STRESS

Original Articles

A Reliability and Validity of the Korean Version of Behavioral Activation for Depression Scale-Short Form: A Community Sample of Adults: Yeongeun Kim, Jini Tae, Yoonhyoung Lee, Kiho Park, Wonhye Lee; STRESS. 2024;32(4):214-220. Published online December 27, 2024; DOI: https://doi.org/10.17547/kjsr.2024.32.4.214

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Abstract PDF: Background
The behavioral activation method is a short-term, evidence-based approach that promotes functional activation by reinforcing adaptive behaviors and eliminating avoidance behaviors. This study aims to validate the Korean version of the Behavior Activation for Depression Scale-Short Form (K-BADS-SF) among Korean community adults, providing an objective measure of behavioral activation.
Methods
A total of 471 participants, ranging in age from 18 to 69 years, completed an online survey. They filled out the K-BADS-SF and its long-form version, the K-BADS, as well as the Behavioral Inhibition System/Behavioral Activation System (BIS/BAS) scales, the Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder-7 (GAD-7). The K-BADS-SF was subject to a thorough psychometric evaluation, which included analyzing internal consistency, test-retest reliability, exploratory and confirmatory factor analyses, and both convergent and discriminant validity analyses.
Results
Exploratory and confirmatory factor analyses show that the model fit of the K-BADS-SF improves when certain items from the original scale are moved from the activation factor to the avoidance factor.
Conclusions
The K-BADS-SF exhibits sufficient reliability and validity in the Korean community sample, confirming its effectiveness as a valuable tool for assessing behavioral activation.

The Effectiveness of an Imagery-Based Behavioral Activation Intervention for Depressive Symptoms: Sujeong Yun, Eun-Jung Shim; STRESS. 2024;32(4):204-213. Published online December 27, 2024; DOI: https://doi.org/10.17547/kjsr.2024.32.4.204

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Abstract PDF: Background
Behavioral activation treatment (BAT) is an evidence-based treatment for depression. However, depressive symptoms can make it difficult to engage in activities crucial for the success of behavioral activation. Mental imagery may assist with activity engagement. This study examined the effectiveness of imagery-based BAT (BAT-I) compared to standard BAT in reducing depressive symptoms and improving behavioral activation, activity anticipation, activity motivation, and activity completion rates.
Methods
Thirty adults with moderate to severe depressive symptoms were randomly assigned to either the BAT-I or BAT groups. The participants received eight sessions of twice-weekly BAT intervention, with an additional four-eight mental imagery sessions provided for the BAT-I group.
Results
Repeated measures analysis of variance indicated that participants in both groups showed reductions in depressive symptoms and improvements in behavioral activation, activity anticipation, and activity motivation. However, the BAT-I group demonstrated significantly higher activity motivation (6.1＞ 5.1) and activity completion rates (93.17%＞66.18%) than the BAT group.
Conclusions
While use of imagery appears to support activity engagement, further research is needed to explore how imagery can be utilized to enhance the BAT effectiveness.

Internalized Shame Mediates the Relationship between Borderline Personality Traits and Suicidal Ideation: Nanyoung Bae, Hyejeen Lee; STRESS. 2024;32(4):196-203. Published online December 27, 2024; DOI: https://doi.org/10.17547/kjsr.2024.32.4.196

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Abstract PDF: Background
Internalized shame, defined as the enduring incorporation of shame as a trait due to repeated experiences of shame, is considered a core emotion in individuals with borderline personality traits. It is closely related to self-destructive behaviors, such as self-harm and suicidal ideation. This study aimed to investigate whether internalized shame mediates the relationship between borderline personality traits and suicidal ideation.
Methods
Self-report questionnaires were administered to 303 undergraduate and graduate students to assess borderline personality traits, suicidal ideation, internalized shame, depression, impulsivity, and history of suicide attempts.
Results
Internalized shame mediated the relationship between borderline personality traits and suicidal ideation, even after controlling for known predictors of suicidal ideation, including depression, impulsivity, history of suicide attempts, sex, and age. Specifically, higher borderline personality traits were associated with stronger feelings of shame, which in turn increased suicidal ideation.
Conclusions
These findings suggest that addressing internalized shame could be a key target for interventions aimed at reducing suicide risk in individuals with borderline personality traits.

