Introduction
Methods
Study design
Settings
Inclusion criteria
Exclusion criteria
Exposure
Adverse childhood experiences
Resilience
Outcome
Mental health
Covariates
Statistics analysis
Results
General demographic statistics
Variables | Total (N, %) | No (n,%) | Have (n,%) | t/χ2 value |
---|---|---|---|---|
Age | 20.54 ± 1.32 | 20.51 ± 2.08 | 0.52 | |
Gender | 69.29** | |||
Male | 1833 | 1025(55.9) | 808(44.1) | |
Female | 1745 | 1211(69.4) | 534(30.6) | |
Residential areas | 2.95 | |||
Country | 1665 | 1018(61.1) | 647(38.9) | |
Town | 783 | 491(62.7) | 292(37.3) | |
Urban | 1130 | 727(64.3) | 403(35.7) | |
Only child | 1.64 | |||
Yes | 11,280 | 720(61.0) | 460(39.0) | |
No | 2399 | 1516(63.2) | 882(36.8) | |
Father’s education | 26.74** | |||
Not clear | 128 | 58(45.3) | 70(54.7) | |
Below primary | 318 | 191(60.1) | 127(39.9) | |
Primary | 427 | 282(66.00 | 145(34.0) | |
Junior high | 1355 | 862(63.6) | 493(36.4) | |
High school or technical secondary school | 732 | 434(59.9) | 298(40.7) | |
Junior college or above | 618 | 409(66.2) | 209(33.8) | |
Mother’s education | 24.36** | |||
Not clear | 153 | 67(43.8) | 86(56.2) | |
Below primary | 729 | 456(62.6) | 273(37.4) | |
Primary | 628 | 401(63.9) | 227(36.1) | |
Junior high | 1100 | 699(63.5) | 401(36.5) | |
High school or technical secondary school | 552 | 346(62.7) | 206(37.3) | |
Junior college or above | 416 | 267(64.2) | 149(35.8) | |
Family economic conditions | 35.88** | |||
Bad | 212 | 98(46.2) | 114(53.8) | |
Worse | 891 | 538(60.4) | 353(39.6) | |
Medium | 2242 | 1462(65.2) | 780(34.8) | |
Better | 207 | 126(60.9) | 81(39.1) | |
Good | 26 | 12(46.2) | 14(53.8) | |
Friends number | 84.12** | |||
No | 85 | 27(31.8) | 58(68.2) | |
1–2 | 1187 | 656(55.3) | 531(44.7) | |
3–5 | 1730 | 1160(67.1) | 570(32.9) | |
6 or more | 576 | 393(68.2) | 183(31.8) |
Variables | Total (N, %) | No (n,%) | Have (n,%) | t/χ2 value |
---|---|---|---|---|
Age | 20.53 ± 1.57 | 20.53 ± 2.11 | 0.07 | |
Gender | 8.52** | |||
Male | 1833 | 1593(86.9) | 240(13.1) | |
Female | 1745 | 1571(90.0) | 174(10.0) | |
Residential areas | 5.21 | |||
Country | 1665 | 1455(87.4) | 210(12.6) | |
Town | 783 | 690(88.1) | 93(11.9) | |
Urban | 1130 | 1019(90.2) | 111(9.8) | |
Only child | 0.38 | |||
Yes | 1049(88.9) | 131(11.1) | ||
No | 2115(88.20 | 283(11.80 | ||
Father’s education | 4.30 | |||
Not clear | 128 | 110(85.9) | 18(14.1) | |
Below primary | 318 | 275(86.50 | 43(13.5) | |
Primary | 427 | 378(88.50 | 49(11.5) | |
Junior high | 1355 | 1214(89.6) | 141(10.4) | |
High school or technical secondary school | 732 | 641(87.6) | 91(12.4) | |
Junior college or above | 618 | 546(88.3) | 72(11.7) | |
