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PurposeTo investigate, in adolescents referred for psychiatric services, the associations of initial self-esteem and family functioning with level and change of quality of life (QoL) over a 3-year period, over and above the effect of their emotional problems.MethodsOf 1648 eligible 13-18 years old patients attending the child and adolescent psychiatric clinic (CAP) at least once, 717 (54.8% females) were enrolled at baseline (a response rate of 43.5%). Self- and parent reports on the McMaster Family Assessment Device were obtained. Adolescents reported self-esteem on the Rosenberg Scale, and emotional problems on the Symptom Check List-5. Adolescents completed the Inventory of Life Quality in Children and Adolescents (ILC). After 3 years, 570 adolescents again completed the ILC, and for 418 adolescents parent information was available. The longitudinal analysis sample of 418 adolescents was representative of the baseline sample for age, gender, emotional problems, and QoL. We used modified growth-model analysis, adjusted for SES, age, gender and time of contact with CAP, where residual variances for ILC at baseline and follow-up were fixed to 0.ResultsA poorer family functioning at baseline, reported by parents, was significantly associated with worsening QoL during the 3 years follow-up period (p = 0.001).ConclusionsParents have important knowledge about their families that may reflect long-term influences on QoL development in adolescent psychiatric patients. Health care providers and policy makers should optimize treatment outcomes by addressing family functioning in adolescents with emotional problems.

The present article examines the transmission of energy-saving behaviors in the family on two levels. We investigated the extent to which energy-saving performance differed between adolescents in relation to parental behavior on an aggregated level but also across single behaviors within adolescents. Furthermore, we investigated whether social context (e.g., private areas in a household) interfered with one of the basic mechanisms assumed for this transmission (observation). Correlations between 13 self-reported single energy-saving behaviors from 264 adolescents and their respective parents (N = 554) were analyzed by combining a path analysis with a multilevel approach. There were strong significant correlations between parents' and adolescents' energy-saving behaviors, mediated by adolescents' perceptions of their parents' behavior. The congruence between parents' self-reports and adolescents' perceptions was lower in private contexts than in shared social contexts in the household. This indicates that differentiated investigations with single behaviors and a focus on the social context (e.g., observability) are needed in transmission research. [ABSTRACT FROM AUTHOR]

Childhood maltreatment is known to be associated with a broad variety of psychopathology and deteriorated well-being in adolescent populations. In the present nationwide study, we aimed to explore global self-esteem, attachment difficulties and substance use as possible mediators of these associations in a high-risk adolescent population. We included 400 adolescents (aged 12–20 years) living in residential youth care in Norway (response rate 67%). The participants completed a semistructured psychiatric interview (Child and Adolescent Psychiatric Assessment (CAPA)), a study-specific questionnaire, a revised version of the Self-Perception Profile for Adolescents (SPPA) and the Questionnaire for Measuring Health-related Quality of Life in Children and Adolescents (KINDL-R). Information was also provided by the adolescent’s primary contact at the institution. Two models were tested using structural equation modelling; one assessed the association between childhood maltreatment and psychopathology, and one assessed the association between childhood maltreatment and well-being. Childhood maltreatment, psychopathology, well-being, global self-esteem and attachment difficulties were treated as latent variables, and substance use was added as an observed variable. The results of this study showed that global self-esteem was a mediator of paths in both models, whereas attachment difficulties and substance use were not. Preventing decline in health and well-being in high-risk adolescents is a main goal, and this study suggests that improving self-esteem, in addition to providing psychiatric health services, could be an important tool for achieving this goal. [ABSTRACT FROM AUTHOR]