanism through which DT brings MV as its consequence. In addition to its implications, several limitations and possible directions for future research were discussed.