Factors Related to Change in Depression among North Korean Refugee Youths in South Korea

Abstract

This study investigated change in depression and revealed factors related to change using one-year follow-up data. A sample of 108 North Korean Refugee Youths (NKRYs) aged 13 to 26 years (66 females) was recruited from two alternative schools for NKRYs in South Korea. Based on the Center for Epidemiologic Studies Depression Scale cut-off score of 16, respondents were grouped based on change in depression score after one year as stable low, alleviated, deteriorated, or prolonged. Multinomial logistic regression assessed the influence of baseline psychological scores (resilience, emotional regulation strategy, and self-esteem), and reported social support (psychological/practical) on the odds of group classification. With the stable low group as the reference category, those with alleviated depression at Time 2 had significantly higher odds of expressive suppression and tended to have lower self-esteem at Time 1. The deteriorated depression group was more likely than the stable low group to have lower resilience and cognitive appraisal scores. Those with prolonged high depression were more likely than the stable low group to have lower resilience, less practical social support, and lower self-esteem. Psychological interventions, particularly those focused on increasing self-esteem and resilience, could be helpful for NKRYs with potential risk of depression. In addition, practical support should be provided on an as-needed basis to prevent chronic depression among NKRYs.

Factors Affecting Changes in the Mental Health of North Korean Refugee Youths: A Three-Year Follow-Up Study

“…Specifically, expressive suppression of emotion was shown to increase depression over time. This result is in line with previous studies that mentioned expressive suppression as a risk factor for depression [ 16 , 21 ]. Aldao, Nolen-Hoeksema, and Schweizer [ 49 ] suggested that the presence of expressive suppression is likely to be more strongly associated with depression than the absence of cognitive reappraisal.…”

“…In addition, resilience was a significant preventative factor for changes in depression in this study. Previous studies on NKRYs focused on resilience as a preventative factor for mental health issues including depression [ 16 , 19 , 24 , 45 , 51 ]. According to McLaughlin, Doane, Costiuc, and Feeny [ 52 ], resilience consists of two aspects: heightened psychological vulnerability and adaptation to risk.…”

“…High levels of depression have been reported in NKRYs who perceive their daily stress to be high [ 11 ]. Low resilience and low self-esteem are known to be factors that maintain depression [ 16 ]. Particularly, resilience is one’s capacity for adapting successfully in spite of adversity or overwhelming circumstances, and its importance as a protective factor for depression was highlighted in a South Australian study with refugee youths [ 17 , 18 ].…”

Trauma History and Mental Health of North Korean Defectors

“…Considering the considerable stigma surrounding mental illness and the low health literacy of NKDs residing in South Korea, it is necessary to provide community-based information to vulnerable groups to promote knowledge of mental illness and ensure the safe use of medications. [20,22,37] • Repatriation experiences [38] • Long staying periods after entrance [21,22,44] • Perceived discrimination [10] • Low income [13,46,47] • Family relationships (family violence, family cohesion) [17,48,49] • Physical illnesses [19,51] • Alexithymia [31] • Emotion regulation strategy [40] • Thoughts of personal failure [41] • Resilience [42]…”

“…Lower resilience was found to be related to more severe depression and prolonged severe depression in a one-year follow-up study that investigated changes in depression in young NKDs [42]. Additionally, in models predicting clinical depression (dichotomous), resilience fully mediated the relationship between family cohesion and clinical depression in NKDs [13].…”