Korean Clinical Psychology Association

Current Issue

Korean Journal of Clinical Psychology - Vol. 38 , No. 4

[ Original Article ]
Korean Journal of Clinical Psychology - Vol. 38 , No. 4 , pp.357-368
ISSN: 2466-197X (Online)
publication date 30 Nov 2019
Received 29 May 2019 Revised 03 Sep 2019 Accepted 01 Oct 2019
DOI: https://doi.org/10.15842/kjcp.2019.38.4.002

일상적 우울이 임상적 우울로 발전하는 경로에 대한 모형탐색
최승원 1 ; 김종남 2 ; 이순묵 3, ; 채정민 4 ; 서동기 5 ; 이혜림 1 ; 김아란 1 ; 이유진 1
1덕성여자대학교 심리학과
2서울여자대학교 교육심리학과
3성균관대학교 심리학과
4서울사이버대학교 상담심리학과
5한림대학교 심리학과

Investigation of a Structural Model of the Development from Daily Depression to Dysfunctional Depression
Sungwon Choi1 ; Jong-Nam Kim2 ; Soonmook Lee3, ; Jungmin Chae4 ; Dong Gi Seo5 ; Hyerim Lee1 ; Aran Kim1 ; Yujin Lee1
1Department of Psychology, Duksung Women’s University, Seoul
2Department of Educational Psychology, Seoul Women’s University, Seoul
3Department of Psychology, Sungkyunkwan University, Seoul
4Department of Counseling Psychology, Seoul Cyber University, Seoul
5Department of Psychology, Hallym University, Chuncheon, Korea
Correspondence to : Soonmook Lee, Department of Psychology, Sungkyunkwan University, 25-2 Seonggyungwan-ro, Jongno-gu, Seoul, Korea; E-mail: smlyhl@chol.com


© 2019 Korean Clinical Psychology Association
Funding Information ▼

초록

본 연구는 대부분의 정상인들이 자연스럽게 경험할 수도 있는 우울경험인 ‘일상우울’과 임상적 수준의 ‘우울증’을 구별하고, 일상우울이 임상적 우울의 발생에 선행한다는 새로운 구조 모형의 타당성을 검증하기 위해 진행되었다. 이를 위해 제주도를 제외한 전국의 성인 남녀 440명을 대상으로 설문조사를 실시하였다. 일상우울의 예측요인으로 예상되는 스트레스지각, 사회경제적 지위, 사회적지지가 일상우울을 매개해 임상수준의 우울을 예측하는 관계모형을 검증한 결과, 우울 유발 변인이 일상우울을 설명하고 이것이 임상적 우울을 예측한다는 모형의 전반적인 적합도가 높게 나타났다. 이는 우울 유발 변인인 스트레스, 사회경제적 지위, 사회적지지가 일상우울을 예측한다는 본 연구의 가설과 일치하였다. 본 연구결과를 통해 일상우울이 역학적 우울의 발생을 예측하는 새로운 개념이 될 수 있다는 가능성이 확인되었으며, 이러한 일상우울 개념의 도입은 우울증 환자들에 대한 사회의 인식을 개선하는 데에도 기여할 수 있을 것으로 보인다. 또한 심리학자의 시각에서 정신병리를 바라본 드문 시도라는 점에서 그 의의가 있다.

Abstract

This study was conducted to distinguish “daily depression,” a depression that most normal people tend to experience naturally, from “dysfunctional depression (including clinical depression),” and to verify the validity of a new structural model in which daily depression precedes the occurrence of clinical depression. To examine our hypothesis, a survey was conducted of 440 adult men and women throughout Korea, excluding Jeju Island. We verified a relationship model with stress perception, socio-economic status, and social support as predictors of normal depression, showing that 1) the overall fit measures of our model of the relationship of predictors with normal depression and dysfunctional depression and of the relationship between normal depression and dysfunctional depression were good, consistent with our hypothesis that causal factors such as stress, socioeconomic status, and social support also predict normal depression, and 2) these preceding variables affect dysfunctional depression directly and indirectly. This study confirmed the possibility that normal depression could be a new concept for predicting the occurrence of epidemiological depression, and the introduction of this concept could also help improve the perception of depression patients in our society. It is also meaningful as a rare attempt to understand mental disorder from a psychologist’s point of view.


Keywords: depressive disorder, daily depression, dysfunctional depression
키워드: 우울장애, 일상우울, 역기능적 우울

Acknowledgments

This work was supported by the National Research Foundation of Korea Grant Funded by the Korean Government (NRF-2014S1A5A2A03064999).


