The Relationship of Depression to Health Risk Behaviors and Health Perceptions in Korean College Students

Article excerpt

High rates of health risk behaviors such as cigarette smoking and alcohol consumption among adolescents have been reported, and these behaviors may extend into adulthood (Albright, 1999). Alcohol is the most widely used drug in the United States and Korea since it is readily available and inexpensive (Neinstein & Pinsky, 1999; Kim & Kim, 2000). Prendergast (1994) reported a prevalence of 90% for alcohol use at least once a year among U.S. college students. In a Korean college student sample, Kim and Kim (2000) reported a prevalence of 84% to 88% for alcohol use. Further, smoking prevalence in adolescents has steadily increased in recent years (Nam, Cho, & Choi, 1996; Wechsler, Rigotti, Gledhill-Hoyt, & Lee, 1999). Cigarette smoking has been listed as the most important source of preventable morbidity and premature death (Neinstein & Pinsky, 1999). Wechsler et al. (1999) examined changes in cigarette smoking among U.S. college students between 1993 and 1997, finding that the prevalence rose from 22.3% to 28.5% . They also reported that students were both starting to smoke regularly and trying to stop. Jeong, Park, Bae, Lee, Jeong, and Baek (1998) reported that 16.6% of Korean male adolescents were current smokers. There is some evidence that depression may play a causal role in smoking. In a longitudinal study, depression in adolescence was found to predict subsequent smoking in adulthood (Kandel & Davies, 1986).

Since health care providers who work with adolescents can and should help their clients avoid cigarette smoking and excessive alcohol use, the factors influencing these health risk behaviors should be determined. A number of researchers have shown that cigarette smoking and alcohol drinking are associated with depression (Anda, Williamson, Escobedo, Mast, Giovino, & Remington, 1990; Jorm, Rodgers, Jacomb, Christensen, Henderson, & Korte, 1999). It is the most prevalent mental health disorder in adolescence. Harrington and Clark (1998) reported that 60% of adolescents experienced depressive symptoms. Korean adolescents and young adults are depressed more often than other age groups, with prevalence rates having been reported at 29% to 61% (Kim, Lee, & Jeon, 2000; Kim & Oh, 1999; Kim & Kim, 2000).

Psychological problems can aggravate, compound, and precipitate somatic problems (Mahon, Yarcheski, & Yarcheski, 1993), and depression can influence the reporting of symptoms and subjective health (Mahon et al., 1993; Mechanic, 1980). According to Gutkovich, Rosenthal, Galynker, Muran, Batchelder, and Itskhoki (1999), depression is significantly associated with the number of psychosomatic complaints among Russian-Jewish immigrants living in the United States.

In the present study, it was assumed that health risk behaviors (alcohol consumption and cigarette smoking) and health perceptions (symptom pattern and subjective health) reflect the suffering of those who are unable to cope with depression. Little is known about the relationships among depression, health risk behaviors, and health perceptions in Korean college students. The purposes of this study were to examine the level of depression, health risk behaviors, and health perceptions among Korean college students and to investigate the relationship of depression to health risk behaviors and health perceptions in this population.

METHOD

Sample

A convenience sample of 434 college students, drawn from four universities in Korea, participated in this study. They ranged in age from 18 to 28 years, with a mean of 21.20 (SD = 2.34). The sample was almost equally divided between men (n = 234) and women (n = 200). A large percentage (70.0%) lived with their parents, while 49 (11.3%) lived alone. Most of the students were unmarried.

Instruments

Depression. Depression was measured using the Beck Depression Inventory (BDI; Beck & Beamsderfer, 1974). …