Predictors of self-esteem in adolescents with a psychiatric referral.

In the literature self-esteem is found to be lower in clinically referred adolescents compared to adolescents without any psychiatric disorder. The aim of this study is to examine self-esteem and associated socio-demographical and psychological factors in clinically referred adolescents in Turkey. Three hundred forty-nine adolescents aged between 12 and 18 years admitted to the Department of Child and Adolescent Psychiatry with a psychiatric complaint were enrolled. Rosenberg Self-Esteem Scale (RSES), Brief Symptom Inventory (BSI), Parenting Style Scale (PSS) and Sense of Identity Assessment Form (SIAF) were used for the evaluation. Self-esteem was lower in: girls, adolescents without siblings, living in non-nuclear families, with a past suicide attempt, and with history of a non-suicidal self-injurious behavior (NSSI). Self-esteem was negatively correlated with identity confusion on SIAF and positively correlated with acceptance/involvement on PSS. Significant predictors of self-esteem were gender, presence of a sibling, history of a NSSI and SIAF scores. Interactions between self-esteem and gender, psychiatric symptoms, parenting and identity development are complex in clinically referred adolescents. Further elucidation of the mechanisms through which these characteristics modify self-esteem will be necessary to guide families and clinicians to help adolescents to maintain high self-esteem levels.