Sahar Dabaghi, Farzaneh Sheikhuleslami*, Minoo Mitra-Chehrzad and Ehsan Kazemnejad
Department of Nursing, Social Determinants of Health Research Center, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
Received date: 01/11/2016; Accepted date: 04/02/2017; Published date: 12/02/2017
Copyright: © 2017 Dabaghi S, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
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Background and objectives: Adolescence is one of the most important and sensitive stages of human development and adolescents are among the most vulnerable groups of a society. Aggression is a major problem associated with adolescence. The family is the first institution to which the individual belongs and family functioning is therefore a major factor in the incidence of aggressive behaviors in adolescents. The present study was conducted to determine the relationship between family functioning and different types of aggression in students aged 14-18 in Rasht, Iran, in 2014-2015. Materials and methods: The present descriptive correlational study was conducted in 2014-15 in the province of Gilan. The study population consisted of 26956 first to third-year students of public and private high schools in districts one and two of Rasht, northern Iran, aged 14-18 and selected through a two-stage cluster sampling method and The study sample size was calculated as 500. Data were collected using a demographic questionnaire, the Buss Perry Aggression Questionnaire (BPAQ) and the Family Assessment Device (FAD) and were then analyzed using descriptive and inferential statistics, including Spearman’s Correlation Test. Results: According to the results obtained, the mean score of general family functioning was 2.49 and the mean score of aggression was 89.87. The results also showed a significant relationship between family functioning and the total aggression score (P=0.0001). Discussion and conclusion: Family functioning has a significant relationship with the incidence of aggression in adolescents and predicts aggressive behaviors in this age group.
Aggression, Family, Students, Adolescents.
Adolescence is one of the most important and sensitive stages of human development and adolescents are among the most vulnerable groups of a society . Adolescence is the fourth stage of human development and begins at the age of 13 and continues until the age of 18-20 . According to a 2013 statistics, adolescents make up one fifth of the world's population, 84% of who live in developing countries. In Iran, the 10-19 year-old age group constitutes more than 20% of the country’s entire population and amounts to 6,400,000, based on a 2013 report .
As one of the most critical periods in human life, adolescence is associated with various changes in different areas, because a combination of biological, psychological and social factors is involved in adolescent development stages . The most important needs in this stage include emotional and affective balance, especially a balance between emotion and reason, the perception of self-worth, self-awareness, practical goal setting, emotional independence from the family, maintaining psychological and emotional balance in the face of environmental stressors, establishing healthy relationships with others, acquiring the social skills required for making friends and learning about a healthy and productive life and the means of acquiring it . The stage of adolescence is characterized by a lack of sufficient experience and the crisis of puberty creates a complex and uncertain situation of intensified emotions that may manifest themselves as severe sensitivity and emotion, often making for an edgy, aggressive, depressed and anxious adolescent. In addition, this stage of human development is also associated with rapid physiological changes, the power of abstract thinking, mood swings, concern about prospects, seeking other people's approval, especially the approval of peers and day-dreaming and fantasizing. Although all these characteristics contribute to the normal development of the adolescent, they can also provoke behavioral, cognitive and emotional problems . The successful transition from childhood to adolescence that requires an essential change in one’s "self-concept" is not an easy transition and will not be successful without the help of others, especially informed parents .
Adolescent aggression is a major problem that is increasingly witnessed on a daily basis in different places, such as at the school, in recreation grounds, at home and on the street. Aggressive behaviors are observed in a variety of forms, including physical (toward other humans, whether inter- or intra-personal and toward objects and personal or public properties), verbal, combined (physical and verbal) and social (breaking the rules) . In today's world, aggression has become a growing social problem in all its different forms and has turned into another aspect of normal behavior that is increasingly observed in the society and in people’s interactions with each other . The spread of aggression in the Iranian society, especially in recent years, makes this behavior one of the most serious social problems of the country. Many domestic and foreign studies have reported varying degrees of aggression among adolescents, from 8% to 20% [9,10]. The results of study in one of Iran's the city (Yasouj) prevalence of aggression have been reported 32% of the participants projected . Also Results of other studies showed high Average of score of total aggression In children and adolescents [2,8,10-12].
Different classifications provide dual and distinctive categories of aggression, including, but not limited to, verbal and non-verbal, direct and indirect, instrumental and hostile, individual and collective, active and passive, and proactive and reactive. Verbal aggression is a verbal attack to establish superiority over others through insult or quarrel, and nonverbal or physical aggression is an attack on a human or non-human subject using the body or other objects. Direct aggression is often a kind of defence and a reaction to failure in the achievement of goals that occurs among peers. Physical aggression contains the intention to harm another person through injury or excruciating pain; in its indirect form, the aggressor tries to disrupt other people's relationships. Instrumental aggression does not contain an intention to harm another person and targets only the attainment of an object or a privilege; hostile aggression, however, does contain the intention to harm . Studies have shown that boys tend to display the physical form of aggression while girls show its verbal form .
