{'fraction_non_alphanumeric': 0.039444479675312324, 'fraction_numerical': 0.02371742025493056, 'mean_word_length': 5.138575321136629, 'pattern_counts': {'":': 0, '<': 1, '<?xml version=': 0, '>': 0, 'https://': 3, 'lorem ipsum': 0, 'www.': 1, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Factors Correlating with the Emotional and Behavioral Problems among Adolescents with Legal Problems

BACKGROUND: The prevalence of emotional and behavioral problems (EBP) among adolescents (12–18 years) in Indonesia is 28.4%. These problems are related to age, sex, family economic level, father’s education, peer relationships, psychosocial skills, and family mental health status. However, factors related to EBPs among adolescents who are dealing with law cases have not been widely reported. AIM: The purpose of this study is to find out factors correlating with the EBPs among adolescents with legal problems. MATERIALS AND METHODS: A cross-sectional design was used in this study. Fifty-nine adolescents with legal problems who were sheltered at the Social Protection and Rehabilitation Centre for Adolescents (SPRCA) and the Guidance Institution for Children (GIC) served respondents. Strengths and Difficulties Questionnaires were used to measure the EBP among adolescents. The Pearson Product Moment and linear regressions were used to analyze the data. RESULTS: The prevalence of the EBP among adolescents with legal problems at SPRCA and GIC is 67.8%. The correlations of emotional problems, behavioral problems, hyperactivity, and peer problems with the EBP among adolescents with legal problems are 67.8%, 64.4%, 13.6%, and 57.6%, respectively. Age and psychosocial skills have an effect of 15.7% on the EBP among adolescents. CONCLUSION: Age and psychosocial skills correlate with the EBP among adolescents with legal problems at the SPRCA and GIC. Edited by: Sinisa Stojanoski Citation: Hartini S, Penyami Y, Prabandari Y. Factors Correlating with the Emotional and Behavioural Problems among Adolescents with Legal Problems. Open Access Maced J Med Sci. 2021 Oct 10; 9(B):1061-1065. https://doi.org/10.3889/oamjms.2021.6028


Introduction
Teenagers having problems with the law often experience cognitive, social-behavioral, and emotional problems. Adolescents who are in prison may experience a decrease in their cognitive control, cognitive function, and emotional regulation [1]. The cognitive function of children having a problem with the law changes in a negative direction.
Emotional and Behavioral Problems (EBP) includes psychosexual changes, peer problems, and risky behaviors such as drug abuse, smoking, alcohol consumption, antisocial behavior, failure to form selfidentity, problems with self-esteem, problems with moral development, and stress [2]. A study in Nepal shows that 17.03% of adolescents have experienced psychosocial dysfunction [3]. Behavioral and emotional problems have been experienced by 42% of the adolescents (11-17 years old) in India and they are composed of 42% of conduct disorders and peer problems, 34% of emotional problems, and 24% of hyperactivity [4]. Another study found out that EBPs have been identified among 20% of adolescents in Taiwan [5]. Another report also indicates that the prevalence of emotional problems, conduct disorder, hyperactivity, and peer problems among the Indian teenagers is 5.9%, 28.2%, 6.5%, and 15.2%, respectively [6], and the prevalence of EBPs among the adolescents (12-18 years old) in Indonesia is 28.4% [7] consisting of emotional problems (29.2%), hyperactivity (8.4%), conduct disorder (32.9%), and peer problems (13.1%). The prevalence of EBPs among adolescents in Turkey is 16.9% [8] and 10% in USA [9].
Behavioral and emotional problems among the adolescents are influenced by different factors such as knowledge, self-efficacy, and psychosocial skills. Factors correlating with EBP are also psychosocial skills, parenting, and stressors in the family [10]. Umami et al. (2019) also report that social loneliness and peer relations are factors correlating with EBP among adolescents in Indonesia [7]. Other different factors such as age, sex, family economic level, and father's education are also reported to correlate with EBP among adolescents (mean: 11.56 years old) in China [11]. Furthermore, inadequate intra-familial communication and parental mental disorder factors are also factors contributing to EBP among Indian adolescents [12]. https://oamjms.eu/index.php/mjms/index Furthermore, factor correlating with EBP among adolescents is self-efficacy. Higher the selfefficacy level helps to control the anti-social behavior. Psychosocial skills including social skills, thinking skills, and emotional skills are also reported to correlate with EBPs. Self-efficacy is also found to correlate with psychosocial well-being such as to help manage social life [13]. High social competence and skills can help adolescents develop coping strategies. Efforts to improve psychosocial skills affect the mental health of adolescents [14].
The Social Protection and Rehabilitation Centre for Adolescents (SPRCA) is an institution that coaches' adolescents with social and legal problems in the Special Region of Yogyakarta (DIY). The legal case mostly found among adolescents in BPRSR is theft (57.7%). The Class I of the Guidance Institution for Children (GIC) in Kutoarjo is an institution that coaches' children who have problems with the law. The GIC is an institution under the Regional Office of the Ministry of Law and Human Rights of Central Java Province. The most frequent case found among adolescents in the GIC is persecution (48.5%).
The purpose of this study is to determine factors that correlate with the EBP among adolescents who have problems with the law.

