Colliding Traumas and Unexpected Outcomes: Examining Complex Relationships Between Sexual Violence,Intersectional Discrimination,and Suicidal Thoughts

Abstract

Suicide is a serious and growing concern in South Korean adolescents. Poly-victimization (i.e., having experienced multiple types of victimization) is a risk factor for increased levels of suicidal ideation (SI) among adolescents. The current study examined the interactive effects of sexual victimization and intersectional discrimination on SI using a national sample of Korean adolescents. Moderation analysis showed that intersectional discrimination moderated the relationship between sexual violence and SI. Specifically, the relationship between sexual victimization and SI was significant and positive in low (−1 SD), medium (mean), and high (+1 SD) levels of intersectional discrimination. In addition, the results indicated that adolescents who experienced sexual victimization in the past year and experienced high levels of intersectional discrimination had the highest chance of experiencing frequent SI. However, the significant negative interaction results suggest that the difference in SI in those who experienced sexual victimization in the past year and those who did not appeared smaller at higher levels of intersectional discrimination. These findings highlight the complexity of poly-victimization and the importance of the need for more nuanced approaches in mental health interventions for individuals affected by multiple forms of victimization.

Keywords

poly-victimization sexual victimization discrimination suicidal ideation Korean adolescents youth

Get full access to this article

View all access options for this article.

References

Allen

A. R.

(2022). Meaninglessness, depression and suicidality: A review of the evidence. In Menzies

R. G.

Menzies

R. E.

Dingle

G. A.

(Eds.), Existential concerns and cognitive-behavioral procedures (pp. 261–281). Springer International Publishing. https://doi.org/10.1007/978-3-031-06932-1_16

American Psychological Association. (2024, May 16). Discrimination: What it is and how to cope. https://www.apa.org/topics/racism-bias-discrimination/types-stress

Amnesty International. (2023). South Korea submission to the UN human rights committee (ASA25/7164/2023). https://www.amnesty.org/en/wp-content/uploads/2023/09/ASA2571642023ENGLISH.pdf

Amnesty International International Secretariat. (2023). Republic of Korea: Discrimination persisting and left unaddressed Amnesty International: Submission to the 42nd session of the UPR Working Group, 26 January 2023. https://www.amnesty.org/en/wp-content/uploads/2022/08/ASA2557612022ENGLISH.pdf

Bowleg

(2012). The problem with the phrase women and minorities: Intersectionality—An important theoretical framework for public health. American Journal of Public Health, 102(7), 1267–1273.

Brauer

Ranger

Ziegler

(2023). Confirmatory factor analyses in psychological test adaptation and development: A nontechnical discussion of the WLSMV estimator [Editorial]. Psychological Test Adaptation and Development, 4(1), 4–12. https://doi.org/10.1027/2698-1866/a000034

Brooks

V. R.

(1981). Minority stress and lesbian women. Lexington Books.

Byun

Kim

K.-K.

Park

(2012). School choice and educational inequality in South Korea. Journal of School Choice, 6(2), 158–183. https://doi.org/10.1080/15582159.2012.673854

Centers for Disease Control and Prevention. (2024, October 4). Types of discrimination. Office of Equal Employment Opportunity and Workplace Equity. https://www.cdc.gov/oeeowe/policies/discrimination.html

10.

Chen

(2022). Parental migration and children’s exposure to polyvictimization in rural China. Journal of Interpersonal Violence, 37(19–20), 17429–17453. https://doi.org/10.1177/08862605211028015

11.

Choi

K.H.

Kim

D.H.

(2015). Trend of suicide rates according to urbanity among adolescents by gender and suicide method in Korea 1997–2012. International Journal of Environmental Research and Public Health, 12(5), 5129–5142. https://doi.org/10.3390/ijerph120505129

12.

