Objective: This study evaluated the Thank You, Sorry, Love (TSL) program's effect on child abuse and the levels of oxidative stress hormone (cortisol, dehydroepiandrosterone sulfate) among North Korean refugee parents. Method: The participants, North Korean refugees (N = 45), were assigned to an experimental group with 10 sessions of TSL program intervention (n = 15), a comparison group with 10 sessions of Program A intervention (n = 15), or a control group with no intervention (n = 15). Effectiveness tests included a pre-test, post-test, and 4-week follow-up test. Results: Child abuse scores and cortisol levels differed significantly between the groups in the post-test and follow-up tests. It was confirmed that the group in the TSL program showed statistically significant improvements in child abuse and cortisol compared to the other groups. Conclusion: The TSL program can be used as a practical intervention to prevent child abuse in North Korean refugee families.
AiyerS. M.HeinzeJ. E.MillerA. L.StoddardS. A.ZimmermanM. A. (2014). Exposure to violence predicting cortisol response during adolescence and early adulthood: Understanding moderating factors. Journal of Youth and Adolescence, 43(7), 1066–1079. https://doi.org/10.1007/s10964-014-0097-8
2.
BanksT.DabbsJ. (1996). Salivary testosterone and cortisol in a delinquent and violent urban subculture. Journal of Social Psychology, 136(1), 49–56. https://doi.org/10.1080/00224545.1996.9923028
3.
BerryJ. W. (2017). Theories and models of acculturation. In S. Schwartz & J. Unger (Eds.), The Oxford handbook of acculturation and health (pp. 15–28). Oxford University Press.
4.
BöhnkeR.BertschK.KrukM. R.RichterS.NaumannE. (2010). Exogenous cortisol enhances aggressive behavior in females, but not in males. Psychoneuroendocrinology, 35(7), 1034–1044. https://doi.org/10.1016/j.psyneuen.2010.01.004
5.
BoudareneM.LegrosJ. J.Timsit-BerthierM. (2002). Study of the stress response: Role of anxiety, cortisol and DHEAs. L’Encephale, 28(2), 139–146.
6.
Brewer-SmythK.BurgessA. W.ShultsJ. (2004). Physical and sexual abuse, salivary cortisol, and neurologic correlates of violent criminal behavior in female prison inmates. Biological Psychiatry, 55(1), 21–31. https://doi.org/10.1016/s0006-3223(03)00705-4
7.
ChoiK.KimJ. Y. (2018). Evaluation of the TSL® program for parents of children with cancer. Research on Social Work Practice, 28(2), 146–153. https://doi.org/10.1177/1049731516637121
8.
ChoiS.LeeI.SongI.KwonO. J.ParkK.HongH.SungK. K.LeeS. (2014). Method of saliva collection for salivary cortisol measurement. Korean Journal of Oriental Physiology & Pathology, 28(2), 223–232.
9.
ChoiY.HeM.HarachiT. W. (2008). Intergenerational cultural dissonance, parent–child conflict and bonding, and youth problem behaviors among Vietnamese and Cambodian immigrant families. Journal of Youth and Adolescence, 37(1), 85–96. https://doi.org/10.1007/s10964-007-9217-z
10.
ChoiY.LimS. Y.JunJ. Y.LeeS. H.YooS. Y.KimS., , GwakA. RKimJ. C.LeeY. J.KimS. J. (2017). The effect of traumatic experiences and psychiatric symptoms on the life satisfaction of North Korean refugees. Psychopathology, 50(3), 203–210. https://doi.org/10.1159/000468544
11.
ChungY. K.KimH. J. (2014). The relationship between traumatic incidents and social adaptation among North Korean refugees: Focusing on the mediating effect of complex post-traumatic stress disorder. Korean Journal of Social Welfare Studies, 45(4), 143–167. https://doi.org/10.16999/kasws.2014.45.4.143
12.
CohenJ. (2013). Statistical power analysis for the behavioral sciences (2nd ed). Routledge.
13.
