Abstract
Background: Anxiety disorders are the most prevalent mental health disorders in children. Cognitive behavioral therapy (CBT) has been established as an evidence-based treatment for this group. However, a considerable amount of patients still do not achieve satisfactory recovery following CBT. In order to improve outcomes, researchers have suggested targeting common, underlying factors in mental health problems, which self-concept could be an example of. Objective: We aimed to explore the role of self-concept in child anxiety disorders, exploring associations between self-concept and gender, age, anxiety and depressive symptoms, and primary anxiety diagnosis, as well as self-concept change from pre-treatment until long-term follow-up 3.9 years after treatment completion. Method: Our thesis is based on data from the ATACA study, a community-based randomized controlled trial (RCT) examining the effect of CBT on child anxiety disorders. The sample consists of children with generalized anxiety disorder (GAD), separation anxiety disorder (SAD), and social anxiety disorder (SOP). Data were analyzed using exploratory analyses, paired and unpaired samples t-tests, two bivariate correlation analyses, as well as a one-way analysis of variance Results: Results showed overall insignificant gender differences in self-concept. However, self-concept was negatively correlated with age, meaning older participants had lower self-concept. Self-concept was correlated with depressive and anxiety symptoms, but self-concept variations based on primary diagnoses were small or insignificant. Self-concept significantly increased from pre-treatment to post-treatment. Self-concept decreased slightly from post-treatment to long-term follow-up, but the self-concept change between pre-treatment and long-term follow-up remained statistically significant. Conclusion: Our thesis supports a connection between self-concept and mental health problems such as anxiety, suggesting that self-concept is a transdiagnostic factor in mental health problems. Moreover, age seems to be an important determinant of self-concept in clinical child samples. Our thesis also indicates that self-concept can be improved by CBT, and further that the improvement remains long-term.