نشریه علمی پژوهشی طب انتظامی Journal of Police Medicine
Volume 11, Issue 1 (2022)
J Police Med 2022, 11(1) |
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Ethics code: IR.ARUMS.REC.1400.088
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Heidari F, Narimani M, Aghajani S, Basharpoor S. The Mediating Role of Moral Apathy in the Relationship between Childhood Maltreatment and Peer Rejection with Conduct Disorder Symptoms in Adolescents. J Police Med 2022; 11 (1) : e25
URL: http://jpmed.ir/article-1-1092-en.html
URL: http://jpmed.ir/article-1-1092-en.html
1- Department of Psychology, School of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
2- Department of Psychology, School of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran ,basharpoor_sajjad@yahoo.com
2- Department of Psychology, School of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran ,
English Extended Abstract: (2834 Views)
INTRODUCTION
... [1]. Individuals with conduct disorder exhibit a repetitive and persistent pattern of behavior in which the basic rights of others or age-appropriate social norms and regulations are violated [2]. Conduct disorder usually appears in childhood or adolescence and affects between 2 and 10% of the general population and an average of 4% of people [2]. Significantly, both factors of childhood maltreatment and childhood conduct disorder increase the risk of recidivism. ... [3]. Childhood maltreatment is also considered a clear risk for violence against parents among adolescents [4, 5] and adults [6]. ... [7]. Children and adolescents with conduct disorder have more verbal and physical aggression and poor social skills compared to their peers, as a result, most of them are rejected by their peers [8]. ... [9, 10]. One-third of children and adolescents in school report social rejection by their peers [11]. Dodge et al. [12] have shown that peer rejection in middle childhood predicts current and future antisocial behavior. Longitudinal studies show that socially deprived children are at high risk of social maladjustment and maladaptive thinking patterns in adulthood [10, 13]. Massing-Schaffer et al. [14] and Cheek et al. [15] have also shown in a study aimed at investigating the relationship between social rejection and suicidal ideation that there is a relationship between acute cases of social rejection and suicidal ideation. ... [16]. People with conduct disorder usually engage in unethical behavior using moral apathy, without feeling guilt or self-blame. Loss aversion includes a series of cognitive mechanisms (such as moral justification, thoughtful labeling, dehumanization, and shame attributions) that allow people to engage in unethical behavior and avoid its negative consequences on their self-esteem. Previous studies show that adolescents who resort to moral apathy to a large extent engage in more aggressive behaviors [17]. ... [18, 19]. Also, moral apathy is related to peer rejection in school [20]. ... [21-23].
AIM(s)
The present study was conducted to determine the mediating role of moral apathy in the relationship between child abuse and peer rejection with conduct disorder symptoms in adolescents.
RESEARCH TYPE
The method of this research is descriptive-correlation of structural equation modeling type.
RESEARCH SOCIETY, PLACE & TIME
The statistical population of this research was all the students of the first and second grades of high school who were studying in Urmia, Iran in the academic year of 2020-2021.
SAMPLING METHOD & NUMBER
Considering that in modeling studies, the minimum sample size is 10-40 people for each observed variable [24], in this study 15 samples were considered for each observed variable. Therefore, the sample size was selected according to the presence of 14 observed variables, and taking into account the attrition of subjects, 220 people were selected by the multi-stage sampling method.
USED DEVICES & MATERIALS
To collect data, the self-report version of the Strengths and Difficulties Questionnaire (SDQ) [25, 26], the Childhood Injuries Questionnaire [27, 28], the peer social rejection scale [10], and the moral apathy scale [29, 30] were used.
METHODS
After receiving permission from Mohaghegh Ardabili University, Department of Education of West Azerbaijan Province in Iran was approached and one district was randomly selected from the two education districts of Urmia, Iran. Then, the selected district was referred and a list of all girls' and boys' schools for the first and second grades of high school was obtained. In the next step, one girls' and one boys' school from each grade (four schools), and after referring to the selected schools from each of the three grades, one class was selected and the link of the research questionnaires was sent to them through the Shad application for answering.
ETHICAL PERMISSION
This research was approved by the ethics committee of Ardabil University of Medical Sciences with the code of ethics IR.ARUMS.REC.1400.088.
