지각된 불공정성과 자살위험의 관계에서 우울을 통한 긍정적 대인관계의 조절된 매개효과: 성별 분석 = Moderated Mediation Effect of Positive Relationships in the Relationship between Perceived Injustice and Suicide Risk through Depression: Gender Analyses

다국어 초록 (Multilingual Abstract)

This study examined whether depression mediates the relationship between perceived injustice (PI) and suicide risk (SR), and whether this relationship differs based on gender and positive relationships. Data from 1,396 participants in the 2012 Korean General Social Survey (KGSS) were analyzed. Measures included KGSS PI items, the MINI suicidality module, the PHQ-9, and the Positive Relations with Others subscale of the PWBS. PROCESS Macro analysis indicated that while depression fully mediated the relationship between PI and SR in men, it only partially mediated it in women. In men, positive relationships did not moderate the relationship between PI and depression or between depression and SR, while it moderated both relationships in women. Finally, the moderated mediation effect of positive relationships was only significant for women. The results suggest that PI and gender should be considered in depression and suicide intervention, and that promoting positive relationships could mitigate some of the negative effects of PI on mental health.

국문 초록 (Abstract)

본 연구는 지각된 불공정성이 우울을 매개하여 자살위험으로 이어지는 관계가 긍정적 대인관계에 따라 달라지는 지와 이 관계가 성별에 따라 차이를 보이는 지 검증하였다. 이를 위해 2012년 한국종합사회조사(KGSS)의 1,396명의 자료를 분석하였다. 연구 변인은 KGSS 공정성 문항, MINI(The Mini International Neuropsychiatric Interview)의 자살성 모듈, 우울증 선별척도(Patient Health Questionnaire-9), 그리고 심리적 안녕감 척도의 긍정적 대인관계 하위 척도로 평가하였다. PROCESS macro로 검증한 결과, 첫째, 남성의 경우 우울이 지각된 불공정성과 자살위험의 관계를 완전 매개한 반면 여성의 경우 부분 매개하였다. 둘째, 남성의 경우 지각된 불공정성과 우울, 그리고 우울과 자살위험의 관계에 대한 긍정적 대인관계의 조절효과가 유의하지 않은 반면 여성에서는 조절효과가 모두 유의하였다. 셋째, 지각된 불공정성과 자살위험의 관계에서 우울을 통한 긍정적 대인관계의 조절된 매개효과는 여성에서만 유의하였다. 본 연구 결과는 지각된 불공정성을 우울 및 자살위험 개입에서 고려해야 하며, 긍정적 대인관계를 증진하는 개입이 지각된 불공정성이 정신건강 문제에 미치는 부정적 영향을 완화하는데 효과적일 가능성을 시사한다.

참고문헌 (Reference)

1 박승진, "한글판 우울증 선별도구(Patient Health Questionnaire-9, PHQ-9)의 신뢰도와 타당도" 대한불안의학회 6 (6): 119-124, 2010

2 유상우, "한국판 Mini International Neuropsychiatric Interview 타당도 연구" 2 (2): 50-55, 2006

3 김지범, "한국종합사회조사 2003-2016" 성균관대학교 출판부 2017

4 박수진, "초기 성인의 우울과 자살사고의 관계: 지각된 짐스러움, 좌절된 소속감의 매개효과 및 삶의 이유의 조절효과" 한국상담심리학회 30 (30): 877-908, 2018

5 정은주, "직장인의 직무 스트레스와 스트레스 대처 전략에 관한 성차 연구" 한국여성정책연구원 82 (82): 137-162, 2012

6 조아라, "중산층 한국인의 생애주기별 자살 충동경험과 위험요인: 비교의식과 관련된 사회심리적 특성을 중심으로- 8차 한국의료패널 자료분석" 한국지역사회간호학회 29 (29): 1-10, 2018

7 엄현주, "중년기 남녀의 자살생각에 관한 예측요인" 한국정신건강사회복지학회 42 (42): 35-62, 2014

8 김도연, "정당한 세상에 대한 믿음이 일반 성인들의 화병 증상에 미치는 영향: 분배공정성과 절차공정성을 중심으로" 한국상담학회 17 (17): 25-45, 2016