Researchers’ interest in the subject of aggression owes to the consequences that these behaviors entail for adolescents and young adults, such as negative images among peers and teachers, rejection by peers, academic failure, drug abuse and delinquency . Previous studies have shown that the likelihood of suicide and delinquency is greater among aggressive adolescents [14,15]. Researchers have also shown that aggressive behaviors are associated with physical diseases such as cardiovascular diseases and tension headaches. According to unofficial statistics, 70% of crimes committed by adolescent boys and 30% of those committed by adolescent girls originate from aggression [16,17]. Given the adverse consequences of aggression, identifying the factors that affect the incidence of such behaviors is crucial.
Biological and hereditary factors, environmental acquisitions and cognitive processing, on the one hand, and personal motives or personal and biological factors (gender, age, personality type, hormones, etc.), environmental factors (disappointment, aggressive role models, etc.) and socioeconomic and family causes are among the factors that affect the incidence of aggression . Studies suggest that certain factors such as family conflicts, marriage failure, the lack of a close relationship with the parents, strict rules and inadequate supervision increase the formation of behavioral problems and the incidence of aggression in young children and adolescents . The family is the first institution to which the individual belongs and in which the most sensitive stages of socialization and acculturation take place . Functioning as a social system, the desirable and undesirable behaviors of the family members affect each member .
The results of a study by Javdan showed that an emotional family atmosphere, life skills and self-revision are significantly related to the incidence of aggression in adolescents, as parents who have a good relationship with their children are highly likely to have well-behaved children who seldom resort to aggressive behaviors .
Family functioning refers to the activities that the members of a family perform to satisfy their needs and maintain their status. Families have traditionally had several functions or duties throughout history . These functions include problem-solving, communication, roles, affective responsiveness, affective involvement and behavioral control. Problemsolving is a sign of the family's ability to solve its problems and the stages that it goes through to achieve this goal; this function is associated with the effective, extensive, clear and direct exchange of information in the family. Roles imply the efficacy of the family in the delegation and performance of its duties and tasks, including providing for the family (food, clothing and shelter), fostering and support, developing life skills and maintaining and managing the family system (for instance, the management of the home, the tasks related to the yard, bills and health matters and decision-making). Affective responsiveness includes the family’s strategies for giving appropriate emotional responses, whether positive (joy, love, attention, kindness and affection) or negative (sadness, depression, fear and anger). Affective involvement refers to the quality of the interest, attention and investment of the family members in/to each other. Behavioral control implies the behavioral standards and liberties that govern the family unit .
Due to the importance of the role of family functioning in the development of mental health in adolescents, researchers have conducted many studies to determine the share of each family function in adolescent misbehaviors and mental health disorders. The results of these studies showed that each of the family functions, including the general family function, communication, affective involvement, roles, problem-solving, affective responsiveness and behavioral control, were less appropriate in the drug-dependent group than in the control group . The results of similar studies suggest that family functioning may have a role in adolescents' tendency to use synthetic drugs, and it is well known that addiction is also a major factor in the incidence of aggressive behaviors.
The results of a study by Rahimnejad revealed a significant relationship between adolescents' mental health and the general family functioning, which means that the poorer is the family functioning; the greater are their adolescent members’ mental disorders .
Family functioning is therefore a major factor affecting the mental health of children and adolescents. While mutually emphasizing the role of family functioning, different studies have ascribed different shares to the role of each of the family functions in the incidence of aggression; for example, Amanian et al. believe that the problem-solving function of the family has a greater role in the incidence of aggression compared to the other family functions . In contrast, another study showed that problem-solving does not have a significant effect on the incidence of misbehaviors, but that roles and family communication have a positive and significant effect on delinquency .
Given the lack of consensus about the factors affecting adolescent aggression and considering that aggression can cause several problems in academic, family, social and occupational performance during both adolescence and in adulthood, and given the importance of family functioning and the different family functions, the present study was conducted to determine the relationship between family functioning and the different types of aggression in adolescents.
The present descriptive-correlational study was conducted in all the public and private high schools of school districts 1 and 2 of Rasht in 2014 on a population of 26956 students aged 14-18. The study sample size was calculated 506 According to the Amanian study (2013) and Table 1 and The correlation coefficient of family roles Variable and to consider The statistical error of 5% and standard deviation with confidence interval 0.2 and According to the following formula:
Since, the present study samples were selected through a two-stage cluster sampling method and the classroom is considered as clusters. So to consider design effect Equal to 2, the final Sample size was calculated. Six of the participants were excluded from the study for not responding to the main study variables.
