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Vol.40 No.3

Psychosocial Factors Predicting Planning Level and Impulsivity of Suicide Attempt using a Decision Tree Analysis
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Abstract

Suicide attempt is usually made as a result of distal planning and/or proximal impulsivity during an acute crisis. The aim of this study was to examine the interaction effects of psychosocial factors that predict the planning level and impulsivity of suicide attempt. Using stratified sampling by age and sex, 300 adults with a history of suicide attempt were recruited. Planning level and impulsivity of the most recent suicide attempt were assessed, and the following were assessed and used as the main predictors: depression, hopelessness, negative urgency, cognitive flexibility, and stress experience. Using decision tree analysis, the results indicated that the interaction between depression and negative urgency predicted the planning level of suicide attempt. Specifically, the higher the level of depression, the higher the planning level of a suicide attempt. In cases of low levels of depression, a higher level of negative urgency predicted the planning level. The psychosocial factors that predicted impulsivity of suicide attempt were the interaction of depression, cognitive flexibility (control and alternatives), and hopelessness. First, the lower the level of depression, the greater the impulsivity of a suicide attempt. Second, when depression levels were low, higher levels of control and alternatives predicted the impulsivity. Third, when the levels of depression, control, and alternatives were low, hopelessness predicted the impulsivity. The results of this study suggest that differential intervention strategies are needed for individuals planning suicide and those who may act impulsively during an acute crisis.

Judgment Factors Involved in Deciding Whether to Continue Living
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Abstract

This study attempted to identify the main judgment factors involved in decision-making by seeing suicide as a result of deciding whether or not to continue life. For this purpose, this study presents the life and death choice situation through the euthanasia scenario and identifies the relationships among three decision-making variables: past life satisfaction, current pain severity, and prediction of future improvement. In addition, the effects of the three variables on euthanasia choice were examined. Data were collected from 515 adults, who rated Suicidal Behavior Questionnaire-Revised (SBQ-R), Center for Epidemiologic Studies Scale-Depression (CES-D), Life Orientation Test-Revised (LOT-R), and Positive Affect and Negative Affect Schedule (PANAS), and one of four types of euthanasia scenarios. In all scenario types, the prediction of future improvement was strongly correlated with euthanasia choice, and the result of hierarchical regression analysis revealed that future prediction was the most important variable explaining euthanasia choice. The current pain severity was the second most important variable explaining the choice of euthanasia. In all scenarios, past life satisfaction was not a significant predictor of euthanasia choices. The results confirm the importance of predicting the future in deciding whether to continue living, as in the deciding whether to continue the experience. In addition, evaluation of the present is a more important factor than evaluation of past life as a whole in suicide decisions.

Impact of Social Acknowledgment on Complete Mental Health of State Violence Survivors
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Abstract

This study examined the effect of social acknowledgement on the mental health of individuals who have experienced state violence in Korea based on the complete mental health model. A total of 138 state violence survivors completed surveys measuring perceived distress from state violence trauma and post-state violence social stressors, complex posttraumatic stress disorder (CPTSD) symptoms, and mental well-being. Conducting a principal axis factoring (PAF) of the post-state violence social stressors, we identified seven factors including three factors related to the absence of social acknowledgment, namely, socio-institutional disapproval, disapproval from state, and relational disapproval. A multiple logistic regression analysis showed that disapproval from state and relational disapproval were risk factors for the languishing and syndrome group, in reference to the complete to moderate mental health group. For recovery, mental well-being should be considered, in addition to symptoms. The government’s social acknowledgment, including seeking justice, apologizing, and making reparation, is a crucial factor related to CPTSD symptoms and mental well-being of survivors of state violence, and seeking recovery should be built upon this acknowledgment.

Approach-Avoidance Bias Among Smokers Towards Pictorial Health Warnings
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Abstract

The purpose of this study was to examine the approach-avoidance bias among smokers towards pictorial health warnings. For this purpose, a computer-based Approach-Avoidance Task (AAT) was conducted for smokers (male college students who smoked less than 20 cigarettes per day, n=19) and non-smokers (male college students who smoked less than 5 cigarettes over their entire lives, n=19), and the AAT score was calculated. Results showed that smokers were significantly more likely to avoid smoking warning stimuli than non-smokers, however, there was no difference between groups for neutral stimuli. Smokers also tended to have slower approach bias to smoking warning stimuli than non-smokers. Finally, we present the clinical implications and limitations of this study and provide suggestions for subsequent studies.

