STRESS

Original Articles

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.

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.

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.

Effect of Emotional Regulation Strategies on Psychological Distress in Obsessive-Compulsive Tendency: Woo-Jin Cha, Myoung-Ho Hyun; STRESS. 2024;32(2):104-110. Published online June 28, 2024; DOI: https://doi.org/10.17547/kjsr.2024.32.2.104

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Abstract PDF: Background
This study examined the effects of emotion regulation strategies on psychological distress in individuals with obsessive-compulsive tendencies.
Methods
A total of 339 adults completed online and offline surveys administered to determine the level of obsessive-compulsive symptoms. Among them, 56 were categorized into the obsessive-compulsive tendency group and randomly assigned to the reappraisal, acceptance, and suppression groups, where each participated in emotion regulation strategy training. Their psychological distress was assessed before and after the training.
Results
The results of the repeated-measures analysis of variance (ANOVA) showed that the main effects of neither group nor time were significant, but the interaction between group and time was significant. The acceptance group showed a significant decrease in psychological distress post-training, whereas the suppression group showed a significant increase. The reappraisal group showed no significant changes in psychological distress before and after the training.
Conclusions
This study demonstrated that the acceptance strategy was especially effective and adaptive in reducing psychological distress. These findings expand our understanding of emotion regulation strategies and have therapeutic implications. Finally, the implications and limitations of this study are discussed, presenting directions for future research.

Relationship between Childhood Trauma and Depression in Youths in the Transition to Independent Living: The Mediating Effect of Disconnection-Rejection Schemas Moderated by Out-of-Home Care Types: Shin Young Park, Myoung-Ho Hyun, Min Jin Jin; STRESS. 2024;32(1):9-18. Published online March 28, 2024; DOI: https://doi.org/10.17547/kjsr.2024.32.1.9

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Abstract PDF: Background
This study explored the relationship between childhood trauma, disconnection-rejection schemas, and depression among youths in the transition to independent living. Additionally, this study examined whether the impact of childhood trauma on depression, mediated by disconnection-rejection schemas, was moderated by the type of out-of-home care (residential care centers, group homes, and foster homes).
Methods
A survey questionnaire measuring childhood trauma, disconnection-rejection schemas, and depression was administered to 201 participants.
Results
Mistrust-abuse and defectiveness-shame schemas mediated the relationship between childhood trauma and depression. In all types of out-of-home care, both the mistrust-abuse and defectiveness-shame schemas mediated the relationship between childhood trauma and depression. There were no significant differences in mediating effects based on the type of out-of-home care.
Conclusions
The findings of this study can be applied to the treatment of depression during the transition to independent living in individuals who have experienced childhood trauma.

Preliminary Validation of the Korean Version of the Alexian Brothers Urge to Self-Injure Scale (ABUSI-K): Min-kyeong Kim, Myoung-Ho Hyun, Seo Jeong Lee; STRESS. 2023;31(4):182-188. Published online December 28, 2023; DOI: https://doi.org/10.17547/kjsr.2023.31.4.182

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Abstract PDF: Background
This study aimed to validate the Korean version of the Alexian-Brothers Urge to Self-injure Scale (ABUSI) for measuring non-suicidal self-injury urges.
Methods
Analysis was conducted on a sample of 389 adult men and women who had inflicted self-harm without suicidal intent within three years. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) was conducted to confirm the single factor of the scale, and convergent validity was assessed to establish the relationship between ABUSI-K and Negative Urgency (UPPS-P), Self-Criticism/Attacking and Reassurance (FSCRS), and Self-Injurious Thoughts and Behaviors Interview (SITBI).
Results
The Korean version of the Alexian-Brothers Urge to Self-Injure Scale (ABUSI-K) showed high internal consistency and, like the original scale, was confirmed to be a single-factor scale measuring the urge to self-injure. Convergent validity with negative urgency, self-criticism/self-attacking and self-reassuring, the NSSI module of self-injurious thoughts and behaviors, and depression and anxiety were also significant, indicating that ABUSI-K’s psychometric benefits are confirmed.
Conclusions
The results of this study will provide a multifaceted understanding of self-injury without suicidal intent and the urges that occur before self-injury. They are expected to be useful in clinical interventions for individuals who have engaged in non-suicidal self-injuries.

