Three distinct mental health and behavioral risk profiles were identified among Bangladeshi adolescents, with sexual abuse (aOR=2.64) and witnessing violence against the mother (aOR=3.56) as the strongest predictors of high-risk membership, and females exposed to household mental illness at disproportionately higher risk.
Key Findings
Results
Latent class analysis identified three distinct mental health and behavioral risk profiles among Bangladeshi adolescents.
The three classes were: low risk (36.3%), moderate risk (36.1%), and high risk (27.6%).
Classification was based on emotional symptoms, conduct problems, insomnia, suicidal behavior, truancy, physical fights, bullying, and peer/social isolation.
The sample consisted of N=1040 adolescents from a cross-sectional school-based survey in Bangladesh.
The high-risk class showed elevated internalizing symptoms, externalizing behaviors, and psychosocial adversities including conduct problems, loneliness, truancy, bullying, and physical fighting.
Results
Witnessing violence against the mother was the strongest predictor of high-risk class membership among adverse childhood experiences.
Witnessing violence against the mother had an adjusted odds ratio of 3.56 for high-risk class membership.
This was identified as the strongest predictor in the fully adjusted multinomial logistic regression model.
This finding highlights domestic violence exposure as a particularly potent adverse childhood experience for adolescent mental health outcomes.
Results
Sexual abuse was a strong predictor of high-risk mental health and behavioral class membership.
Sexual abuse was associated with an adjusted odds ratio of 2.64 for membership in the high-risk class.
Sexual abuse was identified as one of the two strongest predictors of high-risk membership in the fully adjusted model.
This association was identified through multinomial logistic regression examining adverse childhood experiences (ACEs) as predictors of latent class membership.
Results
Lack of peer support was significantly associated with both moderate-risk and high-risk class membership.
Lack of peer support was associated with increased odds of moderate-risk membership (aOR=2.13).
Lack of peer support was also associated with increased odds of high-risk membership (aOR=2.25).
The similar magnitude of association across both risk groups suggests peer support deficits are broadly relevant across the risk spectrum, not only for the highest-risk adolescents.
Results
Poor parental understanding was significantly associated with moderate-risk class membership.
Poor parental understanding increased the odds of moderate-risk classification (aOR=1.70).
This finding was identified in the fully adjusted multinomial logistic regression model.
The association was specific to moderate-risk rather than high-risk membership, suggesting differential roles for family relational factors across risk levels.
Results
Female adolescents exposed to household mental illness had disproportionately higher odds of belonging to the high-risk class.
This finding emerged from an interaction model examining gender and household mental illness exposure.
The interaction between female sex and household mental illness predicted disproportionately higher odds of high-risk class membership.
This suggests a gender-specific vulnerability to familial mental illness as an environmental stressor during adolescence.
The finding supports the need for gender-sensitive interventions in this population.
Results
More than one quarter of the adolescent sample was classified as high-risk for mental health and behavioral problems.
27.6% of the sample of 1040 Bangladeshi school-based adolescents fell into the high-risk class.
An additional 36.1% were classified as moderate risk, meaning nearly two-thirds of the sample were not in the low-risk category.
The study was conducted in Bangladesh, a low- and middle-income country (LMIC) where mental health concerns among adolescents remain under-recognized.
The authors note that adolescents in LMICs experience a disproportionately high burden of emotional and behavioral problems shaped by early adversities, limited psychosocial support, and structural disadvantages.
What This Means
This research suggests that among a large sample of school-going adolescents in Bangladesh, nearly two-thirds showed at least moderate levels of mental health and behavioral concerns when researchers used a statistical method to group students by their symptom patterns. Three distinct groups emerged: low risk (about 36%), moderate risk (about 36%), and high risk (about 28%). The high-risk group had elevated rates of emotional problems, conduct issues, sleep difficulties, suicidal behavior, school avoidance, bullying involvement, and social isolation all occurring together.
The study found that certain childhood experiences and social factors strongly predicted which group a young person fell into. Witnessing violence against their mother and experiencing sexual abuse were the most powerful predictors of being in the high-risk group. Lacking peer support roughly doubled the odds of being in either the moderate- or high-risk group, while poor parental understanding was linked to moderate risk. Girls who lived in households where a family member had a mental illness were at especially elevated risk compared to boys in the same circumstances, pointing to a gender-specific vulnerability.
This research suggests that adolescent mental health challenges in Bangladesh — and likely in other similar settings — are not random but cluster in identifiable patterns tied to trauma, family environment, and gender. The findings point to the importance of trauma-informed approaches that specifically address household violence exposure and sexual abuse, as well as programs that strengthen peer relationships and parental responsiveness. The gender difference in response to household mental illness also suggests that support programs may need to be tailored differently for girls and boys.
Al-Mamun F, ALmerab M, Mamun M. (2026). Identifying Adolescent Mental Health and Behavioral Risk Profiles: The Role of Childhood Adversities, Family Environment, and Peer Support.. Brain and behavior. https://doi.org/10.1002/brb3.71531