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Journal of Korean Academy of Nursing (2001) Vol. 31, No.

The Effect on the Self-Esteem Promotion Program on Self-Esteem and Mental Health of Adolescents with Minor Delinquency
Eun Young Choi, RN, PhD1, Eun Joo Oh, RN, PhD2

This research was performed to investigate the effectiveness of self-esteem promotion program(SEPP) to adolescents with minor delinquency on self-esteem and mental health. Samples of this study were 36 adolescents with signs of minor delinquency in the third grade of middle schools who reside in K city. Data analysis was conducted by chi-square test which tests the general homogeneity between the experiment group and the control group. To test hypothesis how SEPP affects on self-esteem, mental health, and delinquency, paired t-test was performed. The results were summarized as follow; 1. After the experimental treatment, self-esteem score was not statistically significant. 2. After the experimental treatment, mental health score was statistically significant. 3. After the experimental treatment, self reported delinquency score was statistically significant. As the result of this research, the SEPP increased the degree of mental health and decreased that of delinquency of the adolescents who committed minor delinquency. Self-esteem is difficult to be changed by itself in number for a short time, but there is potential effect, which can be expected the preceding changes of mental health and behavior of participants.
Key Words: Self-esteem promotion program; Self-esteem; Mental health

INTRODUCTION
The juvenile delinquency has emerged as a major social problem since getting into a higher industrial society in 1970s. The juvenile delinquency has increased each year and has had tendency to become more violent in quality and grouping. In addition the age has become lower as time goes on. 7.8 percent of total crime were caused by adolescents in 1997, which were distributed as violent crime(38.5%), theft(20.5%), felonious crime(2.5%), and so on. The felonious crimes including murder, robbery, rape, and incendiarism show tendency to increase, the portion was 2.4% in 1997, comparing to 1.8% in 1993.

The mental mal-adaptation experiences the fear of rage and aggressive urge in the immature situation, and induces factors of health problem which leads to frustration, defeatism, depression, and hedonism. It easily falls into drugs without confidence as an independent personality, as well. Shim(1994) showed that students who conducted more self centered, unrealistic, anti-social behavior, had less self-esteem. In Chois study(1996), the most precaution or intervention as one time judicious guidance to juvenile delinquency and the counter plan after this delinquency had already been serious, have performed by schools and institutions. Thurs, the effort of the first, second cure to intervene before the delinquent problem grows seriously is highly restricted. In Chois

1. Full-time instructor, Department of Nursing, Seonam University 2. School Inspector, Gwangju Metropolitan office Education Corresponding author: EunYoung Choi, PhD, RN, 720 Kwangchi-dong, Namwon, Chonbuk 590-711, Korea Tel: 8263-620-0106 Fax: 8263-620-0305 E-mail: eychoi@tiger.seonam.ac.kr Received August 29, 2001 ; Accepted December 21, 2001

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study(1990), as promoting self-esteem he or she respected herself as a human being, became capable, had attachment, and got along well with others as well as he or she had fewer complaints. However, if she became losing self-esteem she experienced critic, self hatred, and depression through feelings that she was meaningless, incapable, and it caused incompetence and isolation, too. Park & Chois research(1990) reported that a juvenile showed lower level of mental health as he or she committed more delinquencies. There was tendency to show mal-adaptive behavior caused by improper control over fretfulness, anxiety, depression, and hostility that hided behind their actions. Especially, there was strong relationship between delinquent experience and hostility. In this research, SEPP is performed to the students shows minor infractions to test this program increases self-esteem and mental health level and makes delinquency level lower. Furthermore, this study will discuss SEPP performs as the second precautious program for the minor infraction as well as the precaution of serious juvenile delinquencies and mental health problems.

tity and the ideal entity as strengthening self-approval with conversation and psychotherapy. As you see, selfesteem affected by attitude of others meaningful to him such as family, colleague, and friends-is the degree of thinking that he is important and valuable. Self-esteem performed in school period relatively lasts for life and positive self-esteem is essential to adapt oneself to society when grown up.
2. Mental Health