Coimbra

B. M.

Hoeboer

C. M.

Yik

Mello

A. F.

Mello

M. F.

Olff

(2022). Meta-analysis of the effect of racial discrimination on suicidality. SSM–Population Health, 20, Article 101283. https://doi.org/10.1016/j.ssmph.2022.101283

13.

Cyrus

(2017). Multiple minorities as multiply marginalized: Applying the minority stress theory to LGBTQ people of color. Journal of Gay & Lesbian Mental Health, 21(3), 194–202. https://doi.org/10.1080/19359705.2017.1320739

14.

Davis

J. P.

Dworkin

E. R.

Helton

Prindle

Patel

Dumas

T. M.

Miller

(2019). Extending poly-victimization theory: Differential effects of adolescents’ experiences of victimization on substance use disorder diagnoses upon treatment entry. Child Abuse & Neglect, 89, 165–177. https://doi.org/10.1016/j.chiabu.2019.01.009

15.

De Oliveira Ramos

Goes

E. F.

Ferreira

A. J. F

. (2022). Intersection of race and gender in self-reports of violent experiences and polyvictimization by young girls in Brazil. Journal of Racial and Ethnic Health Disparities, 9(4), 1506–1516. https://doi.org/10.1007/s40615-021-01089-2

16.

Ding

S. L.

Kim

Kang

(2020). Imagined homogeneity: Identity and geopolitical and geoeconomic influences in the linguistic landscape of Seoul. Lingua, 244, 102851. https://doi.org/10.1016/j.lingua.2020.102851

17.

Donath

Bergmann

M. C.

Kliem

Hillemacher

Baier

(2019). Epidemiology of suicidal ideation, suicide attempts, and direct self-injurious behavior in adolescents with a migration background: A representative study. BMC Pediatrics, 19(1), 45. https://doi.org/10.1186/s12887-019-1404-z

18.

Dworkin

E. R.

DeCou

C. R.

Fitzpatrick

(2022). Associations between sexual assault and suicidal thoughts and behavior: A meta-analysis. Psychological Trauma: Theory, Research, Practice, and Policy, 14(7), 1208–1211. https://doi.org/10.1037/tra0000570

19.

Finkelhor

Ormrod

R. K.

Turner

H. A.

(2007). Polyvictimization and trauma in a national longitudinal cohort. Development and Psychopathology, 19(1), 149–166. https://doi.org/10.1017/S0954579407070083

20.

Finkelhor

Turner

Hamby

Ormrod

(2011). Polyvictimization: Children’s exposure to multiple types of violence, crime, and abuse. U.S. Department of Justice: Office of Juvenile Justice and Delinquency Prevention. https://www.ojp.gov/pdffiles1/ojjdp/235504.pdf

21.

Flores

M. W.

Sharp

Carson

N. J.

Cook

B. L.

(2023). Estimates of major depressive disorder and treatment among adolescents by race and ethnicity. JAMA Pediatrics, 177(11), 1215. https://doi.org/10.1001/jamapediatrics.2023.3996

22.

Forrest

L. N.

Beccia

A. L.

Exten

Gehman

Ansell

E. B.

(2023). Intersectional prevalence of suicide ideation, plan, and attempt based on gender, sexual orientation, race and ethnicity, and rurality. JAMA Psychiatry, 80(10), 1037. https://doi.org/10.1001/jamapsychiatry.2023.2295

23.

Frost

D. M.

Meyer

I. H.

(2023). Minority stress theory: Application, critique, and continued relevance. Current Opinion in Psychology, 51, Article 101579. https://doi.org/10.1016/j.copsyc.2023.101579

24.

González-Castro

J. L.

Ubillos-Landa

Puente-Martínez

Gracia-Leiva

Arias-Rodriguez

G. M.

Páez-Rovira

(2021). Posttraumatic stress symptoms among polyvictimized women in the Colombian armed conflict: The mediating role of social acknowledgment. Frontiers in Psychology, 12, Article 741917. https://doi.org/10.3389/fpsyg.2021.741917

25.

