¿Ü»ó ÈÄ ½ºÆ®·¹½º Àå¾Ö(Posttraumatic Stress Disorder, PTSD)

 

 ¿Ü»ó ÈÄ ½ºÆ®·¹½º Àå¾Ö(Posttraumatic Stress Disorder, ¾àÀÚ·Î PTSD) Áï PTSD·Î °íÅëÀ» ¹Þ°í ÀÖ´Â °³ÀεéÀº Ç×»ó Á¤»óÀûÀÎ Àΰ£ÀÇ °æÇèÀÇ ¹üÀ§¸¦ ³Ñ¾î°¡´Â ÇÑ °³ÀÇ »óóÀûÀÎ À̺¥Æ®µéÀ» °æÇèÀ» ÇÑ´Ù´Â °ÍÀÌ´Ù. ÇÇÇØÀÚµéÀº °úµµÇÏ°Ô ¿¹¹ÎÇÑ ÀÚÀ²½Å°æ È°µ¿(½ÉÇÑ ºÒ¾ÈÀå¾Ö Áõ¼¼µé)°ú ÀÎÁöÀûÀÎ Áõ¼¼µé Áï Á¤½ÅÁýÁß¿¡ ¾î·Á¿ò°ú ±â¾ï ¼Õ»ó°ú °°Àº °Í¿¡ ÀÇÇؼ­ Ư¡ÀÌ µÇ´Â ºÒ¾ÈÀ» °æÇèÀ» ÇÑ´Ù´Â °ÍÀÌ´Ù. °íÀüÀûÀÎ PTSDÀÇ Áõ¼¼·Î½á ¶Ç ÇÑ°¡Áö Ư¡Àº ±× »óó¸¦ Àç °æÇèÀ» ÇÏ´Â °ÍÀÌ´Ù. °¨Á¤ÀûÀÎ ¹ÝÀÀÀÌ ¹«°¨°¢ÇÏ°í ¾ïÁ¦µÊÀ» µ¿¹ÝÀ» ÇÑ´Ù. ÀÌ·¯ÇÑ »óó °æÇèÀÇ °¡Àå ÈçÇÑ ´ëÇ¥ÀûÀÎ °ÍÀÌ ÀüÀï¿¡¼­ ÀüÅõ °æÇè, ÀüÇà Æ÷·Î °æÇè ȤÀº Áý´Ü ¼ö¿ë¼Ò °æÇèµé µîÀÌ PTSD¸¦ µµ¹ßÇÏ´Â »óȲÀ¸·Î ÀÏÂïÀÌ ³ëÆ®µÇ¾îÁö°í ÀÖ¾ú´Ù(Barlow, 1988).

 ¿Ü»ó ÈÄ ½ºÆ®·¹½º Àå¾Ö´Â ¿À·£ ¿ª»ç¸¦ °¡Áö°í ÀÖ´Ù. ±×·¯³ª ÀÌ°ÍÀÌ ÇÐÀÚµéÀÇ °úÇÐÀûÀÎ º»°ÝÀûÀÎ ¿¬±¸·Î µîÀåÇÑ °ÍÀº ¿À·¡ µÇÁö ¾Ê´Â´Ù. Á¦ 1 Â÷ ¼¼°è ´ëÀü°ú Á¦ 2Â÷ ¼¼°è ´ëÀüÀ» °ÅÄ¡¸é¼­ ÀüÅõ ÁßÀ̰ųª ÀüÅõ¿¡ Âü°¡ÇÑ Å𿪠±ºÀÎµé »çÀÌ¿¡¼­ Á¤»ó ÇൿÀ» ¹þ¾î³­ Áõ¼¼µéÀÌ ´«¿¡ ¶ç°Ô µÇ¾î ÇÐÀÚµéÀÇ °ü½ÉÀ» ²ø °Ô µÇ¸é¼­ º»°ÝÀûÀÎ ¿¬±¸°¡ ½ÃÀ۵Ǿú´Ù. ÀÌ·± ÀÌÀ¯ ¶§¹®¿¡ PTSDÀÇ Ãʹݱâ À̸§ÀÌ "Æ÷ź ¼îÅ©" "ÀüÅõ ÇÇ·ÎÁõ" ȤÀº "ÀüÅõ ½Å°æÁõ" µîÀÇ À̸§À¸·Î ºÙ¿©Áö°Ô µÇ¾ú´Ù(Grinker & Spiegal, 1945). ±×·¯³ª ±× ÀÌÀü¿¡ ÀÌ¹Ì 1896³â¿¡ ¿ÀÆæÇÏÀ̸Ó(Oppenheim)¿¡ ÀÇÇؼ­ "»óó ½Å°æÁõ" ±×¸®°í 1896³â¿¡ µ¶ÀÏÀÇ Á¤½Å°ú ÀÇ»çÀÎ Å©·¡Æ縰(Kraepelin)¿¡ ÀÇÇؼ­ ºÙ¿©Áø "°øÆ÷ ½Å°æÁõ, ³î·¥ ½Å°æÁõ"(fright neuorsis)À̸§ µéÀÌ ÀÌ¹Ì µîÀåÇØ ÀÖ¾ú´Ù. Å©·¡Æ縰(Kraepelin, 1896)´Â ÀÌ Á¶°ÇÀ» ÇÑ °³ÀÇ ºÐ¸®µÈ Ä¡·á ½ÇÁ¦·Î½á °í·Á¸¦ Çß´Ù. ÇÑ °³ÀÇ »óó¿¡ ºÙ¿©Áø ÀÌ·¯ÇÑ ¿©·¯ °¡ÁöÀÇ À̸§µéÀÌ ÅëÇյǾî PTSDÀÇ À̸§À¸·Î µîÀåÇÏ°Ô µÈ °ÍÀº 1960³â´ë¿¡¼­ 1970³â´ë¿¡ º£Æ®³² ÀüÀïÀ¸·Î ÀÎÇÏ¿© ÇÐÀÚµéÀÌ ¸ð¿©¼­ ÀÇ°ß ÀÏÄ¡·Î ¿Ü»ó ÈÄ ½ºÆ®·¹½º Àå¾Ö(Posttraumatic Stress Disorder)¶ó´Â À̸§À¸·Î °ø½Ä µîÀåÇÑ °ÍÀÌ 1980³â DSM-¥²¿¡¼­ ³ªÅ¸³ª°Ô µÇ¾ú´Ù(Barlow, 1988).