9 신혜진, "정당한 세상에 대한 믿음이 대학생의 우울에 미치는 영향에서 낙관성과 인지적 유연성의 매개효과" 학습자중심교과교육학회 18 (18): 413-437, 2018

10 김은하, "정당한 세상에 대한 개인적인 믿음이 일반 성인들의 우울 증상에 미치는 영향: 내외통제성을 통한 공동체의식의 조절된 매개효과" 한국상담학회 18 (18): 1-22, 2017

11 전지혜, "장애차별경험과 장애인의 우울감의 관계 연구 -자아존중감의 매개효과와 사회적 지지의 조절효과를 중심으로-" 한국정신건강사회복지학회 (35) : 51-80, 2010

12 이수인, "자살생각에 대한 사회적 영향 요인과 심리적 영향 요인의 통합적 접근" 민주사회정책연구원 (30) : 104-139, 2016

13 김현정, "자살 위험성에 영향을 미치는 요인-애그뉴의 일반긴장이론을 중심으로-" 대한범죄학회 5 (5): 75-110, 2011

14 송리라, "아동기 트라우마 경험과 성인기 우울의 관계: 사회적 관계의 조절효과" 한국인구학회 39 (39): 1-24, 2016

15 김명소, "심리적 안녕감의 구성개념분석" 15 (15): 19-39, 2001

16 송인덕, "서베이 모드와 사회적 바람직함 편향: 민감한 주제에 대한 전화 면접, 대면 면접, 온라인 서베이 응답 비교" 한국조사연구학회 14 (14): 165-199, 2013

17 한국보건사회연구원, "사회통합지수 개발 연구"

18 이웅, "박탈경험과 불평등인식의 관계연구: 우울의 매개효과 검증" 한국보건사회연구원 34 (34): 93-122, 2014

19 황정우, "동거 및 독거노인의 우울이 자살사고에 미치는 영향과 대인관계의 조절효과" 한국정신건강사회복지학회 45 (45): 36-62, 2017

20 조영주, "대학생의 지각된 스트레스, 실존적 안녕, 우울 및 자살 사고의 관계: 6주 단기 종단 연구" 한국상담심리학회 28 (28): 801-827, 2016

21 이혜선, "대학생의 자살관련생각과 행동의 원인 및 자살을 선택하지 않은 이유" 한국상담심리학회 24 (24): 703-728, 2012

22 박영례, "대학생의 스트레스가 우울에 미치는 영향:사회적 지지의 조절효과를 중심으로" 한국성인간호학회 25 (25): 549-558, 2013

23 구희령, "대학생도 직장인도 90%가 “헬조선 맞다”...‘금수저-흙수저’사회가 이유 1위"

24 이인정, "노인의 우울과 자살생각의 관계에 대한 위기사건, 사회적 지지의 조절효과" 한국보건사회연구원 31 (31): 34-62, 2011

25 백지은, "남성노인과 여성노인의 사회적 지지 경험이 심리적 건강에 미치는 영향" 한국여성심리학회 15 (15): 425-445, 2010

26 윤희웅, "[KSOI의 여론스코프]“우리 사회는 불공정” 74%"

27 Min, J. Y., "Workplace injustice and self-reported disease and absenteeism in South Korea" 57 (57): 87-96, 2014

28 Wickham, S., "Why does relative deprivation affect mental health? The role of justice, trust and social rank in psychological wellbeing and paranoid ideation" 13 (13): 114-126, 2014

29 Spitzer, R. L., "Validation and utility of a self-report version of Prime-MD: The PHQ primary care study" 282 (282): 1737-1744, 1999

30 Reevy, G. M., "Use of social support: Gender and personality differences" 44 (44): 437-459, 2001

31 De Vogli, R., "Unfairness and health: Evidence from the Whitehall II study" 61 (61): 513-518, 2007

32 Prati, G., "The relation of perceived and received social support to mental health among first respondents: A meta-analytic review" 38 (38): 403-417, 2010

33 Sheehan, D. V., "The mini-international neuropsychiatric interview (MINI): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10" 59 : 22-33, 1998

34 Möller-Leimkühler, A. M., "The gender gap in suicide and premature death or: Why are men so vulnerable?" 253 (253): 1-8, 2003

