Exploring the Psychosexual Problems among Young Teenagers: Case Study at Asrama Bahagia (Rehab Centre)

The aim of this research is to explore the psychosexual problems among teenagers at Asrama Bahagia (Rehab Centre), Kuala Lumpur. We can analyze that delinquency activity seen as tumor cells spreading into the human body widely nowadays. In fact, there are countless factors that contribute to the reasons why teenagers are involved in social delinquency activities, yet the issues are still subjected to in depth investigation. This is a qualitative study involving seven trainees at a selected shelter of sexually active teenagers situated in Kuala Lumpur. This study employee’s different technique of data collection which consist of interview, focus group discussion and observation. The findings indicated that the severity of negative social circles influences, lead the teenagers to negative behavior pattern. Peer influences, social media and digital media are three main factors that trigger psychosexual behavior among teenagers and health problems, disowned by family & society and unwanted pregnancy are the major consequences faced by teenagers involved in psychosexual activity. This study recommends further research to be carried out using larger sample size include both gender (male and female) and may consider to test is the relationship between parenting styles and teenagers’ involvement in psychosexual activities.


Introduction
The increase in social problems among the adolescents is very alarming around the globe and Malaysia is not an exception. The decline in social and moral conduct among our teenagers is a serious concern. The involvement of our adolescents into social delinquency activity seen as tumor cells spreading into the human body till date there's no one solution to solve this issues or no single method to curb the issues from spreading widely. There are various types of social delinquency which involves todays' younger generation such as smoking, 'fix' (illegal racing), gangsters, the act of bullying, free sex practice, unplanned pregnancy, illegitimate child, drug abuse, child abandonment and sexual assault. The sudden increase in the number of teenagers' involvement in such activities captured the attention of related government and authorities in Malaysia (Cheng, 2014). Deputy Prime Minister and Women, Family and Community Development Minister Datuk Seri Dr. Wan Azizah Wan Ismail pointed out "among [other leading cases than] illegitimate children and baby dumping were incest, child abuse, domestics violence, premarital sex and pornography" (Teo,2018). Additionally, teenagers getting involved in various forms of social illnesses is a worrying issue in Malaysia. Adolescents can be easily influenced by peer pressure, mass media, cultural shock, trial and error attitude, promiscuity, poor family background and poor environment. This is supported by a study conducted by Alimoradi et al (2015) which suggested that there are four main factors: personal, family, peers, school and community which contribute to high risk sexual behavior among teenagers. Lim (2018) pointed out that "peer influence [has] contributed significantly in [teen] pregnancies". Furthermore, in another study conducted by Boricic et al (2015) in Serbia proved that there is a strong association between demographic characteristics and socio-economic status in engaging risky behavior among teenagers. A study conducted by Nasir (2016) shows that low family socioeconomic status, experienced of physically and/or sexually abuse by family members, and lack of relationship between respondents and their parents influenced the involvement of respondent in delinquency. As a nation progresses, living expenses increases and it affects significantly on family institutions as both parents are required to work in order to support the rising cost of living. According to Lum (2018), a study was conducted in two different teenage shelter homes where the result indicated that half of the participants reported had poor communication with their parents to discuss their personal problem. The hectic work schedule of parents lead them to spend less time in educating moral values and set good behavioral examples to their children. This is supported by the findings from a study conducted by Shahruddin et al (2018) shows that the parent-child attachment and self-esteem is related to attitude sexual behavior and therefore parents should maximize time to ensure that youth do not feel isolated in the family. The study will be beneficial in creating positive surrounding in the regards of the importance living environment which influences the adolescent's lifestyles in building good relationship with parents, teachers, peers and society. Parents and teachers will be equipped with more in depth information and knowledge in managing and nurturing the mischievousness teenagers. The implementation of suggest recommendations from the study could assist the local governmental and private sector of children department in taking necessary steps to curb the issues from escalating. In order to cater this issue, the teenagers themselves should also be prepared with adequate knowledge on sex education. The lack of reproductive health education among teenagers is worrying as it is necessary for them to acknowledge about the importance of reproductive health such as hygiene, reproduction process, robust of the irresponsible behavior such as unplanned pregnancy, abortion and sexually transmitted diseases. Lum (2018) concluded that there is insufficient sexual and reproductive health knowledge among teenagers. A study conducted by Malaysian Youth Sexual and Reproductive Health Survey in 2015 proved that sexually active teenagers have low level of knowledge regarding sex, protection against pregnancies and sexually transmitted diseases (Teo, 2018). Therefore, the findings will be an eye-opener for the adolescent as it will reveal the risks that involved in such delinquency activity. This helps adolescents to have a better understanding of their risky acts, thoughts, vulnerability and challenges faced by them. The purpose of this study is to identify the involvement of psychosexual issue happened among teenagers in Asrama Bahagia, Kuala Lumpur and to investigate the implication of adolescents' involvement in psychosexual activity. Most research done till this date merely conclude that the turmoil is progressing vigorously, it's correlation to moral acts and the trigger factors. In order to address these issues effectively, focus should be given on how to manage and control young teenagers from being exposed to such activities. An observation on the cause and effect relationship regarding psychosexual issues involving teenagers would help to achieve that objective.