The study was approved by the Ethics Committee of Guilan University of Medical Sciences (code 2930506211) and a letter of introduction was presented to the educational institutions in school districts 1 and 2 of Rasht. The samples were then selected through random cluster sampling. For this purpose, the population was first divided into 12 classes according to school district (1 and 2), school type (public and private), gender (male or female) and grade year (first, second and third). The population belonging to these 12 classes was then calculated as a fraction of the total population, so that the number of male and female students in the public and private schools of districts 1 and 2 was separately divided by the total number of the students and multiplied by the estimated sample size (506) and the number of male and female students that had to be studied from the public and private schools of each district was thus determined and this number was then divided by the mean number of the students in the public and private schools of each district so as to find the number of the classrooms. The number of the students selected from the public and non-public schools of each district was ultimately divided into the total number of the classrooms so as to find the number of students that had to be selected from each classroom. All the classrooms were then coded according to grade year, field of study, school name, school type and school district, and 42 classrooms were selected through random sampling and were considered as the clusters and the students were then randomly selected from each classroom.
All the first- to third-grade high school students from the different districts were diagnosed with no acute or chronic physical diseases and were also on no particular medications. The students then signed written consent forms for participation in the study. Data were collected using a two-part demographic questionnaire, the Bass and Perry Aggression Questionnaire (BPAQ) and the Family Assessment Device (FAD).
The BPAQ is a 29-item questionnaire that is scored based on a Likert scale and assesses overall aggression in four dimensions (physical, verbal, anger and hostility). The responses given to each item place the respondent on a 5-point scale, consisting of 1 (extremely uncharacteristic), 2 (somewhat uncharacteristic), 3 (neither uncharacteristic nor characteristic), 4 (somewhat characteristic) and 5 (extremely characteristic). The total score ranges from 29 to 145 and higher scores indicate a greater aggression. The total score is divided between the four dimensions; the physical aggression score ranges from 9 to 45 , the verbal aggression score from 5 to 25, the anger score from 7 to 35, and the hostility score from 8 to 40. Items 24 and 29 are reverse-scored. The higher does the respondent score on these items, the higher is his aggression in the physical, verbal, anger and hostility dimensions. This questionnaire was translated by Sanaee-Zaker  and its validity and reliability were calculated and confirmed by Samani in 2007 . In the present study, Cronbach's alpha method was used to determine the validity and reliability of BPAQ questionnaire, respectively to subscale physical, verbal, anger and hostility Equal to 0.82, 0.73, 0.86, 0.78 and for total aggression have been equal to 0.79 which explain the validity and reliability were acceptable.
Family functioning was assessed using the FAD, which is a self-reporting scale developed in 2004 by Epstein, Ballin and Bishop based on McMaster's model. This 60-item tool assesses general family functioning in six dimensions, including affective involvement, affective responsiveness, behavioral control, communication, problem solving and roles and consists of seven subscales and is scored based on a 4-point Likert scale (strongly agree: 1, agree: 2, disagree: 3, and strongly disagree: 4). Anyone aged 12 and over can complete this questionnaire. The questionnaire items describe appropriate and inappropriate family functioning. The scores obtained in each of the subscales are added together and then divided by the number of answered items in each subscale. A subscale is deemed invalid and the related dimension is eliminated if more than 40% of the items in the subscale remain unanswered. Each dimension has a cut-off point, and family functioning is considered appropriate in a dimension if its score is less than the cut-off point, and inappropriate if its score is equal to or higher than the cut-off point That cut-off point for subscales of problem solving, communication, roles, affective involvement, affective responsiveness, behavioral control is respectively equal to 2.2, 2.2, 2.3, 2.2, 2.1, 1.9 and for total function is 2. Items 2, 12, 24, 38, 50 and 60 pertain to the dimension of problem-solving, 3, 14, 18, 29, 43, 52 and 59 to communication, 4, 10, 15, 23, 30, 34, 40, 45 and 53 to roles, 9, 19, 28, 35, 39, 49 and 57 to affective responsiveness, 5, 13, 22, 25, 33, 37, 42 and 54 to affective involvement and 7, 17, 20, 27, 32, 44, 47, 48, 55 and 58 to behavioral control . The psychometric assessment of this tool was carried out in Iran in 2011 by Yousefi and its validity and reliability were also confirmed . In the present study, Cronbach's alpha method was used to determine the validity and reliability of FAD questionnaire, respectively To subscales of affective involvement, affective responsiveness, behavioral control, communication, problem solving and roles Equal to 0.83, 0.75, 0.77, 0.80, 0.76, 0.80 and the total function was 0.82 which explain the validity and reliability were acceptable.
