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Original Articles
Relationship between Childhood Trauma and Depression in Youths in the Transition to Independent Living: The Mediating Effect of Disconnection-Rejection Schemas Moderated by Out-of-Home Care Types
Shin Young Park, Myoung-Ho Hyun, Min Jin Jin
STRESS. 2024;32(1):9-18.   Published online March 28, 2024
DOI: https://doi.org/10.17547/kjsr.2024.32.1.9
  • 1,160 View
  • 9 Download
Abstract PDF
Background
This study explored the relationship between childhood trauma, disconnection-rejection schemas, and depression among youths in the transition to independent living. Additionally, this study examined whether the impact of childhood trauma on depression, mediated by disconnection-rejection schemas, was moderated by the type of out-of-home care (residential care centers, group homes, and foster homes).
Methods
A survey questionnaire measuring childhood trauma, disconnection-rejection schemas, and depression was administered to 201 participants.
Results
Mistrust-abuse and defectiveness-shame schemas mediated the relationship between childhood trauma and depression. In all types of out-of-home care, both the mistrust-abuse and defectiveness-shame schemas mediated the relationship between childhood trauma and depression. There were no significant differences in mediating effects based on the type of out-of-home care.
Conclusions
The findings of this study can be applied to the treatment of depression during the transition to independent living in individuals who have experienced childhood trauma.
Association between Suicidal Ideation and Blood Cadmium Levels Based on the 3rd to 7th Korea National Health and Nutrition Examination Surveys
Sunmi Kim
STRESS. 2024;32(1):46-52.   Published online March 28, 2024
DOI: https://doi.org/10.17547/kjsr.2024.32.1.46
  • 171 View
  • 3 Download
Abstract PDF
Background
This study aimed to determine the association between blood cadmium levels and suicidal ideation.
Methods
Using data from the 3rd to 7th Korea National Health and Nutrition Examination Surveys, the geometric mean of blood cadmium levels according to suicidal ideation was compared using multiple linear regression analyses in male and female adults. The frequency of suicidal ideation according to the blood cadmium levels was also compared using multiple logistic regression models.
Results
In total, 6,877 men and 6,698 women were included in the study. When adjusting for all potential confounding factors, the geometric mean of blood cadmium levels was significantly higher in participants with suicidal ideation than in those without suicidal ideation in both men (0.92 ng/ml [95% confidence interval 0.87∼0.97 ng/ml] vs. 0.86 ng/ml [0.84∼0.88 ng/ml]; p=.026) and women (1.05 ng/ml [95% confidence interval 1.01∼1.10 ng/ml] vs. 0.99 ng/ml [0.98∼1.02 ng/ml]; p=.006). After adjusting for potential confounders, the frequency of suicidal ideation significantly increased as blood cadmium levels increased in men (p for trend=.014) and women (p for trend=.034).
Conclusions
Results revealed an association between blood cadmium levels and suicidal ideation in Korean adults.
Effect of Cognitive Processing Style on Attentional Blink during Analogue Trauma
Ye Ji Son, Yun-Kyeung Choi
STRESS. 2024;32(1):38-45.   Published online March 28, 2024
DOI: https://doi.org/10.17547/kjsr.2024.32.1.38
  • 256 View
  • 5 Download
Abstract PDF
Background
This study attempted to examine the impact of each cognitive processing style (bottom-up, top-down) on attention patterns following a traumatic experience by measuring attentional blink (AB).
Methods
Participants were 37 university students with no direct experience of traffic accidents. They were randomly assigned to either a single-task (bottom-up processing) group or a dual-task (top-down processing) group, who performed the Rapid Serial Visual Presentation (RSVP) after watching an analogue trauma video. The correct response rate to target stimuli was then compared between groups based on stimulus type and stimulus presentation interval.
Results
In the dual-task group, no significant differences were found. However, in the single-task group, a trend towards a decrease in the correct response rate to the target stimulus was observed 200 ms after the presentation of the traumatic stimulus (i.e., AB).
