Background: Modernization process brings in economic and demographic changes where traditional masculinity could be

forced to transform as men face conflicting messages about appropriate role norms.

Objectives: This study aimed to evaluate gender role conflict (GRC) among Malay adolescent boys and its associated

socio-demographic factors using the newly validated Malay GRCS-A.

Methods: A total of 282 Malay adolescent boys aged 13-17 from 6 secondary schools in Kota Bharu, Kelantan were randomly

selected and evaluated using the Malay GRCS-A and DASS-21 to assess GRC and psychological wellbeing respectively.

Results: GRC was significantly associated with anxiety and stress, but not with depression. Regression analysis showed GRC

was positively correlated with upper secondary school (older age) and negatively correlated with separated parents and very low

household income (< RM 1,000 per month).

Conclusion: This study adds to the growing literature of GRC, particularly in the Malay adolescent boys. High GRC potentially

worsen the already high prevalence of psychological distress among adolescents in Malaysi

Husain, Maruzairi

Mansor, Noorazida Zaharah

Othman, Zahiruddin

Yaacob, Mohd Jamil

Yasin, Mohd Azhar Mohd

Repository@USM

528 International Medical Journal Vol. 21, No. 6, pp. 528- 530 , December 2014PSYCHOLOGICAL MEDICINEGender Role Conflict among Malay Adolescent Boys inMalaysiaNoorazida Zaharah Mansor* 1’, Zahiruddin Othman2), Mohd Azhar Mohd Yasin2), Maruzairi Husain21, Mohd Jamil Yaacob3’ABSTRACTBackground: Modernization process brings in economic and demographic changes where traditional masculinity could be forced to transform as men face conflicting messages about appropriate role norms.Objectives: This study aimed to evaluate gender role conflict (GRC) among Malay adolescent boys and its associated socio-demographic factors using the newly validated Malay GRCS-A.Methods: A total of 282 Malay adolescent boys aged 13-17 from 6 secondary schools in Kota Bharu, Kelantan were randomly selected and evaluated using the Malay GRCS-A and DASS-21 to assess GRC and psychological wellbeing respectively.Results: GRC was significantly associated with anxiety and stress, but not with depression. Regression analysis showed GRC was positively correlated with upper secondary school (older age) and negatively correlated with separated parents and very low household income (< RM 1,000 per month).Conclusion: This study adds to the growing literature of GRC, particularly in the Malay adolescent boys. High GRC poten­tially worsen the already high prevalence of psychological distress among adolescents in Malaysia.KEY WORDSgender role conflict, Malay, adolescent, GRCS-AINTRODUCTIONGender role conflict (GRC) is defined as a psychological state in which socialized gender roles, learned in sexist and patriarchal societies, exert negative consequences for the person or others. GRC is the conse­quence of adhering or, alternatively, a result of failing to firmly adhere to masculine gender role norms". It occurs in situational contexts when men experience deviation from or failure to meet gender role norms of masculinity ideology, or discrepancies between their real self-concepts and ideal self-concepts, based on gender role stereotypes and masculini­ty ideology. GRC results in devaluation (i.e., negative critiques of self or others when conforming to, deviating from, or violating stereotypic gender role norms of masculinity), restrictions (i.e., confining others or oneself to stereotypic norms of masculinity), or violations (i.e., harming oneself, harming others, or being harmed by others when deviating from or conforming to gender role norms of masculinity ideology) of a per­son’s or another human potential2’. The male GRC has been linked to a number of negative outcomes such as harsh attitudes and behaviour toward women3’, decreased willingness to seek counselling4'6’, decreased willingness to refer friends and family members to seek help7’, increased levels of stress8’, and increased experience of male body dissatisfaction5’.Kelantan is a rural state with predominantly Malay Muslim popula­tion. It is an agrarian state with lush paddy fields and rustic fishing vil­lages. Most of the rural inhabitants are farmers and fisherman. Adolescent (age 10-19) constitutes 25.2% of the state populations with94.9% of them from ethnic Malay10’. Modernization process brings in economic and demographic changes where an increasing number of the population, especially in urban area, work in government and private sectors. These rapid social changes exerted considerable influence on living styles and family structure. Women may not strictly adhere to their traditional role as primary caregivers to infants'" as more women entered the labor force and play significant roles socially, economically and politically. The institutional, cultural, and economic changes sug­gest that traditional masculinity could be forced to transform in the face of the new realities in women's roles and that these changes could set the stage for increased gender role conflict as men face conflicting mes­sages about appropriate role norms. Additionally, increasing physical differentiation between boys and girls during puberty sets in motion more pressure by socialization agents to conform to conventional gen­der-differentiated social roles and creates greater adolescent