To explore the Harter Self-Perception Profile for Adolescents (SPPA) as an indicator of psychosocial outcome in adolescents with chronic physical disorders, we administered the questionnaire along with other well-established measures of psychosocial outcome (the semistructured Child Assessment Schedule (CAS) interview and the Youth Self Report (YSR) and Child Behavior Checklist (CBCL) questionnaires) to one group of diseased adolescents with good psychosocial adjustment (juvenile chronic arthritis, JCA) and one with a high level of psychosocial maladjustment (anorectal anomalies, ARA). The adolescents with ARA had significantly lower scores of global self-worth, school competence, and social acceptance as compared to the adolescents with JCA. However, global self-worth in neither group was impaired as compared with that of the general Norwegian adolescent population. Perceived physical appearance was the single self-concept domain accounting for the variance in global self-worth (R2 = 0.71, p < 0.001). Among the other measures of psychosocial outcome, global self-worth was most strongly related to mood according to the CAS interview (r = -0.53, p < 0.001) and to the YSR internalizing score (r = -0.53, p < 0.001). Our findings indicate that the SPPA has limited ability to identify chronically diseased adolescents with adverse psychosocial outcome.