The Relationship between Sleep Quality and Depressive Mood in University Students Experiencing Financial Difficulties: An Ecological Momentary Assessment Study
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Abstract

This study aimed to examine the mediating effects of fatigue, stress, and affect on the relationship between sleep quality and depressive mood in university students experiencing financial difficulties. Participants (35) were university students in a metropolitan area of South Korea, recruited from September 2019 to December 2019 and from February 2020 to June 2020. They completed a pre-ecological momentary assessment online survey assessing sleep quality, fatigue, stress, and quality of life. Subsequently, participants participated in a 14-day ecological momentary assessment of daily depressive mood, sleep quality, fatigue, stress, and positive and negative affect. A multilevel mediation analysis indicated that fatigue completely mediated the relationship between sleep quality and depressive mood at the within- and between-subject levels, whereas stress and positive affect completely mediated the relationship only at the within-subject level. Negative affect did not mediate the relationship between sleep quality and depressive mood either at the within- or between-subject level. These findings suggest that interventions targeting mediators such as fatigue, stress and affect may alleviate the impact of poor sleep quality on depressive mood among university students experiencing financial difficulties.

Longitudinal Reciprocal Association between Depressive and Bulimic Symptoms among Female College Students with Subclinical Levels of Bulimia Nervosa: A Cross-Lagged Model
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Abstract

Although bulimic and depressive symptoms are highly comorbid, their reciprocal association remains unclear. The goal of this study was therefore to examine the longitudinal reciprocal relationship between bulimic and depressive symptoms among female college students experiencing subclinical levels of bulimia nervosa. We also incorporated negative affect and emotion dysregulation as common risk factors for both bulimic and depressive symptoms. Participants were 117 female college students who reported relatively high levels of bulimic symptoms during the initial screening. They completed a series of self-report inventories assessing bulimic and depressive symptoms, negative affect, and emotion dysregulation at baseline (T1) and at six-month (T2) and one-year (T3) follow-ups. The results of an autoregressive cross-lagged model indicated that depressive symptoms at T1 and T2 significantly predicted bulimic symptoms at T2 and T3, respectively, controlling for the temporal stability of each symptom, as well as the effects of negative affect and emotion dysregulation. Conversely, bulimic symptoms did not predict future depressive symptoms across time. These findings suggest that depressive symptoms may be a potential target for the early identification and prevention of bulimic symptoms among high-risk females.

The Effects of Incompleteness and Obsessive Beliefs on Obsessive-Compulsive Symptoms: The Moderated Mediating Effect of Mindfulness
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Abstract

The purpose of this study was to examine the moderated mediating effect of mindfulness through obsessive beliefs on the relationship between incompleteness and obsessive-compulsive symptoms. A total of 555 undergraduate students completed the Obsessive-Compulsive Trait Core Domains Questionnaire (OC-TCDQ), Obsessive Beliefs Questionnaire 44 (OBQ-44), the Padua Inventory-Washington State University Revision (PI-WSUR), and the Mindfulness Scale. Data were analyzed using SPSS 23.0 and its Macro. The main findings were as follows: First, the results of bootstrapping indicated that obsessive beliefs mediated the relationship between incompleteness and obsessive-compulsive symptoms. Second, hierarchical regression and slope analyses revealed the moderating effect of mindfulness on the relationship between obsessive beliefs and obsessive compulsive symptoms. Third, mindfulness moderated the mediating effect of incompleteness on obsessive-compulsive symptoms through obsessive beliefs. Finally, the results indicated that among several factors of mindfulness, present-moment awareness, concentration, and de-centered attention influence the relationship between obsession and obsessive-compulsive disorder, which is considered useful for future therapeutic interventions.

Effects of Cognitive Emotional Regulation Strategies and Triggering Event on Displaced Aggression
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Abstract

The aim of the present experimental study was to examine the effects of cognitive emotional regulation strategies (rumination, cognitive reappraisal, distraction) and triggering event on displaced aggression. The participants (n=114) was manipulated by providing a fake negative feedback on participant’s own essay regardless of the excellence of their writings. Next, participants were randomly assignment to one of the following groups: rumination, cognitive reappraisal, distraction. Then manipulated by the presence or absence of triggering event. Finally, displaced aggression was assessed by an opportunity to harm another person’s (given the triggering event) chance to earn money, allowing aggressiveness to be operationalized through the assignment of more difficult problems to another person. ANOVA results of the study (n=81) revealed the significant main effects of cognitive emotional regulation strategy and triggering event, as well as interaction effect of cognitive emotional regulation strategy and triggering event was significant. That is, Participants in the rumination group expressed higher displaced aggression than those in the cognitive reappraisal and distraction groups when they experiencing the triggering event. And there was no significant difference between cognitive reappraisal and distraction groups. The limitations of the study and implications for future research are discussed.

