Skip to main content

Advertisement

SpringerLink
Log in

Behavioral Problems Reported by Adolescents and Parents from HIV Affected Families in China

  • Original Paper
  • Published:
Journal of Child and Family Studies Aims and scope Submit manuscript

Abstract

This study examined the influence of various factors on the behavioral problems of adolescents affected by HIV while considering the agreement between adolescent and parent reports on problem behaviors. A total of 136 families each with one parent living with HIV (PLH) and one child aged 13–18 were included. Structural equation modeling was used to explore relationships between selected family measures and adolescent’s problem behaviors. The correlation between the PLH and adolescent-reported behavioral problem measures was low (β = 0.11). PLH-reported adolescent problem behaviors were negatively related to PLH-reported parental bonding (β = −0.39), family routines (β = −0.26), and positively associated with family conflict (β = 0.21). Adolescent-reported family participation was associated with self-reported problem behaviors (β = −0.35). Our study reported discrete perceptions of adolescent problem behaviors from parents’ and adolescents’ points of view. Future intervention efforts should emphasize family contextual factors to improve behavioral outcomes in adolescents affected by HIV.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  • Achenbach, T. M., & Rescorla, L. (2001). Manual for the ASEBA school-age forms & profiles. Burlington, VT: Achenbach System of Empirically Based Assessment.

    Google Scholar 

  • Achenbach, T. M., & Ruffle, T. M. (2000). The child behavior checklist and related forms for assessing behavioral/emotional problems and competencies. Pediatrics in Review, 21(8), 265–271.

    Article  PubMed  Google Scholar 

  • Acock, A. C. (2013). Discovering structural equation modeling using Stata (Revised edition). College Station, TX: Stata Press.

    Google Scholar 

  • Agnew, R. (1992). Foundation for a general strain theory of crime and delinquency. Criminology, 30(1), 47–88.

    Article  Google Scholar 

  • Aseltine, R. H., Gore, S., & Gordon, J. (2000). Life stress, anger and anxiety, and delinquency: an empirical test of general strain theory. Journal of Health and Social Behavior, 41(3), 256–275.

    Article  PubMed  Google Scholar 

  • Baca, C. B., Vickrey, B. G., Hays, R. D., Vassar, S. D., & Berg, A. T. (2010). Differences in child versus parent reports of the child’s health‐related quality of life in children with epilepsy and healthy siblings. Value in Health, 13(6), 778–786.

    Article  PubMed  PubMed Central  Google Scholar 

  • Billioud, S. (2007). Confucianism, “cultural tradition” and official discourses in China at the start of the new century. China Perspectives, 3, 50–65.

    Google Scholar 

  • Bloom, B. L. (1985). A factor analysis of self‐report measures of family functioning. Family Process, 24(2), 225–239.

    Article  PubMed  Google Scholar 

  • Bloom, B. L., & Naar, S. (1994). Self‐report measures of family functioning: extensions of a factorial analysis. Family Process, 33(2), 203–216.

    Article  PubMed  Google Scholar 

  • Brislin, R. W. (1970). Back-translation for cross-cultural research. Journal of Cross-cultural Psychology, 1(3), 185–216.

    Article  Google Scholar 

  • Cao, Y., Chen, X., & Fan, R. (2011). Toward a Confucian family-oriented health care system for the future of China. Journal of Medicine and Philosophy, 36(5), 452–465.

    Article  PubMed  Google Scholar 

  • Chi, P., & Li, X. (2013). Impact of parental HIV/AIDS on children’s psychological well-being: a systematic review of global literature. AIDS and Behavior, 17(7), 2554–2574.

    Article  PubMed  PubMed Central  Google Scholar 

  • Chi, P., Li, X., Tam, C. C., Du, H., Guoxiang, Z., & Zhao, J. (2015). Parenting mediates the impact of caregivers’ distress on children’s well-being in families affected by HIV/AIDS. AIDS and Behavior, 19(11), 2130–2139. https://doi.org/10.1007/s10461-015-1104-0.

    Article  PubMed  PubMed Central  Google Scholar 

  • Cremeens, J., Eiser, C., & Blades, M. (2006). Factors influencing agreement between child self-report and parent proxy-reports on the Pediatric Quality of Life Inventory™ 4.0 (PedsQL™) Generic Core Scales. Health and Quality of Life Outcomes, 4, 58.

    Article  PubMed  PubMed Central  Google Scholar 

  • Crespo, C., Santos, S., Canavarro, M. C., Kielpikowski, M., Pryor, J., & Féres-Carneiro, T. (2013). Family routines and rituals in the context of chronic conditions: a review. International Journal of Psychology, 48(5), 729–746.

