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Relationship of verbal aggresiveness with self-esteem and depression in verbally aggressive adolescents at public middle school
Nindy Atika Rahayu, Achir Yani S. Hamid
Corresponding author
achir@ui.ac.id

Corresponding author.
Faculty of Nursing, Universitas Indonesia, Depok, West Java, Indonesia
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Adolescence spans from 11 to 20 years of age and is divided into three phases&#58; early &#40;11&#8211;14 years&#41;&#44; middle &#40;15&#8211;17 years&#41;&#44; and late adolescents &#40;18&#8211;20 years&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">1</span></a> Fundamentally&#44; the family is the source of security to support adolescents development&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">2</span></a> When the sense of security is family is not fulfilling&#44; adolescents will turn to friends to satisfy their needs of friendship&#44; self-esteem&#44; and intimacy&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">2</span></a> When failing to belong to a group of friends&#44; adolescents may encounter low self-esteem&#44; loneliness&#44; and depression&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">3</span></a> Therefore&#44; some adolescents showing the typical attributes of group to be accepted&#44; even by committing violent behavior such as verbal aggressiveness&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Verbal aggressiveness is a behavior of using aggressive language which can violate the rights of others&#44; usually in the form of interrupting habit&#44; sarcasm&#44; or other forms of verbal abuse&#44; including bullying&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">4</span></a> The perpetrators may become popular in the group&#44; which has the same attitude and have an increased self-esteem accordingly so that they keep this behavior&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">3</span></a> Some studies found that adolescents with verbal aggressiveness usually have low life satisfaction&#44; poor family background&#44; and low self-esteem&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">5</span></a> On the other hand&#44; the victims of verbal abuse may experience psychological trauma and even psychiatric disorders&#44; such as panic attacks&#44; phobias&#44; and depression&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Self-esteem is an individual&#39;s personal judgment about self-worth based on the person&#39;s self-ideal&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">6</span></a> Self-esteem has an important role for adolescents to develop the identity and the basic self-attribute to connect with others in meaningful and satisfying relationships&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">7</span></a> In addition&#44; self-esteem also reflects the success of adolescents in adapting to the world&#46; Self-esteem can be shaped by the person&#39;s experience related to their own perception of self-worth&#44; often referred to as the &#8216;bottom line&#8217;&#44; which specifies their response when a similar situation arises&#44; regardless of the appropriateness&#46; If a person keeps applying an inappropriate response to a situation&#44; and never change it&#44; then low self-esteem may persist and can lead to depression&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">6</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">In 2018&#44; Indonesia ranked 65th in the global suicide prevalence&#44; with 2&#46;9 suicide incidence per 100&#44;000 people&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">8</span></a> In 2015&#44; 40&#37; of children and adolescents committed suicide due to bullying&#46; Meanwhile&#44; the Indonesian Child Protection Commission revealed they had received reports of 26&#44;000 cases of bullying from 2011 to September 2017&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">9</span></a> The Indonesian National Development Planning Agency showed that until May 2018&#44; Indonesia&#39;s youth population had reached 45&#46;1 million or 17&#37; of the total Indonesia population&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">10</span></a> Given the growing number of adolescents in Indonesia&#44; coupled with the increase in psychosocial matters surrounding this young population&#44; it is important to assess the verbal aggressiveness among adolescents&#46; In this study&#44; we investigated the relationship of verbal aggressiveness with the self-esteem and depression in Indonesian adolescents who were committed verbal aggression&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Method</span><p id="par0025" class="elsevierStylePara elsevierViewall">A cross-sectional&#44; descriptive-correlative design was used in this study&#46; The participants were recruited at a public middle school in Jakarta&#44; Indonesia&#44; using purposive sampling&#46; We screened all grade VII and VIII students for verbal aggressiveness and had 415 eligible students who took part in the study&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Three questionnaires were used to measure the variables&#44; the Verbal Aggressiveness Scale &#40;VAS&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">11</span></a> Rosenberg Self-Esteem Scale &#40;RSES&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">12</span></a> and 11-item Kutcher Adolescent Depression Scale &#40;KADS-11&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">13</span></a> We modified these questionnaires and tested them for the validity