The role of strengths in anger and conduct problems in maltreated adolescents - ResearchOnline@JCU

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Child Abuse & Neglect

Research article

The role of strengths in anger and conduct problems in maltreated adolescents

Monica Go

^a,∗

, Chi Meng Chu

^b

, Joanna Barlas

^c

, Grace S. Chng

^b

aClinicalandForensicPsychologyService,MinistryofSocialandFamilyDevelopment,Singapore

bCentreforResearchonRehabilitationandProtection,MinistryofSocialandFamilyDevelopment,Singapore

cClinicalPsychology,CollegeofHealthcareSciences,JamesCookUniversitySingapore

a r t i c l e i n f o

Articlehistory:

Received20January2016 Receivedinrevisedform 29December2016 Accepted31January2017

Keywords:

Maltreatment Strengths Adolescents Protectivefactors Anger

Conductproblems

a b s t r a c t

Despitemulti-typemaltreatment,someindividualsdemonstratepositiveadaptationand continuetodevelopinahealthyway.Amultitudeofstrengthfactorshavebeenlinkedto adaptivefunctioningandresilience,butthishasnotbeenadequatelyexaminedinmal- treatedadolescent’spsychosocialfunctioning.Thisstudysoughttoexaminetheroleof strengthssuchashavingtalents/interests,familyrelationships,educationalsupport,the roleoftherecognitionandapplicationofthesestrengths,andtheroleofmulti-typemal- treatmentonangercontrolandconductproblems.Onehundredandthirtyparticipants(61 males;69females)aged13–19yearsoldwereratedusingtheSingaporeversionofChild andAdolescentNeedandStrengths(CANS)tool.Theresultsrevealedthatcertainstrengths wereassociatedwithangerandconductproblems,buttherecognitionandapplication ofstrengthsemergedasaconsistentlysignificantpredictorforbothoutcomes.Hence,to understandandapplyone’sstrengthsmaybeequallyasimportantasmerelypossessing thosestrengths.Thisstudyextendscurrentunderstandingoftheimportanceofstrengths withagroupofmaltreatedadolescentsinanAsiancontext.Adoptingaperson-centered andstrengthbasedapproachwillfurtherenhancetheeffectivenessofinterventionsand improveoutcomesformaltreatedadolescentslivinginresidentialcare.

©2017PublishedbyElsevierLtd.

1. Strengthsandmaltreatment

Systematicreviewsexaminingchildhoodmaltreatmentandadversityrevealthatamultitudeofstrengthfactors(e.g., individual,family,andcommunity)arelinkedtoadaptivefunctioning(Afifi&MacMillan,2011;Khanlou&Wray,2014;

Noltemeyer&Bush,2013).Adaptivefunctioningcanoccurdespitemulti-typemaltreatment(MTM)(Collin-Vézina,Coleman, Milne,&Daigneault,2011),whichreferstoexperiencingmorethanonetypeofmaltreatment(Higgins&McCabe,1998).

Thishasbeenshowntoresultinmaladaptiveoutcomeswhichtendtopersistintoadolescence(Trickettetal.,2011)and acrossthelifespan(Hahm,Lee,Ozonoff,&VanWert,2010;Norman,Byambaa,Butchart,Scott,&Vos,2012).Fergusand Zimmerman(2005)notedthatat-riskadolescentsmaypossessmultipleassets(e.g.,individual-levelprotectivefactorssuch ascompetenceandefficacy)andhaveaccesstomultipleresources(e.g.,contextualandenvironmentalinfluencessuchas familysupportandcommunityservices)whichcanenablethemtoachievebetteroutcomes.

∗ Correspondingauthorat:ClinicalandForensicPsychologyService,MinistryofSocialandFamilyDevelopment,512ThomsonRoad,MSFBuilding,12th Floor,298136,Singapore.

E-mailaddress:monicago@msf.gov.sg(M.Go).

http://dx.doi.org/10.1016/j.chiabu.2017.01.028 0145-2134/©2017PublishedbyElsevierLtd.

1.1. Roleofstrengthsasprotectivefactors

Strengthsshifttheattentionfromproblems(deficits)inmaltreatedindividualstowardsproficiency,assets,skills,and internalresources.AccordingtoEpstein(1999),children’semotionalandbehavioralstrengthsmaybeconceptualizedasskills andcompetenciesunderfivedomains,namely,(i)interpersonalstrengths;(ii)affectivestrengths;(iii)familyinvolvement;(iv) schoolfunctioning;and(v)intrapersonalstrengths.Lyons,Uziel-Miller,Reyes,andSokol(2000)foundthatstrengthspredicted successinthereductionofriskbehaviorforchildrenandadolescentslivinginresidentialplacements.Likewise,Oswald, Cohen,Jenson,andLyons(2001)furthershowedthatstrengthsmitigatedthenegativeimpactofriskbehaviorssuchasharm toselfandothers.

Atanindividuallevel,theopportunitytoengageinsport,art,musicandhobbiesenhancesfunctioningandwell-being inadolescence(Gilligan,1999).Thepleasureofengagementandthesatisfactionofmasteryservetobuildtheadolescent’s self-esteem,pro-socialbehavior,supportiverelationshipsandsocialintegration.BabissandGangwisch(2009)foundthat sportsparticipationprotectedadolescentsfromdepressionandsuicidalideationbyincreasingtheirself-esteemandsocial support.