35 Burleson, B. R., "The experience and effects of emotional support: What the study of cultural and gender differences can tell us about close relationships, emotion, and interpersonal communication" 10 (10): 1-23, 2003

36 Loveless, M., "The deterioration of democratic political culture: Consequences of the perception of inequality" 26 (26): 471-491, 2013

37 Park, S., "The association of suicide risk with negative life events and social support according to gender in Asian patients with major depressive disorder" 228 (228): 277-282, 2015

38 Kroenke, K., "The PHQ-9: Validity of a brief depression severity measure" 16 (16): 606-613, 2001

39 Hunt, I. M., "Suicide within 12 months of mental health service contact in different age and diagnostic groups: National clinical survey" 188 (188): 135-142, 2006

40 Barrios, L. C., "Suicide ideation among US college students associations with other injury risk behaviors" 48 (48): 229-233, 2000

41 Cohen, S., "Stress, social support, and the buffering hypothesis" 98 (98): 310-357, 1985

42 Pinel, E. C., "Stigma consciousness: The psychological legacy of social stereotypes" 76 (76): 114-128, 1999

43 Bosma, H., "Socioeconomic inequalities in mortality and importance of perceived control: Cohort study" 319 (319): 1469-1470, 1999

44 Kawachi, I., "Social ties and mental health" 78 (78): 458-467, 2001

45 Jensen, M. P., "Social support, depression, and physical disability: Age and diagnostic group effects" 7 (7): 164-172, 2014

46 Wang, X., "Social support moderates stress effects on depression" 8 : 41-45, 2014

47 Gottlieb, B. H., "Social support concepts and measures" 69 (69): 511-520, 2010

48 Kleiman, E. M., "Social support as a protective factor in suicide: Findings from two nationally representative samples" 150 (150): 540-545, 2013

49 Cobb, S., "Social support as a moderator of life stress" 38 (38): 300-314, 1976

50 Poudel-Tandukar, K., "Social support and suicide in Japanese men and women-The Japan Public Health Center (JPHC)-based prospective study" 45 (45): 1545-1550, 2011

51 Mulia, N., "Social disadvantage, stress, and alcohol use among Black, Hispanic, and White Americans: Findings from the 2005 US National Alcohol Survey" 69 (69): 824-833, 2008

52 World Health Organization, "Social determinants of mental health"

53 Okamoto, M., "Social capital and suicide: An ecological study in Tokyo, Japan" 18 : 306-312, 2013

54 Kendler, K. S., "Sex differences in the relationship between social support and risk for major depression: A longitudinal study of opposite-sex twin pairs" 162 (162): 250-256, 2005

55 Kendler, K. S., "Sex differences in the pathways to major depression: A study of opposite-sex twin pairs" 171 (171): 426-435, 2014

56 Lewis, T. T., "Self-reported experiences of discrimination and health: scientific advances, ongoing controversies, and emerging issues" 11 : 407-440, 2015

57 Brausch, A. M., "Self-esteem and social support as moderators of depression, body image, and disordered eating for suicidal ideation in adolescents" 42 (42): 779-789, 2014

58 Zhang, J., "Relative deprivation and psychopathology of Chinese college students" 150 (150): 903-907, 2013

59 Lu, L., "Receiving and giving support: Effects on relationships and well-being" 5 (5): 123-133, 1992

60 Milner, A., "Psychosocial job stressors and thoughts about suicide among males: A cross-sectional study from the first wave of the ten to men cohort" 147 : 72-76, 2017

61 Jang, J. M., "Predictors of suicidal ideation in a community sample: Roles of anger, self-esteem, and depression" 216 (216): 74-81, 2014

62 Becker, T. E., "Potential problems in the statistical control of variables in organizational research: A qualitative analysis with recommendations" 8 (8): 274-289, 2005

63 Otto, K., "Posttraumatic symptoms, depression, and anxiety of flood victims: The impact of the belief in a just world" 40 (40): 1075-1084, 2006

64 Ford, M. T., "Perceived unfairness at work, social and personal resources, and resting blood pressure" 30 (30): 12-22, 2014

65 Bosma, H., "Perceived unfairness and socioeconomic inequalities in functional decline: The Dutch SMILE prospective cohort study" 12 (12): 818-823, 2012

