OBJECTIVES: Shift work is a stressful situation. It is important to know the factors associated with the ability to adapt to a shift work schedule. The aim of the present study was to investigate the association between sleep, as well as personality variables, and the resilience of shift work nurses. METHOD: Self-report questionnaires were administered to 95 nurses who worked in one national university hospital. Connor-Davidson resilience scale, hospital anxiety and depression scale, morningness-eveningness scale, Pittsburgh sleep quality index, other sleep-related questionnaires, and Korean defense style questionnaires were used. RESULTS: Age, shift work duration, off-day oversleep, depression, anxiety, adaptive defense style, and self-suppressive defense style were significantly associated with resilience (p < 0.05). Multiple regression analysis showed that age (beta = 0.34, p < 0.05), depression (beta = -0.25, p < 0.05), adaptive defense style (beta = 0.45, p < 0.001), and self-suppressive defense style (beta = -0.19, p < 0.05) significantly predicted the resilience of shift work nurses. Concerning individual defense mechanisms, resignation (beta = -0.20, p < 0.05), sublimation (beta = 0.19, p < 0.05), omnipotence (beta = 0.19, p < 0.05), and humor (beta = 0.20, p < 0.05) significantly predicted the resiliency. CONCLUSION: The findings indicate that a specific defense style and other mechanisms were associated with the resilience of shift work nurses. A future prospective study with more participants could further clarify the relationship between sleep-related variables, as well as personality factors, and resilience of shift work nurses.
Anxiety ; Appointments and Schedules ; Defense Mechanisms ; Depression ; Surveys and Questionnaires ; Sublimation

The aim of the study was to evaluate the effect of school violence on depressive symptoms among the offspring of multicultural families in South Korea. Data from the National Survey of Multicultural Families 2012, conducted by the Korean Women's Development Institute and Statistics Korea, were used in this study. Complex samples logistic regression was performed to determine the effect of school violence on depressive mood. The survey participants were 3999 students between the ages of 9 and 24. Of the participants, 22.1% reported experiencing depressive symptoms and 9.1% reported experiencing school violence within the last year. School violence was a strong risk factor (OR=5.142, 95% CI=4.067–6.500) for depressive symptoms after adjusting for personal, familial and school factors. School violence is a serious contributor to depressive mood among the offspring of multicultural families. There is a significant need to monitor school violence among this vulnerable group.
Depression* ; Humans ; Korea* ; Logistic Models ; Risk Factors ; Violence*

Objective: This study investigated the types of daily life stressors associated with social media use in adolescents with problematic Internet/smartphone use in a city in Korea. Methods: Data from 2,997 Internet and smartphone users who participated in a survey about the actual use of smart digital media in Korea were included. The measurement tools included questionnaires on Internet and smartphone usage patterns and types of daily life stressors as well as the Internet Gaming Use-Elicited Symptom Screen and a smartphone addiction scale. The subjects were divided into a problematic Internet/smartphone use group and a control group. We compared the types of daily life stressors associated with social media use for each group. Results: All types of daily life stressors were more prevalent in the problematic Internet use group than in the control group. In the problematic Internet/smartphone use group, the types of daily life stressors that were positively associated with social media use were sibling rivalry and physical health. In the control group, social media use was negatively associated with daily life stressors related to appearance and heterosexual relationships. Conclusion There is a need to provide personalized stress management related to social media use for adolescents with problematic Internet/smartphone use.

Objective: This study investigated the types of daily life stressors associated with social media use in adolescents with problematic Internet/smartphone use in a city in Korea. Methods: Data from 2,997 Internet and smartphone users who participated in a survey about the actual use of smart digital media in Korea were included. The measurement tools included questionnaires on Internet and smartphone usage patterns and types of daily life stressors as well as the Internet Gaming Use-Elicited Symptom Screen and a smartphone addiction scale. The subjects were divided into a problematic Internet/smartphone use group and a control group. We compared the types of daily life stressors associated with social media use for each group. Results: All types of daily life stressors were more prevalent in the problematic Internet use group than in the control group. In the problematic Internet/smartphone use group, the types of daily life stressors that were positively associated with social media use were sibling rivalry and physical health. In the control group, social media use was negatively associated with daily life stressors related to appearance and heterosexual relationships. Conclusion There is a need to provide personalized stress management related to social media use for adolescents with problematic Internet/smartphone use.

