Global self-worth in adolescents with chronic illness

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.