Gustafsson

P. E.

Nilsson

Svedin

C. G.

(2009). Polytraumatization and psychological symptoms in children and adolescents. European Child & Adolescent Psychiatry, 18(5), 274–283. https://doi.org/10.1007/s00787-008-0728-2

26.

Haahr-Pedersen

Ershadi

A. E.

Hyland

Hansen

Perera

Sheaf

Bramsen

R. H.

Spitz

Vallières

(2020). Polyvictimization and psychopathology among children and adolescents: A systematic review of studies using the Juvenile Victimization Questionnaire. Child Abuse & Neglect, 107, Article 104589. https://doi.org/10.1016/j.chiabu.2020.104589

27.

Hamby

Taylor

Jones

Mitchell

K. J.

Turner

H. A.

Newlin

(2018). From poly-victimization to poly-strengths: Understanding the web of violence can transform research on youth violence and illuminate the path to prevention and resilience. Journal of Interpersonal Violence, 33(5), 719–739. https://doi.org/10.1177/0886260517744847

28.

Han

H. S.

(2004). Women’s life during the chosŏn dynasty. International Journal of Korean History, 6(1), 113-160.

29.

Hankyoreh. (2022, July). 7 in 10 Koreans report experiencing mental health issues, a rising trend. https://english.hani.co.kr/arti/english_edition/e_national/1147909.html

30.

Harvard International Review. (2022, March 11). The struggle of mental health care delivery in South Korea and Singapore. . https://hir.harvard.edu/the-struggle-of-mental-health-care-delivery-in-south-korea-and-singapore/

31.

Hong

J. S.

Kim

Lee

J. M.

Saxon

Thornberg

(2023). Pathways from polyvictimization to offline and online sexual harassment victimization among south korean adolescents. Archives of Sexual Behavior, 52(7), 2779–2788. https://doi.org/10.1007/s10508-023-02569-8

32.

Ilic

(2022). Worldwide suicide mortality trends (2000–2019): A joinpoint regression analysis. World Journal of Psychiatry, 12(8), 1044–1060. https://doi.org/10.5498/wjp.v12.i8.1044

33.

Jaeeun

(2023, March 15). [New neighbors] S. Korea needs anti-discrimination law to be an open community for immigrants. The Korea Herald. https://www.koreaherald.com/view.php?ud=20230315000559

34.

Jang

Lee

Kim

(2022). Suicide rate and social environment characteristics in South Korea: The roles of socioeconomic, demographic, urbanicity, general health behaviors, and other environmental factors on suicide rate. BMC Public Health, 22(1), 410. https://doi.org/10.1186/s12889-022-12843-4

35.

Jouriles

E. N.

Sitton

M. J.

Rosenfield

Lui

P. P.

McDonald

(2024). Interpersonal violence, racial discrimination, and mental health symptoms among adolescents of color in the juvenile-justice system. Journal of Interpersonal Violence, 39(13–14), 3158–3183. https://doi.org/10.1177/08862605241227981

36.

Jung

H. W.

(2023). A new variation of modern prejudice: Young Korean men’s anti-feminism and male-victim ideology. Frontiers in Psychology, 14, Article 1230577. https://doi.org/10.3389/fpsyg.2023.1230577

37.

Kang

H. K.

Burton

D. L.

(2014). Effects of racial discrimination, childhood trauma, and trauma symptoms on juvenile delinquency in African American incarcerated youth. Journal of Aggression, Maltreatment & Trauma, 23(10), 1109–1125.

38.

Kang

E.-H.

Hyun

M. K.

Choi

S. M.

Kim

J.-M.

Kim

G.-M.

Woo

J.-M.

(2015). Twelve-month prevalence and predictors of self-reported suicidal ideation and suicide attempt among Korean adolescents in a web-based nationwide survey. Australian & New Zealand Journal of Psychiatry, 49(1), 47–53. https://doi.org/10.1177/0004867414540752

39.

