The Korean ‘Examination Hell’: Long Hours of Studying, Distress, and Depression

The role of emotions in academic performance of undergraduate medical students: a narrative review

BACKGROUND

This paper is devoted to a narrative review of the literature on emotions and academic performance in medicine. The review aims to examine the role emotions play in the academic performance of undergraduate medical students.

METHODS

Eight electronic databases were used to search the literature from 2013 to 2023, including Academic Search Ultimate, British Education Index, CINAHL, Education Abstract, ERIC, Medline, APA Psych Articles and APA Psych Info. Using specific keywords and terms in the databases, 3,285,208 articles were found. After applying the predefined exclusion and inclusion criteria to include only medical students and academic performance as an outcome, 45 articles remained, and two reviewers assessed the quality of the retrieved literature; 17 articles were selected for the narrative synthesis.

RESULT

The findings indicate that depression and anxiety are the most frequently reported variables in the reviewed literature, and they have negative and positive impacts on the academic performance of medical students. The included literature also reported that a high number of medical students experienced test anxiety during their study, which affected their academic performance. Positive emotions lead to positive academic outcomes and vice versa. However, Feelings of shame did not have any effect on the academic performance of medical students.

DISCUSSION

The review suggests a significant relationship between emotions and academic performance among undergraduate medical students. While the evidence may not establish causation, it underscores the importance of considering emotional factors in understanding student performance. However, reliance on cross-sectional studies and self-reported data may introduce recall bias. Future research should concentrate on developing anxiety reduction strategies and enhancing mental well-being to improve academic performance.

Strain, Anger, and Violent Behavior of South Korean Adolescents

Although general strain theory (GST) highlights the mediating role of anger between strain and violent behavior, the extant body of literature has been criticized for lack of rigorous testing of the mediating role of anger and lack of application in different cultural contexts. To cover this research gap, the current study investigated the mediating effect of anger between primary sources of strain of South Korean adolescents (i.e., parental abuse, academic-related strain, and negative relations to teacher) and violent behavior. Using structural equation modeling based on a nationally representative longitudinal dataset (n = 3,120), this study found a significant mediating role of anger in connecting strain and violent behavior of South Korean adolescents. Results from the present study support the main proposition of the GST on the mediating role of anger and its applicability in a cross-cultural context. Theoretical and practical implications are discussed.

Adverse childhood experience and persistent insomnia during emerging adulthood: do positive childhood experiences matter?

BACKGROUND

Adverse childhood experiences (ACE) have been documented to have long-term impacts on sleep disturbances. However, less is known about how ACE co-occurs with positive childhood experiences (PCE) and modulate their effects on adult sleep disturbances, particularly in the context of persistent insomnia. Building on resilience theory, this study aims to examine the interplay between ACE and PCE and their effects on persistent insomnia during emerging adulthood.

METHODS

A total of 2,841 emerging adults were recruited from the Taiwan Youth Project. Persistent insomnia during emerging adulthood was assessed using two adult surveys (mean age = 19.8 and 21.9). The ACE (10 items) and PCE (7 items) were obtained from the baseline survey (mean age = 13.8). A series of logistic regression analyses were conducted.

RESULTS

Among the emerging adults, 29.22% had persistent insomnia. Consistent with the compensatory model, ACE and PCE exerted opposing effects on persistent insomnia during emerging adulthood. In line with the protective model, the negative effect of ACE is mitigated when individuals have high PCE. However, consistent with the challenge model, the protective effect of PCE on persistent insomnia was inhibited in individuals with four or more ACE.

CONCLUSIONS

PCE serves as a protective factor, shielding emerging adults from the adverse effects of ACE on persistent insomnia. It is essential to prioritize positive experiences during early life to promote lifelong sleep health.

Trends in Depressive Symptoms and Suicidality of South Korean Adolescents: Comparison of Expected and Observed Prevalence During the COVID-19 Pandemic

PURPOSE

Depressive symptoms and suicidality of adolescents during the COVID-19 pandemic are emerging public health issues. However, there is a lack of representative studies on adolescents' mental health that considers the preceding secular trends.

METHODS

This descriptive study used nationally representative cross-sectional data of Korean adolescents from the Korea Youth Risk Behavior Survey from 2005 to 2020 (N = 1,035,382). We utilized joinpoint regression analysis to explore the temporal prevalence trends of depressive symptoms, suicidal ideation, and suicide attempts. Based on the annual percentage change until 2019, the expected and actual prevalence in 2020 (N = 54,948) was compared to describe departures of prevalence from the trend line. These trends between sex, school level, ethnic status, and socioeconomic status were also compared.

RESULTS

Considering the recent increase in secular trends until 2019, the actual observed values in 2020 were lower than expected by 13% in depressive symptoms, 20% in suicidal ideation, and 40% in suicide attempts. The gap between sexes, school levels, ethnic status, and socioeconomic groups was similar or narrowed in 2020 compared to previous trends.

DISCUSSION

We observed a lower prevalence of depressive symptoms and suicidality among Korean adolescents than expected about 9 months from the beginning of the COVID-19 pandemic despite the recent increase in secular trends.

Academic Stress and Emotional Adjustment: A Gender-Based Post-COVID Study

Background

The worldwide spread of COVID-19 infection and its preventive measures has resulted in global disruption of overall functioning of the individuals. In the post-COVID period, several stressors associated with the pandemic have exacerbated adjustment problems in students and impacted their mental health.

Purpose

The study aims to assess the Academic Stress and Emotional Adjustment of male and female secondary school students in Uttar Pradesh, post-COVID-19 pandemic lockdown.

Methods

A sample of 500 students from various schools in Uttar Pradesh pursuing high school were included in the study. A purposive sampling technique was employed for data collection based on inclusion and exclusion criteria. The Scale for Assessing Academic Stress and the Adolescents Emotional Adjustment Inventory were used to assess the academic stress and emotional adjustment of secondary school students post-COVID-19 pandemic lockdown.