and reliability of 30 students of another middle school in Jakarta&#46; All questionnaires were found to be valid and reliable &#40;Cronbach&#39;s Alpha of VAS<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;851&#59; RSES<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;848&#59; KADS-11<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;758&#41;&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Data were analyzed univariately and bivariately to describes the characteristics of each variable and assess the relationships of variables&#46; The independent variable of this study was the verbal aggressiveness&#44; while the dependent variables were self-esteem and depression&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">We adhered to ethical principles for research involving human subjects&#46; Ethical approval was issued by the Ethics Committee of the Faculty of Nursing&#44; Universitas Indonesia&#44; in the letter number SK-202&#47;UN2&#46;F12&#46;D1&#46;2&#46;1&#47;ETIK&#46;FIK&#46;2019&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="par0045" class="elsevierStylePara elsevierViewall">The adolescents in this study were aged 12&#8211;14 years &#40;mean<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>13&#46;48&#41;&#44; which fell into the early adolescent age bracket&#46; We had a fairly similar proportion of the adolescent boys and girls who had committed verbal aggressiveness &#40;48&#46;9&#37; male&#59; 51&#46;1&#37; female&#41;&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The summary of the verbal aggressiveness&#44; self-esteem&#44; and depression categories of the participants are presented in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">Concerning the verbal aggressiveness&#44; the majority of the participants did a moderate level of verbal aggressiveness &#40;55&#46;9&#37;&#41;&#46; According to the age group&#44; the oldest group &#40;14 years&#41; had committed more verbal aggressiveness&#46; We also found that girls had more significant and moderate levels of verbal aggressiveness than their boy counterparts &#40;16&#46;5&#37; vs&#46; 4&#46;4&#37; at the significant level&#59; and 56&#46;6&#37; vs&#46; 55&#46;2&#37; at the moderate level&#41;&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">From the self-esteem categorization&#44; we can see that more than half of the participants &#40;54&#46;5&#37;&#41; had high self-esteem&#46; A higher number of adolescents with high self-esteem is found in grade VIII&#44; aged 14 years&#44; and adolescent boys&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Furthermore&#44; we obtained half of the participants in this study &#40;50&#46;4&#37;&#41; reported to have depression&#46; The distribution of depression was somewhat fair in grade VII and VII participants&#46; While the adolescents aged 13 years had a slightly higher proportion of depression &#40;53&#46;0&#37;&#41;&#44; the proportion was notably high among the adolescent girls &#40;61&#46;3&#37;&#41;&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">We then performed the Pearson product-moment test to see the relationship between the verbal aggressiveness and self-esteem of the participants &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">The verbal aggressiveness was statistically significantly correlated with self-esteem &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;000&#41;&#46; The <span class="elsevierStyleItalic">Pearson correlation</span> value between these two dimensions was &#8722;0&#46;191&#44; indicating the higher the verbal aggressiveness level of the participants&#44; the lower their self-esteem&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Finally&#44; we conducted a Mann&#8211;Whitney test to analyze the correlation between verbal aggressiveness and depression &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">The correlation was found to be statistically significant &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;000&#59; <span class="elsevierStyleItalic">Z</span> value<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;4&#46;274&#41;&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Discussion</span><p id="par0090" class="elsevierStylePara elsevierViewall">Puberty occurs at the adolescents period and is associated with emotional instability&#44;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">1</span></a> and at the same time&#44; increasing autonomy and the need of friendship&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">14</span></a> To be accepted at a certain peer group&#44; adolescents may exhibit the behavior related of the group&#44; including verbal aggression or bullying&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">3</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">We had 51&#46;1&#37; girl participants&#44; a little higher than the boy participants&#46; Whereas&#44; in a prior study done by Febriawan&#44; Takwin&#44; &#38; Muhamad&#44; adolescent boys tended to have a higher average of verbal aggressiveness scores than the adolescent girls&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">15</span></a> Our finding is also different from the previous study in Indonesia that found adolescent boys tend to have a higher average verbal aggressiveness score than the adolescent girls&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">15</span></a> Different location&#44; demography&#44; and the limitation of this cross-sectional study design may explain this difference&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">16</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">We