To examine the prevalence of depressive symptoms and differentiate factors associated with them in urban and rural areas by applying the Ecological Models of Health Behavior.

We employed a cross-sectional design and convenience sample of 460 female adolescents. The instruments included the Adolescent Mental-Health Problem-Behavior Questionnaire (AMPQ-II) and the Beck Depression Inventory (BDI).

Depressive symptoms were confirmed in 15.7% of urban adolescents and 22.9% of rural adolescents (p<.05). In the urban group, perception of health and stress associated with school performance were significantly associated with depressive symptoms. In the rural group, aca-demic/internet related problems and rule violations were significantly associated with depressive symptoms (p<.05). General life happiness, worry/ anxiety, and mood/suicidal ideation were common factors in both urban and rural areas (p<.05).

Multiple factors were associated with depressive symptoms, and those significant factors differed between urban and rural female youths. Accordingly, tailored approaches are required considering urban and rural differences. The approaches should include intrapersonal, interpersonal, and organizational levels of interventions.

Although research has established the existence of an association between smoking and depression among adolescents, researchers have not reached consensus on the nature of the association.

The purpose of this paper is to review the literature, to examine the nature of the relationship between smoking and depression in adolescence, and to suggest future research directions.

A literature search was conducted from the following six databases: (a) Ovid MEDLINE, (b) CINAHL, (c) PubMed Unrestricted, (d) PsycINFO, (e) ERIC, and (f) Sociological Abstracts. The combinations of the words, “depression,” “smoking,” “tobacco,” “adolescent,” and “teen” were used for keyword searches to find relevant articles.

In 47 of 57 studies, significant associations between smoking and depression were found. However, these significant relationships may either be spurious or unrelated to depression because a substantial number of studies did not adjust for confounders or did not use validated instruments to measure depression. Additionally, if the relationship is causal, its direction remains controversial. Five relationships have been suggested: (a) Depression causes smoking, (b) smoking causes depression, (c) there is a bidirectional relationship between smoking and depression, (d) smoking and depression occur due to confounders, and (e) subgroups with different relationships between the two conditions exist.

It is necessary to further explore the relationship between smoking and depression. Future research should consider the need for: (a) longitudinal research designs, (b) more accurate measurement of depression, and (c) the control of confounders between smoking and depression.

The purpose of this study was to determine the relationship between peer and parental factors and smoking behavior of adolescents in urban cities and to investigate whether there are gender differences.

A stratified and random cluster sampling design was used to obtain a cross-sectional sample of high school students in two urban cities. The sample consisted of 512 Korean adolescents (256 boys and 256 girls) aged 15 to 18 (mean age 16.7±.58). Self-reported questionnaire consisted of adolescent smoking behavior, peer smoking and alcohol use, parental smoking and alcohol use, father-mother-peer relationships and perceived social support from peers and parents. Multiple logistic regression analysis was used to examine the hypothesized model.

The findings showed that peer and parental factors accounted for 30.3% of the variance in adolescent smoking and peer smoking was most strongly associated with adolescent smoking behavior (OR=10.18). In addition, peer smoking (OR=4.71), peer alcohol use (OR=4.21), and peer relationships (OR=1.03) were significantly associated with boys' smoking behavior. In girls, peer smoking (OR=26.50) and parent smoking (OR=5.48) were significantly associated with smoking behavior.

Consistent with previous findings, peer smoking is a significant factor on adolescent smoking. Specifically, boys would be more influenced from peers than girls. Therefore, smoking prevention programs for adolescents might be focused on the social context such as, resisting to peer pressure and enhancing the self-efficacy to control.

This study was designed to identify the variables affecting male adolescents' sexual intercourse through a comprehensive analysis of individual and environmental factors.

The subjects of this descriptive survey on causal relations were 462 subjects enrolled in liberal and vocational high schools selected on a convenience sampling basis. The data collected from May-July 2002 was put to logistic regression analysis to build a forecast model. Findings: 1) Individual factors such as school record, experience seeking, non-inhibition and sexual permissiveness, 2) family factors such as parental living arrangement, 3) school factorssuch as career tract and 4) peer factors such as having a boy/girl friend were identified as significant variables forecasting sexual intercourse.

The theoretical model built on the basis of the major findings of this study will hopefully help promote a wholesome youth culture related to sexual intercourse.It is recommended that a program be developed that can help control the variables identified in this study along with a follow-up study to verify the model.

This study was to identify the effects of the predictive factors ofInternet addiction and to develop a predictive model that explains Internet addiction among adolescents in Korea.