Method
A qualitative research approach was followed for the purpose of this study. The study took place in Asrama Bahagia located in Kampung Pandan, Kuala Lumpur. Approximately sixty-four teenagers are placed at this correction facility to which they have been sentenced for a period of one to three years. The participants of this case study are seven females who are sexually active teenagers between the age range of thirteen to eighteen years old. In this study purposive sampling technique was chosen as this technique enables the researcher to gain better insights from participants' perspectives.

Data Collection
The researcher conducted semi structured interview in an informal conversation manner in the meeting room of the institution on September 27, 2019 with the seven participants and one staff of the institution as mentioned earlier was audio recorded. A focus group discussion was held on September 28, 2019 in the activity hall of the institution. On September 29, 2019 seven participants were observed of their daily activities and the reflection/notes points were jotted down during the observation process at Asrama Bahagia Kuala Lumpur. The observation notes were recorded at Microsoft Word spreadsheet for data analysis purpose while interview and focus group discussion were audio recorded by the researcher.

Data Analysis
All vital responses during observation, focus group discussion and interviews were recorded, noted down during the process as to enhance the authentic of the findings. The researcher used the data collection method to analyze and interpret the collected data based on themes that has been categorized.

Literature Review Extended information on general background can be included in a separate section, namely
Literature Review, which outlines the rationale and objectives of the study. Health Minister Datuk Seri Dr S. Subramaniam revealed that in Malaysia "an average of 18,000 teenagers are pregnant annually and about 25% or 4,500 cases involved pregnancy out of wedlock" ("50 Teenagers",2015). This means that an average of 50 cases have been reported on a daily basis. Ng (2010) a co-founder of Youth Asia stated youth and sex is a perennial issue in Malaysia. In Malaysia, sexual intercourse among adolescents are quite worrying as this is against the local norms and culture (Azizan, 2010). Lum (2018) mentioned that the insufficient sexual knowledge among the teenagers is likelihood of their involvement in risky sexual behavior. Jalil (2014) stated that in a study conducted in 2004 among 1700 teenagers, 50 per cent of them did not know well about the functions of reproductive organs (Azizan, 2010). Furthermore, a survey done by the Sunday Star online in collaboration with Utar Creative Industries Faculty lecturer Kumarasuriar (2010) found out that "when asked about their reasons for having sex, only 6.7 per cent said they took the plunge because their friends were doing it, 29 per cent said they were curious, 28 per cent said they wanted to have fun, while 18 per cent said they were in love with their lovers, and 15 per cent said their respective partners pressured them into sex" (Azizan, 2010). The lack of knowledge about sexual intercourse among teenagers lead them to be involved in such immoral activity without thinking the consequences. Other than lacking sexual and reproductive knowledge, social circle influence is another factor that adds to the problem. Peers may influence the adolescent self and social relationships circle. According to Utar Creative Industries Faculty lecturer Kumarasuriar (2010) that "many research findings show that peers have a strong influence in forming adolescent/teen beliefs and influencing their behavior during the teenage years." (Azizan, 2010). During social development stage peers play a crucial role in adolescents lives as this influences their sense of self and self-esteem (HealthyFamiliesBc, 2014). This is supported by Raising Children Network (2017) where it is stated that peer influences and peer pressure can be either positive or negative as there is a chance for them to become more assertive, joining new activities or get more involved in school yet there's negative side where they might turn to antisocial as this could be the biggest factors of shaping their long term choices and behavior. A healthy family institution is needed to prevent more damage. "The instability in family structure and welfare use serve as risk factors for early sexually activity" (Lohman,2009). A stronger parent-child relationship has been proven for better outcomes for children. According to Parenting Ni (2018), "The parent-child relationship is one that nurtures the physical, emotional and social development of the child". This is supported by Kalpana (2019), "The relationship lays the foundation for the child's personality, choices and overall behavior". Many previous studies have documented the positive association of parenting style and the effects on the child behaviour. It is necessary for parents to create a healthier relationship at home and became a positive role model for them. The late adolescence stage where cognitive developments progress in complex thinking skills and are now more focused in more global thoughts such as the teenagers became more mature, looking what role to play in community, making career choices, college preferences, weighs the parental inputs" (Forehand, n.d). It is clear that during adolescence stage, it is important for parents to encourage their children to be more expressive while listening to them and at the same time assist them in forming more mature thinking patterns.

