The Effect of Time Spent on Online Gaming on Problematic Game Use in Male: Moderating Effects of Loneliness, Living Alone, and Household Size.

OBJECTIVE: This study aimed to investigate the association between gaming time and problematic game use (PGU) within a large sample of Korean male gamers and to examine the potential moderating effects of loneliness, living alone, and household size. METHODS: This study employed data from 743 male gamers from the National Mental Health Survey 2021, a nationally representative survey of mental illness conducted in South Korea. Self-reported data on the average gaming time per day, severity of PGU, loneliness, living alone, and household size were used. RESULTS: Gaming time was positively associated with PGU and this relationship was significantly moderated by loneliness such that the positive effect of gaming time on PGU was greater when the levels of loneliness were high. The three-way interaction effect of gaming time, loneliness, and living alone was also significant, in that the moderating effect of loneliness on the relationship between gaming time and PGU was significant only in the living alone group. However, household size (i.e., number of housemates) did not moderate the interaction between gaming time and loneliness among gamers living with housemates. CONCLUSION: These results suggest the importance of considering loneliness and living arrangements of male gamers, in addition to gaming time, in identifying and intervening with individuals at heightened risk of PGU.

A Three-Year Longitudinal Study of Risk Factors for Suicidality in North Korean Defectors.

BACKGROUND: This longitudinal study examined risk factors for future suicidality among North Korean defectors (NKDs) living in South Korea. METHODS: The subjects were 300 NKDs registered with a regional adaptation center (the Hana Center) in South Korea. Face-to-face interviews were conducted using the North Korean version of the World Health Organization's Composite International Diagnostic Interview to diagnose mental disorders according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Subjects were also asked about sociodemographic and clinical factors at baseline. At follow-up after three years, the NKDs (n = 172 respondents) were asked to participate in an online survey, responding to self-questionnaires about suicidality. Logistic regression analyses were used to explore associations between baseline variables and future suicidality among NKDs. RESULTS: Thirty (17.4%) of the 172 survey respondents reported suicidality at follow-up. The presence of health problems over the past year, any prior suicidality at baseline, a higher score on a trauma-related scale, and a lower score on a resilience scale at baseline were associated with greater odds of suicidality at follow-up after adjusting for age, sex, and educational level. Of all mental disorder categories, major depressive disorder, dysthymia, agoraphobia, and social phobia were also associated with significantly increased odds of suicidality at follow-up after adjusting for age, sex, educational level, and prior suicidality at baseline. CONCLUSION: Resilience, a previous history of suicidality, and the presence of lifetime depressive disorder and anxiety disorder should be given consideration in mental health support and suicide prevention in NKDs.

Child Effortful Control as a Moderator of the Effects of Parenting on Children's Behavioral Adjustment: A Longitudinal Study Spanning 3 to 10 Years.

This study aimed to examine independent and interactive contributions of parenting behaviors (e.g., physical punishment, inductive discipline, warm responsiveness) and child effortful control on child externalizing problems during early and middle childhood. Participants were 241 children (123girls) of middle-income families in the U.S. who were primarily European Americans (91%) and at risk for school-age problem behaviors. Data were collected at ages 3, 6, and 10 using multiple methods, informants, and contexts. Results of hierarchical regression analyses indicated both independent and interactive influences of parenting behaviors and child effortful control on children's externalizing behaviors. Importantly, effortful control buffered the negative influence of physical punishment, but not other parenting behaviors, such that physical punishment was associated with external behaviors at 6 years only for children with poorer effortful control abilities. The results highlight both parental discipline strategies and child effortful control as promising targets for early identification and prevention of future problem behaviors. Summary: Parenting and child effortful control have long been topics of research on child development. However, relatively little is known about the long-term effects of early parenting in the context of effortful control and the possibility that those processes may differ across different dimensions of parenting (i.e., warm responsiveness, inductive discipline, and physical punishment) Therefore, this study aimed to examine independent and interactive contributions of parenting behaviors and child effortful control on child externalizing problems during early and middle childhood. Participants were 241 children (123girls) of middle-income families who were at risk for school-age problem behaviors. Data were collected using multiple methods, informants, and contexts. Specifically, child effortful control at 3 years was measured using multiple tasks, and parenting at 3 years was assessed via maternal report during home interview. Teachers contributed ratings of child externalizing behaviors at 3, 6, and 10 years. Results indicated both independent and interactive influences of parenting behaviors and child effortful control on children's externalizing behaviors. Importantly, effortful control buffered the negative influence of physical punishment, but not other parenting behaviors, such that physical punishment was associated with external behaviors at 6 years only for children with poorer effortful control abilities. Moreover, parents' use of physical punishment at age 3 showed a long-lasting association with children's problem behaviors at ages 6 and 10 years. The findings suggest that children with more advanced effortful control may be less susceptible to long-term detrimental contribution of physical punishment, although by no means they are protected from harmful effects of punitive discipline. This study provides more sophisticated explanations on the influence of early parenting and child effortful control on externalizing behaviors spanning early to middle childhood. The results also highlight different parental discipline strategies and child effortful controls as promising targets for early identification and prevention of children's future problem behaviors in childhood.

