2.Longitudinal Associations Between Child and Family Factors With Korean Children’s Subjective Happiness Before and During COVID-19 in Late Childhood
Journal of the Korean Academy of Child and Adolescent Psychiatry 2026;37(2):115-123
Objectives:
This study investigated the trajectories of subjective happiness among children aged 8–13, assessed the impact of the COVID-19 pandemic, and identified child- and family-level predictors of variations in happiness.
Methods:
Drawing on 5855 person-years of data from the nationally representative Panel Study on Korean Children, we employed longitudinal multilevel modeling to examine trends, including those during the pandemic period, and to estimate the influence of childand family-level predictors. Sex differences were analyzed using interaction terms and stratified analyses.
Results:
The study revealed a significant negative temporal trend in children’s subjective happiness from ages 8 to 13 years, with a sharp decline associated with the onset of the pandemic in 2020 (b=-1.524, p<0.001). Regarding child-level predictors, male sex, sleep duration, subjective health, and number of friends were positive predictors. Maternal education was a positive family-level predictor, whereas maternal stress was a negative predictor. In terms of sex differences, the happiness levels of both males and females remained significantly below the pre-pandemic levels. Overweight/obesity, sleep duration, maternal education level, and paternal subjective health were significant predictors among females but not among males.
Conclusion
Although we found a decline in happiness with age, we confirmed that COVID-19 had a significant impact on children’s subjective happiness. Our findings underscore the need to identify the key predictors of happiness and to consider proactive strategies to prepare for future infectious disease outbreaks.
3.Relationship of Serum Tricellulin, MarvelD3, and Tumor Necrosis Factor-Alpha Levels With Obsessive-Compulsive Disorder Severity in Children and Adolescents
Kübranur ÜNAL ; Yasemin Taş TORUN ; Mehmet Emre EROL ; Zeynep Kübra KURT ; Cansu ÖZBAŞ
Journal of the Korean Academy of Child and Adolescent Psychiatry 2026;37(2):105-114
Objectives:
Obsessive-compulsive disorder (OCD) is a neuropsychiatric disorder characterized by obsessions and compulsions, with a prevalence of 1%–3%. Tight junction (TJ) proteins contribute to maintaining the epithelial barrier. This study investigated the association of serum TJ-associated MARVEL protein family and inflammatory markers with OCD severity in children and adolescents.
Methods:
A total of 43 drug-naive children with “pure” OCD and 37 age-matched healthy controls were included in the study. Serum levels of occludin, tricellulin, MarvelD3, which belong to the TJ-associated MARVEL protein family, along with inflammatory markers (C-reactive protein, tumor necrosis factor-alpha [TNF-α], interleukin-6) were assessed. The severity of OCD was ascertained using the Maudsley Obsessive-Compulsive Inventory (MOCI). Biochemical data of patients and control groups were compared against clinical features such as OCD severity and time since symptom onset.
Results:
Both groups showed similar sociodemographic factors, except that psychiatric disorders and family histories of OCD were significantly higher in the OCD group. Although serum TJ levels were not significantly different between groups, serum tricellulin (r= 0.427, p=0.004), MarvelD3 (r=0.489, p<0.001), and TNF-α (r=0.495, p<0.001) levels had a positive correlation with the severity of OCD based on MOCI.
Conclusion
The findings suggest that tricellulin, MarvelD3, and TNF-α may be associated with OCD severity. Further comprehensive research is required to determine the role of TJ proteins belonging to the MARVEL protein family in the pathophysiology of OCD.
4.Psychological Characteristics Associated With Cyberbullying:Focusing on the Victim-Perpetrators and Gender Differences
Geon-Taek BAE ; Sang-Ick LEE ; Chul-Jin SHIN ; Jung-Woo SON ; Siekyeong KIM ; Gawon JU ; Jeonghwan LEE ; Joon Hyung JUNG ; Seungwon CHUNG
Journal of the Korean Academy of Child and Adolescent Psychiatry 2026;37(2):95-104
Objectives:
Cyberbullying is a modern form of violence involving intentional harassment through electronic devices. We aimed to investigate how psychological characteristics differ based on cyberbullying involvement, identify the psychological factors associated with cyberbullying, and examine whether these factors vary by gender.
