Self-concept in Adolescents with Physical-Mental Comorbidity

Abstract

Objective Little is known about self-concept in adolescents with physical-mental comorbidity. This study investigated whether physical-mental comorbidity was associated with self-concept in adolescents and examined if adolescent age or sex moderated the association between physical-mental comorbidity and self-concept. Methods Study data were obtained from the Multimorbidity in Youth across the Life-course (MY LIFE), an ongoing Canadian study of adolescents with chronic physical illness who were recruited from outpatient clinics at a pediatric hospital. A total of 116 adolescents aged ≥ 10 years provided self-reports on key measures. Results Adolescents with comorbidity (n = 48) had lower self-concept scores on the Self-Determination Questionnaire (SDQ; d = 0.62) and Self-Perception Profile for Children (SPPC; d = 0.53) vs. adolescents without comorbidity (n = 68). An age × comorbidity status interaction was found and age-stratified models were computed to investigate this moderating effect of age. Amongst older adolescents, comorbidity was associated with lower SDQ (B = -2.55, p < .001), but this association was not found among younger adolescents (B = -0.29, p = .680). A similar effect was found for SPPC among older (B = -0.48, p = .001) and younger adolescents (B = 0.03, p = .842). Adolescent sex was not found to be a moderator. Conclusions Physical-mental comorbidity in adolescence was associated with lower self-concept and this association was moderated by age—differences between adolescents with vs. without comorbidity were greater for older adolescents and were clinically relevant. Opportunities to support positive self-perceptions for adolescents with comorbidity are warranted, especially when planning the transition from pediatric to adult health services.

Validating the Ontario Child Health Study Emotional Behavioural Scales‐Brief Version (OCHS‐EBS‐B) in children with chronic physical illness

“…Effects of physical-mental comorbidity on psychosocial health are also prominent in children. Evidence suggests that although physical and mental illness independently have negative influences on child health-related quality of life and self-concept (Ferro & Boyle, 2013;Silva et al, 2019), effects are compounded in children with physical-mental comorbidity in a dose-response manner across morbidities (Ferro, Dol, Patte, et al, 2023;Ferro, Qureshi, et al, 2021). Levels of physical activity in children with physical-mental comorbidity are also compromised, especially among children experiencing mood or anxiety disorders who are less likely to meet physical activity guidelines (Bedard et al, 2023).…”