The Relationship Between Posttraumatic Embitterment Disorder and Stress, Depression, Self-Esteem, Impulsiveness, and Suicidal Ideation in Korea Soldiers in the Local Area.

BACKGROUND: The purpose of this study was to identify the prevalence of posttraumatic embitterment disorder (PTED) among soldiers, and examine its relation to stress, depression, self-esteem, impulsiveness, and suicidal ideation. METHODS: The subjects of this study were 200 soldiers and 197 control subjects, a total of 397 persons. Measurement tools used included the PTED self-rating scale, Stress Response Inventory, Beck Depression Inventory, Rosenberg Self-Esteem Inventory, Barratt Impulsiveness Scale, and Beck Scale of Suicide Ideation. RESULT: The major findings of the analysis are as follows: first, 11.5% of the soldiers were in the risk group for PTED, and 4% of them had PTED. Second, PTED in the soldiers was significantly associated with a number of variables such as their educational background, stress, depression, self-esteem, impulsiveness, and suicidal ideation, while it was not significantly associated with age. Third, through the hierarchical multiple regression analysis, it was found that academic background, stress, and depression had a statistically significant positive effect on the incidence of PTED in the soldiers. CONCLUSION: In order to prevent and effectively intervene in PTED in soldiers, there is a need for interventional efforts focused on depression and stress related to negative life events.

Relationships between Smartphone Addiction and Smartphone Usage Types, Depression, ADHD, Stress, Interpersonal Problems, and Parenting Attitude with Middle School Students.

BACKGROUND: The purpose of this study was to examine the relationships between smartphone addiction of middle school students and smartphone usage types, depression, attention deficit hyperactivity disorder (ADHD), stress, interpersonal problems, and parenting attitude. In particular, we wanted to find out how smartphone usage types predict smartphone addiction when controlling depression, ADHD, perceived stress, interpersonal problems, and parenting attitudes, which are the main predictors of existing smartphone addiction in this study. METHODS: The subjects of this study included 487 local middle school students (253 girls and 234 boys). The measurement instruments used were the smartphone addiction scale, patient health questionnaire-9 (PHQ-9), Korean ADHD rating scales (K-ARS), perceived stress scale (PSS), Short form of the Korean-inventory of interpersonal problems circumplex scales (KIIP-SC), and the parenting attitude scale. We identified the relationships between the variables with correlation analysis and examined the predictors of smartphone addiction with hierarchical multiple regression analysis. RESULT: The factors that influence smartphone addiction were sex (ß = 3.14, P < 0.01), stress (ß = 2.99, P < 0.01), and interpersonal problems (ß = 3.81, P < 0.001). In addition, when the confounding variables of smartphone addiction were controlled to examine the effects of smartphone usage types on smartphone addiction, social network service (SNS) (ß = 2.66, P < 0.01) and music/videos (ß = 2.73, P < 0.01) were found to significantly positively affect smartphone addiction, whereas study (ß = -2.54, P < 0.05) had a significantly negatively effect. And these factors explained 29.5% of the variance in smartphone addiction. CONCLUSION: The order of the usage types with the highest influence on smartphone addiction was: enjoying music/videos, SNS, and study. This suggests that selective intervention depending on the main smartphone usage type can be effective.

Who has sustained psychological symptoms nine years after the Hebei Spirit oil spill?: The Health Effect Research on Hebei Spirit oil spill (HEROS) study.

