Global self-worth in adolescents with chronic illness
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Date
2014
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University of New Brunswick
Abstract
Aim: The goal of this study was to test the applicability of Harter's (1990) model of
adolescent self-perception to global self-worth among youth with chronic illness.
Method: Fifty-three adolescents with asthma, arthritis or diabetes completed an online
survey. Factors that have been previously shown to predict higher global self-worth
among typically developing adolescents (i.e., male gender, older age, higher parent
support, few~r depressive symptoms) were examined. In addition, the possible role of
physical health-related quality of life was examined. Adolescents' reports of discounting
and autonomy were evaluated as potential moderators of the relationship between
physical health-related quality of life and global self-worth. Results: The results
indicated that overall the youth with chronic illness reported a moderate level of global
self-worth and this level was comparable to that of typically developing youth. Consistent
with Harter's model, the discrepancy domains of competence, as a group, predicted global
self-worth, with romantic appeal emerging as a significant unique predictor. Consistent
with expectations, male gender, a lower level of depressive symptoms, a higher physical
health-related quality of life, discounting more domains and a higher level of autonomy
were associated with higher global self-worth. Unexpectedly, however, age and parent
support were not related to global self-worth. Examination of the hypothesized predictor
variables as a group revealed that level of depressive symptoms was the only unique
individual predictor of global self-worth. Moreover, contrary to the expectations, neither
discounting nor autonomy were found to be significant moderators. Conclusions: It
appears from this study that having a chronic illness does not invariably place a youth at
risk for lower global self-worth. Rather, universal factors, such as male gender, a higher level of autonomy, and a lower level of depressive symptoms are the most salient factors
that promote global self-worth. In addition, higher physical health-related quality of life,
especially less pain, may be associated with higher global self-worth due to fewer
depressive symptoms. Overall, the results suggest that using Harter's model is relevant
and appropriate for youth with chronic illness. Future research using normative models
for assessment and intervention of self-esteem problems in youth with chronic illness is
recommended.