The Involvement of Psychosexual Issue among Teenagers
The reason that led teenagers to be involved in psychosexual problems are due to their social circle influences. This kind of intimates' social circle influences may trajectory negative experiences on oneself. In addition, few of the participants had minimal bonding with their parents as both of their parents were working full time and due to this poor communication and lack of guidance made these teenagers to rely on others such as peers, boyfriends, best friends for advice, opinion, suggestion. The severity of negative social circles influences, leads them to negative behavior pattern. Below is the result from the interviewed respondents.
"I got involved in sexual activities when I was 15 when my boyfriend asked me to come to his house. I thought he wanted to go and see a movie because he called my friend, so I went. And then he gave me a glass of water but I refused. He pulled a face when I did that, so I took it from him and drank. A few minutes later, I started to feel sleepy and went to the room. It was his room. Then, the last thing I remembered was him coming in and he took off his clothes." (Respondent 1) "I was studying in Banting at the time. I became friends with gangsters. They fight all the time...it was at that time I met my boyfriend, and we fell in love…He was also a gangster" "After that, I always skipped school and followed him. He always drove me to his house becausehis parents went to work…he's an only child so…I was the only one there. Sometimes he would brought me to stay at hotels." (Respondent 2) "I did it with my boyfriend". "We were just hanging out in a room..and he started joking around. It was fine at first, but I didn't know he watched that video. And then he asked me to have sex with him." (Respondent 3) "hmmmm..He liked me, and asked me if I wanted to be his girlfriend. After 4 to 5 months ah…I went to his house and we had sex." (Respondent 4) "I was involved with this activity when I first got a phone of my own." "A handphone to be exact, and since then I get to know a lot of people. Starting from there, I met with strangers…" "That is where I met that man, He invited me to do things. So this all started because of friends and boyfriend. He taught me those things and I got involved." (Respondent 5) "I was 15 when I got involved in sexual problems. I met that guy at school and we talked…and then we went to a friend's house, hang out at night. It was only after school did we started having a sexual relationship." (Respondent 6) "Because of friends…" "We hang out and she introduced me to that guy." (Respondent 7)