The data collected were analyzed in SPSS-21 using descriptive (frequency, percentage, mean, standard deviation and median) and inferential statistics (Spearman’s Correlation Coefficient).
Of the total of 506 questionnaires distributed among the participants, six were left unanswered in their main variables and were thus eliminated, reducing the number of participants to 500. According to the results obtained, 98% of the families had an inappropriate overall functioning (Table 1).
|Dimension||Number||Percentage||Mean ± SD||Median|
|Overall Functioning||Inappropriate||490||98||2.49 ± 0.2||2.5|
Table 1. The frequency distribution of family functioning based on the mean scores and the overall family functioning.
The mean score of aggression was calculated as 15.22 in the verbal dimension, 24.17 in the hostility dimension, 29.86 in the physical dimension and 20.63 in the anger dimension, and the mean overall score of aggression was calculated as 89.87 (Table 2). Physical aggression received the highest score of all the dimensions.
|Aggression Dimension||Mean||95% Confidence Interval||Median||Standard Deviation||Minimum||Maximum|
|Lower Bound||Upper Bound|
|Score of Physical Aggression||29.86||29.33||30.39||30||6.01||11||43|
|Mean Score of Physical Aggression||3.32||3.26||3.38||3.33||0.67||1.22||4.7|
|Score of Verbal Aggression||15.22||14.88||15.55||15||3.78||6||25|
|Mean score of Verbal Aggression||3.04||2.98||3.11||3||0.76||1.2||5|
|Score of Aggression in the form of Anger||20.63||20.17||21.09||21||5.25||8||35|
|Mean Score of Aggression in the form of Anger||2.95||2.88||3.01||3||0.75||1.14||5|
|Score of Aggression in the form of Hostility||24.17||23.7||24.64||24||5.38||9||37|
|Mean Score of Aggression in the form of Hostility||3.02||2.96||3.08||3||0.67||1.13||4.63|
|Overall Score of Aggression||89.87||88.33||91.42||90||17.54||41||135|
|Mean Overall score of Aggression||3.1||3.05||3.15||3.1||0.6||1.41||4.66|
Table 2. The mean score (and standard deviation) and the other statistical indicators of aggression in the students by dimension.
According to the results obtained, family functioning was significantly related to all the four dimensions of aggression, including physical aggression, verbal aggression, anger and hostility (P=0.0001) and there was a significant relationship between the overall score of aggression and the overall score of family functioning (P=0.0001; Table 3).
|Aggression Dimension/Family Functioning Dimension||Physical Aggression||Verbal Aggression||Anger||Hostility||Overall Aggression|
|Overall Functioning||Correlation Coefficient||0.403||0.336||0.344||0.336||0.42|
Table 3. The correlation between the different dimensions of aggression and family functioning.
The results obtained confirm the relationship between family functioning and different dimensions of aggression.
In a study conducted by Hojjat et al. entitled "Comparison of the dimensions of family functioning and normal juvenile offenders", the mean and standard deviation of family functioning in the normal and offender groups were 1.76 ± 0.32 and 1.86 ± 0.31 in problem-solving, 2.05 ± 0.2 and 1.82 ± 0.4 in communication, 1.93 ± 0.24 and 1.76 ± 0.38 in roles, 2.15 ± 0.21 and 2.17 ± 0.22 in affective responsiveness, 2.08 ± 0.33 and 1.9 ± 0.42 in affective involvement, 2.2 ± 0.3 and 1.91 ± 0.45 in behavioral control and 2.1 ± 0.26 and 1.89 ± 0.39 overall. No significant differences were thus observed between the two groups in terms of the problem-solving and affective responsiveness dimensions of family functioning, while a significant difference was observed between them in terms of communication, roles, affective involvement and overall functioning, indicating an inappropriate family functioning in the offender group .
The results of a study by Modanloo et al. entitled "Family functioning in parents of children with cancer" revealed a mean and standard deviation of 96.2 ± 0.5 in the problem-solving dimension of family functioning, 2.75 ± 0.4 in communication, 2.57 ± 0.38 in roles, 2.72 ± 0.31 in affective responsiveness, 2.66 ± 0.38 in affective involvement, 2.68 ± 0.33 in behavioral control and 2.74 ± 0.41 overall, indicating poor family functioning in each of the dimensions . The majority of families have healthy and unhealthy functioning periods throughout their life. Healthy families have a suitable and clear organization. Stress is a natural part of the family life; however, alongside individual members, the family also seeks to use different tools to prevent the turning of stressful situations into troubling events. Some of these tools are less healthy than others and the family functioning may fluctuate from appropriate to inappropriate or vice versa on different occasions .