LITERATURE REVIEW
1. Self-Esteem

People want love and acceptance and have anxiety to get positive consideration from others as they grow. Because of these needs, others who are meaningful to juveniles can strongly affect on them by providing love and acceptance or not doing so. In that aspect, it is very important to get positive self-concept through proper, desirable self-esteem. Choi & Jun(1993) defined that self-esteem is made by the feeling or self valuation experienced in his past time and considered self-esteem as a kind of mental tendency which represents the recognized, estimated level for himself. They categorized selfesteem into self-esteem in general, self-esteem in society, self-esteem in family, and self-esteem in school. Self-esteem in school period is significantly affected by the family structure, the environment, the parents attitude for raising, the school environment, and the character of teachers. Corpulent adolescents suffer characteristic disorder with complex about appearance and mental uneasiness. It is reported that lower self-esteem is a major problem of mental disease. Many experimenters insist that it should be possible for students to improve self-esteem by SEPPs. Jun(1974) said that self-esteem is enhanced by the proper harmony between the present en-

Jun(1987) mentioned that the person in good mental health judges himself practically and accepts his advantages and disadvantages as what they are, and shows his faithful concern to others. He seeks intrinsic value rather than extrinsic one, and takes care of himself without hurting others in seeking it. She also defined good mental health as who can overcome the stress and frustration without disagreement of his character. According to Gwon, whether a persons mental is healthy or not is decided by adaptability to environment. The mentally healthy person has a series of habit to make him adapt himself to the environment successfully. Mental health means the character that he can manifest his maximum ability to adapt himself to surroundings and manage his life independently, constructively, and voluntarily(Ha. et. al., 2000). The correlated researches to the mental health are followed. Um & Ha(1993) showed that the higher mental health is resulted from the higher self-actualization. In testing female high school students. Choi(1993) tested how mental health is related to the sub-factors of mental health, such as self-esteem in general, self-esteem in family, self-esteem in society, and self-esteem in school. For high school students, the result was significant in that higher self-esteem group has less mental health problem than lower group does. Recently, it is reported that middle and high school students depression, neurosis, and suicide is increasing. Kim(1990) said that juvenile delinquency appears with developing mental health problems. In Lees study(1996), juveniles who punished by court because of drug abuse, paranoia, robbery, and violence characterized the low level of mental health concerning somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychocitism. Mental health problem of adolescents becomes an important social issue and needs remedy.

Choi et al. Self-Esteem Promotion Program for Adolescents 1183

3. SEPP and juvenile delinquent

The word delinquency comes from wrong-doing, neglect of duty. Generally not-desirable doing is referred to delinquency which comes from sociologic term and the doer is called as a delinquent. In other words, juvenile delinquent means the juvenile who has conducted wrong-doings in the ethical, social, and legal aspects. In 1993, delinquency preventive program performed in public self-esteem as one of human beings basic instinct. As the result, there was much effect on reducing the delinquency. Reasoner(1994) stated that SEPP was specially effective to promoting studies, and reducing vandalism, absence without due notice, pregnancy, drug abuse, and violence in school. The other studies performed SEPP in school (Curtis & Shaver, 1981 ; Greene & Uroff, 1989), were testified that self-esteem and accomplishment of study were improved. But there were few studies which experimented the relationship between SEPP and mental health of delinquent juveniles. The studies related to self-esteem promotion were merely subject to chronic patients.

and lead the natural homogeneity of group. 2) Three experimental assistants will distribute the behavior report. After filling it out for 30 minutes, simples will talk about the answer of contents on it ach other and share their opinions. 3) Let them say I can do it five times and discuss felling for the last time. Make them practice their feelings in real life.
2. Subjects and Methodology

METHODS
1. Development of SEPP

SEPP in this study is designed by adjusting the program developed by Palomares(1991) & Jung(1997) and by the consultation of two other nurse professors. The purposes of this SEPP are to promote self-esteem clarified in precedent researches, to improve mental health related to whole health, and to reduce delinquency. The contents of SEPP are followed. 1) Introduction. 2) My reality. 3) Look inside of me. 4) Send secret message to friends. 5) Find treasures from friends. 6) Find positive words. 7) Positive self-communication. 8) Learn the discrimination about passive, positive, and insistent Response. 9) Self present(insistent) behavior : the criteria of insistence. 10) You can do it because you think you can do it. 11) My motto. 12) I accomplished my goal. Finale, give ones impression of program. Each period consists of presentation and discussion in the group after preparing the behavior report by samples and it takes about 60 minutes, respectively. Details in each period are followed. 1) Before starting period, samples will be guided by the experimenter for 10 minutes and talk about the subject voluntarily. In doing so, the effect of programs in each period will be increased