The Implication of Adolescents' Involvement in Psychosexual Activity
The first theme on the consequence of engaging in psychosexual activity from the perspective of the teenagers is health problems. Adolescence can be an exciting period in one's life but at the same time this period can be confusing and challenging as teenagers are in a state of mind where they want to explore and experiments things around them. Engaging in unprotected sex can result in health problems and this risky behavior remains too prevalent among the teenagers. Interdisciplinary health groups, government and non-profit organization bodies should collaborate and design preventions programs and policy to outreach the adolescence earlier.
"The effect is we are at risk to get infected with syphilis, HIV." (Respondent 1) "I'm R4, I think we would be viewed negatively by the society, and infected with diseases." (Respondent 4) "We could get diseases and expelled from school. Neglected and excluded from the family." (Respondent 6) "It can result in illnesses, pregnancy and being rejected by family." (Respondent 7) The second theme on the major implication of adolescents involving in psychosexual activity is being disowned by family & society. In Malaysia engaging in pre-marital sex and being pregnant out of wedlock, are subjected to a strong social stigma as this behavior is unacceptable to the society and its' social norms. The sad reality is girls who carries baby out of wedlock are being labelled as a disgrace to family and this is the reason why many girls facing this issue avoid telling and seeking help from their family members out of fear. This social stigma leads to many baby dumping cases.
"Maybe we could get pregnant and be excluded from the society." (Respondent 2) "I'm R4, I think we would be viewed negatively by the society, and infected with diseases." (Respondent 4) "The consequences are we could be judged, and our future would be destroyed." (Respondent 5) "We could get diseases and expelled from school. Neglected and excluded from the family." (Respondent 6) "It can cause illnesses, pregnancy and being rejected by family." (Respondent 7) The last theme on the consequences of getting involved in psychosexual activity is unwanted pregnancy. Teenage pregnancy is filled with many challenges as not only she will experience physical changes but will also face mental, emotional, social as well as health changes. Teen pregnancies were proven to be linked with greater risk of medical complication during delivery. Hence, addressing and creating awareness from an early age might help to reduce teenagers from involving in this risky behavior.
"Maybe we could get pregnant and be excluded from the society." (Respondent 2) "We would feel regretful, ashamed, and pregnant." (Respondent 3) "It can cause illnesses, pregnancy and being rejected by family." (Respondent 7) The crunching number of teenagers pregnancy is progressing vigorously in Malaysia. According to Health Minister Datuk Seri Dr S. Subramaniam in Malaysia "an average of 18,000 teenagers are pregnant annually and about 25% or 4,500 cases involved pregnancy out of wedlock" ("50 Teenagers",2015). This means that an average of 50 cases have been reported on a daily bases. This is supported by data revealed by Ministry of Health "1,500 cases of teenage pregnancies every month excluding those goes unreported" (Goh, 2016). The figures of teen pregnancy and engaging in sexual activity from an early age are worrying as these data grim figures are sobering.
Many past studies have pour out their concern over this epidemic phenomenon. From the interviews and group discussion it can be seen that majority of them had consensus sex, some of them were manipulated or guilt-trapped into having intercourse by their partner and one of the participants being doped and ticked before her boyfriend committed the immoral behavior. This findings being supported by Reproductive Rights Advocacy Alliance Malaysia (RRAAM) co-chairperson Rashidah Abdullah highlights the reports from governments clinics and hospitals showed that cases of unwanted pregnancies and consensual sex among teens below 18 years old increases (Azizan, 2010).
Unwanted pregnancy has profound effect on the teenagers' education, health, socially and economically. A teenager who is pregnant is most likely to drop out from school permanently as it is difficult to continue their studies as they have to commit to take care of themselves and the child. There is certain risk involved in teen pregnancy, this is supported by Dr. Aizura Syafinaz who pointed out that "teenage mothers [with little or no prenatal care were at greater risk of having medical complication as] the girl is more likely to develop preeclampsia, a severe condition associated with high blood pressure" (Said, 2018). In another statement released by Dr. Aizura Syafinaz, "the incidence of caesarean section was higher in teenage mothers as the pelvic bones do not reach their maximum size until the age of 18, hence the pelvis of the teenage mother may not have grown enough to allow vaginal delivery of a normal size baby" (Lum, 2018). Another health issue to be noted, according to Dr Aida Syafinaz, is that "the risk of postpartum depression was higher among teenage mother which can lead to severe depression as in suicidal and filicidal (thoughts of killing one's own offspring) ideas and attempts" (Said, 2019). Socially and economically the researcher believes that the teenager is most likely to suffer from poverty, and financially devastated because incapable to support her newborn and this leads to emotional trauma. The teenager had to bear huge humiliation and negative remarks from society, family and friends as teen pregnancy is still subject to social stigma.
Hence, the researcher believes that lack of maturity and lack of sex education contribute both directly and indirectly to unwanted pregnancy among the teenagers. This is supported by Abd Jalil (2014) stated that in a study conducted in 2004 among 1700 teenagers, 50 per cent of them did not know well about the functions of reproductive organs (Azizan, 2010). In a survey done by the Sunday Star online a collaboration with Utar Creative Industries Faculty lecturer Kumarasuriar (2010) found out that "the ignorance [of not using any form of] contraception is worrying as 40 per cent of those who have had sex experienced it before they turned 18 years old, 42 per cent of the respondents have had multiple sexual partners, 24 per cent said they have had a maximum of five sexual partners, 14 per cent said they have slept with more than five people, 2 per cent had more than 10 sexual partners and 3 per cent claimed more than 20" (Azizan, 2010). Clearly can be seen that the lack of knowledge about sexual intercourse among teenagers lead them to be involved in such immoral activity without thinking about the consequences. One of most effective approach can be taken to prevent teen pregnancy is through a proper sex education by instilling moral and religious values among the teenagers. Additionally, parents should keep an eye on their children's' activities, who are they friends, and whereabouts of their children after school or during weekends. According to Lohman (2009) "instability in family structure and welfare use serve as risk factors for early sexually activity". Parents should spend quality time with children so that they would not be looking for love and attention elsewhere.