Exploring trajectories of depressive symptoms in North Korean defectors: A latent class mixed analysis.

Background: North Korean defectors (NKDs) are known to be vulnerable to depression due to the influence of various psychosocial factors during their settlement process. Therefore, this study aimed to explore different trajectories of depressive symptoms in NKDs and identify predictors of the worsening of depressive symptoms. In particular, the focus was on whether posttraumatic stress disorder (PTSD) functions as a significant predictor. Methods: Participants consisted of 300 NKDs who settled in South Korea within 3 years of entering in the country. Five waves of longitudinal data collected from 2016 to 2019 were used. In this study, the North Korean Composite International Diagnostic Interview (NK-CIDI), a diagnostic interview tool, was conducted at baseline and depressive symptoms were measured at each wave. Trajectory identification was based on latent class mixed modeling. Logistic regression was used to extract the significant factors predicting a high/increasing depressive symptom trajectory. Results: Two trajectories of depressive symptoms were identified: "low/stable symptom" (76.7% of participants) and "high/increasing symptom" (23.3% of participants). Predictors of the high/increasing symptom group were being female and a low use of mental health services. Generalized anxiety disorder, social phobia, and alcohol dependence acted as significant predictors. Although PTSD was not a significant predictor, self-reported PTSD symptom scores were high in the high/increasing symptom group. Conclusions: Identifying the trajectories of depressive symptoms in NKDs helps identify the risk factors of clinically vulnerable groups. In the process of establishing government-level interventions, it may be helpful to create a therapeutic environment. In addition, when evaluating initial psychiatric problems, it is important to primarily consider NKDs' anxiety levels and alcohol problems. There should also be an appropriate consideration of PTSD symptoms.

Developmental Trajectory of Inattention and Its Association With Depressive Symptoms in Adolescence: Peer Relationships as a Mediator.

This study investigated the developmental trajectory of inattention symptoms as a predictor of later depressive symptoms in adolescence, and examined potential mediating role of peer relationships in this process. Participants were adolescents who were part of the large longitudinal panel study on Korean Youths, Korean Children & Youth Panel Survey 2010 (KCYPS 2010) of the National Youth Policy Institute (NYPI). Specifically, data were drawn from two cohorts of KCYPS that differed in participant age (Panel 1: 2003 birth cohort, n = 2,342, 48.2% girls; Panel 2: 2000 birth cohorts, n = 2,378, 40.0% girls). We analyzed data collected from 2010 to 2016 when children in panel 1 were 6-7 to 12-13 years old, and children in panel 2 were 9-10 to 15-16 years old. Results of latent growth modeling (LGM) were as follows. In Panel 1, the inattention symptoms increased from 9-10 to 12-13 years. Otherwise, the inattention symptoms decreased from 11-12 to 15-16 years in panel 2. Additionally, in both panels, initial status and slope of inattention significantly predicted later levels of depressive symptoms, and peer relationships partly mediated the association between inattention trajectory and depressive symptoms. The findings are discussed with respect to considering the growth of inattention and the quality of peer relationships as promising targets for early identification and intervention of depression in adolescents.

