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Original Article
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
  • 341 View
  • 45 Download
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.
Review Articles
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
  • 303 View
  • 21 Download
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.
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
  • 1,340 View
  • 43 Download
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
Influence of Single Parents’ Parenting Stress on Adolescent Children’s Internet Addiction: Focusing on the Moderating Effect of Family Economic Status
Jaekyoung Lee, RaeHyuck Lee
STRESS. 2023;31(3):142-147.   Published online September 30, 2023
DOI: https://doi.org/10.17547/kjsr.2023.31.3.142
  • 1,481 View
  • 42 Download
Abstract PDF
Background
This study investigated the influence of parenting stress among single parents on the level of Internet addiction in their adolescent children, while also considering the moderating effect of family economic status.
Methods
An analysis was conducted using regression models to assess direct and moderating effects, utilizing data from the 2021 Survey of Single-parent Families, focusing on single parents with adolescent children.
Results
It was observed that single parents’ parenting stress had a positive and significant influence on the level of Internet addiction seen in their adolescent children. Furthermore, this influence was observed to be even stronger when the family’s economic status was lower.
Conclusions
This study empirically examined the influence of parenting and economic circumstances on the level of Internet addiction among adolescent children in single-parent families, drawing on nationally representative data. The study also underscored the need for diverse intervention strategies.
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
  • 3,407 View
  • 208 Download
  • 2 Citations
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
The Role of Trauma in Addiction and Recovery: A Qualitative Meta-Synthesis
Jandi Kim, Misook Kim, Youjin Shin, Byunghee Kim, Sungjae Kim
STRESS. 2021;29(1):45-59.   Published online March 31, 2021
DOI: https://doi.org/10.17547/kjsr.2021.29.1.45
  • 4,891 View
  • 171 Download
  • 2 Citations
Abstract PDF
Background

Trauma is a physically or emotionally harmful or life-threatening event that negatively affects well-being. Recently, a high correlation between trauma and substance addiction has been recognized. The aim of this study is to synthesize qualitative studies to understand the effects of trauma involved in the addiction and recovery process.

Methods

By searching qualitative studies about addiction and recovery, 17 Korean studies (80 subjects) were finally included in our analysis.

Results

We recorded the traumas experienced, and their effects on addiction and recovery. Trauma reduced self-esteem and triggered psychological pain, while addiction was perceived as a countermeasure. As the trauma became accepted, participants acknowledged themselves, realized the value of their existence, and formed trusting relationships with others. Recovery progressed as the trauma healed.

Conclusions

Our study facilitates a comprehensive and systematic understanding of the role of trauma on addiction.

Citations

Citations to this article as recorded by  
  • A Qualitative Meta-Synthesis on Drug Addicts Recovery Based on a Transtheoretical Model
    Riah Kim, Youngeun Park, Jieun Kim
    Journal of Korean Academy of psychiatric and Mental Health Nursing.2024; 33(3): 238.     CrossRef
  • Effects of Music Therapy on Subjective Stress Response, Salivary Cortisol, and Fatigue for Intensive Care Nurses
    Hyun Hee Ji, Hyun Sook Jo
    Korean Journal of Health Promotion.2017; 17(2): 119.     CrossRef
Relationship between Recovery Orientation of Mental Health Promotion Facilities and Mental Health Recovery in Persons with Mental Illness: Mediating Effect of Recovery Promotion Relationship Competence of Provider
Eun Ju Bong, Myung Hee Park
STRESS. 2021;29(1):28-36.   Published online March 31, 2021
DOI: https://doi.org/10.17547/kjsr.2021.29.1.28
  • 2,932 View
  • 60 Download
Abstract PDF
Background

The purpose of this study was to examine the recovery orientation of mental health facilities, mental health recovery, and the mediating effects of recovery promotion relationship competence of provider between the recovery orientation of mental health facilities and mental health recovery in individuals with mental Illness.

Methods

This study was conducted using a descriptive survey design. The participants were 225 individuals with mental illness using mental health facilities in Gwangju City. Data were collected from January 10 to February 22, 2019, using self-report questionnaires and were analyzed using descriptive statistics, Pearson’s correlation coefficient, hierarchical multiple regression, and Sobel test with SPSS 22.0.

