Journal List > J Korean Acad Psychiatr Ment Health Nurs > v.25(3) > 1058081

Jung and Lee: Effects of Ego-resilience Interventions among Children and Adolescents in Korea: A Meta-analysis



This study was a meta-analysis planned to exam effects of ego-resilience interventions among children and adolescents in Korea.


Search for relevant articles included several electronic databases and hand-search from article references. Thirteen studies met inclusion criteria from 1,638 studies. Comprehensive Meta-Analysis (version 3) and Review Manager (version 5) were used to analyze effect sizes, investigate possible causes of heterogeneity and check publication bias with a funnel plot and its trim-and-fill analysis.


Overall effect size of ego-resilience interventions were medium (Hedges'g=0.66) and medium heterogeneity (I2=54%). Subgroup analysis was performed to estimate causes of heterogeneity. The effect size for normal populations (g=0.70) was larger than for risk populations (g=0.64). Interventions for primary school students (g=0.74) were more effective than interventions for adolescents (g=0.51). Interventions in the community (g=0.72) shown larger effect size than intervention at school (g=0.51). Art therapy (g=0.79) had a better effect than cognitive behavior therapy (g=0.62). Interventions with over 1,000 minutes (g=1.10) and intervention with over 11 sessions (g=1.40) were effective. This study found no significant publication bias.


Based on current findings, there is obvious evidence that ego-resilience interventions have significant effects in improving ego-resilience among children and adolescents in Korea.

Figures and Tables

Figure 1

Flow of studies included from database search.

Figure 2

Forest plots of the effects of ego-resilience interventions.

Figure 3

Funnel plot of effect sizes by standard error.

Table 1

Characteristics of Enrolled Study


RCT=Randomized controled trial; NRCT=Non-randomized controled trial; CBT=Cognitive behavior therapy; AT=Art therapy; ERS=Ego-Resilience Scale (ERS, Block & Kremen, 1996); RSA=Resilience Scale for Adolescent (RSA, Joo & Lee, 2011); RQT=Resilience Quotient Test (RQT, Reivich & Shatte, 2002); WestED=Healthy Kids Resilience Assessment (WestED, 1999); IR=Interpersonal relationship; EV=Energy or vitality; EC=Emotional control; Cu=Curiosity; Op=Optimism; SE=Self-efficacy; PBS=Problem solving skill; StC=Study competence; RNF=Regulating negative emotion; SR=Supportive relationship; Co=Control; Sp=Spontaneity; SC=Social competence; ASS=Autonomy and sence of self; SMP=Sense of meaning and purpose.

Table 2

Results for Subgroups Analysis


k=Number of studies; CI=Confidence interval; Qb=Q-value between subgroups.


CONFLICTS OF INTEREST The authors declared no conflict of interest.


Appendix 1

Studies Included in Meta-analysis

T=Thesis; J=Published journal article.

Appendix 2

Quality Assessment of Studies Included in Meta-analysis (SIGN)

Y=Yes; N=No; N/R=Not-reported; NA=Not applicable; ++=All or most of the criteria have been fulfilled; where they have not been fulfilled the conclusions of the study or review are thought very unlikely to be altered; +=Some of the criteria have been fulfilled; those criteria that have not been fulfilled or not adequately described are thought unlikely to alter the conclusions.


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