Atthefamily-level,studieshaveshownthatparentfunctioningandresponsivenesshaveapositiveinfluenceonchild outcomes.Childrenwhowereexposedtointerpersonalintimatepartnerviolence(IPV)hadfeweradjustmentproblems iftheirmothersusedwarmandeffectiveparenting(Graham-Bermann,Gruber,Howell,&Girz,2009).Incontrast,more severebehavioralproblemswereobservedinchildrenexposedtoIPViftheirmothersweredepressed.Overall,parent functioningcaninfluencechildadjustment,whichcanbeexaminedviaproxiessuchasinternalizingandexternalizing problems.Sexuallyabusedadolescentfemales,whohadfewerconflictswiththeirmothers,reportedgreaterinterpersonal trustinrelationships,moreactivecoping,andlessdruguse(Daigneault,Hébert,&Tourigny,2007).Inaddition,maltreated adolescentswhoperceivedgreateremotionalsupportfromtheircaregiversreportedlowerlevelsofdepressionandbetter self-esteemoneyearaftersexualabusediscovery(Rosenthal,Feiring,&Taska,2003).Parentalresponsivenesshasbeen foundtobenegativelyassociatedwithadolescents’problembehavior(Lietal.,2011),aswellasdepressionandsubstance abuse(Bond,Toumbourou,Thomas,Catalano,&Patton,2005).

Atthecommunitylevel,studieshaveshownthatgreaterschoolengagementwasassociatedwithhigherlevelsofwell- beingandalowerlikelihoodofdelinquency(Tyler,Johnson,&Brownridge,2008).Inaddition,studentswhoreportedhigher perceptionsofteachers’supportweremorelikelytostayengagedinschool(Klem&Connell,2004)andhadfewermisconduct incidents(Schmidt,2003).

Comparedtosocial supportfromparentsand teachers,perceivedpeersupportprotected victimizedchildren from depressivesymptoms(Tanigawa,Furlong,Felix,&Sharkey,2011).Giventhatsocial withdrawalandisolationarecom- mondepressivesymptoms,theavailabilityofsupportivepeerswhoofferedhelpinproblem-solving,healthyappraisalsof stressandasenseofcare,likelyinfluencedthevictim’scopingabilityandpsychosocialadjustment.Positivepeerrelation- shipswerealsorelatedtoadaptiveoutcomesformaltreatedchildren(Schultz,Tharp-Taylor,Haviland,&Jaycox,(2009)).

Intheirlongitudinalstudy,Powers,Ressler,andBradley(2009)foundthatperceivedsocialsupportfromfriendsprotected maltreatedgirlsfromadultdepression.

1.2. Angerandconductproblemsinmaltreatedchildren

Pastresearchhasdemonstratedthatmaltreatedchildrenhaveelevatedlevelsofangerandahigherriskofdevelop- ingemotionaldysregulation(Cole,Martin,&Dennis,2004),comparedtonon-maltreatedchildren(Robinsonetal.,2009).

Difficultiesinregulatingnegativeemotions,whichindicatesbarriersto“monitoring,evaluatingandmodifyingemotional reactions”inordertoreachone’sgoal(Thompson,1994,p.27),couldresultinmisreadingsocialcuesandresponding inappropriatelyinsocialsituations.Invariably,thisadverselyaffectsone’sinterpersonalrelationshipsandqualityoflife.

Angerhasbeenassociatedwithinternalizingsymptomologysuchasdepressionandanxiety(Koh,Kim,&Park,2002).

Difficultiesregulatingangercanmaintainorexacerbatedepressionandanxiety,therebyresultinginincreasedemotional distress,andimpairedsocialfunctioning(Berenbaum,Raghavan,Le,Vernon,&Gomez,2003).Ameta-analysisbyAldao, Nolen-Hoeksema,and Schweizer(2010)showedthatemotional regulationstrategiesacrossdifferentpsychopathology groups(e.g.,depressionandanxiety)wererelatedtodifferentlevelsofpsychopathology.Maladaptivecognitiveemotional strategies(e.g.,rumination,avoidance,andsuppression)werelinkedwithmorepsychopathologywhereasadaptivestrate- gies(e.g.,acceptance,reappraisal,andproblemsolving)werelinkedwithlesspsychopathology.Hence,itisimportantto understandthepathwaystoimproveangermanagementandincreaseemotionalregulation.

Angerissueshavebeenfoundtobeassociatedwithhigherlevelsofexternalizingproblemsinchildren(Zeman,Shipman,

&Suveg,2002)andadolescents(Silk,Steinberg,&Morris,2003).Inasampleofmaltreatedchildren,TeislandCicchetti (2008)showedthatpooremotionalregulationaccountedforaggressionanddisruptivebehavior.Maltreatedchildrenare morelikelytolacktheskillstomanagetheirnegativeemotions.Thismayalsobeduetothelackofopportunitiestolearn adaptiveemotionalregulationfromtheirparents.Inalongitudinalstudy,Conger,Neppl,Kim,andScaramella,(2003)found thatangerandaggressivebehaviorwastransmittedacrossgenerations.Hence,itisimportanttounderstandantecedentsof externalizingproblemsinmaltreatedadolescentstoinforminterventionsforbetteroutcomes.

