• child and adolescent;
  • institutional dynamics

Accessible summary

  • The findings from this study reveal that the notion of anticipated and deleterious differences in quality of life (QoL) between children with severe emotional and behavioural problems and those without such difficulties is not supported. Indeed, results reveal counter-intuitive findings with children with emotional and behavioural problems reporting better QoL than those without such presenting problems on a number of QoL subscales.
  • The type of QoL measure and related subscales appears to be sensitive to differing aspects of self-report QoL, with in some instances, some QoL subscales being more discriminatory between groups compared with other QoL subscales. Consequently, the choice of QoL measure is critically important in accurately and reliably determining QoL in children with significant emotional and behavioural problems.


One hundred and seventy-four males completed a quality of life (QoL) assessment utilizing, a generic paediatric quality of life inventory (PedsQL) and the short form (36) health survey (SF36). The adolescents aged 13–16 years were in a Scottish Centre for young males with social, emotional, behavioural and educational problems. To identify similarities and differences, a comparison group (n = 110) of males in the third and fourth year in a mainstream secondary school were also administered the PedsQL and the SF36 self-rating scales. The effectiveness of the PedsQL and the SF36 for assessing QoL for adolescent males was investigated. There were significant differences between the groups in the Centre and between the Centre groups and the comparison group in terms of their QoL. The results between the groups were found in the PedsQL subscales ‘physical functioning’ where secure > comparison (P = 0.04); secure > residential (P = 0.008); and PedsQL subscale ‘social functioning’ day > comparison (P = 0.026); secure > comparison (P = 0.037). SF36 subscales ‘role physical functioning’ secure > residential (P < 0.001); day > residential (P < 0.001). SF36 ‘role mental functioning’ day > residential (P = 0.001). This study provides a unique insight into the complex dimensions influencing the QoL of this specific group of young people.