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Impact of Early Adolescent Anxiety Disorders on Self-Esteem Development From Adolescence to Young Adulthood

  • Lizmarie Maldonado
    Affiliations
    Department of Epidemiology & Biostatistics, College of Public Health, University of South Florida, Tampa, Florida
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  • Yangxin Huang
    Affiliations
    Department of Epidemiology & Biostatistics, College of Public Health, University of South Florida, Tampa, Florida
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  • Ren Chen
    Affiliations
    Department of Epidemiology & Biostatistics, College of Public Health, University of South Florida, Tampa, Florida

    Clinical and Transitional Science Institute (CTSI) at College of Medicine, University of South Florida, Tampa, Florida
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  • Stephanie Kasen
    Affiliations
    New York State Psychiatric Institute, New York, New York

    Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York
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  • Patricia Cohen
    Affiliations
    New York State Psychiatric Institute, New York, New York

    Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York

    Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
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  • Henian Chen
    Correspondence
    Address correspondence to: Henian Chen, M.D., Ph.D., Department of Epidemiology & Biostatistics, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd., MDC 56, Tampa, FL 33612.
    Affiliations
    Department of Epidemiology & Biostatistics, College of Public Health, University of South Florida, Tampa, Florida

    Clinical and Transitional Science Institute (CTSI) at College of Medicine, University of South Florida, Tampa, Florida
    Search for articles by this author

      Abstract

      Purpose

      To examine the association between early adolescent anxiety disorders and self-esteem development from early adolescence through young adulthood.

      Methods

      Self-esteem was measured at mean ages 13, 16, and 22 for 821 participants from the Children in the Community Study, a population-based longitudinal cohort. Anxiety disorders were measured at mean age 13 years. Multilevel growth models were employed to analyze the change in self-esteem from early adolescence to young adulthood and to evaluate whether adolescent anxiety disorders predict both average and slope of self-esteem development.

      Results

      Self-esteem increased during adolescence and continued to increase in young adulthood. Girls had lower average self-esteem than boys, but this difference disappeared when examining the effect of anxiety. Adolescents with anxiety disorder had lower self-esteem, on average, compared with healthy adolescents (effect size [ES] = −.35, p < .01). Social phobia was found to have the greatest relative impact on average self-esteem (ES = −.30, p < .01), followed by overanxious disorder (ES = −.17, p < .05), and simple phobia (ES = −.17, p < .05). Obsessive compulsive-disorder (OCD) predicted a significant decline in self-esteem from adolescence to young adulthood (β = −.1, p < .05). Separation anxiety disorder was not found to have any significant impact on self-esteem development.

      Conclusions

      All but one of the assessed adolescent anxiety disorders were related to lower self-esteem, with social phobia having the greatest impact. OCD predicted a decline in self-esteem trajectory with age. The importance of raising self-esteem in adolescents with anxiety and other mental disorders is discussed.

