For children of every background, age, and ability level, self-esteem is extremely important. When a child has Attention Deficit Hyperactivity Disorder (ADHD), self-esteem may be easily damaged by negative comments from other people. It is not surprising that many children with ADHD develop poor self-esteem or even more serious emotional problems such as depression. The academic problems, peer problems, and conflict with parents and teachers that are frequently experienced can make daily life a struggle. The distressful stories of those who have struggled with years of the inconsistencies and failure that curses the individual afflicted with ADHD would leave no doubt that poor self-image is an inevitable outcome. The scientific literature also supports this conviction.
Concerning the causes of ADHD, although a specific cause is not known, there are a number of factors incriminated in its development. These contain genetics, diet, social and environmental factors. For example several studies have investigated the possible association between season of birth and incidence of ADHD. Two recent studies in the United States presented that date of birth was a predictor of diagnosis and treatment of ADHD based on the age at which children started school. These studies found that children who were relatively younger than their peers within the same grade were more likely to receive a diagnosis of ADHD. Furthermore, studies conclude that prenatal exposure to tobacco smoke and alcohol consumption along with environmental causes are risk factors for ADHD. Also, there appears to be a connection between children’s diet and ADHD. For example children who ingest many commonly used artificial food colors and food preservatives, are more likely to have a diagnosis of ADHD.
Studies also indicate that the disorder is highly heritable and that genetics contribute to approximately 75% of cases. Most researchers believe that the majority of ADHD cases arise from a combination of various genes, many of which affect dopamine transporters. Although ADHD does not follow the traditional model of a genetic disease, there are genes which might play a role but no single gene, to date, has been shown to make a major contribution to ADHD. Although ADHD’s etiology remains unclear, emerging evidence register its strong neurobiologic and genetic background.
According to the Diagnostic and Statistical Manual of Mental Disorders, ADHD has three subtypes. When the most symptoms displayed are in the hyperactivity and impulsivity categories, the individual belongs to the predominantly hyperactive – impulsive subtype. Symptoms of inattention may also be present in this subtype but they are fewer. The second is the inattentive subtype. In this case the majority of symptoms are in the inattention category. Children who belong to this subtype, although may sit quietly, they are not paying attention to what they are doing. These children may also have difficulties getting along with other children. The third is a combined type where children have symptoms from both subtypes above to the same extent. Most children with ADHD seem to have the third combined type.
ADHD impacts throughout children’s community life with difficulties in their home and school. This disorder often leads to poor peer relations, aggression and learning problems which are associated with academic failure and increased risk for depression. In addition ADHD is a risk factor for negative self-concept and development of low self-esteem. Recent studies presented results of a relationship between ADHD symptoms and global self-esteem using twin methodology. For example results support that there was a long-term and statistically significant relationship between high scores of parental-reported ADHD symptoms measured at 8 years of age and low scores in measures of self-esteem at 13 years of age. However there are studies which presented conflicting findings. This could be because of conceptual problems regarding definitions of self-esteem and the different methods and instruments which researchers use in order to measure self-esteem. So it’s very important to understand this complexity and where exactly self-esteem is referred.
Generally self-esteem refers to an individual’s beliefs about one’s worth and is often accompanied by a strong influence. Some researchers in the past have argued from a conventional and philosophical point of view that self-esteem is the awareness of the absolute value of someone’s own personality or gravity. Specifically in 1980’s researchers imported that self-esteem is the satisfaction or dissatisfaction with oneself. Beyond the philosophical standpoints, in the field of psychology self-esteem began to be described as a feeling of self-appreciation. A lot of psychologists have debated its’ definition but no certain view has been established. More recent studies conclude that self-esteem is an abstract cognitive and emotional concept of someone’s idea of his values, as well as the level at which he accepts and respects his idea of his self-image. So, a main component of self-esteem is its level which can vary from high to low self-appreciation. High self-esteem includes positive emotion and that means a person fully accepts and values himself, is satisfied with himself and feels worthy of respect. On the other hand low self-esteem includes negative emotion, a person who does not value himself or approve his individual traits, and his opinion regarding himself is non-satisfying. Moreover, concerning the questionnaires which measure self-esteem, it could be regarded as a multidimensional concept and could be described as different dimensions of the self-image in different contexts. For instance the “I Think I Am” self-esteem questionnaire includes five subscales. These scales refer to physical characteristics, skills and talents, psychological well-being, relationships with parents and family, and relationships with others.
Some researchers, trying to define self-esteem, they recommend two types on the basis of two psychological processes. The first type refers to evaluation which emphasizes on the role of cognition. This type includes mainly mechanistic causal descriptions. The second type refers to affection which emphasizes on the role of feelings. This type involves mainly humanistic views of behavior. Sometimes self-esteem is contingent, which means that the feelings about oneself are an effect and depend on some standards of excellence or some interpersonal expectations. People differ in the extent to which their self-esteem is contingent. Areas on which people usually base their self-esteem are competency, acceptance by others, physical appearance and other domains.
