인지적 탈융합 처치와 심리적 유연성이 대학생의 발표불안 반응 및 주의 편향 감소에 미치는 효과 = Effects of Cognitive Defusion and Psychological Flexibility on Reduction in Anxiety Responses to a Public-Speaking Situation and Attentional bias among Undergraduate Students

다국어 초록 (Multilingual Abstract)

The primary aim of this study was to examine the relative impacts of cognitive defusion treatment on anxiety responses to a public-speaking situation, the emotional discomfort and believability of self-referential thoughts, and the degree of attentional bias, as compared to a thought distraction treatment. A secondary aim of the current study was to explore the role of psychological flexibility as a moderator in these treatment effects. University students were randomly assigned to either cognitive defusion(n=27) or thought distraction(n=23) conditions. As expected, under the cognitive defusion condition, a greater decrease was observed in subjective anxiety responses to an impromptu speech situation and the emotional discomfort and believability of negative self-referential thoughts when compared with the thought distraction condition. Next, the partial effects of the cognitive defusion treatment on diastolic blood pressure and pulse immediately after relaxation period were moderated by the levels of psychological flexibility. Moreover, psychological flexibility was shown to moderate the efficacy of the cognitive defusion treatment on the believability of negative self-referential thoughts immediately after the speech. In addition, under the cognitive defusion condition, the extent of cognitive interference on a modified Stroop task showed a greater reduction when compared with the thought distraction condition, when controlling for treatment expectancy and psychological flexibility. In conclusion, the results suggest that cognitive defusion is a useful intervention for reducing speech anxiety responses and the emotional discomfort and believability of negative self-referential thoughts, and that psychological flexibility may emerge as a moderator of the relative efficacy of cognitive defusion.

참고문헌 (Reference)

1 조용래, "한국판 발표불안척도의 신뢰도와 타당도에 관한 연구" 18 (18): 165-178, 1999

2 허재홍, "한국어판 수용-행동 질문지Ⅱ 신뢰도 및 타당도 연구" 한국상담심리학회 21 (21): 861-878, 2009

3 성형모, "한국어판 백 우울 설문지 2판의 신뢰도 및 타당도 연구" 대한생물치료정신의학회 14 (14): 201-212, 2008

4 김환, "진술문 반복 읽기가 부정적 기분 개선에 미치는 영향" 한국인지행동치료학회 8 (8): 29-40, 2008

5 김기평, "인지적 탈융합 처치가 발표불안의 부정적인 자동적 사고와 불안반응에 미치는 효과" 중앙대학교 대학원 2011

6 문현미, "심리적 수용 촉진 프로그램의 개발과 효과 : 수용-전념 치료 모델을 중심으로" 가톨릭대학교 대학원 2006

7 박성신, "수용처치가 대학생의 발표불안 감소에 미치는 영향" 한림대학교 대학원 2006

8 윤혜영, "사회불안장애의 인지행동치료 효과 : 주의편향과 암묵적 자존감을 중심으로" 고려대학교 대학원 2011

9 신미연, "사회불안 경향성자의 위협자극에 대한 주의 편향의 시간 과정" 중앙대학교 대학원 2006

10 조용래, "사회공포증에 대한 인지적 평가 Ⅲ: 역기능적 신념검사의 개발 및 타당화." 18 : 141-162, 1999

11 조용래, "비디오 피드백이 사회불안장애 집단의 사회적 자기상의 개선에 미치는 효과" 6 : 23-39, 2006

12 이정흠, "불안장애 환자의 선택적 주의 편향 특성" 高麗大學校 大學院 1999

13 조용래, "발표불안에 대한 비디오 피드백의 효과:중재변인과 매개변인" 한국임상심리학회 26 (26): 293-322, 2007

14 김수인, "대학생의 발표불안에 대한 수용전념 집단치료의 효과 -인지적 탈융합기법을 중심으로" 한국상담심리학회 25 (25): 19-40, 2013

15 조용래, "대인불안에 대한 인지적 평가 : 사회적 상호작용에 대한 자기 효능감 척도의 개발과 타당도에 관한 연구" 4 : 397-434, 1997

16 Masuda, A., "The role of psychological flexibility in the relationship between self-concealment and disordered eating symptoms" 12 (12): 131-135, 2011

