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An Evaluation of Psychological Well-being, Decision-Making Processes and Self-Esteem in Adolescents in Institutional Care

Yıl 2025, Cilt: 52 Sayı: 4, 683 - 693, 12.12.2025
https://doi.org/10.5798/dicletip.1840641

Öz

Objective: This study investigates the relationships between depression, anxiety, stress, self-esteem, and decision-making among adolescents in institutional care in Turkey, addressing an important research gap in this area.
Methods: The sample consisted of 83 adolescents aged 12-18 years, excluding those with mental disabilities who were in institutional care. Participants completed self-assessment questionnaires, including the Turkish versions of the Depression Anxiety Stress Scale (DASS 21), the Rosenberg Self-Esteem Scale (RSE), and the Adolescent Decision-Making Questionnaire (ADMQ).
Results: The sample consisted primarily of females (55.4%) with a mean age of 15.22 years, and no significant gender differences were observed across the measures. A critical finding emerged regarding the duration of stay: adolescents who had been in institutional care for less than two years demonstrated significantly lower scores on the Adolescent Decision-Making Questionnaire (ADMQ). Self-esteem (RSE) was found to be strongly and negatively associated with all three distress measures (Depression, Anxiety, and Stress), and it emerged as the only significant predictor in this model, accounting for over half (52.5%) of the variance in overall psychological distress. Alarmingly, the prevalence rates for the DASS-21 subscales indicated that over half of the participants (50.6%) reported clinically significant levels of depression, followed by anxiety (31.3%) and stress (16.8%).
Conclusion: These findings highlight the urgent need for targeted mental health interventions to support adolescents in institutional care, focusing on enhancing self-esteem, improving decision-making, and integrating mental health resources into care frameworks to foster better overall well-being.

Etik Beyan

This study was approved by the Ethics Committee on 15 May 2025 with decision number 2025/212.