Mother’s education | 11.43* | |||
Not clear | 153 | 127(83.0) | 26(17.0) | |
Below primary | 729 | 634(87.0) | 95(13.0) | |
Primary | 628 | 554(88.2) | 74(11.8) | |
Junior high | 1100 | 984(89.5) | 116(10.5) | |
High school or technical secondary school | 552 | 484(87.7) | 68(12.3) | |
Junior college or above | 416 | 381(91.6) | 35(8.4) | |
Family economic conditions | 41.17** | |||
Bad | 212 | 160(75.5) | 52(24.5) | |
Worse | 891 | 781(87.7) | 110(12.3) | |
Medium | 2242 | 2014(89.8) | 228(10.2) | |
Better | 207 | 184(88.9) | 23(11.1) | |
Good | 26 | 25(96.2) | 1(3.8) | |
Friends number | 42.01** | |||
No | 85 | 63(74.1) | 22(25.9) | |
1–2 | 1187 | 1017(85.7) | 170(14.3) | |
3–5 | 1730 | 1545(89.3) | 185(10.7) | |
6 or more | 576 | 539(93.6) | 37(6.4) |
Association between independent variables and adolescent psychological and behavioral problems
Depression | |||||||
---|---|---|---|---|---|---|---|
Emotional abuse | R2 | β | t | p | F | LLCI | ULCI |
Model 1 | 0.03 | 1.19 | 10.19 | <0.01 | 109.97 | 0.97 | 1.42 |
Model 2 | 0.07 | 1.14 | 10.15 | <0.01 | 31.61 | 0.92 | 1.36 |
Physical abuse | |||||||
Model 1 | 0.017 | 1.21 | 7.76 | <0.01 | 60.18 | 0.91 | 1.52 |
Model 2 | 0.06 | 1.06 | 6.88 | <0.01 | 25.11 | 0.76 | 1.36 |
Sexual abuse | |||||||
Model 1 | 0.01 | 1.28 | 5.96 | <0.01 | 35.56 | 0.86 | 1.70 |
Model 2 | 0.055 | 1.12 | 5.31 | <0.01 | 22.89 | 0.70 | 1.53 |
Emotional neglect | |||||||
Model 1 | 0.17 | 0.97 | 27.18 | <0.01 | 738.49 | 0.90 | 1.04 |
Model 2 | 0.19 | 0.91 | 25.11 | <0.01 | 93.14 | 0.84 | 0.98 |
Physical neglect | |||||||
Model 1 | 0.16 | 1.55 | 25.80 | <0.01 | 665.79 | 1.43 | 1.67 |
Model 2 | 0.17 | 1.45 | 23.46 | <0.01 | 83.78 | 1.33 | 1.57 |
ACEs | |||||||
Model 1 | 0.20 | 0.62 | 29.89 | <0.01 | 893.37 | 0.58 | 0.66 |
Model 2 | 0.22 | 0.58 | 27.60 | <0.01 | 108.38 | 0.54 | 0.62 |
BMI | |||||||
Model 1 | 0.004 | 0.14 | 3.76 | <0.01 | 14.10 | 0.065 | 0.21 |
Model 2 | 0.048 | 0.073 | 2.01 | <0.05 | 22.39 | 0.002 | 0.15 |
Resilience | |||||||
Model 1 | 0.35 | -0.28 | -44.13 | <0.01 | 1947.42 | -0.29 | -0.27 |
Model 2 | 0.36 | -0.27 | -42.05 | <0.01 | 253.74 | -0.28 | -0.26 |
Anxiety | |||||||
---|---|---|---|---|---|---|---|
Emotional abuse | R2 | β | t | p | F | LLCI | ULCI |
Model 1 | 0.05 | 1.03 | 12.91 | <0.01 | 166.65 | 0.88 | 1.19 |
Model 2 | 0.08 | 0.99 | 12.53 | <0.01 | 35.29 | 0.84 | 1.15 |
Physical abuse | |||||||
Model 1 | 0.02 | 0.96 | 8.67 | <0.01 | 75.10 | 0.74 | 1.17 |
Model 2 | 0.058 | 0.86 | 7.91 | <0.01 | 24.35 | 0.65 | 1.08 |
Sexual abuse | |||||||
Model 1 | 0.02 | 1.38 | 9.14 | <0.01 | 83.57 | 1.08 | 1.67 |
Model 2 | 0.06 | 1.28 | 8.64 | <0.01 | 25.75 | 0.99 | 1.57 |