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.

The Dual Mediation Effect of Evaluative Concerns Perfectionism and Mindfulness in the Relationship between Temperament and Depression among Office Workers: SeoYeon Park, Yejin Cho, Myoung-Ho Hyun; STRESS. 2023;31(2):87-95. Published online June 30, 2023; DOI: https://doi.org/10.17547/kjsr.2023.31.2.87

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Abstract PDF: Background
This study investigates the dual mediation effect of evaluative concerns perfectionism and mindfulness in the relationship between temperament and depression among office workers.
Methods
220 Korean office workers completed online surveys measuring levels of FCB-TI perseveration (PE) and emotional reactivity (ER), evaluative concerns perfectionism, mindfulness, and depression.
Results
The data analysis results showed that evaluative concerns perfectionism and mindfulness both mediated the relationship between temperament types and depression. Additionally, evaluative concerns perfectionism and mindfulness had dual mediating effect between temperament and depression.
Conclusions
Based on the results of this study, PE and ER temperament could increase the level of evaluative concerns perfectionism, decreasing the level of mindfulness and increasing the risk of depression. The findings highlight the potential value of mindfulness-based interventions focusing on alleviating perfectionism concerning others’ evaluation for preventing and treating depression in office settings.

The Mediating Role of Anger Rumination in the Relationship between Job Stress and Problem Drinking among Community-Oriented Police Officers: Dawon Jang, Myoung-Ho Hyun; STRESS. 2023;31(2):81-86. Published online June 30, 2023; DOI: https://doi.org/10.17547/kjsr.2023.31.2.81

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Abstract PDF: Background
This study investigated the mediating effect of anger rumination in the relationship between job stress and problem drinking among community-oriented police officers.
Methods
The study participants were 107 community-oriented police officers working in local police stations and substations in the Seoul-Gyeonggi area. Participants completed the Police Job Stress Scale, Anger Rumination Scale (K-ARS), and Alcohol Use Disorder Identification Test (AUDIT). Data was collected from September to October 2022, and the mediation analysis was performed using SPSS PROCESS Macro model 4.
Results
Analysis showed that anger rumination fully mediates the relationship between job stress and problem drinking among community-oriented police officers.
Conclusions
This study emphasizes the importance of interventions or treatments that address both job stress and anger rumination for community-oriented police officers with alcohol-related problems. Such interventions can contribute to preventing and managing problem drinking that threatens the well-being of individual police officers and the police organization.

Effects of Social Anxiety Level on Negative Interpretation Bias in Ambiguous Social Situations: Focused on Relational Intimacy: Hye Ji Yun, Myoung-Ho Hyun; STRESS. 2023;31(1):11-17. Published online March 31, 2023; DOI: https://doi.org/10.17547/kjsr.2023.31.1.11

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Abstract PDF

Background
This study aimed to examine the differences in negative interpretation bias in ambiguous social situations according to social anxiety level and then confirm the degree of negative interpretation bias according to the relational intimacy with the interacting partner.
Methods
A total of 405 adults in their 20s completed the surveys that measured the levels of social interaction anxiety, and the highest 10% (n=30) and lowest 10% (n=30) scorers finally participated in the study. This study used a 2 (high/low social anxiety)×3 (relational intimacy: a stranger/a moderately intimate person/a very intimate person) factorial design. The study provided participants with 15 randomized scenarios with the same social context but different interacting partners and confirmed the degree of agreement with the negative interpretation presented in each situation.
Results
The high social anxiety group showed more negative interpretation bias in ambiguous social situations compared to the low social anxiety group. Regarding the negative interpretation biases according to relational intimacy, the high social anxiety group showed the most negative interpretation bias in social interactions with a moderately intimate person than they did with a stranger or very intimate person.
Conclusions
Social anxiety may have different effects on the degree of negative interpretation bias depending on intimacy in social interactions, suggesting that differentiated therapeutic interventions are needed.