66 Robbins, J. M., "Perceived unfairness and employee health: A meta-analytic integration" 97 (97): 235-272, 2012

67 Sullivan, M. J., "Perceived injustice: A risk factor for problematic pain outcomes" 28 (28): 484-488, 2012

68 Chou, K. L., "Perceived discrimination and depression among new migrants to Hong Kong: The moderating role of social support and neighborhood collective efficacy" 138 (138): 63-70, 2012

69 Dalgard, O. S., "Negative life events, social support and gender difference in depression - A multinational community survey with data from th ODIN study" 41 (41): 444-451, 2006

70 Beshai, S., "Minding the gap: Subjective relative deprivation and depressive symptoms" 173 : 18-25, 2017

71 Sheppard, M., "Mental health and social justice: Gender, race and psychological consequences of unfairness" 32 (32): 779-797, 2002

72 Scholten, S., "Mental distress and perceived wealth, justice and freedom across eight countries: The invisible power of the macrosystem" 13 (13): 1-20, 2018

73 Jackson, B., "Linking perceived unfairness to physical health: The perceived unfairness model" 10 (10): 21-40, 2006

74 임아영, "Job-Seeking Stress, Mental Health Problems, and the Role of Perceived Social Support in University Graduates in Korea" 대한의학회 33 (33): 1-13, 2018

75 Hayes, A. F., "Introduction to mediation, moderation, and conditional process analysis: A regression-based approach" Guilford Pres 2013

76 Pabayo, R., "Income inequality within urban settings and depressive symptoms among adolescents" 70 (70): 997-1003, 2016

77 Ryff, C. D., "Happiness is everything, or is it? Explorations on the meaning of psychological, well-being" 57 (57): 1069-1081, 1989

78 Elliott, M., "Gender differences in causes of depression" 33 (33): 183-198, 2001

79 Howard, L. W., "Flight from unfairness: Effects of perceived injustice on emotional exhaustion and employee withdrawal" 25 (25): 409-428, 2010

80 Clements, C. M., "Dysphoria and hopelessness following battering: The role of perceived control, coping, and self-esteem" 19 (19): 25-36, 2004

81 Eibner, C., "Does relative deprivation predict the need for mental health services" 7 (7): 167-175, 2004

82 Brown-Iannuzzi, J. L., "Discrimination hurts, but mindfulness may help: Trait mindfulness moderates the relationship between perceived discrimination and depressive symptoms" 56 : 201-205, 2014

83 Nanayakkara, S., "Depression and exposure to suicide predict suicide attempt" 30 (30): 991-996, 2013

84 Nock, M. K., "Cross-national prevalence and risk factors for suicidal ideation, plans and attempts" 192 (192): 98-105, 2008

85 Sheih, G., "Clarifying the role of mean centering in multicollinearity of interaction effects" 64 (64): 462-477, 2011

86 Hayes, A. F., "Cautions regarding the interpretation of regression coefficients and hypothesis tests in linear models with interactions" 6 (6): 1-11, 2012

87 Houle, J., "Can social support help prevent men from suicide attempt?" 30 (30): 61-83, 2005

88 Fredrick, S. S., "Can social support buffer the association between depression and suicidal ideation in adolescent boys and girls?" 55 (55): 490-505, 2018

89 Van der Feltz-Cornelis, C. M., "Best practice elements of multilevel suicide prevention strategies" 32 : 319-333, 2011

90 Lee, C. Y. S., "Associations among stress, gender, sources of social support, and health in emerging adults" 33 (33): 378-388, 2017

91 Corning, A. F., "Assessing perceived social inequity: A relative deprivation framework" 78 (78): 463-477, 2000

92 Besharat, M. A., "Anger and major depressive disorder: The mediating role of emotion regulation and anger rumination" 6 (6): 35-41, 2013

93 Bernstein, M., "An empirical examination of relative deprivation theory" 16 (16): 442-456, 1980

94 Preacher, K. J., "Addressing moderated mediation hypotheses: Theory, methods, and prescriptions" 42 (42): 185-227, 2007

95 Lee, C., "A closer look at self-esteem, perceived social support, and coping strategy: A prospective study of depressive symptomatology across the transition to college" 33 (33): 560-585, 2014

96 통계청, "2017년 사망원인통계"