Conclusions
This tendency can be explained by the phenomenon of automatic attentional capture by traumatic stimuli, suggesting a relationship between bottom-up processing and attentional bias.
The Relationship between Level of Therapist Support and Efficacy and Adherence in Internet-Based Cognitive Behavioral Therapy for Disordered Eating Behaviors
Seyeom Kim, Eun-Jung Shim
STRESS. 2024;32(1):29-37.   Published online March 28, 2024
DOI: https://doi.org/10.17547/kjsr.2024.32.1.29
  • 272 View
  • 4 Download
Abstract PDF
Background
Therapist support is an important intervention design factor in internet-delivered psychotherapy. However, the relationship between therapist support and intervention outcomes is not well established. This study examined the relationship between therapist support, efficacy, and adherence to Internet-based Cognitive Behavioral Therapy (I-CBT) for disordered eating behaviors.
Methods
Thirty-six women with disordered eating behaviors were recruited and randomly assigned to three groups: low, medium, and high levels of therapist support. The participants received eight sessions of I-CBT, twice a week, with varying levels of therapist support.
Results
While all three groups showed a reduction in eating disorder risk factors (i.e., body image disturbance, disordered eating behaviors, depression, and anxiety), there were no significant differences in these improvements by therapist support level. However, there were significant differences in intervention completion rates by therapist support level, with higher levels of support associated with increased intervention completion rates.
Conclusions
Therapist support can potentially improve adherence to internet-based interventions.
Relationship between Mindfulness and Stress Response in High School Students: Mediating Effect of Self-Regulation Ability
Yoonjung Choi, Mihee Lee, Jeongik Choi
STRESS. 2024;32(1):19-28.   Published online March 28, 2024
DOI: https://doi.org/10.17547/kjsr.2024.32.1.19
  • 355 View
  • 21 Download
Abstract PDF
Background
This study explored the applicability of mindfulness meditation as an intervention approach in school counseling for managing daily stress in high school students. The study investigated the mediating effect of self-regulation ability on the relationship between mindfulness and stress response.
Methods
Data from 244 high school students (119 men and 125 women) were used to examine the mediating effect, controlling for academic variables using Hayes’ (2013) Process Macro Model 4.
Results
There was a positive correlation between mindfulness and self-regulation abilities, and mindfulness and self-regulation abilities were negatively correlated with stress response. Moreover, for students who perceived higher academic achievement levels, self-regulation abilities were positively correlated, and stress response were negatively correlated. Results showed a full mediating effect of self-regulation ability on the adverse relationship between mindfulness and stress response. The mediating effects of self-regulation modes were differentially observed in the adverse relationship between mindful consciousness and attitude dimensions of stress response.
Conclusions
These findings suggest that when applying mindfulness meditation as a daily stress management strategy for high school students, enhancing their self-regulation ability should be the focus of intervention.
Effect of Daily Stress on School Adjustment among Children at Community Child Centers: Mediating Roles of Inattention and Social Withdrawal
RaeHyuck Lee
STRESS. 2024;32(1):1-8.   Published online March 28, 2024
DOI: https://doi.org/10.17547/kjsr.2024.32.1.1
  • 272 View
  • 9 Download
Abstract PDF
Background
This study verifies the influence of daily stress on school adjustment through inattention and social withdrawal among children at community child centers.
Methods
Analyses were performed on data collected from the Child Panel Survey of the Community Child Centers, followed by a series of regression analyses.
Results
First, daily stress had a negative and significant influence on school adjustment. Second, both inattention and social withdrawal among children mediated the influence of daily stress on school adjustment. Finally, the influence of daily stress on school adjustment was serially dual-mediated through inattention and social withdrawal.
Conclusions
This study presents evidence-based strategies that could help the school adjustment of children at community child centers.