 ÇÐÀÚµéÀÌ ¹àÇô³½ °ÍÀº ¼ö ¸¹Àº »óóµé°ú ½É¸®ÀûÀÎ Çö»óÀ¸·Î ½ÉÇÑ °¨Á¤ÀûÀÎ ´ë º¯µ¿ ȤÀº ½ÉÇÑ °©ÀÛ½º·± °øÆ÷, ³î·¥ µé·Î½á ºÒ¾ÈÀÌ ½×¿© PTSD°¡ °ÇÃàÀÌ µÈ °ÍÀ̶ó°í »ý°¢À» Çß´Ù. ±×·¯¹Ç·Î ½É°¢ÇÑ »ç°íµé ±×¸®°í ºÎ»ó ÈÄ¿¡ °üÂûµÇ¾îÁú ¼ö ÀÖ´Ù. Ãʹݱ⿡ ÀüÀï¿¡ Âü°¡ÇÑ ±ºÀεé Çѵ¥¼­ ³ªÅ¸³ª´Â Áõ¼¼µé¿¡ À̾ ¹Î°£Àεé Çѵ¥¼­ Àç³­À¸·Î µîÀåÇÏ´Â °ÍÀÌ µå·¯³ª°Ô µÇ¾ú´Ù. Ưº°È÷ È­Àç, ÀÚµ¿Â÷ »ç°í È¤Àº ±âÂ÷ Å»¼±°ú Ãæµ¹ µî°ú °°Àº ´ëÇü »ç°í ÀÌÈÄ¿¡ ÀϾ ¼ö ÀÖ´Ù´Â °ÍÀÌ ¹àÇôÁ³´Ù. ÀÚµ¿Â÷ »ç°íµé¿¡ ´õ ºÙ¿©¼­ »ê¾÷ ÀçÇصé ÀÚ¿¬ Àç³­µé(¿¹¸¦ µé¾î¼­ ÁöÁø, È«¼ö, ºØ±« »ç°í, »ê»çÅ µî), ½ÅüÀû °ø°Ýµé(Ưº°È÷ ¼ºÆøÇà(°­°£)) ȤÀº »ç¶ûÇÏ´Â »ç¶÷ÀÇ Á×À½(¾Ö¿Ï µ¿¹°µé Æ÷ÇÔ) µîÀÌ PTSD¸¦ »ý»êÇÒ ¼ö ÀÖ´Ù´Â °ÍÀÌ ¹àÇôÁ³´Ù(Barlow, 1988).

