STRESS

Most-download articles are from the articles published in 2023 during the last three month.

Original Articles

Test Linking of Suicide Risk Assessment Instruments: Comparing Cut-Off Scores for Suicide Risk: Hwajeong Yu, Yuhwa Han, Sungeun You; STRESS. 2023;31(1):25-36. Published online March 31, 2023; DOI: https://doi.org/10.17547/kjsr.2023.31.1.25

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Abstract PDF: Background
Communicating the objective meaning of the cut-off criteria for high-risk among suicide risk assessment tools is challenging because they measure different aspects of suicide risk. This study aimed to provide comparable scores among widely used suicide assessment instruments by using test linking.
Methods
Linking was performed using the equipercentile method with the data of 400 adults. Then, for an independent sample of 165 adults, the validity of linking was tested by providing an overall percent agreement of group classification.
Results
Linking results indicated that the score of 4 on the C-SSRS corresponded to 8 on the DSI-SS and 16 on the SBQ-R, respectively. The overall percent agreement of group classification based on the cutoff score of 4 on the C-SSRS was high in both scales, supporting the validity of linking.
Conclusions
The study results provide comparable criteria for the high-risk group among the three measures. Mental health practitioners could utilize our results in identifying people at high suicide risk.

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

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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.

Validation of the Korean Adaptation of the State-Trait Anger Expression Inventory-2 (K-STAXI-2): Kyum Koo Chon, Kyung Hyun Suh, Joonsuk YI, Sungwon Roh, Yongmi Lee, Sojung Kim, Euiyeon Kim, Ju Yul Lee, Aron Choi; STRESS. 2023;31(3):133-141. Published online September 30, 2023; DOI: https://doi.org/10.17547/kjsr.2023.31.3.133

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Abstract PDF

Background
This study aimed to validate the Korean adaptation of the State-Trait Anger Expression Inventory-2 (K-STAXI-2).
Methods
The study included a sample of 307 normal adults and 81 comparable adult patients. The data were analyzed using factor analyses, internal consistency measures, assessments of convergent and discriminant validity, t-tests between groups, and test-retest reliability.
Results
(1) Exploratory factor analyses revealed clear-cut factors for anger experience (state anger and trait anger) and anger expression (anger expression-in, anger expression-out, anger control-in, and anger control-out); (2) correlation analyses between K-STAXI-2 and the Emotional Stress Inventory demonstrated convergent and discriminant validity; (3) t-test between the patient group and the normal adults group provided additional construct validity; (4) internal consistencies of the six subscales showed a satisfactory level of reliability (α=.81 to α=.94); and (5) test-retest reliability over four weeks showed a satisfactory level of reliability.
Conclusions
The results further support the reliability and validity of the K-STAXI-2, suggesting its usefulness in various fields such as medicine, nursing, psychology, addiction, organization, education, and criminal justice.

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A Multinational Comparison Study of the Patient‐Reported Outcomes Measurement Information System Anxiety, Depression, and Anger Item Bank in the General Population
Jiseon Lee, Yeonjung Lim, Dong Gi Seo, Minji K. Lee, Benjamin D. Schalet, Felix Fischer, Matthias Rose, Danbee Kang, Juhee Cho
International Journal of Methods in Psychiatric Research.2025;[Epub] CrossRef

Double Mediation Effect of Social Interaction Anxiety and Experiential Avoidance between Internalized Shame and Social Media Addiction Tendency: Kiyeon Nam, Myoung-Ho Hyun, Young-Sil Kwon; STRESS. 2025;33(1):45-52. Published online March 28, 2025; DOI: https://doi.org/10.17547/kjsr.2025.33.1.45

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Abstract PDF: Background
This study examined the pathway by which internalized shame influences the tendency toward social media addiction through the mediating roles of social interaction anxiety and experiential avoidance.
Methods
Data were collected from 174 Korean adults who completed surveys measuring internalized shame, social interaction anxiety, experiential avoidance, and social media addiction. Linear regression and Process Macro were used for data analysis.
Results
Internalized shame affected social media addiction by mediating experiential avoidance, and the mediation effect of social interaction anxiety was not significant. However, the double mediating effect of social interaction anxiety and experiential avoidance on the relationship between internalized shame and social media addiction was significant.
Conclusions
People who chronically experience negative perceptions and shame about themselves seek stability through others; however, they experience anxiety in face-to-face interactions and use social media to control and avoid these anxieties. To effectively reduce the tendency toward social media addiction, intervention is required to avoid social interaction anxiety, rather than attempting to change maladaptive identity.

