Seim Astrid R, Jozefiak Thomas, Wichstrøm Lars, Lydersen Stian, Kayed Nanna S
Department of Child and Adolescent Psychiatry, St. Olavs Hospital, Trondheim, Norway; Department of Mental Health, Faculty of Medicine and Health Sciences, NTNU Norwegian University of Science and Technology, Trondheim, Norway.
Department of Mental Health, Faculty of Medicine and Health Sciences, NTNU Norwegian University of Science and Technology, Trondheim, Norway.
Child Abuse Negl. 2021 Aug;118:105141. doi: 10.1016/j.chiabu.2021.105141. Epub 2021 Jun 2.
Low self-esteem predicts negative outcomes and mediates the association between childhood adversity and mental health problems in adolescence. Reactive attachment disorder (RAD) and disinhibited social engagement disorder (DSED) are presumably caused by early insufficient care, but their association with self-esteem is unknown.
Investigate global and domain-specific self-esteem in adolescents with RAD or DSED.
All adolescents living in Norwegian residential youth care (RYC) (N = 306; age 12-20) were compared with a sample from the general Norwegian adolescent population (N = 10,480; age 12-20).
Self-esteem for scholastic competence (SC), social acceptance (SA), athletic competence (AC), physical appearance (PA), romantic appeal (RA), close friendship (CF), and self-worth (SW) was investigated using the revised version of the Self-Perception Profile for Adolescents.
Compared to the general population, adolescents with RAD diagnosis had lower SC (mean difference, MD = -0.30, p = .020) and higher CF (MD = 0.25, p = .021), whereas adolescents with DSED diagnosis had lower SC (MD = -0.42, p = .005), SA (MD = -0.40, p = .015), AC (MD = -0.22, p = .038), PA (MD = -0.33, p = .048), and SW (MD = -0.37, p = .013). Compared to adolescents in RYC without RAD/DSED diagnoses, adolescents with DSED diagnoses had lower SA (MD = -0.42, p = .012) and SW (MD = -0.32, p = .037). More RAD symptoms were associated with lower SA (B = -0.051, p = .013), AC (B = -0.048, p = .028), RA (B = -0.053, p = .007), and CF (B = -0.052, p = .005). More DSED symptoms were associated with lower SC (B = -0.125, p = .038).
Both global and domain-specific self-esteem in adolescents with RAD or DSED should be assessed; developmental support and treatment plans should be adjusted accordingly.
低自尊预示着负面结果，并介导童年逆境与青少年心理健康问题之间的关联。反应性依恋障碍（RAD）和脱抑制性社会参与障碍（DSED）可能是由早期照料不足所致，但其与自尊的关联尚不清楚。
调查患有RAD或DSED的青少年的整体自尊和特定领域自尊。
将所有居住在挪威寄宿制青少年护理机构（RYC）的青少年（N = 306；年龄12 - 20岁）与挪威青少年普通人群样本（N = 10480；年龄12 - 20岁）进行比较。
使用修订版青少年自我认知量表对学业能力（SC）、社会接纳（SA）、运动能力（AC）、外貌（PA）、浪漫吸引力（RA）、亲密友谊（CF）和自我价值（SW）方面的自尊进行调查。
与普通人群相比，被诊断为RAD的青少年SC较低（平均差异，MD = -0.30，p = 0.020），CF较高（MD = 0.25，p = 0.021）；而被诊断为DSED的青少年SC较低（MD = -0.42，p = 0.005），SA较低（MD = -0.40，p = 0.015），AC较低（MD = -0.22，p = 0.038），PA较低（MD = -0.33，p = 0.048），SW较低（MD = -0.37，p = 0.013）。与未被诊断为RAD/DSED的RYC青少年相比，被诊断为DSED的青少年SA较低（MD = -0.42，p = 0.012），SW较低（MD = -0.32，p = 0.037）。更多的RAD症状与较低的SA（B = -0.051，p = 0.013）、AC（B = -0.048，p = 0.028）、RA（B = -0.053，p = 0.007）和CF（B = -0.052，p = 0.005）相关。更多的DSED症状与较低的SC（B = -0.125，p = 0.038）相关。
应对患有RAD或DSED的青少年的整体自尊和特定领域自尊进行评估；应相应调整发展支持和治疗计划。
