Abstracts for the 15th International Conference on Child and Adolescent Psychopathology (ICCAP 2023), Kuching, Sarawak (on Borneo Island), August 7 –9, 2023
Guest Editor:
Cecilia A Essau, HBA, MA, PhD, Habilitation, SFHEA, CPsychol, FBPsS
Chair, Organizing and Scientifi c Committees of the ICCAP2023
Parenting Practices and Attitudes Towards Adolescent Mental Health in MALAYSIA
Darlene Koh1, Liz Jones2, Patrick Olivier1, & Marie Yap1
1Monash University, Melbourne, AUSTRALIA
2Monash University Malaysia, MALAYSIA
Background: ‘Partners in Parenting’ (PiP) is an evidence-based digital parenting intervention that supports parents in reducing the risk of adolescent anxiety and depression, and has demonstrated efficacy in Australia. Before deploying it in Malaysia, PiP may need adaptations to a Southeast Asian context, where more familistic and interdependent values are endorsed.
Aims: The study presents Phase one of adapting PiP to MALAYSIA where we explored MALAYSIAn parenting practices, as well as parents’ attitudes and beliefs towards adolescent mental health and help seeking from professionals.
Methods: Semi-structured interviews were conducted in English, Malay, Chinese or Tamil with 39 MALAYSIAn parents of adolescents (aged 12-17 years) attending public schools.
Results: Thematic analysis was used to identify aspects of MALAYSIAn parenting that may differ from PiP assumptions about parenting. Preliminary coding found religion and the extended family to be strong influences in guiding parenting. Fathers described a more distant, practical relationship with their adolescents, while mothers shared a closer, emotional one. MALAYSIAn parents have mixed perceptions about adolescent mental health, perceiving it as a rising concern, but also expressing unfamiliarity or discomfort with the topic. Consulting with a mental health professional was largely acceptable, but only as a last resort.
Conclusions: PiP adaptations for MALAYSIA may include incorporating cultural nuances in parenting (e.g., religion) and demystifying issues of teenage mental health and help seeking. A culturally relevant and accessible PiP for MALAYSIAn parents has the potential to support families, especially given the increased demand on local mental health services following the COVID-19 pandemic.
Parent-Child Communication About Educational Aspirations: What are Adolescents in Rural China Saying?
Xiaodi Chen1, Jennifer L. Allen2, Eirini Flouri3, Xinyi Cao3, & Therese Hesketh1
1University College London, UK
2University of Bath, UK
3UCL Institute of Education, UK
Background: According to the two-step model of intergenerational value transmission (Grusec & Goodnow, 1994) and self-determination theory (Deci & Ryan, 2002), the importance of parents in the transmission of educational aspirations to children is well-established. However, little is known about the quality of parent-child communication about educational aspirations and how this communication relates to children’s educational aspirations in socioeconomically disadvantaged families in rural China.
Aims: We adopted a qualitative design to gain insight into parent-child communication around educational aspirations from the perspective of Chinese rural adolescents.
Methods: Twenty-three 9th-grade students were recruited from middle schools in Songzi, a poor rural county in central China. Participants comprised twelve boys and eleven girls aged 14 to 16 years (M = 14.65 years, SD = 0.59). Students completed one-to-one qualitative interviews about parent-child communication and their educational aspirations in June 2020.
Results: Thematic analysis revealed that adolescents’ educational aspirations were strongly influenced by their parents’ beliefs and aspirations for them, with fulfilling parental aspirations and achieving economic success being important influences on rural adolescents’ educational aspirations. However, parent-child communication quality was undermined when parents had an authoritarian communication style and when parents were absent due to rural-urban migration, in which case adolescents reported stress and perceived lack of support in achieving their goals. In addition, mothers were viewed as playing a more vital role in communication than fathers.
Conclusions: These findings provide implications for school and community-based interventions that promote rural parents’ ability to communicate effectively with their children about academic concerns.
Exploring Foster Parents’ Coping of Grief Related to Foster Children’s Reunification
Shahida Abdullah, Pei Yu Lee, Adrienne Sng, Sharina Mohamed Amran, & Ong Shu Qi
Boys’ Town, SINGAPORE
Background: Foster parents play an important role in enhancing the lived experiences of young persons in out-of-home care. Hence, strengthening support for quality caregiving is crucial. However, despite developments in literature reporting foster parents’ grief when faced with the reunification of foster child(ren), few studies have been conducted on how they can be supported to cope with this transition. More research would thus be helpful to facilitate the formulation of a holistic framework for foster parents to positively journey with the children under their care.
Aims: To examine how foster parents cope with grief related to foster children’s reunification; and how services can support through this transition.
Methods: Twenty foster parents will be interviewed on their experiences of grief related to their foster children’s reunification, their coping techniques, and the services received through this transition.
Results: The Research has obtained approval from Department Ethics Review Committee (NUS). The results are anticipated to provide insights on how foster parents can be better supported through changes in frameworks, policies, or practices to cope with the grief related to their foster children’s reunification.
Conclusions: The findings are expected to provide insights into how foster parents can be supported through their grief while they continue care for their foster children amidst reunification. There may also be the added benefit of enhancing their overall fostering experience, improving their willingness to continue fostering. This may help to increase retention rates of foster parents, enabling more children in out-of-home care to be placed in a foster home.