Kaynakça

  • 1.Crone EA, Dahl RE. Understanding adolescence asa period of social–affective engagement and goalflexibility. Nat Rev Neurosci. 2012;13(9):636-50.
  • 2.Morantz G, Kadiyala S, Yotebieng M, et al. Childabuse and neglect among orphaned children andyouth living in extended families in sub-SaharanAfrica: What have we learned from qualitativeinquiry? Vulnerable Child Youth Stud.2013;8(4):338-52.
  • 3.Sumathi S, Rajeswari S. Self-esteem ofinstitutionalized adolescents. 2022.
  • 4.Duraisamy P, Anitha C, Saravanan C, et al. Impactof parental deprivation and psychological well-being among adolescent orphans: A systematicreview. J ReAttach Ther Dev Divers. 2023;6(1s):125-39.
  • 5.Golovey L, Vasylyeva O, Shulga M, et al. ConflictBetween Self-Esteem And Aspirations Related ToPsychological Wellbeing Of Adolescents. Eur ProcSoc Behav Sci. 2020;94.
  • 6.Polihronakis T. Information packet: Mental healthcare issues of children and youth in foster care.National Resource Center for Family CenteredPractice and Permanency Planning at the HunterCollege of School of Social Work. 2008.
  • 7.Lehmann S, Funk M, Stuhlinger U, et al. Mentaldisorders in foster children: a study of prevalence,comorbidity and risk factors. Child AdolescPsychiatry Ment Health. 2013;7:1-12.
  • 8.Simsek Z, Erol N, Öztop D, et al. Prevalence andpredictors of emotional and behavioral problemsreported by teachers among institutionally rearedchildren and adolescents in Turkish orphanagescompared with community controls. Child YouthServ Rev. 2007;29(7):883-99.
  • 9.Gaviţa OA, Miclea M, Mureşan V, et al. The efficacyof a short cognitive–behavioral parent program inthe treatment of externalizing behavior disorders inRomanian foster care children: Building parentalemotion-regulation through unconditional self-andchild-acceptance strategies. Child Youth Serv Rev.2012;34(7):1290-7.
  • 10.Mohammadzadeh M, Khadijah Y, Noraini M, et al.Emotional health and self-esteem amongadolescents in Malaysian orphanages. CommunityMent Health J. 2018;54:117-25.
  • 11.Lovibond PF, Lovibond SH. The structure ofnegative emotional states: Comparison of theDepression Anxiety Stress Scales (DASS) with theBeck Depression and Anxiety Inventories. Behav Res Ther. 1995;33(3):335-43.
  • 12.Gloster AT, Rhoades HM, Novy DM, et al.Psychometric properties of the Depression Anxietyand Stress Scale-21 in older primary care patients. J Affect Disord. 2008;110(3):248-59.
  • 13.Sariçam H. The psychometric properties ofTurkish version of Depression Anxiety Stress Scale-21 (DASS-21) in health control and clinical samples.J Cogn Behav Psychother Res. 2018;7(1):19.
  • 14.Çuhadaroğlu F. Adolesanlarda benlik saygısı.Uzmanlık Tezi, Hacettepe Üniversitesi Tıp FakültesiPsikiyatri Anabilim Dalı, Ankara. 1986.
  • 15.Mann L, Harmoni R, Power C. Adolescentdecision-making: The development of competence. JAdolesc. 1989;12(3):265-78.
  • 16.Çolakkadioğlu O, Güçray SS. Ergenlerde KararVerme Ölçeği'ni Türkçe'ye Uyarlama Çalışması.Eurasian J Educ Res (EJER). 2007(26).
  • 17.Singh A, Suvidha D. Well-being of orphans: areview on their mental health status. Int J Sci Res SciTechnol. 2016;2(5):180-4.
  • 18.Sushma B, Padmaja G, Agarwal S. Well-being,psychosocial problems and social interactionanxiety in children. Int J Indian Psychol.2016;3(4):30-43.
  • 19.Avakyan TV, Volikova SV. Social anxiety inchildren. Psychol Russia. 2014;7(1):73.
  • 20.Shafiq F, Haider SI, Ijaz S. Anxiety, depression,stress, and decision-making among orphans andnon-orphans in Pakistan. Psychol Res Behav Manag.2020:313-8.
  • 21.Ibrahim A, El-Sayed H, El-Ghandour M, et al.Prevalence and predictors of depression amongorphans in Dakahlia's orphanages, Egypt. Int J CollabRes Intern Med Public Health. 2012;4(12):2036.
  • 22.Safdar S. Comparative analysis of childhooddepression and self-esteem among orphan girls andboys. J Psychol Clin Psychiatry. 2018;9(1):1-4.
  • 23.Wanjiru M, Gathogo J. The impact of gender onorphans’ self-esteem and academic performanceamong secondary school students in Kirinyaga andNyeri Counties of Kenya. 2014.
  • 24.Behrendth M. The psychological impact ofparental loss and orphan-hood of children in an areaof high HIV prevalence: A cross sectional study inNorth West region of Camroon. 2008.
  • 25.Shiferaw G, Bacha L, Tsegaye D. Prevalence ofdepression and its associated factors among orphanchildren in orphanages in Ilu Abba Bor Zone, SouthWest Ethiopia. Psychiatry J. 2018;2018(1):6865085.
  • 26.Sahoo S, Khess CR. Prevalence of depression,anxiety, and stress among young male adults inIndia: a dimensional and categorical diagnoses-based study. J Nerv Ment Dis. 2010;198(12):901-4.
  • 27.Ramli J, Yahaya A, Lazin S. Depression amongresidents in orphanage in Kota Bharu. Kelantanhttp://eprints. utm. my/10127/1/JOURNAL_DALAM_SITI_ZAINAB. pdf.2010.
  • 28.WI WS, Ismail Z, Bakar A, et al. Prevalence ofdepression in adolescents living in residentialhomes in Perak, Malaysia and its association withsocio-demographic and personal factors. Malays J Psychiatry. 2014;23(2):40-51.
  • 29.Workye T. Psychological wellbeing betweeninstitutional and non institutional orphan childrenin Gulele sub city, Addis Ababa. Addis Ababa,Ethiopia: Addis Ababa University. 2015.
  • 30.Fawzy N, Fouad A. Psychosocial anddevelopmental status of orphanage children:Epidemiological study. Curr Psychiatry.2010;17(2):41-8.
  • 31.Thabet L, Thabet AAM. Mental health problemsamong orphanage children in the Gaza Strip. AdoptFoster. 2007;31(2):54-62.
  • 32.Rezaei E, Malekpour M, Oreyzi H. The Effect ofthe. Clin Psychol Pers. 2009;7(1):21-8.