Kenny

D. A.

Kaniskan

McCoach

D. B.

(2015). The performance of RMSEA in models with small degrees of freedom. Sociological Methods & Research, 44(3), 486–507.

40.

Kim

A. M.

(2020). Factors associated with the suicide rates in Korea. Psychiatry Research, 284, Article 112745. https://doi.org/10.1016/j.psychres.2020.112745

41.

Kim

(2018). Elusive belonging: Marriage immigrants and “multiculturalism” in rural South Korea. University of Hawai’i Press. https://doi.org/10.21313/hawaii/9780824869816.001.0001

42.

Kim

(2024). Online gender-based hate speech in South Korea. International Review of Law, Computers & Technology, 38(2), 140–149. https://doi.org/10.1080/13600869.2023.2295093

43.

Korea Sexual Violence Relief Center. (n.d.). https://www.sisters.or.kr/

44.

Korea Times . (2023, March 7). Foreign residents struggle with Korea’s “impossible” body standards. https://www.koreatimes.co.kr/www/nation/2024/05/113_346561.html

45.

Kwak

(2021). The influence of Western culture on plastic surgery consumption in South Korea. Journal of Gynecology and Women’s Health, 21(2), Article 336059. https://doi.org/10.19080/JGWH.2021.21.556059

46.

M. T. H.

Holton

Romero

Fisher

(2018). Polyvictimization among children and adolescents in low- and lower-middle-income countries: A systematic review and meta-analysis. Trauma, Violence, & Abuse, 19(3), 323–342. https://doi.org/10.1177/1524838016659489

47.

Lee

G.-Y.

Choi

Y.-J.

(2015). Association of school, family, and mental health characteristics with suicidal ideation among Korean adolescents: Suicidal ideation in Korean adolescents. Research in Nursing & Health, 38(4), 301–310. https://doi.org/10.1002/nur.21661

48.

Lee

Son

Yoon

Kim

S. S.

(2017). Lookism hurts: Appearance discrimination and self-rated health in South Korea. International Journal for Equity in Health, 16(1), 204. https://doi.org/10.1186/s12939-017-0678-8

49.

Lee

(2022). Intersectional discrimination, bullying/cyberbullying, and suicidal ideation among South Korean youths: A latent profile analysis (LPA). International Journal of Adolescence and Youth, 27(1), 325–336. https://doi.org/10.1080/02673843.2022.2095214

50.

Lee

M. S.

Jhone

J. H.

Kim

J. B.

Kweon

Y. S.

Hong

H. J.

(2022). Characteristics of Korean children and adolescents who die by suicide based on teachers’ reports. International Journal of Environmental Research and Public Health, 19(11), Article 6812. https://doi.org/10.3390/ijerph19116812

51.

Lee

S. U.

I. H.

Jeon

H. J.

Roh

(2017). Suicide rates across income levels: Retrospective cohort data on 1 million participants collected between 2003 and 2013 in South Korea. Journal of Epidemiology, 27(6), 258–264. https://doi.org/10.1016/j.je.2016.06.008

52.

Lee

(2023). Korea’s middle class: Current status and policy challenges (KDI Focus, 119). Korea Development Institute.

53.

Lei

Velez

B. L.

Seoud

J. M.

Motulsky

W. N.

(2022). A test of minority stress theory with Asian Americans. The Counseling Psychologist, 50(7), 1009–1038. https://doi.org/10.1177/00110000221107554

54.

C.-H.

(2016). Confirmatory factor analysis with ordinal data: Comparing robust maximum likelihood and diagonally weighted least squares. Behavior Research Methods, 48(3), 936–949. https://doi.org/10.3758/s13428-015-0619-7

55.

L. W.

Gee

G. C.

Dong

(2018). Association of self-reported discrimination and suicide ideation in older Chinese Americans. The American Journal of Geriatric Psychiatry, 26(1), 42–51. https://doi.org/10.1016/j.jagp.2017.08.006

56.