Does Stress Affect Adolescent Anxiety by Mediating Sleep Time?: Si On Jang; STRESS. 2024;32(3):142-152. Published online September 30, 2024; DOI: https://doi.org/10.17547/kjsr.2024.32.3.142

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Abstract PDF

Background
Health is essential for the sustainable well-being, yet high stress, anxiety, and lack of sleep among Korean adolescents have become significant social concerns.
Methods
This study examined the impact of stress on anxiety and investigated whether sleep time mediates this relationship in 46,870 male and female adolescents, ranging from first-year of middle school students to third-year high school students. Data were obtained from the "18th Korea Youth Risk Behavior Survey" conducted by the Korea Disease Control and Prevention Agency.
Results
The analysis showed that increased stress was associated with reduced sleep time and higher anxiety levels, stress was found to heighten anxiety, partly by reducing sleep time.
Conclusions
Based on these findings, the study recommends: ① developing mental health indicators to quickly identify adolescents at risk for mental health issues, ② encouraging cooperation between schools, government agencies, healthcare providers to enhance access to mental health programs for adolescents, and ③ implementing policies that promote healthy behaviors, ensure adequate sleep, and improve overall well-being.

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Comparative effects of music therapy and aromatherapy on stress, quality of life, and happiness among shift nurses in Korea: a randomized controlled trial
So-heun Lee, Won-jong Kim, Eun-Hi Choi, Myung-Haeng Hur
Journal of Korean Biological Nursing Science.2024; 26(4): 337. CrossRef

The Effect of Perceived Stress on Drinking Problem of Korean College Students: From the Perspective of Escape Theory: Dawon Yoon, Youngho Lee; STRESS. 2023;31(1):1-10. Published online March 31, 2023; DOI: https://doi.org/10.17547/kjsr.2023.31.1.1

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Abstract PDF

Background
This study examined how the perceived stress of college students leads to drinking problems based on the Escape Theory.
Methods
A total of 485 college students were surveyed. A moderated mediation analysis was used to test the hypotheses.
Results
Since no significant correlation was found between perceived stress and drinking problem, the dependent variable was replaced with problematic drinking, a sub-factor of drinking problem. Escape from self fully mediated the relationship between perceived stress and problematic drinking. The interaction of perceived stress and dysfunctional self-focus was correlated with escape from self. Coping motives to drinking strengthened the pathways from escape from self to problematic drinking.
Conclusions
This study shows the need for therapeutic interventions to curb college students’ drinking problems. This study’s significance and limitations are also discussed.

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The Relationship between Perceived Stress, Subjective Health Status, and Symptoms of Dry Eye and Dry Mouth among Optometry Students at a University
Se-Jin Kim, Min-Hee Hong
The Korean Journal of Vision Science.2024; 26(3): 195. CrossRef

Review Article

An Integrative Review of Psychosocial Intervention Programs for Children and Adolescents who Experienced Traumatic Events: Eun-Mi Seol, Soo-Hyun Nam; STRESS. 2024;32(3):121-132. Published online September 30, 2024; DOI: https://doi.org/10.17547/kjsr.2024.32.3.121

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Abstract PDF: Background
This integrative review study aims to analyze the core components, intervention strategies, and effects of psychosocial intervention programs conducted for children and adolescents in Korea who have experienced traumatic events.
Methods
The integrative review involved a search of major domestic databases using key terms such as 'children’, 'adolescents’, 'trauma’, 'post-traumatic stress’, 'intervention’, and 'education’. A total of 10 studies were selected for analysis based on predefined criteria.
Results
The 10 selected studies were categorized into three types of interventions based on the environment and structure of the intervention delivery: individual-based interventions targeting only children and adolescents, family-based interventions involving family members, and school-based interventions conducted within schools. These interventions were found to be effective in addressing mental health issues caused by trauma in children and adolescents.
Conclusions
Despite the serious nature of traumatic experiences among children and adolescents, this integrative review found that domestic research on psychosocial interventions for this population lacks rigorous study design and is limited in the selection of participants and trauma events. Therefore, the study suggests the need for the development and dissemination of more proactive psychosocial interventions for children and adolescents. The findings of this study are expected to serve as foundational data for the development of trauma managing programs for this population.

Original Articles

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

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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.

Moderated Mediating Effect of Anxiety by Household Type on the Relationship between Daily Life Stress and Non-Suicidal Self-Injury among Adolescents: RaeHyuck Lee; STRESS. 2024;32(4):188-195. Published online December 27, 2024; DOI: https://doi.org/10.17547/kjsr.2024.32.4.188

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Abstract PDF

Background
This study examined the impact of adolescents’ daily life stress on non-suicidal self-injury among adolescents, focusing on the mediating role of anxiety and the moderated mediating effect of anxiety by household type (two-parent vs. single-parent households).
Methods
This study utilized data from the Korean Teenagers’ Mental Health Study, conducted by the National Youth Policy Institute and applied the PROCESS macro method for analysis.
Results
First, daily life stress significantly increased the likelihood of non-suicidal self-injury among adolescents. Second, anxiety played a full mediating role. Third, no significant difference was observed in the direct impact of daily life stress on non-suicidal self-injury between adolescents from two-parent and single-parent households. Fourth, the mediating effect of anxiety on the relationship between daily life stress and non-suicidal self-injury was more pronounced among adolescents in single-parent households than those in two-parent households.
Conclusions
The findings highlight the need for tailored interventions to deal with non-suicidal self-injuries among adolescents, particularly in the context of household type.

