Danpho Wichuda, Thommachot Palisara
Child and Adolescent Psychiatry, Mahidol University Ramathibodi Hospital, Bangkok, Thailand.
Child and Adolescent Psychiatry, Mahidol University Ramathibodi Hospital, Bangkok, Thailand
BMJ Paediatr Open. 2025 May 2;9(1):e003238. doi: 10.1136/bmjpo-2024-003238.
Adolescents in out-of-home care face higher mental health risks and exhibit significant behavioural difficulties associated with these risks. Resilience processes involve a complex interplay between individual, family and community characteristics, enhancing mental well-being while reducing the risk of depression and anxiety. Despite its significance, research on resilience factors in Thai adolescents in out-of-home care remains limited.
This cross-sectional study explored the factors influencing resilience among adolescents living in five out-of-home care facilities in Bangkok. A total of 407 participants were recruited through cluster sampling. Eligible participants were required to be within 10-19 years, able to read, write, or communicate effectively and provide written informed consent. Data collection was conducted using a self-report questionnaire, which included several standardised tools: the Youth Risk Behavior Survey to evaluate safety, the Inventory of Parent and Peer Attachment to assess attachment to caregivers and peers, the 9-item Resilience Inventory to measure resilience levels, the Patient Health Questionnaire for Adolescents to assess depression, and the Generalized Anxiety Disorder questionnaire to assess anxiety. Data were analysed using Pearson correlation and multivariate linear regression.
Peer attachment demonstrated the strongest positive association with resilience (B=1.486, p<0.001), followed by caregiver attachment (B=0.561, p=0.014). Higher depressive symptoms (B=-0.236, p=0.011) and suicidal risk (B=-2.276, p=0.008) were significantly associated with lower resilience. Factors such as extracurricular activities, sense of safety and physical or mental health conditions were not significantly associated with resilience in multivariate analysis.
Adolescents in out-of-home care with strong relationships with caregivers and peers displayed greater resilience and lower rates of depression and suicidal risk. These findings highlight the importance of supportive relationships in fostering resilience and improving mental health outcomes in this population.
接受院外照料的青少年面临更高的心理健康风险,并表现出与这些风险相关的显著行为困难。复原力过程涉及个体、家庭和社区特征之间的复杂相互作用,在降低抑郁和焦虑风险的同时提高心理健康水平。尽管其具有重要意义,但关于泰国接受院外照料青少年的复原力因素的研究仍然有限。
这项横断面研究探讨了影响居住在曼谷五个院外照料机构的青少年复原力的因素。通过整群抽样招募了总共407名参与者。符合条件的参与者必须在10至19岁之间,能够有效阅读、写作或交流,并提供书面知情同意书。使用自我报告问卷进行数据收集,该问卷包括几种标准化工具:用于评估安全性的青少年风险行为调查、用于评估与照顾者和同伴依恋关系的父母与同伴依恋量表、用于测量复原力水平的9项复原力量表、用于评估抑郁的青少年患者健康问卷以及用于评估焦虑的广泛性焦虑症问卷。使用Pearson相关性分析和多元线性回归分析数据。
同伴依恋与复原力表现出最强的正相关(B = 1.486,p < 0.001),其次是照顾者依恋(B = 0.561,p = 0.014)。较高的抑郁症状(B = -0.236,p = 0.011)和自杀风险(B = -2.276,p = 0.008)与较低的复原力显著相关。在多变量分析中,课外活动、安全感和身心健康状况等因素与复原力没有显著关联。
与照顾者和同伴关系密切的院外照料青少年表现出更强的复原力以及更低的抑郁和自杀风险发生率。这些发现凸显了支持性人际关系在培养该人群复原力和改善心理健康结果方面的重要性。