Self-esteem and perceived stress in young adolescents with chronic disease. Unexpected findings

This pilot study was designed to investigate the relationship between perceived stress, self-esteem and "functional" pain in young adolescents with and without chronic disease. Twenty children with chronic disease and 15 without who were seen in a pediatric outpatient clinic completed a symptom survey, the Piers-Harris Self-Concept Survey, and Lewis's Feel-Bad Scale. Adolescents with significant self-reported complaints of abdominal pain, chest pain, and headaches (without documented organic cause) scored higher on the Feel-Bad scale (p less than 0.002) and lower on the self-concept scale (p less than 0.02) than those without functional complaints. Patients with chronic disease scored higher on the self-esteem measure (61 +/- 14 versus 48 +/- 14, p less than 0.01) and lower on the stress measure (80 +/- 40 versus 120 +/- 54, p less than 0.02) than those without a chronic disease. These findings of lower stress and higher self-esteem in adolescents with chronic illness were unexpected. Possible explanations are discussed.