awareness of gender differences12’. Gender identity development can be an arduous process in adolescents which have great and lasting effects on adoles­cent development13’. The objective of this study, therefore, was to evalu­ate GRC among Malay adolescent boys and its associated socio-demo- graphic factors.Received on May 15, 2014 and accepted on October 1, 20141) Hospital Tengku Ampuan Afzan 25100 Kuantan, Pahang, Malaysia2) School of Medical Sciences, Universiti Sains Malaysia 16150 Kubang Kerian, Kelantan, Malaysia3) A1MST UniversityJalan Semeling-Bedong, 08100 Bedong, Kedah, MalaysiaCorrespondence to: Zahiruddin Othman(e-mail: zahirkb@usm.my)(6) 2014 Japan Health Sciences University& Japan International Cultural Exchange FoundationMansor N. Z. et al. 529Table 1. Simple linear regression analysis to determine factors associated with total GRCS-A score (n = 282)Variables Frequency (%) Simple Linear Regressionb‘(95% Cl) P-vaiueAge (mean, SD) 15.1 (1.3) 4.03 (2.49, 5.57) <0.001FormLower form 165 (58.5) -Upper form 117(41.5) 11.16(6.98, 15.33) <0.001Parents' marital statusTogether 255 (90.4) -Separated 6(2 .1) -18.27 (-33.07,-3.47) 0.016Divorced/Died 21 (7.4) -1.88 (-10.10, 6.34) 0.653Living with whomBoth 250 (88.6) -Father 6(2 .1 ) 1.82 (-13.13, 16.77) 0.811Mother 14(5.0) -8.97 (-18.85, 0.91) 0.075Others 12 (4.3) -10.32 (-20.94, 0.30) 0.057Income per month (RM)High (> 5000) 149 (52.8) -Middle (3000-4999) 70 (24.8) 4.72 (-1.51, 10.94) 0.137Low (1000-2999) 39(13.8) 2.23 (-2.76, 7.21) 0.380Very low (< 1000) 24 (8.5) -4.28 (-8.57, 0.02) 0.050Siblings (median, IQR)Boy 3.0 (2) 1.21 (-0.15, 2.58) 0.081Girl 2.0 (2) -0.39 (-1.71, 0.94) 0.568House choresNot according to gender 77 (27.3) -According to gender 205 (72.7) -0.80 (-5.65, 4.04) 0.744“crude regression coefficientM E T H O D O L O G YPartic ipantsThe study protocol was approved by the Human Research Ethics Committee of USM and Kelantan State Education Department. A list of secondary schools in Kota Bharu district was obtained from the state education department. Every 7,h school in the list was chosen using sim­ple stratified random sampling technique. The school authorities then randomly selected male students from a list of all the form 1 to form 5 students in the 6 selected secondary schools. The students were told that participation was voluntary and anonymous. A total of 282 Malay male students, whose parents, guardians or teachers had given written informed consent, agreed to take part in the study. The first author administered a set of questionnaires consisting of socio-demographic proforma, the Malay GRCS-A'1" and DASS-21l5). All participants filled up the questionnaires in the classroom in the presence of the researcher, or a class teacher, or both to assist them with understanding the items.Instrum entsThe Gender Role Conflict Scale for Adolescents (GRCS-A) is rated on a 6-point Likert scale from 1 (strongly agree) to 6 (strongly disagree) that measures negative aspects of male gender role associated with per­sonal restriction, devaluation, or violation of self and others in adoles­cent boys. It consists of 29 items in 4 subscales; restricted affection between men (RABM), restricted emotionality (RE), conflict between work, school, and family (CWSF) and, need for success and achieve­ment (NSA). Total scores can range from 29 tol 16, with higher scores indicating greater gender role conflict'6’. It was translated into Malay and validated for use in local adolescent boys. The internal consistency coefficients of each subscale and total Malay GRCS-A were good with RABM 0.58, RE 0.65, CWSF 0.64, NSA 0.62, and total scale 0.76'4’.The DASS-21 is designed to measure negative emotional states of depression, anxiety and stress. It consists of three 7-item self-report sub­scales rated on 4-point severity/frequency scales for each state experi-Table 2. Multiple linear regression analysis to determinefactors associated with total GRCS-A score (n = 282)Variables Multiple Linear RegressionAdjusted b" (95% Cl) t stat P-valueForm 10.84 (6.70, 14.98) 5.15 <0.001Parents separated -14.94 (-29.09, -0.79) -2.08 0.039Very low income -4.13 (-8.21,-0.05) -1.99 0.047“adjusted regression coefficientR2 = 0.342. The model reasonably fits well. Model assumptions are met. There are no interaction and multicollinearity problem.Table 3. Simple logistic regression analysis of GRCS-A and DASSDASS subscaleCrude OR (95%)Simple Logistic Regression Wald statistics (df) P-valueDepression 1.017(0.999, 1.034) 3.475 0.062Anxiety 1.014(1.001, 1.028) 4.157 0.041Stress 1.024(1.004, 1.044) 5.613 0.018enced over the past week. The Malay language (BM DASS-21) has good Cronbach's alpha values for depression, anxiety and stress at 0.84, 0.74 and 0.79 respectively. Additionally, it has good factor loading val­ues for most items ranging 0.39 to 0.73'5’. A study in Australia found that it measures depression and anxiety quite similarly as in adults1”. However, the stress assessment in adolescent may need further evalua­tion.Statistical analysisFrom the data analysis, all the data were normally distributed based on histogram and Kolmogorov-Smimov test. Therefore, parametric test was selected. The association between socio-demographic data and gen­der role conflict were initially analyzed using simple linear regression (SLR) before further test using multiple linear regressions (MLR) to measure the strength