ArticleBMC psychology2026
Self-esteem patterns and the associations with health-related quality of life, self-rated health and lifestyle behaviour among junior high school students: a latent class analysis.
Article in BMC psychology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPrevious studies have investigated associations of self-esteem with mental health among adolescents. Very few studies have examined the relationship of self-esteem patterns with health-related quality of life (HRQoL), mental health and lifestyle behaviour. This study aims to explore patterns of self-esteem, and analyze their associations with HRQoL, self-rated health, mental health and lifestyle behaviour among junior high school students.
methodsWe used the survey data for health behaviour and health among junior high school students in Jining city of Shandong province of China. Latent class analysis was used to identify students with heterogeneous response patterns of self-esteem. Multinomial and traditional logistic regressions and linear regression were applied to examine the relationships of self-esteem patterns with lifestyle behaviours, self-rated health and HRQoL respectively.
resultsThree subgroups of students with distinct patterns of self-esteem were identified. The first group (class 1) was named as "high self-esteem" group (55%). The second group (class 2) was labelled as "moderate self-esteem" group (33%). The third group was named as "low self-esteem" group (12%). Moderate and low self-esteem patterns (relative to high self-esteem) were associated with lower HRQoL and higher odds of poorer self-rated health and mental health. Skipping a breakfast, shorter sleep time and lower level of physical activity was respectively related to low self-esteem.
conclusionsThe findings in this study suggest that low self-esteem patterns are associated with poorer HRQoL, low mental health and self-rated overall health. Lower self-esteem patterns are related to unhealthy lifestyle behaviours characterized as breakfast skipping, insufficient sleep time and low level of physical activity among junior high school students. Further research is needed to extend prospective studies and intervention research to better elucidate the relationships between lifestyle behaviours and self-esteem, and between self-esteem and HRQoL, mental and physical health among adolescents. Health intervention programs that promote self-esteem levels and healthy lifestyles together are recommended to enhance HRQoL and health among junior high school students.
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