Status of human rights violations and trauma among North Korean defectors: a cross-sectional study

Purpose This study aimed to identify the types of human rights violations and the associated psychological trauma experienced by North Korean defectors. It also examined the impact of trauma on the defectors’ interpersonal relationships, employment, and overall quality of life, while evaluating exis...

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Main Authors: So Hee Lee, Won Woong Lee, Haewoo Lee, Jin Yong Jun, Jin-Won Noh
Format: Article
Language:English
Published: Ewha Womans University College of Medicine 2025-04-01
Series:The Ewha Medical Journal
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Online Access:http://www.e-emj.org/upload/pdf/emj-2025-00367.pdf
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author So Hee Lee
Won Woong Lee
Haewoo Lee
Jin Yong Jun
Jin-Won Noh
author_facet So Hee Lee
Won Woong Lee
Haewoo Lee
Jin Yong Jun
Jin-Won Noh
author_sort So Hee Lee
collection DOAJ
description Purpose This study aimed to identify the types of human rights violations and the associated psychological trauma experienced by North Korean defectors. It also examined the impact of trauma on the defectors’ interpersonal relationships, employment, and overall quality of life, while evaluating existing psychological support policies to suggest potential improvements. Methods A multidisciplinary research team conducted an observational survey and in-depth interviews with approximately 300 North Korean defectors residing in South Korea from June to September 2017. Standardized measurement tools, including the Post-Traumatic Stress Disorder (PTSD) Checklist (PCL-5), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder Scale-7 (GAD-7), and Short Form-8 Health Survey (SF-8), were employed. Statistical analyses consisted of frequency analysis, cross-tabulation, factor analysis, and logistic regression. Results The findings revealed a high prevalence of human rights violations, such as public executions (82%), forced self-criticism (82.3%), and severe starvation or illness (62.7%). Additionally, there were elevated rates of PTSD (56%), severe depression (28.3%), anxiety (25%), and insomnia (23.3%). Defectors who resided in China before entering South Korea reported significantly worse mental health outcomes and a lower quality of life. Moreover, trauma was strongly and negatively correlated with social adjustment, interpersonal relationships, employment stability, and overall well-being. Conclusion An urgent revision of existing policies is needed to incorporate specialized, trauma-informed care infrastructures within medical institutions. Furthermore, broad societal education to reduce stigma and enhance integration efforts is essential to effectively support the psychological well-being and social integration of North Korean defectors.
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spelling doaj-art-c3cfa32dd8b5472a907c5e218094c4822025-08-26T00:04:46ZengEwha Womans University College of MedicineThe Ewha Medical Journal2234-31802234-25912025-04-0148210.12771/emj.2025.003671616Status of human rights violations and trauma among North Korean defectors: a cross-sectional studySo Hee Lee0Won Woong Lee1Haewoo Lee2Jin Yong Jun3Jin-Won Noh4Department of Psychiatry, National Medical Center, Seoul, KoreaDepartment of Social Welfare, Catholic Kwandong University, Gangneung, KoreaDepartment of Psychiatry, Kangwon National University Hospital, Chuncheon, KoreaDepartment of Psychiatry, Ulsan University Hospital, Ulsan, KoreaDivision of Health Administration, Yonsei University, Wonju, KoreaPurpose This study aimed to identify the types of human rights violations and the associated psychological trauma experienced by North Korean defectors. It also examined the impact of trauma on the defectors’ interpersonal relationships, employment, and overall quality of life, while evaluating existing psychological support policies to suggest potential improvements. Methods A multidisciplinary research team conducted an observational survey and in-depth interviews with approximately 300 North Korean defectors residing in South Korea from June to September 2017. Standardized measurement tools, including the Post-Traumatic Stress Disorder (PTSD) Checklist (PCL-5), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder Scale-7 (GAD-7), and Short Form-8 Health Survey (SF-8), were employed. Statistical analyses consisted of frequency analysis, cross-tabulation, factor analysis, and logistic regression. Results The findings revealed a high prevalence of human rights violations, such as public executions (82%), forced self-criticism (82.3%), and severe starvation or illness (62.7%). Additionally, there were elevated rates of PTSD (56%), severe depression (28.3%), anxiety (25%), and insomnia (23.3%). Defectors who resided in China before entering South Korea reported significantly worse mental health outcomes and a lower quality of life. Moreover, trauma was strongly and negatively correlated with social adjustment, interpersonal relationships, employment stability, and overall well-being. Conclusion An urgent revision of existing policies is needed to incorporate specialized, trauma-informed care infrastructures within medical institutions. Furthermore, broad societal education to reduce stigma and enhance integration efforts is essential to effectively support the psychological well-being and social integration of North Korean defectors.http://www.e-emj.org/upload/pdf/emj-2025-00367.pdfdemocratic people’s republic of koreahealth policyhuman rightspost-traumatic stress disorderssocial integration
spellingShingle So Hee Lee
Won Woong Lee
Haewoo Lee
Jin Yong Jun
Jin-Won Noh
Status of human rights violations and trauma among North Korean defectors: a cross-sectional study
The Ewha Medical Journal
democratic people’s republic of korea
health policy
human rights
post-traumatic stress disorders
social integration
title Status of human rights violations and trauma among North Korean defectors: a cross-sectional study
title_full Status of human rights violations and trauma among North Korean defectors: a cross-sectional study
title_fullStr Status of human rights violations and trauma among North Korean defectors: a cross-sectional study
title_full_unstemmed Status of human rights violations and trauma among North Korean defectors: a cross-sectional study
title_short Status of human rights violations and trauma among North Korean defectors: a cross-sectional study
title_sort status of human rights violations and trauma among north korean defectors a cross sectional study
topic democratic people’s republic of korea
health policy
human rights
post-traumatic stress disorders
social integration
url http://www.e-emj.org/upload/pdf/emj-2025-00367.pdf
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AT jinyongjun statusofhumanrightsviolationsandtraumaamongnorthkoreandefectorsacrosssectionalstudy
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