 ÀÌµé ¹ÝÀÀÇൿµéÀÇ Ãʹݱ⠸¹´Â ¿¹µéÀº °³ÀεéÀÇ Àϱâ ȤÀº ±â·Ï¿¡¼­ »ó¼¼ÇÏ°Ô ±â¼úµÇ¾îÁö°í ÀÖ´Ù. 17¼¼±âÀÇ À¯¸íÇÑ Àϱâ ÀÛ°¡ÀÎ »ç¹«¿¤ ÆäÇÇ(Samuel Pepsy, 1666)°¡ 1666³â¿¡ ·±´øÀÇ ´ë È­Á¦ »ç°ÇÀ¸·Î »ó´çÇÑ »ý¸í°ú Àç»êÀÇ ¼Õ»ó ±×¸®°í ´«¿¡ ¶ç´Â µµ½ÃÀÇ ÇØüÀÇ °á°ú¸¦ Àϱâ·Î ±â¼úÇÑ ±×ÀÇ ±Û¿¡¼­ "³ª´Â À̳¯ ÀÌÈÄ¿¡ ÀÌ È­ÀçÀÇ °Å´ëÇÑ ÅÍ·¯ ¶§¹®¿¡ ¹ã¿¡ ÀáÀ» Àß ¼ö°¡ ¾ø¾ú´Ù. ±×¸®°í ¸ÅÀÏ ¹ã¸¶´Ù ±× È­À縦 »ý°¢À» Çϸ鼭 »õº® 2½Ã±îÁö ÀáÀ» Àß ¼ö°¡ ¾ø¾ú´Ù"°í ºÒ¸éÁõ »Ó¸¸ ¾Æ´Ï¶ó ±× À̺¥Æ®µéÀÌ Àç¹ßÇÏ´Â ²ÞµéÀÌ PTSDÀÇ ´«¿¡ ¶ç´Â Ư¡ÀÌ µÇ¾ú´Ù. ´õ ºÙ¿©¼­ ÆäÇÇ(Pepsy)´Â "³»°¡ ¾Æ´Ñ °Í °°Àº ´À³¦"(depersonalization)°ú "Çö½ÇÀÌ ¾Æ´Ñ °Íó·³ ´À²¸Áö´Â ´À³¦"(derealization)¸¦ °ú½Ã¸¦ Çß´Ù. »Ó¸¸ ¾Æ´Ï¶ó "»ç¶÷µéÀº Á׾´Âµ¥ ÀڽŰú ÀÚ½ÅÀÇ Àç»êµéÀ» ±¸Á¦ÇÑ °Í¿¡ ´ëÇÑ ÁËÀǽÄ"ÀÇ Æ¯Â¡ÀûÀÎ °ÍµéÀ» °ú½Ã¸¦ Çß´Ù. Àç¹ß°ú ħÅõÀûÀΠȸ»ó°ú ±× À̺¥Æ®¿¡ °ü°èµÈ ²Þµé¿¡ ´õ ºÙ¿©¼­ ±× °³ÀÎÀº Ç÷¹½¬¹é(flashback) ¿¡ÇǼҵåµéÀ» °æÇèÀ» ÇÒ ¼ö ÀÖ´Ù. ±× Ç÷¹½¬¹é(flashback) ¿¡ÇÇ¼Òµå ¾È¿¡¼­ Àû¾îµµ ±× Àç³­ À̺¥Æ®µéÀÇ ÀϺθ¦ Àç¹ß·Î °æÇèÀ» ÇÏ´Â °ÍÀÌ´Ù. ±× »óó À̺¥Æ®µéÀÇ ¸éµéÀ» ´àÀº À̺¥Æ®µéÀÇ È¸ÇÇ ±×¸®°í ±Ø´ÜÀûÀÎ ºÒÄè°¨ÀÌ ¿ª½Ã ÈçÇÏ´Ù. ÀÌ È¸ÇÇ´Â ±× À̺¥Æ®ÀÇ ¾î¶² ¸éµéÀ» ±â¾ïÇÒ ¼ö°¡ ¾ø´Â °Í°ú °ü°èµÇ¾î ÀÖ´Ù. Èï¹Ì ÀÖ°Ôµµ ÀÌ È¸ÇÇÀÇ ÀϺδ °¨Á¤ÀûÀÎ °æÇèµéÀÇ ¹«°¨°¢ ȤÀº °¨Á¤ÀûÀÎ °æÇèµéÀÇ Á¦ÇÑÀÌ Æ÷ÇԵǾîÁ® ÀÖ´Ù. ÀÌ ¹«°¨°¢ÀÌ ´ëÀΰü°è¿¡ Æı«ÀûÀÏ ¼ö ÀÖ´Ù. ÀÌ·¯ÇÑ ÁýÁßÀûÀÎ °¨Á¤ °æÇèÀÇ È¸ÇÇ´Â °øȲ Àå¾Ö¿¡¼­ »ý¸®ÀûÀÎ Áõ¼¼¿Í À¯»çÇÏ´Ù´Â Á¡¿¡¼­ PTSD´Â DSM-¥²¿¡¼­ ºÒ¾È Àå¾Ö ¼Ó¿¡ Æ÷ÇԵǾîÀÖ´Ù. ºÒ¾È Àå¾ÖÀÇ 7°³ÀÇ ¼¼ºÎ Àå¾Ö Áß¿¡ Çϳª·Î ¼Ò¼ÓÀÌ µÇ¾îÀÖ´Ù.

  PTSD´Â ±ØµµÀÇ Àç³­À» ´çÇÑ ¾î¸°À̵é Çѵ¥¼­µµ ÈçÇÏ°Ô º¼ ¼ö ÀÖ´Ù. ¾î¸°À̵é Çѵ¥¼­ ³ªÅ¸³ª´Â Áõ¼¼µéÀº ÀáÀ» Àڱ⠾î·Æ°í  ¾Ç¸ùÀ» ²Ù¸ç ±ô¦ ±ô¦ ³î·¡°í ±×¸®°í Å×·¯¿Í ºñ¸íÀ» Áö¸£¸é¼­ ºó¹øÇÏ°Ô ±ú¾î³­´Ù. ¸Ô´Â °ÍÀ» °ÅºÎÇÏ°í ±×¸®°í ´ë¼Òº¯À» °¡¸®´Â ½À°ü¿¡¼­ ÅðÇàÀ» º¸ÀδÙ(¿ÀÁÜ½Î°Ô ¶Ë½Î°Ô).

