Longitudinal Model Predicting Self‐Concept in Pediatric Chronic Illness

Abstract

Although self-concept has been identified as salient to the psychosocial adjustment of adolescents dealing with a chronic illness (CI), little research has focused on its predictors it. Given that depression and parent-child attachment have been linked to self-concept in the population at large, the goal of this study was to evaluate these relationships longitudinally in a sample of adolescents with CI. Using participant data from the Mastering Each New Direction (MEND) program, a 3-month psychosocial, family based intensive outpatient program for adolescents with CI, we employed multilevel modeling to test longitudinal changes in self-concept, as predicted by depressive symptoms and parent-child attachment, in a sample of 50 youths (M = 14.56, SD = 1.82) participating in MEND. Both "time spent in the program" and decreases in depressive symptoms were associated with increases in self-concept over time. Higher baseline levels of avoidant attachment to both mother and father were also associated with greater initial levels of self-concept. Targeting depressive symptoms and supporting adaptive changes in attachment may be key to promoting a healthy self-concept in pediatric CI populations. The association between avoidant attachment and higher baseline self-concept scores may reflect differences in participants' autonomy, self-confidence, or depression. Limitations of the study include variability in the amount of time spent in the program, attrition in final time point measures, and the inability to fully examine and model all potential covariates due to a small sample size (e.g. power).

Familial Risk Factors and Emotional Problems in Early Childhood: The Promotive and Protective Role of Children’s Self-Efficacy and Self-Concept

“…Nonetheless, results from studies with older subjects generated important knowledge that might also apply to younger children. Emerson et al (2019) found that decreases in depressive symptoms were linked to increases in self-concept in adolescents with a chronic illness that participated in a psychosocial, family based intensive outpatient program. Chavez-Hernandez et al (2018) reported that self-evaluation and family self-concept were associated with depression in middle to late childhood.…”

An examination of characteristics, social supports, caregiver resilience and hospital readmissions of children with medical complexity

“…In this study, we measured the feasibility of collecting repeated measures data, with CMC caregivers at high participant attrition risk during the onset of a pandemic. Despite this, the study's overall 31% attrition rate was similar to a pre‐pandemic study of caregivers of children with chronic health conditions reporting a 30% attrition rate over 60 days (Emerson et al, 2019). One possible explanation the study team had for the 31% attrition in this study is related to offering paper surveys during enrolment of the first 15 caregivers.…”

“…Despite this, the study's overall 31% attrition rate was similar to a T A B L E 7 Community healthcare supports. pre-pandemic study of caregivers of children with chronic health conditions reporting a 30% attrition rate over 60 days (Emerson et al, 2019). One possible explanation the study team had for the 31% attrition in this study is related to offering paper surveys during enrolment of the first 15 caregivers.…”