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| ORIGINAL ARTICLE |
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| Year : 2022 | Volume
: 5
| Issue : 3 | Page : 115-121 |
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Aggression, self-esteem, and resilience among children: A school-based cross-sectional study from central India
Yachana Choudhary1, Mohan Kumar2, Rajendra Mahore3, GW Lanke3, Manju Dubey4
1 Department of Community Medicine, AIIMS, Jodhpur, Rajasthan, India
2 Department of Community Medicine, KMCH Institute of Health Sciences and Research, Coimbatore, Tamil Nadu, India
3 Department of Community Medicine, GMC, Bhopal, Madhya Pradesh, India
4 Department of Community Medicine, RIMS, Raipur, Chhattisgarh, India
| Date of Submission | 12-Dec-2021 |
| Date of Decision | 13-Jun-2022 |
| Date of Acceptance | 14-Jul-2022 |
| Date of Web Publication | 9-Aug-2022 |
Correspondence Address:
Manju Dubey
Department of Community and Family Medicine, AIIMS, Raipur - 492 099, Chhattisgarh
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/shb.shb_165_21
Introduction: Adolescence as a life stage is associated with physical and psychological changes with an interplay of biological, social, and environmental factors. The aim of this study was to determine the prevalence of aggression among children and the factors associated with aggression. Methods: This was an analytical cross-sectional study conducted in schools of Bhopal, Madhya Pradesh, India, between 2017 and 2019 among higher and higher secondary class children. All children from high and higher secondary classes were included, resulting in a sample of 192. Information on sociodemographic, family, psychosocial, lifestyle, addiction factors, aggression (Buss–Perry Aggression Questionnaire), self-esteem (Rosenberg self-esteem scale), and resilience (Nicholson McBride Resilience Questionnaire) were obtained. Results: The prevalence of aggression among children from Classes 9th to 12th was 49.5%; physical aggression was 42.7%, verbal aggression was 31.8%, anger was 44.3%, and hostility was 44.8%. Almost half (44.3%) of the children had self-esteem and only 1.6% of children had an established level of resilience. Of the sociodemographic factors considered, type of school, gender, parents' education; of the family factors considered, family members taking alcohol/drugs, parents having frequent arguments, parents hitting children and using abusive language; of the psychosocial, lifestyle and addiction factors considered, feeling neglected, grade, watching TV and practice of reading books were significantly associated with the presence of aggression in children (P < 0.05). Conclusion: Overall findings suggest the need for strengthening life skills education, positive immediate environment, coping at the individual level, social intelligence, and cautious approach toward boosting self-esteem.
Keywords: Aggression, children, life skills education, resilience, self-esteem
How to cite this article:
Choudhary Y, Kumar M, Mahore R, Lanke G W, Dubey M. Aggression, self-esteem, and resilience among children: A school-based cross-sectional study from central India. Asian J Soc Health Behav 2022;5:115-21 |
How to cite this URL:
Choudhary Y, Kumar M, Mahore R, Lanke G W, Dubey M. Aggression, self-esteem, and resilience among children: A school-based cross-sectional study from central India. Asian J Soc Health Behav [serial online] 2022 [cited 2023 Dec 3];5:115-21. Available from: http://www.healthandbehavior.com/text.asp?2022/5/3/115/353633 |
| Introduction | |  |
Globally, 1.2 billion adolescents aged 10–19 years (Both sexes, in 2021) make up 16% of the world's population, of which 20.9% (0.251 billion) are from India – 18.02% of the total Indian population.[1],[2] The mental health conditions among adolescents account for 16% of the global burden of disease and injury – majority are undetected and untreated. The consequences of not addressing adolescent mental health conditions may extend to adulthood – impairing physical and mental health/well-being and limiting opportunities to lead fulfilling lives as adults.[3],[4]
Adolescence as a life stage is associated with physical and psychological changes. Psychological problems in this period occur due to scholastic backwardness compared to the high expectation, gender, disturbed relationships with parents, teachers, seniors and peers, family adversity and/or social disadvantage, substance abuse, and sexual experimentation. All these are often directly or indirectly associated with aggression as well as psychological morbidity.[5] The increasing crime rates and violent activities of youth in India are evident – 32,235 cases had been registered against juveniles (2019), an increase of 2.0% over 2018. The crime rate depicted a small increase from 7.1% in 2018 to 7.2% in 2019 and the majority in conflict with law were in the age group of 16–18 years (75.2%).[6]