1.3. TraumaexposureandchildwelfareresearchinSingapore

Todate,thereisapaucityofresearchintraumaexposureandchildwelfareinSingapore.Singaporeisanindependent island-stateinSouthEastAsiawithatotalpopulationof5.6million(SingaporeDepartmentofStatistics,2016), where theMinistryofSocialandFamilyDevelopment(MSF)hasstatutoryresponsibilitiestoprotectchildrenfromabuseand neglectundertheChildrenandYoungPersonsAct(2003).Childrenareplacedinfostercareorvoluntarychildren’shomes (VCHs)whenplacementwithinkinshipcareorwithinfamilyisnotpossible.MostVCHsaresupportedbycommunity resourcestoproviderelevanteducational,recreational,andmentalhealthservicestoresidents.Thesefacilitiesaresomewhat differentfromtheinstitutionalcareinothercountries,whichtypicallycatertochildrenwithsevereemotionalorbehavioral dysregulation.Forexample,childrenrequiringout-of-homecarearemorelikelytobeplacedinfostercarethaninstitutional careintheUnitedStatesofAmericaandCanada,whereaschildrenrequiringout-of-homecareinSingaporearemorelikely tobeplacedinresidentialcareratherthanfostercare.Between2010and2014,2247childrenwereadmittedintoVCHs,and 409childrenwereplacedinfostercare.Childreninout-of-homecareinSingaporehavealowerprevalenceofbehavioral andemotionalneedsthanchildreninothercountries,andthesechildrenaremoresimilartoageneralchildwelfaresample inNorthAmericathanresidentialcaresamplesinthesecountries(Liuetal.,2014;Liuetal.,2016).

Liuetal.(2016)foundthat63%ofalarge-scaleout-of-home-caresample(N=721)inSingaporehadexperiencedat leastoneinterpersonaltrauma,withneglect(34%)andphysicalabuse(31%)beingmostprevalent.Childrenwithmultiple interpersonaltraumaexposure(35%)weresignificantlyolder,morelikelytobefemale,andhadahighernumberoflife functioning,behavioral,andemotional,aswellasriskbehaviorneedscomparedwithchildrenwithnoprevioustrauma.

Morerelevanttothecurrentstudy,Sim,Li,andChu(2016)foundthattheprotectiveeffectsofhighstrengthsagainstthe impactofchildmaltreatmentwereapparentatbaselineinbothresidentialandfostercare,despitecleardifferencesin children’sprofilesacrossplacementtypes.However,theseinitialbenefitsappearedtopersistsomewhatforchildrenin fostercarebutseemedtodiminishinmorerestrictive,residentialsettings.Thiswarrantsfurtherinvestigationinchildren withmoresimilarprofilesacrossaperiodoftime.Furthermore,astudyof1750childrenknowntoChildProtectionServices (CPS)inSingapore(Lietal.,2014)indicatedthattheoverallpercentageofCPSre-entry(i.e.,duetofurtherconcernsofabuse orneglect)is10.5%,withriskfactorssuchasbeingolderthan2yearsofage,havingahistoryofneglect,alargerfamilysize, lowerhouseholdincome,andmaternalunemployment.

1.4. Presentstudy

Thepresentstudyhencerecognizestheimportanceofstrengthsinmitigatingthenegativeeffectsofmaltreatment,and seekstotestseveralhypothesesonappliedstrengths,andangercontrolandconductproblemswithintheSingaporechild welfaresystem.Inparticular,itseekstoexaminetheroleofstrengthsonmultiplelevelsasknowninadevelopmental ecological-systemsframework(Benzies&Mychasiuk,2009;Bronfenbrenner,1977).Thevariablesexaminedrangefromthe individuallevelofhavingtalents/interestsandeducationalsupport,tothefamilylevelofhavinggoodfamilyrelationships.

Theauthorsalsorecognizethattohavestrengthsperseisnotsufficient;itmaybeequallyormoreimportantthatthe adolescentrecognizesthesestrengthsandusestheminrelevantsituationsforhealthydevelopmentandgrowth.Thus,the individual’srecognitionandapplicationofstrengths,whichtheauthorshavetermed“AppliedStrengths”inthepresent study,isalsoexamined.ThetwooutcomevariablesofinterestinthecurrentstudyareAngerControlProblemandConduct Problem.Theroleofstrengthsonthesetwooutcomeswouldprovideadeeperunderstandingofadolescents’emotional andbehavioralfunctioning,andthetypeofsupportthatcanreducethenegativeimpactofmaltreatment.Additionally,the currentstudyexaminestheimpactofMTMthroughaMaltreatmentCompositescoreanditsinteractionwiththevarious strengths.

Inparticular,threehypothesesweretested:

Hypothesis1. AngerControlProblemandConductProblemwouldbesignificantlyassociatedwiththestrengthsmeasured:

Talents/Interest,FamilyRelationships,EducationalSupportandAppliedStrengths,andwithMaltreatmentComposite.

Hypothesis2. Talents/Interest,FamilyRelationships,EducationalSupport,AppliedStrengthsandMaltreatmentComposite wouldbesignificantpredictorsofadolescents’AngerControlProblemandConductProblem.

Hypothesis3. ThestrengthsofTalents/Interest,FamilyRelationships,EducationalSupport,andAppliedStrengthswould haveamoderatingeffectontherelationshipbetweenMaltreatmentCompositeandAngerControlProblem,andtherela- tionshipbetweenMaltreatmentCompositeandConductProblem.