Kurum Bakımı Altındaki Ergenlerde Psikolojik İyi Olma Durumu, Karar Verme Süreçleri ve Öz Saygının Değerlendirilmesi

Yıl 2025, Cilt: 52 Sayı: 4, 683 - 693, 12.12.2025
https://doi.org/10.5798/dicletip.1840641

Öz

Amaç: Bu çalışma, Türkiye'de kurum bakımındaki ergenlerde depresyon, anksiyete, stres, benlik saygısı ve karar verme arasındaki ilişkileri araştırmakta ve bu alandaki önemli bir araştırma boşluğunu ele almaktadır.
Yöntemler: Örneklem, kurum bakımında kalan ve zihinsel engelli olanlar hariç tutulan 12-18 yaş arası 83 ergenden oluşmaktadır. Katılımcılar, Depresyon Anksiyete Stres Ölçeği (DASS 21), Rosenberg Benlik Saygısı Ölçeği (RSE) ve Ergen Karar Verme Anketi'nin (ADMQ) Türkçe versiyonlarını içeren öz değerlendirme anketlerini doldurmuştur.
Bulgular: Örneklem, yaş ortalaması 15,22 olan ve çoğunluğu kadınlardan (%55,4) oluşan ergenlerden oluşmuş, ölçülen değişkenler arasında anlamlı bir cinsiyet farkı gözlenmemiştir. Kalış süresi ile ilgili kritik bir bulgu ortaya çıkmıştır: Kurum bakımında iki yıldan az kalan ergenler, Ergen Karar Verme Anketi'nde (ADMQ) anlamlı derecede düşük puanlar göstermiştir. Öz saygı, her üç sıkıntı ölçümüyle (Depresyon, Anksiyete ve Stres) güçlü ve negatif bir şekilde ilişkili bulunmuş ve genel psikolojik sıkıntıdaki varyansın yarısından fazlasını (%52,5) açıklayan, bu modeldeki tek anlamlı yordayıcı olarak ortaya çıkmıştır. Endişe verici bir şekilde, DASS-21 alt ölçeklerinin yaygınlık oranları, katılımcıların yarısından fazlasının (%50,6) klinik olarak anlamlı depresyon düzeyleri bildirdiğini, bunu anksiyete (%31,3) ve stresin (%16,8) takip ettiğini göstermiştir.
Sonuç: Bu bulgular, kurum bakımındaki ergenleri desteklemek için özsaygıyı artırmaya, karar verme süreçlerini iyileştirmeye ve ruh sağlığı kaynaklarını bakım çerçevelerine entegre ederek genel refahı daha iyi hale getirmeye odaklanan hedefli ruh sağlığı müdahalelerine duyulan acil ihtiyacı vurgulamaktadır.