The samples of this study were composed of 50 students who were recommended by a nursing teacher or a disciplinary teacher among third graders in three middle schools located in K city. 1) Students who visited the nursing room more than 10 times because of the school violence. 2) Students warned by teachers owing to frequent quarrel, disobedience of a teachers instruction, cunnings, possession of salacious books, dress disorder and so on. 3) Students were exposed absence without due notice, smoking, violence, or visiting to the red-light districts and so on once or twice. 4) Students who convicted runway, violent crime or robbery once or twice. The experimenter excluded students who were diagnosed serious mental behavioral disorder through the first interview in the nursing room or classroom. Students who scored below IQ 80 and expected it was too hard for them to understand this program were excluded, as well. 46 students were picked in the sampling process. Among them 10 students refused to participate in it because they had to go to private institutes after school. The last thirty six students were given random numbers and eighteen students who picked odd numbers were appointed to the experiment group, eighteen one students who took even numbers were to the control group. Self-esteem, mental health, and self-report of delinquency were respectively tested to both groups as the pre-test. After the pre-test, SEPP was performed to the experiment group total twelve times, 60 minutes each time, twice a week from August 25 to September 30, but there was no treatment to the control group. This pre-test were performed in classrooms by the experimenters and three assistants who were seniors in the nurse collage. After finishing all programs, self-esteem, mental health, and self-report of delinquency were tested to both groups as the post-test.

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3. Instruments 1) Self-esteem

Self-esteem score was used, which was adjusted from Coopersmiths test(1972) by Choi & Jun(1993). This score consisted of four sub-factors (self-esteem in general, self-esteem in society, self-esteem in school, and selfesteem in family) and total 32 questions. Each question had five scores from 5 highly positive to 1 highly negative. Higher score meant higher self-esteem with exception that 8 questions about negative behaviors were scored in contrast. Cronbachs Alpah was 0.89 in this test. 2) Mental health Derogatis, Rickels & Rock(1976) developed simple mental diagnosis test and Kim, Lee, & Kim(1978) standardized it. The simple mental diagnosis test designed by Lee(1986) to make 47 questions with factor analysis was used in this research. The contents of this test were comTable 1. General characteristics of subject Subject Age 14 15 16 Male Female None buddhism christianity Catholicism none primary school middle school high school college and over none primary School middle School high School college and over company employee public official professional technician self-employed business nuclear family large family extrovert introvert eldest middle last only daughter(son) Experiment Group Number(%) 6(33.3) 10(55.6) 2(11.1) 8(44.4) 10(55.6) 12(66.7) 2(11.1) 2(11.1) 2(11.1) 0(0.0) 1(5.6) 5(27.8) 10(55.6) 2(11.1) 1(5.6) 1(5.6) 4(22.2) 11(61.1) 1(5.6) 4(22.2) 0(0.0) 3(16.7) 4(22.2) 7(38.9) 15(83.3) 1(5.6) 9(56.3) 4(22.2) 7(38.9) 2(11.1) 6(33.3) 3(16.7)

posed of nine symptoms - somatization, obsession, sensitivity to others, frustration, anxiety, fear, paranoia, and neurosis. Each question was scored from 1 not at all to 5 very serious and the lower score told the higher mental health. Cronbachs Alpah was 0.95 in this test. 3) Delinquency To examinate the self-esteem of juvenile delinquency, forty eight questions for delinquent scales in Moons study(1993) were selected. These scales included from minor infraction like disobedience and friendship with delinquents to criminal like group fight, bond inhalation, and so on. This score was recorded from 1 not at all to 5 many times in each question and the higher score meant the higher delinquency. To compare the effect between pre-test and post-test, self report was performed for the last two months and Cronbachs Alpha was 0.85.