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The Influence of Attention-Deficit/Hyperactivity on School Adjustment among Adolescents: Focusing on the Moderated Mediation Effect of Depression by Household Economic Status
RaeHyuck Lee
STRESS.2025; 33(1): 13. CrossRef

Review Article

Psychological Interventions for Chronic Pain: An Umbrella Review of Systematic Reviews and Meta-Analyses of Randomized Controlled Trials: Eun-Mi Koh; STRESS. 2024;32(3):111-120. Published online September 30, 2024; DOI: https://doi.org/10.17547/kjsr.2024.32.3.111

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Abstract PDF: Background
There is a continuous increase in the number of studies showing that psychological interventions help reduce chronic pain. Systematic review studies that analyze the effect are also increasing. The aim of this umbrella review was to synthesise the best available research evidence for the effectiveness of standardised psychological interventon for adults with chronic pain.
Methods
Using MEDLINE (PubMed) and Cochrane CENTRAL search engines, four systematic reviews met the study criteria, including 60 randomized control trials and 7,025 patients with chronic pain.
Results
Compared to waiting control and treatment as usual, psychological interventions displayed medium effect sizes for pain intensity (SMD −0.35, CI −0.42 to −0.29, 4 reviews, N=4,061), pain disability (SMD −0.44, CI −0.51 to −0.36, 3 reviews, N=2,609), and physical functioning (SMD 0.38, CI 0.29 to 0.48, 2 reviews, N=1,699). Additionally, psychological interventions exhibited a medium effect size in reducing pain intensity (SMD −0.34, CI −0.42 to −0.26, 2 reviews, N=2,508) and pain disability (SMD −0.43, CI −0.51 to −0.35, 2 reviews, N=2,563) in chronic low back pain.
Conclusions
The results reaffirm that psychological interventions, along with drug or conventional treatments, can be helpful in managing chronic pain.

Original Articles

Academic Mental Health and Stress Mindset among High School Students: Job Demands-Resources Model: Ji-Eon Kim, Hyo-Shim Cho, Tae-Hyung Kwon, Eun-Young Kim, Ochir Erdenezaya Tsogt, Soohyun Cho; STRESS. 2024;32(2):66-73. Published online June 28, 2024; DOI: https://doi.org/10.17547/kjsr.2024.32.2.66

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Abstract PDF: Background
This study aimed to identify stress mindset as an intervention factor for academic stress management within the framework of the Job Demands-Resources Model. We investigated the role of a stress mindset in the relationship between academic demands, resources, burnout, engagement as academic mental health.
Methods
From the perspective of academic interpersonal perceptions, 391 first- and second-year high school students were analyzed using a structural equation model consisting of observed variables with demands and resources from parents, teachers, and peers.
Results
The low-stress mindset group showed a significant pathway from academic demands to academic burnout. The high-stress mindset group demonstrated pathways from academic resources to academic burnout and engagement.
Conclusions
These findings highlight the significance of a stress mindset in enhancing the academic mental health of high school students.

Validation of the Sexual Self-Determination Competency Assessment Scale: Yu-jeong Son, Hyeon-gi Hong, Ki-pyoung Kim, Hyung-ki Ji, Hye-hyun Cho, Chae-bin Lee, Myoung-Ho Hyun; STRESS. 2025;33(1):33-44. Published online March 28, 2025; DOI: https://doi.org/10.17547/kjsr.2025.33.1.33

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Abstract PDF: Background
This study aims to refine and validate the Sexual Self-Determination Competency Assessment Scale (2020) to enhance its effectiveness.
Methods
The scale comprises self-reported and scenario-based sections. We revised item phrasing; expanded content to better address sexual crimes involving children, adolescents, and individuals with intellectual disabilities; and adjusted the scoring method for better comprehension by individuals with intellectual disabilities. The revised scale was administered to 500 middle and high school students aged 14∼18 to assess reliability and validity. Additionally, we replaced Likert-scale items with open-ended questions to minimize response bias in the scenario-based section. Interviews were conducted with 17 adolescents and individuals with intellectual limitations.
Results
The self-report section demonstrated content validity through an expert review of item appropriateness. Construct and criterion validities were confirmed through statistical analyses. The internal consistency was also high. In the scenario-based section, four open-ended questions were finalized based on interview data, and five scoring criteria were developed to evaluate responses.
Conclusions
This study improved the format and content of the existing scale, thereby enhancing its applicability in investigative and practical contexts. Notably, modifying scenario-based items to an open-ended format enables a qualitative assessment of perception, judgment, and coping abilities in sexual offense scenarios, representing a significant contribution to the field.