2. Method 2.1. Participants

Aconveniencesampleofonehundredandthirtyadolescents(46.8%male;53.2%female)from11identifiedVoluntary Children’sHomes(VCHs)inSingaporewasincludedinthepresentstudy.TheparticipantswereinvolvedwiththeRehabil- itationandProtectionGroup,MinistryofSocialandFamilyDevelopment(MSF),andmetinclusioncriteriafor(i)historyof

maltreatment(e.g.,neglect,physical,andemotionalabuse);(ii)non-JuvenileArrestcases;and(iii)residinginaVCHbetween March2012andFebruary2013.Theageoftheparticipantsrangedfrom13to19years(M=15.1,SD=1.58,Mdn=15),with 79.2%between13and16yearsoldand20.8%between17and19yearsold.Informationregardingtheethnicityofthe participantsandtheirdurationofstayintheVCHswasnotavailable.Theterm“maltreatedadolescents”hereafterrefersto adolescentswithahistoryofmaltreatmentasindicatedbycaseworkerassessment.

2.2. Ethics

EthicalapprovalwasobtainedthroughanethicsreviewpanelwithintheMinistryofSocialandFamilyDevelopment,and theHumanResearchEthicsCommitteeofJamesCookUniversity.

2.3. Measure

TheChildandAdolescentNeedsandStrengths(CANS)instrumentwasdevelopedbyLyons(2009)andhasbeenused foreffectiveassessment,planning,outcome-monitoringanddecision-makinginmorethan30statesintheUnitedStates ofAmerica(Lyons,Weiner,&Lyons,2004;Wintersetal.,2005).TheSingaporeversionofCANSwasadaptedforthechild welfarepopulationbyateamofprofessionalsinconsultationwiththedeveloperofCANS.AsMSFisthemainstatutorybody inchargeofchildprotectionandwelfare,andCANShasbeenrolledoutwithinMSF,CANScanbeconsideredtobewidely usedwiththispopulationinSingapore.

TheSingaporeCANSversionwasdesignedtoidentifykeyneedsandstrengthsofchildrenandadolescents.Itconsistsof sevendomains(i.e.,LifeDomainFunctioning,School,ChildBehavioralandEmotionalNeeds,Trauma,ChildRiskBehavior, Strengths,andIdentifiedLong-termCaregiver).EachCANSitemcanbequantitativelyratedonafour-pointscalewhich translatesintodifferentactionlevelstoguidecasemanagementandserviceprovision(i.e.“0”indicatesnoevidenceofa need;“1”indicatesmildneedrequiringmonitoring;“2”indicatesamoderateneedrequiringactionand“3”indicatesasevere needrequiringimmediateorintensiveaction).TheratingsofTalents/Interest,FamilyRelationships,EducationalSupport andAppliedStrengthswererecodedintheanalysissuchthataratingof‘3indicatedahigherlevelofstrength.ForApplied Strengths,thisindicatedthattheyouthwasabletorecognizeandusehis/herstrengthstopromotehealthydevelopment andproblemsolvingwhilearatingof‘0indicatedthattheyouthfailedtorecognizehis/herstrengthsandisthereforeunable toutilizethem.

Currently,theCANSiswidelyusedinmanychildwelfaresystemsintheUnitedStatestosupportdecisionmaking, qualityimprovementsandoutcometracking(Lyons,2004;Lyons,Weiner,&Lyons,2001).Severalstudieshaveestablished themeasurementpropertiesoftheCANS(Chor,McClelland,Weiner,Jordan,&Lyons,2012;Epsteinetal.,2011Epstein, Bobo,Cull,&Gatlin,2011;Lyonsetal.,2004).ThesestudieshaveestablishedCANSasaclinicalassessmenttoolwithhigh fieldreliabilityevenattheitemlevel,suchthatindividualitemsmaybeexaminedindataanalyses(Anderson,Lyons,Giles, Price,&Estle,2003).Thereisalsoevidenceforitspredictivevalidity(Park,Epstein,Jordan,Mandell,&Lyons,2009)aswell asconcurrentvalidity,wherebyCANSdomainscoreshavebeendemonstratedtocorrelatewithotherestablishedchild assessmentscalessuchastheChildandAdolescentFunctionalAssessmentScale(CAFAS)andtheChildBehaviorChecklist (Lyons,2009).ThecorrelationbetweenCANSandCAFASis0.63(df=247,p<0.001)(Lyonsetal.,2011).

ThevalidityandreliabilityofSingaporeCANSformeasuringtheneedsandstrengthsofSingaporeanchildreninpublic carewasreportedbyHengandLiu(2014).Inanotherpaper,goodreliabilityfortheSingaporeCANSwasalsodemonstrated wheretheintraclasscorrelationcoefficients(ICCs)betweencaseworkersandresearcherswerebetween0.79and0.89(Liu etal.,2014).FurtherresearchusingtheSingaporeCANSwasreportedinarecentpaperbySimetal.(2016).

Forthisstudy,atotalofnineitemsfromtheSingaporeCANSwereselectedtoinvestigatetheimpactofmulti-level strengths(i.e.,personal,familyandschool).ThreeitemsfromtheTraumadomainwereselected(e.g.,Neglect,Physical AbuseandEmotionalAbuse).AngerControlandConductProblemswereselectedfromtheChildBehavioralandEmotional Needsdomain.Finally,fouritemsfromtheChildStrengthsdomainwereselected(i.e.,Resilience,Talents/Interest,Family RelationshipsandEducationalSupport).TheCANSitem“Resilience”wasre-termedas“AppliedStrengths”inthisstudyas theauthorsperceivedthatresiliencemaybetoobroadaconcepttobedefinedbyasingularmeasurementitem.Inter-rater reliabilitychecksontheCANSratingswereconducted.

