The impact of family function as a moderating variable on the association between adverse childhood experiences (ACEs) and behavioral problems in male adolescents aged 10–17 Years in Indonesia

Abstract

Objectives: Adverse childhood experiences (ACEs) are strongly linked to behavioral issues in adolescents, yet the protective role of family dynamics remains unclear. This study aims to examine the relationship betwen ACEs and adolescent behavioral problems while exploring the moderating role of family functioning. Methods: The case-control study analyzed secondary data from the Indonesia National Mental Health Survey (I-NAMHS) on 198 male adolescents (10–17 years). Conditional logistic regression and moderation analysis were used to assess the impact of ACEs on behavioral problems and the moderating role of family function. Results: Compared with adolescents with no ACE exposure, adolescents with 1–2 ACEs had a higher risk of behavioral problems (OR=5.96, 95 % CI [2.29, 15.15], p<0.001), increasing further with ≥3 ACEs (OR=8.65, 95 % CI [3.21, 23.3], p<0.001). Positive family function reduced these risks (adjusted OR=4.94 for 1–2 ACEs; OR=6.95 for ≥3 ACEs). Family communication had the strongest protective effect (OR=0.33–0.41, p<0.05), but mediation analysis showed family function was not a strong mediator (OR=2.73, p>0.05). Conclusions: Family function is a predictive factor in adolescent behavioral outcomes, serving as a protective buffer against the negative effects of ACEs. However, it does not fully mediate this relationship. Future research should explore additional mediators, such as peer support and coping strategies, to develop more targeted interventions.