The Effects of Internalized Shame and Social Exclusion on Approach-Avoidance Behavior: Jae-Yun Sim, Myoung-Ho Hyun; STRESS. 2024;32(4):171-177. Published online December 27, 2024; DOI: https://doi.org/10.17547/kjsr.2024.32.4.171

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Abstract PDF: Background
This study examined the effects of internalized shame and social exclusion on approach-avoidance behavior.
Methods
A survey was conducted offline and online with 618 adult participants to assess their level of internalized shame. Among them, 59 were selected and assigned to either the high- or low-internalized shame group. These participants were then randomly assigned to either the social exclusion or inclusion condition. After experimental manipulation, explicit and implicit approach-avoidance behaviors were measured.
Results
In terms of explicit behavioral choices, the high-internalized shame group exhibited approach behavior in the social inclusion condition and avoidance behavior in the exclusion condition. In terms of explicit behavioral preferences, the high-internalized shame group and social exclusion condition exhibited avoidance responses. In terms of implicit behavior, the low-internalized shame group exhibited approach responses in the social exclusion condition, whereas the high-internalized shame group exhibited avoidance responses.
Conclusions
This study investigated the impact of internalized shame and social exclusion on social functioning and confirmed that individuals with high levels of internalized shame are more vulnerable to social exclusion. Finally, the implications, significance, and limitations of this study are discussed.

Efficacy of Ecological Momentary Intervention Tailored to Drinking Motives for Reducing Problematic Drinking in Young Adults: Hee-Eun Kim, Eun-Jung Shim; STRESS. 2024;32(3):161-169. Published online September 30, 2024; DOI: https://doi.org/10.17547/kjsr.2024.32.3.161

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Abstract PDF: Background
Brief interventions can inform young problematic drinkers about the risks associated with alcohol use. Ecological Momentary Interventions (EMIs), which provide feedback closer to the point of drinking, may help to translate the internal changes made from these brief interventions into actual behavior.
Methods
Thirty-six problematic drinkers aged 19∼34 years were randomly assigned to one of three groups: Ecological Momentary Assessment (EMA), Standard EMI, or Tailored EMI. Participants in all groups completed two daily EMAs for four weeks following a single-session intervention. They reported their drinking intentions and motives for the current day, and their alcohol consumption and drinking motives from the previous day. The Standard EMI group received feedback on the general negative consequences of drinking, while the Tailored EMI group received feedback specifically tailored to their drinking motives based on their EMA responses.
Results
Problematic drinking, along with related variables (e.g., drinking behavior, alcohol consumption, negative consequences, alcohol expectancies, and drinking motives) was reduced across all groups.
Conclusions
Further research is needed on the potential of monitoring drinking behavior to reduce problematic drinking and how to improve tailored EMI.

Effectiveness of Non-Pharmacological Interventions among Problem Drinkers in Korea: A Systematic Review and Meta-Analysis: Junggeun Ahn, Heeseung Choi, Jiu Kim, Wooin Jang; STRESS. 2023;31(3):123-132. Published online September 30, 2023; DOI: https://doi.org/10.17547/kjsr.2023.31.3.123

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Abstract PDF: Background
This study aimed to identify trends in domestic research and conduct a meta-analysis of studies investigating the effects of non-pharmacological interventions targeting domestic problem drinkers. The objectives were to synthesize and analyze the results of these studies, while evaluating potential bias and estimating effect size.
Methods
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched five domestic databases (RISS, KISS, DBpia, KoreaMed, and Science ON) for journals and theses published until July 2022. Researchers independently assessed study quality using Cochrane RoB 2 or ROBINS-I.
Results
Of the 307 studies extracted, 12 were included in systematic review. The meta-analysis included 11 studies on problem drinking and 8 on alcohol abstinence self-efficacy. Random effects models were used for analysis, given the heterogeneity among the studies. Non-pharmacological interventions effectively reduced problem drinking (g=−1.22, 95% CI: −1.69 to −0.75, p＜.001) and enhanced alcohol abstinence self-efficacy (g=1.16, 95% CI: 0.54 to 1.79, p＜.001).
Conclusions
Non-pharmacological intervention programs targeting problem drinkers effectively reduced problem drinking and enhanced alcohol abstinence self-efficacy. This study provides valuable evidence for developing and implementing such programs for problem drinkers.

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