탈북 청소년의 외상 후 스트레스 장애 증상의 변화와 관련된 요인들
Factors That Affect Changes in Post-Trauma Stress Disorder Symptoms Among North Korean Refugee Youths
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Objectives This study aimed to investigate the trajectory of post-traumatic stress disorder (PTSD) symptoms among North Korean adolescents. We sought to identify the protective and risk factors influencing changes in PTSD symptoms. Methods We evaluated 130 North Korean refugee youths aged 12 to 27 years who completed a baseline and follow-up assessment after one year. We classified subjects with similar changes in PTSD symptom trajectories using latent class growth analysis. Subsequently, we performed analysis of variance and chi-square tests to determine if there were significant differences across these identified groups. Lastly, we conducted a multinomial logistic regression analysis to determine the factors that influenced the changes in PTSD symptoms. Results The participants were classified into four groups: stable high group (class 1), alleviated group (class 2), stable moderate group (class 3), and stable low group (class 4). With the stable high group as the reference category, for every one-point increase in the resilience score, the probability of belonging to class 2, class 3, and class 4 increased 1.22-fold (p=0.034), 1.14-fold (p=0.039), and 1.28-fold (p=0.003), respectively. The stable moderate and the stable low groups were more likely than the stable high group to have more psychological support (p=0.035 and p=0.027, respectively). Moreover, men were more likely to belong to the stable low group than to the stable high group. Conclusion We found that resilience and psychological support were protective factors that prevented the development and exacerbation of PTSD symptoms. Therefore, interventions aimed at enhancing resilience and providing psychological support are crucial for the mental health promotion of North Korean defector adolescents in the high-risk group for PTSD.
Abstract
Objectives This study aimed to investigate the trajectory of post-traumatic stress disorder (PTSD) symptoms among North Korean adolescents. We sought to identify the protective and risk factors influencing changes in PTSD symptoms. Methods We evaluated 130 North Korean refugee youths aged 12 to 27 years who completed a baseline and follow-up assessment after one year. We classified subjects with similar changes in PTSD symptom trajectories using latent class growth analysis. Subsequently, we performed analysis of variance and chi-square tests to determine if there were significant differences across these identified groups. Lastly, we conducted a multinomial logistic regression analysis to determine the factors that influenced the changes in PTSD symptoms. Results The participants were classified into four groups: stable high group (class 1), alleviated group (class 2), stable moderate group (class 3), and stable low group (class 4). With the stable high group as the reference category, for every one-point increase in the resilience score, the probability of belonging to class 2, class 3, and class 4 increased 1.22-fold (p=0.034), 1.14-fold (p=0.039), and 1.28-fold (p=0.003), respectively. The stable moderate and the stable low groups were more likely than the stable high group to have more psychological support (p=0.035 and p=0.027, respectively). Moreover, men were more likely to belong to the stable low group than to the stable high group. Conclusion We found that resilience and psychological support were protective factors that prevented the development and exacerbation of PTSD symptoms. Therefore, interventions aimed at enhancing resilience and providing psychological support are crucial for the mental health promotion of North Korean defector adolescents in the high-risk group for PTSD.
참고문헌 (49)
- "Settlement support for North Korean defectors, number of North Korean defectors entering South Korea"[URL]
- 2022 survey on the settlement status of North Korean defectors, "Korea Hana Foundation", Korea Hana Foundation, ~ (2022)
- Noh JW, "Trauma history and mental health of North Korean defectors", Curr Behav Neurosci Rep, 7, pp.250~257 (2020)
- Park J, "Exposure to family and organized violence and associated mental health in North Korean refugee youth compared to South Korean youth", Confl Health, 13, pp.46~ (2019)
- Elhai JD, "Psychometric properties of the UCLA PTSD reaction index. part II : investigating factor structure findings in a national clinic-referred youth sample", J Trauma Stress, 26, pp.10~18 (2013)
- Heim C, "Current research trends in early life stress and depression : review of human studies on sensitive periods, gene-environment interactions, and epigenetics", Exp Neurol, 233, pp.102~111 (2012)
- Kerig PK, "Posttraumatic stress as a mediator of the relationship between trauma and mental health problems among juvenile delinquents", J Youth Adolesc, 38, pp.1214~1225 (2009)
- Kessler RC, "Posttraumatic stress disorder in the national comorbidity survey", Arch Gen Psychiatry, 52, pp.1048~1060 (1995)
- Montgomery E, "Long-term effects of organized violence on young Middle Eastern refugees’ mental health", Soc Sci Med, 67, pp.1596~1603 (2008)
- Ward CL, "Exposure to violence and its relationship to psychopathology in adolescents", Inj Prev, 7, pp.297~301 (2001)