Results

The results of the study revealed that there was a significant difference in academic stress and emotional adjustment between male and female secondary school students. A significant positive relationship between academic stress and emotional adjustment was found, which indicates a high level of academic stress perpetuates emotional maladjustment. Furthermore, it was found that the level of academic stress and emotional adjustment were higher among females as compared to males.

Conclusion

It can be concluded that the extended impact of COVID-19 has led to a surfeited level of distress propounding that females are more predisposed to academic stress and tend to have poor emotional adjustment than their male counterparts.

Physical Activity, Screen Time, and Academic Burden: A Cross-Sectional Analysis of Health among Chinese Adolescents

This paper aims to analyze the effects of physical activity, screen time, and academic burden on adolescent health in China and compare their effects by using the nationally representative sample data from the CEPS (China Educational Panel Survey) cross-section data. This paper first uses regression analysis to examine the relationship between physical activity, screen time, academic burden and health among Chinese adolescents. Then, this paper uses the clustering analysis the influence of physical activity, screen time, and academic burden on the health of Chinese adolescents. The empirical results show that: (1) along with exercise, helping with the housework also has a clear health-promoting effect on adolescents; (2) the time spent surfing the Internet or playing video games, and heavy studying or homework off campus have a negative effect on adolescents' self-rated health and mental health; (3) physical activity has the greatest impact on self-rated health, while screen time has the greatest impact on mental health, and academic burden is not the most important factor affecting adolescent health in China.

The moderating effect of resilience on the relationship between academic stress and school adjustment in Korean students

Introduction

This study investigated the moderating effects of resilience on the relationship between academic stress and school adjustment among Korean adolescents. We examined the moderating effect for the total scores of school adjustment and the two subscales of school adjustment (academic adjustment and general school adjustment).

Methods

Data were obtained in Pusan, Korea, using the convenience sampling method, and a total of 674 participants' responses were used for the final analysis. Hierarchical regression analysis and multiple regression analysis were performed to examine our research questions.

Results

The results of the study showed that academic stress was a significant predictor of school adjustment among Korean adolescents. More specifically, academic stress was related to poor school adjustment. The study also found that resilience has a significant mediating effect on the relationship between academic stress and school adjustment.

Discussion

Our findings suggest that resilience is likely to alleviate the harmful effect of academic stress on school adjustment. Finally, implications for school-based intervention were discussed for providing practical academic assistance.

The Impact of Life Domains on Developmental Trajectories of Peer Delinquency among Korean Adolescents: A Partial Test of Agnew's General Theory of Crime and Delinquency with a Group-Based Trajectory Modeling Approach

Agnew introduced a new integrated theory; the General Theory of Crime and Delinquency, in which he attempted to corral the most influential predictors of criminal behavior into more parsimonious propositions of multiple life domains-self, family, peer, school, and work-as well as constraints against crime and motivations for it. This study presents a partial test of the theory using longitudinal data of 2,351 Korean adolescents. A group-based modeling approach (latent class growth analysis) was run to examine direct effects of life domains on peer delinquency as well as mediating effects of constraints and motivation on their relationships. The study identified three subgroups: early onset/decreasing (3.2%), moderate (12.4%), and low/none (84.4%). The findings revealed that the self and peer domains exhibited a positive impact on the early onset/decreasing trajectory group compared to the low/none group with the constraint exhibiting a negative impact. The moderate trajectory group demonstrated that the self-domain was significant but was not rendered insignificant after controlling for constraints and motivations. The study provided moderate support for life domains within Agnew's new theory for peer delinquency in nonwestern countries.

Viewing the Joint Operation of Five Major Decision Difficulties Within the Dual-Process Theory of Career Decision-Making

While research has identified a five-factor model of career decision-making difficulty based on meta-analytical evidence and cross-cultural comparison, the field lacks an elaborated theoretical account of the joint operation of the five decision difficulties. The current study drew on the dual-process theory of career decision-making (DTC) to examine the interplay of the five decision difficulties in predicting career decidedness in the Chinese context. Study 1 developed and validated measures of decision ambiguity, advance in narrowing down, and career decidedness in a sample of Chinese college students ( n = 180). Study 2 examined the structural model using another sample of Chinese college students ( n = 408). Focusing on the relations of the five major decision difficulties to career decidedness, the results did not support the standalone mechanism of confusion management but supported the standalone mechanism of ambiguity management. Additionally, the results supported the crossover mechanism from confusion management to ambiguity management and the crossover mechanism from ambiguity management to confusion management. The results not only shed light on the role of each difficulty but also offer evidence for the interplay of key DTC macro elements. The practical implications based on the joint operation of the five decision-making difficulties are discussed.

Associations Between Academic Stress, Mental Distress, Academic Self-Disclosure to Parents and School Engagement in Hong Kong

Numerous studies have indicated that academic stress is associated with various detrimental personal physical and emotional outcomes; however, relatively few studies have explored how academic stress affects adolescents' interactions with their significant others in families and schools, which are two important social systems for school-age adolescents. In addition, there are also few studies examining how academic stress influences adolescents' self-disclosure to parents and school engagement in East Asian districts particularly in Hong Kong, where the level of academic stress among adolescents is high. This study examines how academic stress affects mental distress, academic self-disclosure to parents and school engagement and explores gender differences in the risk for the outcomes of academic stress. One thousand and eight hundred and four students from eight secondary schools in Hong Kong participated in this study. The results indicate that academic stress has a significant association with all three outcomes, but the correlation with school engagement is positive, which is contrary to the findings of most previous studies. The possible reasons for such positive association are discussed. In addition, the model can be applied to both genders, but females are more susceptible to the detrimental outcomes of academic stress by suffering a higher level of mental distress. This study suggests that academic stress should be an important entry point to tackle adolescents' mental distress while interventions should be targeted at females who are experiencing a higher level of mental distress. In addition, in view of the significant associations between academic stress and self-disclosure to parents, as well as between academic stress and school engagement, suggestions are provided to families and schools on how to proactively provide support to those students who are experiencing academic stress.