      Keywords

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      References

        • Cohen P.
        • Kasen S.
        • Chen H.
        • et al.
        Variations in patterns of developmental transitions in the emerging adulthood period.
        Dev Psychol. 2003; 39: 657-669
        • Erol R.
        • Orth U.
        Self-esteem development from age 14 to 30 years: A longitudinal study.
        J Pers Soc Psychol. 2011; 101: 607-619
        • Robins R.
        • Trzesniewski K.
        Self-esteem development across the lifespan.
        Curr Dir Psychol Sci. 2005; 14: 158-162
        • Wallis D.
        Depression, anxiety and self-esteem: A clinical field study.
        Behav Change. 2002; 19: 112-120
        • Aarons G.
        • Monn A.
        • Leslie L.
        • et al.
        Association between mental and physical health problems in high-risk adolescents: A longitudinal study.
        J Adolesc Health. 2008; 43: 260-267
        • Birndorf S.
        • Ryan S.
        • Auinger P.
        • et al.
        High self-esteem among adolescents: Longitudinal trends, sex differences, and protective factors.
        J Adolesc Health. 2005; 37: 194-201
        • Orth U.
        • Robins R.
        • Trzesniewski K.
        Self-esteem development from young adulthood to old age: A cohort-sequential longitudinal study.
        J Pers Soc Psychol. 2010; 98: 645-658
        • Trzesniewski K.
        • Moffit T.
        • Poulton R.
        • et al.
        Low self-esteem during adolescence predicts poor health, criminal behavior, and limited economic prospects during adulthood.
        Dev Psychol. 2006; 42: 381-389
        • Andrews G.
        • Crino R.
        • Hunt C.
        • et al.
        The treatment of anxiety disorders: Clinician's guide and patient manuals.
        Cambridge University Press, Cambridge1994
        • Oakley-Browne M.A.
        The epidemiology of anxiety disorders.
        Int Rev Psychiatr. 1991; 3: 243-252
        • Merikangas K.R.
        • He J.
        • Burstein M.
        • et al.
        Lifetime prevalence of mental disorders in U.S. adolescents: Results from the National Comorbidity Survey Replication – Adolescent Supplement (NCS-A).
        J Am Acad Child Adolesc Psychiatry. 2010; 49: 980-989
        • Block J.
        • Robins R.
        A longitudinal study of consistency and change in self-esteem from early adolescence to early adulthood.
        Child Dev. 1993; 64: 909-923
        • Greenberg J.
        • Solomon S.
        • Pyszczynski R.
        • et al.
        Why do people need self-esteem? Converging evidence that self-esteem serves an anxiety-buffering function.
        J Pers Soc Psychol. 1992; 63: 913-922
        • Ehntholt K.
        • Salkovskis P.
        • Rimes K.
        Obsessive-compulsive disorder, anxiety disorders, and self-esteem: An exploratory study.
        Behav Res Ther. 1999; 37: 771-781
        • Marchand A.
        • Goupil G.
        • Trudel G.
        • et al.
        Fear and social self-esteem in individuals suffering from panic disorder with agoraphobia.
        Scand J Behav Ther. 1995; 23: 163-167
        • Rosenberg M.
        The association between self-esteem and anxiety.
        J Psychiat Res. 1962; 1: 135-152
        • Orth U.
        • Robins R.W.
        • Roberts B.W.
        Low self-esteem prospectively predicts depression in adolescence and young adulthood.
        J Pers Soc Psychol. 2008; 95: 695-708
        • Lee A.
        • Hankin B.L.
        Insecure attachment, dysfunctional attitudes, and low self-esteem predicting prospective symptoms of depression and anxiety during adolescence.
        J Clin Child Adolesc Psychol. 2009; 38: 219-231
        • Kogan L.S.
        • Smith J.
        • Jenkins S.
        Ecological validity of indicator data as predictors of survey findings.
        J Soc Serv Res. 1978; 1: 117-132
        • Costello E.J.
        • Edelbrock C.S.
        • Duncan M.K.
        • et al.
        Testing of the NIMH Diagnostic Interview Schedule for Children (DISC) in a clinical population: Final report to the Center for Epidemiological Studies, NIMH.
        University of Pittsburgh, Pittsburgh, PA1984
        • American Psychiatric Association
        Diagnostic and statistical manual of mental disorders.
        revised 3rd ed. American Psychiatric Association, Washington, DC1987
        • Cohen P.
        • Cohen J.
        Life values and adolescent mental health.
        Lawrence Erlbaum Associates, Mahwah, NJ1996
        • Bird H.R.
        • Gould M.
        • Staghezza B.
        Aggregating data from multiple informants in child psychiatry epidemiological research.
        J Am Acad Child Adol Psychiatry. 1992; 49: 282-291
        • Berenson K.
        • Crawford T.
        • Cohen P.
        Implications of identification with parents and parents' acceptance for adolescent and young adult self-esteem.
        Self Identity. 2005; 4: 289-301
        • Laird N.M.
        • Ware J.H.
        Random-effects models for longitudinal data.
        Biometrics. 1982; 38: 963-974
        • Singer J.
        Using SAS PROC MIXED to fit multilevel models, hierarchical models, and individual growth models.
        J Educ Behav Stat. 1998; 4: 323-355
        • Gentile B.
        • Campbell W.
        • Twenge J.
        Birth cohort differences in self-esteem, 1988-2008: A cross-temporal meta-analysis.
        Rev Gen Psychol. 2010; 14: 261-268
        • McCarthy J.
        • Hoge D.
        Analysis of age effects in longitudinal studies of adolescent self-esteem.
        Dev Psychol. 1982; 18: 372-379
        • Roberts J.
        Self-esteem from a clinical perspective.
        in: Kernis M. Self-esteem issues and answers: A sourcebook of current perspectives. Psychology Press, New York2006
        • Baldwin S.
        • Hoffman J.
        The dynamics of self-esteem: A growth-curve analysis.
        J Youth Adolescence. 2002; 31: 101-113
        • La Greca A.
        • Harrison H.
        Adolescent peer relations, friendships, and romantic relationships: Do they predict social anxiety and depression?.
        J Clin Child Adolesc. 2005; 34: 49-61
        • Zimmerman M.
        • Copeland L.
        • Shope J.
        • et al.
        A longitudinal study of self-esteem: Implications for adolescent development.
        J Youth Adolescence. 1997; 26: 117-141
        • Geist C.
        • Borecki S.
        Social avoidance and distress as a predictor of perceived locus of control and level of self-esteem.
        J Clin Psychol. 2006; 38: 611-613
        • Beesdo K.
        • Knappe S.
        • Pine D.
        Anxiety and anxiety disorders in children and adolescents: Developmental issues and implications for DSM-V.
        Psychiatr Clin N Am. 2009; 32: 483-524
        • Hale III, W.
        • Raaijmakers Q.
        • Muris P.
        • et al.
        Developmental trajectories of adolescent anxiety disorder symptoms: A 5-year prospective community study.
        J Am Acad Child Psy. 2008; 47: 556-564
        • Lewinsohn P.
        • Holm-Denoma J.
        • Small J.
        • et al.
        Separation anxiety disorder in childhood as a risk factor for future mental illness.
        J Am Acad Child Psy. 2008; 47: 548-555
        • Cameron C.L.
        Obsessive-compulsive disorder in children and adolescents.
        J Psychiatr Ment Health. 2007; 14: 696-704
        • Doron G.
        • Kyrios M.
        Obsessive compulsive disorder: A review of possible specific internal representations within a broader cognitive theory.
        Clin Psychol Rev. 2005; 25: 415-432
        • Bhar S.
        • Kyrios M.
        An investigation of self-ambivalence in obsessive-compulsive disorder.
        Behav Res Ther. 2007; 45: 1845-1857
        • Robins R.
        • Trzesniewski K.
        • Tracy J.
        • et al.
        Global self-esteem across the life span.
        Psychol Aging. 2002; 17: 423-434