Citations

Citations to this article as recorded by

Mental imagery abilities in different modalities moderate the efficacy of cognitive bias modification for interpretation bias in social anxiety
Charlene L.M. Lam, Andy S. Hin, Luciana N.S. Lau, Zhiqi Zhang, Chantel J. Leung
Journal of Behavior Therapy and Experimental Psychiatry.2025; 88: 102031. CrossRef
Unmet expectations: social inclusion and the interaction between social anxiety and ambiguous or positive feedback
Rémi Thériault, Flavie Dion-Cliche, Stéphane Dandeneau
Frontiers in Psychology.2023;[Epub] CrossRef

The Effect of Directed Avoidance on Impulsive Behaviors among Individuals with Traits of Borderline Personality Disorder: Hoi Jin Yoon, Myoung-Ho Hyun; STRESS. 2022;30(4):260-267. Published online December 30, 2022; DOI: https://doi.org/10.17547/kjsr.2022.30.4.260

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Abstract PDF: Background
This study aims to examine the emotion regulation effect of directed avoidance on the impulsive behavior of individuals with traits of borderline personality disorder (BPD).
Methods
A total of 44 participants with BPD traits were randomly assigned to the control group (n=22) and treatment group (n=22). Participants in the treatment group were directed to use avoidance when they experienced a negative emotion. Positive and negative emotions and impulsivity were measured before and after the negative emotion was induced; impulsivity was measured using the Stroop test and Contingency Delay task.
Results
The Stroop test’s results demonstrated that there was a significant interaction effect of time and error between the groups, specifically, impulsivity increased in the control group when negative emotions were induced. However, the results of Contingency Delay task were marginally significant. The main effect of directed avoidance on discount rate k slightly increased but did not reach a significant level, and the interaction effect between the groups and time was not found. In the control group, discount rate k significantly increased after directed avoidance was induced; however, it was not significant in the treatment group.
Conclusions
Findings from our study supported the effect of directed avoidance could be used as an emotional regulation method among individuals with traits of BPD, such as controlling impulsive behaviors. Finally, limitations of this study and implications of the short-term intervention method using the immediate emotional control effect of directed avoidance for the future are discussed.

The Role of Disability Acceptance and Emotional Support in the Association between Negative Experiences and Depression in Disabled People with Cancer: A Moderated Mediation Model: Young Won Shin, Min Jin Jin, Myoung-Ho Hyun; STRESS. 2022;30(4):244-251. Published online December 30, 2022; DOI: https://doi.org/10.17547/kjsr.2022.30.4.244

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Abstract PDF

Background
This study examined the moderating effect of emotional support from acquaintances and the mediating effect of disability acceptance in the association between disability-related negative experiences and depression in disabled people with cancer.
Methods
Data were collected from 295 participants in the“Disabled-Life Panel Research” conducted by the Korea Disabled people’s Development Institute. The collected data were analyzed using SPSS Windows 26.0 with the PROCESS Macro program 4.0 as a moderated mediating model.
Results
Higher disability-related negative experiences caused lower disability acceptance, which predicted higher depression levels. Emotional support played a significant moderating role in this relationship. The effect of negative experiences on disability acceptance was weaker in disabled individuals with cancer who perceived higher social support from acquaintances.
Conclusions
These results suggest that focusing on emotional support is important in protecting the psychological health of disabled people with cancer who are alienated from society.

Citations

Citations to this article as recorded by

Disability acceptance and depressive symptoms: the moderating role of social support
Gum-Ryeong Park, Sujeong Park, Jinho Kim
Disability and Rehabilitation.2024; 46(26): 6424. CrossRef

Review Article

Research Trends in the Diagnostic Classification of Food Addiction and Future Tasks: Juwon Lee, Myoung-Ho Hyun; STRESS. 2022;30(4):187-195. Published online December 30, 2022; DOI: https://doi.org/10.17547/kjsr.2022.30.4.187