Academic Expectations of Stress Inventory: A Psychometric Evaluation of Validity and Reliability of the Persian Version

This study aims to evaluate the psychometric properties of the Academic Expectations of Stress Inventory (AESI) in terms of validity and reliability measurements among Persian students. A total sample of 620 high-school students (n_female = 328, n_male = 292) was recruited to complete scales on academic expectations of stress, self-efficacy, and depression. The AESI was translated from English to Persian and its translation was further checked by three experts. We used a cross-sectional research design to collect data. The results approved the internal consistency, test–retest reliability, convergent, and construct validity of the ASEI. Additionally, confirmatory factor analysis confirmed the two-factor structure of the AESI, including the expectation of self and the expectations of parents/teachers. AESI was related to depression and self-efficacy in an empirically and theoretically expected direction. Moreover, configural and metric invariance were supported by gifted vs. non-gifted groups, but not scalar. No invariance was supported by gender groups. In conclusion, the psychometric properties of the Persian version of the AESI were confirmed to be used for educational, clinical, and research purposes in Iran.

Sleep trajectories from early adolescence to emerging adulthood: Evidence from a nine-year population-based study

INTRODUCTION

Adolescence to emerging adulthood is a developmental period when individuals experience substantial biological changes and social transitions. In East Asian societies, this period is also marked by high pressure around college entrance exams. However, little is known about how young people's sleep changes over time, or how it is impacted by social institutions in the cultural context. This study fills this gap in the literature by examining sleep trajectories from adolescence to emerging adulthood using a population-based, longitudinal sample from Taiwan.

METHODS

Multilevel models were applied to longitudinal data from the Taiwan Youth Project (N = 1,489) to estimate sleep trajectories from age 14 to 22 for total time in bed, bedtime, and wake-up time by gender and by educational pathway, controlling for family background.

RESULTS

Analysis revealed that Taiwanese youth sleep less as adolescents than as emerging adults. Gender differences exist in adolescents' sleep trajectories but narrow after age 18. Differences in weekday and weekend time in bed vary by gender and change as individuals emerge into adulthood. Finally, college attendees and high school only attendees display differences in sleep that begin in high school and continue through college.

CONCLUSIONS

The findings provide evidence of developmental changes in sleep from adolescence to emerging adulthood and demonstrate that sleep trajectories are gendered and socially patterned. The study is also one of the first to examine the sleep trajectories of East Asian youth and, as such, sheds light on the role of educational and cultural context as an influential factor.

The effect of high school entrance exam reform on adolescents’ depressive symptoms in Taiwan: A closer look at gender differences

In the current study, we followed motivational theories and investigated whether granting junior high school students one more opportunity to take the high-stakes high school entrance exam alleviates students’ depressive symptoms, and whether the effect is comparable for adolescent boys and girls residing in Taiwan. We analyzed two longitudinal datasets (seventh to tenth grade) from two neighboring cohorts, in which one cohort could take the exam just once (i.e., the pre-reform cohort) and the other twice (i.e., the post-reform cohort). Using a lagged-dependent-variable difference-in-differences model to compare the level of depressive symptoms before and after the entrance exam for the two cohorts, the results revealed that the reform was associated with increases in the level of depressive symptoms for both boys and girls. Despite a higher level of depressive symptoms overall, adolescent girls in the post-reform cohort showed a slower increase in the level of depressive symptoms than boys.

What makes adolescents psychologically distressed? Life events as risk factors for depression and suicide

Adolescence is a vulnerable period for psychological distress. This study aimed to comprehensively investigate the distribution of major stress-causing factors and their correlates in a large population of adolescents. A computerized self-report questionnaire was completed by 291,110 participating adolescents over a 4-year period using a cross-sectional study design. The questionnaire included items assessing demographic variables, major stressors, severity of perceived stress, and mental health outcomes such as depressed mood, suicidal ideation, and attempts. Among the major stressors, schoolwork/career was the most predominant (54.7%). However, the odds ratios for depressed mood and suicidal ideation were the highest in the stressor of conflict with peers (OR = 1.97 for depressed mood and OR = 2.00 for suicidal ideation), followed by family circumstances (OR = 1.77 and 1.94 for depressed mood and suicidal ideation, respectively). Conversely, schoolwork/career presented significantly lower odds ratios of 0.87 and 0.87 for depressed mood and suicidal ideation, respectively. This study provides important information on psychological distress related to adolescents' mental health. Although school/career was the most prevalent source of psychological stress, the odds ratios for negative health outcomes of adolescents were higher in interpersonal problems such as conflicts with parents and peers and family circumstances. The present findings might help parents and clinicians understand the psychological distress of adolescents and improve their mental health.

Network analysis for the symptom of depression with Children's Depression Inventory in a large sample of school-aged children

BACKGROUND

Depressive disorders have various symptom presentations, which may have complex and dynamic interactions. This study aimed to investigate the network structures underlying the symptoms and to identify the central symptoms of depression in school-aged children.

METHODS

Participants were a large community sample of elementary school children aged 6 to 12 years (N = 10,233). To assess the depressive symptoms, we utilized the Children's Depression Inventory (CDI). We binarized the scores on the CDI to generate a symptom network using the eLasso method, based on the Ising model. We evaluated the centralities in individual symptoms using the network centrality indices and the associations between symptoms.