Aggression is any form of behavior that is intended to injure another person physically or verbally or to destroy property. Aggressive behaviors – direct/physical or indirect/relational, reactive or proactive, internally or externally directed has a few theoretical perspectives; psychoanalytical (instinctive drive), ethological (self-perpetuating instinct), frustration-aggression hypothesis, and social learning model.[7] Over the years, social learning through interactions in early childhood has been seen as a building block for levels of aggression, which plays a crucial role in the development of peer relationships – the interplay of biological, social, and environmental factors as predictors of aggression – the role of schools cannot be overlooked.[8] Self-esteem is a double edged sword. Both high and low self-esteem may attribute to aggression. Those with high self-esteem may exaggerate their successes and good traits; high self-esteem may facilitate persistence after failure. The correlations between self-esteem and school performance are modest, and on the contrary, it may sometimes be counterproductive. High self-esteem can partly be the result of good school performance, and the same holds true for job performance and occupational success. On the other hand, low self-esteem may contribute to externalizing behavior and delinquency.[9],[10]
Resilience meaning the ability to “bounce back” is one other factor linked with aggression. It is the capacity to recover from challenges, the ability to adapt to change and adversities, and cope with the stress of everyday living. It is an active skill that can be learned. It ranges from a developing level of resilience where although one may not always feel at the mercy of events, they would benefit from developing aspects of their behavior and responding to situations; to an exceptional level where a person is very resilient most of the time and rarely fail to bounce back – whatever life throws at them. They believe in making their own luck.[11],[12]
Against this background, the primary objective of the study was to determine the prevalence of aggression among children from higher and higher secondary classes and to study factors associated with aggression in the study population. The secondary objectives were to understand the relation between aggression, self-esteem, and resilience among children.
| Methods | | |
Study design and participants
This was a cross-sectional study conducted in schools in Bhopal, Madhya Pradesh, India, between 2017 and 2019. The study included students of high and higher secondary classes (9th to 12th standard), provided they were present on the day of the survey and agreed to consent for participation.
Sample size estimation
Previous literature showed the prevalence of aggression among children to range between 61.0% and 67.0%. We computed sample size using 61.0% prevalence (to obtain maximum sample size), 10.0% absolute precision, and 95% confidence interval (CI). As the study participants were selected from only two schools and not from all schools in Bhopal, Madhya Pradesh – to account for the variation in probability at which participants are selected, we used the design effect of two. Finally, the minimum sample size was estimated to be 182.
Sampling
A convenience sample of two schools were included in the study – one government and the other a private school. In each school, all children from high and higher secondary classes (9th to 12th standard) present on the day of the survey were included (complete enumeration), resulting in a sample of 192 children. Each school was visited twice; on day 1, permission was sought from respective school principals, an explanation of the study was given, and consent/assent forms were handed out to all eligible students. On day 2, the predesigned, pretested, semi-structured pro forma – that includes sociodemographic characteristics, family, psychosocial and lifestyle factors, and addiction, was administered to the participating students.
Measures
Buss-Perry Aggression Questionnaire
Aggression among children was estimated using Buss–Perry Aggression Questionnaire (BPAQ). The BPAQ has test–retest reliability, strong convergent validity, and is appropriate for both adolescents and adults. The internal consistency of the scale was acceptable, and gender invariance was supported. The scale had a total of 29 questions – to determine physical aggression (9 questions), verbal aggression (5), anger (7), and hostility (8) – on a 5-point scale used to indicate how uncharacteristic or characteristic each of the statements is in describing oneself. The total score for aggression is the sum of these scale scores. Higher scores indicate higher aggressive behavior.[13],[14]
Rosenberg Self-Esteem Scale
It was used to assess self-esteem. This was a 10-item scale that measured global self-worth by measuring both positive and negative feelings about the self-answered using a 4-point Likert scale ranging from strongly agree to strongly disagree. The scores were on a continuous scale– higher scores indicating higher self-esteem. The Rosenberg Self-Esteem Scale presented high ratings in reliability areas; internal consistency was 0.77; minimum coefficient of reproducibility was at least 0.90; alpha coefficients ranging from 0.72 to 0.87, and test–retest reliability calculated at 0.85 (2-week interval) and 0.63 (7-month interval).[15],[16]
Nicholson McBride Resilience Questionnaire
This was a 12-item scale – on a 5-point Likert scale ranging from strongly disagree to strongly agree. The total scores were categorized as developing level of resilience (scores 0–37), established (38–43), strong (44–48), and exceptional level of resilience (49–60). The evidence show 80% validity (Cronbach's alpha = 0.800) with good item consistency.[17]
The scales in English were translated into Hindi by two bilingual personals individually – matched, discussed in the presence of a third bilingual person – with consensus, a Hindi-translated version was made. This version was then translated back to English by two bilingual personals individually, and a final back-translated version was arrived at in consultation with the third bilingual person. The back-translated version was matched with the original scales.