Early Socialization of Hostile Attribution Bias: The Roles of Parental Attributions, Parental Discipline, and Child Attributes.

The goal of this study was to examine child and parent predictors of children's hostile attribution bias (HAB) with a particular focus on exploring the associations between parents' early attribution of child misbehavior and children's HAB in the transition to school-age. Participants were 241 children (118 girls) of middle-income families who were at risk for school-age conduct problems. Multi-method, multi-informant data were collected on maternal attributions of child misbehavior, parental use of corporal punishment, and child attributes (i.e., verbal IQ, effortful control, theory of mind, emotional understanding) at 3 years, and child HAB in ambiguous situations at 6 years. Results indicated that mothers' internal explanations for children's misconduct may either reduce or increase children's later HAB depending on the specific content of attributions, such that mothers' belief that children misbehave because of their internal state (i.e., emotional state or temperament) was associated with lower levels of child HAB, whereas attributing power-based motives (i.e., manipulative, controlling intentions) in children was associated with higher levels of HAB. The findings are discussed with respect to appreciating the complexity of parents' explanations for children's behavior, and considering parental cognition as a potential target for early identification and prevention of child HAB and related problems.

The moderating effect of heart rate variability on the relationship between alpha asymmetry and depressive symptoms.

Electroencephalographic (EEG) research has suggested relatively reduced brain activity in the left frontal and right posterior region trait-markers of depression. However, inconsistent results have been reported. Based on previous studies reporting the heart rate variability (HRV) as an index of emotional regulation, this study makes a novel investigation of the role of heart rate variability (HRV) as a moderator in the relationship between frontal and parietal alpha asymmetry and depression. Resting EEG (eyes open) was recorded in 38 patients with MDD and 34 healthy subjects. Frontal and parietal alpha asymmetries were calculated at total (8-12 Hz), high (10-12 Hz), and low (8-10 Hz) alpha frequency bands. Three vagally mediated HRV (vmHRV) components (LF, HF, and the LF/HF ratio) were calculated in the frequency domain. Relatively greater right parietal alpha activity significantly predicted the severity of depression only when HF was low (or the LF/HF ratio was high) at low alpha frequency band. The interaction effect of parietal alpha asymmetry and vmHRV remained significant after including anxiety score as a covariate. No moderation effect of vmHRV was found for frontal sites and other frequency bands, as well as healthy subjects. These findings suggest that vmHRV moderates the association between parietal alpha asymmetry at low frequency band and depression for MDD patients. We suggest that the interaction between parietal alpha asymmetry and vmHRV may be a biomarker of MDD.

Longitudinal Association Between Children's Callous-Unemotional Traits and Social Competence: Child Executive Function and Maternal Warmth as Moderators.

This study examined the longitudinal association between children's early callous-unemotional (CU) traits and social competence in the transition to school-age, and tested whether this relationship was moderated by child executive function and maternal warmth. Participants were 643 children (49% girls) who were part of the Panel Study on Korean Children (PSKC) of the Korea Institute of Child Care and Education (KICCE). Mothers rated children's CU at 5 years and executive function at 8 years, and maternal warmth at 5 years. Teachers reported on children's social competence at 8 years. Results of the model including child executive function as the moderator indicated that deficits in child executive function and child sex (boys) predicted lower social competence. In addition, the moderating effect of executive function on the relationship between CU and social competence approached a trend such that CU predicted lower social competence only for children with lower executive function. In the model that included maternal warmth as a moderator, CU traits was associated with lower social competence, and this effect was more pronounced for boys as indicated by a significant effects of CU × child sex on social competence. The findings are discussed with respect to considering individual and contextual factors by which early CU becomes associated with individual differences in children's social competence.