This study evaluated risk factors for sustained psychological symptoms in affected residents, nine years after the Hebei Spirit oil spill in Korea in 2007. The participants included residents of high-exposure areas, living within 2 km from the contaminated coast (n = 2013), among the cohort of the Health Effect Research on Hebei Spirit oil spill study from 2009 to 2016. Symptoms for post-traumatic stress disorder (PTSD), depression, psychosocial distress, and anxiety, as well as sociodemographic information were assessed through questionnaire interviews. Trajectory analysis was conducted to identify the group with sustained symptoms over time and logistic regression analysis was performed to identify risk factors for sustained symptoms adjusted for covariates. A longer duration of clean-up work, lower household income, and presence of a chronic disease in all type of symptoms, and being female, younger age, and higher educational level in all symptoms but PTSD, showed a significant association with increased risk of sustained symptoms. The highest risk was found in the subgroup with a longer clean-up together with offshore and maritime occupations or lower income in PTSD, depression, and anxiety, compared with those with a shorter clean-up and other occupation or higher income. Increased risk of sustained PTSD in relation to a longer clean-up was limited to those with a lower educational level (p-interaction = 0.009). The results suggested that participating longer in clean-up work increased sustained psychological symptoms, synergistically with socioeconomic factors such as offshore and maritime occupations, lower household income, or economic losses related to educational level.

Genome-wide analysis of spatiotemporal gene expression patterns during floral organ development in Brassica rapa.

Flowering is a key agronomic trait that directly influences crop yield and quality and serves as a model system for elucidating the molecular basis that controls successful reproduction, adaptation, and diversification of flowering plants. Adequate knowledge of continuous series of expression data from the floral transition to maturation is lacking in Brassica rapa. To unravel the genome expression associated with the development of early small floral buds (< 2 mm; FB2), early large floral buds (2-4 mm; FB4), stamens (STs) and carpels (CPs), transcriptome profiling was carried out with a Br300K oligo microarray. The results showed that at least 6848 known nonredundant genes (30% of the genes of the Br300K) were differentially expressed during the floral transition from vegetative tissues to maturation. Functional annotation of the differentially expressed genes (DEGs) (fold change ≥ 5) by comparison with a close relative, Arabidopsis thaliana, revealed 6552 unigenes (4579 upregulated; 1973 downregulated), including 131 Brassica-specific and 116 functionally known floral Arabidopsis homologs. Additionally, 1723, 236 and 232 DEGs were preferentially expressed in the tissues of STs, FB2, and CPs. These DEGs also included 43 transcription factors, mainly AP2/ERF-ERF, NAC, MADS-MIKC, C2H2, bHLH, and WRKY members. The differential gene expression during flower development induced dramatic changes in activities related to metabolic processes (23.7%), cellular (22.7%) processes, responses to the stimuli (7.5%) and reproduction (1%). A relatively large number of DEGs were observed in STs and were overrepresented by photosynthesis-related activities. Subsequent analysis via semiquantitative RT-PCR, histological analysis performed with in situ hybridization of BrLTP1 and transgenic reporter lines (BrLTP promoter::GUS) of B. rapa ssp. pekinensis supported the spatiotemporal expression patterns. Together, these results suggest that a temporally and spatially regulated process of the selective expression of distinct fractions of the same genome leads to the development of floral organs. Interestingly, most of the differentially expressed floral transcripts were located on chromosomes 3 and 9. This study generated a genome expression atlas of the early floral transition to maturation that represented the flowering regulatory elements of Brassica rapa.

A Case of Paraphilia with Osteoporosis and Administered with Depot Leuprorelin.

Paraphilia is a complex psychological and psychiatric disorder that has been difficult to treat. Leuprorelin has been used as one of the therapeutic methods for paraphilia. Leuprorelin administration could change insulin resistance and accelerate bone loss. The case study in this work was a 59-year-old man who visited a hospital with the chief complaints of frotteuristic behaviors in public places, a continuous increase in sexual desire, and sexual molestation behavior that started in 2007. We injected leuprorelin (3.6 mg) intramuscularly every month for this patient with paraphilia and comorbidities of osteoporosis and hyperthyroidism. The clinical global impression (CGI), Sex Addiction Screening Test (SAST), Wilson Sex Fantasy Questionnaire (WSFQ), physical examination, and laboratory tests were performed. After 12 months of leuprorelin injection for paraphilia, we found a significant improvement in abnormal sexual behavior/desire without aggravation of osteoporosis/hyperthyroidism. Gonadotrophin-Releasing Hormone (GnRH) analogs could be used as alternative or supplementary treatment methods for paraphilia with osteoporosis/hyperthyroidism.