 PTSDÀÇ °¨Á¤ÀûÀÎ ¸éµéÀÌ ±×°ÍÀÇ Æ¯Â¡µéÀ» Á¤ÀÇ·Î Á¦°øÇÏÁö ÀÖÁö¸¸ ´ëÀΰü°èÀÇ Àç³­ ¿ª½Ã »ó´çÇÏ´Ù. PTSDÀÇ ÇÇÇØÀÚµéÀº Ưº°È÷ ÀüÅõ¿¡ Âü°¡ Çß´ø ±ºÀεéÀÌ Ä£¹Ð°¨À» °¡Áø ¹®Á¦µé ±×¸®°í »çȸ »ýÈ°¿¡ ¹®Á¦¸¦ °¡Áú ¼ö ÀÖ´Ù. ÀÌ °ü°è¿¡¼­ Á¾Á¾ ÆíÁýÁõÀûÀÌ µÇ°Å³ª Àû´ëÀûÀÌ µÈ´Ù. ¾ËÄÝÀ̳ª ¸¶¾à µîÀÇ ¾à¹° ³²¿ëÀ» ÈçÇÏ°Ô º¼ ¼ö ÀÖ´Ù(Roberts et al, 1982).

 

»ç°Ç ¹ßº´ ºñÀ²°ú ÁøÇà ÄÚ½º

 ÃÖ±ÙÀÇ Àü¿°º´ ¿ªÇÐ ¿¬±¸ Á¶»ç¿¡¼­ ·Îºó(Robins et al, 1987)Àº º£Æ®³² ÂüÀü ¿ë»çÀÇ 60%°¡ ÇÑ °³ ȤÀº ¿©·¯ °³ÀÇ ÀüÅõ °ü·Ã PTSD Áõ¼¼¸¦ °¡Áö°í ÀÖ´Ù°í º¸°í¸¦ Çß´Ù. ´õ ºÙ¿©¼­ ³²ºÎ Ķ¸®Æ÷´Ï¾Æ ÀçÇâ ±ºÀÎ º´¿øÀ¸·ÎºÎÅÍ ³ª¿Â Ä¡·á »ùÇÿ¡¼­ Æ÷ÀÌ(Foy et al, 1987)´Â ³ôÀº ÀüÅõ °æÇè¿¡ ³ëÃâµÈ Å𿪠±ºÀεéÀÇ »ùÇÃ(ÀüÅõ °æÇè ³ëÃâÀº ÀüÅõ¿¡ Âü°¡ÇÏ°í ºÎ»óÀ» ´çÇÑ ÀçÇâ ±ºÀεé·Î Á¤ÀǵÊ)ÀÇ PTSDÀÇ ºñÀ²(DSM-¥²ÀÇ PTSD ±âÁØ¿¡ ÀÏÄ¡)ÀÌ 70% ºñÀ²·Î ³ô°Ô º¸°í µÇ¾ú´Ù.