RESULTS

Of the symptoms, loneliness, self-hatred, school dislike, and low self-esteem were the most central symptoms in the network of depressive symptoms. School work difficulty-school performance decrement, sadness-crying, self-hatred-negative body image, low self-esteem-fight, anhedonia-school dislike, sadness-loneliness, self-deprecation-school work difficulty, and school dislike-lack of friendship had significantly higher edge weight than most edges. The estimated network between the symptoms was robust to stability and accuracy tests.

LIMITATIONS

Participants were not clinical but community samples, who show lower level of symptoms.

CONCLUSION

The present symptom network analysis provided important insights on various interconnectivities between individual symptoms in childhood depression and on the central symptoms. In addition, our findings presented both similarities and differences with a previous Western study, thus, warranting future cross-cultural studies.

Adding stress to the stressed: Senior high school students' mental health amidst the COVID-19 nationwide lockdown in Greece

The two-year preparation for the National university entrance exams in Greece is one of the most trying periods in a young person's life, physically and emotionally. The present study reports the results from 442 last year senior high school students who completed an online survey (16-30 April 2020) concerning the lockdown impact on their mental health. Overall, the rate of positive screen for depression (PHQ-9 score ≥ 11) significantly increased from 48.5% to 63.8% and of those scoring within severe depression range (PHQ-9 ≥20) from 10% to 27%; for anxiety (GAD-7 score ≥ 11) increased from 23.8% to 49.5% and of those scoring within severe anxiety range (GAD-7≥17) from 3.8% to 20.5%. After taking sex and baseline (one month prior to the lockdown) levels of depression and anxiety into account, the level of lockdown experienced distress was predictive of depression and anxiety levels in time of home confinement, accounting for about 30% of variance in symptoms severity scores. Although our results may be subject to sampling and recall bias, the unexpectedly high rates of anxiety and depression warrant an urgent call to action aiming at mitigating and managing mental health risks of senior high school students in future waves of pandemic.

Gender disparities in fear of failure among 15-year-old students: The role of gender inequality, the organisation of schooling and economic conditions

INTRODUCTION

Prior research indicates that female students express higher fear of failure than male students and that fear of failure is associated with lower social and emotional well-being and higher levels of stress, anxiety, burnout and depression. Fear of failure also leads individuals to limit their choices and take fewer risks than would be warranted given their ability and context to minimise the possibility of failing.

METHODS

We examined cross-country differences in gender gaps in fear of failure as well as factors that explain gender gaps and variations of gender gaps across countries using multilevel modelling techniques. Participants were 517,047 15-year-old students from 59 countries who took part in the 2018 Programme for International Student Assessment (PISA).

RESULTS

Within countries, students with higher reading achievement and who lacked a growth mindset reported higher fear of failure. The gender gap in fear of failure was especially high among high-achieving students and students with high-achieving peers. The size of the gender gap in fear of failure differed across countries: it was higher in countries with higher levels of economic prosperity, with lower levels of societal-level gender inequality and countries with comprehensive education systems.

CONCLUSIONS

The greater prevalence of fear of failure among female students among high-achieving students attending high-achieving schools in prosperous and more gender equal societies could help to explain the paradox of the persistent underrepresentation of females in certain occupations in contexts that are most supportive of females.

Academic Stress in the Final Years of School: A Systematic Literature Review

Heightened academic stress in the final years of schooling is a common concern, yet little is known about how stress changes over time and what individual, school and family factors are associated with distress. We conducted a systematic review to examine the nature of distress in students in their final two years of secondary school. Sixty studies were eligible for inclusion. The main findings indicated severity of distress differed across the 17 countries sampled and measures used. There was some consistencies suggesting about 1 in 6 students experienced excessive distress. Female gender and anxiety proneness were consistently associated with increased distress, and freedom from negative cognitions with reduced distress. There was some evidence that individual characteristics (perfectionism, avoidance, coping, self-efficacy, resilience), lifestyle (sleep, homework), school, family and peer connectedness were associated with distress. Overall at-risk students can be predicted by theoretical models of anxiety and distress targeted with psychological interventions.

Opportunities and peer support for aggression and delinquency during adolescence in nine countries

This study tested culture-general and culture-specific aspects of adolescent developmental processes by focusing on opportunities and peer support for aggressive and delinquent behavior, which could help account for cultural similarities and differences in problem behavior during adolescence. Adolescents from 12 cultural groups in 9 countries (China, Colombia, Italy, Jordan, Kenya, the Philippines, Sweden, Thailand, and the United States) provided data at ages 12, 14, and 15. Variance in opportunities and peer support for aggression and delinquency, as well as aggressive and delinquent behavior, was greater within than between cultures. Across cultural groups, opportunities and peer support for aggression and delinquency increased from early to mid-adolescence. Consistently across diverse cultural groups, opportunities and peer support for aggression and delinquency predicted subsequent aggressive and delinquent behavior, even after controlling for prior aggressive and delinquent behavior. The findings illustrate ways that international collaborative research can contribute to developmental science by embedding the study of development within cultural contexts.

Body composition of school-aged children with disabilities

BACKGROUND

Children with disabilities are more likely to have problems related to growth and development than typically developing children. This study aimed to compare the growth and body composition indices of children with disabilities with those of typically developing children.

METHODS

Students from two elementary schools and one special school were recruited. Height, bodyweight, fat mass, fat-free mass, skeletal muscle mass, and percentage body fat (PBF) were measured. Raw data and proportions of classifications (under, within, and over range) according to the reference value were analyzed.