Associations between urinary cotinine and symptoms of attention deficit/hyperactivity disorder and autism spectrum disorder.

BACKGROUND: The present study investigated associations between urinary cotinine levels as a biomarker of secondhand smoke exposure and symptoms of attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). METHODS: A total of 520 child participants (200 with ADHD, 67 with ASD, and 253 normal control subjects) were assessed using the Korean version of the ADHD rating scale (K-ARS), Autism spectrum screening questionnaire (ASSQ), and Behavioral Assessment System for Children, second edition (BASC-2). The Korean version of the computer-based continuous performance test was used to assess cognitive function. Urinary cotinine was evaluated as a biomarker of secondhand smoke exposure. RESULTS: Urinary cotinine levels were significantly and positively associated with K-ARS score (B = 4.00, p < 0.001), ASSQ score (B = 1.71, p = 0.030), the behavioral problem subscales of the BASC-2 (B = 1.68-3.52, p < 0.001-0.045), and omission and commission errors in the continuous performance test (B = 6.21-8.42, p < 0.001-0.019). Urinary cotinine levels were also associated with the increased odds ratio of ADHD (OR = 1.55, 95% CI 1.05-2.30, p = 0.028) and ASD (OR = 1.89, 95% CI 1.12-3.21, p = 0.018). CONCLUSION: Urinary cotinine levels were associated with lower behavioral adaptation and cognitive function and increased odds ratios of ADHD and ASD, indicating a negative effect of secondhand smoke exposure on the symptomatic manifestation of ADHD and ASD.

Associations between attention-deficit/hyperactivity disorder symptoms and dietary habits in elementary school children.

OBJECTIVE: The aim of the present study was to investigate the associations between dietary habits and attention deficit/hyperactivity disorder (ADHD) symptoms in elementary school children. METHODS: The parents of 16,831 participating children assessed the ADHD symptoms of their children by responding to the Korean version of the ADHD rating scale (K-ARS). Parents also responded to the food habit questionnaire, which consists of 8 items regarding the eating pace, the frequency of overeating, and patterns of eating six types of food: fast food, soft drinks, instant noodles, fruit and vegetables, and milk. RESULTS: K-ARS scores were positively associated with higher consumption of foods categorized as unhealthy, including fast food, soft drinks, and instant noodles, and negatively associated with higher consumption of fruit and vegetables categorized as healthy foods. K-ARS scores were also higher in the groups who overate more frequently and ate faster or slower compared to other family members. CONCLUSION: Our findings may provide useful clinical information for dietary interventions in children with ADHD.

Therapeutic Effects of Leuprorelin (Leuprolide Acetate) in Sexual Offenders with Paraphilia.

BACKGROUND: This study examined the clinical effects of leuprolide acetate in sexual offenders with paraphilic disorders evaluated by means of objective psychiatric assessment. METHODS: The subjects of this study were seven sexual offenders who were being treated by means of an injection for sexual impulse control by a court order. They had been diagnosed with paraphilia by a psychiatrist based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) and had been put on probation by the Ministry of Justice between January 2016 and December 2016. RESULTS: After twelve months, we observed significant improvement in symptoms, as decrease of abnormal sexual interest and activity, sexual fantasy, Clinical Global Impression-Severity (CGI-S), and Clinical Global Impression-Impulsivity (GCI-I). There were a mild feminization of the body shape, feelings of fatigue, and mild hot flushes. No other adverse effect was reported. CONCLUSION: These results suggested that the clinical effects of leuprolide acetate in sexual offenders might be an effective treatment and safety strategy.

Association of Monoamine Oxidase A (MAOA) Gene uVNTR and rs6323 Polymorphisms with Attention Deficit and Hyperactivity Disorder in Korean Children.