of the relationship with gender role conflict and also to provide a way of controlling for confounding factors.RESULTSA total number of 290 participants from 6 secondary schools in Kota Bharu district were recruited for this study. The response rate was 97.2% as 8 students did not complete all the answers and was excluded from the analysis. Most of the participants lived with both parents (88.6%), and the house chores were divided according to gender (72.7%). More than half of the participants' fathers were self-employed (55.7%) while the mothers were housewives (63.5%), and household income of more than RM 5,000 (52.8%). The GRCS-A total, RABM, RE, CWSF and NSA scores (mean, SD) were 112.9 (18.4), 24.4 (8.2), 34.8 (7.0), 24.9 (6.1) and, 28.7 (4.2) respectively.Socio-demographic factors age, upper form, separated parents, liv­ing with mother or others and, middle and very low income emerged as factors with P-value level < 0.25 in SLR analysis. These factors were further subjected to MLR analysis. The interpretation of the final model of GRC associated factors are; 1) Participants in upper secondary school were more likely to have a higher GRCS-A score; 2) Participants whose parents were separated tend to have lower GRCS-A score and; 3) Participants from very low household income were likely to have lower GRCS-A score. The model explained 34% of variation of the total GRCS-A score (R2 = 0.342) with the 3 significant variables. Finally, simple logistic regression analysis of GRCS-A and DASS, showed GRC was significantly correlated with anxiety and stress in the participants. The correlation with depression, however, was not significant (P = 0.062).530 Gender Role Conflict among Malay Adolescent BoysDISCUSSIONThree associated factors were identified in this study. Firstly, Malay adolescent boys from the upper form (age 16-17) had more GRC com­pared to those in lower form (age 13-15). In other word, the older boys tend to have more GRC. This is consistent with the findings that college men had higher GRC score compared to middle age men especially in success, power and competition factor and conflict between work, fami­ly and rest181. It showed that gender stereotyping follows a curvilinear age pattern in which it is low at early ages, before gender becomes important factor in dealing with people; then higher, when relationship or career choices become important and finally lower, when young adults accept greater flexibility for gender related behavior. There will be general increase in tolerance for gender atypical activities for self and others despite how family and peer social environment influenced gender related behavior with increasing age. Apart from that, increase in gender role knowledge preceded increases in gender role flexibility which usually increases during adolescence.Secondly, Malay adolescent boys whose parents were separated had less GRC compared to boys whose parents were still together or had divorced. Parents are the models of children's gender role attitudes where they inevitably involve in guiding and reinforcing any sex-typed behavior onto their children by encouraging gender-stereotypical activi­ties'91. Maternal and paternal authoritativeness was found to be signifi­cantly correlated with college students' femininity201. High level of fathers’ involvement particularly with sons may reinforce a more tradi­tional gender ideology as father tends to react negatively to crying and fearfulness in sons than in daughters2'1. A study noted higher levels of mother-child conflict and higher levels of father-child conflict in the tra­ditional group compared to the divergent and egalitarian family221. However, there is no strong evidence to support that parental divorce or parental marital disharmony to have implications for egalitarian views about roles of men or women and cause less GRC among the male ado­lescent involved.Thirdly, Malay adolescent boys from very low household income had lower GRC. Socioeconomic factors may affect family gender role attitudes with women and men who were noted to express more egali­tarian gender role attitudes have higher educational level and achieve­ment, as well as income231. Women who contribute more to the family tend to be more egalitarian and children from more economically advan­taged family backgrounds are noted to have more egalitarian gender attitudes. Higher education provides jobs with higher salary and the ability to contribute more to the family economy. Nevertheless, this finding was not consistent with the general ideas that lower socioeco­nomic status or education is associated with higher GRC.This study adds to the growing literature of GRC, in particular the adolescent boys. Higher GRC was significantly associated with psycho­logical wellbeing of Malay adolescent boys, specifically anxiety and stress, as well as older age. GRC was lower among Malay adolescent boys whose parents had separated suggesting the possibility that mascu­linity ideology was less prominent. Low socio-economic status, surpris­ingly, was associated with low GRC which warrant further study in future. 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Gender Role Conflict among Malay Adolescent Boys in

Malaysia

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Gender Role Conflict among Malay Adolescent Boys in Malaysia

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