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Vol.28 No.6

Kyong-Mee Chung ; Jane Shin pp.1067-1093 https://doi.org/10.17315/kjhp.2023.28.6.001
초록보기
Abstract

E-Mental health service is attracting attention as a new method of providing mental health services, but the information related to public’s perceptions and attitudes about the services is very limited. In this study, the public's perception and needs for e-Mental health service were investigated using a questionnaire for adult men and women. Specifically, in Study 1, a survey of 396 adult men and women was conducted to understand the usage status, intention to use, and preference factors of app-based psychological intervention. Results showed that the participants' experience in using psychological service apps was somewhat low, but the future use intention was relatively high, and the most preferred function of apps was to provide information on psychological difficulties. In Study 2, 500 adult men and women were surveyed on the current usage and perception of digital therapy and preferred factors. Results showed that the recognition and usage experience of digital therapy was low, but the perception was relatively positive. Also, continuous updates, symptom-based intervention, and effectiveness of the intervention were the most important factors when selecting digital therapy. Based on this result, implications for revitalizing e-Mental health service and recommendation for further studies were discussed.

Jun-Ho Yoon ; Hyun-Soo Kim pp.1095-1117 https://doi.org/10.17315/kjhp.2023.28.6.002
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Abstract

This study aimed to formulate a conceptual model for the male infertility processes in relation to psychological factors, which can be examined by delving into the underlying core phenomena associated with psychological stress. To achieve this objective, we employed a dual sampling approach, utilizing both snowball sampling and purposive sampling, to gather a cohort of men who had experienced infertility for more than two years. In-depth interviews were subsequently conducted with a diverse group of eight participants ranging in age from 20 years to 50 years. Qualitative data from these in-depth interviews were meticulously transcribed and subjected to analysis employing the grounded theory methodology. Through an open coding process, a total of 120 concepts, 26 subcategories, and 11 overarching categories emerged. Additionally, utilizing axial coding, we identified 'Experience and perception of infertility' as a causal condition, 'Infertility trauma' and 'Cognitive misconceptions about pregnancy and childbirth' as contextual conditions, and 'Psychological distress' as the phenomenon under scrutiny. Furthermore, the intervention conditions were found to be 'Changes in the support system' and 'Changes in the perception of wives,' along with 'Self-reflection' and 'Acquisition of knowledge about pregnancy and childbirth' as the interactive factors. The resultant outcome encompassed 'Efforts to address infertility' and 'Alterations in marital relationships.' Through the selective coding process, we uncovered the core category of 'Cognitive and emotional transformation.' Building upon this, we classified various male infertility experiences into the following four distinct types: 'Communication type', 'Conflict type', 'Wait and see type' and 'Self-reflection type'. Based on these findings, we engaged in a comprehensive discussion regarding the significance and limitations of this study, and offered suggestions for prospective research endeavors.

Bo Yeon Huh ; Yang Sun Kim ; Hyo Jung Shin pp.1119-1142 https://doi.org/10.17315/kjhp.2023.28.6.003
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Abstract

This study was conducted based on grounded theory, a qualitative research method, to gain further in-depth understanding of the burnout experienced by surgeons and the process of coping with burnout. For this purpose, individual in-depth interviews were conducted with nine surgical residents working at a university hospital. As a result of analyzing the interview data based on grounded theory, 34 subcategories and 17 categories were derived from a total of 73 concepts. To summarize the results of this study, the causal conditions for burn-out experienced by surgical residents were imbalance between personal life and work, excessive responsibility experienced by a novice doctor, and inexperience in professionalism. The contextual conditions included double hardship of training and working life, long process to become a specialist, environment where it was difficult to receive help from seniors (doctors), and relational conflicts within the hospital. The central phenomenon of burnout was found to be the experience of a professional identity crisis as a doctor, such as facing physical limitations, becoming emotionally exhausted, feeling helpless, and experiencing professional skepticism. In this process, work mastery, experience of accomplishment, experience of receiving direct help, and personal personality characteristics that further increased the difficulty were found to influence the action/interaction strategies as mediating conditions. To cope with this, exhausted surgical residents alternately used immediate responses to resolve immediate difficulties and adaptive responses focused on problem solving. As a result, surgical residents were found to reflect on their role as doctors and reorganize their calling by reflecting on hardships of the long training process and recalling the motivation and professionalism for choosing a career that had been forgotten due to burnout. Finally, we comprehensively discussed the burnout experience of surgical residents and presented the significance and limitations of this study.