Objective: Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder. The genetic cause of ADHD is still unclear, but the dopaminergic, serotonergic, and noradrenergic pathways have shown a strong association. In particular, monoamine oxidase A (MAOA) plays an important role in the catabolism of these neurotransmitters, suggesting that the MAOA gene is associated with ADHD. Therefore, we evaluated the relationship between the MAOA gene polymorphisms (uVNTR and rs6323) and ADHD. Materials and methods: We collected a total of 472 Korean children (150 ADHD cases and 322 controls) using the Korean version of the Dupaul Attention Deficit Hyperactivity Disorder Rating Scales (K-ARS). Genotyping was performed by PCR and PCR-RFLP. The Behavior Assessment System for Children Second Edition (BASC-2) was used to evaluate the problem behaviors within ADHD children. Results: We observed significant associations between the rs6323 and ADHD in girls (p < 0.05) and the TT genotype was observed as a protective factor against ADHD in the recessive model (OR 0.31, 95% CI 0.100⁻0.950, p = 0.022). The 3.5R-G haplotype showed a significant association in ADHD boys (p = 0.043). The analysis of subtype also revealed that the 4.5R allele of uVNTR was a risk factor for the development of ADHD in the combined symptom among girls (OR 1.87, 95% CI 1.014⁻3.453, p = 0.031). In the BASC-2 analysis, the MAOA uVNTR polymorphism was associated with activities of daily living in ADHD boys (p = 0.017). Conclusion: These results suggest the importance of the MAOA gene polymorphisms in the development of ADHD in Korean children. A larger sample set and functional studies are required to further elucidate of our findings.

Secondhand Smoke Exposure and Low Blood Lead Levels in Association With Attention-Deficit Hyperactivity Disorder and Its Symptom Domain in Children: A Community-Based Case-Control Study.

AIM: Secondhand smoke (SHS) is a major indoor pollutant. We examined the possible association between exposure to both SHS and low levels of lead and attention-deficit-hyperactivity disorder (ADHD) and its symptom domain in children. METHODS: This case-control study was based on the results of a community survey using the ADHD rating scale conducted in 49 elementary schools. Both cases and control subjects were confirmed by a child psychiatrist. Each case was matched with one control subject according to gender, school, and grade in school. Using a multivariate conditional logistic regression model, we analyzed 214 case-control pairs of children who ranged in age from 6 to 10 years. Urine and blood levels of cotinine and of lead were determined, and information pertaining to SHS exposure was obtained by means of a questionnaire. RESULTS: Exposure to low levels of lead (geometric mean = 1.65 µg/dL) was related to ADHD, particularly inattention (odds ratio [OR] = 1.67, 95% confidence interval [CI] = 1.07-2.59), whereas SHS exposure was associated mainly with hyperactivity/impulsivity (OR = 3.85, 95% CI = 1.55-9.56). In the pathway from blood lead to hyperactivity/impulsivity, children's SHS exposure mediated and indirectly accounted for about 73% of this relationship. The combined exposure to lead and SHS synergistically increased the risk of ADHD, evident as both inattention and hyperactivity/impulsivity. CONCLUSION: SHS, which is associated with hyperactivity/impulsivity in particular, combined with exposure to low blood levels of lead synergistically increased the risk of ADHD. Therefore, the exposure of children to both SHS and lead needs to be reduced. IMPLICATIONS: Although exposure to low levels of lead has been shown to be associated with ADHD, there is little evidence of symptom domain specificity. In our study, low blood lead levels were related to inattention. In addition, prenatal or postnatal exposure to SHS increased the risk of ADHD, particularly hyperactivity/impulsivity. Combined exposure to lead and SHS synergistically increased the risk for both these ADHD symptom domains. To protect children from environmental risk factors related to ADHD, it is necessary to further reduce children's exposure to SHS and lead, even in those with low blood lead levels.

Prevalence of Attention-Deficit/Hyperactivity Disorder and its Comorbidity among Korean Children in a Community Population.