STATISTICAL ANALYSIS
Data were analyzed using descriptive statistical tools and to test hypotheses structural equation modeling was used through SmartPLS 3 software.
FINDING by TEXT
In this research, 220 students from the first and second grades of high school in the age range of 12-19 years old with an average age of 16.15±1.54 years participated. The frequency of subjects based on demographic variables is shown in Table 1. According to Table 2, the values of skewness and kurtosis of some variables were not in the range of -2 to +2, therefore, the data did not have a normal distribution, and PLS software was used to perform structural equations for abnormal data. The obtained results showed that all values of Cronbach's alpha and composite reliability of the research constructs were more than 0.7. Also, the value of AVE for the constructs was more than 0.5, which indicated the convergent validity and reliability of the research model. The results of the divergent validity of the variables showed that the average square root of the variance extracted for each of the constructs was higher compared to the correlation of that construct with other constructs; therefore, it can be said that in the research model, the existing variables interacted more with the items related to themselves than with other structures. In other words, the model had good validity. Also, the value of R square for the structure of moral apathy was 0.34 and the structure of symptoms of conduct disorder was 0.56, which indicated a suitable value. The Q2 values showed that the endogenous variables of both constructs had a good predictive ability with their respective constructs. The effect size values in Table 3 indicated the appropriate effect size for the constructs of peer rejection, childhood maltreatment, and moral apathy, and the greatest effect was related to moral apathy on symptoms of conduct disorder. According to charts 1 and 2 and table 4, the results of the bootstrap significance test for the significance test of the path coefficients showed that the direct path coefficients of childhood maltreatment (p<0.001; β=0.38) and moral apathy (p<0.001; 40 (β=0) were significant to the symptoms of conduct disorder. Also, the direct path coefficients of childhood maltreatment (p<0.001; β=0.42) and peer rejection (p<0.01; β=0.23) on moral apathy were significant. In addition, childhood maltreatment (p<0.01; β=0.10) and peer rejection (p<0.01; β=0.06) had an indirect effect on conduct disorder symptoms through the mediation of moral apathy.
MAIN COMPARISION to the SIMILAR STUDIES
The results of this study showed that childhood maltreatment had a direct effect on the symptoms of conduct disorder. These results are consistent with the results of the study by Desanctisa et al. [3] who showed that moderate to severe childhood maltreatment increases the risk of childhood conduct disorder, and both factors of childhood maltreatment and conduct disorder significantly increases the risk of recidivism. Hoeve et al. [4], Wang et al. [5], and Richey et al. [6] have also shown that childhood maltreatment is a clear risk factor for committing violence against parents and adults. Schwartz et al. [7] have also stated that exposure to adverse childhood experiences is associated with alcohol use problems and high levels of antisocial behavior. ... [31]. The obtained results showed that the direct path of peer rejection to conduct disorder symptoms was not significant. These results are inconsistent with the results of Dodge et al. [12] who showed that peer rejection in middle childhood predicts current and future antisocial behavior. These results are also inconsistent with the results of Massing-Schaffer et al. [14] and Cheek et al. [15], which revealed the association between social exclusion and negative psychological outcomes. The lack of a direct relationship between peer rejection and behavior disorder symptoms in this study can be related to the collection of data in this study during the Corona epidemic period, in which due to compliance with social distancing guidelines, students had less contact with their peers, in this way, they were less likely to be rejected by their peers. On the other hand, the important affecting factor of social exclusion on behavioral abnormalities is the level of emotional arousal, and this level of arousal is also dependent on the degree of intimacy with the rejecter's peer and their social status. Therefore, in addition to experiencing less social rejection in Corona conditions, the subjects of the present study may have lacked deep intimacy with their peers and experienced less emotional arousal in the event of rejection, and this factor may have reduced the negative consequences of rejection. According to the results of this study, moral apathy had a direct effect on the symptoms of conduct disorder. These results are in line with the results of Shulman et al. [21] and Espejo-Siles et al. [22] who showed that moral apathy is an important predictor of aggressive behavior and violence towards peers in children and adolescents. Also, the results of this study showed that childhood maltreatment has an indirect effect on conduct disorder symptoms due to moral apathy. These results are consistent with the results of Wang et al. [5] and Fang et al. [19]. Also, peer rejection through moral apathy had an indirect effect on conduct disorder symptoms. These results are in line with the results of Gini et al. [17] and Muratori et al. [18] who have shown that in adolescents with disruptive behavior disorders, more tendencies of moral apathy are related to high levels of inclemency traits. Fontaine et al. [33] have also shown that adolescents who experience high social rejection from their peers resort to moral apathy processes more than other adolescents. In the explanation of this hypothesis, it can be said that the person's concern about social life or the person's previous memories of rejection may reduce their attention on the self-regulation of their disorder and lead them to maladaptive coping strategies such as the use of moral apathy mechanisms and have an indirect effect on conduct disorder problems.