Social and Emotional Development Among MALAYSIA Urban Low-Income Preschool Children: The Role of Children’s Temperament and Mothers’ Perceived Stress
Laili Harlina Khairuddin & Zainal Madon
Universiti Putra Malaysia, MALAYSIA
Background: The early years of a child’s life are crucial for the development of strong social and emotional skills that will serve as a blueprint for their future development and well-being. Individual and maternal characteristics like temperament and mothers’ perceived stress have been demonstrated to have a direct effect on the social and emotional development of children. Despite this, additional research is necessary to acquire a better knowledge of the dynamics of urban low-income children’s social and emotional development.
Aims: The main purpose of this research is to determine the role of children’s temperament and mothers’ perceived stress as predictors of social and emotional development among MALAYSIA urban preschool children from low-income households.
Methods: Data were obtained using a survey method involving 360 mothers of preschool children from B40 group whose children attend Taska PERMATA KEMAS in Kuala Lumpur, Putrajaya, and Selangor urban areas.
Results: The findings indicate that negative affectivity and effortful control significantly predicted social and emotional development of the children, but not mothers’ perceived stress. Children’s effortful control had the highest contribution (ß= -55, p < 0.05), followed by negative affect (ß= .40, p < 0.05).
Conclusions: These findings suggest that children with higher level of effortful control and lower level of negative affectivity have better social and emotional development. Furthermore, further research in other samples of the B40 group is required due to the fact that a variety of factors may affect mothers’ perceptions of stress differently, hence influencing the development of their children in a variety of ways.
Predicting Adolescent Well-Being Using Age, Gender, Resilience, and Family Resilience
Hazalizah Hamzah1, Fatanah Ramlee1, Siti Aisyah Panatik2, Tan Chee Seng3, Nurul Iman Abdul Jalil3, & Syara Shazanna Zulkifli1
1Sultan Idris Education University, MALAYSIA
2University of Technology Malaysia, MALAYSIA
3Universiti Tunku Abdul Rahman, MALAYSIA
Background: Social and emotional well-being are fundamental to better mental health which prevents future behavioural problems once youth emerge into the young adulthood phase. High resilience has been supported by evidence-based research to improve well-being status. As youths are in the stage of developing their social identity, resilience plays a crucial role in maintaining a healthy level of well-being and preventing future social, emotional, and behavioural problems.
Aims: This study investigates the contributors to social and emotional well-being among youth in MALAYSIA using family resilience, resilience, age, and gender as predictors.
Methods: A total of 325 youths aged 15 to 24 years old (M = 20.23, SD = 2.92) recruited through convenience sampling completed both online and offline surveys. Data were analysed using descriptive statistics and stepwise multiple regression in SPSS.
Results: Regression analysis showed that family resilience, resilience, and age significantly influence the well-being of youth. Precisely, resilience is the biggest contributor to well-being (39%), and interestingly, younger youth showed better well-being than older youth.
Conclusions: This study further supported the major roles of resilience, family resilience and age on the level of well-being of youths in Malaysia, and advocates for upskilling programmes on resilience to empower youths and enhance their social and emotional well-being level.
Infant Social Experiences in the MALAYSIAn Context: A Comparison With United Kingdom and South Africa
Jasmine Yi Xin Tang1, Leonardo De Pascalis2, Laura Bozicevic2, Mark Tomlinson3, Lynne Murray4, Teck-Hock Toh5, Alvin Lai Oon Ng1, Pei Jun Woo1, & Valentina Sclafani6
1Sunway University, MALAYSIA
2University of Liverpool, UK
3Stellenbosch University, South Africa
4University of Reading, UK
5Department of Paediatrics & Clinical Research Centre, Sibu Hospital, MALAYSIA
6University of Lincoln, UK
Background: Child development is culturally shaped through daily interactions with caregivers, both between and within cultures, and influenced by socioeconomic status (SES). However, the impact of culture vs socio-economic status (SES) on mother-infant interactions and the quantity of social stimulation infants receive from their mothers has not been widely investigated.
Aims: We compared mother-infant social engagement in four different populations, including a lower SES urban population from Sibu, MALAYSIA (M), a lower SES peri-urban settlement outside Cape Town (South Africa) –Khayelistsa (K), and two urban middle SES –Reading, UK (R) and Stellenbosch, South Africa (S).
Methods: Spot observations collected through naturalistic observations at 2-3 months postpartum were used to code the amount of time mothers spent: close to the infant, in face-to-face positions; in active social engagement with infants during face-to-face contact.
Results: Compared to M, R and S, K mothers spent less time close to their infants. When close to them, M mothers spent less time in a face-to-face position than the other groups. However, in face-to-face contact, M and K mothers spent similar time socially engaging with their infants, and less compared to R and S.
Conclusion: M mothers show both similarities and differences with mothers from other cultures, highlighting the role of culture in shaping specific aspects of maternal behaviours. Despite cultural differences, mothers living in a low SES context show similarly low levels of infant social stimulation, potentially putting infants at risk for developmental deficits. Parental education on consistent social stimulation should be emphasized for positive child outcomes.
Discipline Methods and Self-Esteem Among Adolescents in MALAYSIA
Wan Anis Yasmin Binti Wan Muhammad & Nur Farhana Ardillah Aftar
Universiti MALAYSIA Sabah, MALAYSIA
Background: Self-esteem is often associated with behavioural and emotional outcomes in children. It is also understood that children with high self-esteem are more inclined to be successful in life compared to their counterparts. Parenting is one of the many factors that contributes to the development of an individual’s self-esteem.
Aims: (1) To yield data on the types of discipline methods used among parents in MALAYSIA. (2) To determine the relationship between discipline methods utilized by parents and self-esteem among adolescents. (3) To identify differences in discipline methods between genders.
