Trauma and Depression among North Korean Refugees: The Mediating Effect of Negative Cognition

Abstract

North Korean refugees experience adaptation difficulties, along with a wide range of psychological problems. Accordingly, this study examined the associations between early traumatic experiences, negative automatic thoughts, and depression among young North Korean refugees living in South Korea. Specifically, we examined how different factors of negative automatic thoughts would mediate the relationship between early trauma and depressive symptoms. A total of 109 North Korean refugees aged 13–29 years were recruited from two alternative schools. Our path analysis indicated that early trauma was positively linked with thoughts of personal failure, physical threat, and hostility, but not with thoughts of social threat. The link with depressive symptoms was only significant for thoughts of personal failure. After removing all non-significant pathways, the model revealed that early traumatic experiences were positively associated with depressive symptoms (ß = 0.61, 95% CI = 0.48–0.73) via thoughts of personal failure (ß = 0.17, 95% CI = 0.08–0.28), as well as directly (ß = 0.44, 95% CI = 0.27–0.59). Interventions that target negative cognitions of personal failure may be helpful for North Korean refugees at risk of depression.

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]…”

“…One study examined the relationship between early traumatic experiences, negative automatic thoughts, and depression in young NKDs (N = 109, 13-29 years) living in the Republic of Korea. Early traumatic experiences were positively associated with depressive symptoms both directly and through thoughts of personal failure [41]. Interventions that target negative cognitions of personal failure could decrease the risk of depression in NKDs.…”

Health of Refugees and Migrants—Where Do We Stand and What Directions Should We Take?

“…Prevention and treatment are essential. High rates of mental health issues are likely impacted by the trauma experienced during crises, travel time to the host country and the many different challenges related to migrant experiences, including separation from family, difficulties in proper use of the health services as a result of cultural differences, lack of knowledge of the new health system, and language barriers [20,21,22,23,24,25].…”

“…Migrants face traumatic events that impact their mental health, with various risk factors, including association between early trauma and depression symptoms and feelings of personal failure [20].…”

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

“…According to a report by the Ministry of Unification (September 2020) [1], there are 33,718 North Korean refugees (NKRs) living in South Korea. Among them, a significant proportion, 40% (13,367), are adolescents and young adults aged 10-29. North Korean refugee youths (NKRYs) are likely to have experienced various physical and psychological traumas in North Korea and are known to experience various direct and indirect traumas from the process of defection to South Korea [2,3].…”