    Article  PubMed  Google Scholar 

  • Davis, E., Nicolas, C., Waters, E., Cook, K., Gibbs, L., Gosch, A., & Ravens-Sieberer, U. (2007). Parent-proxy and child self-reported health-related quality of life: using qualitative methods to explain the discordance. Quality of Life Research, 16(5), 863–871.

    Article  PubMed  Google Scholar 

  • Eisenberg, M. E., Olson, R. E., Neumark-Sztainer, D., Story, M., & Bearinger, L. H. (2004). Correlations between family meals and psychosocial well-being among adolescents. Archives of Pediatrics & Adolescent Medicine, 158(8), 792–796.

    Article  Google Scholar 

  • Erhart, M., Ellert, U., Kurth, B. M., & Ravens-Sieberer, U. (2009). Measuring adolescents’ HRQoL via self reports and parent proxy reports: an evaluation of the psychometric properties of both versions of the KINDL-R instrument. Health and Quality of Life Outcomes, 7, 77.

    Article  PubMed  PubMed Central  Google Scholar 

  • Ewart, C. K. (1991). Social action theory for a public health psychology. American Psychologist, 46(9), 931–946.

    Article  PubMed  Google Scholar 

  • Fang, X., Li, X., Stanton, B., Hong, Y., Zhang, L., Zhao, G., & Lin, D. (2009). Parental HIV/AIDS and psychosocial adjustment among rural Chinese children. Journal of Pediatric Psychology, 34(10), 1053–1062.

    Article  PubMed  PubMed Central  Google Scholar 

  • Fiese, B. H. (2007). Routines and rituals: opportunities for participation in family health. Occupation, Participation and Health, 27(1), 41–49.

    Article  Google Scholar 

  • Formoso, D., Gonzales, N. A., & Aiken, L. S. (2000). Family conflict and children’s internalizing and externalizing behavior: protective factors. American Journal of Community Psychology, 28(2), 175–199.

    Article  PubMed  Google Scholar 

  • Hagan, J., & Foster, H. (2001). Youth violence and the end of adolescence. American Sociological Review, 66(6), 874–899.

    Article  Google Scholar 

  • Holroyd, E. (2001). Hong Kong Chinese daughters’ intergenerational caregiving obligations. Social Science & Medicine, 53(9), 1125–1134.

    Article  Google Scholar 

  • Jensen, E. W., James, S. A., Boyce, W. T., & Hartnett, S. A. (1983). The family routines inventory: Development and validation. Social Science & Medicine, 17(4), 201–211.

    Article  Google Scholar 

  • Kuperminc, G. P., Wilkins, N. J., Jurkovic, G. J., & Perilla, J. L. (2013). Filial responsibility, perceived fairness, and psychological functioning of Latino youth from immigrant families. Journal of Family Psychology, 27(2), 173–182.

    Article  PubMed  Google Scholar 

  • Lee, M. B., Lester, P., & Rotheram-Borus, M. J. (2002). The relationship between adjustment of mothers with HIV and their adolescent daughters. Clinical Child Psychology and Psychiatry, 7(1), 71–84.

    Article  Google Scholar 

  • Lee, S. J., Detels, R., Rotheram-Borus, M. J., Duan, N., & Lord, L. (2007). Depression and social support among HIV-affected adolescents. AIDS Patient Care and STDs, 21(6), 409–417.

    Article  PubMed  PubMed Central  Google Scholar 

  • Li, L., Sun, S., Wu, Z., Wu, S., Lin, C., & Yan, Z. (2007). Disclosure of HIV status is a family matter: field notes from China. Journal of Family Psychology, 21(2), 307–314.

    Article  PubMed  PubMed Central  Google Scholar 

  • Li, L., Wu, S., Wu, Z., Sun, S., Cui, H., & Jia, M. (2006). Understanding family support for people living with HIV/AIDS in Yunnan, China. AIDS and Behavior, 10(5), 509–517.

    Article  PubMed  PubMed Central  Google Scholar 

  • Li, X., Barnett, D., Fang, X., Lin, X., Zhao, G., Zhao, J., & Stanton, B. (2009). Lifetime incidences of traumatic events and mental health among children affected by HIV/AIDS in rural China. Journal of Clinical Child & Adolescent Psychology, 38(5), 731–744. https://doi.org/10.1080/15374410903103601.

    Article  Google Scholar 

  • Li, L., Wu, Z. Y., Wu, S., Jia, M. H., Lieber, E., & Lu, Y. (2008). Impacts of HIV/AIDS stigma on family identity and interactions in China. Families, Systems & Health, 26(4), 431–442.

