STRESS

Original Articles

The Moderated Moderation Effect of Anxiety and Self-Esteem on the Influence of Daily Stress on Non-Suicidal Self-Injury among Middle School Students: RaeHyuck Lee; STRESS. 2026;34(2):94-103. Published online June 30, 2026; DOI: https://doi.org/10.17547/kjsr.2026.34.2.94

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Abstract PDF: Background
This study examined the moderation effect of anxiety and the moderated moderation effect of anxiety on self-esteem in the relationship between daily stress and non-suicidal self-injury (NSSI) among middle school students.
Methods
Data from 1,948 middle school students from the Teen Mental Health Survey were analyzed using regression analysis and the SPSS PROCESS Macro method.
Results
The findings revealed that daily stress had a significant positive association with NSSI. Furthermore, the moderation effect of anxiety was confirmed, indicating that the positive association between daily stress and NSSI was significantly amplified as anxiety increased. In addition, a moderated moderation effect was found, demonstrating that the moderation effect of daily stress and anxiety on NSSI varied depending on the level of self-esteem. Specifically, the negative moderation effect of daily stress and anxiety on NSSI decreased as self-esteem increased.
Conclusions
Based on the results, this study proposes intervention strategies to prevent NSSI among middle school students, focusing on improving self-esteem and reducing anxiety and daily stress.

The Influence of ADHD Traits on School Maladjustment in Middle School Students: Focusing on the Serial Mediation Effect of Daily Life Stress and Self-Esteem: RaeHyuck Lee; STRESS. 2026;34(2):63-72. Published online June 30, 2026; DOI: https://doi.org/10.17547/kjsr.2026.34.2.63

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Abstract PDF: Background
This study examined the influence of attention-deficit/hyperactivity disorder (ADHD) traits on school maladjustment among middle school students and investigated the mediating effects of daily life stress and self-esteem on this relationship.
Methods
Data were drawn from the Korean Teenager Mental Health Survey. A total of 1,948 middle school students were analyzed using PROCESS Macro Model 6.
Results
A positive association between ADHD traits and school maladjustment was observed. Self-esteem significantly mediated the relationship between ADHD traits and school maladjustment. In addition, a significant serial mediation pathway was identified: higher ADHD traits were associated with increased daily life stress, which, in turn, was associated with to lower self-esteem, ultimately leading to greater school maladjustment.
Conclusions
The findings suggest that ADHD traits contribute to school maladjustment both directly and indirectly through psychological processes. In particular, the sequential pathway involving daily life stress and self-esteem highlights the importance of considering both stress experiences and self-evaluation mechanisms. Interventions aimed at reducing school maladjustment among middle school students should therefore address not only ADHD-related characteristics but also promote stress management and the enhancement of self-esteem.

The Moderated Moderation Effect of ADHD Symptoms and Self-Esteem on the Relationship between Daily Life Stress and Depression among Adolescents: RaeHyuck Lee; STRESS. 2026;34(1):34-42. Published online March 30, 2026; DOI: https://doi.org/10.17547/kjsr.2026.34.1.34

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Abstract PDF: Background
This study examined the moderated moderation effect of attention deficit/hyperactivity disorder (ADHD) symptoms and self-esteem on the relationship between daily life stress and depression among adolescents.
Methods
Data from 5,937 school-attending adolescents, obtained from the 2021 Mental Health Survey of Adolescents, were analyzed using the PROCESS Macro.
Results
First, daily life stress had a significantly positive influence on depression. Second, ADHD symptoms moderated the relationship between daily life stress and depression such that higher levels of ADHD symptoms amplified the deleterious effect of stress on depression. Third, a moderated moderation effect was confirmed, indicating that self-esteem further conditioned the moderating influence of ADHD symptoms. Specifically, higher levels of self-esteem mitigated the synergistic risk effect of stress and ADHD symptoms on depression.
Conclusions
Based on these findings, this study suggests strategies to enhance psychological protective factors to prevent depression among adolescents with ADHD.

