1.Effects of Maternal Depression on Adolescent Offspring Depression and Anxiety: Mediating Role of Emotional Trauma in a Community-Based Study
Jihwan KIM ; Min Ah JOO ; Duk-Soo MOON ; Young Sook KWACK ; Bung-Nyun KIM ; Na Ri KANG
Journal of the Korean Academy of Child and Adolescent Psychiatry 2025;36(2):62-68
Objectives:
Maternal depression negatively affects depression and anxiety symptoms in the offspring. This study examined the association between maternal depression and their adolescent offspring depression and anxiety, as well as the mediating role of emotional trauma in determining the association.
Methods:
Participants were 237 mothers (46.08±5.00 years) and their adolescent offspring (16.54±1.51 years). The participants completed the Beck Depression Inventory-II, Early Trauma Inventory Self Report-Short Form, Center for Epidemiological Studies Depression Scale for Children, and the Screen for Children’s Anxiety Related Disorders. The mediating effect of emotional trauma on offspring was explored using mediation analysis.
Results:
Maternal depressive symptoms were significantly correlated with adolescent offspring traumatic experiences, as well as with their depressive and anxiety symptoms. Mediation analysis results showed that emotional trauma of offspring significantly mediated the effect of maternal depression on their depressive and anxiety symptoms.
Conclusion
Findings indicate that maternal depression was significantly associated with depressive and anxiety symptoms in adolescent offspring, mediated by their emotional trauma. Future research is needed to investigate pathways and intervention strategies to prevent the intergenerational transmission of emotional problems.
2.Effects of Maternal Depression on Adolescent Offspring Depression and Anxiety: Mediating Role of Emotional Trauma in a Community-Based Study
Jihwan KIM ; Min Ah JOO ; Duk-Soo MOON ; Young Sook KWACK ; Bung-Nyun KIM ; Na Ri KANG
Journal of the Korean Academy of Child and Adolescent Psychiatry 2025;36(2):62-68
Objectives:
Maternal depression negatively affects depression and anxiety symptoms in the offspring. This study examined the association between maternal depression and their adolescent offspring depression and anxiety, as well as the mediating role of emotional trauma in determining the association.
Methods:
Participants were 237 mothers (46.08±5.00 years) and their adolescent offspring (16.54±1.51 years). The participants completed the Beck Depression Inventory-II, Early Trauma Inventory Self Report-Short Form, Center for Epidemiological Studies Depression Scale for Children, and the Screen for Children’s Anxiety Related Disorders. The mediating effect of emotional trauma on offspring was explored using mediation analysis.
Results:
Maternal depressive symptoms were significantly correlated with adolescent offspring traumatic experiences, as well as with their depressive and anxiety symptoms. Mediation analysis results showed that emotional trauma of offspring significantly mediated the effect of maternal depression on their depressive and anxiety symptoms.
Conclusion
Findings indicate that maternal depression was significantly associated with depressive and anxiety symptoms in adolescent offspring, mediated by their emotional trauma. Future research is needed to investigate pathways and intervention strategies to prevent the intergenerational transmission of emotional problems.
3.Effects of Maternal Depression on Adolescent Offspring Depression and Anxiety: Mediating Role of Emotional Trauma in a Community-Based Study
Jihwan KIM ; Min Ah JOO ; Duk-Soo MOON ; Young Sook KWACK ; Bung-Nyun KIM ; Na Ri KANG
Journal of the Korean Academy of Child and Adolescent Psychiatry 2025;36(2):62-68
Objectives:
Maternal depression negatively affects depression and anxiety symptoms in the offspring. This study examined the association between maternal depression and their adolescent offspring depression and anxiety, as well as the mediating role of emotional trauma in determining the association.
Methods:
Participants were 237 mothers (46.08±5.00 years) and their adolescent offspring (16.54±1.51 years). The participants completed the Beck Depression Inventory-II, Early Trauma Inventory Self Report-Short Form, Center for Epidemiological Studies Depression Scale for Children, and the Screen for Children’s Anxiety Related Disorders. The mediating effect of emotional trauma on offspring was explored using mediation analysis.
