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.

Moderated Mediating Effect of Anxiety by Household Type on the Relationship between Daily Life Stress and Non-Suicidal Self-Injury among Adolescents: RaeHyuck Lee; STRESS. 2024;32(4):188-195. Published online December 27, 2024; DOI: https://doi.org/10.17547/kjsr.2024.32.4.188

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Background
This study examined the impact of adolescents’ daily life stress on non-suicidal self-injury among adolescents, focusing on the mediating role of anxiety and the moderated mediating effect of anxiety by household type (two-parent vs. single-parent households).
Methods
This study utilized data from the Korean Teenagers’ Mental Health Study, conducted by the National Youth Policy Institute and applied the PROCESS macro method for analysis.
Results
First, daily life stress significantly increased the likelihood of non-suicidal self-injury among adolescents. Second, anxiety played a full mediating role. Third, no significant difference was observed in the direct impact of daily life stress on non-suicidal self-injury between adolescents from two-parent and single-parent households. Fourth, the mediating effect of anxiety on the relationship between daily life stress and non-suicidal self-injury was more pronounced among adolescents in single-parent households than those in two-parent households.
Conclusions
The findings highlight the need for tailored interventions to deal with non-suicidal self-injuries among adolescents, particularly in the context of household type.

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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. 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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1 Citations

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

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.

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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3 Citations

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

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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2 Citations

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

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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 Relation between Social Anxiety, Self-Focused Attention and State Anxiety: The Moderated Mediation Effect of the Self-image on a Screen: TaeHo Um, Mirihae Kim, Jung-Ho Kim; STRESS. 2022;30(4):234-243. Published online December 30, 2022; DOI: https://doi.org/10.17547/kjsr.2022.30.4.234

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Abstract PDF: Background
This study examined how seeing one’s own image during video communication affects the cognitive process of social anxiety.
Methods
Fifty-two university students were recruited and assessed for social anxiety and dispositional self-focused attention. They were randomly assigned to different exposure and size settings of self-images on a screen (none, middle, big). Subsequently, a simulated video interview was conducted. During the experiment, changes in state anxiety (subjective anxiety, heart rate) and state self-focused attention were assessed.
Results
First, self-focused attention mediated the effect of social anxiety on subjective anxiety. Second, the mediation effect of state self-focused attention on social anxiety’s influence on subjective anxiety was not moderated by the exposure and size of the self-image on the screen. Third, the mediation effect of dispositional self-focused attention on social anxiety’s influence on subjective anxiety was moderated by the exposure and size of the self-image on the screen. The moderated mediation effects of the exposure and size of the self-image on the screen were significant for middle and big sizes.
Conclusions
These findings suggest that dispositional self-focused attention—a cognitive characteristic of social anxiety—can interact with the exposure and size of a self-image on a screen, causing higher anxiety.

The Influence of COVID-19-Induced Depression on Smartphone Usage Time among Multicultural Adolescents and the Moderated Mediation Effect of Gender through Anxiety: RaeHyuck Lee; STRESS. 2022;30(3):147-154. Published online September 30, 2022; DOI: https://doi.org/10.17547/kjsr.2022.30.3.147

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Abstract PDF: Background
This study aimed to verify the influence of COVID-19-induced depression on smartphone usage time among multicultural adolescents, as well as the moderated mediation effect of gender through anxiety.
Methods
Using the raw data from the 2021 Korea Youth Risk Behavior Survey, a sample of 1,161 multicultural adolescents was recruited for this study. Models 4 and 7 of the PROCESS macro method were used for data analysis.
Results
COVID-19-induced depression among multicultural adolescents positively influenced their smartphone usage time. Moreover, their anxiety fully mediated the influence of COVID-19-induced depression on their smartphone usage time. The mediation effect of COVID-19-induced depression on smartphone usage time through anxiety was moderated by their gender.
Conclusions
The results are significant in that they provide insights for addressing the problem of smartphone usage among multicultural adolescents amid a disaster like COVID-19.