Methods: A cross sectional online survey was conducted involving 76 adolescents aged between 15 and 18 years. A child-form of Alabama Parenting Questionnaire (APQ) in Malay version was used to identify the types of discipline methods applied by their parents. APQ involved five dimensions to measure the discipline methods by five categories related in parenting which are involvement, positive parenting, poor monitoring/supervision, inconsistent discipline and corporal punishment. The Malay version of Rosenberg Self-Esteem Scale (RSES) was used to examine the level of self- esteem among adolescents.
Results: (1) Many of the parents utilize positive methods on their children compared to use of corporal punishments. (2) There was no correlation between parenting practices and self-esteem of the children. (3) There was no significant difference in parenting practices between genders on all the five subscales except for poor monitoring or supervision which was significantly higher for male children.
Conclusions: Data from this study suggests that MALAYSIAn parents engage in a more positive approach in addressing their children’s behaviour. Although, there was only one gender difference in discipline methods, this is suggestive of possible differences in the way parents view male and female children which potentially can be due to values and cultural factors. Findings of this study suggests that this area is worthy of further exploration.
Identifying and Addressing Barriers to Engaging in Enriching Parent-Child Activities Amongst Families With 1-to-3-Year-Olds
Alexandra Hendry1 & Nayeli Gonzalez-Gomez2
1University of Oxford, UK
2Oxford Brookes University, UK
Background: Research during the pandemic revealed that time spent engaging in parent-child activities was predictive of 8-to-36-month-olds’ executive function skills. Given the importance of executive functions for social, academic and health outcomes, supporting families to engage in parent-child activities has potential to initiate a positive cascade of effects.
Aims: In collaboration with parents and Early Years practitioners: identify barriers to engaging in parent-child activities; develop resource packs to address those barriers; and evaluate their impacts.
Methods: In Phase 1, we ran workshops with parents and Early Years practitioners to identify barriers to engaging in parent-child activities and used these insights to produce 500 activity packs –the “Not-So-Messy Animal Play” and “Chalk, Talk and Walk” packs –combining evidence-informed ideas with high-quality, physical resources. We distributed these to families in economically-deprived areas in Oxfordshire. In Phase 2, we added a “Little Explorer” pack and distributed 600 more packs. We are evaluating project impacts using parent feedback (photos, free-text, and questionnaire ratings) and practitioner interviews.
Results: On scales ranging from 1-(low)-to-5(high), preliminary (n=24) mean scores indicate the packs are useful to parents in getting new practical ideas (4.25), encouraging them to spend more time doing activities with their child (4.08), increasing the range of activities they do (4.21), and increasing confidence in supporting their child’s development (4.29). We will present themes identified in the practitioner interviews, and photographic and free-text feedback from parents.
Conclusions: This co-developed project demonstrates how reducing barriers to engaging in parent-child activities can positively impact children’s developmental opportunities.
Stepping Into the Shoes of Young Children With Down Syndrome: Understanding Sensorimotor Patterns of Parent-Child Interaction
Hana D’Souza1,2, Kate Mee1, Catalina Suarez-Rivera3,4, & Chen Yu5
1Cardiff University, UK
2University of Cambridge, UK
3New York University, USA
4UCL, UK
5The University of Texas at Austin, USA
Background: A lot of our knowledge on how young children experience the world currently comes from screen-based tasks or standardized tests. Surprisingly little is known about their everyday experiences, where parent-child interaction is at the core. During this free-flowing activity, parents direct or react to their child, while their child—who is often surrounded by interesting objects and in pursuit of their own goals—directs, reacts to, or ignores the activity of their parent.
Aims: What sensorimotor patterns (e.g., looking, object handling, speech) define the rich context of parent-child interaction? The revolutionary technology of head-mounted eye-trackers/cameras has provided us with insights into the dynamic interplay between various components of parent-child interaction in typically developing children, challenging fundamental assumptions about everyday interactions (e.g., how much the child looks at faces). This is the first study to use the same technology with young children with Down syndrome and their parents.
Methods: Fifteen children with Down syndrome, aged 3-5 years, and 15 typically developing children matched on ability level, took part in this head-mounted eye-tracking study of parent-child interaction. The interaction data was coded frame-by-frame.
Results: The data will be analysed for looking behaviours, object handling, and parental speech.
Conclusions: The sensorimotor properties of these interactions will be discussed in the context of the strengths and difficulties young children with Down syndrome experience, as well as the large individual differences we observe. We hope that this research will provide insights for parents and practitioners into how to better support young children with Down syndrome.
Paternal Postnatal Depression and Offspring Emotional and Behavioural Development at Age 7 Years in a UK-Birth Cohort: The Mediating Role of Paternal Parenting Confidence, Warmth, and Conflict
Iryna Culpin1,2, Rebecca M Pearson1,2, Nicky Wright2,4, Alan Stein5,6, Marc H Bornstein7,8,9, Henning Tiemeier10,11, Eivor Fredriksen12, Jonathan Evans1, Tina Miller13, Esther Dermott1, Jon Heron1, Hannah M Sallis1, & Gemma Hammerton1,3
1University of Bristol, UK
2Manchester Metropolitan University, UK
4University of Leeds, UK
5University of Oxford, UK
7University of the Witwatersrand, SOUTH AFRICA
8Eunice Kennedy Shriver National Institute of Child Health and Human Development, USA & Institute for Fiscal Studies, UK
9UNICEF, USA
10Erasmus University Medical Center, Netherlands
11Harvard T.H. Chan School of Public Health, Boston, USA
12University of Oslo, Norway
13Oxford Brookes University, UK
Background: The adverse impact of paternal postnatal depression (PND) on child development has received increased attention. However, research that examines mechanisms that transmit risks from paternal PND to adverse child development is limited.
