STRESS

Most-read 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.

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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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

The Mediating Role of Smartphone Usage Time in the Relation between Stress and Anxiety among Adolescents during the COVID-19 Pandemic: Eunha Jeong; STRESS. 2023;31(2):65-72. Published online June 30, 2023; DOI: https://doi.org/10.17547/kjsr.2023.31.2.65

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Abstract PDF

Background
This study examines the mediating effect of smartphone usage time on the relationship between stress and anxiety among adolescents.
Methods
Data on 54,848 adolescents were obtained from the 17th (2021) Korea Youth Behavior Survey. The data were analyzed using PROCESS Macro Version 4.1 (Model 4) to examine the effect and significance of each path in the mediation model.
Results
There was a statistically significant direct effect of stress on anxiety. Additionally, smartphone usage time mediated the relationship between stress and anxiety, indicating a significant indirect effect.
Conclusions
The findings suggest the importance of addressing stress coping strategies and implementing effective intervention programs related to smartphone use to promote adolescents’ mental health.

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The Relationship between Health-related Behavior and Generalized Anxiety Disorder in Korean Adolescents
Sun-Hwa Kim, So-Yeon Ryu, Seong-Woo Choi, Mi-Ah Han, Jong Park
Journal of Health Informatics and Statistics.2025; 50(1): 65. CrossRef
Does Stress Affect Adolescent Anxiety by Mediating Sleep Time?
Si On Jang
STRESS.2024; 32(3): 142. CrossRef
Influence of Sedentary Behavior and Smartphone Use on the Risk of Generalized Anxiety Disorder among Adolescents
Kyong Sil Park
Journal of Korean Academy of psychiatric and Mental Health Nursing.2023; 32(4): 363. 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

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.

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.

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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

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

Relationship between Mindfulness and Stress Response in High School Students: Mediating Effect of Self-Regulation Ability: Yoonjung Choi, Mihee Lee, Jeongik Choi; STRESS. 2024;32(1):19-28. Published online March 28, 2024; DOI: https://doi.org/10.17547/kjsr.2024.32.1.19

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Abstract PDF: Background
This study explored the applicability of mindfulness meditation as an intervention approach in school counseling for managing daily stress in high school students. The study investigated the mediating effect of self-regulation ability on the relationship between mindfulness and stress response.
Methods
Data from 244 high school students (119 men and 125 women) were used to examine the mediating effect, controlling for academic variables using Hayes’ (2013) Process Macro Model 4.
Results
There was a positive correlation between mindfulness and self-regulation abilities, and mindfulness and self-regulation abilities were negatively correlated with stress response. Moreover, for students who perceived higher academic achievement levels, self-regulation abilities were positively correlated, and stress response were negatively correlated. Results showed a full mediating effect of self-regulation ability on the adverse relationship between mindfulness and stress response. The mediating effects of self-regulation modes were differentially observed in the adverse relationship between mindful consciousness and attitude dimensions of stress response.
Conclusions
These findings suggest that when applying mindfulness meditation as a daily stress management strategy for high school students, enhancing their self-regulation ability should be the focus of intervention.

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

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.

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.

The Moderating Role of Perceived Social Support in the Relation between Type D Personality and PTSD Symptoms among ICU and ER Nurses: Sohyeon Kim, Myung-Ho Hyun; STRESS. 2023;31(4):197-204. Published online December 28, 2023; DOI: https://doi.org/10.17547/kjsr.2023.31.4.197

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Abstract PDF: Background
This study examined the moderating effects of four types of perceived social support on the relation between type D personality and post-traumatic stress disorder (PTSD) symptoms among ICU and ER nurses.
Methods
Data were collected from 223 ICU and ER nurses in university or general hospitals located in Seoul. A questionnaire survey method was used for data collection and SPSS Windows 28.0 and PROCESS Macro Program were used for data analysis.
Results
The results showed that only the moderating effect of senior support was statistically significant, while perceived support from family, friends, and coworkers were not. Specifically, the effect of type D personality on post-traumatic stress disorder (PTSD) symptoms was weaker in ICU and ER nurses who perceived higher social support from senior nurses.
Conclusions
The study highlighted the significance of senior support in protecting the psychological health of ICU and ER nurses. Additionally, it addressed the major considerations in developing practical interventions in hospital settings.

