From childhood adversity to problem behaviors: Role of psychological and structural social integration

Lo-Hsin Chao; Meng-Che Tsai; Ya-Lun Liang; Carol Strong; Chung-Ying Lin

doi:10.1111/ped.13436

From childhood adversity to problem behaviors: Role of psychological and structural social integration

Pediatr Int. 2018 Jan;60(1):23-29. doi: 10.1111/ped.13436. Epub 2017 Dec 14.

Authors

Lo-Hsin Chao¹, Meng-Che Tsai², Ya-Lun Liang¹, Carol Strong¹, Chung-Ying Lin³

Affiliations

¹ Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
² Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
³ Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong.

PMID: 29059487
DOI: 10.1111/ped.13436

Abstract

Background: Childhood adversity (CA) is associated with problem behaviors in adolescence, but the mediators, that is, those factors that help build resilience and prevent some children who experience CA from engaging in problem behaviors, await more exploration, including social integration. The aim of this study was to identify the association between CA and adolescent problem behaviors, and to further examine the mediating role of social integration distinctly as psychological and structural integration.

Methods: Data used were from the Taiwan Education Panel Survey, a core panel of 4,261 students (age 13) surveyed in 2001 and followed for three more waves until age 18. For psychological integration, an average score was calculated to represent adolescents' feelings about their school. Structural integration was constructed using several items about adolescents' school and extracurricular activities. We used structural equation modeling with the diagonally weighted least squares method to examine the effect of CA on the primary outcome: adolescent problem behaviors via social integration.

Results: The hypothesized structural equation model specifying the path from CA to adolescent problem behavior had good fit. Respondents with one CA were indirectly linked to problem behaviors via psychological but not structural integration (e.g. the level of participation in school and non-school activities). On mediation analysis, psychological integration significantly mediated the paths from one CA to all six problem behaviors (all P < 0.05).

Conclusion: The presence of only one CA was indirectly associated with problem behavior via psychological integration; two or more CA were not associated with significant paths to problem behaviors. The contribution of social integration is crucial to an adolescent's development from CA to problem behaviors. To form supportive social relationships to achieve better health, we suggest that those adolescents who have been exposed to CA should be helped to join more teams and take part in more activities, thereby increasing their opportunities for social interaction, and improving their communication skills.

Keywords: childhood adversity; mediation; problem behavior; social integration; structural equation model.

MeSH terms

Adolescent
Adolescent Behavior / psychology*
Female
Humans
Life Change Events*
Longitudinal Studies
Male
Models, Psychological
Problem Behavior / psychology*
Social Participation / psychology*
Social Support*
Taiwan