Underlying pathway of factors leading to mental health in Iranian young adolescents: A structural equation modeling

Abstract

Background: The present study aimed to provide a field-tested model of constituting factors affecting mental health in young Iranian adolescents. Materials and Methods: In this cross-sectional study, a conceptual model was proposed based on an extensive literature review. A total of 254 young adolescents aged 11-14 years were recruited from north, south, east, and west regions of Tehran megacity by a random cluster sampling procedure, of whom 244 adolescents participated. The adolescents and their mothers altogether completed eight questionnaires pertaining to the proposed conceptual model: (1) Strengths and Difficulties Questionnaire (SDQ), (2) Childhood Experience of Care and Abuse Questionnaire, (3) Child Exposure to Domestic Violence Scale, (4) Drug Abuse Screening Test-10, (5) Baumrind Parenting Style Questionnaire, (6) Conflict Behavior Questionnaire, (7) General Health Questionnaire-28, and (8) Garmaroodi Socioeconomic Status Questionnaire. The statistical analysis was performed using structural equation modeling. Results: This study demonstrated that parent mental health (b = -0.111), experience of father's care (b = -1.112), conflict with mother (b = 0.309), conflict with father (b = 0.135), and exposure to domestic violence (b = 0.217), as well as age (b = 0.93) and gender (b = 0.139), had direct effect on adolescent mental health (all P < 0.05). Further, the results showed that exposure to domestic violence and conflict with mother had the greatest direct impact on adolescent mental health among all other family-related factors, followed by conflict with father and parent mental health. Conflict with mother and conflict with father also affected adolescent mental health indirectly through experience of domestic violence and had a mediating effect for the influence of several other factors on adolescent mental health, thus playing an important role in the pathway leading to young adolescent mental health status in the Iranian population. Conclusion: Overall, the final model proved to be fit and the factors constituting the final model were able to predict 88% of the variations in the mental health of Iranian adolescents. This model can guide clinical psychologists, psychiatrists, and other mental health workers in a more realistic and effective prevention or treatment planning for their young clients. Moreover, it may help in arriving at a comprehensive preventive policymaking for mental health policymakers.