LIMITATIONS
This study had several limitations. First, the measurement of childhood maltreatment in this study was only based on the subjects' self-report. Although many studies confirm the reliability and validity of the childhood injury questionnaire, any self-report instrument is vulnerable to many biases such as social desirability, the person's mood at the time of reporting, and the person's memory. The lack of use of clinical samples with conduct disorder was another limitation of the present study.
SUGGESTIONS
It is suggested that in future studies, other tools such as observation and interview be used to measure the variables, and to increase the generalizability of the results to those suffering from conduct disorder, clinical samples with this disorder be used.
CONCLUSIONS
The results of this study show that in addition to the direct effect of childhood maltreatment on conduct disorder symptoms, moral apathy acts as a mediator of the effects of childhood maltreatment and peer social rejection on conduct symptoms.
CLINICAL & PRACTICAL TIPS in POLICE MEDICINE
Considering the greater involvement of those with conduct disorder with the law and their high vulnerability for antisocial behavior in the present and future, the results of this study can be used in the design of preventive programs and early intervention in conduct disorder.
ACKNOWLEDGMENTS
The authors of the article express their gratitude to the management of the Education Department of West Azerbaijan province in Iran and all school principals and students participating in this research.
CONFLICT of INTEREST
The authors state that there is no conflict of interest in the present study.
FUNDING SOURCES
This research is a part of the findings of the Ph.D. thesis of the first author of this article, which was implemented with the financial support of the Research Vice-Chancellor of Mohaghegh Ardabili University.
... [1]. Individuals with conduct disorder exhibit a repetitive and persistent pattern of behavior in which the basic rights of others or age-appropriate social norms and regulations are violated [2]. Conduct disorder usually appears in childhood or adolescence and affects between 2 and 10% of the general population and an average of 4% of people [2]. Significantly, both factors of childhood maltreatment and childhood conduct disorder increase the risk of recidivism. ... [3]. Childhood maltreatment is also considered a clear risk for violence against parents among adolescents [4, 5] and adults [6]. ... [7]. Children and adolescents with conduct disorder have more verbal and physical aggression and poor social skills compared to their peers, as a result, most of them are rejected by their peers [8]. ... [9, 10]. One-third of children and adolescents in school report social rejection by their peers [11]. Dodge et al. [12] have shown that peer rejection in middle childhood predicts current and future antisocial behavior. Longitudinal studies show that socially deprived children are at high risk of social maladjustment and maladaptive thinking patterns in adulthood [10, 13]. Massing-Schaffer et al. [14] and Cheek et al. [15] have also shown in a study aimed at investigating the relationship between social rejection and suicidal ideation that there is a relationship between acute cases of social rejection and suicidal ideation. ... [16]. People with conduct disorder usually engage in unethical behavior using moral apathy, without feeling guilt or self-blame. Loss aversion includes a series of cognitive mechanisms (such as moral justification, thoughtful labeling, dehumanization, and shame attributions) that allow people to engage in unethical behavior and avoid its negative consequences on their self-esteem. Previous studies show that adolescents who resort to moral apathy to a large extent engage in more aggressive behaviors [17]. ... [18, 19]. Also, moral apathy is related to peer rejection in school [20]. ... [21-23].
AIM(s)
The present study was conducted to determine the mediating role of moral apathy in the relationship between child abuse and peer rejection with conduct disorder symptoms in adolescents.
RESEARCH TYPE
The method of this research is descriptive-correlation of structural equation modeling type.
RESEARCH SOCIETY, PLACE & TIME
The statistical population of this research was all the students of the first and second grades of high school who were studying in Urmia, Iran in the academic year of 2020-2021.
