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- When Does Adolescents’ Stress Become Somatic Symptoms? A Moderated Mediation Model of ADHD Tendency, Stress, and Somatic Symptoms by Household Economic Status
- RaeHyuck Lee
- STRESS. 2026;34(1):43-51. Published online March 30, 2026
- DOI: https://doi.org/10.17547/kjsr.2026.34.1.43
- 303 View
- 17 Download
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Abstract
PDF - Background
This study examines whether stress mediates the association between Attention-Deficit/Hyperactivity Disorder (ADHD) tendency and somatic symptoms among adolescents, and whether this association varies by household economic status.
Methods
Using nationwide data from 6,689 Korean adolescents, ADHD tendency, perceived stress, somatic symptoms, and subjective household economic status were assessed using validated self-reporting scales. Multiple regression and the PROCESS Macro were applied to test the direct, mediation (Model 4), and moderated mediation effects (Model 14), controlling for gender, age, and out-of-school status. Bootstrapping was performed using 10,000 re-samples.
Results
ADHD tendency was positively associated with somatic symptoms. Stress partially mediated this relationship. Stress’ effect on somatic symptoms was negatively moderated by household economic status. Consequently, ADHD tendency’s indirect effect on somatic symptoms through stress significantly varied by household economic status.
Conclusions
ADHD tendency contributes to somatic symptoms through elevated stress. This process is shaped by the socioeconomic context. Interventions targeting stress reduction, particularly among economically vulnerable adolescents, may help prevent somatic symptom development.
- 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
- 267 View
- 11 Download
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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.
- The Double-Mediating Effect of Interpersonal Competence and Social Support on the Relationship between ADHD Traits and Depression in Early Adulthood
- Jae Sun An
- STRESS. 2023;31(1):44-50. Published online March 31, 2023
- DOI: https://doi.org/10.17547/kjsr.2023.31.1.44
- 5,199 View
- 209 Download
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Abstract
PDF
- Background
This study aims to analyze the relationship between interpersonal competence, social support, ADHD traits, and depression in early adulthood, and by using the double-mediation model, to examine the effect of the first two variables on the last two.
Methods
The participants comprised 146 male and 155 female adults aged between 19 and 34, from whom data was collected through the Korean version of the WHO Adult ADHD Self-Report Scale, interpersonal competence and depression subscales of the mental health test developed by Suh et al., and social support scale developed by Iverson et al.
Results
The results showed that adult ADHD traits were negatively correlated with interpersonal competence and social support, and positively correlated with depression. In addition, interpersonal competence was positively correlated with social support and negatively correlated with depression, whereas social support was negatively correlated with depression. Finally, interpersonal competence and social support sequentially mediated adult ADHD traits and depression.
Conclusions
This sequential double-mediating effect is of great academic significance and suggests that improving interpersonal competence and social support may be effective in mitigating the negative effect of ADHD traits on depression in early adulthood.
- Burnout, Depression, Suicide Idea, Anxiety, ADHD, and Impulsiveness, Self-Esteem, and Quality of Life with Social Workers
- Youn Kim, Ji Hee Wee, Nam Hee Kim, Myung Ho Lim
- STRESS. 2019;27(3):209-214. Published online September 30, 2019
- DOI: https://doi.org/10.17547/kjsr.2019.27.3.209
- 5,692 View
- 159 Download
- 2 Citations
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Abstract
PDF
Objective: This study aimed to evaluate relationships between attention-deficit/hyperactivity disorder (ADHD) symptoms, depression, suicidal ideation, anxiety, impulsiveness, burnout, self-esteem and quality of life and social sorkers group in Korea.
Methods: A set of questionnaires were provided to a total of 153 social workers and 454 other participants as a comparison group. All subjects were evaluated using the Korean Adult Attention- Deficit/Hyperactivity Disorder Scales, the Beck’s Depression Inventory, Beck’s Scale of Suicide Ideation, Beck’s Anxiety Inventory, Baratt’ Impulsiveness Scale, Maslach Burnout Inventory, Rosenberg‘s Self-esteem Inventory, Quality of Life Scale.
Results: The participants who belonged to the social workers group were more likely to demonstrate the symptoms of ADHD and higher levels of depression, suicide idea, anxiety, impulsiveness, burnout and lower levels of self-esteem, quality of life. Further, the results of logistic regression analysis confirmed the association between the social workers group and ADHD symptoms, depression, self-esteem.
Conclusions: Timely and effective evaluation and treatment of ADHD, self-esteem, as well as depression was required for social workers.
