Hyein Chang’s research while affiliated with Sungkyunkwan University and other places

Objective This study aimed to evaluate the reliability and validity of the Binge Eating Disorder Screener‐7 (BEDS‐7) across 42 countries and 26 languages, assessing its reliability and validity as a screening tool for binge‐eating disorder (BED) in diverse cultural contexts. Specifically, it sought to enhance early recognition of BED symptoms in primary care settings globally, contributing to a standardized framework for assessing BED. Method The International Sex Survey, a cross‐sectional online study, was conducted in 42 countries and 26 languages. A diverse community sample of 82,243 participants, aged 18 years or older, completed the BEDS‐7 and measures of sexuality, mental health, substance use, and sociodemographic characteristics. Confirmatory factor analyses and tests of measurement invariance were employed to evaluate the reliability and validity of the BEDS‐7 across languages, countries, genders, and sexual orientations. Results The BEDS‐7 demonstrated scalar factorial invariance across languages and countries, indicating consistent factor loadings and item intercepts. In contrast, the screener showed residual invariance across gender and sexual orientation groups, supporting its robustness across these demographics. Kruskal–Wallis tests revealed significant differences in BED symptoms across languages, countries, genders, and sexual orientations, with the highest BED scores observed among queer, pansexual, and gender‐diverse individuals. The BEDS‐7 also demonstrated adequate reliability (Cronbach's alpha > 0.80) and moderate criterion validity. Discussion The findings provide further evidence of the reliability and validity of the BEDS‐7 as a potential screening tool for identifying probable cases of BED globally, facilitating early intervention in primary care settings.

Sexual satisfaction can be important for overall well-being and has been described as a sexual right. Individual and cultural factors, such as gender identity and sexual orientation, may influence the ways in which individuals describe, share, or experience their sexuality. The aims of the present study were to examine the factor structure of the five-item Global Measure of Sexual Satisfaction (GMSEX) in a large sample of adults in relationships, to conduct measurement invariance tests to examine whether the GMSEX functions similarly across language-, country-, gender- and sexual orientation-based subgroups, and to evaluate its validity with sexuality and relationship-related outcomes. Results of a confirmatory analysis among 51,778 participants from 42 different countries across five continents (Mage = 32.39 years, SD = 12.52, 56.9% cisgender women) corroborated the proposed one-dimensional factor structure of the scale. Measurement invariance tests also indicated that the scale was fully invariant across gender- and sexual orientation-based subgroups, and partially invariant across language- and country-based subgroups. The GMSEX correlated negatively with masturbation frequency and relationship length and positively with the frequency of sexual activity. Our findings support the validity of the GMSEX as a short and reliable scale to measure sexual satisfaction across diverse samples.

Objective This study aimed to investigate the association between gaming time and problematic game use (PGU) within a large sample of Korean male gamers and to examine the potential moderating effects of loneliness, living alone, and household size.Methods This study employed data from 743 male gamers from the National Mental Health Survey 2021, a nationally representative survey of mental illness conducted in South Korea. Self-reported data on the average gaming time per day, severity of PGU, loneliness, living alone, and household size were used.Results Gaming time was positively associated with PGU and this relationship was significantly moderated by loneliness such that the positive effect of gaming time on PGU was greater when the levels of loneliness were high. The three-way interaction effect of gaming time, loneliness, and living alone was also significant, in that the moderating effect of loneliness on the relationship between gaming time and PGU was significant only in the living alone group. However, household size (i.e., number of housemates) did not moderate the interaction between gaming time and loneliness among gamers living with housemates.Conclusion These results suggest the importance of considering loneliness and living arrangements of male gamers, in addition to gaming time, in identifying and intervening with individuals at heightened risk of PGU.

This study examined the mechanism by which social isolation and loneliness may become associated with major psychiatric disorders using the data from a nationally representative sample of Korean adults who participated in the National Mental Health Survey of Korea 2021 (N = 5511, Mage = 48.57, SD = 15.27). Of particular interest were the roles of depressive and anxiety disorders as mediators of the association between social isolation or loneliness, and other psychiatric disorders. Social isolation, loneliness, and psychiatric conditions (i.e., depressive disorders, anxiety disorders, tobacco use disorder, alcohol use disorder, and suicidal behavior) of participants were assessed by trained interviewers administering clinical diagnostic interviews and inventories. The results indicated that only loneliness was related to depressive disorders, while both social isolation and loneliness were related to anxiety disorders. Second, only depressive disorders were associated with alcohol use disorder and suicidal behavior, while anxiety disorders were not associated with any other psychiatric disorders. Specifically, the influence of loneliness on alcohol use disorder and suicidal behavior was significantly mediated by depressive disorders. The findings suggest that social relations and affective disorders may be considered potential targets for intervention in major psychiatric disorders.