Association between Daily Stress, Sleep Duration, and Attention-Deficit or Hyperactivity Problems among Teenagers: Focusing on the Moderated Mediating Effect of Positive Family Relationships: RaeHyuck Lee; STRESS. 2025;33(4):201-208. Published online December 31, 2025; DOI: https://doi.org/10.17547/kjsr.2025.33.4.201

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1 Citations

Abstract PDF

Background
This study investigated the association between daily stress, sleep duration, and attention-deficit or hyperactivity problems (ADH) among teenagers and the moderated mediating effect of positive family relationships.
Methods
The data of a nationally representative sample of teenagers were analyzed using regression analyses.
Results
Daily stress was positively associated with ADH. Sleep duration partially mediated the association between daily stress and ADH. Positive family relationships moderated the mediating effect of sleep duration. Specifically, the mediating effect decreased with increasing levels of positive family relationships.
Conclusions
Based on its results, this study discusses ways to intervene in ADH among teenagers.

Citations

Citations to this article as recorded by

The Moderated Moderation Effect of ADHD Symptoms and Self-Esteem on the Relationship between Daily Life Stress and Depression among Adolescents
RaeHyuck Lee
STRESS.2026; 34(1): 34. CrossRef

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

3,171 View
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5 Citations

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.

Citations

Citations to this article as recorded by

Association Between Physical Activity and Perceived Stress Among Adolescents Across Urbanicity Levels: Korea Youth Risk Behavior Survey, 2018-2023
Eunhui Kim, Chae-Been Kim, Seungho Ryu
The Asian Journal of Kinesiology.2026; 28(1): 139. CrossRef
Assessing the prevalence, characteristics and psychosocial correlates of nonsuicidal self-injury among Vietnamese adolescent psychiatric outpatients: a cross-sectional study
Hoang Yen Nguyen, Xuan Thang Pham, Cong Thien Le, Thi Thu Ha Le, Thi Thu Ha Tran, Thi Hue Doan, Thien Thang Tran, Tuan Khiem Ngo, Thi Nguyet Nga Pham, Thi Ha An Tran, Van Tuan Nguyen
Frontiers in Psychiatry.2026;[Epub] CrossRef
The Moderated Moderation Effect of Anxiety and Self-Esteem on the Influence of Daily Stress on Non-Suicidal Self-Injury among Middle School Students
RaeHyuck Lee
STRESS.2026; 34(2): 94. CrossRef
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
The Influence of School Maladjustment on Non-Suicidal Self-Injury among Adolescents: Focusing on the Moderated Mediating Effect of Anxiety According to Single-Parent Family Status
RaeHyuck Lee, Jaekyoung Lee
STRESS.2025; 33(3): 155. CrossRef

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

5,031 View
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7 Citations

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.

Citations

Citations to this article as recorded by

Acculturative stress and social isolation in multicultural adolescents: A moderated mediation model of social withdrawal and in-school support
Woo Gwan Jo, Joseph Ahn, Wonjong Horace Lee
International Journal of Intercultural Relations.2026; 110: 102324. CrossRef
The Influence of ADHD Traits on School Maladjustment in Middle School Students: Focusing on the Serial Mediation Effect of Daily Life Stress and Self-Esteem
RaeHyuck Lee
STRESS.2026; 34(2): 63. CrossRef
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
Happiness experiences among South Korean elementary school students receiving local children’s center services: a qualitative study using Giorgi’s phenomenological method
Hae Kyung Jo
Child Health Nursing Research.2025; 31(2): 96. CrossRef
Association between Daily Stress, Sleep Duration, and Attention-Deficit or Hyperactivity Problems among Teenagers: Focusing on the Moderated Mediating Effect of Positive Family Relationships
RaeHyuck Lee
STRESS.2025; 33(4): 201. CrossRef
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. CrossRef
A Phenomenological Study on Breast Cancer Survivors' Experiences of Mind Subtraction Meditation
Mi Ra Yun
Asian Oncology Nursing.2016; 16(3): 158. CrossRef

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