- Kim YJ, "Posttraumatic stress disorder as a mediator between trauma exposure and comorbid mental health conditions in North Korean refugee youth resettled in South Korea", J Interpers Violence, 31, pp.425~443 (2016)
- Cicchetti D, "A developmental psychopathology perspective on adolescence", J Consult Clin Psychol, 70, pp.6~20 (2002)
- Choi SK, "Anxiety and depression among North Korean young defectors in South Korea and their association with health-related quality of life", Yonsei Med J, 52, pp.502~509 (2011)
- Lee YM, "The psychological problems of North Korean adolescent refugees living in South Korea", Psychiatry Investig, 9, pp.217~222 (2012)
- Park SH, "A study on North Korean youth policy", Stud Korean Youth, 7, pp.114~138 (1991)
- Chae JM, "Key issues and research direction of the psychological researches for the young North Korean defectors", Korean J Cult Soc Issues, 22, pp.675~693 (2016)
- Smith P, "Principal components analysis of the impact of event scale with children in war", Pers Individ Differ, 34, pp.315~322 (2003)
- Horowitz M, "Impact of event scale : a measure of subjective stress", Psychosom Med, 41, pp.209~218 (1979)
- Yule W, "Post-traumatic stress disorder in child survivors of shipping disasters : the sinking of the ‘Jupiter’", Psychother Psychosom, 57, pp.200~205 (1992)
- Dyregrov A, "Factor analysis of the impact of event scale with children in war", Scand J Psychol, 37, pp.339~350 (1996)
- Perrin S, "The children’s revised impact of event scale(CRIES) : validity as a screening instrument for PTSD", Behav Cogn Psychother, 33, pp.487~498 (2005)
- Smith BW, "The brief resilience scale : assessing the ability to bounce back", Int J Behav Med, 15, pp.194~200 (2008)
- Gross JJ, "Emotion regulation questionnaire(ERQ)" (2003), APA PsycTests
- Han SH, "Relationships of positive and negative emotion to cognitive reappraisal and expressive suppression emotional regulation strategies and self-control in adolescence", Korean J Child Stud, 27, pp.1~11 (2006)
- Cantril H, "The pattern of human concerns" (1965), Rutgers University Press
- Olson DH, "Handbook of measurements for marriage and family therapy", pp.1985, Brunner
- Muthén B, "Integrating person-centered and variablecentered analyses : growth mixture modeling with latent trajectory classes", Alcohol Clin Exp Res, 24, pp.882~891 (2000)
- Nylund KL, "Deciding on the number of classes in latent class analysis and growth mixture modeling : a Monte Carlo simulation study", Struct Equ Modeling, 14, pp.535~569 (2007)
- Muthén LK, "Mplus: Statistical Analysis with Latent Variables", User’s Guide (Version 8), ~ (2017)
- Montgomery E, "Trauma and resilience in young refugees : a 9-year follow-up study", Dev Psychopathol, 22, pp.477~489 (2010)
- Reed RV, "Mental health of displaced and refugee children resettled in low-income and middle-income countries : risk and protective factors", Lancet, 379, pp.250~265 (2012)
- Lee Y, "Mental health status of North Korean refugees in South Korea and risk and protective factors : a 10-year review of the literature", Eur J Psychotraumatol, 8(sup2), pp.1369833~ (2017)
- Mesman E, "Resilience and mental health in children and adolescents : an update of the recent literature and future directions", Curr Opin Psychiatry, 34, pp.586~592 (2021)
- Lee JS, "Resilience buffers the impact of traumatic events on the development of PTSD symptoms in firefighters", J Affect Disord, 162, pp.128~133 (2014)
- Thabet A, "Trauma, PTSD, anxiety and coping strategies among Palestinians adolescents exposed to war in Gaza", Arab J Psychiatr, 25, pp.71~82 (2014)
- LeDoux JE, "A call to action : overcoming anxiety through active coping", Am J Psychiatry, 158, pp.1953~1955 (2001)
- Murray H, "Clients’ experiences of returning to the trauma site during PTSD treatment : an exploratory study", Behav Cogn Psychother, 44, pp.420~430 (2016)
- Briscione MA, "Conditioned fear associated phenotypes as robust, translational indices of trauma-, stressor-, and anxiety-related behaviors", Front Psychiatry, 5, pp.88~ (2014)
- Sarason BR, "Social support : an interactional view" (1990), John Wiley & Sons
- Blair RG, "Risk factors associated with PTSD and major depression among Cambodian refugees in Utah", Health Soc Work, 25, pp.23~30 (2000)
- Danga SD, "Associations between traumatic experience and resilience in adolescent refugees : a scoping review", Youth, 2, pp.681~690 (2022)
- Hébert M, "Post traumatic stress disorder", PTSD in adolescent victims of sexual abuse : resilience and social support as protection factors, 2014, pp.19, 685~694
- Haskell SG, "Gender differences in rates of depression, PTSD, pain, obesity, and military sexual trauma among Connecticut war veterans of Iraq and Afghanistan", J Womens Health(Larchmt), 19, pp.267~271 (2010)
- Kokras N, "Sex differences in animal models of psychiatric disorders", Br J Pharmacol, 171, pp.4595~4619 (2014)
- Olff M, "Gender differences in posttraumatic stress disorder", Psychol Bull, 133, pp.183~204 (2007)
- Rasmusson AM, "Gender and PTSD", pp.43~75 (2002), Guilford Press
- Norris FH, "60, 000 disaster victims speak : part I. An empirical review of the empirical literature, 1981-2001", Psychiatry, 65, pp.207~239 (2002)
- Bajwa J, "Psychological capital and life satisfaction of refugees in Canada : evidence from a community-based educational support program", J Community Psychol, 47, pp.504~516 (2019)
- Sleijpen M, "Lives on hold : a qualitative study of young refugees’ resilience strategies", Childhood, 24, pp.348~365 (2017)