Results

The findings of this study showed that the recovery promotion relationship competence of provider partially mediated the relationship between the recovery orientation of mental health facilities and mental health recovery.

Conclusions

To promote mental health recovery for individuals with mental illness, organizational efforts to provide recovery-oriented services and training to improve recovery promotion relationship competence of provider are needed.

Distractive Emotion Regulation: The Construct and Its Measurement
Dohyeon Kim, Hae Youn Choi
STRESS. 2021;29(1):11-20.   Published online March 31, 2021
DOI: https://doi.org/10.17547/kjsr.2021.29.1.11
  • 3,582 View
  • 57 Download
Abstract PDF
Background

Distractive emotion regulation, which relieves arousal through attention shift, protects individuals from strong stress. Distractive emotion regulation is widely used in everyday life and although it has great implications in the context of adaptation such as to addiction, it is generally not considered separately from avoidant regulation, it has neither been clearly defined nor measured.

Methods

Through a literature review and qualitative analysis, we selected adults’ distractive emotion regulation behaviors. We explored the construct by developing measurement on the distractive behaviors that adults use to regulate emotion.

Results

Factor analysis revealed that distractive emotion regulation consisted of four factors: “consumption distraction” concerned with activities such as shopping, internet use, and TV viewing; “arousal control distraction” related to activities such as exercise, bathing, and deep breathing; “reserving distraction” pertaining to activities such as eating, sleeping, and listening to music; and “aggressive distraction” involving behaviors such as bullying, physical destructiveness, or cursing. Each factor had a different correlation with stress coping dimensions and subjective well-being.

Conclusions

Distractive emotion regulation is a multidimensional concept composed of sub-factors with different functions and clinical implications in daily life.

Relationship between Complex Trauma Experience in Childhood-Adolescence and Interpersonal Trauma in Adulthood: Mediating Effects of Dissociation Experience, Relationship Addiction, and Internalized Shame
Yumi Oh, Min Kyu Rhee
STRESS. 2021;29(1):1-10.   Published online March 31, 2021
DOI: https://doi.org/10.17547/kjsr.2021.29.1.1
  • 3,213 View
  • 161 Download
Abstract PDF
Background

The purpose of this study is to verify the mediating effects of dissociation experience, relationship addiction, and internalized shame in the relationship between complex trauma experience in childhood-adolescence and interpersonal trauma in adulthood.

Methods

Two hundred and thirty-eight adults participated in this study. They were administered the Korean versions of the Trauma Antecedents Questionnaire, Impact of Event Scale-Revised, Dissociative Experiences Scale, Relationship Addiction Questionnaire, and Internalized Shame Scale. The data were analyzed with descriptive statistics, correlation analysis, reliability analysis, and structural equation modeling.

Results

First, dissociation and internalized shame had a double mediating effect in the relationship between complex trauma experience in childhood-adolescence and interpersonal trauma in adulthood. Second, relationship addiction and internalized shame had a double mediating effect in the relationship between complex trauma experience in childhood-adolescence and interpersonal trauma in adulthood. Third, dissociation, relationship addiction, and internalized shame had a triple mediating effect in the relationship between complex trauma experience in childhood-adolescence and interpersonal trauma in adulthood.

Conclusions

Therapeutic intervention for revictimization should address symptoms such as dissociation, relationship addiction, and internalized shame. In addition, people with complex trauma experiences in childhood-adolescence require preventive intervention to avoid further exposure to interpersonal trauma.

The Moderating Effect of Self-Control in the Relationship between Daily Stress and SNS Addiction Tendency of Adolescents
Jung A Ko, Ji Young Kim, Hye Young Kim
STRESS. 2020;28(3):153-159.   Published online September 30, 2020
DOI: https://doi.org/10.17547/kjsr.2020.28.3.153
  • 5,855 View
  • 344 Download
Abstract PDF
Background

The purpose of the study was to test the moderating role of self-control in the relationship between daily stress and online social networking addiction of adolescents.

Methods

The daily stress scale, online social networking addiction scale, and self-control scale were administered to a sample of 225 adolescents. The data were analyzed using SPSS 25.0 and SPSS PROCESS macro.