also found 55&#46;9&#37; of 415 participants have done a moderate level of verbal aggressiveness&#46; Verbal aggressiveness may emerge when family&#44; as the main support system of the adolescents&#44; is not fulfilling its role&#44; which leads the teenagers to look for peer groups to replace that roles&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">2</span></a> The verbal aggression problem arises when the peer group chosen by the adolescents has a tendency toward verbal aggression&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">The results of this study are in accordance with the Bandura&#39;s social learning theory&#44; which argues that aggressive behavior can be learned from the environment&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">16</span></a> Bandura argue that adolescents learn the behavior by imitating their peers or other people and receiving positive response from others toward their learned behavior&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">16</span></a> Fourteen years-old adolescents in this study reported a higher level of verbal aggressiveness&#46; All participants&#44; however&#44; were in the early adolescence&#44; which previous studies had indicated its increasing trend of verbal aggressiveness&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">6</span></a></p><p id="par0110" class="elsevierStylePara elsevierViewall">Regarding self-esteem&#44; we found that more adolescents who had been committing verbal aggressiveness &#40;54&#46;5&#37;&#41; had high self-esteem&#46; On the other hand&#44; Esteves&#44; Jimenez&#44; &#38; Moreno reported that verbal aggressive adolescents tend to have low self-esteem&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">5</span></a> The results of this study are in accordance with the literature&#44; which states that as we age&#44; our personality will develop in a more mature direction&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">17</span></a> In addition&#44; girls are more susceptible to lower self-esteem&#44; as in our study finding&#44; because they tend to be more sensitive so that they are easier to feel sad and lonely&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">18</span></a> A research in Bulgaria also found that girls had lower self-esteem levels than the adolescent boys&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">19</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">Around half of the adolescents in this study &#40;50&#46;4&#37;&#41; reported to have depression&#46; Adolescents coming from the dysfunctional family may have academic as well as social problems&#44; which then can contribute to the emergence of depressive symptoms in adolescents&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">20</span></a> Poor relationship with peers is also linked to depression in adolescents&#44; according to Vanhalst &#38; Lau&#44; as cited by Santrock&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">20</span></a> Adolescents who do not have close friends&#44; lacked interaction with friends&#44; and rejected with peers are more prone to get depressed&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">20</span></a> This notion is supported by research from Bukowski&#44; Laursen&#44; &#38; Hoza that found friendship can prevent depression in adolescents&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">20</span></a></p><p id="par0120" class="elsevierStylePara elsevierViewall">As in low self-esteem&#44; depressions were found in a larger proportion of adolescent girls &#40;61&#46;3&#37;&#41;&#46; This finding is aligned with previous study findings that depression is more common among adolescent girls&#46;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">18&#44;20</span></a> Rose et al&#46; argue that hormonal imbalance can bring a heightened emotional instability&#44; which may lead to depression in girls&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">20</span></a> However&#44; we did not examine further how these factors can influence the level of depression of adolescents&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">The result of this study demonstrates the correlation between verbal aggressiveness and self-esteem in adolescents who committed verbal aggression&#46; We also found that the higher the level of verbal aggressiveness&#44; the lower the self-esteem&#46; This finding agrees with the study result of Esteves&#44; Jimenez&#44; and Moreno&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">5</span></a> Walker and Bright&#44; as cited by Teng&#44; Liu&#44; and Guo argued that people with low self-esteem tend to behave aggressively to protect themselves&#44; to cover up feeling awkward&#44; and eventually increase their self-esteem again&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">2</span></a> The high social status in the eyes of peers can make teenagers more confident and increase their self-esteem&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">3</span></a> As explained by the social learning theory&#44; the reinforcement of aggressive behavior in the adolescent&#39;s social environment may sustain such behavior&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">16</span></a></p><p id="par0130" class="elsevierStylePara elsevierViewall">There was also a significant relationship between verbal aggressiveness and depression in this study&#46; This result is in accordance with the result of the prior studies&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">5</span></a> The depressive symptoms in the