DickersonS. S.KemenyM. E. (2004). Acute stressors and cortisol responses: A theoretical integration and synthesis of laboratory research. Psychological Bulletin, 130(3), 355–391. https://doi.org/10.1037/0033-2909.130.3.355
14.
EmeryC. R.LeeJ. Y.KangC. (2015). Life after the pan and the fire: Depression, order, attachment, and the legacy of abuse among North Korean refugee youth and adolescent children of North Korean refugees. Child Abuse & Neglect, 45, 90–100. https://doi.org/10.1016/j.chiabu.2015.02.002
15.
FaulF.ErdfelderE.BuchnerA.LangA.-G. (2009). Statistical power analyses using G*power 3.1: Tests for correlation and regression analyses. Behavior Research Methods, 41(4), 1149–1160. https://doi.org/10.3758/BRM.41.4.1149
16.
GellesR. J. (1997). Intimate violence in families (3rd ed.). Sage Publications, Inc.
17.
GordisE. B.GrangerD. A.SusmanE. J.TrickettP. K. (2006). Asymmetry between salivary cortisol and α-amylase reactivity to stress: Relation to aggressive behavior in adolescents. Psychoneuroendocrinology, 31(8), 976–987. https://doi.org/10.1016/j.psyneuen.2006.05.010
18.
HayD. F. (2005). The beginnings of aggression in infancy. In R. Tremblay & W. Hartup (Eds.), Developmental origins of aggression (pp. 107–132). The Guilford Press.
19.
HongS. A. (2013). The North Korean female defectors and their settlement tasks: From the family perspective. The Korean Journal of Unification Affairs, 25(2), 173–205.
20.
JangS.SeoM. S.WooJ. (2016). The correlations between cortisol, dehydroepiandrosterone sulfate (DHEAS) and severity of depressive symptoms. Journal of the Korean Society of Biological Therapies in Psychiatry, 22(2), 93–100.
21.
JeonW. T.YuS. E.ChoY. A.EomJ. S. (2008). Traumatic experiences and mental health of North Korean refugees in South Korea. Psychiatry Investigation, 5(4), 213–220. https://doi.org/10.4306/pi.2008.5.4.213
KangS. J. (2014). Experimental design and analysis of variance. Kyoyookbook.
24.
KhawajaN. G.WhiteK. M.SchweitzerR.GreensladeJ. (2008). Difficulties and coping strategies of Sudanese refugees: A qualitative approach. Transcultural Psychiatry, 45(3), 489–512. https://doi.org/10.1177/1363461508094678
25.
KimH. J.KimJ. Y.KimD. G. (2016). “Thank you, sorry, love” (TSL) therapy with North Korean refugee women: A pilot study. Research on Social Work Practice, 26(7), 816–824. https://doi.org/10.1177/1049731515570137
26.
KimJ. Y. (2014). TSL family therapy and family welfare. Hak JI Sa.
27.
KimJ. Y.KimD. G.NamS. I. (2012). TSL family therapy followed by improved marital quality and reduced oxidative stress. Research on Social Work Practice, 22(4), 389–399. https://doi.org/10.1177/1049731512442104
28.
KimS.YangO. K. (2015). Qualitative study on the experiences of child care and education among North Korean refugee mothers. Social Work Practice & Research, 12(1), 5–38.
29.
KochF. S.LudvigssonJ.SepaA. (2010). Parents’ psychological stress over time may affect children’s cortisol at age 8. Journal of Pediatric Psychology, 35(9), 950–959. https://doi.org/10.1093/jpepsy/jsp132
30.
KumpferK. L.WhitesideH. O.GreeneJ. A.AllenK. C. (2010). Effectiveness outcomes of four age versions of the strengthening families program in statewide field sites. Group Dynamics: Theory, Research, and Practice, 14(3), 211–229. https://doi.org/10.1037/a0020602
31.
LeeD. E. (2016). A study on the effect of TSL family program for improving mental health and self-control of juvenile offenders: Focusing on parent-child education for juveniles in youth offending institute [Unpublished doctoral dissertation]. Yonsei University.
