Heekyung Lee

The relationship between childhood trauma and the severity of adulthood depression and anxiety symptoms in a clinical sample: The mediating role of cognitive emotion regulation strategies

BACKGROUND Childhood trauma is an important factor in adverse mental health outcomes, including depression and anxiety. The purpose of the present study was to evaluate a hypothesized model describing a pathway of childhood trauma and its influence on psychiatric symptoms in patients with depressive disorder. In this model, childhood trauma was positively associated with current depression and anxiety symptoms, which were mediated by a cognitive emotional regulation strategy. METHOD Patients with depressive disorder (n=585, 266 men, 316 women) completed the Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Childhood Trauma Questionnaire (CTQ), and Cognitive Emotion Regulation Questionnaire (CERQ). We divided the cognitive emotion regulation strategies into adaptive and maladaptive strategies using a CERQ subscore. We employed structural equation modeling (SEM) and simple/multiple mediation analyses. RESULTS The indirect effect of maladaptive strategies was significant in the relationship between overall childhood trauma and depression/anxiety severity, whereas the mediation effect of adaptive strategies was limited to depressive symptoms. With respect to specific types of trauma, maladaptive strategies mediated the association between emotional abuse and current depression/anxiety, while the mediation effect of adaptive strategies was limited to emotional neglect. LIMITATIONS This studys cross-sectional design does not allow establishment of causal relationships. Childhood trauma recall bias may be possible. CONCLUSIONS These findings support the hypothesized model in which childhood trauma is associated with adulthood depression/anxiety symptoms in clinical samples, and mediated by emotion regulation strategies. These results suggest that cognitive emotion dysregulation is an important factor affecting depression/anxiety symptoms in patients with childhood trauma.

Attachment styles, grief responses, and the moderating role of coping strategies in parents bereaved by the Sewol ferry accident

ABSTRACT Background: Previous studies on the influence of different types of attachment on grief responses have yielded contradictory outcomes. Little research has been conducted to identify the psychological processes that moderate the relationship between attachment representations and patterns of grief in disaster-related grief. Objective: The present study examines the effects of different attachment types on the grief responses of parents bereaved by loss of a child in a ferry accident, along with the moderating role of coping strategies. Methods: Bereaved parents (n = 81) completed self-report questionnaires evaluating attachment, coping strategies, complicated grief, and shame/guilt. We performed correlational analyses to examine the associations among variables. We also conducted hierarchical regression analyses and simple slope analyses to examine the moderation effects of coping strategies. Results: Anxious attachment was associated with severe shame/guilt, and avoidant attachment correlated with complicated grief. Anxious attachment was positively associated with all types of coping strategies, and avoidant attachment was negatively related to problem- and emotion-focused coping. The use of problem-focused coping strategies was a significant moderator of the relationship between the avoidant attachment dimension and shame/guilt. Avoidant attachment had a significant effect on shame/guilt in groups with a high level of problem-focused coping. In contrast, none of the coping strategies significantly moderated the relationship between anxious attachment and grief response. Conclusions: The results suggest that people with highly avoidant attachment might be overwhelmed by shame and guilt when they try to use problem-focused coping strategies. This finding suggests that grief interventions should be organized with consideration of individual differences in attachment representations.

Factor structure of the perfectionistic self-presentation scale in Korea.

This study explored the factor structure of the Korean version of the Perfectionistic Self-Presentation Scale, originally developed by Hewitt and colleagues in 2003 with three factors (Perfectionistic Self-promotion, Non-display of Imperfection, and Non-disclosure of Imperfection). In Study 1, a confirmatory factor analysis was performed on the Korean version with 27 items for 151 Korean college students, but the model fit was poor. Subsequently, an exploratory factor analysis was conducted, and the results yielded three factors as found in Hewitt, et al., yet with 20 items rather than the original 27 items. This new version had good internal consistency (Cronbachs alpha = .88); convergent validity estimate was established with a measure of self-presentation motivation. In Study 2, to support the structural validity of the Korean version, another confirmatory factor analysis was conducted with 203 Korean college students. The model fit was good, but a few amendments were made.