Internet Gaming Disorder and Mental Health Literacy: A Latent Profile Analysis of Korean Adolescents.

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.

Systematic Review of Extended Reality Digital Therapy for Enhancing Mental Health Among South Korean Adolescents and Young Adults.

Digital therapy using extended reality (XR) holds great promise for addressing the mental health needs of adolescents and young adults. This study addresses a notable research gap in South Korea by systematically reviewing XR-based digital therapy for the mental health of South Korean adolescents and young adults. We analyzed 26 studies encompassing various aspects, including study type, publication date, research field, research methodology, data sources, program types, program content, sample characteristics, target population, assessment tools, and program effectiveness. Notably, 46.15% of the studies employed an experimental design, whereas over 53% utilized non-experimental approaches. Experimental studies lacked a genuine design, standardized questionnaires, and control variables. Similarly, non-experimental studies failed to report specific literature selection criteria. Consequently, future studies should adopt rigorous methodologies to enhance reliability and validity. Moreover, over 85% of the 26 studies focused solely on virtual reality and did not incorporate augmented or mixed reality. This study identifies the limitations of the previous research. These findings emphasize the need for structured investigations to advance the development of XR-based digital therapy to promote mental health in adolescents and young adults in South Korea.

The child abuse reporting guideline compliance in Korean newspapers.

The rate of child abuse has sharply increased worldwide, especially during the COVID-19 pandemic. As the media's role in addressing child abuse cases is crucial, several international and formal organizations have established child abuse reporting guidelines. This study investigated how closely journalists follow reporting guidelines in addressing child abuse cases. Five major Korean presses and 189 articles from January 1, 2018, to January 31, 2021, were selected using the keyword "child abuse." Each article was analyzed using a guideline framework consisting of 13 items regarding the five principles of the Korean Ministry of Health and Welfare and Central Child Protection Agency reporting guidelines. This study identified a radical growth in media reporting on child abuse cases in South Korea; almost 60% of the articles analyzed came from 2020 and 2021. More than 80% of the articles analyzed did not provide abuse resources, and 70% did not provide factual information. 57.1% of the articles instigated negative stereotypes, and about 30% explicitly mentioned certain family types in the headlines. Nearly 20% of the articles provided excessive details about the method used. Approximately 16% exposed victims' identities. Some articles (7.9%) also described victims as sharing responsibility for the abuse. This study indicates that the media reports of child abuse in South Korea did not follow the guidelines in many facets. The present study discusses the limitations of the current guidelines and suggests future directions for the news media in reporting on child abuse cases nationwide.

Impact of COVID-19 on Adolescents' Smartphone Addiction in South Korea.

The outbreak of COVID-19 impacted numerous people globally, but most notably affected adolescents negatively by contributing to the increase in their use of media and smartphones and therefore their susceptibility to smartphone addiction. Based on the social-ecological model, this study seeks to identify the individual-, family-, and school-level factors of smartphone addiction through two groups of users: a first group whose smartphone usage time increased after the outbreak of COVID-19, and a second group whose usage time did not. Based on the data collected from 360 Korean adolescents aged 15 to 18, results reveal that personal-level factors (i.e., gender, depressive symptoms, self-control, and cyberbullying victimization) are associated with smartphone addiction. For the group whose smartphone usage time increased after the outbreak, economic status, academic performance, and academic year were related to smartphone addiction. Based on these findings, the study makes specific guidelines and suggestions on addressing the smartphone addiction among Korean adolescents.

An International Systematic Review of Prevalence, Risk, and Protective Factors Associated with Young People's E-Cigarette Use.