32.
LeeJ. S. (2014). A study on the effect of workplace TSL program in improving work-family enrichment, mental and physical health: Focusing on bio-medical-social (BMS) perspective on married male workers [Unpublished doctoral dissertation]. Yonsei University.
33.
LeeK. Y. (2012). A study on the effect of TSL program in improving mental health and reducing aggression of adolescents exposed family violence: Focusing on the bio-medico-social (BMS) perspective [Unpublished doctoral dissertation]. Yonsei University.
34.
LeeS. H.ChoS. C.KimC. D.JinM. J. (2007). (The) social and psychological acculturation of North Korean defector families. SNU Press.
35.
LosonczI. (2015). Goals without means: A Mertonian critique of Australia’s resettlement policy for south Sudanese refugees. Journal of Refugee Studies, 30(1), 47–70. https://doi.org/10.1093/jrs/fev017
36.
LutherS. S.CicchettiD.BeckerB. (2000). The construct of resilience: A critical evaluation and guidelines for future work. Child Development, 71(3), 543–562. https://doi.org/10.1111/1467-8624.00164
37.
McBurnettK.LaheyB. B.RathouzP. J.LoeberR. (2000). Low salivary cortisol and persistent aggression in boys referred for disruptive behavior. Archives of General Psychiatry, 57(1), 38–43. https://doi.org/10.1001/archpsyc.57.1.38
38.
Ministry of Gender Equality and Family. (2010). The national survey on domestic violence in 2010. Ministry of Gender Equality and Family.
39.
Ministry of Unification. (2017). Nationwide survey about settlement of North Korean refugees in South Korea. Korea Hana Foundation.
NathanS.Bunde-BirousteA.EversC.KempL.MacKenzieJ.HenleyR. (2010). Social cohesion through football: A quasi-experimental mixed methods design to evaluate a complex health promotion program. BMC Public Health, 10(1), 587. https://doi.org/10.1186/1471-2458-10-587
43.
NicolsonN. A. (2008). Measurement of cortisol. In L. Luecken & L. Gallo (Eds.), Handbook of physiological research methods in health psychology (pp. 37–74). Sage Publications, Inc.
44.
OskisA.ClowA.LovedayC.HucklebridgeF.SbarraD. A. (2015). Biological stress regulation in female adolescents: A key role for confiding. Journal of Youth and Adolescence, 44(5), 1066–1077. https://doi.org/10.1007/s10964-014-0182-z
45.
ParkH.KimY.ParkH. R. (2011). Grounded theory approach to transition process of parenting experience among mothers defecting from North Korean. Child Health Nursing Research, 17(1), 48–57. https://doi.org/10.4094/jkachn.2011.17.1.48
46.
QuinnG. P.KeoughM. J. (2002). Experimental design and data analysis for biologists. Cambridge University Press.
RiederJ. K.GoshinL. S.SissokoD. G.KleshchovaO.WeierichM. R. (2019). Salivary biomarkers of parenting stress in mothers under community criminal justice supervision. Nursing Research, 68(1), 48–56. https://doi.org/10.1097/NNR.0000000000000323
49.
RyuW. (2019). Development and effectiveness of a TSL-CPN program for child abuse prevention in North Korean refugee families: Focusing on biomedical social science perspective [Unpublished doctoral thesis]. Yonsei University.
50.
RyuW.ParkS. W. (2018). Post-traumatic stress disorder and social isolation among North Korean refugee women in South Korea: The moderating role of formal and informal support. Sustainability, 10(4), 1246. https://doi.org/10.3390/su10041246
51.
SchmidtJ. A.PadillaB. (2003). Self-esteem and family challenge: An investigation of their effects on achievement. Journal of Youth and Adolescence, 32(1), 37–46. https://doi.org/10.1023/A:1021080323230
52.
SeoJ. Y. (2015). Developing TSL-MIL program to decrease violence of military personnel and examining its effectiveness: Focusing on the biomedical social scientific perspective [Unpublished doctoral dissertation]. Yonsei University.