References
1. Beck, A. T. (2002). Cognitive models of depression. Clinical Advances in Cognitive Psychotherapy: Theory and Application, 14, 29-61.
2. Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the Beck Depression Inventory-II. San Antonio, TX: Psychological Corporation.
3. Bentler, P. M. (1990). Comparative fit indexes in structural models. Psychological Bulletin, 107, 238.
4. Bentler, P. M., & Bonett, D. G. (1980). Significance tests and goodness of fit in the analysis of covariance structures. Psychological Bulletin, 88, 588.
5. Browne, M. W., & Cudeck, R. (1993). Alternative ways of assessing model fit. In K. A. Bollen and J. S. Long (Eds.), Testing structural equation models (pp. 136-162). Newbury Park, CA: Sage.
6. Burke, H. M., Davis, M. C., Otte, C., & Mohr, D. C. (2005). Depression and cortisol responses to psychological stress: A meta-analysis. Psychoneuroendocrinology, 30, 846-856.
7. Carlson, J. G., & Hatfield, E. (1992). Psychology of emotion. San Diego, CA: Harcourt Brace Jovanovich.
8. Cho, H. J., Yim, H. W., Hyun, M. H., Jo, S. J., Ji, Y. N., Jun, T. Y., & Bang, M. H. (2008). Study of the attitudes toward depression in general population. The Korean Society of Stress Medicine, 16, 233-240.
9. Choi, I. S. (2012). Effects of Maternal parenting behavior of social support and negative emotional experience. Korean Journal of Youth Studies, 19, 135-160.
10. Choi, S., Lee, S., Kim, J., Choi, Y. K., Seo, D. G., & Chae, J. (2018). Review of reactive depression and endogeneous depression concepts. Korean Journal of Clinical Psychology, 37, 213-226.
11. Chon, K. K., Kwon, K. D., & Kim, S. K. (1999). An attempt to Revise the Korean Adaptation of the CES-D. Journal of Social Science Research, 6, 429-451.
12. Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 385-396.
13. Dobson, K. S., & Shaw, B. F. (1986) Cognitive assessment with major depressive disorders. Cognitive Therapy and Research, 10, 13-29.
14. Dowlatshahi, E. A., Wakkee, M., Arends, L. R., & Nijsten, T. (2014). The prevalence and odds of depressive symptoms and clinical depression in psoriasis patients: A systematic review and meta-analysis. Journal of Investigative Dermatology, 134, 1542-1551.
15. Dunkley, D. M., & Blanksteir, K. R. (2000). Self-critical perfectionism, coping, hassles and current distress: A structural equation modeling approach. Cognitive Therapy and Research, 24, 713-730.
16. George, L. K., Blazer, D. G., Hughes, D. C., & Fowler, N. (1989). Social support and the outcome of major depression. The British Journal of Psychiatry, 154, 478-485.
17. Fukuda, K. (2014). Etiological classification of depression based on the enzymes of tryptophan metabolism. BMC Psychiatry, 14, 372.
18. Halfin, A. (2007). Depression: The benefits of early and appropriate treatment. The American Journal of Managed Care, 13(4 Suppl), S92-7.
19. Hammarstrom, A., & Janlert, U. (1997). Nervous and depressive symptoms in a longitudinal study of youth unemployment-selection or exposure? Journal of Adolescence, 20, 293-305.
20. Hammen, C. (2005). Stress and depression. The Annual Review of Clinical Psychology, 1, 293-319.
21. Han, J. H., Lee, J. H., Ok, S. H., Ryff, C., & Markrs, N. (2002). Gender, Social Roles and Mental health in mid-life. Journal of Korea Gerontological Society, 22, 209-225.
22. Heo, J. E., & Tae, Y. S. (2014). Influence of spiritual wellbeing and social support on depression in middle-aged women. Korean Journal of Adult Nursing, 26, 181-190.
23. Jeon, H. J. (2012). Epidemiologic studies on depression and suicide. Journal of the Korean Medical Association, 55, 322-328.
24. Kim, S. Y. (2016). The basic and expansion of exploratory structural equation modeling (ESEM): with MPLUS example. Seoul, Korea: Hakjisa.
25. Kwon, J. H. (1996). A test of a vulnerability-stress model of prepartum depression. Korean Journal of Clinical Psychology, 15, 33-43.
26. Kwon, H. I. & Kwon, J. H. (2012). Cognitive vulnerability to depression: Relation to rumination and memory bias. Journal of Korean Psychological Association, 31, 975-1001.
27. Lee, S., Kim, J. N., Chae, J. M., Choi, S., & Seo, D. G. (2018a). The Development and validation of the normal depression scale. Korean Journal of Clinical Psychology, 37, 411-430.
28. Lee, S., Kim, J. N., Chae, J. M., Choi, S., & Seo, D. G. (2018b). Development and validation of short form of the normal depression scale for individual screening. Stress, 26, 277-289.