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.

Social Representation Study on Disabled Persons: A Longitudinal Study of Mentally Ill Patients and Verification of Differences by Type: Yeun-Joo Hur, KyuMan Han, MinKyu Rhee; STRESS. 2024;32(4):178-187. Published online December 27, 2024; DOI: https://doi.org/10.17547/kjsr.2024.32.4.178

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Abstract PDF: Background
This study aimed to examine changes in the social representation of mental illness over the past 50 years and to compare these changes with the social representation of physical disability.
Methods
To measure the causes, symptoms, treatment, and attitudes toward patients and hospitals for the general public, opinion surveys on mental illness were based on questionnaires, and in the case of physically disabled people, the scale of mental illness was revised and supplemented.
Results
As a result of this study, it was confirmed that the social representation of the general public about mental illness has changed significantly over the past 50 years, but certain parts have deteriorated in some negative directions. Furthermore, when comparing the physically disabled and the mentally ill, it was confirmed that the social representation of the mentally ill was more negatively formed than that of the physically disabled.
Conclusions
Based on these research results, the implications and limitations of this study were discussed.

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.

Emotional Dissonance and Coping Strategies According to the Emotional Processing Type of Call Center Counselors: SoonJin Choi, HaeYoun Choi; STRESS. 2024;32(3):153-160. Published online September 30, 2024; DOI: https://doi.org/10.17547/kjsr.2024.32.3.153

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Abstract PDF: Background
This study explored the emotional processing types of call center counselors and examined the differences in emotional dissonance and related adaptation indicates of coping strategies, emotional exhaustion and work performance orientation according to the types.
Methods
A total of 271 call center agents (204 females, 67 males; mean age 36.5) participated in the study. Latent class analysis of emotional awareness, emotional expression, ambivalence over emotional expression were conducted. Analysis of variance(ANOVA) was used to examine differences in adaptation indicators according to emotion processing type.
Results
Emotional processing types were categorized into Clear(CG), Passive(PG) Repressive(RG) groups. The CG showed low emotional dissonance, good adaptation indicates and functional coping strategies whereas results for the RG type revealed the opposite.
Conclusions
By distinguishing between emotional processing types, this study found that emotional processing type is more closely correlated with burnout and work performance orientation than emotional dissonance itself.

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.

Citations

Citations to this article as recorded by

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

Review Articles

An Integrative Review of Interventions for Preventing Internet and Smartphone Addiction in Elementary School Students: Based on the IMB Model: Hyemin Park, Bohye Kim, Jaehee Jeong, Hwa Jeong Kim, Yebin Kim; STRESS. 2024;32(3):133-141. Published online September 30, 2024; DOI: https://doi.org/10.17547/kjsr.2024.32.3.133

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Abstract PDF: Background
This study analyzes and evaluates the effectiveness of various interventions designed to prevent internet and smartphone addiction among elementary school students based on the Information-Motivation-Behavioral Skills (IMB) model.
Methods
An integrative literature review examined studies published in the last ten years that focus on preventive interventions for internet and smartphone addiction among elementary school students. The selected studies were analyzed using the IMB model, which includes information, motivation, and behavioral skills as key components.
Results
The analysis identified several critical components of effective prevention programs: providing relevant information, enhancing interpersonal relationships, emotional management, self-control, and impulse control skills. Effective programs often included group interventions, visual aids, play activities, and parental involvement.
Conclusions
The findings suggest that balanced integration of information, motivation, and behavioral skills is essential for developing effective prevention programs for internet and smartphone addiction among elementary school students. The study provides a foundation for future research and the development of comprehensive prevention programs tailored to the unique characteristics of this age group.

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.