Emotional neglect | |||||||
Model 1 | 0.11 | 0.55 | 21.31 | <0.01 | 453.99 | 0.50 | 0.61 |
Model 2 | 0.13 | 0.51 | 19.34 | <0.01 | 60.43 | 0.46 | 0.56 |
Physical neglect | |||||||
Model 1 | 0.11 | 0.93 | 21.35 | <0.01 | 455.94 | 0.85 | 1.02 |
Model 2 | 0.13 | 0.86 | 19.19 | <0.01 | 59.78 | 0.77 | 0.95 |
ACEs | |||||||
Model 1 | 0.16 | 0.39 | 25.74 | <0.01 | 662.30 | 0.36 | 0.42 |
Model 2 | 0.17 | 0.36 | 23.60 | <0.01 | 81.64 | 0.33 | 0.39 |
BMI | |||||||
Model 1 | 0.003 | 0.086 | 3.33 | <0.01 | 11.08 | 0.035 | 0.14 |
Model 2 | 0.04 | 0.045 | 1.76 | 0.079 | 19.59 | -0.005 | 0.096 |
Resilience | |||||||
Model 1 | 0.14 | -0.13 | -24.50 | <0.01 | 600.33 | -0.14 | -0.12 |
Model 2 | 0.16 | -0.12 | -22.48 | <0.01 | 85.08 | -0.13 | -0.11 |
DASS-pressure | |||||||
---|---|---|---|---|---|---|---|
Emotional abuse | R2 | β | t | p | F | LLCI | ULCI |
Model 1 | 0.09 | 0.57 | 18.53 | <0.01 | 343.25 | 0.51 | 0.63 |
Model 2 | 0.11 | 0.54 | 17.59 | <0.01 | 49.78 | 0.48 | 0.60 |
Physical abuse | |||||||
Model 1 | 0.02 | 0.37 | 8.38 | <0.01 | 70.15 | 0.28 | 0.45 |
Model 2 | 0.05 | 0.35 | 8.08 | <0.01 | 21.68 | 0.27 | 0.44 |
Sexual abuse | |||||||
Model 1 | 0.02 | 0.50 | 8.30 | <0.01 | 68.86 | 0.38 | 0.61 |
Model 2 | 0.05 | 0.47 | 7.95 | <0.01 | 21.44 | 0.35 | 0.59 |
Emotional neglect | |||||||
Model 1 | 0.006 | 0.05 | 4.48 | <0.01 | 20.05 | 0.03 | 0.07 |
Model 2 | 0.04 | 0.03 | 3.01 | <0.01 | 15.20 | 0.01 | 0.06 |
Physical neglect | |||||||
Model 1 | 0.004 | 0.07 | 3.76 | <0.01 | 14.10 | 0.03 | 0.11 |
Model 2 | 0.04 | 0.05 | 2.43 | <0.05 | 14.84 | 0.01 | 0.08 |
ACEs | |||||||
Model 1 | 0.03 | 0.06 | 93.89 | <0.01 | 9.69 | 0.05 | 0.07 |
Model 2 | 0.05 | 0.05 | 8.22 | <0.01 | 21.94 | 0.04 | 0.07 |
BMI | |||||||
Model 1 | 0.001 | 0.02 | 2.29 | <0.05 | 5.25 | 0.003 | 0.04 |
Model 2 | 0.04 | 0.02 | 2.06 | <0.05 | 14.65 | 0.001 | 0.04 |
Resilience | |||||||
Model 1 | 0.03 | -0.02 | -9.65 | <0.01 | 93.16 | -0.03 | -0.02 |
Model 2 | 0.05 | -0.02 | -7.97 | <0.01 | 21.47 | -0.02 | -0.01 |
Impact of the moderation analysis between emotional abuse and resilience, Body Mass Index on adolescent mental health
Variables | DASS-depression | |||||
---|---|---|---|---|---|---|
coeff
|
SE
| t value | P value | LLCI | ULCI | |
Emotional abuse | 1.42 | 0.27 | 5.19 | <0.01 | 0.88 | 1.95 |
Resilience | 0.05 | 0.02 | 1.97 | <0.05 | 0.0002 | 0.09 |
BMI | 0.19 | 0.06 | 3.02 | <0.01 | 0.07 | 0.32 |
Int_1 | -0.015 | 0.004 | -3.55 | <0.01 | -0.02 | -0.007 |
Int_2 | -0.04 | 0.01 | -3.75 | <0.01 | -0.06 | -0.02 |
Int_3 | -0.003 | 0.001 | -2.98 | <0.01 | -0.005 | -0.001 |
Int_4 | 0.0007 | 0.0002 | 3.79 | <0.01 | 0.0003 | 0.001 |
Variables | DASS-anxiety | |||||