17 Mattia, J. I., "The revised Stroop color-naming task in social phobics" 31 (31): 305-313, 1993

18 Keele, K. D., "The pain chart" 2 : 6-8, 1948

19 Becker, E. S., "The emotional Stroop effect in anxiety disorders : General emotionality or disorder specificity?" 15 (15): 147-159, 2001

20 Masuda, A., "The effects of cognitive defusion and thought distraction on emotional discomfort and believability of negative self-referential thoughts" 41 : 11-17, 2010

21 Singer, A. R., "The effect of the cognitive style of acceptance on negative mood in a recovered depressed sample" 26 : 471-479, 2009

22 권효석, "The Amelioration of Anxiety Sensitivity by Cognitive Defusion Techniques: A Focus on the Fear of Respiratory Symptoms" 한국임상심리학회 29 (29): 745-760, 2010

23 McNeil, D. W., "Social phobia: Diagnosis, assessment, and treatment" The Guilford Press 202-231, 1995

24 Clark, D. M., "Social phobia: Diagnosis assessment, & treatment" Guilford Press 69-73, 1995

25 Hope, D. A., "Representations of the self in social phobia : vulnerability to social threat" 14 (14): 177-189, 1990

26 Masuda, A., "Psychological flexibility mediates the relations between self-concealment and negative psychological outcomes" 50 (50): 243-247, 2011

27 Bond, F. W., "Preliminary psychometric properties of the Acceptance and Action Questionnaire-II : A revised measure of psychological flexibility and experiential avoidance" 42 : 676-688, 2011

28 Paul, G. L., "Insight versus desentization in psychotherapy" Stanford University Press 1966

29 Rodebaugh, L. T., "I might look OK, but I’m still doubtful, anxious, and avoidant : The mixed effects of enhanced video feedback on social anxiety symptoms" 42 : 1435-1451, 2004

30 Hofmann, S. G., "How to handle anxiety : The effects of reappraisal, acceptance, and suppression strategies on anxious arousal" 47 : 389-394, 2009

31 Herbert, J. D., "From social anxiety to social phobia: Multiple perspectives" Allyn & Bacon 20-45, 2001

32 Mahone, E. M., "Focus of attention and social anxiety : The role of negative self-thoughts and perceived positive attributes of the other" 17 : 209-224, 1993

33 Borkovec, T. D., "Credibility of analogue therapy rationales" 3 : 257-260, 1972

34 Masuda, A., "Cognitive defusion versus thought distraction : A clinical rationale, training, and experiential exercise in altering psychological impacts of negative self-referential thoughts" 34 (34): 520-538, 2010

35 Masuda, A., "Cognitive defusion and self-referential negative thoughts : Examining the impact of a ninety year old technique" 42 : 477-485, 2004

36 Spokas, M. E., "Cognitive biases in social phobia" 6 (6): 204-210, 2007

37 MacLeod, C., "Clinical anxiety and the selective encoding of threatening information" 3 : 279-292, 1991

38 Beck, A. T., "BDI-II, Beck Depression Inventory: Manual" Harcourt Brace 1996

39 Lundh, L., "Attentional Bias, Self-consciousness and Perfectionism in Social Phobia Before and After Cognitive-Behaviour Therapy" 30 : 4-16, 2001

40 Beidel, D. C., "Assessment of social phobia : Reliability of an impromptu speech task" 3 : 149-158, 1989

41 Cohen, J., "Applied multiple regression/correlation analysis for the behavioral sciences" Erlbaum 2003

42 Beck, A. T., "Anxiety disorders and phobias: A cognitive perspective" Basic Books 1985

43 Healy, H, A., "An experimental test of a cognitive defusion exercise : Coping with negative and positive self-statements" 28 : 623-640, 2008

44 Hayes, S. C., "Acceptance and commitment therapy: An experiential approach to behavior change" Guilford Press 1999

45 Dalrymple, K., "Acceptance and commitment therapy for generalized social anxiety disorder: a pilot study" 31 (31): 543-568, 2007

46 Hayes, S. C., "Acceptance and commitment therapy : Model, processes and outcomes" 44 : 1-25, 2006

47 Twohig, M. P., "A randomized clinical trial of acceptance and commitment therapy vs. progressive relaxation training for obsessive compulsive disorder" 78 (78): 705-716, 2010

48 Rapee, R. M., "A model of social phobia" 35 : 740-756, 1997

49 Hayes, S. C., "A Practical Guide to Acceptance and Commitment Therapy" Springer 3-29, 2004