29. Lee, S. M., Kim, J. N., Choi, S. W., Chae, J., Choi, Y., Seo, D. G., & Kwon, H. I. (2017). New directions for depression studies: Introduction of behavioral science approach. Korean Journal of Psychology: General, 36, 293-323.
30. Little, T. D., Cunningham, W. A., Shahar, G., & Widaman, K. F. (2002). To parcel or not to parcel: Exploring the question, weighing the merits. Structural Equation Modeling, 9, 151-173.
31. Maj, M. (2011). When does depression become a mental disorder? The British Journal of Psychiatry, 199, 85-86.
32. Malone, D. A., & Lartey, P. (2004). Depression and suicide. Clinical Preventive Medicine II, 69-80. American Medical Association.
33. Mazure, C. M. (1998). Life stressors as risk factors in depression. Clinical Psychology: Science and Practice, 5, 291-313.
34. Miech, R. A., & Shanahan, M. J. (2000). Socioeconomic status and depression over the life course. Journal of Health and Social Behavior, 162-176.
35. Mirowsky, J., & Ross, C. E. (2001). Age and the effect of economic hardship on depression. Journal of Health and Social Behavior, 132-150.
36. Morley, T. E., & Moran, G. (2011). The origins of cognitive vulnerability in early childhood: Mechanisms linking early attachment to later depression. Clinical Psychology Review, 31, 1071-1082.
37. Park. E. O. (2001). A study on social support and Depression by Gender among adults. Korean Journal of Women Health Nursing, 17, 169-177.
38. Park. E. O. (2011). Depression and social support among adults in Jeju province, South Korea. Journal of Agricultural Medicine and Community Health, 36, 25-35.
39. Park, J. J. (1985). Study to development a scale of social support. Unpublished doctoral dissertation, Yeonsei University, Seoul, Korea.
40. Park, S. H., Son, C. N., & Oh, S. W. (1993). The effect of stress, social support, dysfunctional attitude and coping on depression. Korea Journal of Clinical Psychology, 1993, 425-437.
41. Patten, C. A., Gillin, J. C., Farkas, A. J., Gilpin, E. A., Berry, C. C., & Pierce, J. P. (1997). Depressive symptoms in California adolescents: Family structure and parental support. Journal of Adolescent Health, 20, 271-278.
42. Peirce, R. S., Frone, M. R., Russell, M., Cooper, M. L., & Mudar, P. (2000). A longitudinal model of social contact, social support, depression, and alcohol use. Health Psychology, 19, 28.
43. Racic, M., Todorovic, R., Ivkovic, N., Masic, S., Joksimovic, B., & Kulic, M. (2017). Self-perceived stress in relation to anxiety, depression and health-related quality of life among health professions students: A cross-sectional study from Bosnia and Herzegovina. Slovenian Journal of Public Health, 56, 251-259.
44. Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385-401.
45. Rho, B., & Mo, S. H. (2007). The effect of levels and dimensions of social support on geriatric depression. Journal of Korean Gerontological Society, 27, 53-69.
46. Rilling, J. K., Winslow, J. T., O’brien, D., Gutman, D. A., Hoffman, J. M., & Kilts, C. D. (2001). Neural correlates of maternal separation in rhesus monkeys. Bio Psychiatry, 49, 146-157.
47. Sung, J. M. (2010). Longitudinal Study on the effects of depression by household’s economic factors according to income levels. Journal of Korean Academy of Social Welfare, 62, 109-132.
48. Uher, R. (2011). Genes, environment, and individual differences in responding to treatment for depression. Harvard Review of Psychiatry, 19, 109-124.
49. Wakefield, J. C., & Schmitz, M. F. (2013). When does depression become a disorder? Using recurrence rates to evaluate the validity of proposed changes in major depression diagnostic thresholds. World Psychiatry, 12, 44-52.
50. Wakefield, J. C., & Schmits, M. F. (2014). Uncomplicated depression is normal sadness, not depressive disorder: Further evidence from the NESARC. World Psychiatry, 13, 317-319.
51. Yang, W. (2015). GIS analysis of depression using location-based Social media data (Doctoral dissertation), University of Georgia. Retrieved from http://purl.galileo.usg.edu/uga_etd/yang_wei_201508_phd.
52. Yu, E. K., & Seol, H. S. (2015). Factorial structure of the social support scale. The Korean Association for Survey Research, 16, 155-184.
53. Zhang, Y., Peters, A., & Chen, G. (2018). Perceived stress mediates the association between sleep quality and symptoms of anxiety and Depression among College Nursing Students. International Journal of Nursing Education Scholarship, 15, 177-186.