Introduction

A Ministry of Health and Welfare survey revealed that the prevalence rate of depression in South Korea is 10.2% [1]. Depression in adolescence is reported to have a negative long-term impact on an individual's life [2], and 26.8% of middle and high school students experience depression according to data from the Korea Disease Control and Prevention Agency [3]. Youth depression is recognized as a critical social problem because it not only shows a chronic course but also reduces academic achievement and interpersonal function, and adversely affects emotional and behavioral development [4]. Adolescent depression can develop into an emotionally disturbed adulthood [5], and its gravity should be recognized because the failure to properly intervene in adolescent depression increases the risk of suicide [6].

Article 10 of the Constitution of the Republic of Korea stipulates that "All humans have dignity and value as humans and have the right to pursue happiness," and human rights are the rights that we as human beings deserve and are the basic conditions for living a human life [7]. Recently, interest in the human rights of children and adolescents has increased, as child abuse has become a social problem in Korea [8]. According to Banks [9], perceived respect for human rights refers to how adolescents perceive their human rights as being respected. Adolescents who have experienced neglect by their parents or have been victims of violence from their peers have a distortion of the cognitive process that leads them to perceive themselves as worthless. This state of infringement of human rights is likely to lower the sense of control and increase depression due to disparaging individual identity [10, 11]. According to a study by Riley et al. [12], violations of human rights influence depression among people living in refugee camps, even after controlling for age, gender, and stressors. A study by Kim and Choi [12] also confirmed that students who suffer school violence, a human rights violation, are more likely to experience depression even when controlling for their gender, family type, and economic level.

While many previous studies have verified the relationship between human rights violations and depression, very few empirical studies have explored whether respect for human rights reduces depression. In the research report on the Human Rights of Children and Youth [13], the group with a high level of respect for human rights had a significantly higher level of self-esteem than the group with a low level of respect for human rights, and depression and suicide rates were significantly lower. A study by Ah [14] showed that even with the control of gender and grade, the greater experience of being respected for human rights, the higher the self-esteem and the lower the level of depression [15]. Although several studies have shown a negative correlation between respect for human rights and depression, additional research is needed to controlling for violations of human rights and demographic risk factors for adolescent depression and to confirm that respect for human rights is a protective factor for depression.

Previous studies have shown that the causes of adolescent depression can be categorized into individual, family, and school-related factors [4]. Among the school-related factors, school violence is closely related to youth depression and is recognized as a serious social problem. According to the School Violence Survey of 2019, conducted by the Ministry of Education [16], 1.6% (59,520) of 3.72 million students enrolled in elementary, middle, and high schools have experienced school violence. Online violence appears to be continually increasing due to the development of information and communication technology and the popularization of smartphone use, and has as serious an impact on the mental health of adolescents as offline violence [17]. Kowalski and Limber [18] demonstrated that adolescents who have experienced offline violence experience emotional and academic problems and that offline violence is strongly associated with depression [19]. Lee [20] revealed the long-term impact of school violence on depression. It was found that adolescents who experienced school violence had low self-esteem and a high level of depression even when their satisfaction with their gender, family structure, financial status, health condition, and academic achievement was controlled.

Recent studies have emphasized the impact of online, as well as offline, violence on the mental health of adolescents. Perren et al. [21] found that both online and offline violence have a significant effect on depression, but online violence has been found to have a greater influence on depression than offline violence. The severity of the damage caused by online violence is emerging as information and communication technologies develop [22]. In particular, online violence can have a greater negative impact on the victim's mental health, making them anxious, as it is not easy to find the perpetrator, and it can happen at any time [23,24,25]. Thus, despite the emerging importance of the impact of online violence on youth depression, there is a severe lack of studies on the impact of both online and offline violence.

Among the individual factors related to adolescent depression, perceived stress was a important variable. Perceived stress refers to the subjective level of stress perceived by individuals in daily life [26], and has been identified as an important risk factor that influences adolescent depression [27, 28]. A meta-analysis study reported that one of the most powerful risk factors for the prediction of adolescent depression is stress [5]. Neese et al. [29] and Kim and Hong [30] demonstrated that the intensity of perceived stress was significantly associated with the severity of depression. As perceived stress increases, the level of rumination increases and the level of depression is likely to increase [30].

Among the family factors associated with adolescent depression, parental attitudes are closely related to adolescent depression. In particular, it has been shown that neglect is a type of child abuse that has an adverse effect on the mental health of adolescents [31]. Neglect is the failure of the parents to provide appropriate care for the healthy development of the child [32]. Many studies have reported that psychological abuse and neglect, in which children experience exploitation, humiliation, and deprivation by their parents, have a significant and positive relationship with depression [33,34,35]. In addition, in a network analysis by Ha and Shim [36], symptoms of depression appeared clearly among the group that experienced neglect out of all types of child abuse. In another study, parental neglect perceived by adolescents was found to increase the likelihood of depression, even when controlling for gender, family economic level, and parental working state [37].

