Mechanisms Behind the Development of Anxiety Symptoms in Norwegian Adolescents: The Interplay Between Self-Esteem and Peer Relations

Author: Sana Parveen Supervisors: Evalill Bølstad Karevold & Silje Kvam Bårdstu Title: Mechanisms Behind the Development of Anxiety Symptoms in Norwegian Adolescents: The Interplay Between Self-Esteem and Peer Relations Background: So far, most studies on anxiety development that have examined the impact of factors like self-esteem and peer relations have focused on symptoms of social anxiety. The current study is amongst the first to address the interplay between self-esteem and peer relations in predicting more general and physiological symptoms of anxiety in adolescence. The overall purpose of the study was to investigate in what way, and to what extent, self-esteem, perceived peer acceptance and peer support predicted symptoms of anxiety in a population-based sample of Norwegian adolescents followed from the age of 16 to 19. More specifically, perceived peer acceptance was proposed to work as a mediator, and peer support as a moderator, in the overall relationship between self-esteem and symptoms of anxiety, which was examined both crosssectionally and longitudinally. Method: The current study is based on data made available from the last two waves of an epidemiological study named Tracking Opportunities and Problems in Childhood and Adolescence (The TOPP Study). The sample consists of Norwegian adolescents followed over a two-year period from they were 16-17 years old at T7 (N = 375) to they were 18-19 years old at T8 (N = 442). Anxiety symptoms were measured by the Anxiety sub-scale in the Depression, Anxiety Stress Scale. Self-esteem and perceived peer acceptance were measured by Harter’s Self-Perception Profile for Adolescents, and peer support was measured using three questions reflecting the adolescent’s experience of attachment, mutual respect and belonging. Crosssectional and longitudinal associations were examined using multiple regression analysis, while controlling for confounding variables like gender and earlier symptom-levels. Results: Self-esteem, perceived peer acceptance and peer support were all negatively related to symptoms of anxiety in adolescents. Perceived peer acceptance partially mediated the relationship between self-esteem and symptoms of anxiety cross-sectionally, however, this mediation was not apparent longitudinally. Peer support, on the other hand, worked as a moderator in the longitudinal relationship between self-esteem and symptoms of anxiety. MECHANISMS BEHIND THE DEVELOPMENT OF ANXIETY SYMPTOMS V Conclusion: The findings support the impact of self-esteem on symptoms of anxiety in adolescence, and the importance of addressing aspects of peer relations also when investigating more general symptoms of anxiety. This rather unique composition of predictors has helped to unravel new pathways to the development of anxiety symptoms, enabling a broader understanding of how the interplay between self-esteem and peer relations in adolescence affects the subsequent development of anxiety symptoms. More specifically the findings highlight the importance of ensuring high levels of self-esteem from early on, as it could serve as a protective factor in the development of anxiety symptoms. If initial levels of self-esteem are low, this will subsequently lower the perceived acceptance from peers, which in turn could result in higher symptom-levels. In addition, low peer support was identified as being a risk factor for developing subsequently higher symptom-levels when combined with low levels of self-esteem. Taken together, findings from the current study stresses the importance of early prevention and intervention and thus also provides an important basis for the development of future prevention programs. MECHANISMS BEHIND THE DEVELOPMENT OF ANXIETY SYMPTOMS VI MECHANISMS BEHIND THE DEVELOPMENT OF ANXIETY SYMPTOMS VII