STRESS

Most-download articles are from the articles published in 2023 during the last three month.

Original Articles

Test Linking of Suicide Risk Assessment Instruments: Comparing Cut-Off Scores for Suicide Risk: Hwajeong Yu, Yuhwa Han, Sungeun You; STRESS. 2023;31(1):25-36. Published online March 31, 2023; DOI: https://doi.org/10.17547/kjsr.2023.31.1.25

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Abstract PDF: Background
Communicating the objective meaning of the cut-off criteria for high-risk among suicide risk assessment tools is challenging because they measure different aspects of suicide risk. This study aimed to provide comparable scores among widely used suicide assessment instruments by using test linking.
Methods
Linking was performed using the equipercentile method with the data of 400 adults. Then, for an independent sample of 165 adults, the validity of linking was tested by providing an overall percent agreement of group classification.
Results
Linking results indicated that the score of 4 on the C-SSRS corresponded to 8 on the DSI-SS and 16 on the SBQ-R, respectively. The overall percent agreement of group classification based on the cutoff score of 4 on the C-SSRS was high in both scales, supporting the validity of linking.
Conclusions
The study results provide comparable criteria for the high-risk group among the three measures. Mental health practitioners could utilize our results in identifying people at high suicide risk.

The Effect of Perceived Stress on Drinking Problem of Korean College Students: From the Perspective of Escape Theory: Dawon Yoon, Youngho Lee; STRESS. 2023;31(1):1-10. Published online March 31, 2023; DOI: https://doi.org/10.17547/kjsr.2023.31.1.1

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Background
This study examined how the perceived stress of college students leads to drinking problems based on the Escape Theory.
Methods
A total of 485 college students were surveyed. A moderated mediation analysis was used to test the hypotheses.
Results
Since no significant correlation was found between perceived stress and drinking problem, the dependent variable was replaced with problematic drinking, a sub-factor of drinking problem. Escape from self fully mediated the relationship between perceived stress and problematic drinking. The interaction of perceived stress and dysfunctional self-focus was correlated with escape from self. Coping motives to drinking strengthened the pathways from escape from self to problematic drinking.
Conclusions
This study shows the need for therapeutic interventions to curb college students’ drinking problems. This study’s significance and limitations are also discussed.

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The Relationship between Perceived Stress, Subjective Health Status, and Symptoms of Dry Eye and Dry Mouth among Optometry Students at a University
Se-Jin Kim, Min-Hee Hong
The Korean Journal of Vision Science.2024; 26(3): 195. CrossRef

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.

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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

Validating a Short Version of the Intolerance of Uncertainty Scale-12 (IUS-12): Somin Lee, Myoung-Ho Hyun, Jaeeun Shin; STRESS. 2023;31(3):97-105. Published online September 30, 2023; DOI: https://doi.org/10.17547/kjsr.2023.31.3.97

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Abstract PDF

Background
This study aims to validate the short version of the Intolerance of Uncertainty Scale-12 (IUS-12).
Methods
A comprehensive set of questionnaires, including the IUS-12, STAI-T, PSWQ, CES-D, and K-CSI, was administered and completed by 404 participants. The average age of the participants was 31.29 years (SD=9.18), comprising 114 men, 287 women, and 3 individuals identifying with the other gender. We conducted a factor analysis on the collected data and compared the fit indices of one-factor, two-factor, and bifactor models. Furthermore, a multiple-group confirmatory factor analysis evaluated measurement invariance between the men’s and women’s groups. Correlational analyses were also conducted.
Results
Data from the study show that the bifactor model was the most appropriate, demonstrating good internal consistency. The Omega coefficients and explained common variance were computed to evaluate the dimensionality of the IUS-12, validating the use of the total score of the scale. Its factor model also showed that the measurement invariance sustained between two gender groups. The correlation analyses between the IUS-12 and other scales assessing attributes such as trait anxiety, worry, depression, and avoidance coping strategy supported convergent validity.
Conclusions
These findings suggest that the IUS-12 is a reliable and valid measure for assessing the intolerance of uncertainty. The study also discusses its limitations and offers recommendations for future research endeavors.