The purpose of this study was to evaluate the mediating effect of depressive symptoms on the relationship between adverse childhood experiences (ACEs) and problematic internet use. The study participants were 180 students between the ages of 9 and 18 years. Path analysis was performed to measure the relationships among ACEs, depressive symptoms and problematic internet use. ACEs significantly affected depressive symptoms (standardized regression weight, 0.36; P < 0.01), and depressive symptoms also affected problematic internet use (standardized regression weight, 0.40; P < 0.01). We found that depressive symptoms had a significant mediating effect on the relationship between problematic internet use and ACEs. The management of depressive symptoms would be important to prevent problematic internet use in children and adolescents with ACEs.

Objective:To explore the care burden of the primary caregivers of maintenance hemodialysis (MHD) patients and its correlation with psychological resilience and social support.Methods:From January 2020 to December 2021, 97 MHD patients and 97 primary caregivers admitted to Zhumadian Central Hospital were selected by convenient sampling. The subjects were investigated with the Zarit Caregiver Burden Interview (ZBI) , Connor-Davidson Resilience Scale (CD-RISC) and Social Support Rating Scale (SSRS) . Pearson correlation analysis was used to explore the correlation between the care burden, psychological resilience and social support of the main caregivers of MHD patients. Model 4 in the PROCESS macro program was used to test the intermediary model, and the significance of the intermediary effect was tested by Bootstrap analysis. A total of 97 questionnaires were distributed, and the effective recovery rate was 100.00%.Results:There were statistically significant differences in the ZBI scores of MHD patients' main caregivers with different ages, with or without other care workers, total care time, daily care time, psychological resilience and social support ( P<0.05) . The total ZBI score of the main caregivers of MHD patients was (42.39±10.61) , of which 1.03% (1/97) had no or very mild burden, 44.33% (43/97) had mild burden, 50.52% (49/97) had moderate burden, and 4.12% (4/97) had severe burden. The total score of CD-RISC of the main caregivers of MHD patients was (53.09±5.69) , of which 79.38% (77/97) of the main caregivers had low-level resilience, and 20.62% (20/97) of the main caregivers had medium-level resilience. The total SSRS score of the main caregivers of MHD patients was (30.33±7.19) , of which 21.65% (21/97) of the main caregivers had low-level social support, 76.29% (74/97) of the main caregivers had medium-level social support, and 2.06% (2/97) of the main caregivers had high-level social support. The care burden of the main caregivers of MHD patients was negatively correlated with psychological resilience and social support, and psychological resilience was positively correlated with social support ( P<0.05) . Social support positively predicted psychological resilience and negatively predicted care burden ( P<0.05) . Psychological resilience negatively predicted care burden ( P<0.05) . The intermediary model (dependent variable was care burden; independent variable was social support; intermediary variable was psychological resilience) had a significant intermediary effect. The indirect effect accounted for 79.23% of the total effect, and the direct effect accounted for 20.77% of the total effect. Conclusions:The main caregivers of MHD patients have moderate care burden, and social support can directly affect the care burden, and also indirectly affect the care burden through the mediation of psychological resilience.

Objectives: ：The purpose of this study was to investigate the relationship between serum vitamin D concentration and resilience in patients hospitalized with bipolar disorder. Methods: ：Serum vitamin D levels were measured on day 1 of hospitalization in 64 patients with bipolar disorder, who were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition. The ConnorDavidson Resilience Scale and the Korean version of the Inventory for Depressive Symptomatology (KIDS) were administered to these patients, and symptoms of mania were evaluated using the Young Mania Rating Scale (YMRS). Patients were then categorized into vitamin D sufficient and deficient groups based on a serum vitamin D cut-off of 20 ng/ mL. Analysis of covariance (ANCOVA) was performed to compare the resilience between the two groups, and multiple linear regression was performed to determine the association between serum vitamin D levels and resilience. Results: ：The vitamin D deficiency group had more depressive episodes than the sufficient group (p<0.05). ANCOVA showed that the vitamin D deficient group had significantly lower resilience scores than the sufficient group (p= 0.034). Moreover, multiple regression analyses conducted by controlling age, sex, body mass index, season of blood sampling, KIDS scores, and YMRS scores, showed a significant association between serum vitamin D concentration and resilience in patients with bipolar disorder (p=0.001). Conclusions ：This study suggested that vitamin D deficiency is associated with resilience as a protective factor against stress and trauma in patients with bipolar disorder. Further research is warranted to determine the causal relationship between vitamin D levels and resilience.