Study design, setting, and samples
This research was a cross-sectional study. Fifty-nine adolescents with legal problems served as respondents. The inclusion criteria in this study were (1) adolescents of 15-19 with legal problems and were being trained at the SPRCA, DIY and GIC of Kutoarjo, Purworejo, (2) those who were willing to become respondents, and (3) those who obtain permission from the guardians/officers at the SPRCA and GIC. The exclusion criteria in this study were those who had severe depression based on the psychological records and recommendations from the SPRCA and GIC.

Ethical consideration
Ethical clearance was obtained from Ethical Committee of the Faculty of Medicine, Public Health and Nursing of Universitas Gadjah Mada (ethic number: KE/FK/0330/EC/2019).

Instruments
The Strengths and Difficulties Questionnaire (SDQ) developed by Goodman was used to measure the EBPs among adolescents [15], [16]. The SDQ had been translated into Indonesian and was once used by Wiguna and Hestyanti; it is available at https:// www.sdqinfo.org/ [17], which consisted of 25 items with five domains: Emotional problems, peer problems, behavioral problems, hyperactivity, and pro-social behavior. The questionnaire was developed based on the Likert scales with the criteria of 2 for correct, 1 for somewhat correct, and 0 for incorrect. There were five unfavorable items with reversed scoring, namely, items 7, 11, 13, 21, and 25. The EBP were calculated from the total score of difficulties (the sum of emotional problems, peer problems, behavioral problems, and hyperactivity). The higher the score of the total difficulties, the higher the EBPs level. Each domain was classified into three criteria: Normal, borderline, and abnormal (Table 1). Questionnaires about the knowledge of psychosocial skills created by Penyami (2020) that are referred to the book of Communication, Information, and Education of the Adolescent Health Cadre of the Ministry of Health (2018) are composed of about ten psychosocial skills of the adolescents [18]. The questionnaires consisted of 25 items and had passed the validity and reliability tests with good results (r = 0.216-0.448 and consistency value = 0.705). The selfefficacy questionnaires consisted of 46 items covering magnitude, generality, and strength [19]. The validity of the self-efficacy questionnaire ranged from 0.306 to 0.605 and the internal consistency value was 0.900 [18].
Pearson Product Moment was used to analyze the correlations between the independent variables and the EBPs among adolescents. The linear regression test was used to determine the factors correlating with the EBP. One similar research also shows that age and gender influence the occurrence of EBP among the orphans [20].

Data collection
This research was conducted in May 2019 at the SRB of the Special Region of Yogyakarta and GIC of Kutoarjo, Purworejo, Central Java. The data were collected after the research permit and ethical clearance were obtained.

Bivariate analysis
The Pearson Product Moment was used to examine the correlations of age, knowledge, selfefficacy, and psychosocial skills of adolescents with EBPs. The one-way ANOVA test determines the correlations of education, types of legal problems, and length of assistance with EBPs.

Multivariate analysis
The multivariate analysis used was linear regression with the backward method. In this method, all selected variables were included in the multivariate analysis, and the insignificant variables were excluded from the analysis gradually. The linear regression analysis started with selecting the candidates for the multivariate test in the variables with p < 0.25.

Participants' background
The average age of the respondents was 16.89 ± 1.16 years old and 94.91% of them are male adolescents. The most frequent legal case is persecution, theft, sexual abuse, and drug abuse consecutively ( Table 2).

The emotional and behavioral problems among adolescents with legal problems
The prevalence of the EBP among adolescents with legal problems is 67.8%. The prevalence of the emotional problems, behavioral problems, hyperactivity, and peer problems is 67.8%, 64.4%, 13.6%, and 57.6%, respectively (Table 3). There are correlations between age and psychosocial skills with the EBP among these adolescents (Table 4). Age is the most dominant factor correlating with the EBP among these adolescents. Age and psychosocial skills make 15.7% of the EBP among these adolescents (Table 5).