Attention Bias to Emotional Expression: Variations Based on Anxiety Tendency and Depression Tendency: Yeongeun Kim, Yoonhyoung Lee, Jini Tae, Wonhye Lee; STRESS. 2023;31(2):73-80. Published online June 30, 2023; DOI: https://doi.org/10.17547/kjsr.2023.31.2.73

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Abstract PDF: Background
This study examined whether automatic attention bias toward emotional stimuli differs among individuals with varying anxiety and depression levels in the non-clinical population.
Methods
A total of 494 participants from the community completed the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7). The dot-probe task was conducted to compare attention biases when emotional stimuli appeared before the target versus neutral stimuli did.
Results
There were differences in attention bias based on the stimuli types, even among the non-clinical community. The anxiety tendency group showed attention bias towards positive expressions, while the depression tendency group showed attention bias toward negative expressions. The group with anxiety and depression tendencies showed mixed characteristics observed in both the anxiety and depression groups.
Conclusions
This study showed that attention bias toward emotional stimuli is an information-processing bias influenced by an individual’s internal state. This study contributes to the understanding of attention bias differences among groups based on anxiety and depression tendencies in non-clinical population of various ages.

Review Article

An Integrative Review of Interventions for Preventing Internet and Smartphone Addiction in Elementary School Students: Based on the IMB Model: Hyemin Park, Bohye Kim, Jaehee Jeong, Hwa Jeong Kim, Yebin Kim; STRESS. 2024;32(3):133-141. Published online September 30, 2024; DOI: https://doi.org/10.17547/kjsr.2024.32.3.133

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Abstract PDF: Background
This study analyzes and evaluates the effectiveness of various interventions designed to prevent internet and smartphone addiction among elementary school students based on the Information-Motivation-Behavioral Skills (IMB) model.
Methods
An integrative literature review examined studies published in the last ten years that focus on preventive interventions for internet and smartphone addiction among elementary school students. The selected studies were analyzed using the IMB model, which includes information, motivation, and behavioral skills as key components.
Results
The analysis identified several critical components of effective prevention programs: providing relevant information, enhancing interpersonal relationships, emotional management, self-control, and impulse control skills. Effective programs often included group interventions, visual aids, play activities, and parental involvement.
Conclusions
The findings suggest that balanced integration of information, motivation, and behavioral skills is essential for developing effective prevention programs for internet and smartphone addiction among elementary school students. The study provides a foundation for future research and the development of comprehensive prevention programs tailored to the unique characteristics of this age group.

Original Article

Effect of Work Overload on Job Burnout: The Moderation Effect of Problem-Focused Coping and Job Autonomy: Jae Won Moon, Hae Youn Choi; STRESS. 2023;31(3):106-112. Published online September 30, 2023; DOI: https://doi.org/10.17547/kjsr.2023.31.3.106

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Abstract PDF: Background
In the contemporary work environment marked by specialization, digitalization, and convergence, job burnout has intensified. This study aims to validate the intricate interplay between individuals and their environment in progression from high-skilled, unstructured job stress.
Methods
This study explores the moderating effects of problem-focused coping and job autonomy on the relationship between work overload and job burnout. The participant pool comprised 150 employees (mean age=40.7, 68.7% women) stationed at large commercial bank branches in Korea.
Results
First, the study did not uncover a statistically significant moderation effect of problem-focused coping on the relationship between work overload and job burnout. Second, the findings revealed that the impact of work overload on job burnout displayed variation contingent upon the levels of problem-focused coping and job autonomy.
Conclusions
This study underscores the pivotal role of ensuring job autonomy within the work environment to effectively mitigate the adverse effects of excessive work situations through problem-focused coping.

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