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The impact of intolerance of uncertainty and job-seeking efficacy among nursing students: The mediating effect of planned happenstance skills
Chung Hee Woo, Ju Ah Kim
The Journal of Korean Academic Society of Nursing Education.2025; 31(2): 151. CrossRef

Validation of the Korean Adaptation of the State-Trait Anger Expression Inventory-2 (K-STAXI-2): Kyum Koo Chon, Kyung Hyun Suh, Joonsuk YI, Sungwon Roh, Yongmi Lee, Sojung Kim, Euiyeon Kim, Ju Yul Lee, Aron Choi; STRESS. 2023;31(3):133-141. Published online September 30, 2023; DOI: https://doi.org/10.17547/kjsr.2023.31.3.133

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Abstract PDF

Background
This study aimed to validate the Korean adaptation of the State-Trait Anger Expression Inventory-2 (K-STAXI-2).
Methods
The study included a sample of 307 normal adults and 81 comparable adult patients. The data were analyzed using factor analyses, internal consistency measures, assessments of convergent and discriminant validity, t-tests between groups, and test-retest reliability.
Results
(1) Exploratory factor analyses revealed clear-cut factors for anger experience (state anger and trait anger) and anger expression (anger expression-in, anger expression-out, anger control-in, and anger control-out); (2) correlation analyses between K-STAXI-2 and the Emotional Stress Inventory demonstrated convergent and discriminant validity; (3) t-test between the patient group and the normal adults group provided additional construct validity; (4) internal consistencies of the six subscales showed a satisfactory level of reliability (α=.81 to α=.94); and (5) test-retest reliability over four weeks showed a satisfactory level of reliability.
Conclusions
The results further support the reliability and validity of the K-STAXI-2, suggesting its usefulness in various fields such as medicine, nursing, psychology, addiction, organization, education, and criminal justice.

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A Multinational Comparison Study of the Patient‐Reported Outcomes Measurement Information System Anxiety, Depression, and Anger Item Bank in the General Population
Jiseon Lee, Yeonjung Lim, Dong Gi Seo, Minji K. Lee, Benjamin D. Schalet, Felix Fischer, Matthias Rose, Danbee Kang, Juhee Cho
International Journal of Methods in Psychiatric Research.2025;[Epub] CrossRef
Being stuck on negatives isn't equally bad: A cross-cultural Bayesian meta-analysis of rumination and its relation to depression
Sooyeon Kim, Seojeong Kim, Sunkyung Yoon
Journal of Affective Disorders.2025; 385: 119365. CrossRef
Differential Association Between Values of Health and Environment, and Emotions of Pride and Compassion
Miangola Ramanoelina, Donghwa Yoon, Dohyun Ahn
Journal of Social Science.2025; 36(2): 129. CrossRef

Academic Mental Health and Stress Mindset among High School Students: Job Demands-Resources Model: Ji-Eon Kim, Hyo-Shim Cho, Tae-Hyung Kwon, Eun-Young Kim, Ochir Erdenezaya Tsogt, Soohyun Cho; STRESS. 2024;32(2):66-73. Published online June 28, 2024; DOI: https://doi.org/10.17547/kjsr.2024.32.2.66

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Abstract PDF: Background
This study aimed to identify stress mindset as an intervention factor for academic stress management within the framework of the Job Demands-Resources Model. We investigated the role of a stress mindset in the relationship between academic demands, resources, burnout, engagement as academic mental health.
Methods
From the perspective of academic interpersonal perceptions, 391 first- and second-year high school students were analyzed using a structural equation model consisting of observed variables with demands and resources from parents, teachers, and peers.
Results
The low-stress mindset group showed a significant pathway from academic demands to academic burnout. The high-stress mindset group demonstrated pathways from academic resources to academic burnout and engagement.
Conclusions
These findings highlight the significance of a stress mindset in enhancing the academic mental health of high school students.

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.

An Integrative Review of Psychosocial Intervention Programs for Infertile Females: Youjin Shin, Soo-Hyun Nam; STRESS. 2023;31(4):158-167. Published online December 28, 2023; DOI: https://doi.org/10.17547/kjsr.2023.31.4.158

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Abstract PDF: Background
This study aims to analyze intervention studies conducted on infertile females in South Korea and research and research the core elements comprising these studies.
Methods
The integrative review was conducted based on the guidelines of Whittmore and Knafl, and included the following steps: problem identification, literature search, data evaluation, data analysis, and presentation. Next, six domestic databases were searched using keywords such as ‘infertility’, ‘intervention’, and ‘education’ in Korean and English, and published studies were reviewed according to specific criteria and quality assessment.
Results
Among 4,109 searched papers, 6 were selected for the final data analysis. A total of six interventions were conducted in the selected articles, and each strategy was variously categorized into cognitive, emotional, behavioral, relational, and physical aspects. All interventions were found to be effective in promoting psychosocial health in infertile females.
Conclusions
Despite the fact that female infertility is a major public health problem in Korea, the low number of articles reveals a relative lack of psychosocial intervention studies. Therefore, it is suggested that future studies incorporate physiological endpoints into psychosocial studies, and we hope that this study will serve as a basis for developing programs for infertile females in the future.

Review Articles

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.

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

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.

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 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.

Review Article

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 Article

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

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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

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