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The Korean Journal of Woman Psychology

Predictors of mental health risks in newly resettled North Korean refugee women

Abstract

This study aimed to find factors that predict high risk groups for mental health condition in recently immigrated North Korean refugee women. The number of North Korean refugee women has increased in the recent years and currently makes up about 3 out of 4 entrants. The rise in their number, greater susceptibility of mental health in women, and multiple trauma these women are suspected to have been exposed to such as human trafficking and sexual violence, call for attention to their mental health. Multinomial logistical regression analysis was conducted to identify the variables determining the likelihood of an individual to be in varying risk groups that were clustered into 4 groups: (1) non-clinical group; (2) PTSD only group; (3) depression/anxiety only group; (4) co-morbidity of PTSD and depression/anxiety group. The findings of the analysis include: trauma exposure increased the odds of an individual to be in one of three clinical groups with the highest odds to be in co-morbidity group. Living with a family increased the odds for favorable mental health status, whereas having a chronic medical problem elevated the odds for poor mental health. Childhood trauma raised the risk of an individual developing depression/anxiety while not affecting the odds against PTSD or mental health co-morbidity. Depression/anxiety seems to be a greater threat to the psychological adjustment of North Korean women than PTSD, looking at the prevalence rates of two clinical conditions. Implications of the study findings and recommendations were made.

keywords
외상, 외상 후 스트레스장애, 우울, 불안, 북한이탈여성, trauma, PTSD, depression, anxiety, North Korean refugee women, trauma, PTSD, depression, anxiety, North Korean refugee women

Reference

1.

강성록 (2000). 탈북자들의 외상 척도 개발 연구. 연세대학교 석사학위 논문

2.

공릉종합사회복지관 (2006). 2006년 새터민 사업보고서Ⅱ. 새터민 정신건강 지원사업. 공릉종합사회복지관 공릉 새터민 정착지원센터.

3.

김미령 (2005). 탈북자의 적응 스트레스와 사회적 지지가 우울성향에 미치는 영향. 한국사회복지학, 57(1). 193-217.

4.

김미정, 정계숙 (2007). 유아기 자녀를 둔 새터민 부모의 양육 이야기. 아동학회지, 28(1), 71-88.

5.

김연희 (2006). A study on the mental health of North Korean defectors: application of a stress process model. 서울대학교 박사학위 논문.

6.

김종남, 최윤경, 채정민 (2008). CES-D와 로샤검사를 통해본 북한이탈주민의 우울감. 한국심리학회지: 사회문제, 14(2), 41-61.

7.

김태현, 노치영 (2003). 북한이탈 여성들의 삶 이야기: 해석학적 현상학을 통한 중국생활 체험 분석. 대한가정학회지, 41(8), 1-17.

8.

김현아, 전명남 (2003). MMPI에 나타난 북한이탈주민의 개인차 특성. 통일연구, 7(2), 129-160.

9.

김희경, 오수성 (2010). 탈북 여성의 MMPI-2 프로파일. 한국심리학회지: 일반, 29(1), 1-20.

10.

노대균 (2001). 탈북자의 개인차 요인이 적응 및 정신건강에 미치는 영향. 중앙대 박사학위 논문.

11.

박윤숙, 윤인진 (2007). 탈북 청소년의 사회적 지지특성과 남한 사회 적응과의 관계. 한국사회학, 41(1), 124-155.

12.

박철옥 (2007). 북한이탈주민의 대인관계적 외상 경험, 용서, 경험 회피와 외상 후 스트레스 증상간의 관계. 이화여자대학교 석사학위 논문.

13.

백혜정, 길은배, 윤인진, 이영란 (2007). 남한 내 북한이탈 청소년들의 심리적응에 영향을 미치는 적응 준비도에 관한 연구. 한국청소년 연구, 18(2), 183-211.

14.

보건복지부 홈페이지 www.mw.go.kr

15.

북한이탈주민 후원회 홈페이지 www. dongposarang.or.kr

16.

서주연 (2006). 북한이탈주민의 외상 후 스트레스 장애(PTSD)와 남한 사회 적응에 관한 탐색적 연구. 이화여자대학교 석사학위 논문.

17.

엄태완 (2004). 북한이탈주민의 우울과 사회적 문제 해결 능력 및 사회적 지지와의 관계. 정신보건과 사회사업, 18, 5-32.

18.

엄태완 (2005). 남북주민 통합을 위한 정신건강 전략-남한 내 북한이탈주민, 저소득주민, 일반주민의 비교를 통하여. 통일정책연구, 14(1), 297-324.

19.

윤인진 (2007). 북한이주민의 사회적응실태와 정착지원방안, 아세아 연구, 5(2), 106-143.

20.

이경희, 배성우 (2006). 북한이탈주민의 남한 사회 정착에 영향을 미치는 요인. 통일정책연구, 15(2), 1-28.