Aims: We aimed to examine pathways from paternal PND to offspring emotional and behavioural development through paternal parenting confidence, warmth, and father-child conflict in a UK-based birth cohort.
Methods: The study comprised 4,094 participants from the Avon Longitudinal Study of Parents and Children. Paternal self-reported PND was assessed using the Edinburgh Postnatal Depression Scale (8 months). Mother-reported offspring emotional and behavioural development was assessed using the Strengths and Difficulties Questionnaire (7 years). Paternal self-reported parenting was assessed on 5 occasions (birth-4 years). Analyses were adjusted for child, socioeconomic, familial and parental characteristics, including maternal PND.
Results: There was evidence of indirect effects from paternal PND to offspring emotional symptoms, hyperactivity and peer problems through the combination of all paternal parenting factors. There was no evidence of a direct effect from paternal PND to offspring emotional and behavioural development once the indirect effect via paternal parenting was accounted for. Specificity analyses revealed indirect effects through paternal parenting confidence in the associations between paternal PND and offspring emotional symptoms and hyperactivity, and through father-child conflict in the paternal PND-offspring hyperactivity association.
Conclusions: Paternal parenting emerged as a mechanism of risk transmission between paternal PND and adverse offspring development. Targeted intervention to increase paternal parenting confidence and decrease father-child conflict may improve outcomes in children of depressed fathers.
Associations Between Adverse Childhood Experiences and Emotion Regulation: The Mediating Role of Self-Esteem
Bao Jie Chang & Chin Choo Yap
Sunway University, MALAYSIA
Background: Adverse childhood experiences (ACE) are incidents that happened between the ages of 0 and 17 that are harmful to a person’s growth; some examples include violence, poverty, and neglect. These experiences are commonly associated with detrimental health outcomes in adulthood, including poor emotion regulation, that could increase the risks of developing psychopathologies and maladaptive behaviours.
Aims: This study aimed to identify the associations between ACE and emotion regulation, specifically two strategies called cognitive reappraisal and expressive suppression, and investigate the mediating role of self-esteem.
Methods: This is a retrospective, correlational, cross-sectional-quantitative study by using online survey. The Emotion Regulation Questionnaire (Gross, 2003), Rosenberg Self-Esteem Scale (Rosenberg, 1965), and Adverse Childhood Experiences Questionnaire-Amended Version (Tranter et al., 2021) were adopted to measure the variables. Convenience sampling was used among 200 consenting young adults aged 18 to 30 who were MALAYSIAns.
Results: The results revealed a negative correlation between ACE and self-esteem, and a positive correlation between self-esteem and cognitive reappraisal. Furthermore, self-esteem was found to mediate the relationship between ACE and cognitive reappraisal. No direct associations were found between ACE and cognitive reappraisal or expressive suppression.
Conclusions: ACE has a far-reaching effect on the emotion regulation of young adults. Therefore, this study highlights the importance of providing psychological help in the form of self-esteem and emotion regulation interventions for youths exposed to childhood adversity to reduce their risks of developing psychopathologies or maladaptive behaviours.
Experiences, Impacts, and Support Needs of Children Affected by Domestic and Family Violence
Silke Meyer
Griffith University, AUSTRALIA
Aims: This presentation examines children’s experiences of domestic and family violence (DFV) and the impact it has on their social and emotional wellbeing and development.
Method: National survey data from over 5,000 young people living in Australia.
Results: Findings highlight the overlap of childhood experiences of DFV and other forms of childhood maltreatment, the intergenerational transmission of violence and immediate and long-term adverse outcomes.
Conclusions: Recognising children as victims in their own right with their own, unique recovery needs is critical in generating better outcomes for children and families affected by DFV. Findings raise policy and practice implications for prevention and early intervention strategies that disrupting the intergenerational transmission of DFV through child-centred recovery support and whole-of-family interventions.
Adolescent Family Violence in Australia: Findings From a National Study of Prevalence, Use of and Exposure to Violence, and Support Needs
Kate Fitz-Gibbon
Monash University, AUSTRALIA
Background: There is increasing recognition of the significant harms and impacts of adolescent family violence (AFV). AFV refers to the use of domestic and family violence (DFV) (including physical, emotional, psychological, verbal, financial and/or sexual abuse) by a young person against their parent, carer, sibling or other family member within the home. While research in this area has developed in recent years, there remains significant gaps in current understandings of this form of family violence.
Aims: The study examined the nature and extent of use of and exposure to DFV, and related support needs among young Australians.
Methods: This presentation presents the findings from an Australian study of over 5,000 young Australians aged 16–20 years old.
Results: This presentation will examine the key findings from this study as well as the implications for policy and practice, including the critical need for greater trauma-informed practice when responding to families affected by AFV.
Children and Young People’s Experiences of Seeking Help and Navigating the Domestic and Family Violence System in an Australian Jurisdiction
Jasmine McGowan
Monash University, AUSTRALIA
Background: In Australia there is increasing acknowledgement of the need to better respond to children and young people (CYP) as victim-survivors of domestic and family violence (DFV) in their own right. Despite this, there has been minimal research conducted directly with CYP who have experienced DFV.
