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1.  Self-esteem is associated with premorbid adjustment and positive psychotic symptoms in early psychosis 
BMC Psychiatry  2011;11:136.
Low levels of self-esteem have been implicated as both a cause and a consequence of severe mental disorders. The main aims of the study were to examine whether premorbid adjustment has an impact on the subject's self-esteem, and whether lowered self-esteem contributes to the development of delusions and hallucinations.
A total of 113 patients from the Thematically Organized Psychosis research study (TOP) were included at first treatment. The Positive and Negative Syndrome Scale (PANSS) was used to assess present symptoms. Premorbid adjustment was measured with the Premorbid Adjustment Scale (PAS) and self-esteem by the Rosenberg Self-Esteem Scale (RSES).
Premorbid social adjustment was significantly related to lower self-esteem and explained a significant proportion of the variance in self-esteem. Self-esteem was significantly associated with the levels of persecutory delusions and hallucinations experienced by the patient and explained a significant proportion of the variance even after adjusting for premorbid functioning and depression.
There are reasons to suspect that premorbid functioning is an important aspect in the development of self- esteem, and, furthermore, that self-esteem is associated with the development of delusions and hallucinations.
PMCID: PMC3180364  PMID: 21854599
Self-esteem; First episode psychosis; Schizophrenia; Premorbid adjustment; Delusions; Hallucinations
Neurotoxicology  2007;29(2):278-285.
The notion that maternal personality characteristics influence cognitive development in their children has been grounded in stress moderation theory. Maternal personality traits, such as self-esteem, may buffer maternal stressors or lead to improved maternal-child interactions that directly impact neurodevelopment. This can be extended to suggest that maternal personality may serve to attenuate or exacerbate the effects of other neurotoxicants, although this has not been studied directly. We examined whether mothers’ self-esteem had a direct or main effect on their children's cognitive outcomes. We also explored the modifying effects of maternal self-esteem on the association between exposure to lead and neurodevelopment in these children. Study participants included 379 mother-child pairs from Mexico City. Data included the Coopersmith self-esteem scale in mothers, children's Bayley's Scale of Infant Development (BSID) scores, and sociodemographic information. Linear regression was used to model the relationship between maternal self-esteem and the Bayley's Mental Development Index (MDI) and Psychomotor Development Index (PDI) scores at age 24 months using regression models stratified by levels of maternal self-esteem. In adjusted models, each point increase in maternal self-esteem was associated with children having 0.2 higher score on the Bayley's MDI (p=0.04). Similar results were observed using the PDI outcome. Moreover, there was evidence that maternal self-esteem attenuated the negative effects of lead exposure, although the interaction fell short of conventional levels of statistical significance.
PMCID: PMC2495770  PMID: 18261800
child; cognition; lead; neurotoxicology; mother-child relations
3.  Implicit Self-Esteem Decreases in Adolescence: A Cross-Sectional Study 
PLoS ONE  2014;9(2):e89988.
Implicit self-esteem has remained an active research topic in both the areas of implicit social cognition and self-esteem in recent decades. The purpose of this study is to explore the development of implicit self-esteem in adolescents. A total of 599 adolescents from junior and senior high schools in East China participated in the study. They ranged in age from 11 to 18 years with a mean age of 14.10 (SD = 2.16). The degree of implicit self-esteem was assessed using the Implicit Association Test (IAT) with the improved D score as the index. Participants also completed the Rosenberg Self-Esteem Scale (α = 0.77). For all surveyed ages, implicit self-esteem was positively biased, all ts>8.59, all ps<0.001. The simple correlation between implicit self-esteem and age was significant, r = −.25, p = 1.0×10−10. A regression with implicit self-esteem as the criterion variable, and age, gender, and age × gender interaction as predictors further revealed the significant negative linear relationship between age and implicit self-esteem, β = −0.19, t = −3.20, p = 0.001. However, explicit self-esteem manifested a reverse “U” shape throughout adolescence. Implicit self-esteem in adolescence manifests a declining trend with increasing age, suggesting that it is sensitive to developmental or age-related changes. This finding enriches our understanding of the development of implicit social cognition.