While the prevalence of young people's conventional cigarette use has decreased in many countries, the use of e-cigarettes has risen. To effectively counteract the growing popularity of e-cigarettes among young people internationally, researchers should know the exact prevalence as well as the protective and risk factors associated with vaping. Based on five eligibility criteria, 53 articles were chosen and analyzed by general characteristics, prevalence, sample characteristics, gender difference, protective factors, and risk factors. In this study, the international pooled prevalence of young people's lifetime e-cigarette use was 15.3%, the current use was 7.7%, and dual use was 4.0%. While the highest lifetime, current, and dual prevalence were found in Sweden, Canada, and the United Kingdom, respectively, the lowest prevalence was found in Germany, followed by South Korea and Sweden. Some protective and risk factors include perceived cost and danger of vaping, parental monitoring, internal developmental assets, cigarette use, family and peer smoking, exposure to online advertisements, and the presence of nearby retail stores. Based on this review, researchers and practitioners can develop different intervention programs and strategies for young smokers.

The Impact of Parental and Peer Attachment on Gaming Addiction among Out-of-School Adolescents in South Korea: The Mediating Role of Social Stigma.

Most studies on gaming addiction have targeted adolescents in schools, while studies on gaming addiction among out-of-school adolescents remain scarce. Therefore, this study investigated the influence of parental and peer attachment on gaming addiction, mediated by social stigma among Korean out-of-school adolescents. The Dropout Youth Panel Survey was used for a sample of 437 dropout adolescents. The results showed that out-of-school adolescents' social stigma fully mediated the relationship between parental and peer attachment and gaming addiction. Parental attachment significantly predicted out-of-school adolescents' gaming addiction by decreasing their social stigma. Peer attachment also influenced gaming addiction in out-of-school adolescents via the mediated effects of social stigma. No direct effect of parental and peer attachment on gaming addiction was found. Social stigma played an important role in decreasing levels of gaming addiction. In addition, our study revealed that the direct and total effects of parental attachment on gaming addiction were greater than the effect of peer attachment. This study empirically verified the importance of social stigma based on modified labeling theory and provides a valid mechanism to describe how Korean out-of-school adolescents develop gaming addictions. The findings suggest effective strategies for prevention and treatment for dropout adolescents in South Korea.

A Social-Ecological Approach to Understanding the Relationship between Cyberbullying Victimization and Suicidal Ideation in South Korean Adolescents: The Moderating Effect of School Connectedness.

BACKGROUND: Cyberbullying victimization and suicidal ideation are both ongoing deleterious social problems in South Korea. Using the social-ecological approach, this study examined the association between cyberbullying victimization and suicidal ideation as well as the buffering role of school connectedness in this relationship. METHODS: A nationally representative sample of 7333 adolescents from the 2016 Korean Children and Youth Right Study participated in the study. Data were analyzed using descriptive statistics, Wald chi-square test, bivariate correlations, and multivariate logistic regression analyses. RESULTS: Nearly 17.7% of adolescents were cyberbullied, and 28.4% had suicidal ideation in the past 12 months. Cyberbullying victims were at an increased risk of suicidal ideation. The results also found that parental abuse, family dysfunction, and perceived peer relationship stress were positively associated with suicidal ideation, while parental support for autonomy was negatively associated with suicidal ideation. Further, school connectedness moderated on the relationship between cyberbullying victimization and adolescent suicidal ideation. CONCLUSIONS: These findings suggest that various stakeholders should consider interventions and preventive programs that address school connectedness when working with adolescents who are victims of cyberbullying and exhibit suicidal behavior.

Public Health Threat of Tobacco and Substance Use in Asia: An Introduction to the Theme Issue.

Tobacco and substance use is a great public health concern in Asia. The prevalence of tobacco smoking, while steadily declined in Western countries over past few decades, has increased in many regions of Asia, especially in low- and middle-income countries. And high-income countries in the region have reported rapid growth rates in e-cigarette use in recent years. Furthermore, illicit drugs, specially cannabis, amphetamines, and opioids, have begun to threaten the health of the people in the region like never before. To better understand the landscape of the two primary public health concerns in Asia, tobacco and substance use, this special issue examines cigarette/e-cigarette use and tobacco control policies for five selected countries (Singapore, China, South Korea, Japan, and Laos People's Democratic Republic); and explores substance use related issues focused on prevention, influencing factors, and policies of three countries (Hon Kong, Malaysia, and India). The research, policy, and clinical implications from this issue will contribute to mitigating the global burden of tobacco and substance use-related public health issues in Asia.