Methods:
A survey was conducted with 449 middle school students in Cheongju, Korea. Participants were categorized into four groups based on their involvement: Neither (N), Victim (V), Perpetrator (P), and Victim-Perpetrator (VP). Psychological characteristics were assessed using the Beck Depression Inventory (BDI), Self-Esteem Scale, and Strengths and Difficulties Questionnaire (SDQ). We compared these characteristics across the four groups and examined their influence on cyberbullying involvement by gender.
Results:
Overall, 31.8% of participants were involved in cyberbullying, with the VP group being the largest (17.1%) among them. The VP group exhibited more severe psychopathology than the N group across most internalizing and externalizing problems. SDQ-Conduct Problems subscale scores were significantly associated with victimization and perpetration. For female participants, high SDQEmotional Symptoms subscale scores were associated with greater victimization, and high BDI scores increased the risk of belonging to the VP group. No variables significantly increased the risk of belonging to the VP group among male participants.
Conclusion
Adolescents who are both victims and perpetrators of cyberbullying face the most significant psychological difficulties.Factors associated with cyberbullying involvement vary by gender, highlighting the need for tailored gender-specific prevention and intervention strategies.
5.The Concept of Autism in Autism Spectrum Disorder and Schizophrenia Spectrum Disorder: Historical Divergence and Phenomenological Rapprochement
Seong Hoon JEONG ; Jung-Woo SON
Journal of the Korean Academy of Child and Adolescent Psychiatry 2026;37(2):82-94
This study aims to trace the historical origins and conceptual divergence of “autism” as employed in autism spectrum disorder (ASD) and schizophrenia spectrum disorder (SSD), and to examine their recent rapprochement through the lens of phenomenological psychopathology. A narrative review was conducted to analyze primary historical sources, including works by Bleuler, Kanner, and their predecessors, along with contemporary literature on neurodevelopmental perspectives, social cognition, and phenomenological psychopathology. The analysis focused on comparing the structures of self-experience between patients with ASD and those with SSD using frameworks such as ipseity disturbance and anomalous self-experience. Bleuler’s “Autismus” (1911) denoted active withdrawal from reality and construction of an inner fantasy world in schizophrenia, whereas Kanner’s “infantile autism” (1943) described innate deficits in forming affective bonds. Despite strict diagnostic separation since DSM-III, recent research reveals shared genetic pathways, social cognitive impairments, and clinical presentations. Phenomenological analysis revealed that while both conditions share common predicaments in being-in-the-world, they manifest qualitatively distinct patterns of self-disorder. Patients with SSD exhibit ipseity disturbance characterized by instability of the minimal self, diminished self-affection, and hyperreflexivity, whereas patients with ASD generally show preserved minimal self but deficient intersubjective attunement. Social withdrawal in SSD represents a defensive retreat against ontological anxiety and self-dissolution, whereas in ASD it reflects involuntary isolation arising from impaired intuitive connections with others. ASD and SSD share common predicaments in being-in-the-world, yet manifest qualitatively distinct forms of self-disorder. This phenomenological framework offers a promising transdiagnostic approach for clarifying the relationship between these two conditions and understanding the essence of “autism.”
8.Understanding Adolescent Non-Suicidal Self-Injury:A Narrative Review of Theoretical Models and Evidence-Based Psychotherapies
Journal of the Korean Academy of Child and Adolescent Psychiatry 2026;37(1):33-43
Objectives:
Adolescent non-suicidal self-injury (NSSI) is a marker of severe emotional distress and a significant public health concern.This narrative review aimed to synthesize major theoretical models explaining the psychopathology of NSSI and critically evaluate the efficacy of evidence-based psychotherapies using the most recent high-level evidence.
Methods:
We searched articles in major academic databases published from January 2000 up to June 2025. We prioritized studies on adolescents, including efficacy studies (randomized controlled trials and meta-analyses) addressing NSSI as a primary outcome, and key theoretical papers.