Background: This longitudinal study examined risk factors for future suicidality among North Korean defectors (NKDs) living in South Korea. Methods: The subjects were 300 NKDs registered with a regional adaptation center (the Hana Center) in South Korea. Face-to-face interviews were conducted using the North Korean version of the World Health Organization's Composite International Diagnostic Interview to diagnose mental disorders according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Subjects were also asked about sociodemographic and clinical factors at baseline. At follow-up after three years, the NKDs (n = 172 respondents) were asked to participate in an online survey, responding to self-questionnaires about suicidality. Logistic regression analyses were used to explore associations between baseline variables and future suicidality among NKDs. Results: Thirty (17.4%) of the 172 survey respondents reported suicidality at follow-up. The presence of health problems over the past year, any prior suicidality at baseline, a higher score on a trauma-related scale, and a lower score on a resilience scale at baseline were associated with greater odds of suicidality at follow-up after adjusting for age, sex, and educational level. Of all mental disorder categories, major depressive disorder, dysthymia, agoraphobia, and social phobia were also associated with significantly increased odds of suicidality at follow-up after adjusting for age, sex, educational level, and prior suicidality at baseline. Conclusion: Resilience, a previous history of suicidality, and the presence of lifetime depressive disorder and anxiety disorder should be given consideration in mental health support and suicide prevention in NKDs.

This study aimed to examine independent and interactive contributions of parenting behaviors (e.g., physical punishment, inductive discipline, warm responsiveness) and child effortful control on child externalizing problems during early and middle childhood. Participants were 241 children (123girls) of middle-income families in the U.S. who were primarily European Americans (91%) and at risk for school-age problem behaviors. Data were collected at ages 3, 6, and 10 using multiple methods, informants, and contexts. Results of hierarchical regression analyses indicated both independent and interactive influences of parenting behaviors and child effortful control on children’s externalizing behaviors. Importantly, effortful control buffered the negative influence of physical punishment, but not other parenting behaviors, such that physical punishment was associated with external behaviors at 6 years only for children with poorer effortful control abilities. The results highlight both parental discipline strategies and child effortful control as promising targets for early identification and prevention of future problem behaviors. Summary: Parenting and child effortful control have long been topics of research on child development. However, relatively little is known about the long-term effects of early parenting in the context of effortful control and the possibility that those processes may differ across different dimensions of parenting (i.e., warm responsiveness, inductive discipline, and physical punishment) Therefore, this study aimed to examine independent and interactive contributions of parenting behaviors and child effortful control on child externalizing problems during early and middle childhood. Participants were 241 children (123girls) of middle-income families who were at risk for school-age problem behaviors. Data were collected using multiple methods, informants, and contexts. Specifically, child effortful control at 3 years was measured using multiple tasks, and parenting at 3 years was assessed via maternal report during home interview. Teachers contributed ratings of child externalizing behaviors at 3, 6, and 10 years. Results indicated both independent and interactive influences of parenting behaviors and child effortful control on children’s externalizing behaviors. Importantly, effortful control buffered the negative influence of physical punishment, but not other parenting behaviors, such that physical punishment was associated with external behaviors at 6 years only for children with poorer effortful control abilities. Moreover, parents’ use of physical punishment at age 3 showed a long-lasting association with children’s problem behaviors at ages 6 and 10 years. The findings suggest that children with more advanced effortful control may be less susceptible to long-term detrimental contribution of physical punishment, although by no means they are protected from harmful effects of punitive discipline. This study provides more sophisticated explanations on the influence of early parenting and child effortful control on externalizing behaviors spanning early to middle childhood. The results also highlight different parental discipline strategies and child effortful controls as promising targets for early identification and prevention of children’s future problem behaviors in childhood.

This study investigates the longitudinal bidirectional process between interparental conflict and children’s negative emotionality, and examines whether they predict children’s later problem behaviors. The participants were 2,150 children (1,091 boys; 1,059 girls) and their parents who participated in a large longitudinal panel study on Korean families, the Panel Survey on Korean Children of the Korea Institute of Child Care and Education. In this study, data from children aged 0–9 years were included in the analysis, and the bidirectional process between interparental conflict and children’s negative emotionality was explored from 0 to 4 years of age. Statistical analysis was conducted using a non-recursive model within a structural equation modeling framework. Both interparental conflict and children’s negative emotionality positively predicted problem behaviors at nine years of age. However, the bidirectional relationship between interparental conflict and children’s negative emotionality appeared in the opposite direction to the hypothesis at age one and was not significant thereafter. In the Discussion section, suggestions for future studies along with the clinical significance of parental conflict as a target to consider in children’s interventions are addressed.