RESULTS

In total, 355 typically developing children, and 73 children with disabilities participated. Fat-free mass was significantly lower in students with disabilities than in typically developing students (32.14 ± 5.82 versus 28.71 ± 5.92, P < 0.05). Compared with typically developing students, students with disabilities showed tendencies of lower ranges of body mass index (BMI) and fat mass index (FMI). The proportion of under, within, or over ranges of FFMI (fat-free mass index) was significantly different between the two groups. Among the factors, age, gender, and disability, disability significantly influenced FFMI in school-aged children. The proportion of three ranges of BMI, PBF, FMI were significantly different among the age groups in students with disabilities (P = 0.006, P = 0.0001, and P = 0.001, respectively). Younger children had significantly greater proportions of under range in BMI, PBF, and FMI.

CONCLUSIONS

Disability significantly affects FFMI, which represents muscle mass. Therefore, it is crucial to make efforts to increase physical activity and to improve nutrition in rehabilitative intervention strategies.

Investigation of the Trend in Adolescent Mental Health and its Related Social Factors: A Multi-Year Cross-Sectional Study For 13 Years

We aimed to investigate the mental health change and associated social correlates in adolescents in terms of depression, suicidal ideation, and suicidal attempt. In total, 978,079 students (12–18 years old, 7th–12th grade) participated in the survey for 13 years (2006–2018) by a multiple-year cross-sectional design (not a repeat measure for smaller group). Mental health outcome variables were assessed using self-report surveys with the independent variables of sex, age, economic status, school achievement, and parental educational level. Korean social indices of income inequality (Gini index, higher scores representing greater economic inequity with score range of 0–1), education (national proportion of tertiary education attainment), and actual suicides were investigated together as related social factors. The prevalence of depressive episodes, suicidal ideation, and suicidal attempt markedly dropped by 34.6%, 42.2%, and 48.3%, respectively. Moreover, the Gini index (from 0.314 in 2008 to 0.295 in 2015) and proportion of tertiary education (from 82.1% in 2006 to 69.7% in 2018) showed a decreasing tendency. These indices and adolescent mental health outcomes highly correlated with each other (Pearson’s r between Gini index and depressive episode = 0.789, suicidal ideation = 0.724, and suicidal attempt = 0.740; Pearson’s r between proportion of tertiary education and depressive episode = 0.930, suicidal ideation = 0.809, and suicidal attempt = 0.851). Adolescent mental health has improved in the last 13 years in Korea, and improvements in social inequality (decreased Gini index) and lessened burden of academic competition (decreased national proportion of tertiary education) were significantly associated with the improvement of adolescent’s mental health. However, the impact of parental educational level on children’s mental health was relatively minimal, compared with the impact of economic inequality and academic burden. Further studies are needed to reveal the underlying mechanism for the association between adolescent mental health and sociodemographic factors to save adolescents from psychological distress.

The Neglected Role of Physical Education Participation on Suicidal Ideation and Stress in High School Adolescents from South Korea

Adolescents are at high risk of suicidal ideation and stress. This study aimed to investigate how physical education participation predicts suicidal ideation and stress in South Korean high school students. Data from the Twelfth Korea Youth Risk Behaviour Web-Based Survey 2016 (KYRBS) were used for analyses. Two multiple logistic regressions were performed to determine the influence of selected factors on suicidal ideation and stress (model 1: subjective health, social support, body mass index, academic achievement, perceived economic status of family, and physical education participation; model 2: adjusting for school type and year). Model 2 revealed negative associations between subjective health, academic achievement, perceived economic status of family, social support, physical education participation (≥2 times/weekly), and suicidal ideation for male students. Female students exhibited negative associations between subjective health, social support, and academic achievement, along with a positive association between body mass index and suicidal ideation. For both genders, stress was negatively associated with subjective health, social support, academic achievement, perceived economic status of family, and physical education participation (≥2 times/weekly). These findings suggest that participating in physical education can mitigate the risk of suicidal ideation and stress among high school students.

Experiencing Sampling Research from Its Beginnings into the Future

Early experience sampling research sought to map the ecology of adolescents' lives. Its contributions include discovery of similar patterns in psychological states across diverse samples: positive emotions with friends, more negative states alone, high challenge but low motivation during schoolwork, and wider variability in teens' than adults' emotions, including more frequent extreme positive states. Recent ambulatory assessment research has expanded this mission and methods in valuable ways. Yet it still demands problem-solving (e.g., engaging participants, formulating analyses that represent teens' complex lives). A promising innovation is use of micro-longitudinal analyses to examine sequential processes (e.g., linkages between stress-coping-emotions; relationship episodes). Qualitative data can add "zones" for development of empirically-based theory about daily processes, such as adolescents' meaning-making and learning self-regulation.

Pathological Gaming in Young Adolescents: A Longitudinal Study Focused on Academic Stress and Self-Control in South Korea

With the increase in social concern regarding pathological gaming among adolescents, the WHO (World Health Organization) included "gaming disorder" in the International Classification of Disorders, 11th version (ICD-11). However, little longitudinal research has been conducted examining social influences on pathological gaming, particularly in Asian countries (e.g., South Korea, China). With 4-year panel data from young adolescents (N = 968, 50.7% girls; M_age = 13.3 years) in South Korea, this study examined the effects of cultural environmental factors (parents' excessive interference, communication with parents, and friends' and teachers' support) on pathological gaming through academic stress and self-control. The results showed the critical role of academic stress and self-control in the effects of environmental factors on pathological gaming. Parents' excessive interference increased the degree to which youth experienced academic stress while the degree of communication with parents decreased this stress. Increased academic stress damaged self-control, which finally increased the degree of pathological gaming. Self-control affected the degree of pathological gaming stronger than gaming time did. The theoretical and practical implications from the study findings are discussed.

Psychosocial determinants of stress among adolescents in an urban slum in a city of Western Maharashtra: a cross-sectional study

INTRODUCTION

Stress is a major underlying factor in the manifestation of many mental disorders. The prevalence of stress among Indian adolescents varies from 13% to 45%. Hence, the present study was done to assess the psychosocial determinants of stress among adolescents in an urban slum.

