Background: This study aimed to investigate the impact of exposure to adverse childhood experiences (ACEs) and stress among the community-based urban pediatric population in Korea. Methods: In 2017, the analysis was conducted on 3,937 children and adolescents in an urban area in Korea based on the impact of actual traumatic experience, addiction, and mental health. The respondents were excluded if they were missing data on the survey, resulting in a final sample size of 3,556. The collected data were analyzed by applying cross-sectional and correlation analyses. Results: Among the respondents in the study group (mean age = 13.77), 43.1% were boys (n = 1,532) and 56.9% were girls (n = 2,024). Overall, 23.5% (n = 835) reported at least one ACE and 1.8% (n = 63) reported experiencing four or more ACEs. Emotional abuse (13.2%) was the most commonly reported ACE, followed by abandonment (7.7%) and physical abuse (7.5%).Self-reported measures of stress were associated with the ACE scores. Conclusion This is the first study of self-reported ACEs from a community-based pediatric population in Korea. We found that the number of the students revealed more than one ACEs was similar to the data in the US community study with self-reporting among the community samples and exposure to adverse experiences is highly correlated with various stress responses.

OBJECTIVES: This study aimed to identify the process of psychosocial assessment, the experience of intervention, and the improvement after the disaster that Danwon high school students survived from the sinking of the Motor Vessel (MV) Sewol in South Korea on April 16, 2014. METHODS: We conducted in-depth qualitative research using individual interviews from January to February 2017. Twenty-one of 75 Danwon high school students survived by the MV Sewol disaster were studied. Two interviewers participated in the in-depth interview. Interviews were transcribed verbatim, coded, and analyzed through content analysis based on psychosocial assessment and intervention after the disaster. RESULTS: Twenty-one participants were 20 years old, where 10 were male (47.62%), and 11 were female (52.38%). More than 75% of the interviewed students felt that mental health services were needed, and more than 85% required mental health assessments. Regarding psychiatric symptoms, the students reported that they suffered depression and insomnia (19.05%), anxiety (14.29%), nightmares and phobias (9.52%), and difficulties regarding concentration, aggression, and game addiction (4.76%). CONCLUSION: Despite survivors experiencing the same disaster, there were differences in their responses to mental health assessments and interventions experienced during the three years, and conflicting opinions were reported. In planning future evaluations and interventions, it is necessary for strategies to cope with flexibly to consider the characteristics and symptoms of the survivors while maintaining principles.
Aggression ; Anxiety ; Depression ; Disasters* ; Dreams ; Female ; Humans ; Korea ; Male ; Mental Health Services ; Mental Health* ; Phobic Disorders ; Qualitative Research ; Sleep Initiation and Maintenance Disorders ; Survivors*

OBJECTIVES: In this study, we aimed to conduct a systematic review of studies investigating psychosocial factors affecting children exposed to disasters. METHODS: In total, 140 studies were retrieved. The studies were published from 1988 to 2015. A systematic review was performed using the PRISMA guidelines. MEDLINE, EMBASE, Cochrane Central, Web of Science, PsycINFO, PubMed, and Google Scholar were searched. Each database was searched using the following terms: ‘Child,’‘Adolescent,’‘Youth,’‘Disaster,’‘Posttraumatic,’‘Psychosocial,’‘Assessment,’‘Evaluation,’ and ‘Screening.’ The identified studies were subjected to data extraction and appraisal. RESULTS: The database search identified 713 articles. Based on the titles and abstracts, the full texts of 118 articles were obtained. The findings of this review can be used as a basis for the design of a psychosocial evaluation tool for disaster preparedness. CONCLUSION: Given the paramount importance of post-disaster evaluation and the weaknesses of current disaster evaluation tools, the need to develop valid and reliable tools and psychometric evaluations cannot be overstated. Our findings provide current evidence supporting various assessments in children, who are very vulnerable psychologically following disasters.
Adolescent* ; Child* ; Disasters* ; Humans ; Mental Health* ; Psychology ; Psychometrics

Objective: The study aimed to describe the frequency and associations of the number of medical visits for the violent victimization and mental health problems in adolescents in South Korea. Methods: In 2017, 62,276 middle and high school students participated in the thirteenth Korea Youth Risk Behavior Web-based Survey (KYRBS). The frequency of violence victimization during the last 12 months was measured. The collected data were analyzed by applying descriptive statistics, chi-square tests, multiple linear regression, and logistic regression analysis, using the SPSS 22.0. The data were weighted to generate national estimates. Results: Among the respondents (sample size=62,276, weighted=3,027,488), 3.7% of boys and 1.7% of girls had experienced being treated by a doctor due to violence during the recent past 12 months. In multiple linear regression analysis, feelings of sadness or hopeless, suicide ideation, suicide plan, suicide attempt were positively associated with violence victimization (F=32656.037, p<0.001) dose response. Conclusion The results found cross-sectional evidence that violence victimization was associated with higher suicide behavior and depressed mood. The victims of violence should be referred follow-up for physical and psychological issues. Also, a policy including the first responders and medical staffs should be initiated.

