Correlates Among Self-concept, Anxiety, Depression, Anger, and Disruptive Behavior in Vulnerable Middle School Youth

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Correlates Among Self-concept, Anxiety, Depression, Anger, and Disruptive Behavior in Vulnerable Middle School Youth Jacqueline Hoying, PhD, RN, NEA-BC The Ohio State University

Faculty Disclosure Faculty Name: Conflicts of Interest: None Employer: Sponsorship: Jacqueline Hoying, PhD, RN, NEA BC The Ohio State University Sigma Theta Tau Epsilon Chapter

Session Goal: Goals and Objectives o Discuss the correlations of the variables in two vulnerable middle school age populations Session Objectives: o Discuss relationships among study variables including self-concept, anxiety, depression, anger, and disruptive behavior between Urban and Appalachian middle school youth Discuss implications for clinical and future research

Middle schools from two vulnerable environments

Vulnerable Adolescents Viewed Differently

Two sub-cultures with different stressors URBAN RURAL APPALACHIA Increased exposure to violence Neighborhood chaos Urban school districts Rural residence Unique culture environment

Similarities in Adverse Health Outcomes: Overweight/Obesity and Mental Health Concerns Occurrence is higher in minority youth from lower socioeconomic status families

Overweight/Obesity in Adolescents Childhood obesity is associated with a 70% increased prevalence of adult obesity 61% increased risk factors for coronary artery disease 26% increased risk of having two or more risk factors and premature death U.S. overall rate 34.2% African American youth 39.5% Appalachian youth 38%

Mental Health Concerns in Adolescents Significant association exists between adolescent obesity and depression Mental Health Disorders U.S. overall rate 17% Low-income youth 21% 1 in 4 adolescents experience mental health issue

Adaptive vs Maladaptive Coping Understanding the differences and similarities in the baseline variables can assist in guiding interventions Anxiety Depression Self-concept Anger Disruptive behavior

Anxiety in Adolescents Youth with anxiety and depression symptoms experience impairment in academic, social, family, and personal health accompanied by increased risk for adult anxiety and depressive disorders, and substance abuse issues Anxiety disorders are the most common mental health disorder Adolescents worry about social competence, health issues, and school performance

Depression in Adolescents Suicide remains the third leading cause of death among 12- to 17-year-olds Suicide rates for African American youth (5-11 yrs.) are significantly higher (and have increased for the first time) compared to a decrease in Caucasian peers

Self-Concept in Adolescents Developmentally, adolescents become increasingly self-conscious and have heightened awareness of how they are perceived by others An indispensable element of mental health is the positive regard one has for self Self-esteem is an individual s collection of thoughts and feelings about their own worth and importance

Anger in Adolescents Although anger is a common and natural emotion, or internal event, problems associated with the inappropriate expression of anger remain among the most serious concerns of parents, educators, and the mental health community Anger, frustration, and violence in minority adolescents (particularly males) is often mistaken for behavior problems and depression

Disruptive Behavior in Adolescents Disruptive Behavior defined broadly as noncompliance, aggression, disruptive classroom behavior, or delinquent behavior as the primary disorder Anger/disruptive behavior in combination with school experiences of overt or covert discrimination and prejudice, may increase depressive symptomatology among minority students increasing mental vulnerability, academic performance issues, and/or high-risk behaviors

Methods A descriptive correlation design was used for this study Students from two middle schools in the Midwest were recruited to participate

Baseline Characteristics URBAN APPALACHIAN Age 11.54 (.62) 13.6 (.56) Gender Male 11 (36%) 14 (48%) Female 20 (65%) 15 (52%) Ethnicity African American 18 (58%) 0 Hispanic 9 (29%) 0 Caucasian 4 (13%) 29 (100%) Public Assistance Yes 15 (75%) 14 (48%) No 5 (25%) 15 (52%) I don t know 11 Weight Healthy Weight 27 (87%) 15 (52%) Overweight 3 (10%) 5 (17%) Obese 1 (3%) 9 (31%)

Appalachian Baseline Correlations Anxiety Depression Self-concept Anger Disruptive Behavior Anxiety 1.566** -.164.549**.704** Depression.566** 1 -.666**.903**.272** Self-concept -.164 -.666** 1 -.644**.013 Anger.549**.903** -.664** 1.228** Disruptive Behavior.704**.272**.013.228** 1 ** Correlation is significant at the 0.01 level

Urban Baseline Correlations Anxiety Depression Self-concept Anger Disruptive Behavior Anxiety 1 -.674** -.485**.681**.346** Depression.674** 1 -.775**.761**.598** Self-concept -.485** -.775** 1 -.713** -.644** Anger.681**.761** -.713** 1.811** Disruptive Behavior.346**.598** -.644**.811** 1 ** Correlation is significant at the 0.01 level

Results Correlations were examined at baseline among the study variables for each set of participants Negative and significant correlations (p=.01) existed between the participants self-concept and depression and self-concept and anger. As the students selfconcept decreased, their depressive symptoms and anger increased for both groups Additionally, self-concept and anxiety, and selfconcept and disruptive behavior were negatively correlated with the urban population. As their selfconcept decreased their anxiety and disruptive behavior increased

Results Additionally, positive and significant correlations (p=.01) existed between depression and anxiety, depression and anger, and depression and disruptive behavior. This suggested that as the students depressive symptoms increased so did the students anxiety, anger, and disruptive behavior Furthermore, positive and significant correlations existed between anxiety and anger, and anxiety and disruptive behavior. As the students anxiety increased so did their anger and disruptive behavior

Results Finally, positive and significant correlations (p=.01) existed between anger and disruptive behavior. Suggesting that as the students anger increased so too did their disruptive behavior These positive and significant correlations were found in the urban and rural student groups for the same variables

Conclusions The middle school years are often stressful for students, specifically for youth who are from underserved areas and subject to health disparities Understanding similarities in baseline correlations among students who are similar can guide behavior interventions to improve healthy lifestyle choices and healthy lifestyle behaviors in middle schoolers

Conclusions Of particular significance is understanding the importance of the findings surrounding self-concept and realizing that positive selfconcept can serve as a protective factor to support positive behavioral outcomes when guiding behavior interventions (i.e. cognitive behavioral skills building)

Future Implications Important to this particular age group are depression and anxiety screening, along with reducing current obesity trends This study underlines the similarities in vulnerable youth populations which appear dissimilar and supports the promising potential to improve mental health outcomes (e.g., anxiety, depression, and suicidal ideation), improved self-concept and decreased maladaptive coping for anger and disruptive behavior through behavior interventions for youth in real-world school settings

Contact Information Jacqueline Hoying 614-688-1641 hoying.80@osu.edu Slide presentation copyright 2016