METHODOLOGY

This was a cross-sectional analytical study (community based) in an urban slum from January to July 17 with a sample of 230 adolescents aged 10-19 years. An Indian Council of Medical Research (ICMR) tool validated for use in the community was self-administered. Data was analyzed using SPSS 20.0.

RESULTS

The commonest stressors were perceived threat to economic position (84.3%), economic difficulty of meeting expenses for treatment of self/family members (63.5%), upcoming exams (61). The stressors that occurred significantly more often (p < 0.05) in males as compared to females were related to sexual desire, conflicts in love affairs, getting a job/employment issues, exam failure and interpersonal relationships within the family. Stressors that occurred significantly more often (p < 0.05) in females than in males were fear of sexual abuse/assault. Significant correlates of the presence of stress were male gender, nuclear family and low family income (p < 0.05).

CONCLUSION

The stressors in adolescents in an urban slum are both internal and external. There are gender differentials in type of stressors faced by adolescents.

Association Between Vitamin D Deficiency and Suspected Nonalcoholic Fatty Liver Disease in an Adolescent Population

PURPOSE

Vitamin D deficiency is a condition widespread throughout the world. Recent studies have suggested that vitamin D deficiency was associated with obesity and metabolic syndrome. The purpose of the study was to examine the relationship between vitamin D deficiency and nonalcoholic fatty liver disease (NAFLD) in adolescents.

METHODS

The data were obtained from the Korean National Health and Nutrition Examination Survey from 2008-2014. A total of 3,878 adolescents were included in the study. Vitamin D deficiency was defined as a 25-hydroxyvitamin D concentration <20 ng/mL and suspected NAFLD was defined as an alanine transaminase concentration >30 U/L.

RESULTS

Vitamin D deficiency was noted in 78.9% of the studied population. Age, body mass index, waist circumference, and blood pressure, glucose, cholesterol, and triglyceride levels were significantly higher in adolescents with suspected NAFLD than in adolescents without suspected NAFLD, while the mean vitamin D level was significantly lower in adolescents with suspected NAFLD. The multivariate-adjusted odds of suspected NAFLD were higher with increased age, male gender, obesity, and metabolic syndrome. Individuals with vitamin D deficiency were at higher risk of suspected NAFLD (odds ratio, 1.77; 95% confidence interval, 1.07-2.95) after adjusting for age, gender, obesity, and metabolic syndrome.

CONCLUSION

Vitamin D deficiency was associated with suspected NAFLD, independent of obesity and metabolic syndrome, in adolescents.

Association between Changes in Anthropometric Indices and in Fasting Insulin Levels among Healthy Korean Adolescents: The JS High School Study

BACKGROUND

This study investigated the association between changes in anthropometric indices and fasting insulin levels among healthy adolescents and whether the association differed by baseline obesity status.

METHODS

This analysis was based on data collected for the JS High School study; 884 healthy adolescents aged 15 to 16 years followed up for 24 to 30 months were included. Changes in anthropometric indices and fasting insulin levels were computed as the difference between baseline and follow-up values. Multivariate linear regression models were used to determine the association between changes in anthropometric indices and fasting insulin levels. Based on body mass index (BMI)-for-age and waist circumference (WC)-for-age percentiles, participants were classified as normal weight (<85th percentile), overweight (85th percentile to <95th percentile), or obese (≥95th percentile).

RESULTS

Changes in BMI, WC, waist-hip ratio, and waist-height ratio were significantly associated with changes in fasting insulin levels in both sexes (P<0.05). In analyses stratified by baseline obesity status, the association between change in BMI and change in fasting insulin was significantly stronger in overweight (males: standardized β=1.136; females: standardized β=1.262) and obese (males: standardized β=1.817; females: standardized β=2.290) participants than in those with normal weight (males: standardized β=0.957; females: standardized β=0.976) at baseline. Results were similar for changes in WC.

CONCLUSION

Changes in anthropometric indices were positively associated with fasting insulin level increases. Moreover, those who were overweight or obese at baseline had a higher absolute increase in fasting insulin levels per one standard deviation unit increase in anthropometric indices than adolescents with normal weight.

Student perceptions of self-efficacy and teacher support for learning in fostering youth competencies: Roles of affective and cognitive engagement

INTRODUCTION

This exploratory study extends research on student engagement by examining the relationships between its different facets, students' perception of teacher support for learning and self-efficacy, and adaptive youth competencies. Guided by Reschly and Christenson's (2012) student engagement framework, affective and cognitive engagement were posited to mediate the relationships between students' perceived beliefs, adaptive competencies and behavior engagement.

METHOD

3776 Singapore Grade 7 and 8 students completed a self report survey questionnaire.

RESULTS

Self-efficacy and teacher support demonstrated different indirect relationships with student competencies and via different engagement pathways. Cognitive engagement mediated the effects of teacher support and self-efficacy on the four student competencies, while affective engagement's mediated effects was only evident on academic buoyancy.

CONCLUSION

This study holds important implications for educational and psychological research on student engagement, demonstrating that the construct, though theorized in a western context, has empirical utility and relevance in an East Asian context.

Examining longitudinal relationship among effort reward imbalance, coping strategies and academic burnout in Korean middle school students

The present study examined the longitudinal relationship between effort-reward imbalance as a stressor and academic burnout as a strain. The study also examined the moderation effect of coping strategies, a problem-focused coping and an emotion-focused coping, in the relationship between effort-reward imbalance as a stressor and middle school students’ academic burnout as a strain using multi-group latent growth modeling (LGM) analysis. The results indicated a significant relationship between the initial status of effort-reward imbalance and the initial status of academic burnout. The results also indicated a significant relationship between the change rate of effort-reward imbalance and that of academic burnout. In addition, problem-focused coping strategies had a moderation effect on the relationship between effort-reward imbalance and academic burnout longitudinally. However, the emotion-focused coping strategy did not have a moderation effect. The authors discuss specific findings and practical implications for teachers and school psychologists.