---|---|---|---|---|---|---|
coeff
|
SE
| t value | P value | LLCI | ULCI | |
Emotional abuse | 0.88 | 0.27 | 3.21 | <0.01 | 0.34 | 1.41 |
Resilience | 0.007 | 0.02 | 0.29 | >0.05 | -0.04 | 0.05 |
BMI | 0.12 | 0.06 | 1.81 | >0.05 | -0.009 | 0.24 |
Int_1 | -0.007 | 0.004 | -1.71 | >0.05 | -0.016 | 0.001 |
Int_2 | -0.028 | 0.01 | -2.51 | <0.05 | -0.05 | -0.006 |
Int_3 | -0.002 | 0.001 | -1.62 | >0.05 | -0.004 | 0.0003 |
Int_4 | 0.0004 | 0.0002 | 2.42 | <0.05 | 0.0001 | 0.0008 |
Variables | DASS-pressure | |||||
---|---|---|---|---|---|---|
coeff
|
SE
| t value | P value | LLCI | ULCI | |
Emotional abuse | 1.21 | 0.31 | 3.88 | <0.01 | 0.60 | 1.82 |
Resilience | 0.02 | 0.03 | 0.75 | >0.05 | -0.03 | 0.07 |
BMI | 0.15 | 0.07 | 2.03 | <0.05 | 0.005 | 0.29 |
Int_1 | -0.01 | 0.005 | -2.26 | <0.05 | -0.02 | -0.001 |
Int_2 | -0.04 | 0.01 | -2.92 | <0.01 | -0.06 | -0.01 |
Int_3 | -0.002 | 0.001 | -1.90 | 0.054 | -0.005 | 0.0001 |
Int_4 | 0.0006 | 0.0002 | 2.85 | <0.01 | 0.0002 | 0.001 |
Impact of the mediate moderation analysis between adverse childhood experiences and resilience, Body Mass Index on adolescent mental health
Variables | DASS-depression | |||||
---|---|---|---|---|---|---|
coeff
|
SE
| t value | P value | LLCI | ULCI | |
ACEs | -0.05 | 0.06 | -0.79 | >0.05 | -0.17 | 0.07 |
Resilience | -0.05 | 0.03 | -1.58 | >0.05 | -0.11 | 0.01 |
BMI | 0.09 | 0.11 | 0.87 | >0.05 | -0.12 | 0.30 |
Int_1 | 0.0003 | 0.0008 | 0.39 | >0.05 | -0.001 | 0.002 |
Int_2 | -0.004 | 0.0025 | -1.45 | >0.05 | -0.008 | 0.001 |
Int_3 | -0.002 | 0.001 | -1.57 | >0.05 | -0.005 | 0.0005 |
Int_4 | 0.0001 | 0.000 | 2.46 | <0.05 | 0.000 | 0.0001 |
Variables | DASS-anxiety | |||||
---|---|---|---|---|---|---|
coeff
|
SE
| t value | P value | LLCI | ULCI | |
ACEs | 0.013 | 0.05 | 0.24 | >0.05 | -0.09 | 0.12 |
Resilience | -0.02 | 0.028 | -0.73 | >0.05 | -0.07 | 0.03 |
BMI | 0.20 | 0.09 | 2.09 | <0.05 | 0.01 | 0.38 |
Int_1 | -0.0002 | 0.0007 | -0.30 | >0.05 | -0.002 | 0.001 |
Int_2 | -0.006 | 0.002 | -2.56 | <0.05 | -0.01 | -0.001 |
Int_3 | -0.003 | 0.001 | -2.53 | <0.05 | -0.005 | -0.0007 |
Int_4 | 0.0001 | 0.000 | 3.21 | <0.01 | 0.0000 | 0.0002 |
Variables | DASS-pressure | |||||
---|---|---|---|---|---|---|
coeff
|
SE
| t value | P value | LLCI | ULCI | |
ACEs | -0.05 | 0.06 | -0.79 | >0.05 | -0.17 | 0.07 |
Resilience | -0.05 | 0.03 | 1.58 | >0.05 | -0.11 | 0.01 |
BMI | 0.09 | 0.11 | 0.87 | >0.05 | -0.12 | 0.30 |
Int_1 | 0.0003 | 0.0008 | 0.38 | >0.05 | -0.001 | 0.002 |
Int_2 | -0.004 | 0.003 | -1.45 | >0.05 | -0.008 | 0.001 |
Int_3 | -0.002 | 0.001 | -1.57 | >0.05 | -0.005 | 0.0005 |
Int_4 | 0.0001 | 0.000 | 2.46 | <0.05 | 0.000 | 0.0001 |