Ethical consideration
Ethics approval was obtained from Institutional Ethics Committee (IEC), Gandhi Medical College, Bhopal (Letter Number 3926–28/MC/IEC/2018). Informed consent and/or assent forms were obtained from students and/or parents before data collection. Data confidentiality was maintained throughout data collection and analysis.
Statistical analysis
Data were entered into Microsoft Excel, and statistical analysis was performed using IBM Corp. Released 2015. IBM SPSS Statistics for Windows, Version 23.0. (Armonk, NY: IBM Corp). Descriptive analysis was performed to present numbers and percentages. Tests of association-Chi-square tests for categorical and t-test for continuous variables were performed. Statistical significance was taken at P < 0.05. The variables significant in univariate analysis were taken for multivariate logistic regression and resulted presented. Pearson correlation coefficient (r) was calculated between physical aggression, verbal aggression, anger, hostility, self-esteem, and resilience in the sample.
| Results | | |
The mean age of the study participants was 15.88 ± 1.483 years (median = 16.00, range = 13–19). Out of 192 study participants, 66 (34.4%) were of 9th class, 50 (26.0%) 10th class, 34 (17.7%) 11th class and 42 (21.9%) children were of 12th class. The average number of family members was 5 (range = 2–12).
The mean score of total aggression was 71.96 ± 19.03 (median = 73.00, range = 29–127); physical aggression (mean = 20.85 ± 7.32, median=21.00,range=9–42),verbal aggression(mean =13.18 ±4.84, median = 13.00,range= 5–25), anger (mean = 16.98 ± 6.28,median=17.00,range=7–35),and hostility (mean = 20.94 ± 6.79, median = 22.00, range = 8–40). The prevalence of aggression among children from Classes 9th to 12th was 49.5%; physical aggression was 42.7%, verbal aggression was 31.8%, anger was 44.3%, and hostility was 44.8% (based on the percentage of children more than the median score).
The mean score of self-esteem was 22.87 + 5.46 (median = 23.00, range = 10–40) and resilience was 30.74 + 6.12 (median = 33.00, range = 9–39). Almost half (44.3%) of the children had self-esteem (based on the percentage of children more than the median score) and 98.4% of children had developing level of resilience, whereas only 1.6% of children had an established level of resilience [Table 1]. | Table 1: Prevalence aggression, self-esteem, and resilience among school going adolescents
Click here to view |
Of the sociodemographic factors considered, type of school (Government school, odd ratio [OR] = 1.929, 95% CI = 1.077–3.454), gender (male, OR = 2.113, 95% CI = 1.156–3.863), education of mother (up to middle school, OR = 3.184, 95% CI = 1.685–6.017), education of father (up to middle school, OR = 2.258, 95% CI = 1.234–4.132) were significantly associated with the presence of aggression in children (P < 0.05) [Table 2]. Of the family factors considered, family member taking alcohol/drugs (Yes, OR = 9.440, 95% CI = 2.720–32.780), parents having frequent arguments (Yes, OR = 7.530, 95% CI = 1.650–34.350), parents hitting children (Yes, OR = 5.592, 95% CI = 1.193–26.230), and parents using abusive language to demean children (Yes, OR = 2.601, 95% CI = 1.022–6.650) were significantly associated with the presence of aggression in children (P < 0.05) [Table 2]; of the psychosocial, lifestyle and addiction factors considered, feeling neglected (Yes, OR = 2.181, 95% CI = 1.043–4.603), grade (<60%, OR = 2.478, 95% CI = 1.209–5.079), prefers watching TV (Yes, OR = 2.143, 95% CI = 1.202–3.801), practice of reading books (No, OR = 2.309, 95% CI = 1.192–4.472), and fight with friends (Yes, OR = 3.551, 95% CI = 1.503–8.423) were significantly associated with the presence of aggression in children (P < 0.05) [Table 2]. In multivariate logistic regression analysis, gender, mother's education, family members taking alcohol/drugs, feeling neglected, grade, preference in watching TV, and practice of reading books were significantly associated with aggression.