Validation of the Korean Version of the Social Behavior Questionnaire
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Abstract

Safety behaviors are forms of avoidance in social anxiety disorder (SAD) and function to reduce pain and conceal anxiety symptoms in social situations perceived as fearful. The use of safety behaviors perpetuates SAD and diminishes the effectiveness of the treatment. The purpose of this study was to validate the Korean version of the Social Behavior Questionnaire (KSBQ), which measures the safety behaviors of individuals with SAD. A total of 742 online panels were recruited based on the Korean 2020 resident registration demographics. We conducted exploratory factor analysis (EFA) on half of the randomly selected data and confirmatory factor analysis (CFA) with the remaining half. According to the EFA results, the K-SBQ had a 28-item three-factor (impression management, avoidance behavior, and anxiety-symptoms control) structure. These results differed from the original scale, which had a two-factor structure (avoidance and impression management). As a result of CFA, the three-factor model showed a suitable model fit. The reliability and convergent validity of the K-SBQ were good, and the discriminant validity was adequate. Further, the ROC curve analysis indicated that 34 points appeared appropriate for the K-SBQ cut-off scores. The study results suggested that the K-SBQ could identify and measure the safety behaviors of individuals with SAD in clinical and research settings.

Difference in Problem Behaviors According to Children’s Temperament and Mothers’ Reaction Type to Children’s Negative Emotions in School-Age Children: Latent Profile Analysis
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Abstract

This study aimed to confirm the latent class of mothers' reactions to children’s negative emotions and evaluate the difference between children’s temperament profile affecting the latent class and the children’s problem behavior about the latent class. To achieve these objectives, we recruited 769 mothers of 4th, 5th, and 6th graders attending elementary schools in the Seoul and Gyeonggi-do areas. This study evaluated children’s temperament, mothers’ reactions to children’s negative emotions, and children’s problem behavior. The results of latent profile analysis using M plus showed that the latent class of mothers’ supportive reactions to children’s negative emotions was divided into ‘passive support group’ (97 subjects; 13.44%), ‘average support group’ (469 subjects; 59.52%), and ‘active support group’ (203 subjects; 27.05%). Moreover, the latent class of maternal non-supportive response was divided into ‘non-supportive: non-punishment group’ (281 subjects; 36.22%), ‘non-supportive: avoidance group’ (382 subjects; 49.5%), and ‘non-supportive: confusion group’ (106 subjects; 14.28%). The reward dependence and persistence temperament of children significantly predicted the latent class for the maternal supportive reactions, while the novelty seeking and harm avoidance temperament of children significantly predicted the latent class for maternal non-supportive reactions. Moreover, children’s internalizing and externalizing behavioral problems were significantly higher in the average support group than in the active support group and in the low support group than in the average support group. The internalizing behavioral problem was significantly higher in the non-supportive: avoidance group and the nonsupportive: confusion group than in the non-supportive: non-punishment group. The externalizing behavioral problem was significantly high in the order of the non-supportive: non-punishment group, the non-supportive: avoidance group, and the non-supportive: confusion group. The results of this study clearly revealed that the vulnerability of children’s temperament could negatively affect children's psychosocial adjustment by increasing the level of parental non-supportive reactions. As a result, there is a need for preventive intervention for children of vulnerable temperament and their parents and providing direction for intervention.

Identification, Assessment, and Evidence-Based Treatment of Sexual Behavior Problems in Children
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Abstract

It is widely accepted that sexual behavior problems (SBPs) in children are distinguished from sexual harassment or deviant sexual behaviors associates with late childhood or adolescence – both in terms of their causes and developmental pathways. However, empirical studies on the factors related to SBPs, along with effective interventions, are limited. In Korea, in particular, there are no empirical studies regarding children's sexual behavior, nor are there any guidelines for the evaluation of, and intervention in, SBPs. This study reviewed the assessments and interventions for SBPs in children via foreign literature and proposed practical recommendations that can be referred to by clinicians helping children and their caregivers.

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