Chao Lo-Hsin, Tsai Meng-Che, Liang Ya-Lun, Strong Carol, Lin Chung-Ying
Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Pediatr Int. 2018 Jan;60(1):23-29. doi: 10.1111/ped.13436. Epub 2017 Dec 14.
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.
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.
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).
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.
童年逆境（CA）与青少年的问题行为有关，但中介因素，即那些有助于培养复原力并防止一些经历过CA的儿童出现问题行为的因素，仍有待进一步探索，包括社会融合。本研究的目的是确定CA与青少年问题行为之间的关联，并进一步明确考察社会融合作为心理融合和结构融合的中介作用。
使用的数据来自台湾教育面板调查，该核心面板对2001年调查的4261名13岁学生进行了跟踪，随后又进行了三轮调查，直至18岁。对于心理融合，计算平均分以代表青少年对学校的感受。结构融合是通过关于青少年学校和课外活动的几个项目构建的。我们使用对角加权最小二乘法的结构方程模型来检验CA对主要结果的影响：通过社会融合导致青少年问题行为。
指定从CA到青少年问题行为路径的假设结构方程模型拟合良好。有一项CA的受访者通过心理融合而非结构融合（例如参与学校和非学校活动的程度）与问题行为间接相关。在中介分析中，心理融合显著中介了从一项CA到所有六种问题行为的路径（所有P<0.05）。
仅存在一项CA通过心理融合与问题行为间接相关；两项或更多项CA与问题行为的显著路径无关。社会融合对青少年从CA发展到问题行为的过程至关重要。为了形成支持性的社会关系以实现更好的健康，我们建议帮助那些经历过CA的青少年加入更多团队并参加更多活动，从而增加他们的社会互动机会，并提高他们的沟通技巧。
