An investigation into depression, anxiety, low self-esteem and external locus of control in children referred to a child and family mental health service

Abstract

Emotional and behavioural problem s in childhood em brace an array o f disorders ranging from depression, anxiety and chronic shyness to non-com pliance, im pulsiveness, stealing and aggression. A chenbach (1991) proposed a dim ensional approach to conceptualising children’s problems. The first dim ension, consisting o f emotional behaviours such as crying, w orrying and w ithdraw al has been given the broad label o f internalising behaviour problems. These disorders are m ost acutely troublesome for the child rather than their parents, carers or teachers. The second dimension, which targets dysregulated behaviours, such as aggressive and delinquent conduct problem s has been term ed externalising behaviour problem s and often reflects a greater cost and challenge for society at large.Psychological problem s in children rarely occur in isolation; for exam ple, a child with externalising behavioural problems may also suffer from depression and low self-esteem, another, who refuses to go to school, may display sym ptom s o f anxiety and depression. In clinic studies about 25 per cent o f referrals have a m ajor depression (Carr, 1999). In a review o f the most im portant epidem iological studies, Anderson (1994) concluded that the overall prevalence for anxiety disorders in children and adolescents is 2 to 9 per cent. Research also suggests that 50 per cent o f children diagnosed as depressed are also anxious and that 25 per cent o f children diagnosed with anxiety disorders are also depressed (Smith, 1999).The expression and presentation o f psychological difficulties in childhood can be varied and assessm ent does not always uncover the underlying features o f psychological problem s in children. Nevertheless, standardised m easures o f selfreport can be useful and valid tools for assessing a child’s own psychological experience. By tapping into specific areas o f concern or difficulty for the child and offering the clinician an improved understanding o f the child’s inner em otional world these tools can make a valuable contribution to the overall therapeutic process.The study aimed to investigate the incidence o f anxiety and depression am ongst children referred to one team o f a Child and Fam ily M ental Flealth Service in Edinburgh. Participants were children aged between 8 to 11-years. Self-report measures o f anxiety, depression, self-esteem and locus o f control were taken to determ ine whether a link could be found between these psychological constructs and internalising and externalising disorders and to determ ine the presence o f comorbidity. In addition, a measure o f parental stress was taken. The relationships between these factors will be explored, results will be given and conclusions reached.