The Long-Term Effectiveness of the Family Check-up on Peer Preference: Parent-Child Interaction and Child Effortful Control as Sequential Mediators.

We examined the longitudinal effects of the Family Check-Up (FCU) intervention beginning in toddlerhood on children's peer preference at school-age. Specifically, a sequential mediational model was proposed in which the FCU was hypothesized to promote peer preference (i.e., higher acceptance and lower rejection by peers) in middle childhood through its positive effects on parent-child interaction and child effortful control in early childhood. Participants were 731 low-income families (49 % female). Qualities of parent-child interaction were observed during structured activities at 2 to 5 years, child effortful control was assessed using behavioral tasks at 5 years, and peer acceptance and rejection were rated by teachers at 7.5 to 10.5 years. Results indicated that the FCU indirectly predicted peer preference by sequentially improving parent-child interaction and child effortful control. The findings are discussed with respect to implications for understanding mechanisms by which early parenting-focused programs may enhance child functioning across time and context.

The Emergence of Parent-Child Coercive Processes in Toddlerhood.

Parent-child coercion typically emerges in toddlerhood with the child's first acts of willful defiance and the parent's first disciplinary attempts. We explored how parents and children may contribute to this process by examining bidirectional and interactive effects between child and maternal negative behavior in 310 low-income, ethnically diverse boys. Using multiple informants and methods, child negative emotionality and maternal negative control were assessed at 18 months and child disruptive behavior and maternal negative control were measured at 24 months. Indicative of parent effects, maternal negative control at 18 months amplified the relation between children's negative emotionality at 18 months and disruptive behavior at 24 months. Child effects were found in an unexpected direction such that children's negative emotionality at 18 months predicted decreases in mothers' negative control at 24 months. Findings are discussed within a transactional framework that emphasizes mutual influence of children and parents over the course of development.

Examining Early Behavioral Persistence as a Dynamic Process: Correlates and Consequences Spanning Ages 3-10 Years.

We investigated systematic changes in 3-year-olds' effortful persistence in a dyadic problem-solving context and explored their correlates (i.e., parenting behavior and demographic characteristics at 3 years) and consequences (i.e., child externalizing behavior at 3, 6, and 10 years) within a sample of 241 middle-income families (118 girls). Results indicated that children may be grouped into three classes based on their behavioral profiles of persistence. Children who were highly persistent over the course of the task were more likely to have higher levels of IQ and mothers who were observed to be more behaviorally responsive than those who showed consistently low levels of task-related behavior. Additionally, children who demonstrated stably low levels of persistence were rated by teachers to display more externalizing behavior at 6 and 10 years than those in the other groups. Profiles of persistence did not predict concurrent levels of child externalizing behavior at the age of 3 years. The findings are discussed with respect to expanding the scope of research on child self-regulation by defining it as a time based construct and tracking its dynamic changes.

The Development of Emotional and Behavioral Control in Early Childhood: Heterotypic Continuity and Relations to Early School Adjustment.

We examined heterotypic continuity of emotional and behavioral control (EBC) across early childhood and related early manifestations of EBC to children's school adjustment in 310 low-income, ethnically diverse boys. Multiple informants and methods were used to measure different indicators of EBC at 18, 24, 42, and 60 months, which were chosen to reflect salient regulatory challenges children face across development. Teachers rated boys' externalizing and internalizing behaviors, and social skills at 72 months. Results indicated a modest degree of heterotypic continuity of EBC, with different constructs of EBC associated between adjacent time points and, in some instances, across more distant time points. Further, children who had struggled with early EBC demonstrated higher externalizing problems and lower social skills in school. Findings suggest that early deficits in EBC may be a target for early identification and prevention, as they may forecast continued difficulty in later-developing EBC skills and socioemotional problems.

Direct and indirect effects of the family check-up on self-regulation from toddlerhood to early school-age.