Kaynakça

  • 1.Crone EA, Dahl RE. Understanding adolescence asa period of social–affective engagement and goalflexibility. Nat Rev Neurosci. 2012;13(9):636-50.
  • 2.Morantz G, Kadiyala S, Yotebieng M, et al. Childabuse and neglect among orphaned children andyouth living in extended families in sub-SaharanAfrica: What have we learned from qualitativeinquiry? Vulnerable Child Youth Stud.2013;8(4):338-52.
  • 3.Sumathi S, Rajeswari S. Self-esteem ofinstitutionalized adolescents. 2022.
  • 4.Duraisamy P, Anitha C, Saravanan C, et al. Impactof parental deprivation and psychological well-being among adolescent orphans: A systematicreview. J ReAttach Ther Dev Divers. 2023;6(1s):125-39.
  • 5.Golovey L, Vasylyeva O, Shulga M, et al. ConflictBetween Self-Esteem And Aspirations Related ToPsychological Wellbeing Of Adolescents. Eur ProcSoc Behav Sci. 2020;94.
  • 6.Polihronakis T. Information packet: Mental healthcare issues of children and youth in foster care.National Resource Center for Family CenteredPractice and Permanency Planning at the HunterCollege of School of Social Work. 2008.
  • 7.Lehmann S, Funk M, Stuhlinger U, et al. Mentaldisorders in foster children: a study of prevalence,comorbidity and risk factors. Child AdolescPsychiatry Ment Health. 2013;7:1-12.
  • 8.Simsek Z, Erol N, Öztop D, et al. Prevalence andpredictors of emotional and behavioral problemsreported by teachers among institutionally rearedchildren and adolescents in Turkish orphanagescompared with community controls. Child YouthServ Rev. 2007;29(7):883-99.
  • 9.Gaviţa OA, Miclea M, Mureşan V, et al. The efficacyof a short cognitive–behavioral parent program inthe treatment of externalizing behavior disorders inRomanian foster care children: Building parentalemotion-regulation through unconditional self-andchild-acceptance strategies. Child Youth Serv Rev.2012;34(7):1290-7.
  • 10.Mohammadzadeh M, Khadijah Y, Noraini M, et al.Emotional health and self-esteem amongadolescents in Malaysian orphanages. CommunityMent Health J. 2018;54:117-25.
  • 11.Lovibond PF, Lovibond SH. The structure ofnegative emotional states: Comparison of theDepression Anxiety Stress Scales (DASS) with theBeck Depression and Anxiety Inventories. Behav Res Ther. 1995;33(3):335-43.
  • 12.Gloster AT, Rhoades HM, Novy DM, et al.Psychometric properties of the Depression Anxietyand Stress Scale-21 in older primary care patients. J Affect Disord. 2008;110(3):248-59.
  • 13.Sariçam H. The psychometric properties ofTurkish version of Depression Anxiety Stress Scale-21 (DASS-21) in health control and clinical samples.J Cogn Behav Psychother Res. 2018;7(1):19.
  • 14.Çuhadaroğlu F. Adolesanlarda benlik saygısı.Uzmanlık Tezi, Hacettepe Üniversitesi Tıp FakültesiPsikiyatri Anabilim Dalı, Ankara. 1986.
  • 15.Mann L, Harmoni R, Power C. Adolescentdecision-making: The development of competence. JAdolesc. 1989;12(3):265-78.
  • 16.Çolakkadioğlu O, Güçray SS. Ergenlerde KararVerme Ölçeği'ni Türkçe'ye Uyarlama Çalışması.Eurasian J Educ Res (EJER). 2007(26).
  • 17.Singh A, Suvidha D. Well-being of orphans: areview on their mental health status. Int J Sci Res SciTechnol. 2016;2(5):180-4.
  • 18.Sushma B, Padmaja G, Agarwal S. Well-being,psychosocial problems and social interactionanxiety in children. Int J Indian Psychol.2016;3(4):30-43.
  • 19.Avakyan TV, Volikova SV. Social anxiety inchildren. Psychol Russia. 2014;7(1):73.
  • 20.Shafiq F, Haider SI, Ijaz S. Anxiety, depression,stress, and decision-making among orphans andnon-orphans in Pakistan. Psychol Res Behav Manag.2020:313-8.
  • 21.Ibrahim A, El-Sayed H, El-Ghandour M, et al.Prevalence and predictors of depression amongorphans in Dakahlia's orphanages, Egypt. Int J CollabRes Intern Med Public Health. 2012;4(12):2036.
  • 22.Safdar S. Comparative analysis of childhooddepression and self-esteem among orphan girls andboys. J Psychol Clin Psychiatry. 2018;9(1):1-4.
  • 23.Wanjiru M, Gathogo J. The impact of gender onorphans’ self-esteem and academic performanceamong secondary school students in Kirinyaga andNyeri Counties of Kenya. 2014.
  • 24.Behrendth M. The psychological impact ofparental loss and orphan-hood of children in an areaof high HIV prevalence: A cross sectional study inNorth West region of Camroon. 2008.
  • 25.Shiferaw G, Bacha L, Tsegaye D. Prevalence ofdepression and its associated factors among orphanchildren in orphanages in Ilu Abba Bor Zone, SouthWest Ethiopia. Psychiatry J. 2018;2018(1):6865085.
  • 26.Sahoo S, Khess CR. Prevalence of depression,anxiety, and stress among young male adults inIndia: a dimensional and categorical diagnoses-based study. J Nerv Ment Dis. 2010;198(12):901-4.
  • 27.Ramli J, Yahaya A, Lazin S. Depression amongresidents in orphanage in Kota Bharu. Kelantanhttp://eprints. utm. my/10127/1/JOURNAL_DALAM_SITI_ZAINAB. pdf.2010.
  • 28.WI WS, Ismail Z, Bakar A, et al. Prevalence ofdepression in adolescents living in residentialhomes in Perak, Malaysia and its association withsocio-demographic and personal factors. Malays J Psychiatry. 2014;23(2):40-51.
  • 29.Workye T. Psychological wellbeing betweeninstitutional and non institutional orphan childrenin Gulele sub city, Addis Ababa. Addis Ababa,Ethiopia: Addis Ababa University. 2015.
  • 30.Fawzy N, Fouad A. Psychosocial anddevelopmental status of orphanage children:Epidemiological study. Curr Psychiatry.2010;17(2):41-8.
  • 31.Thabet L, Thabet AAM. Mental health problemsamong orphanage children in the Gaza Strip. AdoptFoster. 2007;31(2):54-62.
  • 32.Rezaei E, Malekpour M, Oreyzi H. The Effect ofthe. Clin Psychol Pers. 2009;7(1):21-8.
Toplam 32 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi, Tıp Eğitimi, Sağlık Hizmetleri ve Sistemleri (Diğer)
Bölüm Araştırma Makalesi
Yazarlar

