The association between alexithymia and posttraumatic stress symptoms following multiple exposures to traumatic events in North Korean refugees

Park, Juhyun; Jun, Jin Yong; Lee, Yu Jin; Kim, Soohyun; Lee, So Hee; Yoo, So Young; Kim, Seog Ju

doi:10.1016/j.jpsychores.2014.09.007

Cited by 50 publications

(56 citation statements)

References 35 publications

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“…NKRs’ psychiatric symptoms were also predicted by passive coping style to avoid problems (Lim et al, 2010; Lim & Han, 2016). In another report, NKRs having more difficulty in emotion identification and expression – alexithymia – were found to have a greater negative impact of traumatic experience on PTSD symptoms, suggesting the significant role of adaptive emotional coping in attenuating the aftermath of stressful events (Park et al, 2015). …”

Section: Resultsmentioning

confidence: 99%

“…Lim and Han (2016)Adult NKRs44540.3PTSD (a scale developed for NKRs)NoNam et al (2016)Adult NKRs30441.0Depression (CES-D)NoJ. Park et al (2015)Adult NKRs19938.6 (19–74)PTSD (IES-R), Depression (CES-D)NoY. Park and Yoon (2007)Adolescent NKRs19719.2 (14–24)Emotional and behavioural problems (K-YSR)NoG.…”

Section: Resultsmentioning

confidence: 99%

“…Consistent with a meta-analysis of refugee populations that identified traumatic events as the strongest mental health risk factor (Steel et al, 2009), the number and severity of these traumatic experiences were all predictive of a wide range psychiatric disorders among NKRs in most studies (Baek, Kil, Yoon, & Lee, 2007; Cho & Kim, 2010; Cho et al, 2011; Choi et al, 2017; Emery, Lee, & Kang, 2015; Jeon, Eom, & Min, 2013; Kim, 2012b, Y. Kim 2013; Kim, Cho, & Kim, 2015; Lee et al, 2016; Lim & Han, 2016; Park et al, 2015). However, in a few studies (Cho et al, 2009; Jeon et al, 2013; Kim, 2016), traumatic experiences were not related to conditions other than PTSD, such as anxiety and depressive symptoms.…”

Section: Resultsmentioning

confidence: 99%

“…In more than a half of studies, no sex differences were found in NKRs’ psychiatric outcomes (Choi et al, 2011; Emery et al, 2015; Jeon et al, 2009; Kim, 2012b; Y. Kim, 2013, 2016; Lee, 2011; Nam et al, 2016; Park et al, 2015; Um et al, 2015); however, the remainder of studies noted consistent patterns of sex differences in various psychological problems. Specifically, female NKRs appear to be more vulnerable to experience emotional and internalizing problems, including depression, anxiety, suicidal ideation, and somatization (Cho et al, 2009; Jun et al, 2015; Kim et al, 2011; Kim & Shin, 2010; 2015; Kim et al, 2008; S. Kim et al, 2011; Y. Kim et al, 2010; Shin et al, 2016).…”

Section: Resultsmentioning

confidence: 99%

“…For adult NKRs, most studies suggested a greater risk for overall psychopathology among older NKRs, including PTSD, depression, substance use, and somatization (Chang & Son, 2014; Choi & Kim, 2011; Choi et al, 2009; Jun et al, 2015; Kim, 2010; Kim & Shin, 2010; Kim et al, 2013; M. Lee et al, 2016; Lim et al, 2010; Park et al, 2015; Yoo et al, 2017), albeit not all studies (Cho & Kim, 2010; Cho et al, 2009; Kim et al, 2010; Song et al, 2016; Um et al, 2015). Particularly, compared to those in their early adulthood (20s to 30s), older adults (40s to 50s) seemed to be more vulnerable to mental health problems (Choi & Kim, 2011; Kim & Shin, 2010).…”

Section: Resultsmentioning

confidence: 99%

See 4 more Smart Citations

Mental health status of North Korean refugees in South Korea and risk and protective factors: a 10-year review of the literature

