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Changing adolescent activity patterns and the correlation of self-esteem and externalizing mental health symptoms across time: results from the USA from 1991 through 2020

Published online by Cambridge University Press:  15 May 2023

Noah T. Kreski Open the ORCID record for Noah T. Kreski [Opens in a new window] ,
Melanie S. Askari ,
Magdalena Cerdá ,
Qixuan Chen ,
Deborah S. Hasin ,
Silvia S. Martins ,
Pia M. Mauro ,
Mark Olfson  and
Katherine M. Keyes
Noah T. Kreski*
Affiliation:
Department of Epidemiology, Columbia University, Mailman School of Public Health, 722 W 168th St, R733, New York, NY 10032, USA
Melanie S. Askari
Affiliation:
Department of Epidemiology, Columbia University, Mailman School of Public Health, 722 W 168th St, R733, New York, NY 10032, USA
Magdalena Cerdá
Affiliation:
Department of Population Health, New York University Grossman School of Medicine, 180 Madison Avenue 4-16, New York, NY 10016, USA
Qixuan Chen
Affiliation:
Department of Biostatistics, Columbia University, Mailman School of Public Health, 722 West 168th Street, R644, New York, NY 10032, USA
Deborah S. Hasin
Affiliation:
Department of Epidemiology, Columbia University, Mailman School of Public Health, 722 W 168th St, R733, New York, NY 10032, USA Department of Psychiatry, New York State Psychiatric Institute, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, 722 W. 168th Street, Room 228F, New York, NY 10032, USA
Silvia S. Martins
Affiliation:
Department of Epidemiology, Columbia University, Mailman School of Public Health, 722 W 168th St, R733, New York, NY 10032, USA
Pia M. Mauro
Affiliation:
Department of Epidemiology, Columbia University, Mailman School of Public Health, 722 W 168th St, R733, New York, NY 10032, USA
Mark Olfson
Affiliation:
Department of Epidemiology, Columbia University, Mailman School of Public Health, 722 W 168th St, R733, New York, NY 10032, USA Department of Psychiatry, New York State Psychiatric Institute, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, 722 W. 168th Street, Room 228F, New York, NY 10032, USA
Katherine M. Keyes
Affiliation:
Department of Epidemiology, Columbia University, Mailman School of Public Health, 722 W 168th St, R733, New York, NY 10032, USA
*
Corresponding author: Noah T. Kreski; Email: ntk2109@cumc.columbia.edu
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Abstract

Background

Common adolescent psychiatric symptoms cluster into two dominant domains: internalizing and externalizing. Both domains are linked to self-esteem, which serves as a protective factor against a wide range of internalizing and externalizing problems. This study examined trends in US adolescents' self-esteem and externalizing symptoms, and their correlation, by sex and patterns of time use.

Methods

Using Monitoring the Future data (N = 338 896 adolescents, grades:8/10/12, years:1991–2020), we generated six patterns of time use using latent profile analysis with 17 behavior items (e.g. sports participation, parties, paid work). Groups were differentiated by high/low engagement in sports and either paid work or high/low peer socialization. Within each group, we mapped annual, sex-stratified means of (and correlation between) self-esteem and externalizing factors. We also examined past-decade rates of change for factor means using linear regression and mapped proportions with top-quartile levels of poor self-esteem, externalizing symptoms, or both.

Results

We found consistent increases in poor self-esteem, decreases in externalizing symptoms, and a positive correlation between the two across nearly all activity groups. We also identified a relatively constant proportion of those with high levels of both in every group. Increases in poor self-esteem were most pronounced for female adolescents with low levels of socializing, among whom externalizing symptoms also increased.

Conclusions

Rising trends in poor self-esteem are consistent across time use groups, as is the existence of a group facing poor self-esteem and externalizing symptoms. Effective interventions for adolescents' poor self-esteem/co-occurring symptoms are needed broadly, but especially among female adolescents with low peer socialization.

Keywords

Adolescentexternalizingself-esteemsocializationtime use
Type
Original Article
Information
Psychological Medicine , Volume 54 , Issue 1 , January 2024 , pp. 169 - 177
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Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press

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