STRESS

Volume 33(1); March 2025

Review Article

An Integrative Review on Risk and Relapse Factors for Narcotics Addiction: Based on an Ecological Model: Youjin Shin, Hwal Lan Bang, Soo-Hyun Nam; STRESS. 2025;33(1):1-12. Published online March 28, 2025; DOI: https://doi.org/10.17547/kjsr.2025.33.1.1

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Abstract PDF: Background
The study aim was to explore and integrate the experiences of individuals with substance addiction in South Korea using a ecological model to identify risk factors and relapse triggers across multiple dimensions.
Methods
This integrative review was conducted using Whittemore and Knafl’s five-step integrative review method. A comprehensive literature search was conducted using five Korean electronic databases from June 13 to July 25, 2023. Keywords included “narcotic,” “drug,” “addict,” and “recovery.”
Results
A total of 22 studies met the inclusion criteria. Risk and relapse factors in narcotics addiction were categorized into intrapersonal (emotional, cognitive, behavioral, physical, physiological), interpersonal (family, relationships, occupation), community (social, structural), and public policy (legal, institutional) aspects. These factors interacted to form a complex structure that heightened addiction risk and overlapped as both risk and relapse factors.
Conclusions
Narcotics addiction remains a serious public health issue that is exacerbated by various intrapersonal, interpersonal, community, and public policy-related factors. The study findings underscore the multifaceted nature of addiction and relapse and provide a broad perspective on the complexities of prevention and recovery strategies.

Original Articles

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):13-21. Published online March 28, 2025; DOI: https://doi.org/10.17547/kjsr.2025.33.1.13

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Abstract PDF: Background
This study examines the influence of attention-deficit/hyperactivity on school adjustment among adolescents and investigates the moderated mediation effect of depression on household economic status.
Methods
The research hypotheses were tested using data from the Korean Teenagers’ Mental Health Study and analyzed utilizing the PROCESS Macro method.
Results
Attention-deficit/hyperactivity had a significant negative impact on students’ school adjustment. Additionally, depression partially mediated the relationship between attention-deficit/hyperactivity and school adjustment. While household economic status did not moderate the influence of attention-deficit/hyperactivity on school adjustment, it did moderate the mediating effect of depression. Specifically, the mediating effect of depression on the relationship between attention-deficit/hyperactivity and school adjustment was more pronounced for adolescents from low-income households than for those from medium- or high- income households.
Conclusions
This study discusses the research implications and considerations.

Effect of Distress Tolerance Improvement Intervention for Problematic Drinkers: Gwang-Pyo Jang, Hyae Young Yoon; STRESS. 2025;33(1):22-32. Published online March 28, 2025; DOI: https://doi.org/10.17547/kjsr.2025.33.1.22

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Abstract PDF: Background
This study examined the effects of an intervention to improving distress tolerance, drinking refusal self-efficacy, and alcohol consumption in problematic drinkers.
Methods
Adults who reported problematic drinking were randomly assigned to either the intervention group (n=11) or comparison group (n=11). The groups were either administered treatment to improve distress tolerance or watch a video in which abstinent women talked about their drinking and abstinence experiences.
Results
The repeated-measures ANOVA showed no significant change in alcohol consumption in the intervention group. However, appraisal, a distress tolerance subscale, and opportunity for drink refusal self-efficacy, a drink refusal self-efficacy subscale, increased.
Conclusions
Short-term interventions to improve distress tolerance may help change distress tolerance and drinking refusal self-efficacy.

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.

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.

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