Risk and protective factors for mental health and wellbeing among adolescent orphans

Figures & data

Table 1. African Youth Psychological Assessment (AYPA).

Subscale	Items
Anxiety	Has constant worries, does not sleep at night, has a lot of worries, Thinks other people are chasing them, Cries continuously
Depression	Has a lot of thoughts, Has pain all over their body, Thinks they are of no use, Thinks about suicide, Sits alone, Gets headaches, Feels a lot of pain in their heart, Sits with their cheek in their palm, Cries when they are alone, Feels cold, Wants to be alone, Holds head, Drinks alcohol, Does not think straight, Mutters to themself, Feels they can do nothing to help themself, Feels sad, Thinks of bad things
Externalizing behaviors	Is disobedient, Insults friends, Fights, uses bad language, Is disrespectful, Misbehaves, Deceives, Is a rough person, Consumes drugs (like marijuana)

Table 2. Descriptive statistics of analytical sample (n = 350).

Variable	N	%
Sex
Female	201	57
Male	149	43
Age
10	68	19
11	45	13
12	36	10
13	72	21
14	127	36
15	2	1
School enrollment
Yes	322	92
No	28	8
Municipal district
Ilala	99	28
Temeke	164	47
Ubongo	87	25
	Mean	SD
Age	12.4	1.5
Pubertal maturation (range 0–3)
Female	1.5	1.2
Male	0.7	0.9
Orphanage experience
Age began care under orphanage	7.2	3.7
Years spent at orphanage	5.4	3.6

Table 3. Mean and standard deviations of measures.

		Total
		Mean (SD)
Risk factors
Emotional neglect		0.57 (0.68)
Emotional abuse		1.13 (0.86)
Physical hardship		1.07 (0.93)
Stigma experienced		1.42 (2.47)
Protective factors
Autonomy		2.72 (0.72)
Self-esteem		3.07 (1.25)
Community relationships		3.84 (0.51)
Psychological symptoms
Depression		6.40 (4.52)
Anxiety		0.69 (1.48)
Externalizing behaviors		0.85 (1.74)
Wellbeing
Health		2.38 (0.65)
Happiness		2.81 (0.44)
Hope		14.98 (3.31)

Figure 1. Structural equation model of Risk and Protective Factors on Psychological Symptoms and Wellbeing.

Note: CFI = 0.926; SRMR = 0.045; RMSEA = 0.059; *p < 0.05, **p < 0.01, ***p < 0.001; Sex was included as a covariate.

A structural equation model is shown with the second-order latent factors, ‘Risk Factors’, comprised of physical neglect, emotional neglect, emotional abuse and stigma measurement paths, and the second-order latent factor, ‘Protective Factors’, comprised of self-esteem, total autonomy and community relationships measurement paths. Structural paths from each second-order latent factor to both ‘Wellbeing’ and ‘Psychopathology’ and displaying the path coefficients. Curved covariance paths between risk and protective factors and between wellbeing and psychopathology latent factors are displayed with covariance coefficients. The error terms of each measure comprising each latent factor are shown.

Table 4. Standardized path coefficients between risk and protective factors and mental health and wellbeing.

Structural paths	Coefficient	SE	Z	p>|z|	95% Confidence Interval
Psychopathology
Risk factors	0.34	0.21	1.61	0.108	−0.74	0.76
Protective factors	−0.53	0.22	−2.43	0.015	−0.96	−0.10
Wellbeing
Risk factors	−0.24	0.29	−0.83	0.405	−0.81	0.33
Protective factors	0.72	0.29	2.46	0.014	0.15	1.29
Measurement model
Risk factors
Emotional abuse	0.57	0.05	12.30	<0.001	0.48	0.66
Emotional neglect	0.37	0.06	6.77	<0.001	0.26	0.48
Physical neglect	0.56	0.05	12.30	<0.001	0.46	0.65
Stigma	0.77	0.04	22.16	<0.001	0.70	0.84
Protective factors
Self-esteem	0.34	0.06	5.70	<0.001	0.23	0.46
Total autonomy	0.45	0.06	8.22	<0.001	0.34	0.56
Community relationships	0.56	0.05	10.34	<0.001	0.45	0.66
Wellbeing
Happiness	0.42	0.05	7.73	<0.001	0.31	0.53
Hope	0.69	0.05	10.34	<0.001	0.58	0.79
Health	0.35	0.06	6.20	<0.001	0.31	0.53
Psychopathology
Externalizing behaviors	0.36	0.05	7.07	<0.001	0.26	0.47
Anxiety symptoms	0.73	0.03	22.67	<0.001	0.67	0.80
Depressive symptoms	0.87	0.03	31.22	<0.001	0.82	0.93

Note: Items in bold are significant at the p < 0.05 level; All measurement model paths were significant at the p < 0.001 level