‘I Am Worthless and Kind’; the specificity of positive and negative self‐evaluation in adolescent depression

OBJECTIVES: Adolescence represents a critical phase when the concept of self is developed and consolidated. Depressed adolescents globally endorse more negative and fewer positive self‐descriptive words compared with non‐depressed adolescents. Yet, the methods used have not allowed for more detailed exploration of the specific content of these self‐endorsements. METHODS: Adolescents, aged 12–18 years, were recruited from the community (n = 204) and from a child and adolescent mental health service in the UK (n = 87). Participants completed measures of depression and a self‐description questionnaire which included 12 positive and 12 negative self‐descriptive adjectives. RESULTS: As expected, we replicated previous findings that depressive symptoms are associated with global positive and negative self‐endorsements. The difference between mean scores was examined for each adjective. Depressed adolescents endorsed all negative adjectives more highly relative to community adolescents; ratings of ‘worthless’ and ‘useless’ had the biggest difference between community and depressed adolescents. Surprisingly, a group of positive prosocial self‐descriptors were endorsed equally by depressed and community adolescents and were not associated with severity of depressive symptoms. CONCLUSIONS: Although depressed adolescents endorsed more negative descriptions of themselves than community adolescents, positive self‐endorsements related to their relationships with other people were not impaired. PRACTITIONER POINTS: Most highly endorsed self‐descriptive negative words by depressed adolescents were ‘worthless’ and ‘useless’. Positive prosocial self‐descriptive adjectives (i.e., trustworthy, friendly, and kind) were highly endorsed by all young people and were not associated with depression. Assessment and treatment should consider the content of adolescent self‐evaluation. The present study is unable to identify whether young people would produce the same themes of positive and negative words in a free response measure. Diagnostic information was only available on the clinical group;