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The Effect of Post-Traumatic Stress on Depression of Korean and Vietnam War Veterans: Mediating Effect Analysis of Ego-Resilience

한국전, 베트남 참전 국가유공자들의 외상 후 스트레스가 우울에 미치는 영향에 대한 융복합적 연구 : 자아-적응유연성의 매개효과 분석

  • Kim, Yunyoung (Department of Nursing, Andong National University) ;
  • Hyun, Hye Sun (Department of Nursing, Sangmyung University) ;
  • Choi, Nayoung (Department of Nursing, Andong National University) ;
  • Kim, Tae Yeol (Department of Health Medical Administration, Yeung Nam University College)
  • Received : 2019.06.10
  • Accepted : 2019.11.20
  • Published : 2019.11.28

Abstract

The purpose of this study was to investigate the relationship between post-traumatic stress and depression in veterans and to examine mediating effects of ego-resilience in relation. Data were collected from 383 subjects of National Merit of the Korean War or Vietnam War with the cooperation of the Daegu Veterinary Association from March to June 2018, and the collected data were analyzed using the SPSS 24.0 Statistics Program to analyze the mediating effects of ego-resilience in post-traumatic stress and depression with hierarchical multiple regression. Post-traumatic stress was found to be high in the case of long absence(F=7.97, p<.001), unemployment(t=2.09, p=.040), poor economic condition(F=64.49, p<.001), and ego-resilience as a parameter in the relationship between post-traumatic stress and depression. Based on the results of this study, it is required to develop various programs focusing on improving ego-resilience and systematic management at the national level in order to intervene in depression of veteran.

본 연구는 참전 국가유공자의 외상 후 스트레스와 우울의 관계를 파악하고, 외상 후 스트레스와 우울의 관계에서 자아-적응유연성의 매개효과를 확인하고자 하였다. 한국보훈협회의 협조를 얻어 2018년 3월부터 6월까지 한국전 또는 베트남 전쟁 참전군인 383명을 대상으로 자료 수집하였다. 수집된 자료는 SPSS 24.0 Statistics Program을 이용하여 외상 후 스트레스와 우울의 관계에서 자아-적응유연성의 매개효과를 계층적 다중회귀분석으로 분석하였다. 대상자의 참전 기간이 긴 경우(F=7.97, p<.001), 무직인 경우(t=2.09, p=.040), 경제 상태가 좋지 않은 경우(F=64.49, p<.001) 외상 후 스트레스가 높았으며, 외상 후 스트레스와 우울의 관계에서 매개변수인 자아-적응유연성이 부분 매개하는 것으로 나타났다. 본 연구결과를 바탕으로 참전군인들의 우울 중재를 위해 자아-적응유연성 향상에 초점을 맞춘 다양한 프로그램 개발 및 국가 차원에서의 체계적인 관리가 요구된다.