초록보기
Abstract

There is a continuous increase in the number of studies showing that mindfulness training has a direct effect on reducing physical pain by regulating brain activation. However, most of the studies have confirmed the effect of pain control after intentionally inducing pain in healthy adults. Therefore, the limitation is that the results cannot be generalized to chronic pain. In order to address this limitation, this study focused on works that verified the physiological effect of the brain after mindfulness training targeting patients with chronic pain. To this end, a systematic literature review was conducted using PubMed and the Cochrane CENTRAL database. A total of four studies met the inclusion criteria, and they were additionally compared with four studies in healthy adults. The degree of pain measured using a subjective scale showed a significant reduction in pain after mindfulness training compared to that in the control group and before training for both chronic pain and acute pain. Changes in mindfulness skills by using subjective scales showed differences according to the mindfulness scales. In the chronic pain study, two studies measured the degree of mindfulness change with the Cognitive and Affective Mindfulness Scale-Revised (CAMS-R) and Kentucky Inventory of Mindfulness Skills (KIMS), and in the acute pain study, two studies were assessed using the Freiburg Minfulness Inventory (FMI). Results showed that only the study assessed by CAMS-R showed no significant change after mindfulness training. Functional magnetic resonance imaging (fMRI) showed that mindfulness training in both chronic pain and acute pain reduced the pain by activating the descending pain modulatory pathways, which is a higher-order brain function. However, brain activation related to bottom-up regulation instead of top-down regulation was found in cases with a training experience of an average of 10 years or more. This suggests that the mechanism of the brain for controlling pain may also vary depending on the level of mindfulness. Studies verifying the brain mechanism of mindfulness in pain control is still in its infancy, and more research should be conducted in the future. This study is significant as it is the first attempt to compare the brain physiological effects of mindfulness in pain management by dividing them into chronic pain and acute pain. The results of this study reaffirmed that mindfulness training in pain management can cause significant pain reduction in chronic pain and acute pain. Moreover, suggestions for future research were discussed.

Si On Park ; Sung-Man Bae pp.1165-1182 https://doi.org/10.17315/kjhp.2023.28.6.005
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Abstract

Based on Williams' “Cry of Pain,” which explains suicide, this study aimed to examine the impact of defeat on suicidal ideation in adult men and women aged 19~34 years, the mediating effect of entrapment and the moderated mediating effect of mindfulness on the relationship between entrapment and suicidal ideation. The sample included 424 men and women aged 19~34 years who were surveyed in Seoul, Gyeong-gi, and Gyeong-sang. Analysis of the collected data was completed with IBM SPSS Statistics v21.0 and SPSS PROCESS Macro Version 3.4. The results of the study were as follows: First, defeat had a direct effect on in suicidal ideation. Second, entrapment partially mediated the relationship between defeat and suicidal ideation Third, mindfulness moderated the relationship between entrapment and suicidal ideation. The results demonstrated the moderating effect of mindfulness on the relationship between entrapment and suicidal ideation. Finally, mindfulness moderated the effect of defeat on suicidal ideation through entrapment, verifying the moderated mediation effect. These results suggest the specific path from defeat to suicidal ideation and confirm the role of mindfulness.

Hyeon-Seung Yun ; Sung-Man Bae pp.1183-1211 https://doi.org/10.17315/kjhp.2023.28.6.006
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Abstract

The study aimed to examine the effects of COVID-19 stress on psychological distress (depression, anxiety, and post-traumatic stress disorder (PTSD) symptoms), and whether optimism and gratitude disposition have a moderating effect on these relationships. Online self-report questionnaires that consisted of the scales for COVID stress, optimism (LOT-R), gratitude disposition, depression (K-CESD-R), anxiety (STAI-Y), and PTSD symptoms (IES-R-K) were completed, and data of 411 participants (180 males and 231 females) were analysed by SPSS 23.0 and PROCESS macro for SPSS 3.3. Results of this study were as follows: First, COVID-19 stress was positively associated with psychological distress. Second, the moderating effect of optimism was partially significant in the relationship between COVID-19 stress and psychological distress. Third, the moderating effect on gratitude disposition was partially significant in the relationship between COVID-19 stress and psychological distress. Fourth, the moderating effect of optimism and gratitude disposition on anxiety was not significant. This study was conducted approximately one year after the COVID-19 outbreak, and these findings provide a theoretical basis for the development and application of an effective intervention program for the general population that suffered from COVID-19 by verifying the moderating effect of optimism and gratitude disposition on the relationship between COVID-19 stress and psychological distress.

Jaegwang Choi ; JeeHyeon Han ; Wonyoung Song pp.1213-1229 https://doi.org/10.17315/kjhp.2023.28.6.007
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Abstract

This study attempted to identify the relationship between borderline personality tendency and obsessive sexual behavior in adults and to find ways to solve self-destructive behavior problems caused by borderline personality tendency by confirming the mediating effect of perceived stress and negative urgency. To this end, a survey was organized and conducted in 306 adults living across the country using scales that can measure borderline personality tendency, perceived stress, negative urgency, and obsessive sexual behavior. Descriptive statistical analysis, reliability analysis, and Pearson correlation analysis were performed on the collected data to confirm the basic characteristics of the data, and the research model was verified using structural equation modeling to verify the research hypothesis. The results of the analysis were as follows: First, the correlation between the main variables used in this study was positively significant. Second, the causal relationship between borderline personality tendencies and compulsive sexual behavior was statistically significant, and the causal relationship, in which perceived stress and negative urgency sequentially mediated the two relationships, was also confirmed to be statistically significant. These results indicated that when the borderline personality tendency was increased, perceived stress and denial urgency could be activated and the frequency of compulsive sexual behavior could increase. Therefore, an intervention to adaptively perceive stress, reduce the level of negative emotions, and endure negative urgency can be an effective way to cope with obsessive sexual behavior caused by borderline personality trends. Finally, the significance and limitations of this study were discussed.