    Article  Google Scholar 

  • Li, L., Ji, G., Liang, L. J., Ding, Y., Tian, J., & Xiao, Y. (2011). A multilevel intervention for HIV-affected families in China: Together for Empowerment Activities (TEA). Social Science & Medicine, 73(8), 1214–1221.

    Article  Google Scholar 

  • Li, L., Liang, L. J., Ji, G., Wu, J., & Xiao, Y. (2014). Effect of a family intervention on psychological outcomes of children affected by parental HIV. AIDS and Behavior, 18(11), 2051–2058.

  • Lin, S. (2008). Forced savings, social safety net, and family support: a new old-age security system for China. Chinese Economy, 41(6), 10–44.

    Article  Google Scholar 

  • Mellins, C. A., Brackis-Cott, E., Dolezal, C., Leu, C. S., Valentin, C., & Meyer-Bahlburg, H. F. (2008). Mental health of early adolescents from high-risk neighborhoods: the role of maternal HIV and other contextual, self-regulation, and family factors. Journal of Pediatric Psychology, 33(10), 1065–1075.

    Article  PubMed  PubMed Central  Google Scholar 

  • Ministry of Health, People’s Republic of China (2011). 2011 Estimates for the HIV/AIDS epidemic in China. http://www.unaids.org.cn/pics/20130521161757.pdf. Accessed 25 Sep 2017.

  • Murphy, D. A., Herbeck, D. M., Marelich, W. D., & Shuster, M. A. (2010). Predictors of sexual behavior among early and middle adolescents affected by maternal HIV. International Journal of Sexual Health, 22(3), 195–204.

    Article  PubMed  PubMed Central  Google Scholar 

  • Murphy, D. A., Marelich, W. D., Herbeck, D. M., & Payne, D. L. (2009). Family routines and parental monitoring as protective factors among early and middle adolescents affected by maternal HIV/AIDS. Child Development, 80(6), 1676–1691.

    Article  PubMed  PubMed Central  Google Scholar 

  • Murphy, D. A., Roberts, K. J., & Herbeck, D. M. (2013). Adolescent response to having an HIV-infected mother. AIDS Care, 25(6), 715–720.

    Article  PubMed  Google Scholar 

  • Moretti, M. M., Obsuth, I., Craig, S. G., & Bartolo, T. (2015). An attachment-based intervention for parents of adolescents at risk: mechanisms of change. Attachment & Human Development, 17(2), 119–135.

    Article  Google Scholar 

  • Parker, G., Tupling, H., & Brown, L. B. (1979). A parental bonding instrument. British Journal of Medical Psychology, 52(1), 1–10.

    Article  Google Scholar 

  • Pedersen, S., & Revenson, T. A. (2005). Parental illness, family functioning, and adolescent well-being: a family ecology framework to guide research. Journal of Family Psychology, 19(3), 404–409.

    Article  Google Scholar 

  • Rarick, C. A. (2009). The historical roots of Chinese cultural values and managerial practices. Journal of International Business Research, 8(2), 59–66.

    Google Scholar 

  • Revenson, T. A., AbraÃdo-Lanza, A. F., Majerovitz, S. D., & Jordan, C. (2005). Couples coping with chronic illness: what’s gender got to do with it? Washington, DC: American Psychological Association.

    Google Scholar 

  • Rosenberg, M. (1965). Society and the adolescent self-image. Princeton, NJ: Princeton University Press.

    Book  Google Scholar 

  • Rotheram-Borus, M. J., Stein, J. A., Jiraphongsa, C., Khumtong, S., Lee, S. J., & Li, L. (2010). Benefits of family and social relationships for Thai parents living with HIV. Prevention Science, 11(3), 298–307.

    Article  PubMed  PubMed Central  Google Scholar 

  • Rotheram-Borus, M. J., Weiss, R., Alber, S., & Lester, P. (2005). Adolescent adjustment before and after HIV-related parental death. Journal of Consulting and Clinical Psychology, 73(2), 221–229.

    Article  PubMed  Google Scholar 

  • Sherr, L., Cluver, L. D., Betancourt, T. S., Kellerman, S. E., Richter, L. M., & Desmond, C. (2014). Evidence of impact: health, psychological and social effects of adult HIV on children. AIDS, 28(Suppl. 3), 251–259.

    Article  Google Scholar 

  • Sherr, L., & Mueller, J. (2009). Where is the evidence base? Mental health issues surrounding bereavement and HIV in children. Journal of Public Mental Health, 7(4), 31–39.