2.3.1. Multi-typemaltreatment.Toconsiderthecumulativeeffectofneglectanddifferenttypesofabuse,aMaltreatment Compositescore(akintoMulti-typemaltreatment)wasobtainedbycomputingthemeanofthesub-typesofmaltreatment (i.e.,Neglect,Physical,andEmotionalabuse).Thisprocedurewasinlinewithpreviousresearch(Sesar,Zivcic-Becirevic,&

Sesar,2008).ThescorefortheMaltreatmentCompositerangedbetween0and3,wherehigherscoresindicatedgreater severity.

2.4. Procedure

ApprovalwassoughtfromMSFtorelease thede-identified retrospectiveCANS dataforthis study.Anyidentifying information wasremovedandreplacedwitha numbercode.BetweenSeptember2012and February2013,ateamof CANS-certifiedresearchassistants(RAs),stafffromMSFandtheChildren’sHomeratedtheCANSitemsforeachparticipant.

Table1

Descriptivesofpredictors.

TotalSample(N=130) Males(n=61) Females(n=69)

M(SD) M(SD) M(SD)

MaltreatmentComposite 1.03(0.63) 0.94(0.62) 1.11(0.64)

Neglect. 1.07(0.97) 0.89(0.84) 1.23(1.05)

PhysicalAbuse 1.12(1.00) 1.05(1.04) 1.19(0.97)

EmotionalAbuse 0.91(0.95) 0.82(0.97) 0.99(0.93)

Talents/Interest 1.94(0.88) 2.02(0.81) 1.87(0.94)

FamilyRelationships 1.54(0.92) 1.39(0.95) 1.67(0.87)

EducationalSupport 2.28(0.62) 2.21(0.64) 2.33(0.61)

AppliedStrengths 2.13(0.76) 2.10(0.72) 2.16(0.80)

Note:Comparisonsacrossageandgenderforallvariableswerenon-significant.

Thescoringwasbasedoninformationfrommultiplesources(e.g.,interviewswithadolescentsandfamily,teacherreports, andcasefiles).Theinter-raterreliabilitybetweenresearchassistants(RAs)andcaseworkersfortheCANSratingswas0.81;

andinter-raterreliabilityamongRAswas0.78.ThecompletedratingsfortheCANSwereuploadedbytheMSFresearchteam (fromMarch2012onwards)andwereextractedfromtheweb-basedSingaporeCANSsystemon2March2013.

2.4.1. Statisticalanalyses.ThedatawasanalyzedusingtheStatisticalPackageforSocialSciences(SPSS)softwareVersion22.

Descriptivestatisticswereemployedtocomparethemeansanddistributionofallthevariables,aswellasageandgender differencesinthesample.AllvariableswerefoundtobenormallydistributedexceptfortheoutcomevariablesofAnger ControlandConductProblems.AngerControlProblemhadaskewnessof1.24(SE=0.21)andkurtosisof0.83(SE=0.42),while ConductProblemhadaskewnessof1.74(SE=0.21)andkurtosisof2.13(SE=0.42).Alogtransformationwasappliedtothe databutnormalityofdatawasnotachieved.Hence,AngerControlandConductProblemswerecodedintobinaryvariables.

Duetosmallcellcounts(<5)inthemoreseverecategories,theseoutcomevariableswererecodedinto‘0’whichindicated noproblemofAngerControlorConductProblemsand‘1’whichindicatedhavingAngerControlorConductproblems.

Tounderstandtheassociationsofthestrengthsmeasuredwiththeoutcomevariables,a seriesoft-testswerefirst conductedtotestifthemeansofMaltreatmentComposite,AppliedStrengths,Talents/Interest,FamilyRelationshipand EducationalSupportweresignificantlydifferentbetweengroups(e.g.withandwithoutAngerControlProblem).

Next,twologisticregressionswereconductedtodeterminethevariancethatthepredictors(i.e.,MaltreatmentCompos- ite,AppliedStrengths,Talents/Interest,FamilyRelationshipsandEducationalSupport)couldexplainforAngerControland ConductProblems(criterionvariables).Lastly,twomoderatedregressionswereconductedwiththreestandardizedpredic- tors(i.e.,CenteredAppliedStrengths,CenteredMaltreatmentComposite,andAppliedStrengths×MaltreatmentComposite interaction).Theinteractiontermwasfirstcenteredandthenmultiplied.ThecriterionvariableswereAngerControland ConductProblems.

3. Results

3.1. Descriptivestatistics

ThemeansandstandarddeviationsofMaltreatmentComposite,AppliedStrengths,Talents/Interest,FamilyRelationships, andEducationalSupportarepresentedinTable1.ThemeansforNeglect,PhysicalandEmotionalabusewereinthemild range,rangingfrom0.82to1.23(highestscoreof“3”indicatesmostseverelevel).Thet-testsandcorrelationalanalyses revealedgenderandagedifferenceswerenon-significantacrossthevariablesinthesample.

Aseriesoft-testswereconductedcomparingthemeansofthevariablesabovebythecategories(NoProblemvsWith Problem)oftheoutcomevariablesofAngerControlandConductProblems.40%(n=52)ofthesamplewerefoundtohave AngerControlProblemand25%(n=32)hadConductProblem.