SAMPLING METHOD & NUMBER
Considering that in modeling studies, the minimum sample size is 10-40 people for each observed variable [24], in this study 15 samples were considered for each observed variable. Therefore, the sample size was selected according to the presence of 14 observed variables, and taking into account the attrition of subjects, 220 people were selected by the multi-stage sampling method.
USED DEVICES & MATERIALS
To collect data, the self-report version of the Strengths and Difficulties Questionnaire (SDQ) [25, 26], the Childhood Injuries Questionnaire [27, 28], the peer social rejection scale [10], and the moral apathy scale [29, 30] were used.
METHODS
After receiving permission from Mohaghegh Ardabili University, Department of Education of West Azerbaijan Province in Iran was approached and one district was randomly selected from the two education districts of Urmia, Iran. Then, the selected district was referred and a list of all girls' and boys' schools for the first and second grades of high school was obtained. In the next step, one girls' and one boys' school from each grade (four schools), and after referring to the selected schools from each of the three grades, one class was selected and the link of the research questionnaires was sent to them through the Shad application for answering.
ETHICAL PERMISSION
This research was approved by the ethics committee of Ardabil University of Medical Sciences with the code of ethics IR.ARUMS.REC.1400.088.
STATISTICAL ANALYSIS
Data were analyzed using descriptive statistical tools and to test hypotheses structural equation modeling was used through SmartPLS 3 software.
FINDING by TEXT
In this research, 220 students from the first and second grades of high school in the age range of 12-19 years old with an average age of 16.15±1.54 years participated. The frequency of subjects based on demographic variables is shown in Table 1. According to Table 2, the values of skewness and kurtosis of some variables were not in the range of -2 to +2, therefore, the data did not have a normal distribution, and PLS software was used to perform structural equations for abnormal data. The obtained results showed that all values of Cronbach's alpha and composite reliability of the research constructs were more than 0.7. Also, the value of AVE for the constructs was more than 0.5, which indicated the convergent validity and reliability of the research model. The results of the divergent validity of the variables showed that the average square root of the variance extracted for each of the constructs was higher compared to the correlation of that construct with other constructs; therefore, it can be said that in the research model, the existing variables interacted more with the items related to themselves than with other structures. In other words, the model had good validity. Also, the value of R square for the structure of moral apathy was 0.34 and the structure of symptoms of conduct disorder was 0.56, which indicated a suitable value. The Q2 values showed that the endogenous variables of both constructs had a good predictive ability with their respective constructs. The effect size values in Table 3 indicated the appropriate effect size for the constructs of peer rejection, childhood maltreatment, and moral apathy, and the greatest effect was related to moral apathy on symptoms of conduct disorder. According to charts 1 and 2 and table 4, the results of the bootstrap significance test for the significance test of the path coefficients showed that the direct path coefficients of childhood maltreatment (p<0.001; β=0.38) and moral apathy (p<0.001; 40 (β=0) were significant to the symptoms of conduct disorder. Also, the direct path coefficients of childhood maltreatment (p<0.001; β=0.42) and peer rejection (p<0.01; β=0.23) on moral apathy were significant. In addition, childhood maltreatment (p<0.01; β=0.10) and peer rejection (p<0.01; β=0.06) had an indirect effect on conduct disorder symptoms through the mediation of moral apathy.