Efficacy of a Serious Game for Individuals with Interpersonal Trauma
Hyae Young Yoon, Sang-Hyun Cho, Yun-Kyeung Choi
STRESS. 2023;31(4):205-219.   Published online December 28, 2023
DOI: https://doi.org/10.17547/kjsr.2023.31.4.205
  • 640 View
  • 14 Download
Abstract PDF
Background
This study aimed to develop a serious game for college students with interpersonal trauma to practice adopting an alternative perspective mentoring a game character with similar experiences.
Methods
We recruited 44 college students with high levels of distress after experiencing interpersonal trauma. They were assigned to either the serious game+relaxation training (SG+RX, n=22) or the virtual reality+relaxation training condition (VR+RX, n=22). Cognitive, emotional, and self-efficacy aspects related to trauma were compared in both groups before and after treatment. In addition, interpersonal perceptions of "warmth, dominance, trust, and accessibility" for facial expressions of happiness, anger, and neutrality were compared in both groups before and after treatment.
Results
Both groups showed positive changes in relaxation, post-traumatic cognition, and post-traumatic emotion after treatment. The SG+RX group showed greater increases in behavioral competence and confidence in the future and rated accessibility to angry/happy facial expressions higher than the VR+RX group.
Conclusions
These findings suggest that an interactive serious game promoting empathy, coping skills, and an alternative perspective effects positive changes for individuals with interpersonal trauma.
The Moderating Role of Perceived Social Support in the Relation between Type D Personality and PTSD Symptoms among ICU and ER Nurses
Sohyeon Kim, Myung-Ho Hyun
STRESS. 2023;31(4):197-204.   Published online December 28, 2023
DOI: https://doi.org/10.17547/kjsr.2023.31.4.197
  • 629 View
  • 11 Download
Abstract PDF
Background
This study examined the moderating effects of four types of perceived social support on the relation between type D personality and post-traumatic stress disorder (PTSD) symptoms among ICU and ER nurses.
Methods
Data were collected from 223 ICU and ER nurses in university or general hospitals located in Seoul. A questionnaire survey method was used for data collection and SPSS Windows 28.0 and PROCESS Macro Program were used for data analysis.
Results
The results showed that only the moderating effect of senior support was statistically significant, while perceived support from family, friends, and coworkers were not. Specifically, the effect of type D personality on post-traumatic stress disorder (PTSD) symptoms was weaker in ICU and ER nurses who perceived higher social support from senior nurses.
Conclusions
The study highlighted the significance of senior support in protecting the psychological health of ICU and ER nurses. Additionally, it addressed the major considerations in developing practical interventions in hospital settings.
Developing Smoking Cessation Program for Female Smokers and Assessment of Its Impacts
Kyung Hyun Suh
STRESS. 2023;31(4):189-196.   Published online December 28, 2023
DOI: https://doi.org/10.17547/kjsr.2023.31.4.189
  • 580 View
  • 14 Download
Abstract PDF
Background
Female smokers find it challenging to quit smoking. The number of female smokers in Korea has not seen any decline. This study developed a smoking cessation program tailored for female smokers and evaluated its effectiveness.
Methods
The treatment group, which was subjected to the smoking cessation program, was composed of seven adult female smokers and five female college students who smoked. The control group comprised 7 adult female smokers and 5 female college students who wanted to quit smoking.
Results
Of the 12 participants in the control group, only 1 (8.3%) reported that she had maintained abstinence for 4 months and 1 week, while 5 (41.7%; 3 adults and 2 students) out of the 12 in the treatment group managed to abstain. For female smokers in this group, the motivation and empowerment to quit smoking increased significantly after participating in the program, and these positive effects were sustained for up to 3 months after the completion of the program.
Conclusions
Female smokers who participated in the program that was developed as part of this study exhibited a significant abstinence rate, and their motivation and empowerment to quit smoking improved. These results indicate that this smoking cessation program can be clinically useful in helping female smokers quit smoking.
Preliminary Validation of the Korean Version of the Alexian Brothers Urge to Self-Injure Scale (ABUSI-K)
Min-kyeong Kim, Myoung-Ho Hyun, Seo Jeong Lee
STRESS. 2023;31(4):182-188.   Published online December 28, 2023
DOI: https://doi.org/10.17547/kjsr.2023.31.4.182
  • 649 View
  • 34 Download
Abstract PDF
Background
This study aimed to validate the Korean version of the Alexian-Brothers Urge to Self-injure Scale (ABUSI) for measuring non-suicidal self-injury urges.