We examined the development of children's inhibitory control from toddlerhood to early school-age (i.e., ages 2 to 7.5 years), investigated the effects of the Family Check-Up on the growth of inhibitory control, and explored whether such effects transferred to the school context. Participants were 731 low-income children (49% female). Results indicated that parental reports of inhibitory control showed positive, nonlinear increase with the growth decelerating over time. Moreover, children in the intervention condition demonstrated higher levels of growth in parental ratings of inhibitory control compared to the control condition. More importantly, the intervention had indirect effects on teacher reports of children's self-control and oppositional defiant behavior as well as examiner ratings of self-control through its promotion of growth in inhibitory control. The findings are discussed with respect to implications for more specifically targeting the promotion of self-regulation in early childhood in addition to reduction in early problem behavior.

Behavioral control in at-risk toddlers: the influence of the family check-up.

This study examines the role of one component of emotion regulation, behavioral control, in the growth of children's early behavior problems by examining whether increases in parental positive behavior support brought about by a family-centered intervention were associated with greater child behavioral control, and whether greater behavioral control at age 3 mediated the association between improvements in aspects of positive behavior support from ages 2 to 3 and decreases in growth of behavior problems from ages 2 to 4. The sample included 713 at-risk children (50% female) and their primary caregivers (50% European American, 28% African American, 13% biracial, 9% other) who were randomly assigned to the intervention or control group. Children had a mean age of 29.91 months at the initial assessment. Data were collected through home visits at child ages 2 to 4, which involved questionnaires for primary caregivers and structured and unstructured play activities for children with primary and alternative caregivers and siblings. Results indicated that the intervention improved parental positive behavior support and reduced growth of child behavior problems. One dimension of positive behavior support, proactive parenting, was modestly associated with behavioral control at age 3, which in turn was significantly associated with growth in behavior problems from ages 2 to 4, with greater behavioral control related to lower levels of growth in behavior problems. Results provide support for the notion that proactive parenting is an important factor in the development of children's behavioral control and that behavioral control plays an important role in the growth of behavior problems.

Individual differences in the development of early peer aggression: integrating contributions of self-regulation, theory of mind, and parenting.

This prospective longitudinal study focused on self-regulatory, social-cognitive, and parenting precursors of individual differences in children's peer-directed aggression at early school age. Participants were 199 3-year-old boys and girls who were reassessed following the transition to kindergarten (5.5-6 years). Peer aggression was assessed in preschool and school settings using naturalistic observations and teacher reports. Children's self-regulation abilities and theory of mind understanding were assessed during a laboratory visit, and parenting risk (corporal punishment and low warmth/responsiveness) was assessed using interview-based and questionnaire measures. Individual differences in children's peer aggression were moderately stable across the preschool to school transition. Preschool-age children who manifested high levels of aggressive peer interactions also showed lower levels of self-regulation and theory of mind understanding, and experienced higher levels of adverse parenting than others. Our main finding was that early corporal punishment was associated with increased levels of peer aggression across the transition from preschool to school, as was the interaction between low maternal emotional support and children's early delays in theory of mind understanding. These data highlight the need for family-directed preventive efforts during the early preschool years.

Child effortful control as a mediator of parenting practices on externalizing behavior: evidence for a sex-differentiated pathway across the transition from preschool to school.

An explanatory model for children's development of disruptive behavior across the transition from preschool to school was tested. It was hypothesized that child effortful control would mediate the effects of parenting on children's externalizing behavior and that child sex would moderate these relations. Participants were 241 children (123 boys) and their parents and teachers. Three dimensions of parenting, warm responsiveness, induction, and corporal punishment, were assessed via maternal report when children were 3 years old. Child effortful control at age 3 was measured using laboratory tasks and a mother-report questionnaire. Mothers and teachers contributed ratings of child externalizing behavior at age 6. Results showed that the hypothesized model fit the data well and that the pattern of associations between constructs differed for boys and girls. For boys, parental warm responsiveness and corporal punishment had significant indirect effects on children's externalizing behavior three years later, mediated by child effortful control. Such relations were not observed for girls. These findings support a sex-differentiated pathway to externalizing behavior across the transition from preschool to school.