MAIN COMPARISION to the SIMILAR STUDIES
The results of this study showed that childhood maltreatment had a direct effect on the symptoms of conduct disorder. These results are consistent with the results of the study by Desanctisa et al. [3] who showed that moderate to severe childhood maltreatment increases the risk of childhood conduct disorder, and both factors of childhood maltreatment and conduct disorder significantly increases the risk of recidivism. Hoeve et al. [4], Wang et al. [5], and Richey et al. [6] have also shown that childhood maltreatment is a clear risk factor for committing violence against parents and adults. Schwartz et al. [7] have also stated that exposure to adverse childhood experiences is associated with alcohol use problems and high levels of antisocial behavior. ... [31]. The obtained results showed that the direct path of peer rejection to conduct disorder symptoms was not significant. These results are inconsistent with the results of Dodge et al. [12] who showed that peer rejection in middle childhood predicts current and future antisocial behavior. These results are also inconsistent with the results of Massing-Schaffer et al. [14] and Cheek et al. [15], which revealed the association between social exclusion and negative psychological outcomes. The lack of a direct relationship between peer rejection and behavior disorder symptoms in this study can be related to the collection of data in this study during the Corona epidemic period, in which due to compliance with social distancing guidelines, students had less contact with their peers, in this way, they were less likely to be rejected by their peers. On the other hand, the important affecting factor of social exclusion on behavioral abnormalities is the level of emotional arousal, and this level of arousal is also dependent on the degree of intimacy with the rejecter's peer and their social status. Therefore, in addition to experiencing less social rejection in Corona conditions, the subjects of the present study may have lacked deep intimacy with their peers and experienced less emotional arousal in the event of rejection, and this factor may have reduced the negative consequences of rejection. According to the results of this study, moral apathy had a direct effect on the symptoms of conduct disorder. These results are in line with the results of Shulman et al. [21] and Espejo-Siles et al. [22] who showed that moral apathy is an important predictor of aggressive behavior and violence towards peers in children and adolescents. Also, the results of this study showed that childhood maltreatment has an indirect effect on conduct disorder symptoms due to moral apathy. These results are consistent with the results of Wang et al. [5] and Fang et al. [19]. Also, peer rejection through moral apathy had an indirect effect on conduct disorder symptoms. These results are in line with the results of Gini et al. [17] and Muratori et al. [18] who have shown that in adolescents with disruptive behavior disorders, more tendencies of moral apathy are related to high levels of inclemency traits. Fontaine et al. [33] have also shown that adolescents who experience high social rejection from their peers resort to moral apathy processes more than other adolescents. In the explanation of this hypothesis, it can be said that the person's concern about social life or the person's previous memories of rejection may reduce their attention on the self-regulation of their disorder and lead them to maladaptive coping strategies such as the use of moral apathy mechanisms and have an indirect effect on conduct disorder problems.
LIMITATIONS
This study had several limitations. First, the measurement of childhood maltreatment in this study was only based on the subjects' self-report. Although many studies confirm the reliability and validity of the childhood injury questionnaire, any self-report instrument is vulnerable to many biases such as social desirability, the person's mood at the time of reporting, and the person's memory. The lack of use of clinical samples with conduct disorder was another limitation of the present study.
SUGGESTIONS
It is suggested that in future studies, other tools such as observation and interview be used to measure the variables, and to increase the generalizability of the results to those suffering from conduct disorder, clinical samples with this disorder be used.
CONCLUSIONS
The results of this study show that in addition to the direct effect of childhood maltreatment on conduct disorder symptoms, moral apathy acts as a mediator of the effects of childhood maltreatment and peer social rejection on conduct symptoms.
CLINICAL & PRACTICAL TIPS in POLICE MEDICINE
Considering the greater involvement of those with conduct disorder with the law and their high vulnerability for antisocial behavior in the present and future, the results of this study can be used in the design of preventive programs and early intervention in conduct disorder.
ACKNOWLEDGMENTS
The authors of the article express their gratitude to the management of the Education Department of West Azerbaijan province in Iran and all school principals and students participating in this research.
CONFLICT of INTEREST
The authors state that there is no conflict of interest in the present study.
FUNDING SOURCES
This research is a part of the findings of the Ph.D. thesis of the first author of this article, which was implemented with the financial support of the Research Vice-Chancellor of Mohaghegh Ardabili University.
