Anxiety and mood (대한불안의학회지)

Korean Academy of Anxiety Disorders (대한불안의학회)
권호 표지
DOI QR코드

DOI QR Code

Longitudinal Trajectories of Mental Health Among North Korean Defectors: A Four-Year Follow-Up Study of Loneliness, Depression, and Life Satisfaction

북한이탈주민 정신건강의 종단적 추세: 외로움, 우울, 삶의 만족도에 대한 4년 추적 연구

  • Park, So Hee (Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center) ;
  • Hong, Jin Pyo (Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center) ;
  • An, Ji Hyun (Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center) ;
  • Lee, Hye Rin (Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center) ;
  • Kim, Myung Hyun (Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center) ;
  • Chang, Hyein (Department of Psychology, Sungkyunkwan University)
  • 박소희 (성균관대학교 의과대학 삼성서울병원 정신건강의학과) ;
  • 홍진표 (성균관대학교 의과대학 삼성서울병원 정신건강의학과) ;
  • 안지현 (성균관대학교 의과대학 삼성서울병원 정신건강의학과) ;
  • 이혜린 (성균관대학교 의과대학 삼성서울병원 정신건강의학과) ;
  • 김명현 (성균관대학교 의과대학 삼성서울병원 정신건강의학과) ;
  • 장혜인 (성균관대학교 심리학과)
  • Received : 2021.05.17
  • Accepted : 2021.08.05
  • Published : 2021.10.30
Download PDF
⟨ Previous Next ⟩

Abstract

Objective : The purpose of this study was to investigate the longitudinal trajectories of life satisfaction, loneliness, and depression and to identify the factors that influence these trajectories in North Korean Defectors (NKD). Methods : NKD (n=300) who registered in the multi-regional adaptation center (Hana Center), within three years of settling in South Korea, were recruited into this study. Life satisfaction, loneliness, and depression were assessed with self-report questionnaires over a period of 4 years (7 waves of data). Latent growth modeling was conducted to assess the changes in life satisfaction, loneliness, and depression. Results : Findings from both unconditional and conditional models (with gender, South Korea settlement age, household income, marital status, and PTSD at wave 1) indicated a linear increase in loneliness and depression, and a linear decrease in life satisfaction over the 4-year period. In the conditional model, gender predicted the intercept of life satisfaction and depression. In addition, PTSD predicted the intercept of life satisfaction, loneliness, and depression and slope of depression. Conclusion : Our finding suggests that the mental health of NKD tends to deteriorate over time after settling in South Korea. Therefore, continuous support is necessary for their successful adaptation to the South Korean Society.

Keywords

Acknowledgement

이 연구는 보건복지부 정신건강 R&D 사업단의 지원을 받아 수행된 연구임(HL19C0018).