PMCID: PMC3934976  PMID: 24587169
4.  Damaged Self-Esteem is Associated with Internalizing Problems 
Implicit and explicit self-esteem are assumed to be important factors in understanding the onset and maintenance of psychological problems. The current study aims to examine the association between implicit and explicit self-esteem and their interaction with depressive symptoms, suicidal ideation, and loneliness. Specifically, the relationship between the size and the direction of the discrepancy between implicit and explicit self-esteem with depressive symptoms, suicidal ideation, and loneliness were examined. Participants were 95 young female adults (M = 21.2 years, SD = 1.88) enrolled in higher education. We administered the IAT to assess implicit self-esteem, and the Rosenberg self-esteem scale to measure explicit self-esteem while psychological problems were assessed through self-reports. Results showed that discrepancies between implicit and explicit self-esteem were positively associated with depressive symptoms, suicidal ideation, and loneliness. In addition, the direction of the discrepancy was specifically relevant: damaged self-esteem (i.e., high implicit self-esteem and low explicit self-esteem) was consistently associated with increased levels of depressive symptoms, suicidal ideation, and loneliness. In contrast, defensive or fragile self-esteem (i.e., low implicit and high explicit self-esteem) was solely associated with loneliness. These findings provide further support that specifically damaged self-esteem is an important vulnerability marker for depressive symptoms, suicidal ideation, and loneliness.
PMCID: PMC3613594  PMID: 23565101
damaged; implicit cognition; self-esteem; suicidal ideation; depression; loneliness
5.  Low self-esteem and psychiatric patients: Part II – The relationship between self-esteem and demographic factors and psychosocial stressors in psychiatric patients 
The objective of the present study was to identify the effects and relative importance of demographic factors and psychosocial stressors on self-esteem of psychiatric patients.
The present study was carried out on a consecutive sample of 1,190 individuals attending an open-access psychiatric outpatient clinic. Patients were diagnosed according to DSM III-R diagnostic criteria following detailed assessments. At screening, patients and controls completed two self-esteem questionnaires, the Rosenberg self-esteem scale and the Janis and Field Social Adequacy scale. In addition, a large amount of demographic and psychosocial data was collected on all patients.
Significantly increased self-esteem was observed with an increase in age, educational achievement and income. Employed patients showed significantly higher self-esteem compared to unemployed patients. Female patients had a significantly lower self-esteem compared to male patients. The self-esteem of psychiatric patients did not vary significantly with their marital status. No relationship was detected between acute stressors and the self-esteem of psychiatric patients, although severe enduring stressors were associated with lower self-esteem in psychiatric patients.
The results of this large study demonstrate that the self-esteem of adult psychiatric patients is affected by a number of demographic and psychosocial factors including age, sex, educational status, income, employment status, and enduring psychosocial stressors.
PMCID: PMC151272  PMID: 12622872
Self-esteem; Demographic factors; Psychosocial stressors
6.  Low self-esteem and psychiatric patients: Part I – The relationship between low self-esteem and psychiatric diagnosis 
The objective of the current study was to determine the prevalence and the degree of lowered self-esteem across the spectrum of psychiatric disorders.
The present study was carried out on a consecutive sample of 1,190 individuals attending an open-access psychiatric outpatient clinic. There were 957 psychiatric patients, 182 cases with conditions not attributable to a mental disorder, and 51 control subjects. Patients were diagnosed according to DSM III-R diagnostic criteria following detailed assessments. At screening, individuals completed two questionnaires to measure self-esteem, the Rosenberg self-esteem scale and the Janis and Field Social Adequacy scale. Statistical analyses were performed on the scores of the two self-esteem scales.
The results of the present study demonstrate that all psychiatric patients suffer some degree of lowered self-esteem. Furthermore, the degree to which self-esteem was lowered differed among various diagnostic groups. Self-esteem was lowest in patients with major depressive disorder, eating disorders, and substance abuse. Also, there is evidence of cumulative effects of psychiatric disorders on self-esteem. Patients who had comorbid diagnoses, particularly when one of the diagnoses was depressive disorders, tended to show lower self-esteem.
Based on both the previous literature, and the results from the current study, we propose that there is a vicious cycle between low self-esteem and onset of psychiatric disorders. Thus, low self-esteem increases the susceptibility for development of psychiatric disorders, and the presence of a psychiatric disorder, in turn, lowers self-esteem. Our findings suggest that this effect is more pronounced with certain psychiatric disorders, such as major depression and eating disorders.