The Experience of Killing and Health in Late Life: Findings from Korean Vietnam War Veterans: Hyunyup Lee, Sungrok Kang; STRESS. 2022;30(2):85-91. Published online June 30, 2022; DOI: https://doi.org/10.17547/kjsr.2022.30.2.85

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Abstract PDF: Background
The current study aimed to examine the effects of combat exposure and killing on mental and subjective physical health later in life among Korean Vietnam War veterans.
Methods
The data were collected from 342 male veterans with a mean age of 72 years (SD=2.57). Veterans were divided based on their histories into three groups: no experience (Group 1), combat exposure only (Group 2), and both killing and combat exposure (Group 3). Analyses of variance (ANOVAs) examined group differences in post-traumatic stress disorder (PTSD) symptoms, anxiety symptoms, hostility, and perceived physical health.
Results
The ANOVAs showed that PTSD, anxiety symptoms and hostility were most prevalent among the veterans in Group 3 (both killing and combat exposure). No significant differences were found between Groups 1 and 2. Perceived physical health was highest among the veterans in Group 1 (no experience). There were no differences between Groups 2 and 3. Even after controlling for the impacts of optimism and social support after homecoming, these results were similar.
Conclusions
The findings indicate that killing experience and combat exposure should be considered in designing interventions for veterans deployed into active combat zones.

The Parallel Multiple Mediating Effects of Work-Family Conflict and Loneliness in the Relationship between Temperaments, Depression, and Anxiety while Working from Home: Yeeun Hwang, Yejin Cho, Yuseung Choi, Myoung-Ho Hyun; STRESS. 2022;30(2):75-84. Published online June 30, 2022; DOI: https://doi.org/10.17547/kjsr.2022.30.2.75

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1 Citations

Abstract PDF

Background
As the number of people working from home has increased since the COVID-19 pandemic, it is important to understand workers’ stress and psychological state while working from home. Work-family conflict and loneliness may be related to working from home, and they could be experienced differently depending on individual traits. Therefore, this study examined the parallel multiple mediating effects of work-family conflict and loneliness in the relationship between personal temperaments and negative emotions such as depression and anxiety.
Methods
Data were collected online from people currently working from home for at least one month, more than once per week. They answered K-DASS-21, UCLA loneliness scale, Work-Family Conflict, and FCB-TI. Only four temperaments were used in the statistic step: Briskness and Sense sensitivity as protective factors and Perseveration and Emotional reactivity as vulnerable factors. The multiple mediating effects were analyzed independently by using the PROCESS macro.
Results
Firstly, Briskness and Sense sensitivity were found to negatively affect depression and anxiety while working from home by significantly mediating work-family conflict and loneliness. Thus, these temperaments would be protective factors while working from home. Secondly, Perseveration and Emotional reactivity positively influenced both negative emotions by mediating two mediation variables, which means that both temperaments are vulnerable factors.
Conclusions
The results suggest that personality traits can impact how people experience stress and negative emotions in working situations, leading to negative psychological states. Consequently, personal temperaments would be important to understand relationships between environments and internal experiences.

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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. CrossRef

The Influence of Parental Psychological Control on Social Anxiety among College Students: The Mediating Effect of Self-Discrepancy and Validation from Others: Kyue Won Lee, Eun Young Park; STRESS. 2022;30(1):45-51. Published online March 31, 2022; DOI: https://doi.org/10.17547/kjsr.2022.30.1.45

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Abstract PDF: Background
This study aimed to investigate the effects of parental psychological control on social anxiety among college students and to understand the mediating effect of self-discrepancy and validation from others between them.
Methods
The participants were 351 college students from Daegu and Gyeongsangbuk-do who responded to a survey. And structural equation model was used to analyze the data.
Results
First, there was no mediating effect of self-discrepancy between parental psychological control and social anxiety. Second, there was a significant mediating effect of validation from others between them. Finally, self-discrepancy and validation from others were found to sequentially mediate between parental psychological control and social anxiety.
Conclusions
This findings suggest that self-discrepancy and validation from others could be used as a therapeutic strategy in treatments.

Modifying Interpretation in Socially Anxious Students Using Cognitive Bias Modification: Effects of Perspective Employing Positive Imagery: Da In Kim, Hyae Young Yoon; STRESS. 2021;29(4):271-282. Published online December 31, 2021; DOI: https://doi.org/10.17547/kjsr.2021.29.4.271

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The Relationship between Taking Propranolol Related to Music Performance Anxiety and Stress Coping Model in Art High School Students Majoring in Music: Dong-Uk Yoon, Byeong-a Song, Hyung-Jun Lee, Eun-ra Yu; STRESS. 2021;29(4):227-234. Published online December 31, 2021; DOI: https://doi.org/10.17547/kjsr.2021.29.4.227

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The Influencing Factors of Burnout in Nurses in the COVID-19 Pandemic Disaster: Jeong Yee Bae, Eun-kyung Lee, Bi-Joo Kim, Eun Ju Lee; STRESS. 2021;29(2):80-86. Published online June 30, 2021; DOI: https://doi.org/10.17547/kjsr.2021.29.2.80

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16 Citations

Abstract PDF

Background

This study aims to identify factors influencing burnout in nurses during COVID-19 disaster situations.

