Self-Perceptions of Young Adults Who Survived Severe Childhood Burn Injury

Abstract

Objective The transition of pediatric burn survivors into adulthood is accompanied by a reformulation of their self concept. In order to anticipate the need for and guide development of appropriate psychosocial interventions, this study examines how young adults who were burned as children perceive themselves and how this perception might affect their self-esteem. Method 82 young adult burn survivors (45 males, 37 females) were assessed using the Tennessee Self-Concept, 2nd Edition (TSCS2) to determine how the participants perceive themselves and their interaction with society. To gain insight into the possible effects of these self-concept scores, relationships were analyzed between self-concept, a behavioral assessment (Young Adult Self-Report, YASR) and a psychiatric symptom assessment (Structured Clinical Interview for DSM-IV Axis I Disorders, SCID I). Results This group of burn survivors scored significantly lower in self-concepts, reflected in TSCS2 sub-scale scores of Physical function, appearance, and sexuality, Moral conduct, Personal values, Academics and work, and Identity than did the reference population. Pearson correlation coefficients showed that as Moral, Personal, Family and Social aspects of self concept decreased, clinical problems endorsed on the YASR sub-scales increased, including Anxiety Somatic, Attention, Intrusive and Aggressive. Persons with lower self-concept scores on the TSCS2 Personal, Family, and Social Scales, were more withdrawn on the YASR. Similarly those with lower TSCS2 scores on the Personal and Family Scales endorsed significantly more Thought Problems on the YASR. Affective distress on the SCID I was associated with significantly lower self concept. TSCS2 Total Self Concept, Personal, and all of the Supplementary Scale scores were significantly lower for the group with an affective disorder. Those whose SCID I scores were consistent with a current anxiety disorder had significantly lower scores for the TSCS2 Total Self Concept and Personal. Lower self-concept was associated with endorsement of SCID I symptoms (Identity, p= .0018, Satisfaction, p=.0018, and Behavior, p= .0004). Although the major limitation of this study using the TSCS2 is the lack of a matched reference population to compare with the burn survivors, the TSCS2 does help in gaining insight into the self esteem issues of this population.

Long-term mental health outcomes after unintentional burns sustained during childhood: a retrospective cohort study

“…The impacts of the initial burn trauma, disfigurement and effects on one’s body image and associated social stigma among paediatric burn survivors, have been the focus of a number of studies [ 8 , 14 , 42 – 44 ]. Latency age and teen-age burn survivors appear to make adjustments to their core personal values by reducing and shifting the importance of physical appearance to emphasising other personal attributes [ 15 ]. However, transitioning from childhood to adulthood and more independent living introduces new challenges related to new personal contacts and relationships, and less familiar environments, which may cause individuals to re-evaluate their situations and self [ 15 ].…”

Cardiorespiratory Capacity and Strength Remain Attenuated in Children with Severe Burn Injuries at Over 3 Years Postburn

“…However, this is not the case with total body fat, which continues to increase in burned children. This may be related to a reduction in physical activity in the years after injury, possibly due to posttraumatic depression (26,27). This inactivity may increase overall fat accumulation (principally central fat), which is typical after burns (28,29).…”

“…However, these values were still 18% to 13% less than those of age- and sex-matched controls. It is suggested that, even though the hypermetabolic state persists for years after burn (27), most of the inflammatory and metabolic dysregulation ends at 3 years postburn (6). Thus, this improvement in metabolic health, in conjunction with normal growth and development, may have enhanced aerobic capacities.…”

Effectiveness of resistance strength training in children and adolescents with ≥30% total body surface area: A systematic review

“…They are vulnerable because of their maturing physical and psychosocial development (Russell et al . 2013 ; Stubbs et al . 2011; Toon et al .…”