Soo Jin Lee

Background: Hwabyung is a psychiatric syndrome originally described in Korea that presents as chronic psychosomatic distress with emotional dysregulation and heightened somatic arousal. However, no objective analysis to clarify its progressive mechanism within a universal biopsychological framework has as yet been done that incorporates insights from traditional East Asian medical psychology. Methods: We recruited 118 patients with Hwabyung and assessed their psychological and somatic symptoms using the Hwabyung Test (HB). Levels of depression, anxiety, and anger expression, as well as biopsychological features were evaluated with the Sasang Personality Questionnaire (SPQ). Psychological and somatic symptoms of Hwabyung were predicted through a regression analysis that used three SPQ subscales: behavioral activation (SPQ-B), cognitive flexibility (SPQ-C), and emotional responsiveness (SPQ-E). Hwabyung subgroups were identified by K-means analysis and their psychosomatic and biopsychological patterns were analyzed with HB and SPQ through ANCOVA and Profile Analysis to explore underlying biopsychological dimensions beyond culture-specific frameworks. Results: The SPQ subscales explained 26.0% of the psychological and 14.3% of the somatic symptoms of Hwabyung. Three distinct Hwabyung subgroups (mild, moderate, and severe) were identified based on the severity of psychological and somatic symptoms. Patients with severe symptoms showed a unique SPQ subscale profile with high SPQ-B, low SPQ-C, and low SPQ-E scores, reflecting volatile, aggressive, rigid, pessimistic, repressed, and isolated biopsychological characteristics. Discussion: This study suggests a representative SPQ subscale profile of Hwabyung and underlying mind-body interaction mechanisms within East-Asian biopsychological theory. It offers a more comprehensive and generalizable understanding of Hwabyung and other culture-bound psychosomatic syndromes, supporting improved diagnostic and intervention strategies across populations.

Media characters’ physical and psychological traits are crucial for character development and audience engagement. This study examines East Asian perspectives on the audience’s perceptions of the physical appearance and personality, using Eum-Yang biopsychological Sasang theory, of five characters from the Netflix series “Squid Game”. A total of 221 university students assessed the traits of five “Squid Game” characters using the Sasang Personality Questionnaire (SPQ) and a visual Body Mass Index (BMI). ANOVA and Profile Analysis revealed significant and comprehensive differences in the SPQ and its subscales (behavior, SPQ-B; cognition, SPQ-C; and emotion, SPQ-E) as well as BMI among the five drama characters. More specifically, Seong Gi-hun (SGH) and Han Mi-nyeo (HMN) were So-Yang types (high SPQ, moderate BMI), Cho Sang-woo (CSW) and Kang Sae-byeok (KSB) were So-Eum types (low SPQ, low BMI), and Jang Deok-su (JDS) was Tae-Eum type (moderate SPQ, high BMI). Psychological profiling showed two patterns: V-shaped (high SPQ-B, low SPQ-C, high SPQ-E) for SGH, HMN, and JDS, and A-shaped (low SPQ-B, high SPQ-C, low SPQ-E) for CSW and KSB. These results contribute to media psychology by highlighting the relevance of Eum-Yang and Sasang typology for creating and analyzing complex characters, thereby enhancing global understanding for East Asian biopsychosocial theories.

Background: Delusions in neurocognitive disorder due to Alzheimer’s disease (AD) worsen patients’ cognitive functions and activities of daily living (ADL), increasing caregiver burden and the risk of mortality. AD patients with delusions tend to experience a more rapid decline in cognition and have demonstrated poorer performance on various cognitive function tests. Considering the prognosis of delusion in AD patients, it tends to be more favorable with appropriate treatment. However, there is a lack of neuropsychological research, specifically examining the impact of delusions in AD, characterized by progressive deterioration of cognitive function. This study investigates the impact of delusions on cognitive function and ADL under conditions controlling for disease severity. Methods: We compared cognitive function and ADL in AD patients aged 65 years or older according to the presence of delusions. To assess longitudinal change, we analyzed data from patients monitored for an average of 15 to 16 months. We assessed cognitive function and ADL using the Seoul Neuropsychological Screening Battery-Second Edition (SNSB–II) and delusions using the Neuropsychiatric Inventory (NPI). We used IBM SPSS Statistics version 25.0 for all statistical analyses. The analysis was not adjusted for multiple comparisons. We investigated how delusions impact cognitive function and ADL, controlling for age, educational level, and disease severity. Results: The delusions group exhibited poorer immediate recall of verbal memory than the non-delusions group. In the follow-up evaluation, patients who developed delusions had lower baseline cognitive function than those who did not, and their language fluency declined over time. In addition, we found the presence of delusions associated with worse functional impairment in ADL as the disease progressed. Conclusion: While controlling for the severity of AD, we found no significant negative impacts of delusions on most cognitive functions. Nevertheless, it is noteworthy that the immediate recall of verbal memory and the Controlled Oral Word Association Test (COWAT)_animal sensitively detected the negative impact of delusions. Furthermore, since delusions are associated with worsening ADL, we understand that delusion treatment is important for improving the quality of life for patients and caregivers.