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Abstract PDF

Background
Although people tend to be exposed to food addiction today, there are no formal diagnostics for Food Addiction. Thus, clinical application for therapy is difficult. The present study reviews the clinical characteristics, mechanisms, and measurement tools, and presents opinions on psychiatric classification to suggest directions for further research.
Methods
The authors conducted a literature search using the terms food addiction or FA. The review included 54 Korea and international studies from 1956 to 2021.
Results
Food addiction has reported similarities with substance use disorder and binge eating disorder. Consequently, it seems to be more reasonable to categorize it as substance or behavioral addiction rather than an eating disorder. Further research is needed on whether food addiction can be classified as a behavioral addiction in that food does not have intoxication properties by itself. Further, it is worth considering the dimensional classification of binge-eating-related spectrum disorder, given the behavioral similarities.
Conclusions
Several studies have attempted to reveal the characteristics of food addiction, but researchers’ views on the psychiatric classification are inconsistent. The addition of food addiction in the Diagnostic and Statistical Manual of Mental Disorder (DSM) seems to require a phased approach. Further work should also verify the effective treatment methods, focusing on underlying mechanism.

Citations

Citations to this article as recorded by

Exploring Emotional, Restrained, and External Eating Behaviors: Impacts on Energy and Nutrient Intakes Among Korean Adults
Geum-Bi Ryu, Young-Ran Heo
Nutrients.2025; 17(3): 473. CrossRef
Comparison of the nutrition quotient by types of eating behavior among male and female university students in Gwangju
Geum-Bi Ryu, Young-Ran Heo
Journal of Nutrition and Health.2023; 56(3): 277. CrossRef

Original Articles

Relationship between Stop Drinking Controllability, Hopelessness, Social Activity and Suicidality for Alcohol Use Disorder: Hye-Young Lee, Young-Sil Kwon, Myoung-Ho Hyun, Na-Rae Lee; STRESS. 2022;30(3):172-178. Published online September 30, 2022; DOI: https://doi.org/10.17547/kjsr.2022.30.3.172

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1 Citations

Abstract PDF

Background
This study aimed to examine the relationship between suicidality, stop drinking controllability, hopelessness, and social activity in a population sample of individuals with alcohol use disorder (AUD) and to determine how AUD contributes to suicidal behavior.
Methods
A total of 252 participants diagnosed with AUD were surveyed, and multiple regression analysis and hierarchical regression analysis were used to analyze the data.
Results
Hopelessness fully mediated the relationship between the ability to stop drinking and suicidality. At low levels of social engagement, the relationship between hopelessness and suicidality was significantly modified by social activity.
Conclusions
The results of this study suggest that patients with AUD who were unable to successfully address their drinking problem and abstain from drinking were more likely to experience hopelessness. In addition, we concluded that hopelessness can lead to suicidal ideation or suicide attempts.

Citations

Citations to this article as recorded by

The process of losing meaning in life among alcoholics
Seong-Jun Maeng, Jun-Hyeok Kang, Sun Kyung Kang, Dong-Jun Lee
Asia Pacific Journal of Social Work and Development.2024; : 1. CrossRef

A Preliminary Study on a Short-Term Counseling Program for Victims of Interpersonal Trauma in the Military: Shin Young Park, Sung Yi Cha, Myoung-Ho Hyun; STRESS. 2022;30(3):155-162. Published online September 30, 2022; DOI: https://doi.org/10.17547/kjsr.2022.30.3.155

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Abstract PDF: Background
This preliminary study was conducted to develop a short-term counseling program for victims who experienced interpersonal trauma in the military and to verify its effectiveness.
Methods
A single group pre-post-mixed design was used for this study. Seven victims who experienced interpersonal trauma within the military participated in the program once a week for five weeks. Participants’ post-traumatic stress symptoms, degree of insomnia, depression, state anxiety, and acceptance behavior levels were assessed and compared at baseline and pre-and post-test.
Results
Participants’ post-traumatic stress symptoms, state anxiety, and depression symptoms significantly reduced and acceptance behavior significantly increased after participating in the short-term counseling program.
Conclusions
The results of this study will help explore therapeutic elements that are helpful for victims who have experienced interpersonal trauma in the military.

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