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

Trauma-Informed Care for Children: A Scoping Review: Kyung-Sook Bang, Ji-Hye Choe, Sinyoung Choi, Yeseul Jeong, Sungjae Kim; STRESS. 2024;32(2):94-103. Published online June 28, 2024; DOI: https://doi.org/10.17547/kjsr.2024.32.2.94

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Abstract PDF

Background
Trauma-informed care involves providing services to traumatized patients with an understanding of and sensitivity to their experiences. This scoping review examines the literature concerning trauma-informed care for children.
Methods
We conducted a comprehensive literature search across domestic (RISS, NDSL, KISS, and DBpia) and international (PubMed, Embase, CINAHL, and PsycINFO) databases. The search terms were “trauma,” “PTSD,” “trauma-informed,” “trauma-focused,” “trauma-sensitive,” “newborn,” “neonate,” “premature infant,” “infant,” “child,” “adolescent,” “teen,” “juvenile,” “adolescence,” “pediatric,” and “nursing”. The final selection comprised 18 documents that were analyzed for general characteristics (publication year, study country, academic sector, research design, and data collection method), population demographics, variables, and measurement tools.
Results
Literature on this topic considerably increased since 2017, with the United States being the predominant research hub (50.0%) and nursing representing the primary academic sector (55.6%). The research designs were mainly quantitative (33.3%) and mixed-method studies (33.3%). Quantitative studies predominantly utilized surveys, while qualitative research employed observations, in-depth interviews, and focus group discussions. Most of the participants were nurses, doctors, and allied health professionals. As a result of analyzing the main variables measured in the literature through WordCloud, variables such as “stress,” “care,” and “knowledge” had the highest frequency. Three studies incorporated or adapted tools to assess trauma-informed care.
Conclusions
The findings of this review serve as foundational data for proposing future research trajectories in trauma-informed care and for enhancing awareness and strategic planning in clinical practice.

Citations

Citations to this article as recorded by

Korean nurses’ knowledge, opinions and current practice of trauma-informed pediatric nursing care in South Korea: a descriptive study
Kyung-Sook Bang, Sun Woo Hong, Hwal Lan Bang, Ji-Hye Choe, Sinyoung Choi
Child Health Nursing Research.2024; 30(4): 309. CrossRef

Influence of the Negative Life Changes Experienced after Becoming Single Mothers on Parenting Stress: Focusing on the Moderated Mediation Effect of Depression by Low-Income Status: RaeHyuck Lee; STRESS. 2024;32(2):85-93. Published online June 28, 2024; DOI: https://doi.org/10.17547/kjsr.2024.32.2.85

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Abstract PDF: Background
This study examines the influence of negative life changes experienced after becoming single mothers and their influence on parenting stress, focusing on the moderated mediation effect of depression influenced by low-income status.
Methods
The research questions were tested by using raw data from the Survey of Single-parent Families and applying the PROCESS macro method.
Results
First, the negative life changes experienced after becoming single mothers were found to positively and significantly influence parenting stress. Second, a partial mediation effect was observed: The levels of negative life changes increased the levels of depression, which, in turn, increased the levels of parenting stress. Third, the mediating effect of depression on the relationship between single mothers’ negative life changes and parenting stress was more pronounced for those with low income compared to those with medium and high income.
Conclusions
This study suggests strategies to address single mothers’ parenting stress.

Stress and Coping of Self-Quarantined People Focusing on Negative Cases of the Coronavirus Disease: A Qualitative Study: Kyung Im Kang, Chanhee Kim, Min Hye Lee; STRESS. 2024;32(2):74-84. Published online June 28, 2024; DOI: https://doi.org/10.17547/kjsr.2024.32.2.74

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Abstract PDF: Background
In South Korea, many people have experienced self-quarantine due to coronavirus disease (COVID-19). This study explored stress, coping, and post-quarantine changes among people who were self-quarantined because of close contact but tested negative for COVID-19 in the early days of the pandemic.
Methods
Qualitative interviews were conducted with four focus groups, each comprising five people. Data were analyzed using inductive content analysis.
Results
Three categories of stress and coping during self-quarantine and post-quarantine changes emerged. First, the category of content related to stress comprised “problems that are difficult to handle alone.” The subcategories were “painful body and mind,” “the experience of being in a jail without bars,” and “repeated internal and external conflicts.” Second, the category for various stress-coping methods was labeled “struggling my way,” and the subcategories were “coping methods that helped me overcome” and “coping methods that added difficulty.” Finally, the category for changes after self-quarantine was labeled “more mature me.” The subcategories involved “thorough observation of infection prevention measures in daily life,” “living together,” and “a new realization of life.”
Conclusions
Our findings contribute toward developing online or offline health programs to help individuals who self-quarantined but tested negative for infectious diseases, allowing them to feel confident to self-quarantine in good health.

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