| Discussion | | |
The present study has highlighted the presence and prevalence of aggression among children of high and higher secondary classes in Schools of Bhopal, Madhya Pradesh, India. One in two children had aggression (49.5%) – slightly lower than that reported in Dutt et al. and Garg et al.[18],[19] The mean aggression scores reported in this study were more than ten points lower than reported by Garg et al.[18] The possible explanation could be the difference in the study area (children from megacities reporting higher scores for aggression) and sociodemographic variations. More than one in three children had physical aggression, verbal aggression, anger, and hostility – independently. Although lower than the prevalence reported in similar other studies, it is significant. Less than one in two children with self-esteem (44.3%) and almost all (98.4%) with a developing level of resilience throws importance on the need for life skills education among children of high and higher secondary classes and/or adolescents – a set of abilities, attitudes and socioemotional competencies that enable individuals to learn, make informed decisions and exercise rights to lead a healthy and productive life and subsequently become agents of change – learning to be and learning to know are important in relation to self-esteem and resilience.[20],[21],[22]
Male children from government schools with parents' education less than middle class were at increased risk of aggression. These findings are similar to those reported by Iqbal et al. and Björkqvist et al.[23],[24] This may be attributed to social intelligence that develops earlier in girls, the interplay of socioenvironmental factors, and the social learning model – parents being the immediate social circle for children, their educational status may predict aggression in children.[25] Intake of alcohol/drugs by family members, frequent arguments, physical violence, and use of abusive language by parents were significant predictors of aggression in children. This could be attributed to observational learning in children – which with reinforcement would be adopted – not only aggression and antisocial behaviors but also prosocial behaviors as well.[26] This sheds light on the importance of positive immediate environment – microsystem under Bronfenbrenner's four ecological settings for developmental change.[27]
Poor grades may catalyze the feeling of being neglected (or vice versa) in children. It is important for teachers and parents to be compassionate and understand that even temporary failure in challenging academic tasks can have important psychological benefits when followed by successful coping – drawing from Self-Determination Theory.[28] Reading books, either academic or nonacademic (ex. Novels, newspapers), provides numerous opportunities to develop critical thinking – lowering aggression.[29]
The domains of aggression – physical, verbal, anger and hostility were positively correlated with each other (P < 0.05) – moderate correlation. Self-esteem was found to be negatively correlated with resilience, though not statistically significant. These findings were similar to those reported by Feggi et al. and Karatas and Cakar.[30],[31] Over the years teachers, parents, therapists, and others have focused efforts on boosting self-esteem, on the assumption that high self-esteem will cause many positive outcomes and benefits (enhanced initiative and pleasant feelings). On the contrary, evidence shows that high self-esteem does not prevent children from smoking, drinking, taking drugs, or engaging in early sex – but fosters experimentation resulting in early sexual activity or drinking, but in general, the effects of self-esteem are negligible. In view of the heterogeneity of high self-esteem, indiscriminate praise might just as easily promote narcissism, with its less desirable consequences. Instead, we recommend using praise to boost self-esteem as a reward for socially desirable behavior and self-improvement.[10]
Limitations
This study may have a few limitations. Although complete enumeration of 9th to 12th Class students from two schools was done, estimation of sample size would have been appropriate. However, for such an estimation prevalence of aggression in the study area was not available, this being the first of its kind in the study area. Second, being a cross-sectional study, the temporality of factors associated with aggression could not be established. Third, the Hindi version of the scales used lack psychometric evidence.
| Conclusion | | |
The study shows a higher prevalence of aggression, lower self-esteem, and developing level of resilience among school children and/or adolescents. The role of sociodemographic, family, psychosocial, lifestyle factors, and addiction were highlighted. Overall findings suggest the need for strengthening life skills education, positive immediate environment, coping at individual level, social intelligence, and a cautious approach toward boosting self-esteem.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2]
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