Self-reported quality of life and self-esteem in sad and anxious school children.
BACKGROUND
Anxiety and depressive symptoms are common in childhood, however problems in need of intervention may not be identified. Children at risk for developing more severe problems can be identified based on elevated symptom levels. Quality of life and self-esteem are important functional domains and may provide additional valuable information.


METHODS
Schoolchildren (n = 915), aged 9-13, who considered themselves to be more anxious or sad than their peers, completed self-reports of anxiety (Multidimensional Anxiety Scale for children (MASC-C), depression (The Short Mood and Feelings Questionnaire; SMFQ), quality of life (Kinder Lebensqualität Fragebogen; KINDL) and self-esteem (Beck self-concept inventory for youth (BSCI-Y) at baseline of a randomized controlled indicative study. Using multivariate analyses, we examined the relationships between internalizing symptoms, quality of life and self-esteem in three at-risk symptom groups. We also examined gender and age differences.


RESULTS
52.1 % of the screened children scored above the defined at-risk level reporting elevated symptoms of either Anxiety and Depression (Combined group) (26.6 %), Depression only (15.4 %) or Anxiety only (10.2 %). One-way ANOVA analysis showed significant mean differences between the symptom groups on self-reported quality of life and self-esteem. Regression analysis predicting quality of life and self-esteem showed that in the Depression only group and the Combined group, symptom levels were significantly associated with lower self-reported scores on both functional domains. In the Combined group, older children reported lower quality of life and self-esteem than younger children. Internalizing symptoms explained more of the variance in quality of life than in self-esteem. Symptoms of depression explained more of the variance than anxious symptoms. Female gender was associated with higher levels of internalizing symptoms, but there was no gender difference in quality of life and self-esteem.


CONCLUSIONS
Internalizing symptoms were associated with lower self-reported quality of life and self-esteem in children in the at-risk groups reporting depressive or depressive and anxious symptoms. A transdiagnostic approach targeting children with internalizing symptoms may be important as an early intervention to change a possible negative trajectory. Tailoring the strategies to the specific symptom pattern of the child will be important to improve self-esteem.


BACKGROUND
Trial registration in Clinical trials: NCT02340637 , June 12, 2014.
Centre for Child and Adolescent Mental Health, Gullhaugveien 1-3, 0484, Oslo, Norway. kristin.martinsen@r-bup.no.
Kristin D
KD
Martinsen
Centre for Child and Adolescent Mental Health, Gullhaugveien 1-3, 0484, Oslo, Norway.
Simon-Peter
SP
Neumer
Centre for Child and Adolescent Mental Health, Gullhaugveien 1-3, 0484, Oslo, Norway.
Solveig
S
Holen
Department of Psychology, University of Oslo, Forskningsveien 3A, 0373, Oslo, Norway.
Trine
T
Waaktaar
NTNU, Regionalt kunnskapssenter for barn og unge (RKBU), Klostergata 46, 7030 Trondheim/St. Olav's Hospital, Trondheim, Norway.
Anne Mari
AM
Sund
Temple University, 1701 North 13th Street, Weiss Hall, Philadelphia, PA, USA.
Philip C
PC
Kendall
D000293:Adolescent; D001007:Anxiety / Q000175:diagnosis; D001008:Anxiety Disorders / Q000175:diagnosis*; D002648:Child; D003863:Depression / Q000175:diagnosis; D003866:Depressive Disorder / Q000175:diagnosis*; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D011788:Quality of Life / Q000523:psychology*; D012307:Risk Factors; D012649:Self Concept; D057566:Self Report
Anxiety; Children at risk; Depression; Prevention; Quality of life; Self-esteem