Control Group Number(%) 5(27.8) 11(61.1) 2(11.1) 5(27.8) 13(72.2) 6(33.3) 3(16.7) 8(44.4) 1(5.6) 1(5.9) 1(5.9) 0(0.0) 10(58.8) 5(29.4) 0(0.0) 1(5.9) 0(0.0) 15(88.2) 1(5.9) 3(16.7) 1(5.6) 0(0.0) 2(11.1) 12(66.7) 3(16.7) 32(88.9) 7(43.8) 23(67.6) 9(50.0) 3(16.7) 6(33.3) 0(0.0)

Total Number(%) 11(30.6) 21(58.3) 4(11.1) 13(36.1) 23(63.9) 18(50.0) 5(13.9) 10(27.8) 3(8.3) 1(2.9) 2(5.7) 5(14.3) 20(57.1) 7(20.0) 1(2.9) 2(5.7) 4(11.4) 26(74.3) 2(5.7) 7(19.4) 1(2.8) 3(8.3) 6(16.7) 19(52.8) 17(94.4) 4(11.1) 14(77.8) 11(32.4) 16(44.4) 5(13.9) 12(33.3) 3(8.3)

X2 .139

p .923

Gender Religion

1.084 6.133

.298 .105

Father education

7.263

.123

Mother education

5.591

.232

Occupation

6.125

.190

Family type Personality Brotherhood

1.125 1.794

.289 .180

3.450

.327

Choi et al. Self-Esteem Promotion Program for Adolescents 1185

4. Data analysis

Collected data were computerized according to the scores after coding by using SPSS/PC. 1) The general characteristics of the subjects were analyzed chi-square test. 2) Paired t-test was used to examine the differences in self-esteem, mental health and self reported delinquency between the two groups.

2. Comparison of self-esteem, mental health and delinquency between two groups

RESULTS
1. Demographic characteristics

The pre-test showed conditions were homogeneous between two groups because there were no significant differences in self-esteem, mental health, and delinquency. The results in the pre-test of self-esteem showed that that experiment group was 99.39 and the control group was 101.83 and mental health was 105.78 and 96.94, respectively. Delinquency in the pre-test was 140.39 in the experiment group and 131.67 in the control group (Table2).
3. The evaluation of the SEPP

There were statistically significant differences between the experiment group and the control group concerning gender, religion, parents education, wealth, occupation, family type, personality, and brotherhood (Table1). Samples in this study were thirty-six third-graders in the middle school and composed of males (36.1%) and females (63.9%). Students who had religion were 50.0% and their parents educational background revealed that 57.1% fathers and 74.3% mothers graduated from high schools. 52.8% of fathers were engaged in self-employed business. The family type of most samples was the nuclear family as 88.9% and 67.6% were characterized as extrovert. 44.4% of samples were the eldest and 33.3% were the last.

Table 2. Comparison of self-esteem, mental health and delinquency between two groups Experimental Group Control Group Mean(SD) Self-esteem Mental health Delinquency 99.39(24.43) 105.78(40.69) 140.39(29.62) Mean(SD) t p

101.83(12.03) -.381 .706 96.94(33.37) .712 .481 131.67(37.18) .778 .442

After participating in SEPP students self-esteem scores were followed (Table 3-1). To compare changes of total self-esteem scores between the pre-test and the post-test in each group, paired t-test was measured. This paired t-test resulted in that the score of the experiment group increased from 99.39 to 103.94(t=-.842, p=.411) and that of the control group increased from 101.83 to 104.50(t=-.590, p=.563). Even though total self-esteem score increased in the experiment group, it was not statistically significant. Considering changes of each sub-factors, scores of selfesteem in general, self-esteem in family, self-esteem in society, and self-esteem in school in the experimental group were not statistically significant (Table 3-2). After adolescents were educated with SEPP, mental health scores were followed (Table 4-1). The score of the experiment group was from 105.78 to 84.89(t=2.821, p=.012) and that of the other group was from 96.94 to 95.56(t=.183, p=.857). There was significant change in the experiment group after education. Considering changes of each sub-factors, scores of de-

Table 3-1. Comparison of total self-esteem score between the pre-test and the post-test in each group Experimental Group pre-test Self-esteem 99.39(24.43) post-test 103.94(13.40) t -.842 p .411 pre-test 101.83(12.03) Control Group post-test 104.50(13.84) t -.590 p .563

