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J Adolesc Health. 2013 Aug;53(2):287-92. doi: 10.1016/j.jadohealth.2013.02.025. Epub 2013 May 3.

Impact of early adolescent anxiety disorders on self-esteem development from adolescence to young adulthood.

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Department of Epidemiology & Biostatistics, College of Public Health, University of South Florida, Tampa, FL 33612, USA.



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


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.


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.


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.


Adolescence; Anxiety disorder; Longitudinal study; Multilevel growth modeling; Self-esteem development

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