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dc.contributor.authorMartinsen, Kristin Dagmar
dc.contributor.authorNeumer, Simon-Peter
dc.contributor.authorHolen, Solveig
dc.contributor.authorWaaktaar, Trine
dc.contributor.authorSund, Anne Mari
dc.contributor.authorKendall, Philip C.
dc.identifier.citationBMC Psychology 2016nb_NO
dc.description.abstractBackground: Anxiety and depressive symptoms are common in childhood, however problems in need of intervention may not be identified. Children at risk for developing more severe problems can be identified based on elevated symptom levels. Quality of life and self-esteem are important functional domains and may provide additional valuable information. Methods: Schoolchildren (n = 915), aged 9–13, who considered themselves to be more anxious or sad than their peers, completed self-reports of anxiety (Multidimensional Anxiety Scale for children (MASC-C), depression (The Short Mood and Feelings Questionnaire; SMFQ), quality of life (Kinder Lebensqualität Fragebogen; KINDL) and self-esteem (Beck self-concept inventory for youth (BSCI-Y) at baseline of a randomized controlled indicative study. Using multivariate analyses, we examined the relationships between internalizing symptoms, quality of life and self-esteem in three at-risk symptom groups. We also examined gender and age differences. Results: 52.1 % of the screened children scored above the defined at-risk level reporting elevated symptoms of either Anxiety and Depression (Combined group) (26.6 %), Depression only (15.4 %) or Anxiety only (10.2 %). One-way ANOVA analysis showed significant mean differences between the symptom groups on self-reported quality of life and self-esteem. Regression analysis predicting quality of life and self-esteem showed that in the Depression only group and the Combined group, symptom levels were significantly associated with lower self-reported scores on both functional domains. In the Combined group, older children reported lower quality of life and self-esteem than younger children. Internalizing symptoms explained more of the variance in quality of life than in self-esteem. Symptoms of depression explained more of the variance than anxious symptoms. Female gender was associated with higher levels of internalizing symptoms, but there was no gender difference in quality of life and self-esteem. Conclusion: Internalizing symptoms were associated with lower self-reported quality of life and self-esteem in children in the at-risk groups reporting depressive or depressive and anxious symptoms. A transdiagnostic approach targeting children with internalizing symptoms may be important as an early intervention to change a possible negative trajectory. Tailoring the strategies to the specific symptom pattern of the child will be important to improve self-esteem. Trial registration: Trial registration in Clinical trials: NCT02340637, June 12, 2014.nb_NO
dc.publisherBioMed Centralnb_NO
dc.subjectQuality of life – Self-esteem – Anxiety – Depression – Children at risk – Preventionnb_NO
dc.titleSelf-reported quality of life and self-esteem in sad and anxious school childrennb_NO
dc.typeJournal articlenb_NO
dc.typePeer reviewednb_NO
dc.rights.holder© 2016 The Author(s)nb_NO
dc.source.journalBMC Psychologynb_NO
dc.relation.projectNorges forskningsråd: 228846nb_NO
dc.description.localcode© 2016 The Author(s). Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.nb_NO

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