The aim of this study was to determine the prevalence of attention deficit hyperactivity disorders (ADHD) in children according to socio-demographic factors and the distribution of ADHD subtypes in a community in Korea. A screening survey using the Korean version of ADHD Rating Scale (K-ARS) was conducted between 2007 and 2008, and clinical interviews by a pediatric psychiatrist were performed for selected children between 2009 and 2010. A total of 49,573 elementary school students, between ages of 7 and 12, constituted the target population, among which 38,365 students (77.2%) and respective parents gave consent to participate. Of the participants, 200 screened children were clinically examined to confirm the diagnosis of ADHD. We estimated the prevalence of ADHD and its comorbidity in the population, after adjusting for nonresponse and nonparticipation. The prevalence of ADHD was 11.7% in boys and 5.2% in girls, with an overall prevalence of 8.5%. The combined type of inattentive and hyperactive was the most frequent at 4.7% of the whole population. Children were more likely to have ADHD if their parents were separated and had less education. Most commonly combined comorbidity was autism spectrum disorder (ASD) (10.1%). The prevalence of ADHD in the school-aged population is an essential information for improving the quality of public health mental services for evaluation and treatment of ADHD.

The associations between ADHD and asthma in Korean children.

BACKGROUND: The aim of this study was to investigate the associations between attention deficit hyperactivity disorder (ADHD), the most common neuropsychiatric disorder in school children, and childhood allergic disease by evaluating their respective prevalence. METHODS: Subjects were comprised of first and second grade students in twenty two elementary schools in a city in the Republic of Korea. The mode of measurement for ADHD was based on DSM-IV from clinical interviews conducted by child psychiatrists. Along with the diagnostic interviews, we also used the epidemiological questionnaires, Computerized Attention Deficit-Hyperactivity Disorder Diagnostic System, the abbreviated Conner's Parent Rating Scale (CPRS), and DuPaul's ADHD Rating Scales. Allergic conditions, such as asthma, have been separately evaluated based on the questionnaire items whose validity and reliability were proved by the International Study of Asthma and Allergies in Children (ISAAC). All questionnaires were completed by the subjects' parents. RESULTS: The lifetime prevalence rate of asthma in ADHD patients was 36.6%, compared to a prevalence of 24.3% in control subjects. The lifetime prevalence rate of allergic rhinitis in ADHD patients was 59.0%, compared to a prevalence of 47.0% in control subjects. Statistically significant difference has been found between the two groups. In the logistic regression model of the ADHD and the control group, the relative risk of asthma was 1.60 times higher (confidence interval 1.301-1.964), the relative risk of allergic rhinitis was 1.38 times higher (confidence interval 1.124-1.681), which showed statistical significance. CONCLUSIONS: The findings of this study suggest significant association between ADHD and childhood asthma and allergic rhinitis. Therefore, appropriate evaluation and treatment are needed for asthmatic children with attention-deficit symptoms, or allergic rhinitis with ADHD. Besides, further research is needed to determine the etiological approach towards ADHD, asthma, and allergic rhinitis.

A case of mental retardation with paraphilia treated with depot leuprorelin.

Paraphilia is a psychiatric disease that has been difficult to cure. However, recently developed therapeutic methods hold promise. The patient was a 20-yr-old male with chief complaints of continuous masturbation, genital exposure, and aggressive behavior that started 2 yr ago. We administered leuprorelin 3.6 mg intramuscular injection per month, a depot gonadotrophin-releasing hormone analogue, to this patient who a severe mentally retardation with paraphilia. The clinical global impression (CGI)-severity, CGI-improvement and aberrant behavior checklist were performed. After one month, we observed significant improvement in symptoms, such as decreases of abnormal sexual behavior and sexual desire. The GnRH analogues are suggested to be used as an alternative or supplementary therapeutic method for sexual offenders after clinical studies.

Child behavior check list and Korean personality inventory for children with functional visual loss.

