Role of Resilience in the Relationship between Adverse Childhood Experiences and Behavior Problems among Thai Adolescents in a Province of Southern Thailand: A School-Based Cross-Sectional Study

Authors

  • Tikumporn Hosiri Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
  • Anawin Jongjaroen Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
  • Soisuda Imaroonrak Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
  • Thanayot Sumalrot Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
  • Sucheera Phattharayuttawat Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand

DOI:

https://doi.org/10.33192/smj.v76i5.267232

Keywords:

Adverse childhood experiences, behavior problems, resilience, adolescent

Abstract

Objective: This study aimed to investigate the relationship between adverse childhood experiences (ACEs), behavior problems, and resilience among adolescents in Southern Thailand, with a particular focus on the role of resilience in mediating the relationship between ACEs and behavior problems.

Materials and Methods: A paper-and-pencil questionnaire, covering participants’ general information, ACEs, behavior problems, and resilience, was distributed to 383 senior high school students in a province in Southern Thailand. The data was analyzed using descriptive statistics, correlation analysis, and path analysis.

Results: Out of the 383 students the questionnaire was distributed to, 374 completed the questionnaire, resulting in a response rate of 97.65%. Alarmingly, 59.36% of the respondents reported experiencing at least one type of ACE. Correlation analysis revealed a significant positive association between ACEs and behavior problems (r=0.17, p<0.01) and a negative correlation with resilience (r = -0.19, p<0.01). Path analysis demonstrated that ACEs directly influenced behavior problems (β=0.23, p<0.01) and resilience (β = -0.24, p<0.01). However, the analysis did not support the hypothesis that resilience mediates the relationship between ACEs and behavior problems.

Conclusion: The findings indicate a troubling prevalence of ACEs among senior high school students in Thailand, likely contributing to current adolescent behavior problems. Although the study's path analysis did not align with prior research, it emphasizes the critical role of resilience in mitigating the adverse effects of ACEs. Therefore, resilience remains a necessary skill in helping adolescents cope with the consequences of adverse childhood experiences.

References

Centers for Disease Control and Prevention. Fast Facts: Preventing Adverse Childhood Experiences [Internet]. Atlanta: National Center for Injury Prevention and Control, Division of Violence Prevention; 2022 [updated 2023 June 29; cited 2023 Jan 9]. Available from: https://www.cdc.gov/violenceprevention/aces/fastfact.html.

Ports KA, Ford DC, Merrick MT, Guinn AS. ACEs: Definitions, measurement, and prevalence. In: Asmundson GJG, Afifi TO, editors. Adverse Childhood Experiences: Academic Press; 2020. p. 17-34.

Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, et al. Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: The Adverse Childhood Experiences (ACE) Study. Am J Prev Med. 1998;14(4):245-58.

Merrick MT, Ford DC, Ports KA, Guinn AS. Prevalence of Adverse Childhood Experiences From the 2011-2014 Behavioral Risk Factor Surveillance System in 23 States. JAMA Pediatr. 2018;172(11):1038-44.

Subramaniam M, Abdin E, Seow E, Vaingankar JA, Shafie S, Shahwan S, et al. Prevalence, socio-demographic correlates and associations of adverse childhood experiences with mental illnesses: Results from the Singapore Mental Health Study. Child Abuse Negl. 2020;103:104447.

Qu G, Ma S, Liu H, Han T, Zhang H, Ding X, et al. Positive childhood experiences can moderate the impact of adverse childhood experiences on adolescent depression and anxiety: Results from a cross-sectional survey. Child Abuse Negl. 2022;125:105511.

Htike M, Thepthien B, Chucharoen P. A web-based survey on adverse childhood experience, anxiety, depression, sexual behavior affecting methamphetamine use among adolescents in Bangkok, Thailand. J Pub Health Dev. 2017;15(3):17-31.

Thepthien B, Htike M. Associations between adverse childhood experiences and adverse health outcomes among adolescents in Bangkok, Thailand. Cogent Psychology. 2020;7(1):1832403.

Bevilacqua L, Kelly Y, Heilmann A, Priest N, Lacey RE. Adverse childhood experiences and trajectories of internalizing, externalizing, and prosocial behaviors from childhood to adolescence. Child Abuse Negl. 2021;112:104890.

Testa A, Jackson DB, Ganson KT, Nagata JM. Adverse Childhood Experiences and Criminal Justice Contact in Adulthood. Acad Pediatr. 2022;22(6):972-80.

Basto-Pereira M, Gouveia-Pereira M, Pereira CR, Barrett EL, Lawler S, Newton N, et al. The global impact of adverse childhood experiences on criminal behavior: A cross-continental study. Child Abuse Negl. 2022;124:105459.

Office of Planning and Budget. Annaul Judicial Statistics B.E.2565 (January - December) Bangkok: Court of Justice; 2023 [cited 2023 October 10]. Available from: https://oppb.coj.go.th/th/content/category/detail/id/8/cid/73/iid/331147.

VandenBos GR. APA dictionary of psychology. 2nd ed. Washington, D.C.: American Psychological Association; 2015.

