Ego Development and Self-Esteem in Diabetic Adolescents

Abstract

This study explores the impact of diabetes mellitus upon aspects of adolescent development. Using specific assessment techniques and interviews, we followed ego development and self-esteem variables. Clinical considerations suggest that both personality dimensions are important for the understanding of diabetic adolescents. The significance of ego development is implied in many case reports, which note the disruption in individual coping that frequently follows the onset of diabetes. Clinical observations and empirical studies have also commented upon diminished self-esteem in diabetic patients. Our sample consisted of male and female diabetic adolescents, whose average age was 13. All patients completed Loevinger's sentence completion test of ego development and the Coopersmith self-esteem inventory. Previous studies have indicated favorable reliability and validity for both instruments. A subgroup of the sample was also interviewed. The ego development and self-esteem scores were contrasted with two groups of similar age adolescents who had previously completed these same tests, and a control group. The diabetic adolescents were clearly at lower levels of ego development than the nondiabetic groups. These lower stages were not correlated with duration of illness. A second finding was that the boys were at lower levels of ego development than the girls, regardless of age or illness duration. Self-esteem scores were associated with both illness duration and ego development. Subjects at the lowest levels of ego development also had the lowest self-esteem. Study of the interviews revealed that the patients at these lower ego development levels manifested concrete, more stereotyped, and resigned responses than those patients at the higher ego development stages.