Results

The results were as follows: First, correlation analysis was conducted to examine the relationship among daily stress, self-control, and online social networking addiction. Daily stress was significantly positively correlated with online social networking addiction. In contrast, self-control was significantly negatively correlated with daily stress. Second, the interaction between self-control and daily stress played a more prominent role in protecting against online social networking addiction in adolescents who reported lower daily stress than those who reported higher daily stress.

Conclusion

This result suggested that it is necessary to strengthen the positive aspects of self-control to adolescents who have difficulty managing their online social networking addiction.

Negative Urgency Mediates the Relation between Negative Emotion and Smartphone Addiction
Ae Kyoung Lee, Hyejeen Lee
STRESS. 2019;27(4):396-403.   Published online December 31, 2019
DOI: https://doi.org/10.17547/kjsr.2019.27.4.396
  • 4,068 View
  • 63 Download
  • 1 Citations
Abstract PDF
Background:

Negative urgency is a tendency to engage in rash behaviors when experiencing negative emotions such as depression, anxiety, and stress, and is known to predict addictive behaviors. This study aimed to investigate the effect of negative urgency on smartphone addiction as one of behavioral addictions.

Methods:

Self-report questionnaires were administered to 350 college (graduate) students to assess the level of depression, anxiety, stress, negative urgency, and smartphone addiction.

Results:

Regression and bootstrapping analyses showed that negative urgency partially mediated the relationships between each of depression, anxiety, and stress and smartphone addiction, even after controlling for age, sex, and average time spent on smartphone per day.

Conclusions:

Negative emotions such as depression, anxiety, or stress affect smartphone addiction through negative urgency. This finding suggests that intervention for smartphone addiction should focus not only on negative emotions but also on reducing negative urgency. Further implications and limitations of this study are discussed.

Citations

Citations to this article as recorded by  
  • Fear of Missing Out and Smartphone Addiction Mediates the Relationship Between Positive and Negative Affect and Sleep Quality Among Chinese University Students
    Li Li, Mark D. Griffiths, Songli Mei, Zhimin Niu
    Frontiers in Psychiatry.2020;[Epub]     CrossRef
Development of Addiction Prevention Care Program for Nurses
Sungjae Kim, Se-Jin Joo, Young Ok Song, Jin-Gyung Cha, Jeongwoon Yang
STRESS. 2019;27(4):389-395.   Published online December 31, 2019
DOI: https://doi.org/10.17547/kjsr.2019.27.4.389
  • 3,225 View
  • 125 Download
Abstract PDF
Background:

The purpose of this study is to develop an addiction preventing program for nurses, which will improve nurses’ general competency of preventing the addiction problem.

Methods:

The develop process is in 3 steps. First, We analyzed the studies. A group of addiction experts did the focus group interview and drew out the core competency that is necessary to the general nurses. At the second step of the process, we developed 8 modules of addiction preventing program. For the last step, we calculated the content validity index (CVI) from the expert, and the average of CVI was 0.9.

Results:

Each module’s topic is; Overall understanding of addiction, Type and characteristic of addiction, Addiction preventing program with SBIRT (Alcoholism, Addiction of internet-game and smartphone, Gambling addiction, Substance addiction), and the Addiction management for internet-game and smartphone addicted adolescent, and employee’s alcoholism).

Conclusions:

This study provides the basic educational information of the four major addiction prevention. Since nurses are the first line medical staff who is responsible for the screening, it is very important to provide and educate nurse.

Stress and Coping of Recovering Alcoholics in Communities
Jaewon Joung, KyungIm Kang
STRESS. 2019;27(3):277-286.   Published online September 30, 2019
DOI: https://doi.org/10.17547/kjsr.2019.27.3.277
  • 3,050 View
  • 79 Download
  • 1 Citations
Abstract PDF
Background:

The purpose of this qualitative study is to identify stresses and coping of recovering alcoholics in communities.

Methods:

Individual interviews were conducted with a total of 8 recovering alcoholics. Data were analyzed using qualitative content analysis.