Madubata

Spivey

L. A.

Alvarez

G. M.

Neblett

E. W.

Prinstein

M. J.

(2022). Forms of racial/ethnic discrimination and suicidal ideation: A prospective examination of African-American and Latinx youth. Journal of Clinical Child & Adolescent Psychology, 51(1), 23–31. https://doi.org/10.1080/15374416.2019.1655756

57.

Marzetti

McDaid

O’Connor

(2022). “Am I really alive?”: Understanding the role of homophobia, biphobia and transphobia in young LGBT+ people’s suicidal distress. Social Science & Medicine, 298, Article 114860. https://doi.org/10.1016/j.socscimed.2022.114860

58.

Meyer

I. H.

(2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological bulletin, 129(5), 674–697. https://doi.org/10.1037/0033-2909.129.5.674

59.

Ministry of Data and Statistics. (2021). Causes of death statistics in 2021. https://www.kostat.go.kr/board.es?mid=a20101000000&bid=11773&act=view&list_no=421206

60.

Morlat

Lei

C. W.

Tse

S. Y.

Guerra

(2022). Polyvictimization and depressive symptomatology in adolescents: Evaluation of the role of school social climate. Children & Schools, 44(3), 163–171. https://doi.org/10.1093/cs/cdac009

61.

National Youth Policy Institute. (n.d.). Children’s and youth rights survey. https://www.nypi.re.kr/archive/board?menuId=MENU00333

62.

OECD. (2009). Society at a glance 2009: OECD social indicators. https://doi.org/10.1787/soc_glance-2008-en

63.

OECD. (2015). Health at a glance 2015: OECD indicators. https://doi.org/10.1787/health_glance-2015-en

64.

(2021, January 5). South Korea: Child’s rapist’s release sparks demand for justice. BBC. https://www.bbc.com/news/world-asia-55465099

65.

Pager

Shepherd

(2008). The sociology of discrimination: Racial discrimination in employment, housing, credit, and consumer markets. Annual Review of Sociology, 34(1), 181–209. https://doi.org/10.1146/annurev.soc.33.040406.131740

66.

Palermo

Pereira

Neijhoft

Bello

Buluma

Diem

Aznar Daban

Fatoumata Kaloga

Islam

Kheam

Lund-Henriksen

Maksud

Maternowska

M. C.

Potts

Rottanak

Samnang

Shawa

Yoshikawa

Peterman

(2019). Risk factors for childhood violence and polyvictimization: A cross-country analysis from three regions. Child Abuse & Neglect, 88, 348–361. https://doi.org/10.1016/j.chiabu.2018.10.012

67.

Pinto-Cortez

Guerra Vio

Barocas

Pereda

(2022). Victimization and poly-victimization in a national representative sample of children and youth: The case of chile. Journal of Aggression, Maltreatment & Trauma, 31(1), 3–21. https://doi.org/10.1080/10926771.2020.1796873

68.

Polanco-Roman

Miranda

Hien

Anglin

D. M.

(2021). Racial/ethnic discrimination as race-based trauma and suicide-related risk in racial/ethnic minority young adults: The explanatory roles of stress sensitivity and dissociation. Psychological Trauma: Theory, Research, Practice, and Policy, 13(7), 759–767. https://doi.org/10.1037/tra0001076

69.

Price

Hill

N. E.

Liang

Perella

(2019). Teacher relationships and adolescents experiencing identity-based victimization: What matters for whom among stigmatized adolescents. School Mental Health, 11(4), 790–806. https://doi.org/10.1007/s12310-019-09327-z

70.

Radtke

S. R.

Wretman

C. J.

Fraga Rizo

Franchino-Olsen

Williams

D. Y.

Chen

W.-T.

