Center for Reproductive Health

Shoshanna L. Fine, Ph.D., M.P.H., Rashelle J. Musci, Ph.D., M.S., Judith K. Bass, Ph.D., M.P.H., M.I.A., Effie Chipeta, Ph.D., Eric M. Mafuta, M.D., Ph.D., M.P.H., Anggriyani W. Pinandari, M.P.H., Siswanto A. Wilopo, M.D., Sc.D., M.Sc., Xiayun Zuo, Ph.D., and Robert W. Blum, M.D., Ph.D., M.P.H.

A Multi-Country Study of Risk and Protective Factors for Emotional and Behavioral Problems Among Early Adolescent

Purpose: Early adolescence (ages 10e14) is a critical period for psychosocial development, but few studies have focused on risk and protective factors for emergent psychosocial challenges among youth living in low- and middle-income countries. This study explored the contribution of social environmental factors to patterns of emotional and behavioral problems among early adolescents across four low- and middle-income countries.

Methods: Participants were drawn from the Global Early Adolescent Study, and included 10,437 early adolescents from six low resource urban settings in the Democratic Republic of Congo, Malawi, Indonesia, and China. Multivariate latent class regression was used to examine the asso- ciations between distinct patterns of emotional and behavioral problems and risk and protective factors across the family, peer, school, and neighborhood levels.

Results: Across countries, childhood adversity, peer bullying behaviors, and a perceived lack of school safety were consistently associated with emotional and behavioral problems. With some contextual variability, peer substance use and a perceived lack of neighborhood safety also emerged as significant risk factors. The magnitude of these associations was generally greatest among a subgroup of early adolescents with co-occurring emotional and behavioral problems.

Discussion: The overall consistency of findings across countries is suggestive of the generalizability of risk factors in early adolescence and indicates that interventions bolstering psychosocial adjustment among this age group may have applicability in diverse cross-national settings. Given the significance of peer bullying behaviors and school safety, multicomponent school-based interventions may be an especially applicable approach.