Background: Morningness (morning-eveningness preference or chronotypes) and personality can be both associated with well-being, but few studies have directly compared these two constructs as correlates of well-being. Thus, the first purpose of this study was to test the effects of interactions between stable personality traits (temperaments) and morningness on well-being. Furthermore, personality factors are often composed of both stable biological factors (temperament) and socio-cultural factors (character), and little is known about personality interplay of temperament and character factors with respect to morningness and well-being. The second purpose of this study was therefore to examine the sequential mediating effects of temperament and character factors on the relationship between morningness and well-being.Methods: The Composite Scale of Morningness, the Korean version of the Temperament and Character Inventory-Revised Short Version (TCI-RS), and the Satisfaction with Life Scale were used to measure morningness, personality dimensions, and well-being, respectively, in 287 Korean university students. Moderating and sequentially mediating effects of temperament and character traits were determined using Hayes’ PROCESS macro in SPSS after controlling for sex and age.Results: First, novelty-seeking (NS) and persistence (PS) temperaments have demonstrated the moderating effect in the association between morningness and well-being. The positive effects of morningness on life satisfaction increased with lower NS and PS, respectively. However, other temperaments such as harm avoidance (HA) and reward dependence (RD) have not shown the moderation in the relationship between morningness on well-being. Second, HA temperament and self-directedness (SD) character sequentially mediated the relationship between morningness and well-being. The combination of low scores of HA and high scores of SD have shown the positive effect on the relationship between morningness and well-being.Discussion: This study demonstrated that both the interactions between temperaments and morningness, and combination of specific TCI-RS temperament and character traits play important roles in influencing the association between morningness and well-being. The significance of the mature SD character and its implications for well-being are discussed with limitation of the present study.

Objectives: There should be an objective analysis on the academic competency for incorporating Computer-based Test (CBT) in the education of traditional Korean medicine (TKM). However, the Item Response Theory (IRT) for analyzing latent competency has not been introduced for its difficulty in calculation, interpretation and utilization.Methods: The current study analyzed responses of 390 students of 8 years to the herbology test with 14 items by utilizing Rasch model, and the characteristics of test and items were evaluated by using characteristic curve, information curve, difficulty, academic competency, and test score. The academic competency of the students across gender and years were presented with scale characteristic curve, Kernel density map, and Wright map, and examined based on T-test and ANOVA.Results: The estimated item, test, and ability parameters based on Rasch model provided reliable information on academic competency, and organized insights on students, test and items not available with test score calculated by the summation of item scores. The test showed acceptable validity for analyzing academic competency, but some of items revealed difficulty parameters to be modified with Wright map. The gender difference was not distinctive, however the differences between test years were obvious with Kernel density map.Conclusion: The current study analyzed the responses in the herbology test for measuring academic competency in the education of TKM using Rasch model, and structured analysis for competency-based Teaching in the e-learning era was suggested. It would provide the foundation for the learning analytics essential for self-directed learning and competency adaptive learning in TKM.

Background: Medical students have a high risk of burnout from tremendous academic stress, and previous cross-sectional studies have explained this risk from the personality perspective. However, the relationship between complex personality profiles and developmental trajectory of burnout has not been delineated yet. Methods: The longitudinal changes in burnout were measured by the Maslach Burnout Inventory-Student Survey (MBI-SS) at baseline (1st week), mid-term (9th week), and end-term (17th week), and personality was examined at baseline using the Temperament and Character Inventory (TCI). Latent trajectory groups based on the MBI-SS total scores were extracted using the General Growth Mixture Model (GGMM), and significant differences in personality profiles among the latent groups were identified using profile analysis and Analysis of Variance. Results: Three burnout trajectory groups of high-increasing (HI), moderate-increasing (MI), and low-stable (LS) were identified, and these groups had significantly different TCI subscale profiles. The HI group had the highest score in Harm-Avoidance (HA) and lowest score in Self-Directedness (SD), and the MI group had a higher score in HA and lower scores in SD and Cooperativeness (CO) when compared to the LS group with the lowest score in HA and highest scores in SD and CO. Conclusion: The current study showed that the HA, SD, and CO subscales of the TCI might explain the longitudinal development of academic burnout in medical students. Prevention of burnout and promotion of well-being in medical education concerning personality are discussed.