Keywords

References

  1. Ministry of patriots and veterans affairs. (2018). The status of veterans (including area) and defoliant in December. Seoul : Ministry of patriots and veterans affairs. https://www.mpva.go.kr/mpva/data/situation01View.do?info_id=6595
  2. M. Y. Chung. (1996). The prevalence and the analysis of variables in veterans with post-traumatic stress disorder. Master dissertation. Yonsei University, Seoul.
  3. T. Y. Kim & S. K. Lee. (2007). A study on the establishment of infrastructure for veteran elderly care center. The Journal of Health Information Management Institute, 16(2), 28-31.
  4. J. H. Choi, M. Y. Chung & I. J. Chung. (1997). The risk factors for post-traumatic stress disorder in veterans, Journal of Korean Neuropsychiatric Association, 36(6), 997-1003.
  5. M. A. Polusny, S. M. Kehle, N. W. Nelson, C. R. Erbes, P. A. Arbisi & P. Thuras. (2011). Longitudinal effects of mild traumatic brain injury and posttraumatic stress disorder comorbidity on postdeployment outcomes in national guard soldiers deployed to Iraq.. Archives of General Psychiatry, 68, 79-89. DOI : 10.1001/archgenpsychiatry.2010.172
  6. C. Zaetta, P. Santonastaso & A. Favaro. (2011). Long-term physical and psychological effects of the vajont disaster. European Journal of Psychotraumatology, 2, 1-5. DOI : 10.3402/ejpt.v2i0.8454
  7. B. K. Jordan, W. E. Schlenger, R. Hough, R. A. Kulka, D. Weiss, J. A. Fairbank & C. R. Marmar. (1991). Lifetime and current prevalence of specific psychiatric disorders among Vietnam veterans and controls. Archives Of General Psychiatry , 48, 207-215. DOI : 10.1001/archpsyc.1991.01810270019002
  8. S. J. Oum, J. H. Choi, T. Y. Kim, H. G. Chung, M. Y. Chung & H. S. So. (2011). The relationship between post-traumatic stress disorder and the quality of life among the Vietnam war veterans. Korean Journal of Psychosomatic Medicine, 19(2), 83-91.
  9. A. L. Byers & K. Yaffe. (2014). Depression and dementias among military veterans. Alzheimer's & Dementia, 10, 116-173. DOI : 10.1016/j.jalz.2014.04.007
  10. Miller, G. (2011). Predicting the psychological risks of war. Science, 333, 520-521. DOI : 10.1126/science.333.6042.520
  11. Y. Church. (2014). Reductions in pain, depression, and anxiety symptoms after PTSD remediation in Veterans. The Journal of Science and Healing, 10(3), 162-169. DOI : 10.1016/j.explore.2014.02.005
  12. H. S. Hyun, T. Y. Kim & Y. Y. Kim. (2018). The influence of post-traumatic stress and social support on depression of Vietnam veterans, The Korean Journal of Health Service Management, 12(1), 137-147. DOI : 10.12811/kshsm.2018.12.1.137
  13. A. S. Masten & J. D. Coatsworth. (1998). The development of competence in favorable and unfavorable environments lessons from research on successful children. American Psychologist, 53(2), 205-220. https://doi.org/10.1037/0003-066X.53.2.205
  14. G. A. Bonanno. (2004). Loss, trauma, and human resilience: have we underestimated the human capacity to thrive after extremely aversive events? American Psychologist, 59(1), 20-28. DOI : 10.1037/0003-066X.59.1.20
  15. J. S. Lee, Y. S. Ahn, K. S. Jeong, J. H. Chae & K. S. Choi. (2014). Resilience buffers the impact of traumatic events on the development of PTSD symptoms in fire-fighters. Journal of Affective Disorders. 162, 128-133. DOI : 10.1016/j.jad.2014.02.031
  16. S. H. Kim. (2018). Effects of resilience on the post-traumatic stress disorder of police officers. Korean Association Of Public Safety And Criminal Justice, 27(2), 69-89. https://doi.org/10.21181/kjpc.2018.27.2.69
  17. M. S. Fritz & D. P. MacKinnon (2007). Required sample size to detect the mediated effect. Psychological Science, 18(3), 233-239. DOI : 10.1111/j.1467-9280.2007.01882.x
  18. D. S. Weiss & C. R. Marmar. (1997). The impact of event scalerevised. In J. P. Wilson, & T. M. Keane (Eds.), Assessing psychological trauma and PTSD: A practitioner's handbook New York, NY: Guilford Press, 339-411.
  19. H. J. Eun, T. W. Kwon, S. M. Lee, T. H. Kim, M. R. Choi & S. J. Cho. (2005). A study on reliability and validity of the Korean version of impact event scale-revised. Journal of Korean Neuropsychiatric Association,. 44(3), 303-310.
  20. L. S. Radloff. (1977). The CES-D scale a self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3), 385-401. DOI : 10.1177/014662167700100306
  21. M. J. Cho & K. H. Kim. (1993). Diagnostic validity of the CES-D(Korean version) in the assessment of DSM- III-R major depression. Journal of Korean Neuropsychiatric Association, 32(3), 381-399.
  22. J. H. Block & A. M. Kremen. (1996). IQ and ego-resiliency: conceptual and empirical connections and separateness. Journal of Personality and Social Psychology, 70(2), 349-361. https://doi.org/10.1037/0022-3514.70.2.349
  23. S. K. Yoo & H. W. Shim. (2002). Psychological protective factors in resilient adolescents in Korea. The Korea Journal of Educational Psychology, 16(4), 189-206.