E-Cigarette, Cigarette, and Dual Use in Korean Adolescents: A Test of Problem Behavior Theory.

E-cigarettes are becoming increasingly popular among adolescent cigarette users. However, little is known about the various factors related to adolescents' use of e-cigarettes, cigarettes, or both in South Korea. Using nationally representative data from the 2017 Korea Youth Risk Behavior Web-based Survey, this study examined the possible problem behavior theory factors that contribute to (1) current e-cigarette use among those who have ever used cigarettes (Model 1), (2) current cigarette use among those who have ever used e-cigarettes (Model 2), and (3) current dual use among current cigarette or e-cigarette users (Model 3). In all three models, our analysis showed that tobacco accessibility and sexual intercourse were significant factors. For Model 2, reasons for using e-cigarettes and alcohol use were correlated with current cigarette use. Except for gender, the significant factors, which included secondhand smoke exposure at home and school type, were the same in Models 1 and 3. Based on these findings, we encourage the South Korean government to pay close attention to potential increase in dual use among adolescents and to take the necessary steps in addressing adolescent e-cigarette use in tobacco prevention and control programs.

Bullying Victimization, School Environment, and Suicide Ideation and Plan: Focusing on Youth in Low- and Middle-Income Countries.

PURPOSE: This study examines the relationship between bullying victimization, measured at individual and school levels, and suicide intent and plan among youth living in less developed parts of the world. METHODS: Multilevel modeling is used to estimate the degree to which school-level bullying has an independent effect on the two suicide measures and how it moderates the impact of individual-level victimization on contemplating and planning suicide. Data are drawn from the Global School-Based Student Health (2000-2012) survey that consists of probability samples of adolescents in low- and middle-income countries. RESULTS: By fitting three-level mixed effects models, we find that adjusting for personal experience of victimization, greater school-level prevalence of bullying has a positive independent relationship with suicide plan, but not ideation. Significant cross-level interaction effects are shown, that is, the bullying-suicide linkage at the individual level is moderated by the school environment. For suicide ideation only, it is weaker in schools where more students are bullied. The association is also less pronounced in the context characterized by higher proportion of physical violence among students and peer hostility on campus. CONCLUSIONS: The bulk of prior research narrowly defines the relationship between bullying and suicide at the individual (e.g., student) level. This study shows that school context (e.g., proportion of bullied peers) must be incorporated into the analysis in better understanding the conditions under which youth think about and/or plan on inflicting lethal self-harm.

Fidelity assessment of the suicide reporting guidelines in Korean newspapers.

BACKGROUND: With the dishonor of being the highest suicide rated country in Organisation for Economic Co-operation and Development, South Korea should take more initiatives in suicide prevention. Although the role of the media and its relation to actual suicide attempts has been tested and supported by many studies, the suicide reporting guidelines are not well followed. The purpose of this study is to examine how well Korean newspapers adhere to existing guidelines and to suggest limitation and improvements for the current guidelines. METHODS: Five mainstream newspapers in South Korea, namely, Kyunghyang Shinmun, Hankyoreh, Chosun Ilbo, JoongAng Daily, and Dong-A Ilbo, were chosen for the analysis. Using the Naver news search engine, articles dated from January 1, 2014, to December 31, 2017, were selected with the keyword "suicide" and advanced option "printed newspaper." However, articles, columns, opinions, and reviews that utilized the word "suicide" in a general context were excluded from the final analysis. Finally, the number of cases was narrowed down to 368. Each article was analyzed using the guideline framework consisting of 13 items: sensational coverage, overstatement, direct wording, method used, details about site/location, photographs, suicide note, generalization, speculation, romanticization, interviews with the bereaved, help-seeking information, and public education. RESULTS: More than 60% of the articles included direct wording (63.9%), mentioned the method used (68.2%), and provided details about the site or location (74.5%). Nearly half of the articles revealed the contents of the suicide note (44.6%). Less than 3% of the suicide reports had information about hotline logo or phone numbers (1.4%) and facts regarding suicide and suicide prevention (2.2%). CONCLUSIONS: Our study revealed that the guidelines were ineffective in their monitoring role and that most of the newspapers were incompliant with many significant guideline items in South Korea. Our findings not only explore the limitations of the current guidelines but also provide an important rationale as to why there should be stronger suicide monitoring regulation or an agency with sufficient authority to prevent suicide in a nation-wide scale.