Although meta-analyses in the past have shown that males have higher self-esteem than females, recent studies have not convinced that there are statistically important differences between genders. Some researchers on the other hand, suggest that there are gender differences in specific domains of self-esteem. For example they conclude that males build higher levels of self-esteem on physical appearance and athletic performance. On the other hand females present higher levels on behavioral conduct and moral-ethical self-esteem. They also argue that no gender differences in academic life, family life and social acceptance affect self-esteem.
According to a very interesting view, if it is true that self-esteem is strictly based on success and failure in domains that are of particular importance to an individual alone, and if it is true that people must have self-esteem, then in some way we are tied to these particular areas of life. Then, some people may become so invested in success in these areas of life that they become enslaved to them.
Moreover literature supports that there are controversies about the origins and development of self-esteem, about the impact, outcome and corrosiveness of the construct. There are controversies about its stability, whether it can be changed, and about how to change it. There are also controversies at the simplest level of agreeing upon a definition. Fueling this controversy is disagreement on just how important self-esteem is in the global scheme of leading a productive and healthy life. Although each person could be characterized as having an overall or standard level of self-esteem, it also fluctuates over situations and time. It also seems that self-esteem changes as children grow because as children develop, there are different factors which constitute self-esteem and for each factor there is different importance. For instance, many previous studies have established that as children grow older, more absent-minded and different views are used to characterize the self. These views include physical and activity-related characteristics in childhood and continue to psychological and social characteristics in adolescence. Also, the development of children’s self-esteem is highly influenced by the environment in which they have grown up. As Harter noted in 1980’s, positive and high levels of self-esteem are connected first of all with the parent-child relationship and the ways parents use to cope with the child’s unwanted emotions and then with self-acceptance and social behavior.
Because of the lack of self-acceptance and the affected social behavior which the most children with ADHD have, we understand that they may have no positive self-esteem. So ADHD seems to be a high predictor of low self-esteem in children, adolescents, and adults. Low self-esteem is the result of improper or no social skills and children with that disorder may be perceived as nasty in the mind of others. Criticism which these people receive is one factor that results in low self-esteem. As children grow, build their relationships at their neighborhood and school. When they reach the age to go to school they begin to assess themselves on the basis of mutual relationships with teachers and friends from academic, social and emotional points. Their performance in these areas increase children’s self-esteem and gives the basis for further development. However, what happens with children with ADHD who have difficulties in their interpersonal relationships? Indeed, it seems difficult for them to develop a healthy self-esteem.
High self-esteem is a significant factor for children and adolescents to manage the stress in more formative ways instead of blaming themselves and becoming depressed. Low self-esteem, on the other hand, could increase depression. Several studies have reported the relationship between ADHD and internalizing problems such as depression and anxiety. Therefore it could be argued that findings of the relationship between ADHD-symptoms and low self-esteem may be due to depression as a factor of disarrangement.
Other studies also reported that persons who were diagnosed with ADHD in childhood presented lower self-esteem in adolescence than children without ADHD. This result is linked with previous studies which establish that low self-esteem in adolescence and early adulthood seems to be an outcome connected with ADHD. It’s very interesting that children who had no longer a diagnosable disorder in adolescence also mentioned significantly lower self-esteem as compared to control group. Moreover, results from many studies support a long-term relationship between ADHD symptoms and low self-esteem. Specifically, a statistically significant relationship has been found between high scores of ADHD symptoms which reported by parents at eight years of age and low scores in measures of self-esteem at thirteen years of age.
ADHD can influence negatively the quality of life related to self-esteem to an important value in addition to the possibility of negative effect on the social and academic field. Researchers reported that children diagnosed with ADHD didn’t have significantly high self-esteem and also had significantly lower quality of life than that of typical population. They connected this result with the fact that these children are frequently exposed to criticism and punishment at home, at school and in other environments because of their disastrous behavior and their difficulties in social relationships. In most cases they are not acclaimed or accepted among peers. This fact leads them to develop negative self-esteem. Furthermore, cross sectional studies have presented a connection between ADHD and low-self-esteem in a population with children aged six to seventeen years of age. Researchers studied health related quality of life and ADHD pointed by caregivers. They concluded that children with ADHD had worse physical and mental health than children without the disorder. Parents also reported that their children had lower self-esteem or more emotional and behavioral problems than the control group.
For children diagnosed with ADHD, the school is a disappointing place. In the typical population, self-esteem plays an important role in influencing academic achievement among young students. Symptoms of ADHD mention cognitive and impulsive disorganization, poor task performance and lack of motivation. So children with ADHD often have learning deficits resulting from failure to pay attention to previously taught lessons. A meta-analysis of the published literature since 1990 in order to determine the importance of achievement problems associated with ADHD, concluded that individuals with the disorder have a negative effect on academic performance.
Due to the above behaviors and characteristics, it is natural that such a child mostly experiences ignorance, rejection and sometimes bullying. In adult life, this is not such common as among children. But it affects the relationships in the family, workplace, and other social environments. ADHD may affect all aspects of a child’s life. Indeed, it has an impact not only on the child, but also on parents and siblings, causing disturbances to family and marital functioning. The adverse effects of ADHD upon children and their families change from the preschool years to primary school and adolescence, with varying aspects of the disorder being more prominent at different stages. ADHD may persist into adulthood causing disruptions to both professional and personal life.
Messinis Stavros, 2012
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