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1. Introduction
Many North Korean refugees often report having experienced traumatic events in North Korea, especially during their escape from North Korea [1] and after settling in South Korea [2]. In particular, research has found that 49.3% of adult North Korean refugees have experienced or witnessed life-threatening events [3]. Among young North Korean refugees, 71% reported having experienced traumatic incidents in the past, such as the death or arrest of family members or hearing about these events, as well as being physically abused by family members or acquaintances [4]. As a result of having experienced such traumatic events, North Korean refugees represent a mentally vulnerable population. Indeed, these traumatic experiences have been consistently found to be associated with psychiatric problems and low life satisfaction among North Korean refugees. In general, the frequency and severity of traumatic experiences have been found to predict post-traumatic stress disorder, anxiety, and depression [4,5,6,7,8,9]. Indeed, depression is the most frequently reported mental health problem among adult North Korean refugees, with the prevalence of depression ranging from 29% [9] to 49% [10].
One possible mechanism through which traumatic experiences contribute to the affective symptoms of traumatized refugees may be the development and maintenance of negative cognitions. The cognitive theory of depression posits that repeated exposure to uncontrollable negative events that an individual fails to escape may alter how an individual perceives and interprets their own life events [11,12,13]. Specifically, when individuals experience a negative event, they attempt to understand and explain its causes. If negative events happen repeatedly and pervasively, they begin to interpret negative events as the consequences of their own actions and perceive them as unchangeable and generalizable to other domains (i.e., an internal, stable, and global attributional explanation) [13,14]. The frequently employed attributional explanations can negatively bias the victim’s general beliefs about themselves and about the world [14,15], from which automatic thoughts with negative themes arises, so-called “streams of consciousness cognitions” [16] (e.g., I will have an accident; I’ve failed my life). In particular, negative events that happened early in an individual’s life can crystallize more stable negative cognitions [14]. The negative cognition, in turn, acts as a cognitive vulnerability to the onset and persistence of affective disorders when facing prospective negative stressors [17,18], disenabling the person’s active...