Relationship Between Middle School Students' Social Skills and Their Characteristics in Child and Adolescent Psychiatry

Introduction

     In child and adolescent psychiatry, children were visited suffering from various difficulties of daily life. 45% of patients came to a child and adolescent psychiatry in Japan because of interpersonal troubles. It indicated nearly half children in child and adolescent psychiatry had interpersonal troubles.

     Social skills are based on intelligence, personality, language, nonverbal behavior and cognition. These are also used in interpersonal communication. Many patients in child and adolescent psychiatry had interpersonal problems, for that reason, it was considered that those patients had low social skills. It was pointed out that patients must raise social skills, so some patients took social skills trainings in child and adolescent psychiatry.

     Basic communication skills are not needed in a particular scene or situation but these are involved in overall interpersonal relations. The patients have many interpersonal troubles in various situations, so that those social skills are investigated by basic communication skills.

     Social skills are learned from family members’ behavior (e.g. mother, father, senior sibling, junior sibling and grandparents). These are strengthened from breeding and learning of socially desirable behavior. It was pointed out that students who have low social skills are bad interpersonal relation, so they tend to make troubles such as getting bullied, quarrel and school refusal.

     It was pointed that middle school students have developmental themes that are independence from parents and establishment of their identity. When it is revealed that relationship between middle school students’ social skills and family structure or school refusal in child and adolescent psychiatry, nurses get one of the evidence for considering intervention in the patients.

Purpose

     The purpose of this study is to clarify the relationship between middle school students’ basic communication skills and family structure or school refusal in outpatient child and adolescent psychiatry.

Methods

Subjects

     227 subjects visited child and adolescent psychiatry were recruited in the present study. It was recruited from 3 hospitals in Japan. Inclusion criteria were as follows: 1) middle school student; 2) not intellectual disability.

Measurement Instrument: Social skills assessment

     A basic communication skills scale for middle school students is an appropriate instrument to assess middle school students’ social skills involved in overall interpersonal relations, which is a self-administered questionnaire. There are 24 items and 4 subscales: behavioral expression (the skill that people convey their own feelings and though properly; 8 items), emotional regulation (the skill to deal with when their emotions is disturbed; 7 items), cognitive decoding (the skill that suitably receive the feelings and thoughts of others; 4 items) and cognitive monitoring (the skill that is thinking about their current feelings and thoughts and considering to stand in another’s position; 5 items). An item score ranges is from 1 (No) to 3 (Yes). The high score indicated high skills.

Demographic

     Demographic information (age, gender, grade, family structure and diagnosis) was investigated from medical record in hospitals. School refusal was investigated by asking participants.

Analyses

     The Mann-Whitney U test and Kruskal-Wallis test were used to detect difference in family structure and school refusal in the basic communication skills scale. The Statistical Package for Social Sciences (SPSS) version 22, at the 95% confidence level was used.

Ethical consideration

     This study was approved by University of Tsukuba Faculty of Medicine, Ethics Committee. Written informed consent that the aim and method of this study was obtained from participants and their parents or guardian caregivers before the initiation of any research procedures.

Results

     This study was involved 188 outpatients (participation rate=82.8%) (boy n=96, girl n=92) (7th-grade n=43, 8th-grade n=53, 9th-grade n=92) (attending school n=145, school refusal n=43) who were 13.7(+/-0.9)  years old. Living with one parent were 44, with two parents were 139 and with no parent were 5. Living with grandparents were 36 and with no grandparents were 152. 17 participants had junior and senior siblings, 77 had junior sibling, 41 had senior sibling and 53 had no sibling.

     There was no statistically significant differences between the number of parent, living with grandparents or not, sibling structure in the basic communication skills scale and all of its subscale. Scores from attending school in the basic communication skills, total score (median=48.0) was greater than those from school refusal (median=45.0, U=2336.5, p=.013). Behavioral expression score from attending school (median=15.0) was greater than those from school refusal (median=12.0, U=2433.0, p=.028). Emotional regulation from attending school (median=13.0) was greater than those from school refusal (median=10.0, U=2492.0, p=.045). No significant differences between attending school and school refusal in cognitive decoding score and cognitive monitoring score.

Discussion

     There were no statistically significant differences among family structure in the basic communication skills. Whereas that the basic communication skills score from attending school was greater than those from school refusal. The results indicated that social skills in middle school students had a greater relevance to the relationship with others outside the family than the relationship with family member. It was considered that nurses will need to be involved in patients in child and adolescent psychiatry to create patients’ interpersonal relations with others outside the family member and prompt in order to communicate. Nurses have to be aware that it can be made the target of middle school students’ interpersonal relationship, and should construct the interpersonal relationship and communication with patients in child and adolescent psychiatry.