The role of self-esteem in the development of psychiatric problems: a three-year prospective study in a clinical sample of adolescents

BACKGROUND: Self-esteem is fundamentally linked to mental health, but its’ role in trajectories of psychiatric problems is unclear. In particular, few studies have addressed the role of self-esteem in the development of attention problems. Hence, we examined the role of global self-esteem in the development of symptoms of anxiety/depression and attention problems, simultaneously, in a clinical sample of adolescents while accounting for gender, therapy, and medication. METHODS: Longitudinal data were obtained from a sample of 201 adolescents—aged 13–18—referred to the Department of Child and Adolescent Psychiatry in Trondheim, Norway. In the baseline study, self-esteem, and symptoms of anxiety/depression and attention problems were measured by means of self-report. Participants were reassessed 3 years later, with a participation rate of 77% in the clinical sample. RESULTS: Analyses showed that high self-esteem at baseline predicted fewer symptoms of both anxiety/depression and attention problems 3 years later after controlling for prior symptom levels, gender, therapy (or not), and medication. CONCLUSIONS: Results highlight the relevance of global self-esteem in the clinical practice, not only with regard to emotional problems, but also to attention problems. Implications for clinicians, parents, and others are discussed.