Data was collected from 664 adolescents in Puasan and Ulsan. Data analysis was done using the SPSS 10.0 Win Program for descriptive and correlational statistics and the LISREL 8.53 Win Program for Covariance structural analysis.

The fit of the hypothetical model to the data was moderate, it was modified by deleting four paths. Compared to the hypothetical model, the revised one had a better fit to the data(χ²/df=6.50, GFI=.99, AGFI=.90, RMR=.02, NNFI=.88, NFI=.98, CN=279). Gender, friend support, and loneliness had significant direct effects on Internet addiction. The direct and indirect effect of self-esteem on Internet addiction was significant.The indirect effect of family support on Internet addiction was significant but its direct effect was insignificant. The direct and indirect effects of stress and impulsiveness on Internet addiction were significant but their total effects were insignificant.

Finally, to decrease loneliness, and to increase family support and self-esteem, an effective intervention program and education should be developed to prevent Internet addiction of adolescents.

This study was to investigate the factors influencing problem behaviors among adolescents.

The subjects for this study were 596 students in middle school in Seoul. The data was collected during the period from May to November, 2001 by use of questionnaires. The instruments used were the Child Problem Behavior list by Hong (1986), the Body Cathexis Scale by Secord and Jourard(1953), and the Beck Depression Inventory by Beck(1978). The data was analyzed by using the SPSS-Win program.

Problem behaviors showed a significant negative correlation with body image (r= -.310. p=.000) and positive correlation with depression (r=.674, p=.000). There were significant differences in the problem behavior scores of subjects according to sex, family status, economic status, and school scores. Female students were found to have a high degree of internalized problem behaviors. In addition, depression, body image, and sex were significant predictors to explain problem behaviors(47.3%). Depression, sex, grade, and school scores were significant predictors to explain externalized problem behaviors(21.9%) and depression and body image, internalized problem behaviors(51.4%).

Since predicting factors of problem behaviors among middle school students by problem behavior type and sex were different, then practitioners should consider these differences when developing programs for them.

The purpose of this study was to identify a path diagram for the influence of family, personality, sexual abuse, drug abuse, coping strategies, and aggressive impulsiveness on aggression, and to develop a sublimation program for Korean adolescent's aggression.

Data was collected by self-report questionnaires. Subjects consisted of 2,111 adolescents. A proportional stratified random sampling method was used. The major instrument was the Mental Health Questionnaire for Korean Adolescents, and the Cronbach's Alpha ranged from .54 to .95 for each subscale. Statistical methods were Chi-square, correlation analysis, and path analysis.

The strongest contributing variables on aggression were person-related aggressive impulsiveness, antisocial personality, self-injured aggressive impulsiveness, gender, sexual abuse, psychosomatic symptoms II, drug abuse, age, parent-child relationship, alcohol abuse and cognitive avoidance coping strategies in the order named. Also the author developed a multi-systemic sublimation program for Korean adolescents's aggression. The multi-systemic sublimation program involves four domains including adolescents, parents, peers and community, and has several therapeutic sub-programs for each domain.

The ecology of human development is composed of multiple, integrated levels of organization, including biological, individual-psychological, social-interpersonal, cultural, and historical levels. Therefore, this multi-systemic sublimation program will prevent and decrease the rate of aggressive behavior among Korean adolescents.

This study was conducted to understand the degree of internet addiction tendency and to find out the factors influencing this addiction tendency among middle school students in Gyeong-buk area.

A total of 450 middle school students in the Daegu and Gyeong-buk area were surveyed in this study. Data collection was conducted through the use of questionnaires.

Internet addiction among middle school students was relatively low (Average user). In the overall ratio distribution, however, students who were classified as either addicted or at risk of addiction accounted for a high percentage, 27%. A positive correlation was found between Internet addiction and Internet expectation, depression and parent control over Internet use. A negative correlation was found between Internet addiction and interpersonal relationship, parent support and self-control. Multiple regression analysis revealed that the most powerful predictor of Internet addiction tendency was depression.

Through the above results, it would be necessary to develop an Internet addiction prevention program for adolescents taking into account for the psychological factors such as depression and Internet use habits. In the future study, the need assessment will be useful for developing this prevention program.

The purpose of this study is to explore the perceptions of obesity and management behaviors of obese adolescents and their families in Korea.

Nine adolescents with moderate-degree obesity and of four their mothers of them were investigated using semi-structured interviews.