Levene’sTestforequalityofvariancesrevealednon-significantestimatesfortestsexceptforthet-testofTalents/Interests byConductProblem.Non-significantestimatesindicatedthatthevariabilityinthetwoconditionsweresimilar.Forthe exception,Satterthwaiteapproximationwasemployedfortheunequalgroupvariances.

Table2showstheresultsfortheoutcomeofAngerControlProblem.Themeanscoresofallthestrengthvariableswere higherforthosewithnoproblemascomparedtothosewithproblems,thoughonlythemeandifferenceinAppliedStrengths, t(128)=4.78,p<0.01wassignificant.FamilyRelationshipswasfoundtobeasignificantpredictorbasedonitsp-valuebut thisfindingwasnotcorroboratedbytheconfidenceinterval,henceindicatingthatthisfindingmaynotberobust.

Table3showstheresultsfortheoutcomeofConductProblem.Anexaminationofthemeanscoresrevealedasimilar patterntotheanalysesdonewithAngerControlProblem;thosewithConductProblemhadhighermeanscoresofMaltreat- mentCompositeandlowermeanscoresonthevariousStrengths.MeandifferencesinTalents/Interest,t(128)=2.33,p<0.05, EducationalSupport,t(128)=2.99,p<0.01,andAppliedStrengths,t(128)=4.01,p<0.01,werefoundtobesignificant.

Table2

ComparisonofMaltreatmentCompositeandStrengthsbyAngerControlProblem.

NoAnger Control Problem (n=78)

WithAnger Control Problem (n=52)

Meandifference 95%CIformean difference

t df

M SD M SD

MaltreatmentComposite 0.98 0.62 1.12 0.66 −0.14 −0.36−0.09 −1.21 128

Talents/Interest 2.01 0.86 1.83 0.90 0.19 −0.12to0.50 1.18 128

FamilyRelationships 1.67 0.95 1.35 0.84 0.32 0.00–0.64 1.98* 128

EducationalSupport 2.33 0.55 2.19 0.72 0.14 −0.08to0.36 1.27 128

AppliedStrengths 2.37 0.61 1.77 0.83 0.60 0.35–0.85 4.78** 128

Note:*p<0.05,**p<0.01.

Table3

ComparisonofMaltreatmentCompositeandStrengthsbyConductProblem.

NoConduct Problem (n=98)

WithConduct Problem (n=32)

Meandifference 95%CIformean difference

t df

M SD M SD

MaltreatmentComposite 0.99 0.62 1.17 0.68 −0.18 −0.43–0.08 −1.37 128

Talents/Interest 2.05 0.80 1.59 1.01 0.46 0.06–0.85 2.33*^S 128

FamilyRelationships 1.60 0.92 1.34 0.90 0.26 −0.11–0.63 1.39 128

EducationalSupport 2.37 0.53 2.00 0.80 0.37 0.12–0.61 2.99** 128

AppliedStrengths 2.28 0.67 1.69 0.86 0.59 0.30–0.88 4.01** 128

Note:*p<0.05,**p<0.01.

SSatterthwaiteapproximationemployedduetounequalgroupvariances.

Table4

LogisticRegressionAnalyses.

Predictors CriterionVariables B OR 95%CI

MaltreatmentComposite AngerControlProblem 0.97 1.10 [0.59,2.05]

Talents/Interest −0.08 0.99 [0.62,1.58]

FamilyRelationships −0.30 0.74 [0.48,1.15]

EducationalSupport −0.24 0.78 [0.39,1.57]

AppliedStrengths −1.14 0.32** [0.18,0.58]

MaltreatmentComposite ConductProblem 0.20 1.22 [0.61,2.44]

Talents/Interest −0.37 0.69 [0.42,1.16]

FamilyRelationships −0.18 0.84 [0.50,1.39]

EducationalSupport −0.81 0.45^a [0.20,1.00]

AppliedStrengths −0.89 0.41* [0.22,0.77]

Maltreatment AngerControlProblem 0.16 1.17 [0.63,2.18]

AppliedStrengths −1.21 0.30** [0.16,0.54]

Interaction(Maltreatment×AppliedStrengths) 0.26 1.30 [0.56,3.00]

Maltreatment ConductProblem 0.27 1.30 [0.63,2.69]

AppliedStrengths −1.04 0.35** [0.19,0.65]

Interaction(Maltreatment×AppliedStrengths) 0.17 1.19 [0.50,2.80]

Note:**p<0.01,*p<0.05,^ap<0.10

3.2. Logisticregressions

TwologisticregressionswereconductedtotestifMaltreatmentCompositeandthestrengthsofTalents/Interest,Educa- tionalSupport,FamilyRelationshipsandAppliedStrengthswerepredictiveoftheoutcomevariables,AngerControlProblem andConductProblem.Table4showstheresultsofthelogisticregressions.

3.2.1. Angercontrolproblem.Atestofthefullmodelagainstaconstantonlymodelwasstatisticallysignificant,indicating thatthepredictorsasasetreliablydistinguishedbetweenthosewhohadandthosewhodidnothaveAngerControlProblem (Chi-square=23.53,df=5,p<0.01).Nagelkerke’sR²of0.22indicatedarelationshipbetweenpredictionandgrouping.The WaldcriteriondemonstratedthatonlyAppliedStrengthsemergedasasignificantpredictor(B=−1.14,SE=0.31,OR=0.32).