Table 3-2. Comparison sub-factor score of self-esteem between the pre-test and the post in each group Experimental Group pre-test Self-esteem in general Self-esteem in society Self-esteem in family Self-esteem in school 20.50(5.24) 31.67(8.26) 26.33(8.18) 20.89(5.49) post-test 21.67(3.96) 32.89(5.21) 30.11(7.64) 19.28(4.98) t -1.028 -.636 -1.626 1.025 p .319 .533 .122 .320 pre-test 18.89(3.25) 30.28(5.46) 30.44(6.26) 22.22(5.22) Control Group post-test 20.06(5.06) 31.39(5.86) 31.83(6.31) 21.22(5.37) t -.751 -.498 -.925 .488 p .463 .625 .368 .632

1186 Journal of Korean Academy of Nursing Vol. 31, No. 7 Table 4-1. Comparison of total mental health score between the pre-test and the post-test in each group Experimental Group pre-test Mental health 105.78(40.69) post-test 84.89(28.81) t 2.821 p .012 pre-test 96.94(33.37) Control Group post-test 95.56(46.71) t .183 p .857

Table 4-2. Comparison sub-factor score of mental health between the pre-test and the post in each group Experimental Group pre-test Somatization Obsessive-compulsive Interpersonal sensitivity Depression Anxiety Hostility Phobic anxiety Paranoid ideation Psychocitism 12.83(7.19) 10.94(3.93) 16.67(6.82) 11.11(5.47) 10.67(4.67) 15.67(6.94) 7.56(3.82) 8.50(3.75) 9.39(4.00) post-test 11.11(4.79) 9.00(3.03) 14.11(5.18) 8.50(4.74) 8.61(4.06) 12.61(6.01) 5.61(1.75) 6.56(2.68) 6.89(3.23) t 1.118 1.899 2.057 3.023 1.882 2.079 2.173 2.501 3.349 p .279 .075 .055 .008 .077 .053 .044 .023 .004 pre-test 13.11(5.75) 10.72(3.55) 16.67(6.44) 9.39(3.58) 10.17(4.57) 13.44(4.68) 6.33(2.89) 7.56(3.11) 7.28(3.48) Control Group post-test 13.00(6.64) 10.94(5.27) 15.61(8.34) 8.94(4.28) 10.00(5.88) 12.88(6.52) 7.22(3.73) 7.00(3.77) 7.78(4.05) t .126 -.191 .576 .452 .158 .458 -1.458 .655 -.900 p .901 .851 .572 .657 .877 .653 .163 .522 .381

Table 5. Comparison of delinquency score between the pre-test and the post-test in each group Experimental Group pre-test Delinquency 140.39(29.62) post-test 93.94(35.26) t 4.412 p .000 pre-test 131.67(37.18) Control Group post-test 136.28(55.40) t -.425 p .676

pression, phobic anxiety, paranoid ideation, and psychocitism in the experiment group were significantly reduced from 11.11, 7.56, 8.50, 9.39 to 8.50, 5.61, 6.56, 6.89 respectively (t=3.023, p=.008, t=2.173, p=.044, t=2.501, p=.023, t=3.349, p=.004) (Table 4-2). The score of delinquency of adolescents who took part in SEPP was measured. Paired t-test of delinquent score was statistically significant in each groups between pretest and post-test. The experiment groups delinquency was significantly reduced from 140.39 in the pre-test to 93.94 in the post-test(t=4.412, p=.000) (Table 5).

DISCUSSION
Self-esteem score in the post-test who participated in SEPP was increased in the experiment group but the difference was not statistically significant. Tested each subfactors scores, scores of self-esteem in general, self-esteem in family, and self-esteem in society, between two groups were not statistically significant but self-esteem was increased. However, the score of self-esteem in school was neither significant, nor self-esteem was increased. This result is consistent with that of Bangs study(1997) which said that self-esteem in school period

is affected by family structure, environment, and attitude of parents. This study supports that self-esteem is easily reformed in the period from 5th-6th grades in elementary school to the middle school in Kims research(1981), too. Self-esteem in school was decreased in both groups and it could be explained by that most of delinquents were in difficulty in passing the entrance exam of the high school. This makes most of them feel negative for themselves in all aspects of school life. In practice, they felt high pressure and had negative attitude about their whole school lives. Mental health scores of adolescents in SEPP showed statistical significancy. So to speak, the mental heath degree was enhanced after education compared to before education. It means that the fear and the hostility which comes from the stress of passing the entrance exam of the high school can be diminished, even a little. The score of delinquency after education in SEPP was greatly decreased. This result accords with that of Moons study(1991) which performed to female high school students in P city and that of Jungs research in 1997, which experimented to adolescents who showed minor delinquencies. The meanings of this research are followed.