Hatamizadeh N, Adibsereshki N, Kazemnejad A, Sajedi F. Randomized trial of a resilience intervention on resilience, behavioral strengths and difficulties of mainstreamed adolescent students with hearing loss. Int J Pediatr Otorhinolaryngol. 2020;128:109722.

Arslan G. Psychological maltreatment, emotional and behavioral problems in adolescents: The mediating role of resilience and self-esteem. Child Abuse Negl. 2016;52:200-9.

Wanichsuwan C. Factor affecting the juvenile delinquency in the Observation and Protection Center of Songkhla Province [Master’s thesis]. PSU Knowledge Bank: Prince of Songkla University; 2010.

Dong M, Anda RF, Felitti VJ, Dube SR, Williamson DF, Thompson TJ, et al. The interrelatedness of multiple forms of childhood abuse, neglect, and household dysfunction. Child Abuse Negl. 2004;28(7):771-84.

Rungmueanporn L, Buathong N, Chandarasiri P, Wittayasai W. Development of the Adverse Childhood Experiences (ACE) Questionnaire Thai version. Chula Med Bull. 2019;1(3):251-60.

Boonyamalik P, Suksawang S, Swangwongsin S, Narakornpijit K. The Development and Validity Testing of Assessments for Preventing and Resolving Violence in Vocational Students. J Psychiatr Assoc Thailand. 2012;57(1):1-18.

Connor KM, Davidson JRT. Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC). Depress Anxiety. 2003;18(2):76-82.

Assink M, Spruit A, Schuts M, Lindauer R, van der Put CE, Stams G-JJM. The intergenerational transmission of child maltreatment: A three-level meta-analysis. Child Abuse Negl. 2018;84:131-45.

Bandura A, Ross D, Ross SA. Transmission of aggression through the imitation of aggressive models. J Abnorm Soc Psychol. 1961;63:575-82.

O'Malley DM, Randell KA, Dowd MD. Family Adversity and Resilience Measures in Pediatric Acute Care Settings. Public Health Nurs. 2016;33(1):3-10.

Citak C, Erten E. Impact of Childhood Trauma and Attachment on Resilience in Remitted Patients with Bipolar Disorder. J Affect Disord. 2021;280(Pt A):219-27.

Mc Gee SL, Maercker A, Carr A, Thoma MV. “Some call it resilience”: A profile of dynamic resilience-related factors in older adult survivors of childhood institutional adversity and maltreatment. Child Abuse Negl. 2020;107:104565.

Conn A-M, Urbach K, Butler N, Bondi N, Cunningham J, Yussman S. Building Youth Resilience to Adverse Childhood Experiences: Small Group Therapy in an Urban School-Based Health Center. Journal of Adolescent Health. 2020;66(2, Supplement):S13.

Oshri A, Duprey EK, Liu S, Gonzalez A. ACEs and resilience: Methodological and conceptual issues. In: Asmundson GJG, Afifi TO, editors. Adverse Childhood Experiences: Academic Press; 2020. p. 287-306.

Yang Y, Ma X, Kelifa MO, Li X, Chen Z, Wang P. The relationship between childhood abuse and depression among adolescents: The mediating role of school connectedness and psychological resilience. Child Abuse Negl. 2022;131:105760.

Zheng K, Chu J, Zhang X, Ding Z, Song Q, Liu Z, et al. Psychological resilience and daily stress mediate the effect of childhood trauma on depression. Child Abuse Negl. 2022;125:105485.

Mlouki I, Bouanene I, Sioud I, Bchir A, al'Absi M, El Mhamdi S. Impulsivity mediates the impact of early life adversity on high risk behaviors among Tunisian adolescents. Prev Med Rep. 2021;23:101424.

Kelifa MO, Yang Y, Herbert C, He Q, Wang P. Psychological resilience and current stressful events as potential mediators between adverse childhood experiences and depression among college students in Eritrea. Child Abuse Negl. 2020;106:104480.

Liu M, Mejia-Lancheros C, Lachaud J, Nisenbaum R, Stergiopoulos V, Hwang SW. Resilience and Adverse Childhood Experiences: Associations With Poor Mental Health Among Homeless Adults. Am J Prev Med. 2020;58(6):807-16.

Krobtrakulchai T, Puranachaikere T, Atsariyasing W, Viravan N, Thongchoi K, Prommin P. Enhancing Adolescent Self-Esteem: A Pilot Randomized Controlled Trial of the Online Mindfulness-Based Intervention Program (MBSI Online). Siriraj Med J. 2024;76(2):40-51.

Published

01-05-2024

How to Cite

Hosiri, T. ., Jongjaroen, A., Imaroonrak, S. ., Sumalrot, T. ., & Phattharayuttawat, S. . (2024). Role of Resilience in the Relationship between Adverse Childhood Experiences and Behavior Problems among Thai Adolescents in a Province of Southern Thailand: A School-Based Cross-Sectional Study. Siriraj Medical Journal, 76(5), 282–292. https://doi.org/10.33192/smj.v76i5.267232

Issue

Section

Original Article

Categories