Analyzing Multilevel Factors Underlying Adolescent Smoking Behaviors: The Roles of Friendship Network, Family Relations, and School Environment.

BACKGROUND: This study investigates the extent to which friendship network, family relations, and school context are related to adolescent cigarette smoking. Friendship network is measured in terms of delinquent peers; family relations in terms of parental supervision; and school environment in terms of objective (eg, antismoking policy) and subjective (eg, school attachment) characteristics. METHODS: Findings are based on the secondary analysis of the health behavior in school-aged children, 2009-2010. Two-level hierarchical generalized linear models are estimated using hierarchical linear modeling 7. RESULTS: At the student level, ties to delinquent friends is significantly related to higher odds of smoking, while greater parental supervision is associated with lower odds. At the school level, antismoking policy and curriculum independently lower smoking behavior. Better within-class peer relations, greater school attachment, and higher academic performance are also negatively related to smoking. Last, the positive association between delinquent friends and smoking is weaker in schools with a formally enacted antismoking policy. However, this association is stronger in schools with better peer relations. CONCLUSIONS: Adolescent smoking behavior is embedded in a broader ecological setting. This research reveals that a proper understanding of it requires comprehensive analysis that incorporates factors measured at individual (student) and contextual (school) levels.

Is the relationship between parental abuse and mobile phone dependency (MPD) contingent across neighborhood characteristics? A multilevel analysis of Korean Children and Youth Panel Survey.

Research indicates that mobile phone dependency (MPD) is associated with various behavioral and internalizing problems. While a significant amount of findings points to its negative outcomes, there is a dearth of evidence concerning the determinants of MPD. This study focuses on this critical, yet understudied, subject by analyzing the associations between abusive parenting style, neighborhood characteristics, and MPD among youths in South Korea, a country with one of the highest mobile broadband penetration rates in the world. Based on the secondary analysis of two waves of Korean Children and Youth Panel Survey (KCYPS), a government-funded multiyear study, we investigate individual- and contextual-level factors underlying MPD. Findings show that, net of a host of time-lagged controls (including baseline dependency from the previous year), abusive parenting style significantly increases adolescent MPD. After adjusting for individual level characteristics, however, no contextual-level effect is found, i.e., residing in a neighborhood with a relatively higher proportion of parental abuse is not related to greater MPD. Finally, two cross-level interaction effects are observed. First, the association between parental abuse and MPD is weaker in a neighborhood context with better educated inhabitants (more college graduates). Second, it is reinforced in demographically "aged" communities with more elderly residents.

A Meta-Analysis of Treatment Interventions for Internet Addiction Among Korean Adolescents.

