Self-esteem in child and adolescent psychiatric patients

Self-esteem is a widely used term in psychiatric referrals. It has been shown to be impaired in various physical and psychological disorders and to be improved by treatment. The availability in recent years of an easy-to-use questionnaire and normative data from a community study make measurement of self-esteem and comparison between clinical and community populations possible. The Harter Modified Self-Esteem Questionnaire was given at first clinic appointment to 132 children aged 8-15 years. Mean scores were calculated within six domains of selfesteem and compared within age and gender groupings with community data and across diagnostic groups. Self-esteem was lower in the clinical than community sample, especially in Global and Scholastic domains. Reductions in self-esteem scores were most striking in adolescent boys and in emotional/psychosomatic disorders. Clinic girls had lower Physical Appearance self-esteem than clinic boys. We conclude that psychopathology severe enough to lead to clinic referral was associated with lowered self-esteem. Specific domains were affected in line with symptomatology, which has implications for treatment.