Results:

Two categories and six subcategories for each category were derived. Two categories were ‘life problems and stresses encountered without drinking’ and ‘constant change efforts and growth’. The identified stresses of the participants were summarized as ‘a body weakened by drinking’, ‘constant vigilance against the ongoing temptation of drinking’, ‘painful regrets for the past’, ‘difficulties in building new relationships’, ‘a lonely life left alone’, ‘a long way to self-reliance’. In addition, the revealed helpful factors in coping with the stresses were ‘strong power by being together’, ‘strong family support’, ‘firm wills constantly strengthened’, ‘healing power of letting-go’, ‘awareness through learning’, ‘participation in various activities to replace drinking’.

Conclusions:

Participants were experiencing various stresses caused by physical, mental and social problems in their recovery process and trying to overcome the difficulties by applying various methods. The results of this study may provide significant information to prevent relapse and maintain the recovery process of alcoholics.

Citations

Citations to this article as recorded by  
  • Exploring the Self-Care Factors for Recovery in Alcohol Use Disorder and the Role of Peer Recovery Coaches: A Qualitative Study
    Jaewon Joung, PhD, PMH-APN, RN, Kyung Im Kang, PhD, RN
    Issues in Mental Health Nursing.2024; 45(5): 520.     CrossRef
The Mediating Effects of Monetary and Non-monetary Motivations on the Relationship between Daily Stress and Gambling Addiction: Based on the Cycle Racing Participants
Sun Kyung Kang, Yoon Choi, Su Bin Park
STRESS. 2019;27(1):132-138.   Published online March 31, 2019
DOI: https://doi.org/10.17547/kjsr.2019.27.1.132
  • 2,152 View
  • 23 Download
Abstract PDF
Background:

The purpose of this study is to investigate the mediating effect of monetary and non-monetary motivations between daily stress and gambling addiction.

Methods:

For this purpose, a questionnaire survey was conducted on 480 volunteers in S-area, and analyzed by structural equation model (SEM).

Results:

The results showed that daily stress and gambling addiction were significantly predicted. Monetary and non-monetary motivations showed a statistically significant correlation with gambling addiction, and as monetary motivation increased, the gambling addiction became stronger. However, in the mediating factors, monetary and non-monetary motivations’ effects were not statistically significant. In other words, when exposed to daily stress, gambling addiction appears regardless of any motivations.

Conclusions:

Based on the results of this study, social welfare practice and policy suggestions for prevention and improvement of gambling addicts’ were presented.

The Mediating Effects of Multidimensional Experiential Avoidance on the Relationship between Stress and Internet/Smartphone Addiction in Adolescents
Hyejeen Lee
STRESS. 2017;25(4):279-285.   Published online December 31, 2017
DOI: https://doi.org/10.17547/kjsr.2017.25.4.279
  • 12,738 View
  • 77 Download
  • 4 Citations
Abstract PDF
Background:

This study examined the mediating effects of experiential avoidance on the relationship between stress and internet/smartphone addiction in adolescents.

Methods:

448 middle school students completed the self-report questionnaires on school stress, home stress, multidimensional experiential avoidance, and internet/smartphone addiction.

Results:

Regression analyses and tests of indirect effects using bootstrapping showed that ‘procrastination’ and ‘distress aversion’ factors of experiential avoidance mediated the relationship between stress (school, home) and internet/smartphone addiction.

Conclusions:

Stress increases internet/smartphone addiction through procrastination or distress aversion in adolescents. Interventions should focus not only on stress but also on experiential avoidance.

Citations

Citations to this article as recorded by  
  • 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.     CrossRef
  • Experiential Avoidance as a Mediator of the Relationship between Dispositional Mindfulness and Problematic Smartphone Use
    George Felix, Manoj Kumar Sharma, Nitin Anand, Binukumar Bhaskarapillai, Ajay Kumar
    International Journal of Yoga.2023; 16(3): 226.     CrossRef
  • Association between Smartphone Addiction and Suicide
    Oyuntuya Shinetsetseg, Yun Hwa Jung, Yu Shin Park, Eun-Cheol Park, Suk-Yong Jang
    International Journal of Environmental Research and Public Health.2022; 19(18): 11600.     CrossRef
  • Children’s Self-Esteem and Problematic Smartphone Use: The Moderating Effect of Family Rituals
    Daeun Kim, Kyung Eun Jahng
    Journal of Child and Family Studies.2019; 28(12): 3446.     CrossRef

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