Effects of stress, social support, and self-esteem on depression in children with limb deficiencies.

Limb deficiencies in children are the result of trauma, disease, or congenital causes. The potentially negative impact on psychologic adjustment from the chronic strain of living with limb deficiencies appears to be mediated by perceived social support (interpersonal protective factor), microstressors and daily hassles (socioenvironmental risk factor), and self-esteem (intrapersonal protective factor). These risk and protective factors were simultaneously investigated as potential predictors of depressive symptomatology in 54 children with congenital or acquired limb deficiencies. Hierarchical multiple regression analyses were used to test the main effects and the interaction effects of the predictor variables on depressive symptomatology. None of the interaction terms were statistically significant. An overall simultaneous multiple regression analysis of the main effects model predicted 72% of the variance in depressive symptomatology, with perceived classmate social support emerging as the strongest predictor variable. The findings are discussed in terms of the risk and protective effects of mediating factors on the psychologic and social adaptation of chronically ill and handicapped children.