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Background <p>Previous 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.</p> Methods <p>We 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.</p> Results <p>Three 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.</p> Conclusions <p>The 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.</p>

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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

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月5日

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  • Ruowei Wang,
  • Shuna Zhai,
  • Chunhong Shen,
  • Jiaoyang Liu,
  • Pei Zhang,
  • Tong Zhang,
  • Qingai Yang,
  • Xiangzheng Ding,
  • Aihua Wang,
  • Xiuyun Wu

摘要

Background

Previous 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.

Methods

We 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.

Results

Three 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.

Conclusions

The 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.