In sum, past studies have identified school violence, perceived stress, and neglect as significant risk factors for adolescent depression. These studies have tended to focus on the risk factors for adolescent depression. However, given the gravity of the impact of adolescent depression, not only on one’s psychological and emotional development but also on one’s mental health in adulthood, more understanding of the factors involved in the prevention of adolescent depression is needed. Therefore, this study aims to verify whether perceived human rights respect can act as a protective factor for adolescent depression.

To verify the relationship between perceived respect for human rights and depression in adolescents, demographic variables must be controlled. According to previous studies, gender has a significant influence on depression [38, 39]. In a meta-study conducted by Salk et al. [39], girls showed more vulnerability to depression than boys, and the difference between symptoms of depression by gender peaked during adolescence. The influence of economic level on depression has also been revealed. Shin and Lee [40] demonstrated that the lower the subjective economic level of adolescents, the higher their level of depression. Shin et al. [41] demonstrated a significant difference in depression among adolescents in different school years.

The purpose of this study was to examine the impacts of perceived stress, neglect, online and offline violence, and respect for human rights on depression through past literature and the theoretical background. The primary aim was to determine whether respect for human rights plays a protective role in adolescent depression. The hypotheses of this study were as follows: Respect for human rights will have a significant and negative influence on adolescent depression after perceived stress, neglect, offline violence and online violence have been controlled.

Material and Methods

Surveys

This study uses data from the Survey on the Human Rights of Children and Youth, which was conducted by the National Youth Policy Institute [42]. The Survey on the Human Rights of Children and Youth is a national sample survey conducted annually to promote human rights by identifying the current state of human rights of children and young adults. It has been conducted since 2006, with 9000 students in grades 4–6 of elementary schools, grades 1–3 of middle school, and grades 1–3 of high school every year. The sample was extracted through multi-stage stratified sampling. The Statistical Yearbook of Education of the Ministry of Education was used as the sampling frame, and the sample was distributed through proportional allocation. The survey method was established by a professional investigator and was performed using self-report questionnaires designed for each grade.

Participants

In this study, data from a final sample of 6277 students were included in the analysis, after excluding those with a high missing rate of relevant information from 6315 middle school and high school students, excluding elementary school students. Because this study used public data, institutional review board approval was not required. Frequency analysis was performed to identify the demographic characteristics of the participants. Among the 6277 participants included in the study, 3269 (52.1%) were boys and 3008 (47.9%) were girls. A total of 3038 (48.4%) were in the upper economic level, 2474 (39.4%) in the middle economic level, and 765 (12.2%) in the lower economic level. The average age of the participants was 15.64 years old. Table 1 presents the results.

Table 1 Demographic characteristics of the sample N = 6277
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Variables and Measures

Neglect

The scale developed by the National Youth Policy Institute was used to measure the degree of neglect [42]. There were four items: “I’ve lived in unclean clothes or slept in such bedding,” “My parents (guardians) disregard me even when I’m sick,” “My parents (guardians) don't care about me not having meal,” and “My parents (guardian) don't care if I'm absent from school.” Each item was measured on a 5-point Likert scale (1 = “never,” 2 = “about 1–2 times a year,” 3 = “about 1–2 times every 2–3 months,” 4 = about “1–2 times a month,” 5 = “1–2 times or more a week”). In addition, the score was calculated through the sum of each item, and it has a score between 0 and 20 points. The higher the score, the greater the experience of neglect. In this study, Cronbach's α for neglect was 0.692.

Perceived Stress

The scale developed by the National Youth Policy Institute was used to measure perceived stress [42]. Six items were used to measure the examinee’s level of stress during the past year on “academic matters (burden of study, school grades, etc.),” “family discord,” “relationship with peers,” “financial difficulties,” “appearance/physical condition,” and “anxiety for the future (career).” Each item is measured on a 4-point Likert scale (1 = “not at all,” 2 = “somewhat disagree,” 3 = “somewhat agree,” 4 = “strongly agree”). In addition, the score was calculated through the sum of each item, and it has a score between 0 and 24 points. The higher the score, the greater the experience of perceived stress. In this study, the Cronbach's α for perceived stress was 0.762.