PMCID: PMC151271  PMID: 12620127
Self-esteem; Psychiatric disorders
7.  Predictors of Depressive Symptoms Among Hispanic Women in South Florida 
Western journal of nursing research  2013;35(10):10.1177/0193945913496152.
U.S. Hispanics, especially women, experience a disproportionate amount of disease burden for depression. This disparity among Hispanic women necessitates examination of factors associated with depression. The objective of this study was to use an adaptation of the Stress Process Model to test whether self-esteem mediated the relationship between Hispanic stress and depressive symptoms. Data for this secondary analysis were from a previous randomized-control HIV prevention trial. Participants were 548 Hispanic women (19–52 years). Data collection measures included the Center for Epidemiological Studies–Depression Scale, Rosenberg Self-Esteem Scale, and Hispanic Stress Scale. The bootstrap method in Mplus 6 was used to test mediation. Results indicated that self-esteem was inversely related to depression, and Hispanic stress was found to be positively related to depression. Self-esteem partially mediated the relationship between stress and depression. Strategies to improve/maintain self-esteem should be considered in future interventions for Hispanic women with depression.
PMCID: PMC3887511  PMID: 23858067
Latinas/Hispanics; depression; CES-D; Hispanic stress; self-esteem
8.  The Impact of Leadership Programme on Self-Esteem and Self-Efficacy in School: A Randomized Controlled Trial 
PLoS ONE  2012;7(12):e52023.
Leadership training programs by experiential learning among adolescents are very popular worldwide and in particular developed countries, but there exists few studies which formally assessed their impact on the psychological well-being of program participants. This study evaluated the effectiveness of leadership training programs on self-esteem and self-efficacy among adolescents.
Methodology/Principal Findings
a total of 180 students of the same grade of one secondary school were randomized into an intervention (n = 50) and a control group (n = 130). The students in the intervention group participated in a 6-month program of leadership training and service learning, while the control group did not participate in any training. Their self-esteem and self-efficacy were assessed by Rosenberg Self-Esteem questionnaire and Chinese Adaptation of the General Self-Efficacy Scale, respectively, before and after the program. Both scales have been recognized internationally as valid and reliable survey instruments to measure these psychological attributes. The scores were compared by Student’s tests according to gender. A total of 180 students were enrolled during the study period October, 2009 to May, 2010. Their mean age was 15.18 years (0.62) and 56.7% were male. Students allocated to the intervention and control group had statistically similar demographic characteristics except gender (male 36.0% vs. 64.6%, p = 0.001). Overall, the self-esteem scores increased by 1.28 and decreased by 0.30 (p = 0.161) while the self-efficacy scores increased by 0.26 and decreased by 0.76 (p = 0.429) in the intervention and control group, respectively. Among female students, the intervention group showed significant improvements in both self-esteem (2.38 vs. −0.24, p<0.001) and self-efficacy (1.32 vs. –0.04, p = 0.043).
Leadership training program were not found to be effective to enhance self-esteem and self-efficacy in adolescents, except girls who showed modest increase in these outcomes. Future research should assess the reasons why these programs are effective among female.
PMCID: PMC3525562  PMID: 23272199
9.  Using Trait-State Models to Evaluate the Longitudinal Consistency of Global Self-Esteem From Adolescence to Adulthood 
The present research used a latent variable trait-state model to evaluate the longitudinal consistency of self-esteem during the transition from adolescence to adulthood. Analyses were based on ten administrations of the Rosenberg Self-Esteem scale (Rosenberg, 1965) spanning the ages of approximately 13 to 32 for a sample of 451 participants. Results indicated that a completely stable trait factor and an autoregressive trait factor accounted for the majority of the variance in latent self-esteem assessments, whereas state factors accounted for about 16% of the variance in repeated assessments of latent self-esteem. The stability of individual differences in self-esteem increased with age consistent with the cumulative continuity principle of personality development.
PMCID: PMC3501685  PMID: 23180899
Rosenberg Self-Esteem Scale; Global Self-Esteem; State; Trait; STARTS Model
10.  Self-esteem and Mortality: Prospective Evidence from a Population-based Study 
Annals of epidemiology  2004;14(1):58-65.
Self-esteem is considered to be importantly associated with both psychosocial states such as depression as well as physical health. There are no population-based studies that examine the association between self-esteem and mortality. The objective of this study was to assess whether low self-esteem was prospectively associated with increased risk of death in a population-based sample of Finnish men.
