Violência familiar, práticas educativas parentais e suas repercussões na saúde mental do adolescente.

Abstract

Worldwide, 10-20% of children and adolescents experience mental disorder. Different factors (individual, family and socioeconomic) are involved in this process. Although individuals who have experienced family violence in childhood (FVC) appear to have higher risk of developing common mental disorders (CMD), this issue is not consensual. A 'good relationship' between parents and children, through positive parenting practices (PP), can function as a protective factor against adversities and FVC. However, children and adolescents education by their parents has been undervalued in health researches. This thesis aims to contribute to this debate in order to investigate whether positive PP (warmth and affection), which occurs concurrently to violent practices, reduces the likelihood of CMD in adolescents. Initially, it was required to continue s-EMBU cross-cultural adaptation process (CCA), an instrument proposed to assess PP. CCA followed universalistic model, first being evaluated conceptual, items, semantic and operational equivalences. Process thus included literature review, discussion with experts, and translation and back-translation of items. Appreciation of measurement equivalence evaluated instrument dimensional structure, by confirmatory (CFA) and exploratory factor analysis. Relations between FVC, PP and CMD in adolescence were estimated from cross-sectional approach. Study population consisted of 487 students from six schools in Rio de Janeiro metropolitan region and participants from Project ELANA (Longitudinal Study for Nutritional Adolescent Evaluation). For data analysis, it was chosen multivariate linear regression and also tested PP modifying effects on CMD development in adolescents exposed to FVC. Regarding s-EMBU, some inconsistencies concerning the items of Overprotection dimension were found, which culminated in only reasonable CFA model fit indices. Items that cover Emotional Warmth dimension mapped adequately the underlying construct. All types of FVC - physical or emotional abuse and physical or emotional neglect - were significant for the development of CMD, even after controlling for socioeconomic and demographic variables and maternal or paternal emotional warmth levels. Harmful effects of physical neglect on adolescent mental health were higher for those who reported low levels of emotional warmth, both maternal and paternal. This s- EMBU version is recommended for Brazilian adolescents, especially in relation to Emotional Warmth dimension. However, adjustments are still needed to component items of the other two dimensions. Results show deleterious effects of childhood maltreatment on adolescent mental health, supporting literature findings. Although it only has been found modifying effect of positive PP in cases of physical neglect, these results suggest these practices may act as attenuators of FVC effect on adolescent mental health. Even if further studies are needed to elucidate the protective role of parents and children relationship in mental health, research programs covering the effects of family violence on adolescent s health should not fail to consider PP as possible modifying or confusion factors in the process.