TheoddsratioshowedthatwhenAppliedStrengthswasraisedbyoneunit,therewas68%lesslikelihoodthattheindividual hadAngerControlProblem.

3.2.2. Conduct problem. A test of thefull model against a constant only model wasalso statisticallysignificant (Chi- square=23.18,df=5,p<0.01).Nagelkerke’sR²wasat0.24.Interestingly,AppliedStrengthsagainemergedasasignificant predictor(B=−0.89,SE=0.32,OR=0.41).ThisindicatedthatforeachincreaseinoneunitinAppliedStrengthsona4-point scale,therewas59%lesslikelihoodofConductProblem.Additionally,Educationalsupportwasalsofoundtobesignificant (B=−0.81,SE=0.41,OR=0.45).HencewhenEducationalSupportincreasesbyaunit,therewas55%lesslikelihoodofhaving ConductProblem.

3.3. Moderationanalyses

Thusfar,onlyAppliedStrengthswasasignificantpredictorofAngerControlandConductProblems.Moderationanalyses weresubsequentlyconductedtoascertainiftherelationshipbetweenMaltreatmentCompositeandtheoutcomevariables weredependentonAppliedStrengths.MeancenteredscoreswerecalculatedforbothMaltreatmentCompositeandApplied Strengths,andaninteractiontermwascomputedfromthecenteredscores.Thesewerethenenteredintologisticregressions withtheoutcomevariables.TheresultsofthemoderatedlogisticregressionsareshowninTable4.

3.3.1. Angercontrolproblem.Theresultsofthemoderatedregressionmodelinpredictingthevarianceoftheadolescents’

AngerControlProblemfromthepredictorsonlyshowedasignificantmaineffectofAppliedStrengths(B=−1.21,SE=0.30, OR=0.30,p<0.001),butnoeffectfortheinteractionterm(i.e.,MaltreatmentCompositexAppliedStrengths).

3.3.2. Conductproblem.SimilarresultswerefoundforConductProblem.TherewasasignificantmaineffectofApplied Strengths(B=−1.04,SE=0.32,OR=0.35,p<0.001)buttheinteractiontermwasnotsignificant.

TheseresultsshowedthatAppliedStrengthswasnotamoderatoroftheeffectofmulti-typemaltreatmentonAnger ControlorConductProblems,butthemaineffectofthisvariableseemedtobeconsistentlysignificantacrossallanalyses.

4. Discussion

InresponsetoHypothesis1,thefindingsofthisstudyconfirmthatstrengthsareinverselyassociatedwithconduct problemsofmaltreatedadolescents.Thefindingsshowthathighereducationalsupportandhavingtalents/interestare associatedwithlowerlevelsofconductproblems.

Singaporehasalwaysplacedahighvalueoneducationasitisrecognizedtobeakeydriverinchangingdevelopmental trajectories.Therefore,hugeamountsofresourcesarebeingpumpedintotheschoolstohelpthosewhostruggleacademically toprogressandmaximisetheirpotential.Thiseducationalsupportwillalsobeimportanttopreventandreduceconduct problemsinfuture.However,thedevelopmentoftalentsandinterestshasnotbeengivenasmuchprominence.Promoting talentsandinterestisinlinewithpastresearch(Gilligan,1999;Tyleretal.,2008)wherebyspendingtimeinactivities relatedtotheirtalents,hobbiesandinterestsnotonlygivesadolescentspleasureandsatisfactionbutimportantly,the senseofmastery,competencyandachievementalsoservetopromoteself-esteem(Gilligan,1999).Morerecently,Trainor, Delfabbro,Anderson,&Winefield,(2010)showedthatleisureactivitieswerelinkedtobetterpsychologicalwell-beingsuch ashigherself-esteem,andmorelifesatisfaction.Insummary,effortstocultivateadolescents’talents/interestscanpotentially enhanceself-esteemandbufferagainstconductproblems.Futureresearchcanconsiderifthishasaprotectiveeffectagainst academicfailure,earlyschooldropout,delinquency,substanceabuseandrecidivisminadulthood.

Interestingly,thefindingsrevealedthatalthoughpossessingindividualstrengthsisimportantforangercontroland conductproblems,theindividual’scapacitytorecognizehisorherownstrengthsandtoapplythemforhealthydevelopment andproblem-solvingappearedtobeasimportantbecauseitconsistentlysurfacedasasignificantfindingforinternalizing andexternalizingproblems.InresponsetoHypothesis2,onlyAppliedStrengths,whichreferstothiscapacitytoknow one’sownstrengthsandtousethem,wasfoundtobepredictiveofthetwooutcomevariables.Thisfindingmayindicate thathavingastrengthandlearningtoapplythisstrengtharedifferentprocesseswhichneedtobeinvestigatedfurther.

Adolescentspossessaffectivestrengthsandself-regulatoryprocessesandtheircapabilitytotapintothematthenecessary momentsmayenablethemtosuccessfullyregulatetheirangerandconductwhenneeded.Thecurrentstudyprimarily considersadolescents’capacitytounderstandandapplytheirstrengths,andmayhaveoverlookedcognitiveprocessessuch asattentionalandcognitivebiases(Romens&Pollak,2012)ormaladaptivecognitivestrategiessuchasrumination(Aldao etal.,2010).Thesecognitivefactorscouldinterferewithadolescents’thinking,planningandeffectiveproblemsolvingwhen theyattempttoregulatetheiranger.DishionandConnell(2006)alsoshowedthatmotivatedattentionprocessesareclosely linkedtoemotionalandbehavioralregulation,withself-regulationmoderatingtherelationshipbetweenpeerdevianceand anti-socialbehavior.