53.
ShinN. (2018). New direction of North Korean defectors’ support policy through parental education program. Multiculture & Peace, 12(1), 207–235. https://doi.org/10.22446/mnpisk.2018.12.1.009
54.
ShirtcliffE. A.GrangerD. A.SchwartzE.CurranM. J. (2001). Use of salivary biomarkers in biobehavioral research: Cotton-based sample collection methods can interfere with salivary immunoassay results. Psychoneuroendocrinology, 26(2), 165–173. https://doi.org/10.1016/s0306-4530(00)00042-1
55.
SimonJ. B.MurphyJ. J.SmithS. M. (2005). Understanding and fostering family resilience. The Family Journal, 13(4), 427–436. https://doi.org/10.1177/1066480705278724
56.
SomaK. K.RendonN. M.BoonstraR.AlbersH. E.DemasG. E. (2015). DHEA Effects on brain and behavior: Insights from comparative studies of aggression. Journal of Steroid Biochemistry and Molecular Biology, 145, 261–272. https://doi.org/10.1016/j.jsbmb.2014.05.011
57.
SonM.KimS. (2017). Family migration of North Korean defectors: With a focus on the phenomenon of chain migrations. Korea Journal of Population Studies, 40(1), 57–81.
58.
SongH. J. (2012). (A) study on the effect of TSL program in improving mental and physical health of middle-aged women: Focusing on the neurobiosocial (NBS) perspective [Unpublished doctoral dissertation]. Yonsei University.
59.
StoneA. A.SchwartzJ. E.SmythJ.KirschbaumC.CohenS.HellhammerD.GrossmanS. (2001). Individual differences in the diurnal cycle of salivary free cortisol: A replication of flattened cycles for some individuals. Psychoneuroendocrinology, 26(3), 295–306. https://doi.org/10.1016/s0306-4530(00)00057-3
60.
StrausM. A.HambyS. L.FinkelhorD.RunyanD. (1995). The parent-child conflict tactics scales (PCCTS), Form A. Family Research Laboratory, University of New Hampshire.
61.
TimshelI.MontgomeryE.DalgaardN. T. (2017). A systematic review of risk and protective factors associated with family related violence in refugee families. Child Abuse & Neglect, 70, 315–330. https://doi.org/10.1016/j.chiabu.2017.06.023
62.
TumenS. (2016). The economic impact of Syrian refugees on host countries: Quasi-experimental evidence from Turkey. American Economic Review, 106(5), 456–460. https://doi.org/10.1257/aer.p20161065
63.
UmM. Y.KimH. J.PalinkasL. A. (2018). Correlates of domestic violence victimization among North Korean refugee women in South Korea. Journal of Interpersonal Violence, 33(13), 2037–2058. https://doi.org/10.1177/0886260515622297
64.
Van GoozenS. H. (2005). Hormones and the developmental origins of aggression. In R. E. Tremblay, W. W. Hartup, & J. Archer (Eds.), Developmental origins of aggression (pp. 281–306). The Guilford Press.
WeineS. M.WareN.KlebicA. (2004). Converting cultural capital among teen refugees and their families from Bosnia-Herzegovina. Psychiatric Services, 55(8), 923–927. https://doi.org/10.1176/appi.ps.55.8.923
67.
XingX.YinT.WangM. (2019). Cortisol stress reactivity moderates the effects of parental corporal punishment on Chinese preschoolers’ executive function. Child Abuse & Neglect, 88, 288–297. https://doi.org/10.1016/j.chiabu.2018.12.004
68.
YangH. (2018). A study of traumatic event experiences and post-traumatic growth (PTG) among North Korean adolescent refugees in South Korea [Unpublished doctoral thesis]. Yonsei University.
69.
YooJ. E. (2013). Misunderstandings and mis-applications on ANCOVA in educational studies. Journal of Learner-Centered Curriculum and Instruction, 13(6), 27–49.