Methods
Analysis was conducted on a sample of 389 adult men and women who had inflicted self-harm without suicidal intent within three years. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) was conducted to confirm the single factor of the scale, and convergent validity was assessed to establish the relationship between ABUSI-K and Negative Urgency (UPPS-P), Self-Criticism/Attacking and Reassurance (FSCRS), and Self-Injurious Thoughts and Behaviors Interview (SITBI).
Results
The Korean version of the Alexian-Brothers Urge to Self-Injure Scale (ABUSI-K) showed high internal consistency and, like the original scale, was confirmed to be a single-factor scale measuring the urge to self-injure. Convergent validity with negative urgency, self-criticism/self-attacking and self-reassuring, the NSSI module of self-injurious thoughts and behaviors, and depression and anxiety were also significant, indicating that ABUSI-K’s psychometric benefits are confirmed.
Conclusions
The results of this study will provide a multifaceted understanding of self-injury without suicidal intent and the urges that occur before self-injury. They are expected to be useful in clinical interventions for individuals who have engaged in non-suicidal self-injuries.
The Mediating Role of Sleep Problems in the Relationship between Economic Hardship and Quality of Life: A Short-Term Longitudinal Study
Hansol Moon, Eun-Jung Shim
STRESS. 2023;31(4):175-181.   Published online December 28, 2023
DOI: https://doi.org/10.17547/kjsr.2023.31.4.175
  • 515 View
  • 19 Download
Abstract PDF
Background
We examined the mediating effect of sleep problems on the relationship between economic hardship (i.e., economic stress and subjective socioeconomic status) and quality of life (QOL).
Methods
We analyzed data from 232 students who completed all three self-report surveys over the course of the semester, employing a simple mediation model examined by the SPSS PROCESS Macro.
Results
The findings revealed that higher levels of economic stress at Time 1 (T1) were associated with higher levels of sleep problems at T2 which, in turn, were associated with a poorer QOL at T3. In contrast, subjective socioeconomic status at T1 was not associated with sleep problems at either T2 or QOL at T3.
Conclusions
The current results suggest that improving sleep problems may be effective in mitigating the negative impact of economic stress on QOL among university students.
The Effects of Risk-Taking Trait and Thwarted Interpersonal Need on Suicidality of Illicit Drugs Abusers: Focusing on Acquired Capability for Suicide
Ki-Yeon Nam, Young-Sil Kwon
STRESS. 2023;31(4):168-174.   Published online December 28, 2023
DOI: https://doi.org/10.17547/kjsr.2023.31.4.168
  • 568 View
  • 24 Download
Abstract PDF
Background
This study aimed to examine the effects of trait and situational factors on suicidality among illicit drugs abusers.
Methods
Data were collected from 185 illicit drugs abusers in Korea who completed a survey to measure the risk-taking trait, impulsive behavior, acquired capability for suicide, thwarted interpersonal need, and suicidality. Multiple regression and hierarchical regression analyses were conducted for data analysis.
Results
The risk-taking trait affected the acquired capability for suicide by partially mediating the impulsive behavior. Additionally, the interaction effect between thwarted interpersonal need and acquired capability for suicide on suicidality was identified.
Conclusions
The higher risk-taking trait of illicit drugs abusers induced higher acquired capability for suicide, which actuates the suicidal desire. Additionally, the repeated exposure of impulsive behavior mediated the path. Furthermore, acquired capability for suicide moderated the relationship between thwarted interpersonal need and suicidality. This study examined the effects of trait and situational factors on suicidality of illicit drugs abusers.