Aims: The presentation gives voice to the lived experience and expertise of young victim-survivors. CYP in this study were unanimous in their agreement that current responses to young victim-survivors of DFV are inadequate.
Methods: This presentation unpacks the findings from a recent study in Victoria (Australia), which directly engaged 17 CYP with lived experience of DFV via in-depth interviews. Interview participants were aged between 10 to 25 years.
Results: Findings highlight opportunities to improve current policy and practice to ensure responses to CYP experiencing DFV are child-centred, age-appropriate and informed by lived experience.
The Role of Hope in Supporting Recovery From Experiences of Sibling Sexual Abuse
Helen Kambouridis
Gatehouse Centre, Royal Children’s Hospital, AUSTRALIA
Background: Sibling sexual abuse (SSA) is 3-5 times more prevalent than sexual abuse perpetrated by a father/step-father. While the literature seeking to explain the dynamics involved in the occurrence of sibling sexual abuse has continued to grow, there has been a lesser focus on how best to work with families who have experienced such abuse. In particular, there is a need both for guidelines for therapists to follow in undertaking such work, and strategies to support therapists to maintain a sense of hope given the complexity and despair with which families who have experienced sibling sexual abuse present.
Aims: (1) To develop guidelines for therapists working with families who have experienced sibling sexual abuse. (2) To better understand the impact on therapists of working with families who have experienced sibling sexual abuse and to develop strategies to support therapists.
Methods: This qualitative study utilised a participatory action research method and collaborative inquiry group process. A group of therapists working in the Victorian sexual assault sector met over a 12-month period to share and explore their experience of working with sibling sexual abuse and to develop their interventions with these families.
Results: The study identified the following overarching themes: a) The impact of different social and professional discourses about SSA on our understanding. b) The challenges for therapists working with families who have experienced SSA. c) The importance of working collaboratively with both families and the service system. d) The importance of using language that is clear, respectful, non-shaming. e) The importance of time, reflective practice, hope and compassion satisfaction in supporting therapists.
Conclusions: The experience of sibling sexual abuse is one that leads to a complicated array of distress, ambivalence, confusion, shame, anger, and guilt for families. Hope is often the furthest thing from their minds. For therapists working with families who have experienced such abuse, the potential to become mired in that same lack of hope, to find themselves caught in the roller coaster that has hijacked the family and pulled to align with different parts of the family system against others can be exhausting. The power of hope, however, together with time to consult with colleagues and engage in reflective practice, to support therapists in this work so that they can best support families, cannot be underestimated.
Child Trafficking and Exploitation: Lived Experience of Survivors
Lissa Ramsepaul
American University, USA
Background: As awareness of the scope of people trafficking across the world has increased, practitioners are still limited in recognizing and intervening child trafficking for purposes of sex work, domestic labor, and illegal adoption has been well documented as a global problem. In recent years, the child sex trade has increased in attention of both the general public and helping professions, but little is known about the lived experience of survivors and the long-term effects of having this life experience.
Aims: This study was undertaken to explore individual, familial, and systemic risk factors which have been reported across several countries to determine the current knowledge of scope and solutions to child trafficking, specifically for the purpose of sex work.
Methods: This study was an exploratory qualitative study that utilized a semi-structured interview to obtain data on lived experience of child trafficking survivors. Data was transcribed and a thematic analysis was conducted to identify common experiences, risk, and resilience factors among survivors.
Results: Themes of SES status, familial conflict, and limited family support emerged as risk factors. Themes of ability to trust, willingness to ask for help, previous mental health treatment, and age at first trafficking episode emerged as resilience factors for overcoming post traumatic effects of experiences while trafficked.
Conclusions: This study sets a foundation for larger, mixed-method research to further explore and measure the risk and resilience factors that surround child trafficking. This study suggests strong thematic correlation among this population.
Dissociation and Childhood Trauma
Noorul Amilin Harun & Tg Mohd Saifuddin Tg Kamarulbahri
Hospital Tengku Ampuan Afzan, Kuantan, MALAYSIA
Background: Dissociation is a common strategy used in coping with very stressful experience. Exposure to repetitive and chronic trauma may cause a child to continue using dissociation even into adulthood.
Aims: To present and discuss the complexities of managing an adolescent with dissociative identities in the context of childhood adversities and difficult family dynamics.
Methods: This case study reports a case of a female adolescent who first presented to psychiatry services at the age of 16 years old for suicidal thoughts and attempt which occurred when the school first opened after the Covid-19 pandemic. She has experienced depressive symptoms for the past eight years which worsened two weeks prior to the attempt, triggered by the thoughts of losing her mother to the Covid-19 and fears about living with her father. The adolescent revealed that apart from the depressive symptoms and suicidality, she had experienced dissociated states since she was 6 years old and described having seven different personalities as a result of traumatic life events during her childhood.
Results: The case study described an adolescent with dissociative identity disorder and the treatment strategies which requires both individual and family works, as well as multidisciplinary/multiagency collaboration and intervention. However, the treatment progress is complicated by various internal and external barriers.
Conclusions: A diagnosis of dissociative identity disorder is often controversial, and it is commonly misdiagnosed or underdiagnosed. It is important for clinicians to recognize this disorder to ensure patient receive proper treatment, as therapy and recovery process may take years.