OBJECTIVE: To investigate the clinical psychiatric characteristics of children with the main complaint of functional visual loss, their behavior and personality were evaluated by the means of the Korean child behavior check list (K-CBCL), and the Korean personality inventory for children (KPI-C). METHODS: The evaluation was carried out by the K-CBCL and the KPI-C, the domestically standardized tools, with 20 child subjects suspected of functional visual loss, among the patients who visited our hospital, between August, 2005 and December, 2012. The control group included 160 children in general schools of the same region. RESULTS: The 20 patients whose main complaint was functional visual loss were diagnosed as having a functional visual disorder. The child patient group showed a higher score for the K-CBCL and KPI-C sub-scales of somatic complaints, social problems, aggressive behavior, internalizing problems, externalizing problems, total behavioral problems, somatization and hyperactivity, than that of the control group. CONCLUSION: The results of the K-CBCL and KPI-C tests among children with functional visual loss, were significantly different from those of the normal control group. This result suggested that psychological factors may influence children with a main complaint of functional visual loss.

Methylphenidate-osmotic-controlled release oral delivery system treatment reduces parenting stress in parents of children and adolescents with attention-deficit/hyperactivity disorder.

OBJECTIVE: The aim of the current study was to investigate the effect of methylphenidate-osmotic release oral delivery system (MPH-OROS) treatment on parenting stress in parents of children and adolescents with attention-deficit/hyperactivity disorder (ADHD). METHODS: Four hundred and ninety-five children and adolescents (391 boys and 104 girls), aged 7 to 18 years who met the Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria for ADHD, were recruited at 48 psychiatric outpatient clinics across South Korea. Children's symptoms, parenting stress, and parental depression were assessed at baseline, week 4, and week 8 of MPH-OROS treatment using the Korean version of the DuPaul's ADHD Rating Scale (ARS), the Beck's Depression Inventory (BDI), and the Parenting Stress Index, Short Form (PSI-SF). RESULTS: We found significantly decreased scores of ARS, parental BDI, and PSI-SF from baseline to week 4 and from week 4 to week 8. Also, there were positive correlations among baseline PSI-SF, ARS, and BDI scores. The changes in BDI and ARS scores were significantly associated with the PSI score changes, accounting for 20.1% and 10.0%, respectively. CONCLUSIONS: We suggest that the increased parenting stress and depression in parents of children and adolescents with ADHD can be improved following the treatment with MPH-OROS.

Development of a chloroplast DNA marker for monitoring of transgene introgression in Brassica napus L.

Chloroplast molecular markers can provide useful information for high-resolution analysis of inter- and intra-specific variation in Brassicaceae and for differentiation between its species. Combining data generated from nuclear and chloroplast markers enables the study of seed and pollen movement, and assists in the assessment of gene-flow from genetically modified (GM) plants through hybridization studies. To develop chloroplast DNA markers for monitoring of transgene introgression in Brassica napus L., we searched for sequence variations in the chloroplast (cp) genome, and developed a simple cpDNA marker that is reliable, time-saving, and easily discriminates among 4 species (B. napus, B. rapa, Raphanus sativus, and Sinapis alba) based on PCR-product length polymorphism. This marker will be useful to identify maternal lineages and to estimate transgene movement of GM canola.

Theta and Gamma Activity Differences in Obsessive-Compulsive Disorder and Panic Disorder: Insights from Resting-State EEG with eLORETA.

Background: Obsessive-compulsive disorder (OCD) and panic disorder (PD) are debilitating psychiatric conditions, yet their underlying neurobiological differences remain underexplored. This study aimed to directly compare resting-state EEGs in patients with OCD and PD, without a healthy control group, using the eLORETA method. Methods: We collected retrospective EEG data from 24 OCD patients and 22 PD patients who were hospitalized due to significant impairment in daily life functions. eLORETA was used to analyze the EEG data. Results: Heightened theta activity was observed in the anterior cingulate cortex (ACC) of OCD patients compared to PD patients (PD vs. OCD, t = -2.168, p < 0.05). Conversely, higher gamma activity was found in the medial frontal gyrus (MFG) and paracentral lobule (PCL) in PD patients (PD vs. OCD, t = 2.173, p < 0.05). Conclusions: Our findings highlight neurobiological differences between OCD and PD patients. Specifically, the increased theta activity in the ACC for OCD patients and elevated gamma activity in the MFG and PCL for PD patients offer preliminary insights into the neural mechanisms of these disorders. Further studies are essential to validate these results and delve deeper into the neural underpinnings.