Itisimportanttonotethatwhilehavingstrengthsandthecapacitytoapplythemiscrucial,inlinewithamoreholistic conceptofresilience,externalresourcesareequallyessentialin providinga conduciveenvironment forindividualsto navigatethemselvestowardshealthydevelopment(Fergus&Zimmerman,2005).

Lastly,inresponsetoHypothesis3,therewasnomoderatingeffectfoundinthecurrentstudy.Despitethis,thepredictive capacitytoapplyone’sstrengthsremainedconsistentlystronginitsimpactonangercontrolandconductproblems.

4.1. Implications

Thisstudyextendscurrentunderstandingoftheimportanceofstrengthswithagroupofmaltreatedadolescentsinan Asiancontext(Fergus&Zimmerman,2005;Lee,Cheung,&Kwong,2013;Olsson,Bond,Burns,Vella-Brodrick,&Sawyer, 2003).Theassociationofdifferentfactorswiththedifferentoutcomessuggeststhatadoptinga“one-size-fits-all”strength- basedapproachtointerventionmaynotyieldoptimaloutcomesforadolescentswithahistoryofmaltreatment.Itistherefore importantforinterventionstobeperson-centeredduringthisdevelopmentalphase.

Thecurrentfindingsidentifytherecognitionandapplicationofstrengthsasakeyprotectivefactorassociatedwithanger controlandconductproblemsformaltreatedadolescents.Ithighlightstheneedforcliniciansandcaseworkerstoinvest moreresourcesandtimeinbuildingthestrengthsofmaltreatedadolescents,andhelpingthemtorecognizeandapply theiridentifiedstrengthsinappropriatesituations.Adolescentswithidentifiedstrengthswhoarenotusingthemwould requirehelptoapplythemtopromoteadaptivefunctioning,whereasthosewithnoidentifiedstrengthswouldneedalonger interventionperiodtoidentify,cultivateandlearnhowtousetheirstrengthsinreal-worldsettings.Identifyingthesetarget groupsforinterventioncaninformhowlimitedresourcesinthesocialworkfieldcanbebetterdistributed.

Thefindingsalsopointtothebenefitsofinvestingfinancialresourcesindevelopingadolescents’talentsandinterests(e.g., sports,arts,andmusic)asaprotectivefactoragainstconductproblems.Encouragingthedevelopmentoftalentsandinterests willlikelyenhanceadolescents’self-esteemandreducetheriskofpsychopathology(e.g.,depressionandanxiety)during adolescenceandadulthood.Likewise,itisimportanttocontinueallocatingresourcestostrengthenfamilyrelationshipsand educationalsupport,asthesewillalsohelptobufferagainstangercontrolandconductproblems.

Theabovesuggestionsareimportantconsiderationforpolicymakersastheycanpotentiallyservetoreduceeconomic burdenonsocietyinthelongterm.Reducingtheriskofmaladaptivefunctioningsuchasangercontrolandconductproblems willservetoimproveadolescents’overallmentalhealth,well-beingandqualityoflife.

4.2. Limitations

Thereareseverallimitationsinthisstudy.First,thestudyreliedonretrospectiveCANSdata,whichdidnotaccount forpossibleconfoundingvariables(e.g.,self-esteem,optimism,andpeersupport).Second,theschoolwasidentifiedasan importantcommunitysupportoutsidetheadolescents’family;however,theinclusionofotherschool-relatedfactorssuchas peersupportandinvolvementinextra-curricularactivitieswouldalsohavebeenhelpfulintheanalysis.Theimpactofother communitysupport(e.g.,neighbors,religiousgroupsandsportsclubs)wasnottakenintoaccountinthisstudy.Relatedly,it isacknowledgedthatdataonethnicityandthedurationofstayatVCHswerenotavailable.Thesefactorsmayhaveplayed apartintheprocessofbuildingstrengthsinsomeway.Finally,maladaptivecognitiveprocesswasnotconsideredinthe analysisandthismaybeasignificantdriverofadolescents’thinkingandproblemsolvinginthecontextofangerregulation.

4.3. Futureresearch

Giventhepaucityofresearchinthefieldofstrengths,thereisaneedformoreresearchtoexamine(i)newanddevelop- mentallyappropriateprotectivefactors(e.g.,useofsocialmediaasaformofsocialsupport);(ii)thedynamicinterplayof individualfactorssuchasoptimismandlocusofcontrol;aswellasotherexternalfactors(e.g.,communitygroupsrelatedto talentsandinterest);and(iii)possiblecognitive-behavioralprocessesthatarelinkedtohealthydevelopmentandoutcomes despiteearlyadversitiesduringearly,middleandlateadolescence.Futurestudiescanalsoconsiderculturalperspectives;for exampleifstrengthsareexpresseddifferentlyinvariousculturesandholdvaryingfunctions.TheChildandYouthResilience Measure(Liebenberg,Ungar,&VandeVijver,2012)isanexampleofatoolwhichseekstobeculturallysensitive.Lastly,in ordertoexaminethelong-termeffectsofstrengthsandtheirimpactonpsychologicalwell-being(e.g.,self-esteem),andthe roleofstrengthsinadolescents’transitiontoyoungadulthood,longitudinaldesignsshouldalsobeencouraged.

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