Understanding Self-Harm and Help-Seeking Behaviour Among Adolescents: A Qualitative Study
Suria Hussin1, Noorul Amilin Harun1, Nik Suhaila Zakaria1, Lim Bee Chiu2, & Asrenee Abd Razak3
1Department of Psychiatry and Mental Health, Hospital Tengku Ampuan Afzan, Kuantan, MALAYSIA
2Clinical Research Department, Hospital Tengku Ampuan Afzan, Kuantan, Pahang, Ministry of Health, MALAYSIA
3Department of Psychiatry, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, MALAYSIA
Background: Self-harm behavior is a global health problem particularly, among adolescents. It can lead to negative outcomes, including repeated self-harm, suicide and mortality, mental health morbidity and poorer education outcomes.
Aims: To understand the self- harm and help-seeking behaviors among adolescents attending outpatient psychiatric clinic in Kuantan, Pahang (MALAYSIA).
Methods: Using qualitative interpretative approach, in-depth interviews using a semi-structured questionnaire were conducted with adolescents. Interview were recorded and transcribed verbatim. Transcripts were analyzed thematically using Collaizi’s method.
Results: Self-harm is common among girls, with mean aged 15.4. Common methods used to self-harm were self-cutting, hitting oneself, scratching with sharp objects, hitting the wall, pulling hair, biting and medication overdose. Majority of the participants had underlying clinical diagnosis of major depressive and anxiety disorders. Most of the triggers preceded the self-harm behaviour are emotional distress following arguments with friends, family members and pressure related to school works. Nine themes emerged: as regulation of feelings, sensation seeking, avoid suicide, stress reduction, regulation of realness, suicide attempt, addictive urge, impulsivity and communicative with others. Delay in help-seeking was related to communication issues, trust issues and normalization of self-harm behaviour.
Conclusions: Our findings provide an indication for the improvement of self-harm prevention programmes mainly targeting secondary school students as well as to enhance the delivery of clinical interventions and also a need for helpful friends and family members to help reduce the urge to self-harm.
Suicidal Risk in Secondary School Adolescents in Post-Pandemic Times: The EPISDAM-School
Adriana Garcia-Ramos1, Wala Ayad-Ahmed2, Marta Velazquez3, Alberto Sanchez-Fernandez-Quejo1, Maria Camila Varela-Mora1, Claudia Sanchez-Gomez1, Paula Arias-Rodriguez1, Nicole Frontero4, Paola Marin-Santos1, Elvira Elvira-Flores1, Veronica Fernandez-Rodrigues1,2 & Alejandro de la Torre-Luque1,5
1Complutense University of Madrid, Spain
2San Carlos Clinic Hospital, Spain
3Autonomous University of Madrid, Spain
4Polytechnic University of Madrid, Spain
5CIBERSAM ISCIII, Spain
Background: Suicide is the leading non-natural cause of death in adolescents worldwide. Numerous studies have pointed out an increase in adolescent suicidal risk and related health service utilisation during the COVID-19 pandemic. It is expected that adolescent suicidal risk will rise in the post-pandemic times.
Aims: To provide accurate estimates of suicidal risk in adolescents aged 12-16 years, in the post-pandemic times. Moreover, it aimed to study the relationship between risk factors and suicidal risk.
Methods: The EPISAM-School study constitutes a prospective study to detect suicidal at-risk adolescents aged 12-16 years (N = 1,255 adolescents, 46.5% male; M = 13.8 years, SD = 1.27), in the Spanish Community of Madrid. The EPISAM-School survey was conducted in school settings in 2023. EPISAM-School data on suicidal risk (Paykel scale), emotional regulation (DERS, FMPS, BIS-11 scales), psychopathology (SDQ) and social support (MSPSS) were collected.
Results: The suicidal risk prevalence rate was 12.6%. Active suicidal thoughts were present in 24.5% of adolescents, and 5.7% of them engaged in a suicidal attempt in the last 12 months. Four covariates were related to suicidal risk group membership: high psychopathology (OR = 1.65), difficulties in emotional regulation (OR = 1.42), impulsivity (OR = 1.37) and the lack of social support (OR = 0.78).
Conclusions: More than 1 in 10 adolescents are at elevated risk of suicidal behaviour in the post-pandemic times. The pandemic has led to dramatic effects on suicidal risk in adolescents. It is urgent to take action to prevent suicide and save lives.
Longitudinal Study of the Mother’s Emotional Distress Trajectories and Their Influence on Adolescent Development of Suicide-Related Behaviours and Psychological Problems
Ivan Perez-Diez1,2, Adriana Garcia-Ramos3, Alberto Sanchez-Fernandez-Quejo3, & Alejandro de la Torre-Luque1,3
1Autonomous University of Madrid, SPAIN
2CIBERSAM ISCIII, SPAIN
3Complutense University of Madrid, SPAIN
Background: Suicide-related behaviours (SRB) and psychological problems have appeared within the ranking of most prominent health hazards among adolescents, in recent decades. Parenting and relationships between family members may be key factors in the development of mental health issues in adolescence.
Aims: This study aimed: (1) to identify the emotional distress trajectories of the mothers across the offspring’s childhood; (2) to relate mother`s trajectory membership with the development of psychopathological problems and SRB in their adolescent sons.
Methods: Longitudinal data on children and their mothers from the Millennium Cohort Study (MCS) were used. Specifically, data from 18,553 children were used (51.24% boys, mean age at baseline = 3.13 years). The Kessler Psychological Distress Scale (K6) was used to longitudinally measure the psychological distress of mothers across their son’s childhood (from age 3 to 14). Growth mixture modelling (GMM) was used to identify mother’s trajectory. Finally, we performed a regression analysis to test whether trajectory membership together with other predictors of interest were able to predict three outcomes when son was 17 years old: behavioural and emotional symptoms, self-harm, and suicide attempts.