The perceptions of obesity was classified into four domains and obesity management behaviors was classified into three domains. The domains regarding the perceptions of obesity include definitions of obesity(a danger signal of health status, deviation status, symbols of growth), causes of obesity(out of balance), opinions about their obesity(contempt, negative preconception, superiority) and changes on thought and attitudes owing to obesity(shrinkage, repulsion, sustaining losses, decreased activity, decreased self-confidence, defensive behaviors). The domains regarding obesity management behaviors include attitude about the management of obesity(not having priority, optimistic view, ardent wish), management behaviors for correcting obesity(encouraging physical activity, control of diet, gathering information, trial of diet control), attitudes about performing the management behaviors for correcting obesity(inconsistency, non-autonomy, conflict).

This study helps to enhance the understanding of the perception of obesity and management behaviors of obese adolescents and their families. Futhermore, based on this understanding, effective and appropriate heath management programs can be planned and conducted.

The purpose of this study was to determine the effects of smartphone apps applying BodyThink program on BMI, percentage of body fat, skeletal muscle rate, body image, and self-esteem of adolescent girls.

Sixty-eight high school girls with a BMI of over 25kg/m² were recruited to participate in this study. Girls from four schools were divided into two groups: the experimental group, which used the smartphone apps applying BodyThink program, and the control group, which used smartphone apps and small group counseling. The experimental group received the BodyThink program 6 times, scheduled once a week, with each session lasting 40~50 minutes. Test measures were completed before and after the 6 week intervention period for all participants. Collected data was analyzed using Shapiro-Wilk test, descriptive statistics, χ² test, independent t-test, Mann-Whitney U test with the SPSS/WIN 18.0 program.

The girls in the experimental group significantly improved their results in BMI(Z=-1.67, p=.042), percentage of body fat (Z=-3.01, p=.001), skeletal muscle rate (t=-3.50, p<.001), and self-esteem (t=2.66, p=.005) after the program, compared to the girls in the control group.

Mobile applications applying psychological and emotional intervention programs have the potential to be effective alternative methods to improve the body composition and self-esteem of obese adolescent girls.

Purpose of this study was to investigate the status of depression in academic high school students and path analysis model for exploring the mediating role of entrapment to depression in relation to academic stress and perceived social support.

Measurements were four reliable questionnaires measuring academic stress, social support, entrapment, and depression. Data were collected from students in 17 high schools in Seoul.

Students (n=5,346) completing the questionnaires indicated depression & entrapment from academic stress. Depression was more prevalent in girls, those whose parents' household income was less than two million won, who did not live with father or mother or both due to divorce, separation, or death, and those who smoked or used alcohol. Entrapment was more prevalent in students similar to cases of depression and in seniors. According to the proposed path model, 48.6% of depression was explained by academic stress, social support, and entrapment. The indirect effect of entrapment as a mediator between academic stress and depression was verified and larger than the direct effect of academic stress on depression.

Considering levels of depression and entrapment demonstrated by these students, better mental health programs with diverse strategies should be developed for their psychological well-being.

This study was conducted to compare the level of depression, self-esteem and mother-adolescent (M-A) communication perceived by both mothers and adolescents between the early adolescent (E-A) group and the late adolescent (L-A) group; and to examine the actor effect and the partner effect of self-esteem and M-A communication on depression in mothers and adolescents.

Participants were 107 Kirogi families who resided in the Midwest region of the U. S. Data were collected from September, 2008 to March, 2009 using the scales of Center for Epidemiologic Studies Depression (CES-D), Self-esteem and Parent-Adolescent Communication Inventory.

Mothers in E-A group reported higher scores on depression than mothers in L-A group. Adolescents in L-A group reported higher scores on depression and lower scores on self-esteem than adolescents in E-A group. In the E-A group, mothers' self-esteem had big actor effect on mothers' depression and partner effect on adolescents' depression. In the L-A group, self-esteem of mothers and adolescents had actor effect on their depression respectively without partner effect. M-A communication of mothers influences mothers' depression negatively and adolescents' depression positively. In both group, M-A communication influences their depression with mediating effect of self-esteem.

To promote Kirogi families' mental health, programs for mothers and adolescents should be developed differently according to adolescents' development stage.

To evaluate the effects of a logotherapy program entitled 'Finding meaning in my life' for adolescents with terminal cancer.

A nonequivalent control group, non-synchronized design was conducted with a convenience sample of 44 late adolescents with terminal cancer. The experimental group (n=22) participated in the 'Finding meaning in my life' program which consisted of five-day sessions for one week. The control group (n=22) received the usual nursing care. The effects were measured using adolescent meaning in life (AMIL), and quality of life (QOL) scales. The collected data were analyzed by descriptive statistics, Chi-square, and t-test using SPSS/PC 17.0 program.