Macy

R. J.

(2024). A systematic review of conceptualizations and operationalizations of youth polyvictimization. Trauma, Violence, & Abuse, 25(4), 2721–2734. https://doi.org/10.1177/15248380231224026

71.

Raykov

Marcoulides

G. A.

Patelis

(2013). Saturated versus just identified models: A note on their distinction. Educational and Psychological Measurement, 73(1), 162–168. https://doi.org/10.1177/0013164412457367

72.

Sabina

Straus

M. A.

(2008). Polyvictimization by dating partners and mental health among U. S. College students. Violence and Victims, 23(6), 667–682. https://doi.org/10.1891/0886-6708.23.6.667

73.

Sarno

E. L.

Newcomb

M. E.

Whitton

S. W.

(2023). Minority stress and intimate partner violence among sexual and gender minorities assigned female at birth. Psychology of Violence, 13(3), 239–247. https://doi.org/10.1037/vio0000466

74.

Schwartz

Kaminer

Hardy

Nöthling

Seedat

(2021). Gender differences in the violence exposure types that predict PTSD and depression in adolescents. Journal of Interpersonal Violence, 36(17–18), 8358–8381. https://doi.org/10.1177/0886260519849691

75.

Seaton

E. K.

Douglass

(2014). School diversity and racial discrimination among African-American adolescents. Cultural Diversity & Ethnic Minority Psychology, 20(2), 156–165. https://doi.org/10.1037/a0035322

76.

Seng

(2024). Rape culture in media coverage: An analysis of the “Nth Room” scandal [Dissertation]. https://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-71427

77.

Statistics Korea. (2023). Korean Social Trends 2023. Statistics Research Institute.

78.

Suárez-Soto

Pereda

Guilera

(2019). Poly-victimization, resilience, and suicidality among adolescents in child and youth-serving systems. Children and Youth Services Review, 106, 104500. https://doi.org/10.1016/j.childyouth.2019.104500

79.

Supreme Court of Korea . (n.d.). https://www.scourt.go.kr

80.

Thompson

Simmonds

(2012). Rape sentencing study: statutory sentencing for rape, defilement, and sexual assault in East, Central, and Southern Africa (Legislative review). Population Council. https://www.svri.org/sites/default/files/attachments/2020-01-06/A%20review%20of%20statutory%20sentencing%20provisions%20for%20rape%20defilement%20and%20sexual%20assault%20in%20East%20Central%20and%20Southern%20Africa.pdf

81.

United States Department of State. (n.d.). 2023 Country reports on human rights practices: Japan. Bureau of Democracy, Human Rights, and Labor. https://www.state.gov/reports/2023-country-reports-on-human-rights-practices/japan/

82.

United States Sentencing Commission. (2019, October 23). Sexual abuse. https://www.ussc.gov/research/quick-facts/sexual-abuse

83.

Westley

Choe

(2007). How does son preference affect populations in Asia?. East-West Center. https://www.eastwestcenter.org/sites/default/files/private/api084.pdf

84.

World Health Organization. (n.d.). Suicide worldwide in 2019: Global health estimates. https://iris.who.int/bitstream/handle/10665/341728/9789240026643-eng.pdf?sequence=1

85.

Wyman Battalen

Mereish

Putney

Sellers

C. M.

Gushwa

McManama O’Brien

K. H

. (2021). Associations of discrimination, suicide ideation severity and attempts, and depressive symptoms among sexual and gender minority youth. Crisis, 42(4), 301–308. https://doi.org/10.1027/0227-5910/a000718

86.

Yoo

(2021). The Korean Survey on the rights of children and the youth advanced report (No. 21-R10-1; Research on the Implementation of the International Convention on Children and Youth’s Rights). National Youth Policy Institute.

87.

(2020). Gendered nationalism in practice: An intersectional analysis of migrant integration policy in South Korea. Gender & Society, 34(6), 976–1004. https://doi.org/10.1177/0891243220965916