This study comprehensively examined the effects of treatment interventions for Internet addiction among adolescents in South Korea through a meta-analysis. We analyzed 70 domestic master's theses and journal articles that reported on controlled studies and involved pre- and post-test analyses in the design. The dates of these publications fall between 2000 and 2015. The total effect size, calculated by random-effect analysis (g), revealed that interventions for the treatment of Internet addiction were effective (ES = 1.838). Meta-ANOVAs revealed differences between groups based on a theoretical model, intervention group size, and intervention duration. Integrative therapy produced larger effect sizes (ES = 2.794) compared to other treatment models such as cognitive behavioral therapy and reality therapy. Effect sizes for interventions, including nine to 12 people (ES = 2.178), were larger than those of interventions including more or fewer participants. Finally, treatment interventions that lasted 8 or more weeks revealed larger effect sizes (ES = 2.294) compared to shorter interventions. The study findings suggest directions for the development and effective operation of future Internet addiction interventions among Korean adolescents. Increasing the effectiveness of these interventions requires an integrative theoretical model, an intervention group size of nine to 12 participants, and a long-term intervention.

The Influence of Stress on Juvenile Delinquency: Focusing on the Buffering Effects of Protective Factors among Korean Adolescents.

The present study sought to examine self-control, parental support, and peer support as internal and external protective factors that buffer the influence of adolescent stress on delinquency among Korean adolescents. To this end, the paper utilized the 1st-year data from the Korea Youth Panel Study (KYPS) conducted by the National Youth Policy Institute; the study surveyed a total of 3,449 2nd-year middle school students. The results of the hierarchical regression analysis indicated that despite high levels of stress, high self-control mitigated the negative influence of stress on delinquency in adolescents. In contrast, parental and peer support were only found to be directly influential on juvenile delinquency. Parental support had only negative influences on status delinquency, and peer support had positive influences on both status and serious delinquency. Based on these results, we propose implications for preventing and intervening with juvenile delinquency.

Linking Traumatic Childhood Experiences to the Physical Health of Korean Adolescents in Out-of-Home Care through Depression and Anxiety.

The main purpose of this study is to assess whether the physical health of Korean adolescents in out-of-home care is affected directly by traumatic childhood experiences and/or indirectly through depression and anxiety. Study participants are 460 adolescents who are included in the first and second wave of the Panel Study on Korean Children in Out-of-Home Care. The data are analyzed using structural equation modeling. Our structural model finds no direct effects of traumatic experiences on physical health. Among the two types of trauma experiences, namely, family instability and violence experiences, only violence experiences affect physical health indirectly through depression and anxiety. Based on the results, practice implications for Korean adolescents in care are discussed.

Examining the Effects of Parental Influence on Adolescent Smoking Behaviors: A Multilevel Analysis of the Global School-Based Student Health Survey (2003-2011).

INTRODUCTION: Based on a large cross-national dataset, we investigated the role of parental smoking (a risk factor) and parental supervision (a protective factor) on the frequency of smoking by youths in resource-poor countries. In addition, we tested for cross-level interactions between these two predictors and national wealth on the outcome variable. METHODS: Pooled cross-sectional data from the Global School-based Student Health Survey (2003-2011) were analyzed, which consists of 58956 students in 31 countries. Hierarchical linear models were estimated to examine the associations between the two parental influence variables and adolescent smoking. RESULTS: Among the control variables, age, gender (male), the experience of being bullied, frequency of getting into physical fights, truancy, and anxiety were significantly related to higher frequency of smoking. With respect to the main predictors, both at the individual level, parental supervision was negatively associated with adolescent smoking, while parental smoking was positively related to it. Two cross-level interaction terms were also observed. National wealth (GDP per capita) significantly moderated, that is, increased, these effects of parental influence on how often the adolescents smoked. CONCLUSIONS: We provided new evidence on the factors related to adolescent smoking in low-income countries, a topic that has received very little attention. We showed that the associations between parental influences and adolescent smoking behaviors are not constant but vary according to the level of economic development. Future research should incorporate this comparative dimension in elaborating and specifying the conditions under which parental influences and other predictors differentially affect adolescent smoking. IMPLICATIONS: Prior research on adolescent smoking focused on developed countries. Based on the secondary analysis of the Global School-based Student Health Survey (2003-2011), this study examines the associations between parental influence (parental smoking and parental supervision) on the frequency of youth smoking behaviors in resource-poor countries. We show that parental smoking is positively related to adolescent smoking, while parental supervision is negatively related to it. We also find that these two associations vary according to national wealth: both effects are stronger in a country with higher per capita GDP.

