'I Am Worthless and Kind'; The Specificity of Positive and Negative Self-Evaluation in Adolescent Depression

Br J Clin Psychol. 2019 Sep;58(3):260-273. doi: 10.1111/bjc.12215. Epub 2018 Dec 16.


Objectives: Adolescence represents a critical phase when the concept of self is developed and consolidated. Depressed adolescents globally endorse more negative and fewer positive self-descriptive words compared with non-depressed adolescents. Yet, the methods used have not allowed for more detailed exploration of the specific content of these self-endorsements.

Methods: Adolescents, aged 12-18 years, were recruited from the community (n = 204) and from a child and adolescent mental health service in the UK (n = 87). Participants completed measures of depression and a self-description questionnaire which included 12 positive and 12 negative self-descriptive adjectives.

Results: As expected, we replicated previous findings that depressive symptoms are associated with global positive and negative self-endorsements. The difference between mean scores was examined for each adjective. Depressed adolescents endorsed all negative adjectives more highly relative to community adolescents; ratings of 'worthless' and 'useless' had the biggest difference between community and depressed adolescents. Surprisingly, a group of positive prosocial self-descriptors were endorsed equally by depressed and community adolescents and were not associated with severity of depressive symptoms.

Conclusions: Although depressed adolescents endorsed more negative descriptions of themselves than community adolescents, positive self-endorsements related to their relationships with other people were not impaired.

Practitioner points: Most highly endorsed self-descriptive negative words by depressed adolescents were 'worthless' and 'useless' Positive prosocial self-descriptive adjectives (i.e., trustworthy, friendly, and kind) were highly endorsed by all young people and were not associated with depression Assessment and treatment should consider the content of adolescent self-evaluation The present study is unable to identify whether young people would produce the same themes of positive and negative words in a free response measure Diagnostic information was only available on the clinical group.

Keywords: adolescence; cognition; depression; self-concept.

MeSH terms

  • Adolescent
  • Adolescent Behavior / psychology*
  • Child
  • Cognition / physiology*
  • Depression / diagnosis
  • Depression / psychology*
  • Depressive Disorder / psychology
  • Diagnostic Self Evaluation
  • Female
  • Humans
  • Male
  • Mental Health Services
  • Self Concept*
  • Self-Assessment*
  • Sensitivity and Specificity
  • Surveys and Questionnaires