DOI QR코드

DOI QR Code

수용전념치료 (ACT)가 우울한 평가염려 완벽주의 대학생의 평가염려 완벽주의, 자기비난, 이분법적 사고 및 우울에 미치는 효과

Effects of Acceptance and Commitment Therapy on Evaluative Concerns Perfectionism, Self-Criticism, Dichotomous Thinking, and Depression in University Students with Evaluative Concerns Perfectionism and Depression

  • Oh, Jeong-eun (Dept. of Psychology, Chonbuk National University) ;
  • Son, ChongNak (Dept. of Psychology, Chonbuk National University)
  • 투고 : 2018.02.26
  • 심사 : 2018.04.20
  • 발행 : 2018.04.28

초록

본 연구는 수영전념치료(ACT)의 6가지 핵심 치료 과정이 평가염려 완벽주의의 자기비난과 이분법적 사고를 감소시키고, 최종적으로 우울까지 감소시킬 수 있다는 가설을 세우고 이를 검증하고자 하였다. 4년제 대학에 다니고 있는 대학생 400명 중 평가염려 완벽주의와 우울이 높고 사전면담을 통해 프로그램 참여에 동의한 22명을 최종적으로 선별하였다. 참가자들은 무작위로 수용전념치료 집단과 통제집단에 각각 11명씩 할당되었다. 수용전념치료 집단에는 총 8회기의 수용전념치료 프로그램을 진행 하였으며, 통제집단에는 어떠한 처치도 행해지지 않았다. 수용전념치료 집단과 통제집단은 프로그램 전, 프로그램이 종료되는 시점 및 프로그램 종결 6주 후에 평가염려 완벽주의, 자기비난, 이분법적 사고, 우울, 수용행동에 대한 질문지에 응답하였다. 그 결과, 수용전념치료(ACT) 프로그램에 참여한 참가자는 통제 집단보다 프로그램 후 평가염려 완벽주의, 자기비난, 이분법적 사고 및 우울 수준이 유의하게 더 감소하였고, 수용 행동은 유의하게 더 증가하였으며, 이것이 추적까지 유지되었다. 반면에 통제 집단에서는 사전, 사후, 추적에서 유의한 변화가 없었다. 본 논문의 마지막에 연구의 의의, 제한점 및 후속 연구에 대한 제언이 논의되었다.

This sturdy proposed and tested whether the six core treatment processes of Acceptance and Commitment Therapy (ACT) reduce self-criticism and dichotomous thinking in Evaluative concerns perfectionists and even diminish depression and ultimately verify it. The sample consisted of 22 subjects who displayed high EC perfectionism and depression. The subjects were randomly assigned to ACT groups or control groups (n-11/each). The ACT program was administered in eight sessions. All participants completed scale about EC perfectionism, self-criticism, dichotomous thinking, depression and acceptance & action at the pre-test, post-test, and the six week follow-up. The results showed that evaluative concerns perfectionism, self-criticism, dichotomous thinking, and depression decreased more in the treatment group than in the control group, whereas acceptance & action increased in the former. Finally, the implications and limitations of this study, along with suggestions for future study were discussed.