Results:
Maternal depressive symptoms were significantly correlated with adolescent offspring traumatic experiences, as well as with their depressive and anxiety symptoms. Mediation analysis results showed that emotional trauma of offspring significantly mediated the effect of maternal depression on their depressive and anxiety symptoms.
Conclusion
Findings indicate that maternal depression was significantly associated with depressive and anxiety symptoms in adolescent offspring, mediated by their emotional trauma. Future research is needed to investigate pathways and intervention strategies to prevent the intergenerational transmission of emotional problems.
4.Analyzing Co-Occurrence of Non-Suicidal Self-Injury With Suicidal Ideation and Related Factors Among Adolescents in Jeju Island
Duk-Soo MOON ; Un-Sun CHUNG ; Young Sook KWACK ; Bung-Nyun KIM ; Na Ri KANG
Journal of the Korean Academy of Child and Adolescent Psychiatry 2024;35(2):119-126
Objectives:
Non-suicidal self-injury (NSSI) and suicidal behavior, including suicidal ideation (SI) and suicide attempts, are important predictors of suicide in adolescents. This study aimed to investigate the associations between NSSI, SI, NSSI+SI, mental health problems, and family factors in Korean adolescents in Jeju Island, with an emphasis on key findings.
Methods:
A total of 561 adolescents completed self-report questionnaires regarding demographics, NSSI, SI, suicidal behavior, perceived family functioning, and mental health problems, which were assessed using Center for Epidemiological Studies Depression Scale for Children, Screen for Children Anxiety-Related Disorders (SCARED), and Youth Self-Report (YSR). Data were analyzed using descriptive statistics, one-way analysis of variance, chi-square test, post-hoc analyses, and multivariate logistic regression.
Results:
In this study, 22.3% of adolescents reported either NSSI or SI, with 5.5% reporting NSSI and 20.7% reporting SI. Combined (NSSI+SI) group showed a significantly higher SCARED score, anxiety/depression, thought problems, attention problem, and rule breaking on YSR than did the SI only group. Higher level of depression and anxiety were significantly associated with NSSI and SI. Female sex and perceived family dissatisfaction were significantly associated factors for SI, but not for NSSI in multivariate logistic regression.
Conclusion
This study provides insights into the clinical characteristics and associated factors among adolescents with NSSI, SI, and NSSI+SI in Jeju Island. Identifying these results can inform the development of targeted prevention and intervention strategies to mitigate the negative consequences of these behaviors and contribute to a better understanding of the role of family in this context.
6.Effects of Group Comprehensive Behavioral Intervention for Tics in Children With Tourette’s Disorder and Chronic Tic Disorder
Na Ri KANG ; Hui-Jeong KIM ; Duk Soo MOON ; Young Sook KWACK
Journal of the Korean Academy of Child and Adolescent Psychiatry 2022;33(4):91-98
Objectives:
Comprehensive behavioral intervention for tics (CBIT) is effective in children with chronic tic disorders. This study aimed to assess the effect of group-based CBIT (group-CBIT) on tic severity and comorbid symptoms. We compared the efficacy of group CBIT with that of a control.
Methods:
Thirty children with chronic tic disorder or Tourette’s disorder were enrolled in this study. Eighteen were assigned to the group-CBIT for eight sessions, and 12 were assigned to the control group. Tics and comorbid symptoms were assessed pre- and postintervention using the Yale Global Tic Severity Scale (YGTSS), Premonitory Urge for Tics Scale, attention-deficit hyperactivity disorder Rating Scale-IV, Children’s Yale-Brown Obsessive-Compulsive Scale, and the Korean-Children Behavioral Checklist. We compared the pre- and post-intervention results of each group and determined the difference in the pre- and post-intervention results between intervention and the control group.
Results:
The YGTSS motor and vocal tic interference, global impairment, and global severity scores decreased in the intervention group only. Group CBIT was superior in reducing the motor tic interference, impairment score, and global severity score to the control group.
Conclusion
The group-CBIT showed an improvement in tic symptoms, especially in reducing the level of interference and impairment of tics.