Family functioning can change under different conditions, and improper solutions to conflicts can lead to the incidence of other crises within the family. It appears that family tensions cannot be resolved by focusing on only one dimension. since weaknesses in each dimension can have different impacts in different families, and each family's needs are specific and can be satisfied according to the capabilities of each single member.
It should be noted that the results of the present study are based on the students' reports of their family functioning, and if the parents’ viewpoints were to be examined, different results would have been achieved. Further studies are therefore recommended to achieve comprehensive results. Moreover, adolescent high-school students experience developmental crises mixed with concerns, idealism, touchiness and fault-finding and indecisiveness and seek a perfect world free of injustice or prejudice, which widens the generation gap with their parents and ultimately leads to tensions between them and make them reproachful critics.
The results of the study also showed a relatively high prevalence of aggression among the students, with physical aggression being the most prevalent type. A study by Motlaq et al. on the prevalence of aggression and its relevant factors in adolescents in Yasuj showed that 32% of the participants projected aggressive behaviors and found the mean overall score of aggression to be 69.7% .
A study by Tippet et al. on American adolescents showed a high prevalence of aggression among this age group (51.2%), with physical aggression being the most prevalent type (48.8%) .
The results of the present study as well as previous studies on the subject show that aggression is likely prevalent among adolescents. Psychologists regard aggression as an emotional state associated with adolescence that is exhibited when the adolescent's demands are not met or when he is faced with conflicting choices .
The results of the present study showed a significant relationship between family functioning and the different types of aggression in the students. The results obtained by Amanian et al. on the relationship between family functioning and adolescent aggression showed that aggression is significantly related to problem-solving (P=0.000), affective responsiveness (P=0.000), roles (P=0.000) and overall family functioning (P=0.000) .
In their study entitled "The role of self-control, quality of relationship with parents and school environment in the mental health and antisocial behavior of adolescents”, Mohammadi-Masiri et al. showed that adolescents' mental health is significantly related to self-control, quality of relationship with parents and the school environment (P<0.01) .
In their study entitled “The longitudinal relationship between peer violence and popularity and delinquency in adolescent boys: Examining effects by family functioning”, Henneberger et al. showed that delinquency and aggression are positively and significantly related to parental supervision (r=-0.01 and P=0.1), family relationships (r=0.0 and P=0.06) and peer violence (r=0.62 and P=0.23) .
Garg examined the relationship between adolescent aggression and the family’s emotional atmosphere and found that the family’s emotional atmosphere is significantly related to the incidence of aggression (r=0-0.28); that is, the more difficult it is for the family members to establish relationships with each other and the more incapable are the parents of creating a family atmosphere conducive to emotional expression for their children, the more likely is the incidence of aggression due to suppressed emotions .
Family functioning is considered to be a factor that predicts the incidence of adolescent aggression. Through identifying social-emotional distress and harms and good parenting methods, the family is likely to have a significant role in reducing and preventing aggressive behaviors in adolescents. Considering the significant relationship observed between the roles dimension of family functioning and aggression, it appears that families are healthier if the family members feel more satisfied with their roles and responsibilities and when the tasks are fairly divided among them. Another major factor involved in the incidence of aggression is the relationship between the parents and their relationship with the children. Functioning as a social system, the desirable and undesirable behaviors of the family members affect each member. If proper behavioral patterns are set in the family, the children also grow up with healthy behaviors. Moreover, given the significant relationship observed between affective responsiveness and affective involvement, it can be said that families that properly respond to each other's emotions and understand each other's values and interests can create a suitable emotional atmosphere at home and thus prevent the suppression of the children's emotions and its subsequent harmful effects. To conclude, the more inappropriate is the family functioning, the more likely is the incidence of adolescent aggression. In the present study due to the high percentage of adolescents dissatisfaction with their family (98%) it is suggested that in the future studied , the manner of behavior control, affective responsiveness and in families with aggressive adolescents be monitored and also Variables such as Menstruation in girls, the views of parents and comparison with the views of adolescence. Furthermore considering the importance of aggression it is suggested that aggression in children and adolescents in other environment and the role of cultural differences in other communities be studied.
Hereby, the authors would like to express their gratitude to all the participating students and their families, the education authorities of Rasht, the officials at Social Determinants of Health Research Center, Guilan University of Medical Sciences and everyone else who helped conduct this study.