An international systematic review of smoking prevalence in addiction treatment.

AIMS: Smoking prevalence is higher among people enrolled in addiction treatment compared with the general population, and very high rates of smoking are associated with opiate drug use and receipt of opiate replacement therapy (ORT). We assessed whether these findings are observed internationally. METHODS: PubMed, PsycINFO and the Alcohol and Alcohol Problems Science Database were searched for papers reporting smoking prevalence among addiction treatment samples, published in English, from 1987 to 2013. Search terms included tobacco use, cessation and substance use disorders using and/or Boolean connectors. For 4549 papers identified, abstracts were reviewed by multiple raters; 239 abstracts met inclusion criteria and these full papers were reviewed for exclusion. Fifty-four studies, collectively comprising 37,364 participants, were included. For each paper we extracted country, author, year, sample size and gender, treatment modality, primary drug treated and smoking prevalence. RESULTS: The random-effect pooled estimate of smoking across people in addiction treatment was 84% [confidence interval (CI) = 79, 88%], while the pooled estimate of smoking prevalence across matched population samples was 31% (CI = 29, 33%). The difference in the pooled estimates was 52% (CI = 48%, 57%, P < .0001). Smoking rates were higher in programs treating opiate use compared with alcohol use [odds ratio (OR) = 2.52, CI = 2.00, 3.17], and higher in ORT compared to out-patient programs (OR = 1.42, CI = 1.19, 1.68). CONCLUSIONS: Smoking rates among people in addiction treatment are more than double those of people with similar demographic characteristics. Smoking rates are also higher in people being treated for opiate dependence compared with people being treated for alcohol use disorder.

Factors associated with perceived health among Korean adolescents.

This study examined the influences of personal, social, and environmental-structural factors on the perceived health of Korean adolescents. Using a two-stage generalized hierarchical logistic linear multilevel model, this study found that general high school enrollment, younger age, normal weight, and frequent exercise increased the likelihood of a positive self-perception of health. Higher levels of parental concern and quality of school life also contributed to the likelihood of students perceiving themselves as healthy. In contrast, psychological symptoms and negative self-esteem decreased the likelihood that students perceived themselves as healthy. The results provide implications for disease prevention and health promotion programs.

Gender differences in factors influencing smoking, drinking, and their co-occurrence among adolescents in South Korea.

INTRODUCTION: This study aimed to examine gender differences in the influence of social, attitudinal, and intrapersonal factors on the onset of smoking, drinking, and the co-occurrence of tobacco and alcohol use among adolescents in South Korea. METHODS: Using time-dependent Cox regression, the study analyzed the Korean Youth Panel Study conducted by the Korean National Youth Policy Institute. The study sample was middle-school second-graders (n = 3,188) in South Korea. RESULTS: This study found gender differences between Korean male and female adolescents in models of smoking and alcohol uptake; the co-occurrence model was identical, however. At first, parental supervision, attachment to friends, drinking friends, self-control, and aggression were common factors in the onset of drinking among Korean adolescents. Stress was shown to be significantly correlated with the onset of male adolescent drinking, whereas family income was a significant factor just for females. In the smoking model, attachment to friends, smoking friends, stigma, and self-control were identified as common factors related to the onset of smoking in both male and female adolescents. Attachment to parents was found to be a significant factor for male adolescents and aggression for females. CONCLUSIONS: The study findings indicate influences on the commencement of smoking, drinking, and concurrent tobacco and alcohol use among Korean male and female adolescents. Culturally sensitive interventions focusing on common risk factors with several differentiated strategies for both boys and girls should be developed and provided for Korean adolescents.