 À¯»çÇÑ ¹ß°ßµéÀº ¹Î°£ÀÎÀÇ »óó ÀÌÈÄ¿¡µµ ºÐ¸íÇß´Ù. ÇÑ °³ÀÇ ¿¬±¸¿¡¼­ ±æÆäÆ®¸¯(Kilpatrick et al, 1988)Àº 2000¸í ÀÌ»óÀÇ ¿©¼ºµéÀ» »ùÇÃÀ» Çؼ­ Á¤½Å°Ç°­ ¹®Á¦µé°ú ÇÇÇØÀÚ °æÇèÀ» ¿¬±¸¸¦ Çß´Ù. »óóµéÀÇ °æÇèµéÀº ¼ºÆøÇà(°­°£), ¼ºÃßÇà, °­µµ ±×¸®°í ¾ÇÈ­µÈ °ø°Ý µîÀÌ Æ÷ÇÔ µÇ¾ú´Ù. ÇǽÇÇèÀÚµéÀº ÀÚ»ì»ý°¢¿¡ ´ëÇؼ­ ÀÚ»ì ½Ãµµ ±×¸®°í ½Å°æÁõ ºØ±¥ µî¿¡ ´ëÇؼ­ Áú¹®À» ¹Þ¾Ò´Ù. À̵é 2000¸íÀÇ ¿©¼ºµé Áß¿¡¼­ ¾à 500¸íÀÌ ½É°¢ÇÑ ¹üÁËÀÇ ÇÇÇØÀÚµéÀ̾ú´Ù. 100¸íÀÌ ¼ºÆøÇà(°­°£)À» ´çÇß´Ù. ¹üÁËÀÇ ÇÇÇØÀÚµéÀº ÀÇ¹Ì ±í°Ô ½Å°æÁõÀÇ ºØ±« ºñÀ²ÀÌ ³ô¾Ò°í ÀÚ»ì »ý°¢µé, ±×¸®°í ÀÚ»ì ½ÃµµµéÀÌ ÇÇÇØÀÚ°¡ ¾Æ´Ñ ÄÁÆ®·Ñ ±×·ìµé º¸´Ù ºñÀ²ÀÌ ³ô¾Ò´Ù. °¡Àå ÀÇ¹Ì ±íÀº °¨Á¤ÀûÀÎ ¿µÇâÀÇ ¹üÁË´Â ¼ºÆøÇà(°­°£)À̾ú´Ù. ¼ºÆøÇà ¹Î°£ ÇÇÇØÀÚÀÇ 19.2%°¡ ÀÚ»ì ½Ãµµ¸¦ Çß´Ù. ÇÇÇØÀÚ°¡ ¾Æ´Ñ ÄÁÆ®·Ñ ±×·ìÀº 2.2%¿Í ºñ±³°¡ µÇ¾ú´Ù. ÀÌµé ±×·ìµéÀÇ °ÅÀÇ 30%°¡ ÀÚ»ì »ý°¢ µéÀ» º¸°í¸¦ Çß´Ù. ¿¬±¸ ÀÛ°¡µéÀº ¹üÁËÀÇ ÇÇÇØÀÚµéÀº ½ÉÇÑ °¨Á¤ÀûÀÎ Áõ¼¼¸¦ °¡Áú À§ÇèÀÌ ½É°¢ÇÏ´Ù°í °á·ÐÀ» ³»·È´Ù(Barlow, 1988).

 

PTSDÀÇ ¹ßº´ ¿øÀÎ

  »óó³ª Àç³­À» ´çÇß´Ù°í Çؼ­ ¸ðµç »ç¶÷µéÀÌ ´Ù ¿Ü»ó ÈÄ ½ºÆ®·¹½º Àå¾Ö¸¦ ¹ßº´ÇÏ´Â °ÍÀº ¾Æ´Ï´Ù. ¿Ü»ó ÈÄ ½ºÆ®·¹½º Àå¾Ö¸¦ ¹ßº´À» ÇÏ´Â »ç¶÷µéÀº ´Ù¸¥ »ç¶óµé°ú ´Þ¸® ¾î¸° ½ÃÀý¿¡ Ãë¾àÁ¡À» °¡Áö°í ÀÖ´Ù´Â °ÍÀÌ ÇÐÀÚµéÀÇ ¿¬±¸¿¡ ÀÇÇؼ­ ¹àÇôÁ³´Ù. ¶ÇÇÑ »óó ±× ÀÚü°¡ ¾ó¸¶³ª ½É°¢ÇÏ´À³Ä ÇÏ´Â ±× »óóÀÇ ÁýÁß Á¤µµ¿¡ ´Þ·Á ÀÖ´Ù´Â °ÍÀ¸·Î ¹àÇôÁ³´Ù(Barlow, 1988).

 ¿Ü»ó ÈÄ ½ºÆ®·¹½º Àå¾Ö´Â Âü ºñ»ó °æ°í, °ÅÁþ ºñ»ó °æ°í, ÇнÀµÈ ºñ»ó °æ°í, ±×¸®°í ´Ü¼øÇÑ Á¤º¸ÀÇ ÀÌÀü µîÀÌ À¯¹ßÇÏ´Â °øÆ÷Áõµé°ú ´Þ¸® ÇÑ °³ÀÇ Æ¯º°ÇÑ ½É°¢ÇÑ »óó¸¦ °æÇè ÇÑ ÈÄ¿¡ »ý°Ü³­´Ù´Â °ÍÀÌ´Ù. »óóÀûÀÎ »îÀÇ À̺¥Æ®ÀÇ ¾ÐµµÀûÀÎ °á°ú·Î ¹ß»ýÇÑ´Ù´Â °ÍÀÌ´Ù. ±× »óóÀûÀÎ À̺¥Æ®ÀÇ ÇÑ ¸é°ú ´àÀº ȤÀº ±× »óó¸¦ »ó¡ÇÏ´Â »óȲµé¿¡ ³ëÃâ ȤÀº ±× »óó°¡ ÀϾ ±â³äÀÏ¿¡ ÀϾ´Ù´Â Á¡ÀÌ´Ù. ±× »óóµé°ú ¿¬°áµÇ¾îÁø ¶Ç ´Ù¸¥ ÀڱصéÀº »ý°¢µé ȤÀº ´À³¦µé »Ó¸¸¾Æ´Ï¶ó ±× À̺¥Æ®ÀÇ ±â¾ïµéµµ Æ÷ÇÔÀÌ µÈ´Ù´Â Á¡ÀÌ´Ù(Barlow, 1988).