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Citations
Citations to this article as recorded by
- Impulsiveness and suicide in male offenders: Examining the buffer roles of regulatory emotional self‐efficacy and flourishing
Yiling Mai, Ruilai Yang, Xiaohua Wu, Zhaoming Xie, Xin Zhang, Xueling Yang, Huanhuan Liu, Jiubo Zhao
Psychology and Psychotherapy: Theory, Research and Practice.2021; 94(2): 289. CrossRef - Latent Profiles of Burnout, Self-Esteem and Depressive Symptomatology among Teachers
Inmaculada Méndez, Juan Pedro Martínez-Ramón, Cecilia Ruiz-Esteban, José Manuel García-Fernández
International Journal of Environmental Research and Public Health.2020; 17(18): 6760. CrossRef
- Impulsiveness and suicide in male offenders: Examining the buffer roles of regulatory emotional self‐efficacy and flourishing
- The Comparison Study of Nurses’Exhaustion and Depression, Anxiety, ADHD, and Impulsivity
- Youn Sil Kim, Namhee Kim, Ji Hee Wee, Beck Hee Chang, Jung Ae Park, Myung Ho Lim
- STRESS. 2019;27(1):17-22. Published online March 31, 2019
- DOI: https://doi.org/10.17547/kjsr.2019.27.1.17
- 5,738 View
- 141 Download
- 3 Citations
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Abstract
PDF
Objective: This study aimed to evaluate the comparison of exhaustion, ADHD, self-esteem, impulsivity, suicidal tendencies and quality of life as well as depression and anxiety in nurses group and comparison group in Korea.
Methods: A set of questionnaires was provided to a total of 97 nurses and 310 other participants as a comparison group. All subjects were evaluated using the Beck’s Depression Inventory, Beck’s Anxiety Inventory, Maslach Burnout Inventory, Korean Adult Attention Deficit Hyperactivity Disorder Scales, Rosenberg’s Self-esteem Inventory, Baratt’ Impulsivity Scale, Beck’s Scale of Suicide Ideation, and Quality of Life Scale.
Results: The results of this study indicated that the nurses were more likely to show depression, anxiety, exhaustion, impulsivity, and quality of life. In the multiple regression analysis, nurses group was the most correlated factor in exhaustion. In addition, anxiety, depression, impulsivity, ADHD, self-esteem, and life satisfaction were also correlated to exhaustion.
Conclusions: Timely and effective evaluation and treatment of impulsivity, as well as depression and anxiety were required for nurses.
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Citations
Citations to this article as recorded by- User Interface Design and Usability Evaluation of a Mental Health Mobile Application for Healthcare Workers: A Nursing Informatics Perspective
Yewon Lee, Eunju Kwak, Mijin Park, Jiyeon Park, Jungjae Kim, Jisan Lee
Journal of Health Informatics and Statistics.2024; 49(3): 248. CrossRef - Psychological Impact of the COVID-19 Pandemic on Licensed Full-Time Practicing Nurses Undertaking Part-Time Studies in Higher Education: A Cross-Sectional Study
Siu-Ling Chan, Naomi Takemura, Pui-Hing Chau, Chia-Chin Lin, Man-Ping Wang
International Journal of Environmental Research and Public Health.2021; 18(16): 8569. CrossRef - The Effect of Work-Life Balance on Job Satisfaction and Turnover Intention of Hospital Nurses: Compared to Female Wage Workers
Dong Min Son, Young-Il Jung
Stress.2019; 27(3): 268. CrossRef
- User Interface Design and Usability Evaluation of a Mental Health Mobile Application for Healthcare Workers: A Nursing Informatics Perspective
- The Effect of Stress on the Subjective Discomfort and Skin Conductance Level in Adults with ADHD Tendency
- Suim Yang, Yongmae Baek
- STRESS. 2017;25(4):299-305. Published online December 31, 2017
- DOI: https://doi.org/10.17547/kjsr.2017.25.4.299
- 4,481 View
- 79 Download
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Abstract
PDF
Background: The purpose of this research was to study an effect of stress stimulation on Skin Conductance Level and subjective discomfort on adult groups with ADHD tendency (12 people) and control group (12 people).
Methods: In order to measure the physiological stress responses, all experiment participators’ Skin Conductance Level was checked through the bio-feedback equipment on the participators’ bodies, which relayed information in the process of the baseline period, the Stroop word-color test period, the resting period, the mental arithmetic test period and the resting period. The subjective discomfort was measured by setting the inconvenience level while taking the tests as a 7 according to the Likert scale.
Results: The result showed that the ADHD tendency group showed higher Skin Conductance Level on the stress circumstances. They maintained the high level during rest phase. Also, the group showed higher subjective discomforted level.
Conclusions: The research confirmed that stress administration and emotion regulations are needed to be included in goals for medication on ADHD groups.
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