A sample of 2682 male residents of Kuopio, Finland were interviewed and followed prospectively as part of the Kuopio Ischemic Heart Disease Risk Factor Study (KIHD). Characteristics of the KIHD sample at baseline included self-esteem, measured by the Rosenberg ten-item scale, socioeconomic factors, behavioral risk factors, other psychosocial characteristics, and prevalent diseases. Mortality was ascertained through linkage to the Finnish national death registry. We assessed the relationship between self-esteem and all-cause mortality using Cox proportional hazards models.
Low self-esteem was associated with a two-fold [hazard ratio (HR) = 2.0, 95% confidence interval (CI) = 1.3–3.2] increase in age-adjusted mortality. This relationship was partially explained by behavioral and socioeconomic factors, and prevalent diseases, and fully explained by other psychosocial characteristics (hopelessness, depression, cynical hostility, and sullenness). When adjusted for hopelessness alone there was no increased risk associated with low self-esteem (HR = 1.3, 95% CI = 0.8–2.2).
This study found no association between self-esteem and all-cause mortality after adjustment for other psychosocial characteristics, primarily hopelessness. Our understanding of the observed relationships between some psychosocial factors and mortality may be improved by simultaneous measurement of multiple psychosocial domains, thus diminishing the potential for residual confounding.
PMCID: PMC3173508  PMID: 14664781
Self-esteem; Mortality; Psychosocial Factors; Socioeconomic Factors
11.  Impact of guided reciprocal peer questioning on nursing students’ self-esteem and learning 
Self-esteem is essential for clinical judgments. Nursing students in clinical environments should make a bridge between theoretical education and clinical function. This study was aimed to survey the effect of guided questioning in peer groups on nursing students’ self-esteem and clinical learning.
Materials and Methods:
In this quasi-experimental study, all nursing students in semester 4 (60) were selected. The autumn semester students (n = 28) were chosen as the control group, and the spring semester students (n = 32) as the experimental group. The experimental group underwent the course of cardiac medical surgical training by the Guided Reciprocal Peer Questioning. The control group was trained by lecture. After confirmation of the validity and reliability of tools including Rosenberg Self-esteem Scale and the researcher-made questionnaire, data were collected and analyzed by SPSS version 17.0.
There was no significant difference concerning demographic and educational characteristics between the two groups. Mean score differences of self-esteem and learning were not significant before teaching, while they were significantly promoted after teaching in the experimental (P < 0.001) and control (P < 0.05) groups. Promotion in the experimental group was more considerable than in the control group.
As revealed by the results, inquiry method, due to its more positive impact on self-esteem and students’ learning, can be applied alone or in combination with the other methods. Conducting this study for other students and for theoretical courses is suggested.
PMCID: PMC3872862  PMID: 24403923
Educational models; Iran; nursing student; questioning; self-esteem
12.  Group Music Intervention Reduces Aggression and Improves Self-esteem in Children with Highly Aggressive Behavior: A Pilot Controlled Trial 
We investigated the effects of group music intervention on aggression and self-esteem in children with highly aggressive behavior. Forty-eight children were allocated to either a music intervention group or an untreated control group. The music intervention group received 50 min of music intervention twice weekly for 15 consecutive weeks. The outcome measures were Child Behavior Checklist Aggression Problems Scale (Parents), Child Aggression Assessment Inventory (Teachers) and Rosenberg Self-esteem Scale. After 15 weeks, the music intervention group showed significant reduction of aggression and improvement of self-esteem compared with the control group. All outcome measures were significantly lower in the music intervention group than prior to treatment, while there was no change in the control group. These findings suggest that music can reduce aggressive behavior and improve self-esteem in children with highly aggressive behavior. Music intervention is an easily accessible therapy for children and as such may be an effective intervention for aggressive behavior. Further more, objective and replicable measures are required from a randomized controlled trial with a larger sample size and active comparable control.
PMCID: PMC2862931  PMID: 18955314
Aggression; child; music intervention; self-esteem
13.  Exploring relationships between facets of self-esteem and drinking behavior among diverse groups of young adults 
Addictive behaviors  2013;38(10):2581-2585.
