Emotional/Behavioral Problems Of Adolescents Of First-degree Relatives Of The Patients:a Case-Control Study

Objective:To investigate the stigma and emtional/behavioral problems of adolescent relatives of patients with psychiatric disorders. And to explore the relationship betweem emotional/behavioral problems with demgraphic variables, stigma, self-esteem, self-efficacy and resilience among adolescent relatives of patients with psychiatric disorders.Methods:Totally104adolescent relatives of patients with psychiatric disorders were recruited from a mental health center in Shandong Province, and age and sex-matched healthy adolescents were recruited as controls. Stigma was measured with the Perceived Devaluation-Discrimination Questionnaire, self-esteem with the Self-esteem Scale (SES), resilience with the Resilience Scale (RS), and emotional/behavioral problems with the Strengths and Difficulties Questionnaire (SDQ). Analyses were performed using SPSS17.0. Sociodemographic variables were characterized with descriptive statistics. Comparisons of two cases for SDQ and other variables were examined by Student’s t-test or one-way ANOVA. Pearson’s correlation analyses were executed to examine the correlations of continuous independent variables with SDQ. Hierarchical linear regression analysis was performed to examine the associations between independent variables and SDQ.Results:1. Stigma scores, SDQ scores, emotional symptoms, conduct problems, hyperactivity-inattention, and peer problems were entirely higher in the adolescent relatives compared with controls, respectively. Meanwhile, SES scores, GSES scores, RS scores and prosocial behavior were lower in the adolescent relatives compared with controls.(P<0.05)2. Stigma scores was significantly higher among both the adolescent relatives and controls (P<0.01) compared with stigma mean(2.50). 3. Univariate analyses of SDQ in relation to demographic characteristics were shown that sex, residential areas, school, singleton or not (P<0.05) were significantly associated with SDQ scores.4. Among the adolescent relatives, SDQ scores were positively correlated with stigma scores (r=0.258, P<0.01), and negatively correlated with GSES(r=-0.463, P<0.01) and RS(r=-0.340, P<0.01), respectively.5. Hierarchical regression was performed with SDQ score as the outcome variable. In block1, demographics (sex groups, residence, school, singleton or not) were put in the model, there were not significantly associations with SDQ(P>0.05). Stigma score was added in Block2, which was significantly associated with SDQ. When resilience and self-efficacy were added in block3, both were significantly associated with SDQ, respectively. Meanwhile, stigma score was not significantly associated with SDQ, which was completely mediated by resilience and self-efficacy. In addition, the interaction term stigmaxresilience and stigmaxself-efficacy were added in block4. No mediating effects between scores on stigma and SDQ were observed by self-efficacy and resilience. Hierarchical linear regression analyses also showed that the stigma, resilience and self-efficacy explained3.5%and12.9%of variance in SDQ, respectively.Conclusion:1. Adolescent relatives of patients with psychiatric disorders might have emotional/behavior problems, higher stigma level, lower self-esteem, lower self-efficacy and lower resilience compared with controls.2. Emotional/behavioral problems of Adolescent relatives of patients with psychiatric disorders might correlated with demographic variables such as sex, residential areas, school, singleton or not.3. Stigma, self-efficacy and resilience all predicted the SDQ. Resilience and GSES were the complete mediators of the relationship between stigma and SDQ.