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Soc Psychiatry Psychiatr Epidemiol. 2018 Jul;53(7):673-684. doi: 10.1007/s00127-018-1508-z. Epub 2018 Apr 4.

Behavioral problem trajectories and self-esteem changes in relation with adolescent depressive symptoms: a longitudinal study.

Author information

1
School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 1/F, 7 Sassoon Road, Pokfulam, Hong Kong, SAR, People's Republic of China.
2
Community Health Systems, School of Nursing, UCSF, San Francisco, CA, USA.
3
School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 1/F, 7 Sassoon Road, Pokfulam, Hong Kong, SAR, People's Republic of China. cms1@hku.hk.
4
CUNY School of Public Health and Health Policy, New York, USA. cms1@hku.hk.

Abstract

PURPOSE:

Prospectively childhood behavioral problems and low self-esteem are associated with depression. However, these mental health changes over time have never been examined. This study assessed the association of childhood behavioral trajectories and self-esteem changes over time with adolescent depressive symptoms.

METHODS:

Parent-reported Rutter behavioral assessments and self-reported Culture-Free Self-Esteem Inventories (SEI) were obtained via record linkage from the Student Health Service, Department of Health (Hong Kong), and the Patient Health Questionnaire-9 (PHQ-9) depressive symptom scores were obtained via active follow-up of the Hong Kong's Children of 1997" Chinese birth cohort. Partitional clustering was used to generate homogenous trajectories between ~ 7 and ~ 11 years for Rutter scores. Changes in low self-esteem between ~ 10 and ~ 12 years were obtained from the SEI. Multiple linear regression was used to estimate their associations with depressive symptom scores at ~ 13 years.

RESULTS:

Four trajectories/groups (stable low, declining, rising, and stable high) of Rutter score and self-esteem groups were created. The stable low behavioral trajectory was associated with the fewest depressive symptoms while the stable high trajectory had 1.23 more depressive symptoms [95% confidence interval (CI) 0.84 to 1.61] than the stable low trajectory. Consistently low self-esteem (stable low) was associated with 2.96 more depressive symptoms (95% CI 2.35-3.57) compared to consistently high self-esteem (stable high).

CONCLUSIONS:

Sustained or worsening childhood behavioral problems and low self-esteem were precursors of adolescent depressive symptoms, and as such could be an early indicator of the need for intervention.

KEYWORDS:

Adolescent; Behavioral problem trajectories; Cohort study; Depression; Self-esteem changes

PMID:
29619579
DOI:
10.1007/s00127-018-1508-z
[Indexed for MEDLINE]

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