An Integrative Review of Psychosocial Intervention Programs for Infertile Females
Youjin Shin, Soo-Hyun Nam
STRESS. 2023;31(4):158-167.   Published online December 28, 2023
DOI: https://doi.org/10.17547/kjsr.2023.31.4.158
  • 564 View
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Abstract PDF
Background
This study aims to analyze intervention studies conducted on infertile females in South Korea and research and research the core elements comprising these studies.
Methods
The integrative review was conducted based on the guidelines of Whittmore and Knafl, and included the following steps: problem identification, literature search, data evaluation, data analysis, and presentation. Next, six domestic databases were searched using keywords such as ‘infertility’, ‘intervention’, and ‘education’ in Korean and English, and published studies were reviewed according to specific criteria and quality assessment.
Results
Among 4,109 searched papers, 6 were selected for the final data analysis. A total of six interventions were conducted in the selected articles, and each strategy was variously categorized into cognitive, emotional, behavioral, relational, and physical aspects. All interventions were found to be effective in promoting psychosocial health in infertile females.
Conclusions
Despite the fact that female infertility is a major public health problem in Korea, the low number of articles reveals a relative lack of psychosocial intervention studies. Therefore, it is suggested that future studies incorporate physiological endpoints into psychosocial studies, and we hope that this study will serve as a basis for developing programs for infertile females in the future.
Review Article
Non-Contact Nursing Education in Communication and Group Counseling: Current Status and Future Directions
Kuem Sun Han, Soo Yeon Lee, Ji Hye Shin
STRESS. 2023;31(4):149-157.   Published online December 28, 2023
DOI: https://doi.org/10.17547/kjsr.2023.31.4.149
  • 662 View
  • 38 Download
Abstract PDF
Background
In nursing, the utilization of diverse therapeutic communication and counseling techniques is crucial for effective nursing care. This study critically evaluated the present state of therapeutic communication and counseling education for nurses so as to explore the applications of non-face-to-face educational methods and to propose potential future directions for nursing education.
Methods
This study targeted academic research published in either English or Korean between 2019 to August 2023 on the topics of communication and counseling education in nursing education.
Results
There were eight studies of non-contact education in communication or counseling published between 2019 and 2023. The review identified various educational interventions currently in use, such as online-based, blended learning, simulation, and role-play education.
Conclusions
Among the various non-contact educational approaches, education based in the Metaverse shows promise due to its ability to offer real-time supervision and a wide range of virtual scenarios. Therefore, we suggest the incorporation of the Metaverse in group counseling education to enrich the learning experience.
Original Article
Validating a Short Version of the Intolerance of Uncertainty Scale-12 (IUS-12)
Somin Lee, Myoung-Ho Hyun, Jaeeun Shin
STRESS. 2023;31(3):97-105.   Published online September 30, 2023
DOI: https://doi.org/10.17547/kjsr.2023.31.3.97
  • 670 View
  • 64 Download
Abstract PDF
Background
This study aims to validate the short version of the Intolerance of Uncertainty Scale-12 (IUS-12).
Methods
A comprehensive set of questionnaires, including the IUS-12, STAI-T, PSWQ, CES-D, and K-CSI, was administered and completed by 404 participants. The average age of the participants was 31.29 years (SD=9.18), comprising 114 men, 287 women, and 3 individuals identifying with the other gender. We conducted a factor analysis on the collected data and compared the fit indices of one-factor, two-factor, and bifactor models. Furthermore, a multiple-group confirmatory factor analysis evaluated measurement invariance between the men’s and women’s groups. Correlational analyses were also conducted.
Results
Data from the study show that the bifactor model was the most appropriate, demonstrating good internal consistency. The Omega coefficients and explained common variance were computed to evaluate the dimensionality of the IUS-12, validating the use of the total score of the scale. Its factor model also showed that the measurement invariance sustained between two gender groups. The correlation analyses between the IUS-12 and other scales assessing attributes such as trait anxiety, worry, depression, and avoidance coping strategy supported convergent validity.
Conclusions
These findings suggest that the IUS-12 is a reliable and valid measure for assessing the intolerance of uncertainty. The study also discusses its limitations and offers recommendations for future research endeavors.

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