STRESS

Original Articles

When Does Adolescents’ Stress Become Somatic Symptoms? A Moderated Mediation Model of ADHD Tendency, Stress, and Somatic Symptoms by Household Economic Status: RaeHyuck Lee; STRESS. 2026;34(1):43-51. Published online March 30, 2026; DOI: https://doi.org/10.17547/kjsr.2026.34.1.43

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Abstract PDF: Background
This study examines whether stress mediates the association between Attention-Deficit/Hyperactivity Disorder (ADHD) tendency and somatic symptoms among adolescents, and whether this association varies by household economic status.
Methods
Using nationwide data from 6,689 Korean adolescents, ADHD tendency, perceived stress, somatic symptoms, and subjective household economic status were assessed using validated self-reporting scales. Multiple regression and the PROCESS Macro were applied to test the direct, mediation (Model 4), and moderated mediation effects (Model 14), controlling for gender, age, and out-of-school status. Bootstrapping was performed using 10,000 re-samples.
Results
ADHD tendency was positively associated with somatic symptoms. Stress partially mediated this relationship. Stress’ effect on somatic symptoms was negatively moderated by household economic status. Consequently, ADHD tendency’s indirect effect on somatic symptoms through stress significantly varied by household economic status.
Conclusions
ADHD tendency contributes to somatic symptoms through elevated stress. This process is shaped by the socioeconomic context. Interventions targeting stress reduction, particularly among economically vulnerable adolescents, may help prevent somatic symptom development.

The Influence of Attention-Deficit/Hyperactivity on School Adjustment among Adolescents: Focusing on the Moderated Mediation Effect of Depression by Household Economic Status: RaeHyuck Lee; STRESS. 2025;33(1):13-21. Published online March 28, 2025; DOI: https://doi.org/10.17547/kjsr.2025.33.1.13

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2 Citations

Background
This study examines the influence of attention-deficit/hyperactivity on school adjustment among adolescents and investigates the moderated mediation effect of depression on household economic status.
Methods
The research hypotheses were tested using data from the Korean Teenagers’ Mental Health Study and analyzed utilizing the PROCESS Macro method.
Results
Attention-deficit/hyperactivity had a significant negative impact on students’ school adjustment. Additionally, depression partially mediated the relationship between attention-deficit/hyperactivity and school adjustment. While household economic status did not moderate the influence of attention-deficit/hyperactivity on school adjustment, it did moderate the mediating effect of depression. Specifically, the mediating effect of depression on the relationship between attention-deficit/hyperactivity and school adjustment was more pronounced for adolescents from low-income households than for those from medium- or high- income households.
Conclusions
This study discusses the research implications and considerations.

Citations

Citations to this article as recorded by

The Moderated Moderation Effect of ADHD Symptoms and Self-Esteem on the Relationship between Daily Life Stress and Depression among Adolescents
RaeHyuck Lee
STRESS.2026; 34(1): 34. CrossRef
The Influence of ADHD Traits on School Maladjustment in Middle School Students: Focusing on the Serial Mediation Effect of Daily Life Stress and Self-Esteem
RaeHyuck Lee
STRESS.2026; 34(2): 63. CrossRef

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