 PTSD°¡ °³¹ßÀÌ µÇ´À³Ä µÇÁö ¾Ê´À³Ä? ÇÏ´Â °ÍÀ» °áÁ¤À» ÇÏ´Â ÇÑ °³ÀÇ Áß¿äÇÑ ¿ªÇÒÀº ±× »óó¸¦ ÀÔÀº ±× »ç¶÷ÀÇ Àû´çÇÑ ´ëÀÀ ±â¼úÀÇ Á¸Àç¿Í ±×¸®°í ´ëÀΰü°è °¨Á¤ Áö¿øÀÇ Á¸Àç¿Í °°Àº º¯¼öµé¿¡ ´Þ·Á ÀÖ´Ù´Â Á¡ÀÌ´Ù. ´ëÀΰü°èÀÇ ±×¹° ¸ÁÀÌ ³Ð°í ±×¸®°í Áö¿øÀÌ ±íÀ»¼ö·Ï PTSDÀÇ ¹ßº´ÀÇ Âù½º´Â °¨¼ÒÇÑ´Ù´Â °ÍÀÌ´Ù(Barlow, 1988).

 PTSD¸¦ ¹ßº´ÇÏ´Â ±× °³ÀÎÀÇ Ãë¾àÁ¡ °¡¿îµ¥´Â ±× °³ÀÎÀÇ °¡Á· ¾È¿¡¼­ °¡Á·ÀÇ Á¤½Åº´¸®¿Íµµ °ü°è°¡ ÀÖ¾ú´Ù. °¡Á· ±¸¼º¿øµé Áß¿¡ ºÒ¾ÈÀå¾Ö, ¿ì¿ïÁõ µî°ú °°Àº Á¤½ÅÀå¾Ö¸¦ °¡Áø »ç¶÷µéÀÌ ¸¹¾Ò´Ù. µ¥À̺ñµå½¼(Davidson et al, 1985)Àº ºñ·Ï ±âÃÊÀûÀ̱ä ÇÏÁö¸¸ PTSD¿¡ Áß¿äÇÑ °¡Á· ¿¬±¸¸¦ ¼öÇàÀ» Çß´Ù. ±×µéÀº PTSD¸¦ °¡Áø 36¸íÀÇ ÀçÇâ ±ºÀεéÀÇ °¡Á·µé ¾È¿¡¼­ °¡Á· ±¸¼º¿øµéÀÌ Á¤½Å º´¸®¸¦ °¡Áø °æ¿ì¿¡ PTSDÀÇ ¹ßº´ ºñÀ²ÀÌ 48%¿´°í °¡Á· Á¤½Åº´¸®°¡ ¾ø´Â ±×·ìÀÇ PTSDÀÇ ºñÀ²ÀÇ 27%¿Í ºñ±³ µÇ¾ú´Ù. °¡Á·ÀÇ Á¤½Åº´¸®¿¡´Â ÀϹÝÈ­µÈ ºÒ¾ÈÀå¾Ö¸¦ °¡Áö°Å³ª ½ÉÇÑ ¿ì¿ïÁõÀ» °¡Áø »ç¶÷µéÀÌ ¸¹¾Ò´Ù(Barlow, 1988).

 PTSD°¡ °øÆ÷Áõ°ú À¯»çÇÑ Á¡Àº ±× »óó À̺¥Æ®¿Í À¯»çÇÑ È¤Àº ±× »óó À̺¥Æ®¸¦ »ó¡ÇÏ´Â Àڱؿ¡ Á÷¸éÀ» ÇÏ¸é °øȲ Àå¾Ö¿Í À¯»çÇÑ ´À³¦µéÀ» °¡Áö°Ô µÈ´Ù. Áï ½ÉÀåÀÌ ¶Ù°í Çö±âÁõÀ̳ª°í È£ÈíÀÌ »¡¶óÁö°í ¸Æ¹ÚÀÌ ¶Ù°í ¼ûÀÌ ¸·È÷´Â Áõ¼¼µéÀ» °æÇèÇÏ°Ô µÈ´Ù. ±×·¯³ª ´Ù¸¥ Á¡Àº PTSD°¡ Ç÷¹½¬¹é(flashback)¸¦ °¡Áø ´Ù´Â Á¡¿¡¼­ Â÷ÀÌ°¡ ÀÖ´Ù. ¾î¶² À¯»çÇÑ ÀÚ±ØÀ̳ª ±× »óó¸¦ »ó¡ÇÏ´Â Àڱؿ¡ Á÷¸éÇÏ¸é ¸¶Ä¡ ±× »óó°¡ Áö±Ý ÇöÀç¿¡ ÀϾ°í ÀÖ´Â °Í °°Àº »óó¸¦ ¹Ýº¹Çؼ­ °æÇèÀ» ÇÏ°Ô µÈ´Ù´Â °ÍÀÌ´Ù(Barlow, 1988).