perpetrators of verbal aggression can be caused by family factors that also trigger the verbal aggression behavior&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">20</span></a> When the adolescents need for the family&#39;s role as the main support system is not appropriately fulfilled&#44; the adolescent tends to have depressive symptoms and then will turn to peers as their major support system&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">2</span></a> However&#44; we did not examine the factors that affect depression in the respondents so that further research is needed&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conclusion</span><p id="par0135" class="elsevierStylePara elsevierViewall">From all participants in this study&#44; 55&#46;9&#37; committing a moderate level of verbal aggressiveness&#44; 45&#46;5&#37; had low self-esteem&#44; and 50&#46;4&#37; experienced depression&#46; This study also indicated a significant relationship between verbal aggressiveness and self-esteem in early adolescents with verbal aggression&#46; The relation between verbal aggressiveness and depression in early adolescents with verbal aggression are also shown&#46; Accordingly&#44; it is important to pay more attention to the verbal aggression incidents in early adolescents&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conflict of interest</span><p id="par0140" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest&#46;</p></span></span>"
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          "identificador" => "xpalclavsec1358792"
          "titulo" => "Keywords"
        ]
        2 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        3 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Method"
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        4 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Results"
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        5 => array:2 [
          "identificador" => "sec0020"
          "titulo" => "Discussion"
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        6 => array:2 [
          "identificador" => "sec0025"
          "titulo" => "Conclusion"
        ]
        7 => array:2 [
          "identificador" => "sec0030"
          "titulo" => "Conflict of interest"
        ]
        8 => array:2 [
          "identificador" => "xack524141"
          "titulo" => "Acknowledgements"
        ]
        9 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2020-09-15"
    "fechaAceptado" => "2020-09-21"
    "PalabrasClave" => array:1 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1358792"
          "palabras" => array:5 [
            0 => "Verbal aggressiveness"
            1 => "Verbal aggression"
            2 => "Early adolescents"
            3 => "Depression"
            4 => "Self-esteem"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:1 [
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">This study determines the relationships of verbal aggressiveness with self-esteem and depression in early adolescents&#46; Quantitative&#44; cross-sectional design were conduct in 415 middle school students with verbal aggressiveness in Jakarta that has been screened as participants&#46; The Verbal Aggressiveness Scale &#40;VAS&#41;&#44; Rosenberg Self-Esteem Scale &#40;RSES&#41;&#44; and 11-ITEM Kutcher Adolescent Depression Scale &#40;KADS-11&#41; questionnaires that had been validity and reliability tested were used&#46; From all participants&#44; 55&#46;9&#37; committing a moderate level of verbal aggressiveness&#44; 45&#46;5&#37; had low self-esteem&#44; and 50&#46;4&#37; experienced depression&#46; The Pearson product-moment test showed a significant relationship between verbal aggressiveness and self-esteem in early adolescents with verbal aggression&#44; while the Mann&#8211;Whitney test also indicated verbal aggressiveness and depression in early adolescents with verbal aggression are related&#46; This study recommends related parties to pay more attention to the verbal aggression incident in early adolescents&#46;</p></span>"
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Peer-review under responsibility of the scientific committee of the 4th International Conference for Global Health &#40;ICGH&#41; in conjunction with the 7th Asian International Conference in Humanized Health Care &#40;AIC-HHC&#41;&#46; Full-text and the content of it is under responsibility of authors of the article&#46;</p>"
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        "detalles" => array:1 [
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            "identificador" => "at1"
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          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Participant&#39;s verbal aggressiveness&#44; self-esteem&#44; and depression categories &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>415&#41;&#46;</p>"
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Verbal aggressiveness&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;191<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;000&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t">209&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t">232&#46;91&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="center" valign="\n
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ISSN: 11308621
Original language: English
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es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

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Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos