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Caracterização de uma amostra de crianças e adolescentes em acolhimento residencial : análise dos fatores de proteção e dos problemas de saúde mental
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A institucionalização de crianças e adolescentes em casas de acolhimento ocorre quando as condições do meio familiar não são adequadas para o seu desenvolvimento, segurança e bemestar. Esta população acumula vários fatores de risco (como experienciarem maus-tratos e serem consequentemente afastados da sua família) e apresenta uma prevalência elevada de problemas de saúde mental. O presente estudo teve como objetivos caracterizar uma amostra de 88 crianças e adolescentes dos 7 aos 17 anos relativamente às suas características sociodemográficas, escolares e institucionais, aos seus recursos individuais e relacionais e aos seus resultados de saúde mental, e explorar as associações entre vários potenciais fatores de proteção e os resultados de saúde mental. Foram utilizados os seguintes instrumentos de avaliação: questionários acerca de informações sociodemográficas, escolares e institucionais, a Escala de Auto-estima de Rosenberg, o Questionário de Regulação Emocional – Crianças e Adolescentes, o Test of Everyday Attention, o Questionário de Ligação a Figuras Significativas, o Questionário de Capacidades e Dificuldades (para o próprio, tutores e professores) e a Escala de Ansiedade e Depressão para Crianças – Revista. A maioria dos participantes reside na sua primeira casa de acolhimento, tem contacto com a família, não tem irmãos na instituição, não tem problemas de saúde mental ou física identificados pelos seus tutores e tem acompanhamento em psicologia ou pedopsiquiatria. Embora o ensino regular seja a situação escolar mais frequente e a maior parte das crianças tenha um aproveitamento escolar positivo, uma grande percentagem dos participantes beneficia de ensino especial ou de adaptações curriculares. É ainda de salientar que uma percentagem considerável dos alunos apresenta resultados negativos e/ou problemas comportamentais na escola. Para além disto, os participantes apresentaram resultados moderados de auto-estima, elevados de qualidade das relações com figuras significativas (que não os pais), e relativamente baixos de autorregulação emocional. Apesar dos resultados de ansiedade, depressão e dificuldades totais (reportadas por todos os informadores) serem relativamente baixos/moderados, são mais elevados do que os valores encontrados noutros estudos. Relativamente às associações entre as variáveis, foram observadas algumas correlações estatisticamente significativas com uma significância de magnitude moderada. Nomeadamente, valores mais elevados de sintomas de externalização e de dificuldades totais foram mais frequentes no sexo masculino. Quanto às variáveis relacionadas com a institucionalização, observou-se uma associação entre um maior número de irmãos na casa de acolhimento e mais sintomas de externalização. No que diz respeito aos recursos individuais, verificaram-se associações entre uma auto-estima mais elevada e menos dificuldades totais, sintomas de
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externalização e sintomas de Perturbação Depressiva Major. Foram também observadas associações entre capacidades de autorregulação da atenção mais elevadas e menos sintomas de internalização, de externalização, de Perturbação de Ansiedade de Separação e de dificuldades totais. Desta forma, os resultados deste estudo sugerem algumas dimensões associadas a melhores resultados de saúde mental nas crianças e adolescentes em acolhimento residencial. A identificação e promoção destas dimensões é importante de modo a reduzir o impacto da adversidade na saúde mental desta população, podendo ser útil na elaboração e planeamento de intervenções.
The institutionalization of children and adolescents on residential homes happens when the conditions of the family environment are not suitable for their development, safety and wellbeing. This population accumulates several risk factors (such as experiencing maltreatment and consequently being separated from their family) and presents a high prevalence of mental health problems. The present study aimed to characterize a sample of 88 children and adolescents from 7 to 17 years of age regarding their sociodemographic, school and institutional characteristics, their individual and relational resources, and their mental health outcomes, and to explore the associations between the various potential protective factors and mental health outcomes. The following evaluation instruments were used: questionnaires about sociodemographic, school and institutional information, the Rosenberg Self-esteem Scale, the Emotional Regulation Questionnaire - Children and Adolescents, the Test of Everyday Attention, the Relationship to Significant Figures Questionnaire, the Strengths and Difficulties Questionnaire (for self, tutors and teachers) and the Revised Child Anxiety and Depression Scale. Most of the participants live in their first institution, have contact with their family, do not have siblings in the institution, do not have physical or mental health problems identified by their tutors and are followed up in psychology or child/adolescent psychiatry. Although regular education is the most frequent school situation and most children have a positive academic achievement, a large percentage of the participants benefit from special education/curricular adaptations. It should also be noted that a considerable percentage of students present negative results and/or behavioral problems in school. The participants presented moderate results of self-esteem, high quality of relationships with relatively high significant figures, and relatively low capacity of emotional self-regulation. Although the results of anxiety, depression and total difficulties (from all informants) are relatively low/moderate, they are higher than those in other studies Regarding the associations between variables, it was observed some significant correlations of moderate strength. In particular, higher values of externalization symptoms and total difficulties were more frequent in the male gender. Concerning the variables related to institutionalization, there was an association between a larger number of siblings in the institution and more externalization symptoms. As for individual resources, there were associations between a higher self-esteem and fewer total difficulties, externalization symptoms and Major Depressive Disorder symptoms. There were also observed associations between better attentional self-regulation abilities and fewer symptoms of internalization, of Separation Anxiety Disorder and of total difficulties. vi Thus, the results of this study suggest some dimensions associated with better mental health outcomes in children and adolescents in residential care. The identification and promotion of these dimensions is important in order to reduce the impact of adversity on the mental health of this population, being useful in the elaboration and planning of interventions.
The institutionalization of children and adolescents on residential homes happens when the conditions of the family environment are not suitable for their development, safety and wellbeing. This population accumulates several risk factors (such as experiencing maltreatment and consequently being separated from their family) and presents a high prevalence of mental health problems. The present study aimed to characterize a sample of 88 children and adolescents from 7 to 17 years of age regarding their sociodemographic, school and institutional characteristics, their individual and relational resources, and their mental health outcomes, and to explore the associations between the various potential protective factors and mental health outcomes. The following evaluation instruments were used: questionnaires about sociodemographic, school and institutional information, the Rosenberg Self-esteem Scale, the Emotional Regulation Questionnaire - Children and Adolescents, the Test of Everyday Attention, the Relationship to Significant Figures Questionnaire, the Strengths and Difficulties Questionnaire (for self, tutors and teachers) and the Revised Child Anxiety and Depression Scale. Most of the participants live in their first institution, have contact with their family, do not have siblings in the institution, do not have physical or mental health problems identified by their tutors and are followed up in psychology or child/adolescent psychiatry. Although regular education is the most frequent school situation and most children have a positive academic achievement, a large percentage of the participants benefit from special education/curricular adaptations. It should also be noted that a considerable percentage of students present negative results and/or behavioral problems in school. The participants presented moderate results of self-esteem, high quality of relationships with relatively high significant figures, and relatively low capacity of emotional self-regulation. Although the results of anxiety, depression and total difficulties (from all informants) are relatively low/moderate, they are higher than those in other studies Regarding the associations between variables, it was observed some significant correlations of moderate strength. In particular, higher values of externalization symptoms and total difficulties were more frequent in the male gender. Concerning the variables related to institutionalization, there was an association between a larger number of siblings in the institution and more externalization symptoms. As for individual resources, there were associations between a higher self-esteem and fewer total difficulties, externalization symptoms and Major Depressive Disorder symptoms. There were also observed associations between better attentional self-regulation abilities and fewer symptoms of internalization, of Separation Anxiety Disorder and of total difficulties. vi Thus, the results of this study suggest some dimensions associated with better mental health outcomes in children and adolescents in residential care. The identification and promotion of these dimensions is important in order to reduce the impact of adversity on the mental health of this population, being useful in the elaboration and planning of interventions.
Descrição
Tese de mestrado, Psicologia (Área de Especialização em Psicologia Clínica e da Saúde - Psicologia da Saúde e da Doença), Universidade de Lisboa, Faculdade de Psicologia, 2019
Palavras-chave
Crianças Adolescentes Institucionalização Saúde mental Teses de mestrado - 2019