İbrahim Zeyrek

Uğur Tekeoğlu

Muhammed Fatih Tabara

Gönderilme Tarihi 7 Ağustos 2025
Kabul Tarihi 14 Kasım 2025
Yayımlanma Tarihi 12 Aralık 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 52 Sayı: 4

Kaynak Göster

APA Zeyrek, İ., Tekeoğlu, U., & Tabara, M. F. (2025). An Evaluation of Psychological Well-being, Decision-Making Processes and Self-Esteem in Adolescents in Institutional Care. Dicle Medical Journal, 52(4), 683-693. https://doi.org/10.5798/dicletip.1840641
AMA Zeyrek İ, Tekeoğlu U, Tabara MF. An Evaluation of Psychological Well-being, Decision-Making Processes and Self-Esteem in Adolescents in Institutional Care. diclemedj. Aralık 2025;52(4):683-693. doi:10.5798/dicletip.1840641
Chicago Zeyrek, İbrahim, Uğur Tekeoğlu, ve Muhammed Fatih Tabara. “An Evaluation of Psychological Well-being, Decision-Making Processes and Self-Esteem in Adolescents in Institutional Care”. Dicle Medical Journal 52, sy. 4 (Aralık 2025): 683-93. https://doi.org/10.5798/dicletip.1840641.
EndNote Zeyrek İ, Tekeoğlu U, Tabara MF (01 Aralık 2025) An Evaluation of Psychological Well-being, Decision-Making Processes and Self-Esteem in Adolescents in Institutional Care. Dicle Medical Journal 52 4 683–693.
IEEE İ. Zeyrek, U. Tekeoğlu, ve M. F. Tabara, “An Evaluation of Psychological Well-being, Decision-Making Processes and Self-Esteem in Adolescents in Institutional Care”, diclemedj, c. 52, sy. 4, ss. 683–693, 2025, doi: 10.5798/dicletip.1840641.
ISNAD Zeyrek, İbrahim vd. “An Evaluation of Psychological Well-being, Decision-Making Processes and Self-Esteem in Adolescents in Institutional Care”. Dicle Medical Journal 52/4 (Aralık2025), 683-693. https://doi.org/10.5798/dicletip.1840641.
JAMA Zeyrek İ, Tekeoğlu U, Tabara MF. An Evaluation of Psychological Well-being, Decision-Making Processes and Self-Esteem in Adolescents in Institutional Care. diclemedj. 2025;52:683–693.
MLA Zeyrek, İbrahim vd. “An Evaluation of Psychological Well-being, Decision-Making Processes and Self-Esteem in Adolescents in Institutional Care”. Dicle Medical Journal, c. 52, sy. 4, 2025, ss. 683-9, doi:10.5798/dicletip.1840641.
Vancouver Zeyrek İ, Tekeoğlu U, Tabara MF. An Evaluation of Psychological Well-being, Decision-Making Processes and Self-Esteem in Adolescents in Institutional Care. diclemedj. 2025;52(4):683-9.