키워드

참고문헌

  1. Chung, S. J. & Yeon, M. H. (1999). A study of the development of cognitive-behavioral group counseling program for reducing the perfectionism. The Korean Journal of Counseling and Psychotherapy, 2, 147-167.
  2. Enns, M. W. & Cox, B. J. (1999). Perfectionism and depression symptom severity in major depressive disorder. Behaviour Research and Therapy, 37, 783-794. https://doi.org/10.1016/S0005-7967(98)00188-0
  3. Jeon, H. S. & Kim, J. H. (2016). The effect of maladaptive perfectionism and core self-evaluation on body dissatisfaction of female college student. Journal of Digital Convergence, 14(11), 557-564. https://doi.org/10.14400/JDC.2016.14.11.557
  4. Kim, H. O., Koo, Y. J., & Park, E. (2015). The influence on mental health of college students by their perceived stress, stress coping, perfectionism, and self esteem. Journal of Digital Convergence, 13(2), 257-266 https://doi.org/10.14400/JDC.2015.13.2.257
  5. Lethbridge, J., Watson, H. J., Egan, S. J., Street, H., & Nathan, P. R. (2011). The role of perfectionism, dichotomous thinking, shape and weight overvaluation, and conditional goal setting in eating disorders. Eating Behaviors, 12, 200-206. https://doi.org/10.1016/j.eatbeh.2011.04.003
  6. Sassaroli, S., Lauro, L. J. R., Ruggiero, G. M., Mauri, M. C., Vinai, P., & Frost, R. (2008). Perfectionism in depression, obsessive-compulsive disorder and eating disorders. Behaviour Research and Therapy, 46, 757-765. https://doi.org/10.1016/j.brat.2008.02.007
  7. Frost, R. O., Marten, P., Lahart, C., & Rosenblate, R. (1990). The dimensions of perfectionism. Cognitive Therapy and Research, 14, 449-468. https://doi.org/10.1007/BF01172967
  8. Hewitt, P. L. & Flett, G. L. (1991). Perfectionism in the self and social contexts: Conceptualization, assessment, and association with psychopathology. Journal of Personality and Social Psychology, 60, 456-470. https://doi.org/10.1037/0022-3514.60.3.456
  9. Dunkley, D. M., Blankstein, K. R., Halsall, J., Williams, M., & Winkworth, G. (2000). The relation between perfectionism and distress: Hassle, coping, and perceived social support as mediators and moderators. Journal of Counseling Psychology, 47, 437-453. https://doi.org/10.1037/0022-0167.47.4.437
  10. Chang, E. C. & Rand, K. L. (2000). Perfectionism as a predictor of subsequent adjustment: Evidence for a specific diathesis-stress mechanism among college student. Journal of Counseling Psychology, 47, 129-137. https://doi.org/10.1037/0022-0167.47.1.129
  11. Hewitt, P. L., Flett, G. L., & Ediger, E. (1996). Perfectionism and depression: Longitudinal assessment of a specific vulnerability hypothesis. Journal of Abnormal Psychology, 105, 276-280. https://doi.org/10.1037/0021-843X.105.2.276
  12. Dunkley, D. M., Zuroff, D. C., & Blankstein, K. R. (2006). Specific perfectionism components versus self-criticism in predicting maladjustment. Personality and Individual Differences, 40, 665-676. https://doi.org/10.1016/j.paid.2005.08.008
  13. Jang, A. K. & Lee, J. Y. (2011). The effects of evaluative concerns perfectionism upon the college students's depression and anxiety with validation from others as a mediating factor. Korean Journal of Counseling, 12, 881-896. https://doi.org/10.15703/kjc.12.3.201106.881
  14. Kim, M. S. & Seo, Y. S. (2009). The relation between evaluative concern perfectionism and psychological distress: Emotion-focused coping and perceived efficacy as mediators. The Korean Journal of Woman Psychology, 14, 427-446. https://doi.org/10.18205/kpa.2009.14.3.007
  15. Blatt, S. J. (1995). The destructiveness of perfectionism: Implications for the treatment of depression. American Psychologist, 50, 1003-1020. https://doi.org/10.1037/0003-066X.50.12.1003
  16. Ashby, J. S., Rice, K. G., & Martin, J. L. (2006). Perfectionism, shame, and depressive symptoms. Journal of Counseling & Development, 84, 148-156. https://doi.org/10.1002/j.1556-6678.2006.tb00390.x
  17. Flett, G. L., Besser, A., Davis, R. A., & Hewitt, P. L. (2003). Dimensions of perfectionism, unconditional self-acceptance, and depression. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 21, 119-138. https://doi.org/10.1023/A:1025051431957
  18. Kim, M. S. & Seo, Y. S. (2009b). The relation between evaluative concern perfectionism and social anxiety: Testing the mediating effects of fear of negative evaluation and self-presentational motivation. Korean Journal of Psychology: General. 28, 525-545.
  19. Kim, H. H. & Kim, C. D. (2011). The classification between evaluative concerns perfectionists and personal standards perfectionists. Korean Journal of Counseling, 12, 373-391. https://doi.org/10.15703/kjc.12.1.201103.373
  20. Kwon, L. J. (2010). The meditating effects of mindfulness and self-criticism on the relation between perfectionism and depression in university students(Unpublished Master's Thesis). University of Kyungpook, Daegu, Korea.
  21. Park, H. J. & Kim, E. J. (2009). The characteristics of positive and negative perfectionism. Seoul: The Korean Psychological Association.
  22. Choi, M. S., Yoo, J. M., & Hyun, M. H. (2005). The mediating and moderating effects of self-efficacy on the relationship between evaluative concerns and personal standards perfectionism and depression. The Korean Journal of Health Psychology, 10, 1-15.
  23. Juster, H. R., Heimberg, R. G., Frost, R. O., Holt, C. S., Mattia, J. I., & Faccenda, K. (1996). Social phobia and perfectionism. Personality and Individual Differences, 21, 403-410. https://doi.org/10.1016/0191-8869(96)00075-X