There were significant differences in AMIL (t=3.36, p<.05) and QOL (t=2.67, p<.05) between the experimental and control groups.

Logotherapy is effective in improving the meaning in life and quality of life of late adolescents with terminal cancer, and can be used to prevent existential distress.

This study was done to examine the effects of aromatherapy on stress and stress responses in adolescents.

A two-group cross-over design was used for this study. The experimental treatment was aroma essential oil inhalation and the placebo treatment was carrier oil inhalation using a necklace. The sample included 36 female high school students. Fisher's exact test, t-test, and paired t-test using SPSS/WIN program were used to analyze the data.

Stress levels were significantly lower when the students received the aroma treatment compared to when they received the placebo treatment. The stress responses except salivary IgA levels were significantly lower when the students received the aroma treatment.

Aroma inhalation could be a very effective stress management method for high school students. Therefore, it is recommended that this program be used in clinical practice as an effective nursing intervention for high school students.

This correlational study was performed to identify the impacts of maternal child rearing attitudes on the menstrual attitudes and the determinants of positive menstrual attitudes in female middle school students.

With convenience sampling, 198 middle school female students were recruited living in one major city and its surrounding areas in Korea. Data was collected using a self administered questionnaire including menstrual attitudes and maternal child rearing attitudes from April 1 to July 15, 2008.

Among the Maternal child rearing attitudes, affectionate, achievement oriented and rational attitudes had positive correlations to a positive menstrual attitude, and an autonomous attitude had a negative correlation to a negative menstrual attitude. As determinants of positive menstrual attitudes, feeling of menarche, mother's response at first menstruation, and rational maternal child rearing attitudes were delineated and their explained variance for a positive menstrual attitude was 18.5%. There was no difference on menstrual attitudes by K clustering in terms of maternal child rearing attitudes.

These results support the critical role of the mother. Especially desirable maternal child rearing attitudes in relation to a positive menstrual attitude would be affectionate, achievement oriented and rational for early adolescent girls. In further studies, considerations are needed for menstruation related education and research for early adolescents and active involvement of the mother & daughter together.

This study was done to investigate cybersex addiction, gender egalitarianism, sexual attitude and the allowance of sexual violence in adolescents, and to identify the relationships among these variables.

The participants were 690 students from two middle schools and three high schools in Seoul. Data was collected through selfreport questionnaires which included a cybersex addiction index, a Korean gender egalitarianism scale for adolescents, a sexual attitude scale and a scale for the allowance of sexual violence. The data was analyzed using the SPSS program.

Of the adolescents, 93.3% reported not being addicted to cybersex, 5.7% reported being mildly addicted, 0.4% moderately addicted, and 0.6% severely addicted. Cybersex addiction, gender egalitarianism, sexual attitude and the allowance of sexual violence in adolescents were different according to general characteristics. Cybersex addiction of adolescents correlated with gender egalitarianism, sexual attitude and the allowance of sexual violence.

Gender egalitarianism, sexual attitude and the allowance of sexual violence in adolescents were influenced by cybersex addiction. Therefore, nursing interventions for prevention and management of cybersex addiction need to be developed and provided to adolescents. In addition, varied programs for teaching sexuality to adolescents should be developed and provided.

This study was to explore the prevalence of alcohol experiences and to identify the expectancy on the effects of alcohol and alcohol knowledge in early adolescents.

The cross-sectional survey of 1854 students from seven middle schools in one district of Seoul was conducted by convenience sampling. Alcohol experience and early onset of alcohol use were measured by the Youth Risk Behavior Survey. Alcohol expectancy was measured by an Alcohol Effects Questionnaire.

Over sixty five percent of adolescents reported that they had previous drinking experiences. The participants with no alcohol drinking experience had a lower level of alcohol knowledge than those with experience(t=2.73, p=.007). In expectancy on effects of alcohol, girls had a more positive alcohol expectation than boys(t=-2.54, p=.011). Alcohol knowledge negatively correlated with alcohol expectancy(r=-.40 p=.000). In regression of alcohol expectancy, gender and alcohol knowledge were significant predictors explaining 17%.

The results support that alcohol expectancy is an important link with early drinking experiences and alcohol knowledge, focusing on the importance of gender differences. Therefore, an alcohol prevention program in early adolescence is needed and should be focused on multidimensionality of the alcohol expectancy with developmental and psychosocial factors for early adolescents.