Ah-Hyeon Shin ; Joon-Ho Park pp.1231-1251 https://doi.org/10.17315/kjhp.2023.28.6.008
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Abstract

This study is set and tested, through an experiment, a two-way interaction hypothesis, which proposes that the level of weight stigma will affect Eating Behavior according to the level of self-affirmation. It was a completely randomized design of 2 (weight stigma: weight stigma/non-stigma) × 2 (self-affirmation: self-affirmation/non-affirmation), and data from 82 females were analyzed. After introducing the participants to the "Task Immersion Study and A New Snacks' Taste Evaluation Study," we manipulated the weight stigma by presenting the first task of the Task Immersion Study as "article-related writing tasks. After manipulating weight stigma, we presented feedback to all participants, inducing ego-threatening by informing them of low immersion scores. Following that, we manipulated self-affirmation by presenting the second task of the Task Immersion Study as "value list-related writing tasks." Afterward, participants in a new snack's taste evaluation study were requested to taste and evaluate three snacks. As a result of this study, the two-way interaction between weight stigma and self-affirmation on eating Behavior was significant, and thus the hypothesis was supported. That is, in the case of the group with non-affirmation, the group with weight stigma ate more snacks than the group with non-stigma, while in the group with self-affirmation, there was no significant difference in eating Behavior between both groups. The results suggest that providing psychological resources, such as identifying important aspects of oneself unrelated to threats in threat situations, can buffer the increase in eating Behavior, a defensive behavior related to threat information. Based on these results, we discuss this study's implications, limitations, and future research directions.

Nohyun Park ; Seongwoo Jo ; Kwangsu Moon ; Sungkun Cho pp.1253-1275 https://doi.org/10.17315/kjhp.2023.28.6.009
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Abstract

The present study aimed to verify the effects of a behavioral activation (BA) program on pain intensity, pain interference, pain catastrophizing, depression, activity frequency, and life satisfaction in patients with complex regional pain syndrome (CRPS). For this purpose, we applied a multiple baseline design consisting of baseline, treatment, and follow-up phases with four CRPS patients. The BA program consisted of a total of eight sessions, primarily conducted in a non-face-to-face, approximately once a week, with each session lasting about 30 to 60 minutes. The target activity was set to focus on positive mood related activities among those showing inconsistency before and after pain onset. Time-series data were collected through daily activity monitoring sheets, encompassing activity logs categorized by the time of day (morning, afternoon, evening), pain intensity, depression, frequency of target activity achievement, and reasons for not accomplishing target activity. The time-series data indicated a significant increase in the frequency of participants' target activity during the treatment phase. This pattern was sustained and even augmented during the follow-up phase. Additionally, depression exhibited a gradual decrease from the intervention phase to the follow-up phase. However, the decrease in pain intensity was relatively lower than the reduction observed in depression. Effect size (Cohen's d) was calculated by measuring participants' pain intensity, pain interference, pain catastrophizing, depression, and life satisfaction pre-, post-, and follow-up (one month after termination) to analyze the effects of the BA program. The results showed moderate to large effect sizes for all variables except pain intensity, and these effects were maintained and increased at follow-up. The findings suggest that the BA program, a psychological approach, is applicable to CRPS patients who experience extreme pain.

MinKyu Rhee ; KyuMan Han ; Geonhee Lee pp.1277-1292 https://doi.org/10.17315/kjhp.2023.28.6.010
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Abstract

This study aimed to examine the reliability, construct validity, and criterion-related validity of a diagnostic scale for adolescent gambling disorder based on DSM-5. In addition, it aimed to compare the psychometric properties of the DSM-5 gambling disorder diagnostic criteria with those of DSM-IV and GPSS, and to examine the accuracy of diagnostic classification. The researcher’s administered a standardized diagnostic criteria questionnaire to all 2,654 adolescent participants in Gyeongnam Province. Reliability, validity, and ROC analyses demonstrated that the DSM-5-based-diagnostic scale for adolescent gambling disorder had satisfactory reliability, validity, and accuracy in diagnostic classification. A cross-tabulation analysis further examines the differences in each scale’s severity distributions. The analysis revealed that the DSM-IV pathological gambling group and the DSM-5 gambling disorder group had a lower proportion of problems compared to the GPSS problem group. Finally, a discussion of the usefulness and accuracy of diagnosing gambling disorder in adolescents is presented based on the findings above, with implications for the future use of diagnostic scales.

The Korean Journal of Health Psychology