Table 1) Multiple numbers and percentages based on demographic information
| Variable | Number | Percentage | |
| Gender | Boy | 115 | 52.3 |
| Girl | 105 | 47.7 | |
| birth rank | First | 143 | 65 |
| Second | 37 | 16.8 | |
| Third | 21 | 9.5 | |
| higher | 19 | 8.2 | |
| Family income | Less than 2 million tomans | 21 | 9.5 |
| Between 2 and 5 million tomans | 64 | 29.1 | |
| Between 5 and 10 million tomans | 89 | 40.5 | |
| Above 10 million tomans | 46 | 20.9 | |
| Grade | seventh | 13 | 5.9 |
| Eighth | 21 | 9.5 | |
| ninth | 34 | 15.5 | |
| the tenth | 74 | 33.6 | |
| Eleventh | 29 | 13.2 | |
| twelfth | 49 | 22.3 | |
| Father's job | Governmental positions | 145 | 56.9 |
| Self-employment | 46 | 20.9 | |
| unemployed | 15 | 8.6 | |
| Retired | 14 | 6.4 | |
| mother's job | Governmental positions | 9 | 4.1 |
| Self-employment | 11 | 5 | |
| Housewife | 196 | 89.1 | |
| Retired | 4 | 1.8 | |
| Father's education | Diploma and less | 46 | 20.91 |
| Masters | 97 | 44.09 | |
| Masters and higher | 77 | 35 | |
| mother's education | Diploma and less | 117 | 53.18 |
| Masters | 53 | 24.09 | |
| Masters and higher | 50 | 22.73 | |
Table 2) The average scores of the subjects in the symptoms of
conduct disorder, childhood maltreatment, peer rejection, and moral apathy
| Variables | Mean | Standard deviation | skewness | kurtosis | |
| Signs of behavior | 2.62 | 1.41 | 1.26 | 1.90 | |
| Child maltreatment | Child maltreatment (total score) | 28.62 | 6.81 | 0.46 | 2.14 |
| Physical tolerance | 7.77 | 2.19 | -1.00 | 1.28 | |
| Emotional maltreatment | 2.27 | 2.57 | -0.83 | 0.98 | |
| Physical maltreatment | 7.75 | 2.16 | 1.48 | 2.13 | |
| sexual maltreatment | 2.95 | 2.44 | 0.19 | -0.36 | |
| Emotional forgiveness | 5.35 | 2.09 | 1.13 | 1.31 | |
| Denial | 0.504 | 1.10 | 1.10 | 4.74 | |
| peer rejection | peer rejection (total score) | 31.91 | 12.41 | 1.83 | 3.13 |
| insult | 7.64 | 3.92 | 1.92 | 3.21 | |
| ignore | 13.10 | 4.75 | 1.84 | 3.70 | |
| Slander and accusation | 5.33 | 2.34 | 2.48 | 6.77 | |
| Physical attacks | 5.83 | 2.86 | 1.81 | 2.74 | |
| Moral apathy | Moral apathy (total score) | 33.64 | 14.83 | 0.46 | 0.18 |
| Moral justification | 9.29 | 2.83 | 0.10 | -0.41 | |
| Smart labeling | 8.45 | 3.48 | 0.52 | 0.69 | |
| Useful comparison | 5.82 | 2.34 | 1.86 | 5.78 | |
| Shifting responsibility | 10.15 | 3.78 | 0.12 | -0.70 | |
| Distribution of responsibility | 4.94 | 1.54 | 1.92 | 3.86 | |
| Distortion of results | 9.89 | 3.10 | 0.45 | 0.48 | |
| documents of shame | 9.61 | 3.78 | 0.51 | -0.19 | |
| Dehumanize | 6.15 | 2.42 | 1.45 | 2.56 | |
Table 3) The values of the effect size index (f2) of the predictor
variables on the variable of conduct symptoms and moral apathy
| Indicator | Conduct Symptoms | Moral apathy |
| child abuse | 0.18 | 0.17 |
| peer rejection | 0.02 | 0.05 |
| Moral apathy | 0.24 | - |
Table 4) Direct and indirect effects of childhood maltreatment and peer
rejection on conduct disorder indicators: the mediating role of moral apathy
| predictor variables | Moral apathy | Conduct Symptoms | ||||
| Direct effect | Indirect effect | total | Direct effect | Indirect effect | Total | |
| Child maltreatment | 0.42** | - | 0.42** | 0.38** | 0.10* | 0.48** |
| peer rejection | 0.23* | - | 0.23* | 0.10 | 0.06* | 0.16* |
| Moral apathy | - | - | - | 0.40** | - | 0.40** |
**Significance at the level of p<0.001; * Significance at the level of p<0.01
Chart 1) Path coefficients of the measurement model
Chart 2) T values of measurement model
Chart 1) Path coefficients of the measurement model
Chart 2) T values of measurement model
Article number: e25
Article Type: Original Research |
Subject:
Police Related Psychology
Received: 2022/04/4 | Accepted: 2022/06/21 | Published: 2022/07/30
Received: 2022/04/4 | Accepted: 2022/06/21 | Published: 2022/07/30
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