Online Violence

The scale developed by the National Youth Policy Institute was used to measure degree of online violence [42]. Five items were used to determine whether an examinee had experienced the following over the past year: being “cursed or insulted,” “threatened,” “sexually harassed,” “having exposed of their private life that they do not want to be revealed,” or ‘bullied on the internet (comments on post boards, messengers [Kakao talk, etc.], Facebook, etc.).” Each item was measured on a 5-point Likert scale (1 = never, 2 = about 1–2 times a year, 3 = about 1–2 times every 2–3 months, 4 = about 1–2 times a month, 5 = 1–2 times or more a week). In addition, the score was calculated through the sum of each item, and it has a score between 0 and 25 points. The higher the score, the greater the experience of online violence. In this study, Cronbach's α for online violence was 0.709.

Offline Violence

The scale developed by the National Youth Policy Institute was used to measure offline violence [42]. Seven items were used to measure how often the student had experienced being severely cursed or insulted, being assaulted or beaten, being bullied, being robbed of their money or things, being threatened, sexual harassment or molestation, and coercive errands by friends, seniors, or juniors at school over the past year. Each question was measured on a 5-point Likert scale (1 = never, 2 = about 1–2 times a year, 3 = about 1–2 times every 2–3 months, 4 = about 1–2 times a month, 5 = 1–2 times or more a week). In addition, the score was calculated through the sum of each item, and it has a score between 0 and 35 points. The higher the score, the greater the experience of being a victim of offline violence. In this study, Cronbach's α for offline violence was 0.793.

Respect for Human Rights

To measure perceived respect for human rights, the scale developed by the National Youth Policy Institute was used [42]. It consisted of five items on the following: home, school, community, country, and cyberspace. Each item was measured on a 4-point Likert scale (1 = “not respected at all,” 2 = “not respected,” 3 = “somewhat respected,” 4 = “highly respected”). In addition, the score was calculated through the sum of each item, and it has a score between 0 and 20 points. The higher the score, the greater the sense of respect for one’s human rights. In this study, the Cronbach's α for respect for human rights was 0.803.

Depression

A scale developed by the National Youth Policy Institute was used to measure depression among adolescents and young adults [42]. It consisted of three items: “I have been lonely for no reason,” “I have been anxious for no reason,” and “I have been sad or depressed for no reason.” Each item was measured on a 4-point Likert scale (1 = “do not agree at all,” 2 = “somewhat disagree,” 3 = “somewhat agree,” 4 = “strongly agree”). In addition, the score was calculated through the sum of each item, and it has a score between 0 and 12 points. The higher the score, the greater the experience of depression. In this study, the Cronbach's α for depression was 0.909.

Analysis

Data from the Survey on the Human Rights of Children and Youth were analyzed with SPSS 25.0. The hierarchical multiple regression analysis was conducted to determine whether gender, age, economic level, neglect, perceived stress, online violence, offline violence, and respect for human rights had a significant influence on adolescent depression. In this study, gender, age, and economic level were included in Step 1, neglet, perceived stress, online violence, and offline violence were added in Step 2, and respect for human rights was added in Step 3.

Results

Correlations

A Pearson’s correlation analysis revealed that the higher the level of depression, the greater the positive correlation between depression and neglect, perceived stress, cyber violence, and offline violence. However, respect for human rights was found to be negatively correlated with depression. The results are presented in Table 2.

Table 2 Correlations N = 6277
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Hierarchical Multiple Regression Analysis

We performed hierarchical multiple regression analysis to determine the association between neglect, perceived stress, online violence, offline violence, respect for human rights and depression (Table 3).

Table 3 Hierarchical multiple regression analysis N = 6277
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In the first step, gender (β = 0.169, p < 0.001), age (β = 0.022, p < 0.05) were significantly associated with depression. However, economic level had no influence on depression. This result indicates that the depression level of female students is significantly higher than that of male students, and depression increases with age. The first step accounted for 15.3% of the variance observed in depression.

In the second step, neglect (β = 0.025, p < 0.05), perceived stress (β = 0.480, p < 0.001), online violence experience (β = 0.058, p < 0.001) were positively associated with depression. However, offline violence had no influence on depression. The second step accounted for an additional 24.7% of variance observed in depression.

In the final step, respect for human rights (β =  − 0. 131, p < 0.001) was negatively associated with depression. These results suggest that adolescents with lower levels of respect for human rights are at a higher risk of depression. The final step accounted for an additional 1.4% of variance observed in depression.

Discussion

This study aimed to identify the impacts of perceived stress, neglect, online violence, offline violence, and respect for human rights on adolescent depression. The primary goal of this study was to verify whether there is a significant relationship between perceived respect for human rights and adolescent depression, even in the presence of control of major risk factors for adolescent depression. The main results of this study are as follows:

First, perceived stress was found to be positively correlated with adolescent depression. This finding is in line with those of numerous previous studies [27]. Perceived stress can be a risk factor for depression at all ages, and for adolescents in particular, it may have a greater negative impact on mental health because of their comparably insufficient stress-coping resources compared with adults [43]. Neglect was also found to have a positive impact on adolescent depression, which supports the results of previous studies [33]. Neglect is closely related to emotional abuse and increases the level of depression by increasing stress and lowering self-esteem [35].