  24. R. M. Baron &, D. A. Kenny. (1986). The moderator-mediator distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology. 51, 1173-1182. https://doi.org/10.1037/0022-3514.51.6.1173
  25. T. Y. Kim & M. S. Jang. (2015). Establishment of advanced medical care for national merit - Psychological characteristics of national merit and post-traumatic stress disorder, The Korean Association for Patriots and Veterans Affairs Studies Conference. (pp. 1-22). Seoul : Ministry of Patriots and Veterans Affairs.
  26. S. C. Kwon, J. C. Song, S. J. Lee, I. A. Kim, J. W. Koh, H. C. Ryou, S. H. Kim, D. H. Kim & S. A. Jung. (2008). Post-traumatic stress symptoms and related factors in fire-fighters of a fire-station. Korean Journal of Occupational and Environmental Medicine, 20(3), 193-204. https://doi.org/10.35371/kjoem.2008.20.3.193
  27. S. K. Park, H. Y. Lee & Y. C. Cho. (2018). The association of job stress and social support with depressive symptoms among manufacturing male workers. Journal of the Korea Academia-Industrial cooperation Society, 19(5), 216-224. https://doi.org/10.5762/KAIS.2018.19.5.216
  28. S. R. Lee & S. A. Lee. (2014). The effects of household income types and sources on the depression and self-respect in elderly Koreans. Korean Journal of Social Welfare Studies, 45(3), 71-95. DOI : 10.16999/kasws.2014.45.3.71
  29. K. M. Connor. (2006). Assessment of resilience in the aftermath of trauma. The Journal of Clinical Psychiatry, 67, 46-49.
  30. L. Campbel-Sills, D. R. Forde & M. B. Stein. (2009). Demographic and childhood environmental predictors of resilience in a community sample. Journal of Psychiatric Research, 43(12), 1007-1012. DOI : 10.1016/j.jpsychires.2009.01.013
  31. E. K. Jeong & Y. S. Hah. (2014). The effect of ego-resiliency, social support, military life satisfaction on growth related military service in Korean veterans. Journal of Military Nursing Research, 32(1), 53-65.
  32. R. A. Kulka, W. E. Schlenger & J. A. Fairbank. (1990). Trauma and the Vietnam war generation, New York, Brunner/Mazel, 43-45.
  33. D. F. Gros, J. C. Flanagan, K. J. Korte, A. C. Mills, K. T. Brady & S. E. Back. (2016). Relations among social support, PTSD symptoms, and substance use in veterans, Psychology of Addictive Behaviors, 30(7), 764-770. DOI : 10.1037/adb0000205
  34. A. Hussain, L. Weisaeth & T. Heir. (2011). Psychiatric disorders and functional impairment among disaster victims after exposure to a natural disaster: a population based study. Journal of Affective Disorders, 128(1-2), 135-141. DOI : 10.1016/j.jad.2010.06.018
  35. M. Leeies, J. Pagura, J. Sareen & J. M. Bolton. (2010). The use of alcohol and drugs to self-medicate symptoms of posttraumatic stress disorder. Depression and Anxiety. 27(8), 731-736. DOI : 10.1002/da.20677
  36. A. C. McFarlane & P. Papay, (1992). Multiple diagnoses in posttraumatic stress disorder in the victims of a natural disaster. The Journal of Nervous and Mental Disease, 180(8), 498-504. https://doi.org/10.1097/00005053-199208000-00004
  37. B. H. Oh. (2006). Suicide and prevention of elderly people. Korean Journal of Clinical Geriatrics, 7(1), 88-92.
  38. C. S. Fullerton, R. J. Ursano & L. Wang. (2004). Acute stress disorder, post-traumatic stress disorder, and depression in disaster or rescue workers. American Journal of Psychiatry, 161(8), 1370-1376. DOI : 10.1176/appi.ajp.161.8.1370
  39. C. Y. Lee & J. H. Park. (2014). The effects of acculturative stress and resilience on depression of university students from North Korea. Family and Environment Research, 52(3), 313-324. https://doi.org/10.6115/fer.2014.027
  40. A. P. Wingo, G. Wrenn, T. Pelletier, A. R. Gutman, B. Bradley & K. J. Ressler. (2010). Moderating effects of resilience on depression in individuals with a history of childhood abuse or trauma exposure. Journal of Affective Disorders, 126(3), 411-414. DOI : 10.1016/j.jad.2010.04.009
  41. Y. S. Park. (2002). The effects of violence of husband on psychopathology of wife. Master dissertation. Busan National University, Busan.
  42. K. T. Green, P. S. Calhoun, M. F. Dennis & J. C. Beckham. (2010). Exploration of the resilience construct in post-traumatic stress disorder severity and functional correlates in military combat veterans who have served since September 11, 2001. The Journal of Clinical Psychiatry, 71(7), 823-830. DOI : 10.4088/JCP.09m05780blu
  43. B. R. Kim & H. C. Shin. (2010). The influence of ego-resilience and meaning in life on posttraumatic growth: Mediating effect of searching for meaning and presence of meaning. The Korean Journal of Counseling and Psychotherapy, 22(1), 117-136.
  44. M. S. Yoon & N. H. Kim. (2013). Post-traumatic growth among university students resulting from parental loss: divorced versus bereaved families. Korean Journal of Family Therapy, 21(2), 177-201. DOI : 10.21479/kaft.2013.21.2.177