Psychosocial Stressors Associated With Emotional and Behavioral Problems Among Street-Connected Adolescents in Dhaka, Bangladesh: A Cross-Sectional Study.

Background Adolescence is a vulnerable period for emotional and behavioural problems, and street-connected adolescents face cumulative psychosocial adversities that may heighten this risk. However, evidence on the relationship between psychosocial stress severity and emotional‒behavioural problems among street adolescents in Bangladesh remains limited. This study aimed to assess psychosocial stressors and emotional-behavioural problems among street adolescents in Dhaka, Bangladesh, and to examine their associations. Methods This cross-sectional study was conducted by the Department of Psychiatry, Bangladesh Medical University, among 106 street adolescents aged 11-17 years who were recruited through purposive sampling from Kamalapur and Tejgaon Railway Stations, Dhaka, between June 2024 and August 2025. Psychosocial stress was assessed via the Dhaka Stress Scale-Adolescent (DSS-Ad), and emotional‒behavioural problems were assessed via the Bangla Strengths and Difficulties Questionnaire (SDQ). Associations were examined using Pearson's chi-square test or Fisher's exact test, as appropriate, and factors independently associated with abnormal conduct problems were examined using multivariable binary logistic regression. Results The mean age was 13.79 ± 1.70 years, and 96 (90.57%) participants were male. Mild stress was the most common category, affecting 58 (54.72%) participants, followed by severe stress in 30 (28.30%) and moderate stress in 18 (16.98%). Conduct problems were the most prevalent abnormal SDQ domain, occurring in 32 (30.19%) participants. Stress severity was significantly associated with emotional and conduct problems (both p < 0.001). After adjustment, moderate stress (adjusted OR (AOR)=4.14, 95% CI: 2.15-17.79) and severe stress (AOR=7.16, 95% CI: 4.57-23.27) were independently associated with higher odds of abnormal conduct problems, indicating a graded association. Adolescents without a history of physical abuse had lower adjusted odds of abnormal conduct problems than those who had experienced physical abuse (AOR=0.25, 95% CI: 0.08-0.82). Conclusions Psychosocial stress severity was strongly associated with emotional and behavioural problems, particularly conduct problems, among street adolescents in Dhaka. These findings suggest that psychosocial stress and violence exposure may represent important areas for trauma-informed assessment and support in this hard-to-reach population. Larger, longitudinal, multicentre studies are warranted to confirm these associations.