Discussion
The main findings of this study are that the age and psychosocial skills of the adolescents contribute to the EBP of as much as 15.7%. The results of a previous study have indicated that gender, communication, social loneliness, peer relationships, and social support influence the EBP among adolescents in Indonesia by 18.2% [7]. Inadequate family communication and parental mental disorder affect the EBPs for as much as 12.8% [12]. The psychosocial skills in this study include self-awareness, empathy, interpersonal relationships, effective communication, critical thinking, creative thinking, problem solving, decision making skills, skills in dealing with stress, and emotional control skills [21]. A similar study reports that there is a correlation between age and EBP among the adolescents [11], [21]. The results of this study indicate that the total difficulty experienced by the adolescents with legal problems reaches 67.8%. The total difficulty found among the adolescents in India is 40% [4], 78.6% among children of 11-13, and 40% among children of 14-17 in New Zealand [22], 25.7% among the adolescents in Pakistan [23], and 34.4% of the adolescents with Congenital Heart Disease in the Netherlands [24].
The results of a similar study also show that 40.5% of children of 5-14 who suffer from lower urinary tract  [22]. One previous study report that conduct disorders have been experienced by 26.54-42% of the adolescents in India [6], [4]. Emotional problems have also occurred among 34% of the adolescents in India [4] and 25.9% of the adolescents in Pakistan [23].
As many as, 13.6% of the adolescents in this study show hyperactivity. It is experienced by 8.4% of the adolescents in Indonesia [7], 24% of the adolescents in India [4], and 23.1% of the adolescents in Pakistan [23]. It has also been identified among 29% of children suffering from lower urinary tract dysfunction [25]. The prevalence of peer problems found among adolescents in this study is 57.6%. Peer problems are reported to be experienced by 42% of adolescents in India [4]. We conclude that the finding of the study is age and psychosocial skills correlate with the EBPs of the 15-19 years old adolescents who have legal problems.
We found that adolescent psychosocial skills were the most dominant factor associated with EBP. A similar study was conducted to Portuguese adolescents showed that psychosocial skills were negatively correlated with EBPs [26]. Psychological skills can be increased of psychological well-being. Furthermore adolescents with psychological well-being can be increased cooperative skill and decreased of mental health problems [27]. Poulou (2012) also reported that adolescents with strong social skill were less likely to present emotional and behavioral difficulties [28]. Psychosocial intervention such as cognitive behavioral therapy and interpersonal therapy evident effective for decrease depression and increase of Psychosocial skill of adolescents [29], [30].
There are several limitations of this study. First, the results of this study were based on the reports from adolescents. The assessment of EBPs would be more effective if it was obtained from a variety of informants. Second, the respondents were not randomly selected. Not all adolescents had the same opportunity to become respondents. In determining the respondents, the researcher paid attention to the inclusion criteria and exclusion criteria that had been determined. Third, this study did not measure the demographic data of the families or relatives who lived with the adolescents, such as the socioeconomic status, the mental health status, and the education level. Despite these limitations, this study should be useful to help design appropriate interventions for adolescents with legal problems and for those living in rehabilitation and support centers.
The results of this study show practical implications for improving the psychosocial skills of adolescents who are dealing with law cases. In this study, the psychosocial skills are a factor that can be associated with their EBPs. Therefore, health workers (psychologists or other health workers) can determine priority interventions. Adolescents who are dealing with law cases and stay in rehabilitation or support centers are at risk of increasing EBPs. Staying in a rehabilitation or support centers contribute more to the rise of emotional and behavioral problems rather than staying in the previous condition. To eliminate stigma and discrimination, they require more intensive and varied interventions.
We recommend that rehabilitation or support centers add training in psychosocial skills including self-awareness, empathy, interpersonal relationships, effective communication, critical thinking, creative thinking, problem solving, decision making skills, skills in dealing with stress, and emotional control skills. In addition to this, it is necessary to strengthen the support of both the family and peers. Parental involvement can prevent or reduce EBPs. Interventions that involve parents and peers will reduce the EBPs.

Conclusion
Age and psychosocial skills correlate with the EBP among adolescents with legal problems at the SPRCA and GIC. It is necessary to develop interventions to improve psychosocial skills, therefore that the risk of EBPs among adolescents can be reduced. All parties involved in caring children and adolescents, including parents, teachers, other professionals, and the community, have a strategic responsibility to promote and provide support when needed it. Besides, to increase interaction of adolescents who are dealing with law cases and stay in rehabilitation or support centers with their parents, the government should make a regulation regarding the visiting hours for parents.