Association of atopic dermatitis with depressive symptoms and suicidal behaviors among adolescents in Korea: the 2013 Korean Youth Risk Behavior Survey

BACKGROUND

Atopic dermatitis (AD) is a chronic skin disease which has been known to negatively influence the mental health of patients. However, only a few studies have explored the prevalence of psychiatric problems among AD patients, particularly among adolescents. In this study, we aimed to assess the association of AD with depressive symptoms and suicidal behaviors among adolescents by analyzing data from the 2013 Korean Youth Risk Behavior Survey, a nationwide web-based survey.

METHODS

Data from 72,435 adolescent middle and high school students in Korea were analyzed. Students self-reported AD diagnosed by a doctor and yes-or-no answers to questions about depressive symptoms and suicide ideation, suicide planning, and suicide attempts were analyzed. Relationships between AD and depressive symptoms or suicidal behaviors were tested by logistic regression models after controlling for potential confounding factors.

RESULTS

The proportion of adolescents who had AD was 6.8%. The proportion of adolescents reporting depressive feelings was 31.0%, suicide ideation was 16.3%, suicide planning was 5.8%, and suicide attempts was 4.2%. Compared to adolescents without AD, adolescents with AD were significantly more likely to experience depressive feelings (odds ratio [OR]: 1.27, 95% confidence interval [Cl]: 1.19-1.36), suicide ideation (OR: 1.34, 95% Cl: 1.24-1.45), suicide planning (OR: 1.46, 95% Cl: 1.32-1.65), and suicide attempts (OR: 1.51, 95% Cl: 1.33-1.72). In the multivariate model, the relationships between AD and suicide ideation (OR: 1.26, 95% Cl:1.16-1.36), suicide planning (OR: 1.28, 95% Cl:1.14-1.44), and suicide attempt (OR: 1.29, 95% Cl:1.13-1.49) were statistically significant.

CONCLUSION

Adolescents who have AD are associated with a higher prevalence of depression symptoms and suicidal behaviors. Adolescent AD patients may need interventions from clinicians and caregivers that use a holistic approach to prevent psychological comorbidities, although further research is needed to clarify this relationship.

Reliability and Validity of the Beck Depression Inventory-II among Korean Adolescents

OBJECTIVE

The Beck Depression Inventory-II (BDI-II) is one of the most popular scales for evaluating the severity of depression in adolescents as well as adults. The prevalence of depression increases during adolescence, and it has shown a rapid increase with occurrence at an earlier age and a tendency to continue into adulthood. Data from an adolescent nonclinical sample provides us more information related to depressive symptoms as potential risk factors. The current study was designed to two objectives: 1) to analyze the reliability and validity the BDI-II among Korean adolescents and 2) to evaluate the factorial structure in a Korean nonclinical adolescent sample.

METHODS

The participants included 1072 adolescent boys and girls. We assessed the internal consistency, corrected item-total correlation, and the convergent validity of the BDI-II. We also performed confirmatory factor analyses to determine the internal structure of the BDI-II for Korean adolescents using Mplus 6.1.

RESULTS

The Cronbach's alpha for the BDI-II total score was 0.89. The correlation between the BDI-II and the PHQ-9 was strong (r=0.75), and anxiety-related measures were 0.68 and 0.71, which were also in the high range. Among the five different factor structures, the modified three-factor model demonstrated the best overall fit.

CONCLUSION

The BDI-II is a reliable tool for measuring the severity of depressive symptoms in Korean adolescents. Therefore, the findings can provide basic information for examining the prevalence rate, intervention strategies for depression in adolescents.

Identifying the Career-Interest Profiles of Junior-High-School Students Through Latent Profile Analysis

Exploring the career-interest profiles of students has both practical and theoretical significance; however, a minimal amount of research has been conducted to address this issue. The present study combined latent profile analysis and differentiation values to investigate the career-interest profiles of 13,853 junior-high-school students. The results indicate that while the students' interests could be stratified into 25 profiles, 44.6% of students could be classified the as having low-differentiation profiles (such as like or dislike all types of vocational activities) and 24.9% of students could be classified the as having the artistic-social (like both artistic and social types of activities) profile. In addition, the proportions of females and males differed significantly among the profiles, but different grades did not. The proportion of males was higher for all three low-differentiation groups than of female proportions. Implications for career practices and future research are proposed.

Risk Factors and Mediators of Suicidal Ideation Among Korean Adolescents

BACKGROUND

A significant number of Korean adolescents have suicidal ideations and it is more prevalent among adolescents than any other age group in Korea.

AIMS

This study was conducted to attain a better understanding of the contributing factors to suicidal ideation among Korean adolescents.

METHOD

We recruited 569 high school students in Grades 10 and 11 in Pyeongtaek, Korea. The Beck Scale for Suicidal Ideation was used to measure suicidal ideation as the outcome variable. The Interpersonal Needs Questionnaire, the Beck Hopelessness Scale, the School Related Stress Scale, the Olweus Bully/Victim Questionnaire, and the Youth Risk Behavior Surveillance questions were used to measure thwarted belongingness and perceived burdensomeness, hopelessness, school-related stress, bullying, and previous suicidal behaviors, respectively. Data analyses included descriptive statistics and structural equation modeling.

RESULTS

The findings suggest that perceived burdensomeness, hopelessness, school-related stress, and previous suicidal behaviors have significant direct effects on suicidal ideation. Hopelessness fully mediated the relation between thwarted belongingness and suicidal ideation, and partially mediated between perceived burdensomeness, school-related stress, and suicidal ideation.

