Sadia Malik  ( Department of Psychology, University of Sargodha, Sargodha, Pakistan. )
Aneeqa Kaiser  ( Department of Psychology, University of Sargodha, Sargodha, Pakistan. )

Objective: To investigate the impact of emotional maltreatment on self-esteem among adolescents, and to see if gender makes a difference in this context.
Methods: The cross-sectional study was conducted from January to April 2014, and comprised adolescents in the age range of 14 to 18 years who were selected using purposive sampling from various government and private schools and colleges of Sargodha, Punjab. The questionnaire on seven dimensions of emotional maltreatment at home and Rosenberg self-esteem scale were used.
Results: There were 400 subjects; 200(50%) boys and as many girls. The overall mean age was 16.14±1.36 years (range: 14-18 years). Correlation coefficient indicated significant negative relationship between emotional maltreatment and self-esteem (degrading r= -0.33, p<0.01; exploitation r= -0.30, p< 0.01; isolating r=-0.36, p<0.01; ignoring r= -0.32, p<0.01; rejecting r=-0.43, p< 0.01; and terrorizing r= -0.35, p<0.01) among students. Emotional maltreatment strongly predicted negative self-esteem (isolating?= -0.12, p<0.05; and rejecting ?= -0.30, p< 0.001) among adolescents. Findings indicated significant gender differences in degrading component of emotional maltreatment and self-esteem.
Conclusion: Emotional maltreatment strongly predicted negative self-esteem among adolescents. Gender was a significant factor in the domain of degrading.
Keywords: Emotional maltreatment, Rejecting, Isolating, Self-esteem. (JPMA 66: 795; 2016)

Introduction
Adolescence is a phase of speedy growth and changes. During this developmental phase adolescents face various mental health problems as well as pressures and environmental  factors.¹ Adolescence starts at the age of 12  and ends at the age of 18 years.² It is considered that adolescence is a time when one\\\'s struggle for exploring reasons for one\\\'s own behaviour dominates all other things³ and hasty alteration during this phase can have an effect on self-esteem, changing responsibility, and multifaceted relations.⁴ Researchers have tried to work out the connection between adolescent\\\'s maltreatment and harmful behavioural and emotional maturity in adolescence.⁵
Children and adolescents\\\' exposure to aggression refers to the experience of  physical abuse, sexual abuse, emotional abuse and domestic violence.⁶ Emotional abuse/maltreatment is a problematic behaviour  that is stressful for  individuals of  all  socioeconomic sectors, ages and  genders.⁷ The  emotional maltreatment  that adolescents  have to face  at  home may  appear  in  diverse  types and  various conditions.  Though there  is  no sufficient consensus on absolute categorisation, acknowledged factors in literature include rejecting, degrading, terrorising, isolating, corrupting/exploiting, denying and ignoring.⁸ Psychological maltreatment (PM), also recognised as emotional abuse and neglect, is widespread around the world.^9-11 Abuse  is  defined as a behaviour that causes  harm, and neglect also has harmful consequences. More over, neglect symbolises the malfunctioning of parental responsibilities like provision of care and safety.¹²
Additionally, it is divided into four main types: physical abuse, physical neglect, emotional abuse and emotional neglect. Sometimes  sexual  abuse is  considered physical  abuse,  but  it  has  its  distinctive  features that discriminate it from other types  of maltreatment. It has been found that emotional abuse is the type of abuse which is most common.¹³ Researchers concluded that children who experience  emotional  abuse  have  the  most horrible  effects  and it is  a significant predictor of  later  maladjustment.¹⁴ Self-esteem is considered a vital part of an individual\\\'s social and cognitive growth.¹⁵ Self-esteem is the level that persons think that they are able, important, successful and admirable.¹⁶
An adolescent\\\'s weak emotional relationship with parents and other caregivers can influence his social life.¹⁷ Numerous authors found significant positive correlation between adolescents \\\'implicit\\\' self-esteem and their parents\\\' \\\'emotional warmth and understanding\\\' and their mothers\\\' favouritism. This suggests positive parenting styles could enhance adolescents\\\' implicit self-esteem. They further revealed that negative parenting styles affected the consistency of adolescents\\\' covert and overt self-esteem.¹⁸
Another research demonstrated that adolescent girls who had high parental security feelings had low emotional autonomy and high level of self-esteem.¹⁹ It was also noted that perceived rejection from parents was the strongest risk factor associated with low self-esteem in adolescents²⁰ Researchers found that fathers\\\' involvement had opposite correlation with depression, aggression, negative self-esteem, lack of self-competence, emotional insensitivity and unenthusiastic world-view in adolescents of Pakistan.²¹ It is also evident that parental rejection is negatively associated with self-esteem in adolescents.²² In another study, family  atmosphere  and  parental  insulting  and hostile  behaviour were found to be associated with poor self-concept and low  self-esteem.²³
Researchers have always been paying attention on investigating the troubles and problems of adolescence because it is a significant era of life and they experience so much trouble that it might cause some psychological issues. The present study was planned to examine the relationship between emotional maltreatment and self-esteem among adolescents, and to explore the role of gender in this equation.