  24. Hewitt, P. L. & Flett, G. L. (1993). Dimensions of perfectionism, daily stress, and depression: A test of the specific vulnerability hypothesis. Journal of Abnormal Psychology, 102, 58-65. https://doi.org/10.1037/0021-843X.102.1.58
  25. Sherry, S. B., Gautreau, C. M., Mushquash, A. R., Sherry, D. L., & Allen, S. L. (2014). Self-critical perfectionism confers vulnerability to depression after controlling for neuroticism: A longitudinal study of middle-aged, community-dwelling women. Personality and Individual Differences, 69, 1-4. https://doi.org/10.1016/j.paid.2014.04.035
  26. Kim, J. M (2009). The mediating effect of self-criticism and shame in the relation between maladaptive perfectionism and maladaptive emotion in university students. Korean Journal of Youth Studies, 16, 205-225.
  27. Dunkley, D. M. & Blankstein, K. R. (2000). Self-critical perfectionism, coping, hassle, and current distress: A structural equation modeling approach. Cognitive Therapy and Research, 24, 713-730. https://doi.org/10.1023/A:1005543529245
  28. Powers, T. A., Zuroff, D. C., & Topciu, R. A. (2004). Covert and overt expressions of self-criticism and perfectionism and their relation to depression. European Journal of Personality, 18, 61-72. https://doi.org/10.1002/per.499
  29. Beck, J. S. (1995). Cognitive therapy: Basics and beyond. New York: The Guilford Press.
  30. Riley, C. & Shafran, R. (2005). Clinical perfectionism: A preliminary qualitative analysis. Behavioral and Cognitive Psychotherapy, 33, 369-374. https://doi.org/10.1017/S1352465805002122
  31. Shafran, R., Cooper, Z., & Fairburn, C. G. (2002). Clinical perfectionism: A cognitive-behavioural analysis. Behaviour Research and Therapy, 40, 773-791. https://doi.org/10.1016/S0005-7967(01)00059-6
  32. Burns, D. (1980). The perfectionist's script for self-defeat. Psychology Today, November, 34-51.
  33. Hamachek, D. E. (1978). Psychodynamics of normal and neurotic perfectionism. Psychology, 15, 27-33.
  34. Basco, M. R. (1999). Never good enough. New York: The Touchstone Press.
  35. Burns, L. R. & Fedewa, B. A. (2005). Cognitive styles: Links with perfectionistic thinking. Personality and Individual Differences, 38, 103-113. https://doi.org/10.1016/j.paid.2004.03.012
  36. Dibartolo, P. M., Frost, R. O., Dixon, A., & Almodovar, S. (2001). Can cognitive restructuring reduce the disruption associated with perfectionistic concerns?. Behavior Therapy, 32, 167-184. https://doi.org/10.1016/S0005-7894(01)80051-4
  37. Flett, G. L. & Hewitt, P. L. (2008). Treatment interventions for perfectionism a cognitive perspective: Introduction to the special issue. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 26, 127-133. https://doi.org/10.1007/s10942-007-0063-4
  38. Flett, G. L. & Hewitt, P. L. (2002). Perfectionism: Theory, research, and treatment. Washington, DC: American Psychological Association.
  39. Lundh, L. G. (2004). Perfectionism and acceptance. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 22, 255-269.
  40. Kim, D. Y. (2006). The effects of the mindfulness meditation and the rational emotive behavior therapy on the reduction of maladaptive perfectionism and stress(Unpublished Master's Thesis).
  41. Yoon, K. H., Kim, J. H., Kim, M. R. H., Hong, S. H., Kang, S. H., & Kim, H. Y. (2013). The effects of mindfulness meditation on maladaptiveness, psychological well-being and subjective well-being of dysfunctional perfectionists. Seoul: The Korean Psychological Association.
  42. Somov, P. G. (2010). Present perfect: A mindfulness approach to letting go perfectionism and the need for control. Oakland, CA: New Harbinger.
  43. Shahar, T. B. (2009). The pursuit of perfect: How to stop chasing perfection and start living a richer, happier life. New York: McGraw-Hill Education.
  44. Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. New York: Guilford Press.
  45. Kim, J. E. & Son, J. N. (2012). The effects of acceptance and commitment therapy on evaluative concerns perfectionism, fear of negative evaluation, experiential avoidance, and self-efficacy of university students with evaluative concerns perfectionism. The Korean Journal of Clinical Psychology, 31, 749-771. https://doi.org/10.15842/kjcp.2012.31.3.007
  46. Han, K. Y. (1993). Multidimensional perfectionism: Concepts, measures, and relationship of maladjustment(Unpublished doctoral dissertation). University of Korea, Seoul, Korea.
  47. Cho, J. I. (1996). A study on two dimension of depression(Unpublished Master's Thesis). University of Korea, Seoul, Korea.
  48. Hwang, S. H. (2007). The role of dichotomous thinking in psychopathology(Unpublished doctoral dissertation). University of Seoul, Seoul, Korea.
  49. Chon, K. K., Choi, S. C., & Yang, B. C. (2001). Integrated adaptation of CES-D in korea. The Korean Journal of Health Psychology, 6, 59-76.
  50. Moon, H. M. (2006). Development and validation of the program for facilitation of psychological acceptance based on acceptance and commitment therapy model(Unpublished doctoral dissertation). University of Catholic, Seoul, Korea.
  51. Ciarrochi, J. & Bailey, A. A. (2008). CBT-practitioner's guide to ACT: How to bridge the gap between cognitive behavioral therapy and acceptance and commitment therapy. Oakland, CA: New Harbinger.
  52. Taranis, L. & Meyer, C. (2010). Perfectionism and compulsive exercise among female exercisers: High personal standards or self-criticism?. Personality and Individual Differences, 49, 3-7. https://doi.org/10.1016/j.paid.2010.02.024