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This study is meaningful in that mental health is increased and delinquency is decreased for the adolescents who convicted minor infractions. In considering that there is higher possibility to commit serious delinquencies if there is no proper intervention, this precautious program, SEPP, can be the alternative of solving the juvenile delinquency. Furthermore, the better thing is the delinquency was reduced with participation in SEEP voluntarily. SEPP as the second precaution was applied to juvenile delinquents, which is almost never tried before in Korea. Most programs to juvenile delinquents was focused on realistic therapy and medical therapy but by performing SEPP to juvenile delinquents the relationship between lower self-esteem and mental health, delinquency was tested. Additionally, considering that mental health increase and self reported delinquency decrease are statistically significant, we can thank that SEPP has potential effect on changing the delinquents attitude even if it did not show this change in number within a short time. However, self-esteem of participants in the experimental group was increased than that of the control group, but the difference is not significant. It is doubtful that SEPP is effective to promote self-esteem. but it is thought that this result is attributed to the problem of SEPP. A few limits of this study is followed. First, one is the limit of program process. Students in cyber generation seemed to want an educational process to which is paid attention by them, but the questionnaire in this study is a traditional format. This makes students approach the program with difficulty, in result. The succeeding studies are desirable to design an appealing educational method to adolescents. Second, the sample size is too small to generalize. The meaningful outcome will be produced if samples are randomly gathered among ages, status, and regional layers. Third, the short experimental period can be indicated as another limits. Reasoner(1994) performed self-esteem program 54 times, but this study did only 12 times. It might have been resulted better if it had performed more enough times.

promotion program to self-esteem and mental health for minor delinquent juveniles. The samples of this study were 36 adolescents with sign of minor delinquency in the third grade of middle school and they reside in K city. The testing period was from August 30 to September 29, 1999. The experimental design was nonequivalent control pre-test post-test design. Experimental tools were self-esteem scores developed by Choi adjusted form Coopersmiths test and mental health scores made by Lees factor analysis of simple mental diagnosis measure which was standardized Derogatis program by Kim and delinquent scores used in Moons study. Data analysis was conducted by chisquare test which tests the general homogeneity between the experiment group and the control group. To test hypothesis how SEPP affects on self-esteem, mental health, and delinquency, paired t-test was performed. The results were summarized as follow; 1. After the experimental treatment, self-esteem score was not statistically significant. 2. After the experimental treatment, mental health score was statistically significant. 3. After the experimental treatment, self reported delinquency score was statistically significant. As seeing above, SEPP increased mental health and decreased delinquency of adolescents who convicted minor infractions. Self-esteem itself may not easily be changed by the short term education but we can assume that there is potential effect on changing participants mental health and behaviors.

References
Bang, Y. J. (1997). A study on the self-esteem and juvenile delinquency. Unpublished Masters Thesis. The Sungshin Womens University of Korea, Seoul. Choi, B. G. & Jun, G. Y. (1993). A Study on the Development of the Self-Esteem Inventory, J of Korean Home Economic, 31(2), 41-54. Choi, J. Y. (1996). The effect of the social capability promotion program, Unpublished Masters Thesis. The Yonsei University of Korea, Seoul. Choi, M. S. (1993). A study on the self-esteem and mental health of high school students. Unpublished Masters Thesis. The Kongju National University of Korea, Seoul. Choi, Y. N. (1990). A study on relationship between self concept and mental health of girls high school students. Unpublished Masters Thesis. The Korea University of Korea, Seoul. Coopersmith, S. (1972). Coopersmith self-inventory. San Francisco : Self-Esteem Institute. Curtis, C. K., & Shaver, J. P. (1981). Improving slow learner self-esteem in secondary social classes, J of Educational Research,

CONCLUSION
This study is purposed to test the effect of self-esteem

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