Subjects and Methods
The cross-sectional study was conducted from January to April 2014, and comprised adolescents in the age range of 14 to 18 years who were selected using purposive sampling from various government and private schools and colleges of Sargodha, Punjab.
For data collection, after informed written consent was obtained from all subjects, the Questionnaire on Seven Dimensions of Emotional Maltreatment at Home (QSDEMH)⁸ was  used to measure emotional maltreatment. Its seven dimensions are degrading. exploiting, corrupting, isolating, ignoring. rejecting and terrorising. Each section consists of seven items on a four-point Likert rating scale of \\\'very often\\\' (4); \\\'often\\\' (3); \\\'sometimes\\\' (2); and \\\'never\\\' (1). The higher the score, the more psychologically maltreated is the participant at home.
The Rosenberg self-esteem (RSE)16 scale was used to measure self-esteem. It is a global measure to assess positive and negative feelings about self. All 10 items are answered using a 4-point Likert scale format ranging from \\\'strongly agree\\\' to \\\'strongly disagree\\\'.
SPSS 20 was used to analyse data. Pearson product moment correlation, regression analysis and independent sample t-test were also used.

Result
There were 400 subjects; 200(50%) boys and as many girls. The overall mean age was 16.14±1.36 years (range: 14-18 years).
Reliability coefficients ranged from 0.57to 0.85, indicating that scales had sufficient internal consistency. Pearson correlation revealed that emotional maltreatment factors degrading, exploiting, isolating, ignoring, rejecting and terrorising were significantly negatively correlated with self-esteem (Table-1)


Multiple regression analysis revealed the impact of isolating and rejecting on self-esteem and the overall model was found significant (F96, 395]= 16.25; p<0.001) suggesting that isolating and rejecting predicted self-esteem and accounted for 18% variance in the outcome variable of  self-esteem (R2=0.18). Among these predictor variables, isolating was a significant negative predictor of self-esteem (b = -0.124; t = -1.92; p<0.05). Rejecting was a significant negative predictor of self-esteem (b = -3.02; t = -3.76; p<0.001) (Table-2)

 
Significant gender differences were noted in degrading and self-esteem, while no significant differences were found in other components of emotional maltreatment (Table-3)



Discussion
The present study was an endeavour to explore the relationship between emotional maltreatment and self-esteem. Results indicated positive relationship between emotional maltreatment and self-esteem. It was hypothesised that emotional maltreatment would be a negative predictor for self-esteem among adolescents. Findings approved the hypothesis. These findings appear  to  be similar  with a previous study which explored  that  emotional abuse appear to be strongly linked with low self-assessment almost certainly  because  children  have a propensity  to internalise  parental  statement  as  part  of  the criteria for self-observation.¹³ Similarly, a study reported that  parental rejection is a significant predictor of negative self-esteem in adolescents.²⁴ It showed  that  parents  in  Pakistani  families  don\\\'t have  concern  about the  mental  and  emotional  requirements  of  their child and it is more challenging for the child. They are uninformed of the consequences, they use insulting and rude verbal communication that hurts their child; adverse behaviour of parent may cause lower level of self-esteem in their child.²⁵ Along the same line, researchers found that father\\\'s rejection had significant negative relationship with self-esteem among adolescents.²⁶
The results are also confirmed by another study that concluded perceived rejection from parents was the strongest risk factor associated with low self-esteem in adolescents.²⁷ Similarly, it was observed that emotional and behavioural problems are considered to have a negative relationship with self-esteem of the children and adolescents.²⁵
The second hypothesis of the present study was that there would be significant gender difference in emotional maltreatment and self-esteem. Findings indicated that boys had slightly higher self-esteem and experienced degrading more than females. So, this hypothesis was accepted. Previous research showed that adolescent girls who had high parental security feelings had high level of self-esteem.26 Current results in this context are inconsistent with previous research.²⁶ This study will be helpful for parents, educationist and clinicians to understand the adolescent\\\'s issues.

Conclusion
Emotional maltreatment strongly predicted negative self-esteem among adolescents. Significant gender differences in the degrading component of emotional maltreatment and self were also found.

Acknowledgement
We are grateful to administrative staff and students who helped us in data collection for the study which was part of M.Phil thesis of Aneeqa Kaiser entitled \\\'Predictors and Consequences of State Resilience Among Adolescents of Sargodha Region: Role of Life Orientation\\\'.

Disclosure: None.

Conflict of interest: None.

Funding source: None.

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