References

  1. Korea Hana Foundation. 2019 Settlement Survey of North Korean Refugees in South Korea. [cited 2021 Feb 23]. Available from: https://northkoreanrefugee.org/eng/resources/research_view.jsp?pk_seq=243.
  2. Kang SR. Development of Trauma Scale for North Korean Refugee. [dissertation]. Seoul: Yonsei University;2001.
  3. Kim H. Difference on complex PTSD and PTSD symptoms according to types of traumatic events in North Korean refugees. Korean Journal of Counseling and Psychotherapy 2012;31:1003-1022.
  4. Jeong YK, Kim HJ. The relationship between traumatic incidents and social adaptation among North Korean refugees: Focusing on the mediating effect of complex post traumatic stress disorder. Korean Journal of Social Welfare Studies 2014;45:143-167. https://doi.org/10.16999/kasws.2014.45.4.143
  5. Lee KE, An JH, Kim DE, Moon CS, Hong JP. Clinical Characteristics of Post-Traumatic Stress Disorder among North Korean Defectors. Anxiety and Mood 2018;14:80-87. https://doi.org/10.24986/ANXMOD.2018.14.2.004
  6. Lee MJ, Chang HI, Jun JY. Perceived discrimination, acculturation, acculturative stress, and depression among North Korean Refugees: a mediated moderation model. Korean Journal of Woman Psychology 2016;21:459-481. https://doi.org/10.18205/kpa.2016.21.3.006
  7. Yang SK. Linguistic accommodation of North Korean refugees. [Unpublished Ph. D. thesis]. Seoul: Seoul National University; 2013.
  8. Kim MR. The effect of the perceived adjustment stress and the coping resources on the depressive symptoms of the North Korean refugees: the comparison between men and women. Ment Health Soc Work 2005;20:95-124.
  9. Kim HA. Meta-analytic review on the mental health among the North Korean refugees in South Korea (depression and post-traumatic stress disorder. Crisisonomy 2016;12:105-124.
  10. Cho YA, Jeon WT, Yu JJ, Um JS. Predictors of depression among North Korean defectors: a 3-year follow-up study. Korean Journal of Counseling and Psychotherapy 2005;17:467-484.
  11. Choi SK, Min SJ, Cho MS, Joung H, Park SM. Anxiety and depression among North Korean young defectors in South Korea and their association with health-related quality of life. Yonsei Med J 2011;52: 502-509. https://doi.org/10.3349/ymj.2011.52.3.502
  12. Murray K, Davidson G, Schweitzer R. Psychological wellbeing of refugees resettling in Australia: a literature review prepared for the Australian Psychological Society. Melbourne: Australian Psychological Society;2008.
  13. Kim MY. The study of the life satisfaction of the North Korean defectors by demographic and context variables. Korean Journal of Clinical Social Work 2007;4:19-39.
  14. Kim YH, Jeon WT, Cho YA. A study on the prevalence and the influencing factors of the mental health problems among recent migrant North Koreans: a focus on 2007 entrants. Unification Policy Studies 2010;19:141-174.
  15. Lee HR, An JH, Yoon SC, Jeong SH, Chang HI, Hong JP. Two-year follow up study of change in satisfaction level and mental health among North Korean defectors. Anxiety and Mood 2019;15:109-114. https://doi.org/10.24986/ANXMOD.2019.15.2.007
  16. Min SK, Jeon WT, Eom JS, Yu SE. Quality of life of North Korean defectors in South Korea: three years follow-up study. J Korean Neuropsychiatr Assoc 2010;49:104-113.
  17. Cho YA, Kim YH, You SE. Predictors of mental health among North Korean defectors residing in South Korea over 7 years. Korean Journal of Counseling and Psychotherapy 2009;21:329-348.
  18. Lee YE, Lee MJ, Park SB. 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 2017;8:1369833. https://doi.org/10.1080/20008198.2017.1369833
  19. Kilpatrick FP, Cantril H. Self-anchoring scaling: a measure of individuals' unique reality worlds. Journal of Individual Psychology 1960; 16:158.
  20. Inc G. World Poll Questions. Washington, D.C, Gallup Inc 2008.
  21. Russell D, Peplau LA, Ferguson ML. Developing a measure of loneliness. J Pers Assess 1978;42:290-294. https://doi.org/10.1207/s15327752jpa4203_11
  22. Russell DW. UCLA Loneliness Scale (Version 3): reliability, validity, and factor structure. J Pers Assess 1996;66:20-40. https://doi.org/10.1207/s15327752jpa6601_2