7.The Impact of Maternal Adverse Childhood Experiences on Offspring’s Internalizing and Externalizing Problems
Na Ri KANG ; Young Sook KWACK ; Jeong-Kook SONG ; Moon-Doo KIM ; Joon Hyuk PARK ; Bung-Nyun KIM ; Duk-Soo MOON
Psychiatry Investigation 2021;18(11):1050-1057
Objective:
Adverse childhood experiences (ACEs) are associated with negative physical and mental health outcomes across the lifespan, but research on intergenerational transmission of maternal ACEs and its impact on the offspring’s mental health problems are limited. The study examines the effects of maternal ACEs on the risk of internalizing or externalizing problems among offspring.
Methods:
There were 450 mother-child dyads. Mothers completed the Adverse Childhood Experiences Questionnaire. The child outcomes included internalizing and externalizing problems assessed by the Korean Child Behavior Checklist (K-CBCL) and Korean Youth Self-Report (K-YSR), depression assessed by the Center for Epidemiological Studies Depression Scale for Children (CES-DC) and anxiety assessed by the Screen for Child Anxiety Related Emotional Disorders (SCARED).
Results:
36.1% of mothers experienced at least one ACE, and 11.1% experienced three or more ACEs. Cumulative maternal ACEs were associated with internalizing problems, externalizing problems, depression and anxiety in the offspring. Household dysfunction from maternal ACEs was significantly associated with delinquent behavior, anxiety/depression, and somatic complaints in the offspring.
Conclusion
The findings support the hypothesis that maternal ACEs are related to mental health problems in the offspring. Further research is needed to determine the factors mediating intergenerational transmission as well as intervention strategies to prevent ACEs and mental health problems in the offspring.
9.Custody Evaluation in High-conflict Situations Focused on Domestic Violence and Parental Alienation Syndrome
Duk Soo MOON ; Myung Hoon LEE ; Dong Sun CHUNG ; Young Sook KWACK
Journal of the Korean Academy of Child and Adolescent Psychiatry 2020;31(2):66-73
In a divorced family, child-centered custody evaluation is essential to ensure the child’s best interests and healthy adaptation. A mental health professional’s role and involvement are required in gaining an in-depth understanding of various environments and dynamics surrounding the child and family. Domestic violence, including child abuse and intimate partner violence (IPV) or parental alienation syndrome (PAS), is often observed in cases of custody evaluation in high-conflict divorced families, sometimes accompanied by allegations.Such cases warrant an extremely careful approach by the evaluator, who needs to be competent in interpreting the familial dynamics based on a reasonable context understanding. Genuine professionalism is a must for a custody evaluator to best help the child and carry out a high-quality custody evaluation process, and evaluators need to be ready for this task through adequate preparation and empowerment. This article is devoted to examining custody evaluation in divorced families in cases of IPV, child abuse, and PAS.
10.Custody Evaluation Process and Report Writing
Dong Sun CHUNG ; Duk Soo MOON ; Myung Hoon LEE ; Young Sook KWACK
Journal of the Korean Academy of Child and Adolescent Psychiatry 2020;31(2):58-65
As in western countries, divorce rates in South Korea have recently been rising, and family disruption has become one of serious social problems. Parents are able to express their opinions and wishes confidently, but the thoughts and wishes of children, especially infants and young children, tend to be ignored. Children can also experience several emotional and behavioral problems during the process of and after their parents’ divorce. When South Korean family courts determine custody arrangements, they typically do not have a systematic strategy and process based on custody evaluation to help children and their parents overcome conflicts and build healthy parent-child relationships after divorce. Furthermore, under the current court system, it is difficult for mental health specialists and child psychiatrists to intervene in familial conflicts as mediators or therapists during the course of divorce proceedings. Acknowledging these limitations, the South Korean family court system implemented a formal program for custody evaluations by child psychiatrists and psychologists in 2017. However, they have faced challenges such as a shortage of experienced specialist and lack of a training system or instruments for evaluation. In this paper, the authors aim to share professional knowledge of and experiences with aspects of the custody evaluation process, such as indications, procedures, methods, psychological tests, resources, and final report writing, to better serve children and their parents undergoing a painful divorce process.

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