Second, previous studies have shown that having experienced violence is positively associated with depression. In addition, online violence, a new form of violence, has emerged with the development of information and communication technologies. Therefore, it is necessary to identify the specific impact of online and offline violence on depression. A study by Hase et al. [44] indicated that offline violence has a greater impact on depression than online violence, while research by Perren et al. [21] found that online violence has a greater impact on depression. This research has indicated that online violence is positively associated with depression, whereas offline violence had no significant association with depression. Violence that occurs in cyberspace makes it difficult to find the perpetrator because of the anonymity and characteristics of its accessibility, and it has the risk of prolonging the after-effects [23, 24]. According to a study by Li et al. [23], adolescents who have been subjected to online violence are more likely to experience depressive symptoms as they experience anxiety, isolation, and fear due to the development of a negative ego identity. The findings of this study suggests that clinicians and researchers need to pay as much if not more attention to online violence than offline violence when dealing with adolescent depression.

Third, violations of human rights have been identified and emphasized as risk factors for adolescent depression in domestic and international studies. Previous studies have shown the impact of violations of human rights on depression in refugee camps [11], and among students, the greater the perception of violations of human rights, the higher their level of depression [12]. Thus, while numerous previous studies have verified the relationship between human rights violations and depression, the relationship between respect for human rights and depression is obscure. This study found that perceived respect for human rights has a negative association with adolescent depression. Among adolescents, perceived respect for human rights can increase self-esteem and reduce depression through recognition of their own values and abilities [14, 15, 45]. Furthermore, depression has been found to be negatively related to respect for human rights at schools, in countries, and at home out of the sub-factors of perceived respect for human rights, which are “home,” “school,” “community,” “country,” and “cyberspace.”

School can be viewed as a small society, and adolescents achieve physical, emotional, and social development through various interactions at school. In particular, experiencing respect for human rights in adolescents’ relationships with their teachers and peers may increase their self-esteem, making them feel less depressed [46]. Perceived respect for human rights at home may also play an important role in reducing depression. Parents' respectful attitudes toward their children’s human rights at home can help prevent depression by increasing adolescent self-esteem [47]. Respect for human rights as perceived by the community and country can also play an important role in reducing depression. Specifically, efforts with respect to policies such as revising the law for adolescents and improving social perception of adolescents can increase their respect for human rights and reduce their depression [48].

Fourth, gender and age were found to have a significant influence on adolescent depression. This outcome is in accordance with those of previous studies [38, 39, 41]. This result indicates that the depression level of female students is significantly higher than that of male students, and depression increases with age. Korean adolescents are more likely to experience more depression as they advance in age because of increased stress from their studies and university entrance exams [49]. However, economic level did not influence adolescent depression.

The contributions and therapeutic implications of this study are as follows: First, compared with previous studies that identified the relationship between violations of human rights and adolescent depression, this study verified a significant relationship between perceived respect for human rights and depression, even after controlling for perceived stress, neglect, and violence, which are known as major risk factors for adolescent depression. These results suggest that perceived respect for human rights can be a protective factor against adolescent depression. Second, this study showed that online violence may have a significant impact on adolescent depression, similar to offline violence. These results indicate that it is necessary to pay as much if not more attention to online violence than to offline violence when addressing the issue of mental health in adolescents. Moreover, these results highlight the necessity of education and effective intervention for online violence, as well as recognition of the seriousness of online violence in the prevention of adolescent depression.

This study was limited in its ability to infer causality between the two variables, because the relationship between perceived respect for human rights and depression was verified using a cross-sectional design. Future research should determine the specific mechanism that explains depression based on the relationship between violence, perceived human rights, and the variables of depression that are identified in this study. In addition, since the scales used in this study showed relatively low reliability, it is necessary to use a more validity and frequently used scales in subsequent studies.

Summary

Past studies have identified school violence, perceived stress, and neglect as significant risk factors for adolescent depression. These studies have tended to focus on the risk factors for adolescent depression. However, given the gravity of the impact of adolescent depression, not only on one’s psychological and emotional development but also on one’s mental health in adulthood, more understanding of the factors involved in the prevention of adolescent depression is needed. Therefore, the purpose of this study was to identify the impacts of respect for human rights on depression even after controlling perceived stress, neglect, and violence, which are major risk factors. The results of this study suggest that perceived respect for human rights can be a protective factor against adolescent depression.