Korean Clinical Psychology Association

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

[ Original Article ]
Korean Journal of Clinical Psychology - Vol. 40, No. 3, pp.177-191
Abbreviation: KJCP
ISSN: 1229-0335 (Print) 2733-4538 (Online)
Print publication date 30 Aug 2021
Received 26 Jan 2021 Revised 12 May 2021 Accepted 13 May 2021
DOI: https://doi.org/10.15842/kjcp.2021.40.3.001

의사결정나무분석을 이용한 자살 시도 계획 수준 및 충동성에 대한 심리사회적 예측 요인
김효중 ; 유성은
충북대학교 심리학과

Psychosocial Factors Predicting Planning Level and Impulsivity of Suicide Attempt using a Decision Tree Analysis
Hyojoong Kim ; Sungeun You
Department of Psychology, Chungbuk National University, Cheongju, Korea
Correspondence to : Sungeun You, Department of Psychology, Chungbuk National University, 1 Chungdae-ro, Seowon-gu, Cheongju, Korea; E-mail: syou@chungbuk.ac.kr
This work is based on the Master’s thesis of the first author (H.K.).

© 2021 Korean Clinical Psychology Association
Funding Information ▼


자살 시도는 장기적인 계획에 의해 실행될 수도 있고 급성 위기 상황에서 충동적으로 실행될 수도 있다. 효과적인 자살 예방과 개입을 위해서는 이러한 자살 시도의 행동 특성을 예측하는 차별적인 요인을 밝히는 것이 중요하다. 본 연구에서는 자살 시도 이전 계획 수준과 자살 시도 당일 충동성을 예측하는 심리사회적 요인을 각각 알아보았다. 특히, 의사결정나무분석을 이용하여 자살 시도의 계획 수준 및 충동성을 예측하는 요인들 간의 상호작용 효과를 알아보는 것을 주요 목적으로 하였다. 이를 위해 성별과 연령대를 층화 표집하여 자살 시도 경험이 있는 성인 300명을 모집하였다. 온라인 설문조사를 통해 자살 행동 이전 계획 수준 및 자살 시도 당일 충동성을 측정하였고, 주요 예측 변인으로 우울, 절망감, 부정 긴급성, 인지적 유연성, 스트레스 경험을 측정하였다. 의사결정나무분석 결과, 자살 시도 이전의 계획 수준은 우울과 부정 긴급성의 상호작용이 예측하였다. 구체적으로 우울 수준이 높을수록 자살 시도 계획 수준이 높았고, 우울 수준이 낮은 경우에는 부정 긴급성이 높을수록 자살 시도 계획 수준이 높게 나타났다. 자살 시도 당일 충동성은 우울, 인지적 유연성(통제, 대안)과 절망감의 상호작용이 예측하였다. 첫째, 우울 수준이 낮을수록 자살 시도 당일 충동성이 높았다. 둘째, 우울 수준이 낮은 경우 통제와 대안 수준이 높을수록 자살 시도 당일 충동성이 높았고, 셋째, 우울, 통제, 대안 수준이 모두 낮을 경우에는 절망감이 높을수록 자살 시도 당일 충동성이 높게 나타났다. 본 연구 결과는 자살 시도 이전 계획 수준이 높은 자살 시도자와 급성 위기 상황에서 충동적으로 자살 시도를 하는 사람들을 위한 차별화된 개입 전략이 필요함을 시사한다.


Suicide attempt is usually made as a result of distal planning and/or proximal impulsivity during an acute crisis. The aim of this study was to examine the interaction effects of psychosocial factors that predict the planning level and impulsivity of suicide attempt. Using stratified sampling by age and sex, 300 adults with a history of suicide attempt were recruited. Planning level and impulsivity of the most recent suicide attempt were assessed, and the following were assessed and used as the main predictors: depression, hopelessness, negative urgency, cognitive flexibility, and stress experience. Using decision tree analysis, the results indicated that the interaction between depression and negative urgency predicted the planning level of suicide attempt. Specifically, the higher the level of depression, the higher the planning level of a suicide attempt. In cases of low levels of depression, a higher level of negative urgency predicted the planning level. The psychosocial factors that predicted impulsivity of suicide attempt were the interaction of depression, cognitive flexibility (control and alternatives), and hopelessness. First, the lower the level of depression, the greater the impulsivity of a suicide attempt. Second, when depression levels were low, higher levels of control and alternatives predicted the impulsivity. Third, when the levels of depression, control, and alternatives were low, hopelessness predicted the impulsivity. The results of this study suggest that differential intervention strategies are needed for individuals planning suicide and those who may act impulsively during an acute crisis.

Keywords: suicide attempt, suicide planning, impulsive suicide attempt, decision tree analysis
키워드: 자살 시도, 자살 계획, 충동적 자살 시도, 의사결정나무분석


This work was supported by the Ministry of Education of the Republic of Korea and the National Research Foundation of Korea (NRF-2020S1A5A2A03044181).

Author contributions statement

HK, graduate student at Chungbuk National University, collected and analyzed data, and led manuscript preparation. HK is now a clinical psychology intern at Chonnam National University Hospital. SY, professor at Chungbuk National 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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