 

PTSDÀÇ Áõ¼¼ÀÇ Æ¯Â¡ ¿ä¾à

 ±× °³ÀÎÀº º¸Åë Àΰ£ÀÇ °æÇèÀÇ ¹üÀ§ ¹Û¿¡ ÀÖ´Â ÇÑ °³ÀÇ À̺¥Æ®¸¦ °æÇèÀ» Çß´Ù. ¿¹¸¦ µé¾î¼­ »ç¶÷ÀÇ »ý¸íÀ» ½É°¢ÇÏ°Ô À§Çù, Çطοî, ½ÅüÀû ÅëÇÕ¿¡ À§Çù µîÀ» °æÇèÇß´Ù. ±× ½ÃÁ¡¿¡¼­ ¾î¸°À̵é, ¹è¿ìÀÚ È¤Àº ´Ù¸¥ °¡±î¿î ÀΠģôµé°ú Ä£±¸µéÀÌ °©ÀÛ½º·± Æı«, »ç°í ȤÀº ½ÅüÀû Æø·ÂÀ¸·Î °á°úÇؼ­ »ìÇصǰųª ½É°¢ÇÏ°Ô ºÎ»óÀ» Á÷Á¢ ´çÇϰųª ȤÀº ¸ñ°ÝÀ» Çß´Ù(Barlow, 1988).

 ±× »óó À̺¥Æ®°¡ ħÅõÀûÀÎ ºÒ±¥ÇÑ È¸»óµéÀÇ Àç¹ß(¾î¸°ÀÌÀÇ °æ¿ì¿¡´Â ±× »óóÀÇ Å׸¶ ȤÀº »óóÀûÀÎ ¸éµéÀÌ Ç¥ÇöµÇ´Â ³îÀ̸¦ ¹Ýº¹ÇÑ´Ù)À» °æÇèÇÑ´Ù. ±× À̺¥Æ®ÀÇ ºÒÄèÇÑ ²ÞµéÀÌ ¹Ýº¹ÀûÀ¸·Î Àç µîÀåÇÑ´Ù. ¸¶Ä¡ ±× »óóÀÇ À̺¥Æ®°¡ ´Ù½Ã ÀϾ°í ÀÖ´Â °Íó·³ °©ÀÛ½º·± ÇൿÀ» Çϰųª ȤÀº ´À³¤´Ù. ±× ´À³¦À» Âø°¢Çϰųª, ȯ°¢À¸·Î ±×¸®°í Çظ®ÀûÀÎ °æÇè(Ç÷¹½¬¹é(flashback) ¿¡ÇǼҵå·Î ±ú¾îÀְųª ¼ú¿¡ ÃëÇØ ÀÖÀ» ¶§µµ ÀϾ´Ù. ±× »óó¸¦ °æÇèÇÑ ±× ³¯ÀÌ ´Ù°¡¿À°Ô µÇ¸é ±× »óó À̺¥Æ®¸¦ ´à°Å³ª ȤÀº »ó¡ÇÏ´Â À̺¥Æ®¿¡ ³ëÃâ¿¡¼­ ÁýÁßÀûÀÎ ½É¸®ÀûÀÎ ºÒÄè°¨À» Àç¹ß·Î ´À³¤´Ù(Barlow, 1988).

 ±× °³ÀÎÀº ±× »óó¿Í ¿¬°áµÈ ÀÚ±ØÀ» Áö¼ÓÀûÀ¸·Î ÇÇÇÑ´Ù. ±× »óó¿Í ¿¬°áµÈ »ý°¢µé°ú ´À³¦µéÀ» ÇÇÇÏ·Á°í ³ë·ÂÇÑ´Ù. ±× »óóÀÇ È¸»óÀ¸·Î ºÒ·¯ ÀÏÀ¸Å°´Â »óȲµé°ú È°µ¿À» ÇÇÇÏ·Á°í ³ë·ÂÇÑ´Ù. ±× »óóÀÇ Áß¿äÇÑ ¸éµéÀ» ȸ»óÀ» ÇÒ ¼ö°¡ ¾ø´Ù(Barlow, 1988).

 ÀÇ¹Ì ±íÀº È°µ¿ÀÌ ´«¿¡ ¶ç°Ô Èï¹ÌÀÇ °¨¼Ò°¡ º¸ÀδÙ(¾î¸°ÀÌÀÇ °æ¿ì¿¡´Â ÃÖ±Ù¿¡ ½ÀµæÇÑ ¹ß´Þ ±â¼ú ¿¹¸¦ µé¾î¼­ ´ë¼Òº¯ ÈƷà ȤÀº ¾ð¾î ±â¼úµéÀ» »ó½ÇÇÏ´Â ÅðÇà ÇൿÀ» º¸ÀδÙ. ¾ÖÂø ȸÇÇ ´À³¦ ȤÀº ´Ù¸¥ »ç¶÷µé·ÎºÎÅÍ ¼Ò¿Ü¸¦ ´À³¤´Ù. °¨Á¤ÀÇ ¹üÀ§°¡ Á¦ÇѵȴÙ. ¿¹¸¦ µé¾î¼­ »ç¶ûÇÏ´Â ´À³¦À» °¡Áú ¼ö°¡ ¾ø´Ù. ±Ù½Ã¾ÈÀûÀÎ ¹Ì·¡ÀÇ °¨°¢ ¿¡¸¦ µé¾î¼­ ¾î¸°ÀÌ´Â Æò»ý µ¿¾È Àü¹®Á÷ ȤÀº °áÈ¥ ȤÀº Àڳฦ °¡ÁöÁö ¾ÊÀ» °ÍÀ̶ó°í ±â´ëÇÑ´Ù(Barlow, 1988).