Lee¹,

Lee²,

Park³

2017

European Journal of Psychotraumatology

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Background: North Korean refugees (NKRs) are often exposed to traumatic events in North Korea and during their defection. Furthermore, they face sociocultural barriers in adapting to the new society to which they have defected. Objective: To integrate previous findings on this mentally vulnerable population, we systematically reviewed articles on the mental health of NKRs in South Korea. Method: We searched for empirical studies conducted in the last 10 years in six online databases (international journals: Embase, PubMed, Scopus, Web of Science; Korean journals: DBPIA, KMbase) through June 2017. Only quantitative studies using new empirical data on the mental health of NKRs were included. We summarized the 56 studies ultimately selected in terms of NKRs’ mental health status and three domains of associated factors: pre- and post-settlement factors and personal factors. Results: NKRs had a high prevalence and severity of psychiatric symptoms, particularly post-traumatic stress disorder and depression. We identified nine risk factors consistently found in previous studies, including traumatic experience, longer stay periods in third country, forced repatriation, acculturative stress, low income, older age, poor physical health, and female and male sex, as well as four protective factors, including educational level in North Korea, social support, family relationship quality, and resilience. Conclusions: We suggest that future studies focus on the causal interactions between different risk and protective factors and mental health outcomes among NKRs from a longitudinal perspective. Furthermore, comprehensive policies for NKRs’ psychological adaptation are needed, particularly the development of evidence-based mental health interventions.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Mental health status of North Korean refugees in South Korea and risk and protective factors: a 10-year review of the literature

Lee¹,

Lee²,

Park³

2017

European Journal of Psychotraumatology

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The Mediating Role of Alexithymia in the Association Between Adverse Childhood Experiences and Postdeployment Mental Health in Canadian Armed Forces Personnel

Edge

Lee

2020

Journal of Traumatic Stress

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Recent studies showing an association between adverse childhood experiences and the development of alexithymia in military personnel have generated interest regarding the role of alexithymia in the pathway linking childhood trauma exposure to mental health disorders. Accordingly, the current study was conducted to (a) examine the associations among adverse childhood experiences, alexithymia, and symptoms of depression and posttraumatic stress disorder (PTSD) among recently deployed Canadian military personnel and (b) assess the mediating role of alexithymia in these associations. Data collected from 2,927 members of the Canadian Armed Forces at baseline and after their return from an overseas deployment were subjected to a prospective path analysis. The results of the path analysis, R 2 = .35, pointed to a significant direct effect of childhood adversity on postdeployment mental health symptoms. Contrary to our expectations, the results also pointed to a negative indirect effect of childhood neglect, suggesting that childhood neglect contributed to lower levels of postdeployment depression and PTSD symptoms through the dimension of alexithymia related to difficulty in describing feelings. These patterns of associations, for the most part, persisted even when accounting for combat exposure during recent deployments, R 2 = .42. The present results are discussed in light of study limitations and methodological considerations, and policy and clinical implications are noted. Adverse childhood experiences (ACE), including child abuse, exposure to intimate partner violence, and neglect, have a range of physical and mental health consequences (Felitti et al., 1998; Gahm, Lucekno, Retzlaff, & Fukada, 2007). Several large, well-designed studies have assessed the role of cumulative ACEs and other traumatic events as potential risk factors for mental health conditions among currently serving military personnel (

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An Interaction Model of Environmental and Psychological Factors Influencing Refugee Mental Health

Kashyap

Keegan²,

Liddell

et al. 2020

Journal of Traumatic Stress

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In this paper, we draw on empirical research and theoretical models of refugee and posttrauma mental health to propose the “Psychological Interaction with Environment (PIE) Matrix Model” of refugee mental health. This model focuses on the mental health of adult refugees and proposes that psychological factors and the external environment interact to influence mental health outcomes and functioning for individuals with refugee backgrounds. Environmental factors include adversity faced before, during, and after the migration journey, including adversity faced in a resettlement or postdisplacement environment. Psychological factors refer to psychological (i.e., cognitive and emotional) mechanisms that individuals may use to cope with adversity. We posit that individuals from refugee backgrounds are likely to show individual differences in psychological processes that may protect against or underpin the development and maintenance of psychopathology following exposure to trauma and displacement. The PIE Matrix Model proposes a framework to guide intervention by identifying key pathways by which psychological and environmental factors impact one another. We suggest that psychological interventions can be targeted according to the kind and level of support different individuals may require, based on individualized and context‐driven assessments of the interaction between environmental and psychological factors at any given point in time. This model draws on existing models of refugee adaptation and highlights the need for longitudinal and experimental research to explain the interaction between these factors and their causal impact on refugee mental health.

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The association between alexithymia and posttraumatic stress symptoms following multiple exposures to traumatic events in North Korean refugees

Cited by 50 publications

References 35 publications

Mental health status of North Korean refugees in South Korea and risk and protective factors: a 10-year review of the literature

Mental health status of North Korean refugees in South Korea and risk and protective factors: a 10-year review of the literature

The Mediating Role of Alexithymia in the Association Between Adverse Childhood Experiences and Postdeployment Mental Health in Canadian Armed Forces Personnel

An Interaction Model of Environmental and Psychological Factors Influencing Refugee Mental Health

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