21.

이숙영 (2005). 북한이탈주민의 외상 경험과 남한 내 결혼 만족도와의 관계: 북한, 탈북과정, 남한 적응과정을 중심으로. 고려대학교 석사학위 논문.

22.

이영호 (1993). 귀인양식, 생활사건, 사건귀인 및 무망감과 우울의 관계. 서울대학교 박사학위 논문.

23.

장혜경, 김영란 (2001). 북한이탈주민 가족의 가족 안정성 및 사회 적응과 여성의 역할. 한국여성개발원.

24.

전겸구, 김교헌 (1991). 대학생용 생활스트레스 척도의 개발: 제어 이론적 접근. 한국심리학회지: 임상, 10. 137-158.

25.

조영아 (2009). 북한이주민의 정신보건 및 신체건강. 16회 한반도 평화포럼 자료집, 59-74, 한반도 평화연구원.

26.

조영아, 김연희, 유시은 (2009). 남한 내 7년 이상 거주한 북한이탈주민의 정신건강 예측요인. 한국심리학회지: 상담 및 심리치료, 21(1), 329-348.

27.

조영아, 전우택 (2005). 탈북 여성들의 남한 사회 적응 문제: 결혼 경험자를 중심으로. 한국심리학회지: 여성, 10(1), 17-35.

28.

조영아, 전우택, 유정자, 엄진섭 (2005). 북한이탈주민의 우울 예측요인: 3년 추적연구. 한국심리학회지: 상담 및 심리치료, 17(2), 467-484.

29.

한국보건사회연구원, 서울대학교 사회복지연구소 (2009). 2008 한국복지패널 기초분석 보고서.

30.

한인영 (2001). 북한이탈주민의 우울 성향에 관한 연구. 정신보건과 사회사업, 11(6), 78-94.

31.

한오수, 안준호, 송선희, 조맹제, 김장규, 배재남, 조성진, 정범수, 서동우, 함봉진, 이동우, 박종익, 홍진표(2000). 한국어판 구조화 임상면담도구 개발: 신뢰도 연구. 신경정신의학, 39(2), 362-372.

32.

홍창형 (2005). 북한이탈주민의 외상 후 스트레스 장애에 대한 3년 추적연구. 연세대학교 석사학위 논문.

33.

홍창형, 유정자, 조영아, 엄진섭, 구현지, 서승원, 안은미, 민성길, 전우택 (2006). 북한이탈주민의 외상후 스트레스 장애에 대한 3년 추적연구. 신경정신의학, 45(1), 49-56.

34.

Beiser, M., Johnson, P. J. & Turner, R. J. (1993). Unemployment, underemployment and depressive affect among Southeast Asian refugees. Psychological Medicine, 23, 731-743.

35.

Blair, R. (2000). Risk factors associated with PTSD and major depression among Cambodian refugees in Utah, Health and Social Work, 25(1), 23-30.

36.

Bolton, P. (2001). Cross-cultural validity and reliability testing of a standard psychiatric assessment instrument without a gold standard. Journal of Nervous and Mental Disease, 189, 238-242.

37.

Buchwald, D., Manson, S. M., Ginges, N. G., Keans, E. M. & Kinzie, D. (1993). Prevalence of depressive symptoms among established Vietnamese refugees in the United States. Journal of General International Medicine, 8, 76-81.

38.

Chung, R. & Bemak, F. (2002). Revisiting the California Southeast Asian mental health needs assessment data: an examination of refugee ethnic and gender differences. Journal of Counseling and Development, 80(1), 111-120.

39.

Chung, R. C., & Kagawa-Singer, M. (1993). Predictors of psychological distress among Southeast Asian refugees. Social Science and Medicine. 36(5), 631-639.

40.

Derogatis, L, R., Lipmann, R. S. & Rickels, K. (1974). The Hopkins Symptom Checklist: A self-report symptom inventory. Behavioral Science, 19(1), 1-15.

41.

Gong-Guy, E. (1987). The California Southeast Asian mental health needs assessment, Sacramento, CA: California State Dept. of Mental Health (Contract No. 85-76282A-2).

42.

Hauff, E. & Vaglum, P. (1995). Organized violence and the stress of exile: Predictors of mental Health in a community cohort of vietnamese refugees three years after resettlement. British Journal of Psychiatry, 166, 360-367.

43.

Hermansson, A, C., Timpka, T. & Thyberg, M. (2002). The mental health of war-wounded refugees; an 8-year follow-up. Journal of nervous and Mental Disease, 190(2), 374-380.

44.

Hinton, W. L., Jenkins, C. N., Christopher, N. H., Mcphee, S., Wong, C., Lai, KY. Q., Le, A., Du, N. & Fordham, D. M. (1998). A survey of depressive symptoms among Vietnamese-American men in three locales: Prevalence and correlates. Journal of Nervous and Mental Disease, 186(1), 677-683.