Methods

The research subjects were 131 nurses who had the experience of nursing patients during the COVID-19 pandemic, and were selected through convenience sampling. The collected data were subjected to percentage, mean and standard deviation, t-test, ANOVA, Pearson’s correlation coefficient, and multiple regression analysis using the SPSS version 24.0 program.

Results

Burnout in nurses showed a statistically significant correlation with anxiety, PTSD, and depression. It was also confirmed that nurses’ depression and shift work were important factors that had significant effects on burnout.

Conclusions

In preparation for new infectious diseases that are expected to become more frequent in the future, a policy to supply nursing manpower and prevent burnout is necessary. In addition, it is necessary to introduce various work systems and develop and disseminate intervention programs for depression and burnout.

Citations

Citations to this article as recorded by

The Effects of Disaster Nursing Core Competence and Coping Flexibility on the Quality of Work Life of Emergency Room Nurses during Long COVID-19
Yu Jin Lee, Chung Hee Woo
Journal of Korean Academy of Nursing Administration.2024; 30(3): 259. CrossRef
Effects of stress on burnout among infection control nurses during the COVID-19 pandemic: the mediating effects of social support and self-efficacy
Su-jin Lee, Ju-Young Park, Seo-Hyeon Kim
BMC Nursing.2024;[Epub] CrossRef
The relationship between secondary traumatic stress and burnout in critical care nurses: The mediating effect of resilience
Yun Jeong Jeong, Sujin Shin
Intensive and Critical Care Nursing.2023; 74: 103327. CrossRef
Stress, COVID‐19 related knowledge, attitude, and infection control performance of nurses at long‐term care hospitals
Ji Ae Shim, Sun Young Jeong
Nursing & Health Sciences.2023; 25(2): 247. CrossRef
The effect of grit on the work engagement of nurses: The mediating effects of positive psychological capital and burnout
Mi Kyung Park, Won Hwa Kim
The Journal of Korean Academic Society of Nursing Education.2023; 29(2): 161. CrossRef
The impact of Long COVID, work stress related to infectious diseases, fatigue, and coping on burnout among care providers in nursing home: A cross-sectional correlation study
Hyunju Lee, Youngja Seo, Jihye Kim, Hye Young Song, Jinhee Park, Youngran Yang
Journal of Korean Gerontological Nursing.2023; 25(3): 271. CrossRef
Burnout and Its Associated Factors Among COVID-19 Frontline Healthcare Workers
Hyeonseok Oh, Euihyun Kwak, So Yeon Hyun, Songeun Lee, Suk-Hyun Lee, In Mok Oh, Minyoung Sim
Journal of Korean Neuropsychiatric Association.2023; 62(4): 199. CrossRef
Factors influencing burnout among Korean nurses caring for patients with COVID-19: a cross-sectional study
Seon Yeong Lee, Mi-Ae You, Jeong Ah Ahn, Eun Ji Seo
Journal of Korean Biological Nursing Science.2023; 25(4): 276. CrossRef
The Influence of Infection Control Knowledge, Emergency Nursing Competency, and Infection Prevention Environment on Burnout among Psychiatric Nurses Caring for Patients with COVID-19
Hyeran Cho, Suyon Baek
Journal of Korean Academy of psychiatric and Mental Health Nursing.2023; 32(4): 482. CrossRef
Factors Influencing Burnout of Nurses Working in a Hospital Nationally Designated for COVID-19 Patients
Hwasoon Kim, Doa Kim, Minsook Kim, Yiseul Kim, Soojin Bang, Gine Lee, Miso Won, Dajung Joo
Korean Journal of Adult Nursing.2022; 34(1): 74. CrossRef
Correlation between Stress and Anxiety to Viral Epidemics (SAVE) and Burnout among Korean Dental Hygienists during the COVID-19 Pandemic: A Cross-Sectional Study
Seul-Ah Lee, Jung-Eun Park, Jong-Hwa Jang
International Journal of Environmental Research and Public Health.2022; 19(6): 3668. CrossRef
Factors Affecting the Quality of Work Life of Nurses at Tertiary General Hospitals in the Context of the COVID-19 Pandemic
Eunhee Hwang
International Journal of Environmental Research and Public Health.2022; 19(8): 4718. CrossRef
The Mediating Effects of Health Concern and Depression in the Relation between Self-quarantined People’s COVID-19 Stress and Fatigue
Sun Hwa Shin, Eun Hye Lee
Journal of Korean Academy of Community Health Nursing.2022; 33(1): 43. CrossRef
Mediating effect of resilience between post-traumatic stress and emotional exhaustion in nurses during the COVID-19 pandemic
Juhee Jeong, Yeoungsuk Song
The Journal of Korean Academic Society of Nursing Education.2022; 28(2): 193. CrossRef
Correlation between COVID-19 and Nurses’ Job Stress and Burnout
Seyoung Yun, Song Vogue Ahn
Health Insurance Review & Assessment Service Research.2022; 2(2): 202. CrossRef
Mediating Effects of Psychological States on Work Performance of Visiting Nurses According to COVID-19 Workplace Quarantine Measures: A Multi-Group Path Analysis Study
Jee-Hyun Hwang
International Journal of Environmental Research and Public Health.2021; 19(1): 444. CrossRef