Results:
NSSI was understood through integrated models, prominently featuring emotion dysregulation (biosocial theory), experiential avoidance (cognitive-behavioral models), impaired mentalization (attachment theory), and operant conditioning (functional model). The synthesis of high-level evidence, including a 2021 review from Cochrane, indicated that dialectical behavior therapy (DBT) had the strongest empirical support (high-certainty evidence) for reducing adolescent NSSI. However, while mentalization-based treatment, acceptance and commitment therapy, and attachment-based family therapy offered promising mechanism-specific approaches, evidence for their effectiveness for NSSI was preliminary or uncertain.
Conclusion
DBT is currently the first-line treatment for NSSIs in adolescents. However, the field must move toward personalized care.Future research should focus on validating alternative therapies through head-to-head randomized controlled trials, identifying the core change mechanisms across treatments, and implementing stepwise care models to improve accessibility.
9.Regulation-Focused Psychotherapy for Children With Emotion Dysregulation
Seri MAENG ; Yang Suk KIM ; Duk-Soo MOON
Journal of the Korean Academy of Child and Adolescent Psychiatry 2026;37(1):4-13
Emotion dysregulation is a transdiagnostic risk factor in childhood psychopathology that contributes to externalizing behaviors. To address this, regulation-focused psychotherapy for children (RFP-C) has been developed as a manualized, short-term psychodynamic intervention for 5- to 12-year-olds with externalizing behaviors rooted in underlying emotion dysregulation and affective conflict. The therapy follows a structured protocol comprising 16 child play therapy sessions and 4 parent sessions. Therapists use symbolic play, identify defense-based play disruptions, and adopt affect labeling to enhance implicit emotion regulation. In parent sessions, the “triangle of conflict” was deployed to reframe behavior as defensive, strengthen reflective functioning, and scaffold regulatory growth. Pilot data (n=3) and a randomized controlled trial (n=43) demonstrated feasibility, high adherence, and statistically significant reductions in oppositional defiant symptoms, with maintenance at the three- and six-month follow-ups. The limitations included a small sample size, reliance on waitlist controls, and scarce long-term durability data. Future research is needed to conduct multisite trials with active comparators, assess applicability across diverse conditions, and examine changes in defense mechanisms. To implement RFP-C across broader clinical settings, it is crucial to train specialized clinicians, identify children who are well suited for RFP-C, and integrate appropriate interventions tailored to each child’s unique challenges.
10.Evidence-Based Psychotherapy for Disruptive Behavior Disorders
Journal of the Korean Academy of Child and Adolescent Psychiatry 2026;37(1):22-32
Disruptive behavior disorder (DBD), which includes oppositional defiant disorder and conduct disorder, is among the most common externalizing disorders in childhood and adolescence. This review aimed to identify evidence-based psychotherapies for DBD and summarize their empirical foundations and characteristics. We searched for randomized controlled trials and systematic reviews using PubMed, PsycINFO, and Google Scholar, focusing on major evidence-based guidelines from the National Institute for Health and Care Excellence (NICE), American Psychological Association (APA), and Agency for Healthcare Research and Quality (AHRQ). Six interventions demonstrated the strongest empirical support: Incredible Years, Triple P, Parent–Child Interaction Therapy, Parent Management Training–Oregon Model, Multisystemic Therapy, and Treatment Foster Care–Oregon Model. These programs share a behavioral foundation that emphasizes parent-centered interventions as the core therapeutic mechanism. Considering treatment resistance and legal implications, multisystemic and community-based approaches are recommended for adolescents with severe antisocial behavior. In Korea, existing studies have primarily applied cognitive-behavioral, child-focused, and group interventions with limited fidelity assessments and few parent-focused trials. Future priorities include disseminating and validating parent-based behavioral therapies, establishing longterm follow-up systems, and adapting digital or telehealth platforms to enhance accessibility. Strengthening evidence-based, scalable behavioral interventions is crucial for improving the outcomes of Korean youths with DBD.

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