CONCLUSION

These findings provide more specific directions for a multidimensional suicide prevention program in order to be successful in reducing suicide rates among Korean adolescents.

Profiles of Coping Strategies in Resilient Adolescents

To understand how resilient adolescents adapt to adverse situations, this study examined resilient adolescents and their coping strategies. Resilience is the phenomenon characterized by good outcomes despite serious threats to adaptation and/or development. The current study aimed to identify the coping strategy profiles that distinguish a resilient group from three other groups—struggling, competent, and vulnerable—specifically to differentiate the resilient group from the competent group. Descriptive discriminant analysis results indicated that resilient adolescents simultaneously utilized not only problem-focused but also the emotion-focused coping strategies. The competent group primarily used problem-focused coping, while the struggling group primarily used emotion-focused strategies. Finally, the vulnerable adolescents used neither problem-focused nor emotion-focused strategies. Practical implications of the results were discussed to guide professionals.

Career Identity and Life Satisfaction

Identity formation is considered as a key factor in the conceptualization of life satisfaction (LS). Recent volatility in labor markets has negatively influenced college students’ LS and attending to the relationship between their career identity (CI) and LS has become important for career researchers and counselors. The purpose of this study is to examine the mediating effects of tolerance for uncertainty (TU) and emotions (positive affect [PA] and negative affect [NA]) in the relationship between CI development and LS. The hypotheses were tested among 199 college students in a prestigious South Korean university. The results indicate that TU and emotions mediate the effects of CI on LS. Based on these findings, career counselors are encouraged to help college students understand the synergy of TU and development of CI, which may increase their sense of LS.

School stress in India: Effects on time and daily emotions

Like adolescents in East Asia, Indian middle-class adolescents face a highly competitive examination system. This study examines the influence of school demands on the daily time use and subjective states of Indian young people. One hundred urban, middle-class, 8th-grade students carried alarm watches for 1 week and provided 4764 reports on their activities and subjective states at random times, following the procedures of the Experience Sampling Method. These adolescents were found to spend one third of their waking time in school-related activities, with girls spending more time than boys. Schoolwork generated negative subjective states as reflected in low affect state, below-average activation levels, lower feeling of choice, and higher social anxiety. These negative states were most frequent during homework. The trade-off faced by Indian adolescents were evident in the findings that those who spent more time doing homework experienced lower average emotional states and more internalising problems, while those who spent more time in leisure experienced more favourable states but also reported higher academic anxiety and lower scholastic achievement.

A Case for "Reverse One-Child" Policies in Japan and South Korea? Examining the Link between Education Costs and Lowest-Low Fertility

Household spending on children's pre-tertiary education is exceptionally high in Japan and South Korea, and has been cited as a cause of low fertility. Previous research attributes this high spending to a cultural emphasis on education in East Asian countries. In this paper, we argue that institutional factors, namely higher education and labor market systems, play an important role in reinforcing the pressure on parents to invest in their children's education. We review evidence showing that graduating from a prestigious university has very high economic and social returns in Japan and South Korea, and examine the implications for fertility within the framework of quantity-quality models. Finally, we put forward 'reverse one-child' policies that directly address the unintended consequences of these institutional factors on fertility. These policies have the additional virtues of having very low fiscal requirements and reducing social inequality.

Suppressor Effects of Positive and Negative Religious Coping on Academic Burnout Among Korean Middle School Students

Statistical suppressor effects in prediction models can provide evidence of the interdependent relationship of independent variables. In this study, the suppressor effects of positive and negative religious coping on academic burnout were examined using longitudinal data. First, 388 middle school students reported their type of religion and use of positive and negative religious coping strategies. Four months later, they also reported their level of academic burnout. From structural equation modeling, significant suppressor effects were found among religious students. That is, the coefficients became larger when both positive and negative religious coping predicted academic burnout simultaneously, compared to when each religious coping predicted academic burnout alone. However, suppressor effects were not found among non-religious students.

Trial for the Prevention of Depression (TriPoD) in final-year secondary students: study protocol for a cluster randomised controlled trial

BACKGROUND

Evidence suggests that current treatments cannot fully alleviate the burden of disease associated with depression but that prevention approaches offer a promising opportunity to further reduce this burden. Adolescence is a critical period in the development of mental illness, and final school examinations are a significant and nearly universal stressor that may act as a trigger for mental health difficulties such as depression. The aim of the present trial is to investigate the impact of SPARX-R, an online, gamified intervention based on cognitive behavioural principles, on the prevention of depression in secondary school students before their final examinations.

METHODS/DESIGN

Government, independent and Catholic secondary schools in New South Wales, Australia, will be recruited to participate in the trial. All students enrolled in their final year of high school (year 12) in participating schools will be invited to participate. To account for possible attrition, the target sample size was set at 1600 participants across 30 schools. Participating schools will be cluster randomised at the school level to receive either SPARX-R or lifeSTYLE, an attention-controlled placebo comparator. The control intervention is an online program aimed at maintaining a healthy lifestyle. The primary outcome will be symptoms of depression, and secondary outcomes will include symptoms of anxiety, suicidal ideation and behaviours, stigma and academic performance. Additional measures of cost-effectiveness, as well as process variables (e.g., adherence, acceptability) and potential predictors of response to treatment, will be collected. Consenting parents will be invited to complete measures regarding their own mental health and expectations for their child. Assessments will be conducted pre- and post-intervention and at 6- and 18-month follow-up. Primary analyses will compare changes in levels of depressive symptomatology for the intervention group relative to the attention control condition using mixed-effects model repeated-measures analyses to account for clustering within schools.

DISCUSSION

This is the first trial of a universal depression prevention intervention delivered to school students in advance of a specific, significant stressor. If found to be effective, this program may offer schools a new approach to preparing students for their final year of schooling.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry identifier: ACTRN12614000316606 . Registered 25 March 2014.