  23. Radloff LS. The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement 1977;1:385-401. https://doi.org/10.1177/014662167700100306
  24. Cho MJ, Kim KH. Diagnostic validity of the CES-D (Korean Version) in the assessment of DSM-III-R major depression. J Korean Neuropsychiatr Assoc 1993;32:381-399.
  25. Park SJ, Lee SH, Jun JY, Lee TY, Han JM, Ahn MH, et al. Reliability and Validity of the North Korean Version of Center for Epidemiologic Studies Depression Scale (CES-D-NK). Anxiety and Mood 2015;11: 54-60.
  26. Horowitz M, Wilner N, Alvarez W. Impact of Event Scale: a measure of subjective stress. Psychosom Med 1979;41:209-218. https://doi.org/10.1097/00006842-197905000-00004
  27. Weiss DS. The impact of event scale: revised. In: Wilson JP, So-Kum Tang CC, editors. Cross-cultural assessment of psychological trauma and PTSD. Boston, MA: Springer;2007. p.219-238.
  28. Won SD, Lee SH, Hong JP, Jun JY, Han JM, Shin MN, et al. A Study on Reliability and Validity of the Impact of Event Scale-Revised-North Korea (IES-R-NK). J Korean Neuropsychiatr Assoc 2015;54: 97-104. https://doi.org/10.4306/jknpa.2015.54.1.97
  29. Byrne BM, Lam WW, Fielding R. Measuring patterns of change in personality assessments: an annotated application of latent growth curve modeling. J Pers Assess 2008;90:536-546. https://doi.org/10.1080/00223890802388350
  30. Duncan SC, Duncan TE, Strycker LA. Alcohol use from ages 9 to 16: A cohort-sequential latent growth model. Drug Alcohol Depend 2006;81:71-81. https://doi.org/10.1016/j.drugalcdep.2005.06.001
  31. Hu Lt, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal 1999;6:1-55. https://doi.org/10.1080/10705519909540118
  32. Hong SH. The criteria for selecting appropriate fit indices in structural equation modeling and their rationales. Korean Journal of Clinical Psychology 2000;19:161-177.
  33. Enders CK, Bandalos DL. The relative performance of full information maximum likelihood estimation for missing data in structural equation models. Structural Equation Modeling 2001;8:430-457. https://doi.org/10.1207/S15328007SEM0803_5
  34. Youm YS, Kim YJ. A study on the development and types of social networks among North Korean immigrants in South Korea. Korean Journal of Socioloy 2011;45:91-129.
  35. Kim BC, Yu SE. North Korean defectors panel study: economic adaptation mental health physical health. Seoul: North Korean Refugees Foundation;2010.
  36. Han S, Nam SI, Kim YK. A study on the influence of life event stress and gender role attitude on North Korean defector's social adaptation in South Korea: Focused on the moderating effect of social support network. North Korean Studies Review 2011;15:189-218.
  37. Chung YK, Kim HJ, Choi JH. The relationship between discrimination and social adaptation among North Korean refugees: mediating effects of self-support efficacy. Social Science Research Review 2015; 31:157-182. https://doi.org/10.18859/ssrr.2015.05.31.2.157
  38. Stewart M, Anderson J, Beiser M, Mwakarimba E, Neufeld A, Simich L, et al. Multicultural meanings of social support among immigrants and refugees. International Migration 2008;46:123-159. https://doi.org/10.1111/j.1468-2435.2008.00439.x
  39. Warner FR. Social support and distress among Q'eqchi' refugee women in Maya Tecun, Mexico. Med Anthropol Q 2007;21:193-217. https://doi.org/10.1525/maq.2007.21.2.193
  40. Eom TW, Lee KY. The relationship among social problem solving capability, social support and depression of North Korean defectors. Ment Health Soc Work 2004;18:5-32.
  41. Tran TV, Manalo V, Nguyen VT. Nonlinear relationship between length of residence and depression in a community-based sample of Vietnamese Americans. Int J Soc Psychiatry 2007;53:85-94. https://doi.org/10.1177/0020764007075025
  42. Nguyen SD. The psycho-social adjustment and mental health needs of Southeast Asian refugees. Can J Psychiatr Nurs 1984;25:6-8.
  43. Baik YO. Research on the actual conditions of the North Korean female defectors in China and aids policies for them. North Korean Studies Review 2002;16:241-264.
  44. Eun HJ, Kwon TW, Lee SM, Kim TH, Choi MR, Cho SJ. A study on reliability and validity of the Korean Version of Impact of Event Scale-Revised. J Korean Neuropsychiatr Assoc 2005;44:303-310.