Central symptoms of post-traumatic stress disorder on adult victims of sexual violence: A network analysis.

This study aimed to identify and compare central post-traumatic stress disorder (PTSD) symptoms experienced by rape and sexual harassment victims, and the differences between the 2 groups. This study included 935 female victims of sexual violence who visited Sunflower Center in Korea between 2014 and 2020. Of the 935 victims, 172 were rape victims and 763 were sexually harassed. The Korean version of the Post-traumatic Diagnosis Scale was used to evaluate PTSD symptoms, and network analysis was performed to examine the differences in symptoms. The central symptom was "Physical reactions (PDS05)" for the group of rape victims and Less interest in activities (PDS09)' for the group of sexual harassment victims. For the group of sexual harassment victims, the most distinct central edge was the one between "Being over alert (PDS16)" and "Being jumpy or easily startled (PDS17)," and for the group of rape victims, it was the edge between "Upset when reminded of the trauma (PDS04)," and "Physical reactions (PDS05)." Network analysis revealed differences in central PTSD symptoms and central edges between sexual harassment and rape victims. Although re-experiencing and avoidance symptom clusters were most central in both groups, the specific central symptoms and edges differed between the 2 groups.

Effect of group sand play therapy on psychopathologies of adolescents with delinquent behaviors.

Prior research has established adolescent vulnerability to delinquent behavior. This single-arm, noninterventional, observational study investigated the effect of sand play therapy on the psychopathologies of adolescents with delinquent behavior. A total of 68 adolescents participated in the study. Participants were treated with 8 weekly sessions of sand play therapy, lasting 50 minutes each and conducted in groups of 3 to 4 members. The psychopathologies of depression, anxiety, self-esteem, impulsiveness, characteristics of attention-deficit hyperactivity disorder (ADHD), and impulsiveness were measured using self-reporting scales. Following therapy, depression (t = 3.28; P = .002; ES = 0.399) and anxiety (t = 4.00; P < .001; ES = 0.485) decreased significantly with moderate effect size. ADHD characteristics (t = 2.73; P = .008) and impulsiveness (t = 2.73; P = .009) also decreased significantly with effect size of 0.330 and 0.327, respectively. Self-esteem (t = -2.06, P = .043; ES = 0.251) was found to have significantly increased. The high-risk group within each psychopathology showed significantly higher improvement than the low-risk group. Results showed that group sand play therapy is effective in improving internalizing problems such as depression and anxiety, as well as externalizing problems of ADHD features and impulsiveness among adolescents with deviant behaviors.

Effects of school sandplay group therapy on children victims of cyberbullying.

Cyberbullying among children is increasing every year, leading to serious public health problems. Victims suffer serious aftereffects such as depression and suicidal ideation; therefore, early and appropriate psychological intervention and the role of schools are emphasized. This study investigated the effects of school sandplay group therapy (SSGT) on children affected by cyberbullying. This study was designed as a parallel-group non-randomized controlled trial. The study subjects were 139 elementary school students (mean age 11.35 years; standard deviation, 0.479; age range 12-13 years) residing in Cheonan City, Korea, who were assigned to the intervention and comparison groups. The intervention group received 10 sessions of therapy on a weekly basis, for 40 minutes per session. No therapy was administered in the control group. The effectiveness of the intervention was assessed using the Children Depression Inventory, Suicidal Ideation Questionnaire-Junior, and Rosenberg Self-Esteem Scale. The assessment for the comparison group was performed concurrently with that of the intervention group. Data were analyzed using multivariate analysis of variance. In this study, the SSGT group showed a significant decrease in depression and suicidal ideation compared to the control group after sandplay group therapy (SGT), and a significant increase in self-esteem. It was confirmed that SSGT can mitigate the negative consequences of cyberbullying and strengthen protective factors. This suggests that the SSGT can be successfully used for crisis counseling.