Discussion
One of the aims of the present study is to identify the involvement of psychosexual issues among teenagers. Based on the research, it is concluded that the main theme for their involvement is social circle influences. There are no denying facts that teenagers are influenced by their social circle as they find themselves being comfortable with a group of people who is same age as theirs, share similar interests and needs. Seidman (2019) highlights that "peer can also influence sexual activity and adolescents are more likely to engage in sexual activity if they believe their friends have liberal attitudes towards sex". Another reason contributing to this factor is because they spend more time with their peers/social circle than they do with their parents. The participants' claimed that both of their parents are working and they had to fend themselves. In other words, teenagers are more likely to be negatively affected when their parents are busy with work or are not attentive to their needs. Therefore, it is important for parents to have an effective communication with teenagers on a regular basis as it helps to establish stronger bonding between them. This study also investigated the perspective of teenagers towards the implication of adolescents' involvement in psychosexual activity. The teenager's perspectives are categorized into three themes which are health problems, disowned by family and society and unwanted pregnancy. The majority responses show that the participants do understand the negative consequences of engaging in sexual behaviors. They are aware there is risk of being infected with diseases, yet there is insufficient reproductive health knowledge among them. Premarital sexual intercourse is considered an act that is against the norms and local culture in Malaysia. The participants expressed grief on how their family members have gone through the wringer, as it brings shame to the family and society. Unwanted pregnancy is an implication that creates profound effect on the teenagers' education, health, socially and economically. Studies are affected because they have to commit to take care of themselves and the child. In terms of health, there is a possibility of dealing with certain risks involved in teen pregnancy. Due to young age, teenagers are also likely to suffer financially as well as emotionally because of humiliation and negative remarks from society, family and friends. This study focuses on factors for involvement of psychosexual issues among teenager and the perceptions from teenagers themselves towards the implication of this behavior. It also highlights the importance for parents to engage in realistic conversation approach with their teenagers regarding matters related to sexual and reproductive health knowledge. This study recommends further research on the relationship between parenting styles and teenagers involvement in psychosexual activities. It also suggests opting for a larger sample size that include both genders.

Conclusion
The aim of this research is to explore the psychosexual problems among teenagers at Asrama Bahagia, Kuala Lumpur. Concentrating on this goal, this study attempts to find answers to four research questions. Firstly, how the involvement of psychosexual issue happened among teenagers? Secondly, how the involvement triggers psychosexual behavior among the teenagers? Thirdly, what are the perspective of teenagers towards the implication of adolescents involvement in psychosexual activities? and lastly what are the strategies to reduce psychosexual behaviors among the teenagers? Hence, the findings of this research indicated that negative social circles influence teenagers to engage/develop negative behavior pattern. The findings of this study also show that peer influences, social media and digital media are the three main factors that trigger psychosexual behavior among teenagers. The findings of this study revealed that health problems, disowned by family & society and unwanted pregnancy are the major consequences faced by teenagers involved in psychosexual activities. Ultimately, the researcher believes that steps taken by Asrama Bahagia, Kuala Lumpur which consists of daily routine, activities and programs helps the participants to rehabilitate themselves by rebuilding and reshaping their risky behavior while enhancing their spiritual values.