Background: This study aimed to examine the factors associated with internet gaming disorder (IGD) and the mediating role of pediatric symptoms (attention, externalizing problems and internalizing problems) in children and adolescents with a family history of addiction as an adverse childhood experience (ACE). Methods: A total of 2,586 children and adolescents (mean age = 14.04 ± 2.34; age range = 11–19 years; 50.5% boys) completed the Internet Game Use-Elicited Symptom Screen and the Pediatric Symptom Checklist-17. IBM SPSS Statistics 21 was used to calculate descriptive statistics and Pearson correlation coefficients and to conduct multiple regression analyses.Mediation analysis was performed using the Sobel test and the SPSS PROCESS macro. Serial multiple mediation analysis was performed using bootstrapping with 5,000 replications. Results: The higher levels of Attention problems (β = −0.228, P < 0.001) and externalizing problems (β = −0.213, P < 0.001) were associated with IGD. Furthermore, the indirect effect of the independent variable on the dependent variable through the mediators was significant (Sobel’s T: Z = −5.006, P < 0.001). These findings suggest that attention and externalizing problems mediate the effect of family history of addiction on IGD. Conclusion This study demonstrated the associations among the family history of addiction, IGD, and pediatric symptoms (attention, externalizing problems, and internalizing problems) among Korean children and adolescents. Therefore, we need to pay attention to pediatric symptoms and develop systematic alternatives to improve mental health among Korean children and adolescents with a family history of addiction as ACEs.

Objective: This study identified latent subtypes of mental health literacy (MHL) for Internet gaming disorder (IGD) and explored their characteristics and differences in various factors in adolescents. Methods: This study analyzed secondary data from the 2019 Youth Smart Digital Media Survey and included data from 1,936 middle and high school students (14–18 years old). Thirteen items of the MHL questionnaire were used for latent profile analysis. We compared the characteristics and predictors of the identified types using various statistical analyses, including one-way ANOVA, chi-square test, and multinomial logistic regression. Results: We identified three subtypes of MHL for IGD in adolescents: “low perception-prefer informal resources,” “moderate perception-preferred resources unclear,” and “high perception-prefer professional resources.” Subtypes showed significant differences in sex, age, family affluence, e-learning time during weekdays, mental health risks, level of problematic smartphone use, and IGD. All variables except IGD predicted one or more latent types. Conclusion Practical interventions are required to improve IGD MHL, including customized prevention based on the differences between the three types.

Background: We aimed to evaluate the feasibility of trauma-focused group therapy in adolescents exposed to traumatic events in Korea. Methods: We recruited 22 adolescents (mean age, 16 years; standard deviation, 1.43; range, 13–18 years). Children in Disaster: Evaluation and Recovery (CIDER) V1.0 is a trauma-focused group therapy comprising eight 50-minute-long sessions. The effectiveness of the intervention was evaluated using the Korean version of the Children's Response to Traumatic Events Scale-Revised (K-CRTES-R), the Beck Depression Inventory (BDI), the State Anxiety Inventory for Children (SAIC), and the Pediatric Quality of Life Inventory (PedsQL). The data were analyzed by the Wilcoxon signed-rank test. Results: A significant improvement was revealed in trauma-related symptom scores (Z = −2.85, P < 0.01), depressive symptom scores (Z = −2.35, P< 0.05) and quality of life scores (Z = −3.08, P< 0.01). Additionally, a marginally significant improvement was found in anxiety symptom scores (Z = −1.90, P = 0.058). Conclusion CIDER is a potentially effective intervention for adolescents exposed to traumatic events. Larger controlled trials are needed.

No abstract available.
Rhabdomyosarcoma, Embryonal*

OBJECTIVES: This study examined the prevalence of psychiatric problems in children with scholastic difficulties who had been referred for mental health services from the Office of Education in Ulsan Metropolitan City. METHODS: Child psychiatrists evaluated the referred children using the DSM-IV. Evaluation tools included the Wechsler Intelligence Scale for Children-III, the Children's Depression Inventory, the Korean form of the State-trait anxiety Inventory for children, the ADHD rating. RESULTS: Seventy-six children consisting of 64 boys (84.2%) and 12 girls (15.8%) participated in the study. The average age was 10.3 (SD=0.93) years old. Approximately 74% of the children referred for scholastic difficulties were diagnosed with mental retardation. The Axis I diagnosis among these children were ADHD (86.8%), depression (21.1%), learning disorder (9.2%), communication disorder (4.8%), pervasive developmental disorder (3.6%), internet addiction (1.3%), and mood disorder (1.3%). Their overall measure according to the Child Depression Inventory was 22.7 (SD=16.8), that for the State-Trait Anxiety Inventory for Children was 33.3 (SD=7.9)/32.4 (SD=9.5), and that for the ADHD rating scale was 18.9 (SD=10.9). CONCLUSION: These results suggest that many children with scholastic difficulties have both complex psychiatric and educational problems.
Anxiety ; Axis, Cervical Vertebra ; Child ; Communication Disorders ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Intellectual Disability ; Intelligence ; Internet ; Learning Disorders ; Mental Health Services ; Mood Disorders ; Parents ; Prevalence ; Psychiatry ; Psychopathology

We present the first report of fetal alcohol effect in a 12 year-old child in Korea. The mother had consumed 162 g of alcohol per week continuously during pregnancy. His first febrile seizure occurred before he was 1 year old, and became more frequent 2 years later. He started showing signs of right paraplegia when he was 3.5 years old and brain MRI revealed periventricular leucomalacia near the left ventricle. He was microcephalic and his growth was retarded. He was irritable, impatient, impulsive, and inattentive, and showed disinterest in school activities and aggressive and dangerous behavior. After the diagnosis of attention deficit/hyperactivity disorder was made, psychopharmacological treatment and family support was initiated. After 10 months, he still had intermittent ideas of reference, although the aggressive behavior, inattentiveness, and impulsivity had improved. Using this case study, we stress the importance of maternal alcohol history in patients with these characteristics.
Brain ; Child ; Dangerous Behavior ; Heart Ventricles ; Humans ; Infant, Newborn ; Korea ; Leukomalacia, Periventricular ; Mothers ; Paraplegia ; Pregnancy ; Seizures ; Seizures, Febrile