STRESS

Volume 32(4); December 2024

Original Articles

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.

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.

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.

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.

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.

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.

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