Effects of Social Support, Pregnancy Stress, and Anxiety on Health-Related Quality of Life in Pregnant Women: Hyun Jung Kim, Hee Sun Kang; STRESS. 2021;29(2):140-148. Published online June 30, 2021; DOI: https://doi.org/10.17547/kjsr.2021.29.2.140

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6 Citations

Abstract PDF

Background

The purpose of this study was to identify the relationships between social support, pregnancy stress, and anxiety of pregnant women and to determine their effect on health-related quality of life.

Methods

A total of 202 pregnant women participated in this study. The collected data were analyzed by the frequency and percentage, mean and standard deviation, independent t-test, ANOVA, Pearson’s correlation coefficients, and hierarchical multiple regression analysis using the STATA/IC 15.1 program.

Results

As a result of this study, the major factors affecting the health-related quality of life of pregnant women were identified as anxiety, educational level, social support, and marital satisfaction. Social support has a positive effect on the health-related quality of life of pregnant women (β=0.27, p< .001), but anxiety had a negative effect (β=−0.56, p<.001).

Conclusions

When planning nursing interventions to improve the health-related quality of life of pregnant women, strategies for lowering the anxiety and improving the social support of pregnant women should be considered.

Citations

Citations to this article as recorded by

Factors Influencing Quality of Life in Pregnant Women With Preterm Labor
So Jin Lee, Ju-Hee Nho, Eun Jee Lee, Dong Hyun Lee
Journal of Korean Maternal and Child Health.2025; 29(2): 87. CrossRef
Are the effects of stress on antenatal depression mediated by self-esteem and moderated by social support?: a cross-sectional study
Eunjoo Lee
Women's Health Nursing.2024; 30(4): 299. CrossRef
Health-related quality of life of migrant workers: a systematic literature review
Hyun-Jin Cho, Kyoungrim Kang, Kyo-Yeon Park
BMC Public Health.2023;[Epub] CrossRef
Effects of a Spouse’s Aromatherapy Hand Massage on Fatigue, Stress, and a Couple’s Relationship in Pregnant Women
Hyang Mi Jung, Eun Jung Oh, Hyun Chul Sung, Myungja Kim
Journal of The Korean Society of Maternal and Child Health.2022; 26(1): 35. CrossRef
Influence of Fetal Attachment and Pregnancy Stress on Health Promotion Behavior in Primigravida
Soo Rueng Yeo, So Young Choi
Journal of The Korean Society of Maternal and Child Health.2022; 26(4): 270. CrossRef
The Influencing Factors on Health-Related Quality of Life in Childbearing Women Based on the Korea National Health and Nutrition Examination Survey (KNHANES) 2019 Data
Jeongim Lee
Journal of The Korean Society of Maternal and Child Health.2021; 25(4): 282. CrossRef

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