Role of Resilience in the Relationship between Adverse Childhood Experiences and Behavior Problems among Thai Adolescents in a Province of Southern Thailand: A School-Based Cross-Sectional Study

Objective: This study aimed to investigate the relationship between adverse childhood experiences (ACEs), behavior problems, and resilience among adolescents in Southern Thailand, with a particular focus on the role of resilience in mediating the relationship between ACEs and behavior problems. Materials and Methods: A paper-and-pencil questionnaire, covering participants’ general information, ACEs, behavior problems, and resilience, was distributed to 383 senior high school students in a province in Southern Thailand. The data was analyzed using descriptive statistics, correlation analysis, and path analysis. Results: Out of the 383 students the questionnaire was distributed to, 374 completed the questionnaire, resulting in a response rate of 97.65%. Alarmingly, 59.36% of the respondents reported experiencing at least one type of ACE. Correlation analysis revealed a significant positive association between ACEs and behavior problems (r=0.17, p<0.01) and a negative correlation with resilience (r = -0.19, p<0.01). Path analysis demonstrated that ACEs directly influenced behavior problems (β=0.23, p<0.01) and resilience (β = -0.24, p<0.01). However, the analysis did not support the hypothesis that resilience mediates the relationship between ACEs and behavior problems. Conclusion: The findings indicate a troubling prevalence of ACEs among senior high school students in Thailand, likely contributing to current adolescent behavior problems. Although the study's path analysis did not align with prior research, it emphasizes the critical role of resilience in mitigating the adverse effects of ACEs. Therefore, resilience remains a necessary skill in helping adolescents cope with the consequences of adverse childhood experiences.