Results: GMM trajectory identification pointed to a better fit of a 3-class model (SABIC = 185241.16). The first class was normative (89% of participants), the second class was decreasing (7% of participants), and the third class was increasing (4% of participants). Regression shows that only trajectories are related to behavioural and emotional symptoms (increasing and decreasing trajectories).
Conclusions: The mother’s emotional distress affects the development of behavioural and emotional symptoms of the adolescent sons.
The Exploration of Knowledge, Attitude and Practice (KAP) on Child Protection and Abuse Issues in MALAYSIA
Abdul Rahman Ahmad Badayai1 & Zaharah Sulaiman2
1National University of Malaysia, MALAYSIA
2University Sains Malaysia, Kelantan, MALAYSIA
Background: Child abuse and neglect can increase the long-term risk of children being exposed to health problems, including chronic illness, physical disability, risky behaviors such as school dropouts, violence and aggression, drug use and abuse, and mental health problems.
Aims: To explore Knowledge, Attitude, Practice (KAP) awareness of the community on child abuse and neglect, successful intervention programs on child protection and successful advocacy of child protection interests among the local community.
Methods: The study employed a quantitative study with a cross sectional design. An online survey on KAP regarding child abuse and neglect was conducted. A total of 292 adults in MALAYSIA answered the survey questions.
Results: Preliminary survey results show that most respondents are aware of the possibility of psychological, sexual, violent and underage marriage among children. However, the majority of respondents were unaware of the existence of child protection services and never asked for help and utilized such services. In fact, respondents also agreed that children are often abused by known individuals and are more at risk of being abused if the child is not with the parents. Respondents also stated that there are some obstacles for them to get child support services such as difficulty in reporting, distrust of the authorities, fear of revenge, the perpetrator is a respected individual in the community and does not know how to refer certain cases to the responsible party.
Conclusions: Various agencies and institutions can benefit from the results of this research, especially non-governmental organizations, government bodies and generally institutions that are directly involved in managing and handling cases of child abuse and neglect in an effort to curb abuse and child neglect in MALAYSIA.
Cyberbullying in Indonesia: Understanding the Prevalence, Risks Factors, and Psychological Implication Among Students
Reny Haning, Ari Sriyani, Kunto Adi Wibowo, & Ashama Afifah
ChildFund International, Indonesia
Background: The rapid growth of internet use in Indonesia has brought with it an alarming increase in cyberbullying. Unfortunately, Indonesia has been ranked poorly in digital civility, making it even more concerning.
Aims: To explore the complexities and impacts of cyberbullying among children and youth in Indonesia to inform recommendations for the development of a systematic solution for reducing children’s vulnerability and risks to digital violence.
Methods: A mixed methodology with a qualitative aspect including analysis of cyberbullying and cyber-victimization cases on media and social media, focus group discussions, and key informant interviews. The quantitative aspect involved a cluster random sampling survey using CASI in four Indonesian provinces to 1,610 students (error: ±2.39%; CI: 95%).
Results: 49.1% of students have engaged in online bullying, whereas 58.6% have experienced cyberbullying in the last three months. Cyberbullying reported included privacy violations, exclusion, stalking, defamation, harassment, online sexual violence, threat, and extortion. Risk factors contributing to cyberbullying included exposure to traditional bullying, negative content, group norms, and parental supervision. Victims of cyberbullying reported their school environment as uncomfortable and unsafe, leading to negative psychological impacts on self-esteem and social anxiety.
Conclusions: Cyberbullying has a significant impact on psychological well-being of students, highlighting the need for improved school procedures and comprehensive approaches to enhance self-esteem, empathy, knowledge, and self-protection. The importance of awareness and education for students, parents, and teachers on cyberbullying prevention is also emphasized. Implementing these recommendations can help improve digital civility and create a safer online environment for children and youth in Indonesia.
Callous-Unemotional (CU) Traits and Child Response to Teacher Rewards in Chinese Preschools
Xinyi Cao1, Matthew Somerville1, Yiyun Shou2, & Jennifer Allen3
1University College London, Institute of Education, UK
2National University of Singapore and National University Health System, SINGAPORE & Australian National University, AUSTRALIA
3University of Bath, UK
Background: The presence of callous-unemotional (CU) traits, a temperament dimension typified by low empathy, lack of guilt, shallow affect, and indifference to performance, has shown promising utility in explaining different pathways to conduct problems (CP). Evidence suggests that children with CP and CU traits show poorer treatment outcomes, possibly due to their atypical responses to rewards and discipline strategies. While punishment insensitivity is a well-established correlate of CU traits, findings for reward sensitivity are mixed. Only limited studies have explored relationships between CU traits and child responses to rewards in school contexts, with no current instrument specifically assessing children’s responses to teacher rewards in real life.
Aims: This research aims to validate a newly developed questionnaire assessing children’s responses to reward strategies that teachers use in daily practice.
Methods: In total, 28 teachers (25 females; M = 34.96 years) reported on 156 children (42.9% girls; M = 5.20 years) on their CU traits, externalising problems and reward sensitivity via questionnaires. The validity and reliability of the newly developed reward sensitivity questionnaire were examined through exploratory factor analysis, principal component analysis, graded response model, intraclass correlation coefficient, correlations with criterion measurements and Cronbach’s alpha.