45.

Hinton, W. L., Tiet, Q., Tran, C. G. & Chesney, M. (1997). Predictors of depression among refugees from Vietnam: A longitudinal study of new arrivals. The Journal of Nervous and Mental Disease, 185(1), 39-45.

46.

Jeon, W., C. Hong & J. Eum (2005). Correlation between traumatic events and post-traumatic stress disorder among North Korean defectors in South Korea. Journal of Traumatic Stress, 18 (2), 147-154.

47.

Kessler, R., Gillis-Lights J., Magee W., Kendler K. & Eaves L. (1997). “Childhood adversity and adult psychopathology” in Gotlieb, I. and W. Blair(eds) (1997). Stress and adversity over the life course. UK: Cambridge University.

48.

Kessler, R., K. McGonagle, S. Zao, C. Nelson, M. Hughes (1994). Life time and 12 month prevalence of psychiatric disorders in the U. S.: results form the National Comordity Survey, Archives of General Psychiatry, 51, 8-19.

49.

Kleijin, W. C., Hovens, J. E. & Rodenburg, J. J. (2001). Posttraumatic stress symptoms in refugees: assessments with the Harvard Trauma Questionnaire and the Hopkins symptom Checklist-25 in different languages. Psychological Reports, 88, 527-532.

50.

Lavik, N. J., Hauff, E., Skrondal, A. & Dolberg, O. (1996). Mental disorder among refugees and the impact of persecution and exile: some findings from and outpatient population. British Journal of Psychiatry, 169, 726-732.

51.

Lee, Y., Lee, M. K., Chun. K. H., Lee, K. Y. & Yoon, J. S. (2001). Trauma experience of North Korean refugees in China. American Journal of Preventive Medicine, 20(3), 225-229.

52.

Mollica, R., K McInnes, T. Pham, M. Fawzi, E. Murphy & L. Lin (1998). The dose-effect relationship between torture and psychiatric symptoms in Vietnamese ex-political detainees and a comparison group, The Journal of Nervous and Mental Disease, 186(9), 543-553.

53.

Mollica, R., Wyshak and J. Lavelle (1987). The psychological impact of war trauma and torture on Southeast Asian refugees. American Journal of Psychiatry, 144(12), 1567-1572.

54.

Rumbaut, R. G. (1989). Portraits, patterns and predictors of the refugee adaptation process: A comparative study of Southeast Asian refugees In D. W. Haines(Ed). Refugees and immigrants: Cambodians, Laotians and Vietnamese in America (p.138-190). Totowa NJ: Rowman & Littlefield.

55.

Sandhu & Asrahadi (1994). Development of an acculturative stress scale for international students: Primary findings, Psychological Reports, 75, 435-448.

56.

Silove, D. & Ekbad (2002). How well do refugees adapt after resettlement in Western countries? Acta Psychiatrica Scandinavica, 106, 401-402.

57.

Silove, D., Sinnerbrink, I., Field, A., Manicavasagar, V. & Steel, Z. (1997). Anxiety, Depression and PTSD in Asylum-seekers: associations with pre-migration trauma and post-migration stressors. The British Journal of Psychiatry, 170(4), 351-357.

58.

Steel, Z., Silove, D., Chey, T., Bauman, A., Phan, T & Phan, P. (2005). Mental disorders, disability and health service use amongst Vietnamese refugees and the host Australian population, Acta Psychiatrica Scandinavian, 111, 300-309.

59.

Steel, Z., Silove, D., Phan, T. & Bauman, A. (2002). Long term effect of psychological trauma on the mental health of Vietnamese refugees resettled in Australia: a population-based study. The Lancet, 360(5), 1056-1062.

60.

Ventevogel, P., G. De Vries, W. Scholte., N., & Shinwar (2007). Properties of Hopkins Symptom Checklist-25 and the self-rating questionnaire (SRQ-20) as screening instruments used in primary care in Afghanistan. Social Psychiatry and Psychiatric Epidemiology, 42(4), 328-335.

61.

Westermeyer, J., Neider, J., & Callies, A. (1989). Psychological adjustment fo Hmong refugees during their first decade in the United States: a longitudinal study. The Journal of Nervous and Mental Disease, 177, 132-139.

62.

Wheaton, B., Roszwell, P. & Hall, K. (1997). The impact of twenty childhood and adult traumatic stressors on the risk of psychiatric disorder. Gotlieb, I., Wheaton, B. (Eds.), 1997, Stress and Adversity over the Life Course: Trajectories and Turning Points, Cambridge University Press.

63.

Winokur, A., Winokur, D. F. & Rickels, K. (1984). Symptoms of emotional stress in family planning service: stability over a four-week period. British Journal of Psychiatry, 144, 395-399.

The Korean Journal of Woman Psychology