Objectives: Adolescent suicide is a serious social problem. Adolescent alcohol use is one of the most important risk factors for adolescent suicide. This study aimed to identify the relationship between drinking habits and suicide among Korean adolescents. Methods: Data from the 14th and 15th Korean Youth Risk Behavior Web-based Survey, conducted in 2018 and 2019, were used for analysis. Multiple logistic regression analysis was used to identify the relationship between drinking habits—including the age of drinking initiation, frequency of drinking, average drinking amount, frequency of drunkenness—and suicidal ideation, plans, and attempts. Results: Even after adjusting for age, sex, school grade, academic achievement, socioeconomic status, depression, stress, and drinking habits, the frequencies of drinking and drunkenness increased the risk of suicide attempts. Suicide attempts were associated with the frequency of drinking in girls and middle school students, and with the frequency of drunkenness in boys and high school students. Conclusion This study identified associations between drinking habits (the age of drinking initiation, frequency of drinking, average amount of drinking, frequency of drunkenness) and suicidal behavior in adolescents. Our findings suggest that to prevent adolescent suicide, it might be necessary to investigate drinking habits, including the frequencies of drinking and drunkenness. Moreover, considering the differences in sex and school grade, it is important to include the individual group characteristics when evaluating drinking habits.

Objectives: Adolescent suicide is a serious social problem. Adolescent alcohol use is one of the most important risk factors for adolescent suicide. This study aimed to identify the relationship between drinking habits and suicide among Korean adolescents. Methods: Data from the 14th and 15th Korean Youth Risk Behavior Web-based Survey, conducted in 2018 and 2019, were used for analysis. Multiple logistic regression analysis was used to identify the relationship between drinking habits—including the age of drinking initiation, frequency of drinking, average drinking amount, frequency of drunkenness—and suicidal ideation, plans, and attempts. Results: Even after adjusting for age, sex, school grade, academic achievement, socioeconomic status, depression, stress, and drinking habits, the frequencies of drinking and drunkenness increased the risk of suicide attempts. Suicide attempts were associated with the frequency of drinking in girls and middle school students, and with the frequency of drunkenness in boys and high school students. Conclusion This study identified associations between drinking habits (the age of drinking initiation, frequency of drinking, average amount of drinking, frequency of drunkenness) and suicidal behavior in adolescents. Our findings suggest that to prevent adolescent suicide, it might be necessary to investigate drinking habits, including the frequencies of drinking and drunkenness. Moreover, considering the differences in sex and school grade, it is important to include the individual group characteristics when evaluating drinking habits.

Objective: The suicide rate in Korea was the highest among countries in the Organisation for Economic Co-operation and Development in 2019. In a previous study, higher intake of vegetables and fruits was associated with a lower risk of suicidal ideation, and carotene-rich fruits and vegetables lowered the risk of depression. This study aimed to examine the direct relationship between carotene intake and suicidal ideation, adjusting for the effect on depression. Methods: This study used data from the Korea National Health and Nutrition Examination Survey (KNHANES) conducted in 2012, 2013, and 2015. Carotene intake was assessed through a food intake frequency survey with a 24-hour recall. Suicidal ideation and depression were assessed using the mental health section of the KNHANES. We applied logistic regression to assess the relationship between carotene intake and suicidal ideation, adjusting for potential confounders. Results: A total of 5,480 females aged 19–64 years were included in this study. Carotene intake was significantly lower in the suicidal ideation group (3,034.5±1,756.4 μg/day) than in the nonsuicidal ideation group (3,225.4±1,795.1 μg/day) (p=0.015). We found a significant inverse association between carotene intake and the risk of suicidal ideation after adjusting for potential confounders (odds ratio=0.934, 95% confidence interval=0.873–0.999). Conclusion These results suggest that carotene intake may be inversely associated with the risk of suicidal ideation. Our findings may inform the development of new nutritional interventions to prevent increases in the risk of suicide worldwide.