Results: The findings suggest a one-factor solution for the teacher-report questionnaire assessing child sensitivity to teacher rewards, and the measure showed good reliability and validity.
Conclusions: Our findings support this new measure and provide a practical tool for future studies on CU traits and children’s responses to teacher rewards, which may help to guide school-based interventions focusing on reward-based classroom management strategies.
Parent’s Knowledge, Attitude, and Decision on HPV Vaccination for Their Adolescents Girls in Kuantan and Pekan, Pahang
Siti Hazariah Abdul Hamid1, Fathin Insyirah Fared Salem2, & Siti Roshaidai Mohd Arifin1
1International Islamic University Malaysia, MALAYSIA
2National Health Institute, MALAYSIA
Background: Cervical cancer is the third common cancer among women 25–59 years of age and the ninth most common in the entire population in MALAYSIA. The MALAYSIAn government has started to implement free HPV vaccination for 13-years-old in 2010 as a preventive measure to combat cervical cancer. The parents are expected to understand well about HPV vaccine as this led to the decision to vaccinate their children. Previous study reported that despite parent high acceptability for vaccinating the girls, their knowledge and awareness regarding the HPV vaccine is still low.
Aims: To assess parent’s knowledge, attitude, and decision making on HPV vaccination for their adolescents’ girls in Kuantan and Pekan, Pahang.
Methods: The cross-sectional study was conducted among 150 parents by using a validated set of questionnaires between September 2021 and February 2022.
Results: The findings revealed that most of the parents show poor knowledge with 51.3% of the HPV vaccine and portray positive attitudes towards HPV vaccination with 90.7%. There is a significant association between attitude towards HPV vaccination and their decision-making with p<0.05. No significant association was found between the decision to get vaccinated and the gender of parents.
Conclusion: The majority of parents exhibit poor knowledge which may affect their decision-making and uptake of HPV vaccination among their children. This highlights the need for healthcare providers to educate parents, community and the girls on HPV vaccination. This effort will reduce the incidence of HPV infection related to cervical cancer.
Stressful Intrapersonal and Interpersonal Experience for Parents of Type 1 Diabetes Mellitus Child
Mohd Nazir Mohd Nazori, Nurulwahida Saad, Muhd Alwi Muhd Helmi, & Muhamad Ariff Ibrahim
International Islamic University Malaysia, MALAYSIA
Background: Children mental health has been shown to be influenced by the parenting process and by the state of mental health of the parents. The experience of parents of children with Type 1 diabetes mellitus (T1DM) creates a unique and impactful environment to their parenting activities and mental state. This experience is less understood in the MALAYSIAn context.
Aims: This study aimed to describe the stressful intrapersonal and interpersonal interactions of parents of T1DM children.
Methods: Focus-group discussions were used to collect in depth information on 16 fathers and mothers that were the main carers for T1DM children. Transcripts were analysed using Atlas.ti and applying thematic analysis. Results were analysed according to the Process-Person-Context-Time Model framework.
Results: Findings revealed two main themes involving person and two different contexts. Within the person context, two subthemes were identified that are: (a) challenges managing worry, and (b) overwhelming responsibilities. Within the two different contexts, six subthemes were identified: (a) microsystem: imposing on T1DM child, (b) microsystem: conflict with healthcare professionals, (c) microsystem: extended family and neighbour’s ignorance, (d) microsystem: discouraging teachers, (e) mesosystem: siblings influence, and (f) mesosystem: extended family coax T1DM child.
Conclusions: In conclusion, parents were affected by the different interactions in managing their T1DM child’s health. The identification of different stakeholders in the interaction allows targeted intervention to maximise and ensure mental well-being in parents and consequently, in the T1DM child.
The Need for the Development of a Digital Entrepreneurship Education Model for B40 Kindergarten Children
Abdul Halim Masnan1, Hafizul Fahri Hanafi2, Nurul Fadly Habidin2, Mohd Nazri Abdul Rahman4, Azizah Zain5, Masayu Dzainudin6, Mohamad Shafiq Zaini7, & Mazeni Ismail8
1,5,6,7,8Universiti Pendidikan Sultan Idris, MALAYSIA
2Universiti Pendidikan Sultan Idris, MALAYSIA
4Universiti Malaya, MALAYSIA
Background: The adequacy of educational development based on children’s survival needs (life survival) in the form of entrepreneurial education is less emphasized. To ensure sustainable economic and technological development, individuals’ knowledge of financial management must be digitally applied at an early stage, through knowledge related to financial literacy, basic entrepreneurial skills, and a high-trust attitude as a person.
Aim: The purpose of this study is to analyse the needs in developing a model for Digital Entrepreneurship Education for B40 group kindergarten children based on teachers’ perceptions.
Method: The respondents of this study consisted of 367 kindergarten teachers across MALAYSIA.This research method was conducted quantitatively using a questionnaire. The collected data were analysed using Statistical Package Social Science (SPSS) version 21 software, considering the mean.
Results: Teachers’ perceptions of building the Digital Entrepreneurship Education Model for B40 Group Kindergarten Children under the aspect of “Children understand the benefits of saving money” had the highest mean of 3.93. While teachers’ perception of “Digital skills should be introduced to children (21st century learning)” recorded the second highest mean with a mean of 3.86, followed by the statement “Children understand the concept of the value of money” with a mean of 3.83.
Conclusion: This study makes a significant contribution to the elements of entrepreneurship, especially the need to develop of a Digital Entrepreneurship Education Model for Kindergarten Children of the B40 group based on teachers’ perceptions.