    Article  Google Scholar 

  • Short, S. E., & Goldberg, R. E. (2015). Children living with HIV-infected adults: estimates for 23 countries in sub-Saharan Africa. PLoS One, 10(11), e0142580.

    Article  PubMed  PubMed Central  Google Scholar 

  • Spagnola, M., & Fiese, B. H. (2007). Family routines and rituals: a context for development in the lives of young children. Infants & Young Children, 20(4), 284–299.

    Article  Google Scholar 

  • Stein, D., Williamson, D. E., Birmaher, B., Brent, D. A., Kaufman, J., Dahl, R. E., & Ryan, N. D. (2000). Parent-child bonding and family functioning in depressed children and children at high risk and low risk for future depression. Journal of the American Academy of Child & Adolescent Psychiatry, 39(11), 1387–1395.

    Article  Google Scholar 

  • The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) (2017). Orphans and vulnerable children. https://www.pepfar.gov/press/258063.htm. Accessed 25 Sep 2017.

  • Thurman, T. R., Kidman, R., & Taylor, T. M. (2015). Bridging the gap: the impact of home visiting programs for orphans and vulnerable children on social grant uptake in South Africa. Children and Youth Services Review, 48, 111–116.

    Article  Google Scholar 

  • USAID (2016). Orphans and vulnerable children affected by HIV and AIDS. https://www.usaid.gov/what-we-do/global-health/hiv-and-aids/technical-areas/orphans-and-vulnerable-children-affected-hiv#section1. Accessed 25 Sep 2017.

  • Van Der Ende, J., Verhulst, F. C., & Tiemeier, H. (2012). Agreement of informants on emotional and behavioral problems from childhood to adulthood. Psychological Assessment, 24(2), 293–300.

    Article  PubMed  Google Scholar 

  • Van Roy, B., Groholt, B., Heyerdahl, S., & Clench-Aas, J. (2010). Understanding discrepancies in parent-child reporting of emotional and behavioral problems: Effects of relational and socio-demographic factors. BMC Psychiatry, 10, 56.

    Article  PubMed  PubMed Central  Google Scholar 

  • Yu, Y., Li, X., Zhang, L., Zhao, J., Zhao, G., Zheng, Y., & Stanton, B. (2013). Domestic chores workload and depressive symptoms among children affected by HIV/AIDS in China. AIDS Care, 25(5), 632–639.

    Article  PubMed  Google Scholar 

  • Zhang, W., & Fuligni, A. J. (2006). Authority, autonomy, and family relationships among adolescents in urban and rural China. Journal of Research on Adolescence, 16(4), 527–537.

    Article  Google Scholar 

  • Zhao, J., Li, X., Qiao, S., Zhao, G., Zhang, L., & Stanton, B. (2015). Parental HIV disclosure: from perspectives of children affected by HIV in Henan China. AIDS Care, 27(4), 416–423. https://doi.org/10.1080/09540121.2014.978733.

    Article  PubMed  Google Scholar 

  • Zolkoski, S. M., & Bullock, L. M. (2012). Resilience in children and youth: a review. Children and Youth Services Review, 34(12), 2295–2303.

    Article  Google Scholar 

Download references

Acknowledgements

This study was funded by National Institute of Child Health & Human Development/NIH (grant number R01HD068165). We would like to thank our project team members in Anhui, China for their contributions to this study.

Author contributions

L.L. designed and executed the study, guided the data analyses and result interpretation. W.S.C. analyzed the data and wrote part of the results. C.-W.L. collaborated in the writing of the manuscript. C.L. collaborated in the writing of the study and editing of the final manuscript. Y.X. and G.J. conducted the fieldwork and collaborated in the writing of the study.

Author information

Authors and Affiliations

  1. Semel Institute for Neuroscience and Human Behavior, Center for Community Health, University of California at Los Angeles, Los Angeles, CA, USA

    Li Li, W. Scott Comulada & Chiao-Wen Lan

  2. Anhui Provincial Center for Disease Control and Prevention, Hefei, China

    Yongkang Xiao

  3. Anhui Provincial Center for Woman and Child Health, Hefei, China

    Guoping Ji

Authors
  1. Li Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. W. Scott Comulada
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Chiao-Wen Lan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Chunqing Lin
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yongkang Xiao
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Guoping Ji
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Li Li.

Ethics declarations

Conflict of interest

The authors declare that they have no competing interests.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Li, L., Comulada, W.S., Lan, CW. et al. Behavioral Problems Reported by Adolescents and Parents from HIV Affected Families in China. J Child Fam Stud 27, 365–373 (2018). https://doi.org/10.1007/s10826-017-0906-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10826-017-0906-2

Keywords

Search

Navigation