Abstract:
To identify psychosocial problems and self-esteem in children with growth
hormone deficiency (GHD) and define the role of some clinical and sociodemographic
determinants in the conceptualization of internalizing and externalizing problems as
criteria for psychosocial functioning.
Materials and Methods: A GHD sample (46 prepubescent children) was selected and
compared to a matched control group (80 healthy children). Psychosocial functioning
in children with GHD was investigated using Goodman’s “Strengths and Difficulties
Questionnaire (SDQ).” The study of children’s self-esteem was carried out by the
Dembo–Rubinstein method.
Results: This study reveals that the GHD sample has more internalizing problems and
lower self-esteem. Higher score and frequency of assessment in the abnormal score for
“total difficulties,” “emotional problem,” and “peer problem” were found in children with
GHD. The SDQ score and the frequency of assessment in the abnormal score for all
SDQ scales in children with more pronounced growth deficit (height SDS < −3) did not
exceed the same indicators in children with less growth retardation (−3 < height SDS
< −2). A comparison of psychosocial features in children with isolated growth hormone
deficiency and multiple pituitary hormones deficiency did not reveal differences in SDQ
score and the frequency of assessment in the abnormal score for all SDQ scales. It
was found that children with GHD have a reduced level of assertions, low self-esteem,
and a weak discrepancy between the level of assertions and self-esteem. Some
sociodemographic determinants (male gender, age < 9 years, and low family income)
and clinical determinants (low compliance and suboptimal growth response after 1 year
of rGHh therapy) have an impact on the overall assessment of psychological problems
in children with GHD. The internalizing difficulties are associated with certain clinical
determinants (growth status and treatment status) and sociodemographic determinants
(female gender, age < 9 years).
Conclusions: The identification of low self-esteem and the high SDQ score for scales
“total difficulties,” “emotional problems,” and “peer problems” indicates psychosocial
maladjustment and conceptualization of internalizing problems in children with GHD.