 Áõ°¡µÈ ÈïºÐÀÇ Áö¼ÓÀûÀÎ Áõ¼¼µéÀ» º¸ÀδÙ(±× »óó ÀÌÀü¿¡´Â ¾ø¾ú´Ù) Áï Àáµé±â ¾î·Æ°Å³ª ÀÚÁÖ ±ú¾î³ª¼­ Àáµé±â ¾î·Á¿î ºÒ¸éÁõÀ» º¸ÀδÙ. Â¥Áõ ȤÀº ºÐ³ëÀÇ Æø¹ßÀ» ÀÚÁÖ º¸ÀδÙ. Á¤½Å ÁýÁßÀÌ ¾î·Æ´Ù. °úµµÇÑ ÁÖº¯ÀÇ °æ°è½ÉÀ» º¸ÀδÙ. °úÀåµÈ ³î¶÷ÀÇ ¹ÝÀÀÀ» º¸ÀδÙ(Barlow, 1988).

 ±× »óó À̺¥Æ®¸¦ ´à°Å³ª ȤÀº »ó¡ÇÏ´Â À̺¥Æ®ÀÇ ³ëÃâ¿¡ »ý¸®ÀûÀÎ ¹ÝÀÀÇൿ ¿¹¸¦ µé¾î¼­ ¿¤¸®º£ÀÌÅÍ ¾È¿¡¼­ ¼ºÆøÇà(°­°£)À» ´çÇÑ ¿©¼ºÀº ¾î¶² ¿¤¸®º£ÀÌÅÍ¿¡ µé¾î°¥ ¶§¸¶´Ù ¶¡À» È기´Ù. Àû¾îµµ 1´Þ ÀÌ»ó À§ÀÇ ÀÌ·¯ÇÑ È¥¶õÀÌ Áö¼ÓµÈ´Ù. ±×·¯ÇÑ Áõ¼¼µéÀÇ ½ÃÀÛÀÌ ±× »óó °æÇè ÀÌÈÄ¿¡ 6°³¿ù ÀÌÈÄ¿¡ ½ÃÀ۵Ǵ °æ¿ìµµ ÀÖ´Ù(Barlow, 1988).

 

Á»´õ ¼¼ºÎÀûÀÎ ¿Ü»ó ÈÄ ½ºÆ®·¹½º Àå¾ÖÀÇ ¿ª»ç¸¦ ¾Ë°í ½ÍÀº »ç¶÷Àº ´ÙÀ½ÀÇ È¨ÆäÀÌÁö¿¡ µé¾î°¡ º¸¼¼¿ä

  

¾Æ·¡ÀÇ ¼­ÀûµéÀº º¸µå¶óÀΰú ¿Ü»ó ÈÄ ½ºÆ®·¹½º Àå¾Ö ±×¸®°í Çظ® Àå¾Ö, Á¤½ÅºÐ¿­Áõ µîÀÇ Á¤½ÅÀå¾Ö Ä¡·á¸¦ À§Çؼ­ Âü°í·Î »ç¿ëÇÑ ¼­ÀûµéÀÔ´Ï´Ù. ÀÌ ºÐ¾ß¸¦ °øºÎ¸¦ ÇÏ°í ½Í¾î½Å ºÐµéÀº Âü°í·Î ÇϽðí ÀÌ Ã¥µéÀº ÇÊÀÚ°¡ °øºÎ¸¦ Çϸ鼭 ÀϺδ ¹ø¿ªµÇ¾î ÀÖ°í ³ª¸ÓÁö ÀϺδ ºÎºÐÀûÀ¸·Î Áß¿äÇÑ ºÎºÐÀ» ¹ßÃéÇؼ­ ¹ø¿ªµÇ¾îÀÖ½À´Ï´Ù. Àü¹®ÀûÀ¸·Î °øºÎ¸¦ ÇÏ°íÀÚ ÇÏ´Â »ç¶÷µéÀº ÀÌ Ã¥µéÀ» ±¸ÀÔÇÏ½Ç ¼ö ÀÖ½À´Ï´Ù. ´õ »ó¼¼ÇÑ °ÍÀ» ¾Ë°í ½ÍÀ¸½Å ºÐÀº ´ÙÀ½ÀÇ Àü¹® ¼­Àû ¾È³»ÀÇ È¨ ÆäÀÌÁö¿¡ µé¾î°¡ º¸¼¼¿ä.

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