Korean Clinical Psychology Association

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Korean Journal of Clinical Psychology - Vol. 40, No. 3

[ Original Article ]
Korean Journal of Clinical Psychology - Vol. 40, No. 3, pp.245-257
Abbreviation: KJCP
ISSN: 1229-0335 (Print) 2733-4538 (Online)
Print publication date 30 Aug 2021
Received 28 Apr 2021 Revised 21 Jun 2021 Accepted 06 Jul 2021
DOI: https://doi.org/10.15842/kjcp.2021.40.3.006

신경성 폭식증 고위험 여자대학생의 신경성 폭식증 증상과 우울 증상 간 종단적 상호관계: 자기회귀교차지연 모형을 중심으로
문하솜 ; 이수진 ; 장혜인
성균관대학교 심리학과

Longitudinal Reciprocal Association between Depressive and Bulimic Symptoms among Female College Students with Subclinical Levels of Bulimia Nervosa: A Cross-Lagged Model
Hasom Moon ; Sujin Lee ; Hyein Chang
Department of Psychology, Sungkyunkwan University, Seoul, Korea
Correspondence to : Hyein Chang, Department of Psychology, Sungkyunkwan University, 25-2 Sungkyunkwan-ro, Jongno-gu, Seoul, Korea; E-mail: hichang@skku.edu
This work had been presented at the 9th World Congress of Behavioural & Cognitive Therapies in 2019.

© 2021 Korean Clinical Psychology Association
Funding Information ▼


신경성 폭식증 증상과 우울 증상은 청소년기와 초기성인기에 공병할 위험이 높은 것으로 알려져 있으나, 두 증상의 양방향적 관련성을 조사하려는 시도는 부족하였다. 이에 본 연구에서는 고위험 여자대학생들을 대상으로 신경성 폭식증 증상과 우울 증상이 시간에 따라 서로 예측하는 과정을 종단자료 분석을 통해 검증하고자 하였다. 이때 신경성 폭식증과 우울장애의 중요한 위험요인으로 여겨지는 부정정서와 정서조절곤란을 통제함으로써, 두 증상 간 양방향적 관계를 더 엄격히 분석하였다. 이를 위해 이미 일정 수준 이상의 섭식문제를 경험하고 있는 신경성 폭식증 고위험 여자대학생 117명을 표집 하여 자기보고식 설문지를 이용해 신경성 폭식증 증상과 우울 증상, 부정정서, 정서조절곤란을 6개월 간격으로 총 3회 측정하였다. 자기회귀교차지연 모형 분석 결과, 이전 시점의 우울 증상이 6개월 후 시점의 신경성 폭식증 증상을 유의하게 예측하였으며, 이는 부정정서와 정서조절곤란의 효과를 통제한 후에도 유의하였다. 반면, 이전 시점의 신경성 폭식증 증상은 이후 시점의 우울 증상을 예측하지 못하였다. 본 연구의 결과를 바탕으로 연구의 이론적, 임상적 함의와 한계점을 논하였다.


Although bulimic and depressive symptoms are highly comorbid, their reciprocal association remains unclear. The goal of this study was therefore to examine the longitudinal reciprocal relationship between bulimic and depressive symptoms among female college students experiencing subclinical levels of bulimia nervosa. We also incorporated negative affect and emotion dysregulation as common risk factors for both bulimic and depressive symptoms. Participants were 117 female college students who reported relatively high levels of bulimic symptoms during the initial screening. They completed a series of self-report inventories assessing bulimic and depressive symptoms, negative affect, and emotion dysregulation at baseline (T1) and at six-month (T2) and one-year (T3) follow-ups. The results of an autoregressive cross-lagged model indicated that depressive symptoms at T1 and T2 significantly predicted bulimic symptoms at T2 and T3, respectively, controlling for the temporal stability of each symptom, as well as the effects of negative affect and emotion dysregulation. Conversely, bulimic symptoms did not predict future depressive symptoms across time. These findings suggest that depressive symptoms may be a potential target for the early identification and prevention of bulimic symptoms among high-risk females.

Keywords: bulimic symptom, depressive symptom, negative affect, emotion dysregulation
키워드: 신경성 폭식증, 우울장애, 부정정서, 정서조절곤란


This work was supported by the Ministry of Education of the Republic of Korea and the National Research Foundation of Korea (NRF-2017S1A5A2A01024881).

Author contributions statement

HM, a graduate student at Sungkyunkwan University, conducted literature review, analyzed data, and led manuscript preparation. SL, a graduate student at Sungkyunkwan University who is now a graduate student at University of Michigan, Ann Arbor, MI, USA, was responsible for data collection and analysis. HC, an associate professor at Sungkyunkwan University, served as the principal investigator of the research grant and supervised the research process. All authors provided critical feedback, participated in revision of the manuscript, and approved the final submission.

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