Theory and empirical evidence suggest that North American-based measures of self-esteem, which measure individualistic positive self-regard, may be less applicable to Eastern cultures. In the present exploratory study, we examined how different conceptualizations of self-esteem, as measured by the Rosenberg Self-esteem Scale and the Collective Self-esteem (CSE) Scale, predicted drinking behavior among three groups of American college students (N = 326) with varying ethnicities: White, Korean, and Chinese/Taiwanese. Hierarchical negative binomial regression was employed to evaluate these relations and ethnic identity was controlled in all analyses. Findings indicated that while global self-esteem was positively associated with drinking for the whole sample, ethnicity moderated this relationship such that global self-esteem was related to drinking for White participants but not for their Chinese/Taiwanese counterparts. In addition, while CSE did not associate with drinking for the whole sample, effects emerged for specific ethnicities. Specifically, private CSE was associated with less drinking for Korean and Chinese/Taiwanese participants. Depending on specific Asian ethnicity, public CSE served as a risk (Korean participants) or a protective factor (Chinese/Taiwanese participants) for drinking. Findings suggest that above and beyond ethnic identity, differential relationships between facets of self-esteem and drinking behavior may exist among White, Korean, and Chinese/Taiwanese young adults. Intervention and prevention programs should develop strategies to help Chinese/Taiwanese- and Korean American young adults to cultivate protective factors within domains of CSE.
PMCID: PMC3727158  PMID: 23811062
Collective self-esteem; self-esteem; alcohol use; young adults; Asian American
14.  The self-esteem and anxiety of children with and without mentally retarded siblings 
The study was carried out with the aim of determining the factors affecting and to evaluate anxiety situations and self-esteem of children with and without mentally retarded siblings.
Materials and Methods:
The sampling included 227 healthy children: 108 of them have mental retarded sibling and 119 of them do not have mental retarded sibling. The context of this study consisted of 15-18 year of age healthy children with mentally retarded siblings and 15-18 year of aged healthy children having at least one sibling between the dates February 15st and June 26st 2010. Personal Information Form, Rosenberg Self-Esteem Scale and Trait Anxiety Scale were used.
It was found out that trait anxiety of 17-18 aged of children with mental retarded sibling (47.04 ± 7.3) was higher than that of the children without mental retarded siblings (44.05 ± 11.23) (P < 0.05). It was observed that self-esteem of children with mentally retarded sibling was not affected from the handicap of their siblings (P > 0.05). Trait anxiety score averages of children with mentally retarded sibling and experience some difficulties due to his or her siblings's handicap (47.00 ± 7.76) were found higher than those of those of the children without any problem with the environment (42.61 ± 7.48) (P < 0.05).
Although the average score of trait anxiety and self-esteem in both groups were not significant different, score of trait anxiety for children with mentally disabled siblings was higher in comparison. It was concluded that anxiety of children with and without mentally retarded siblings increased as self-esteem of these children decreased.
PMCID: PMC3906787  PMID: 24523782
Mental retardation; self-esteem; sibling; trait anxiety
15.  Differential effects of self-esteem and interpersonal competence on humor styles 
In contrast with an early implicit “facilitative hypothesis” of humor, a revised specificity hypothesis predicts that the benefits of humor depend on the specific style of humor used. Information on predictors of these humor styles in turn enhances the ability to predict the effect on well-being.
We examined the relationships between interpersonal competence, self-esteem, and different styles of humor, while also examining the contributions of age and gender. Participants (n = 201) aged 18–63 years completed the Rosenberg Self-Esteem Inventory, the Interpersonal Competence Questionnaire, and the Humor Styles Questionnaire, and gave demographic information.
High self-esteem was associated with higher use of affiliative, aggressive, and self-enhancing humor styles, but lower use of self-defeating humor. High interpersonal competence predicted greater use of affiliative humor, whereas low interpersonal competence predicted greater use of aggressive humor. Further analyses showed that initiation competence predicted affiliative humor (positively) but both initiation competence (positively) and conflict management competence (negatively) predicted aggressive humor.
The findings that both self-esteem and initiation competence contribute to use of aggressive humor add to knowledge of who is likely to use this potentially harmful humor style. We conclude that a readiness to initiate humorous interactions is not on its own a general and positive attribute contributing to “good” humor.
PMCID: PMC3500141  PMID: 23180973
self-esteem; interpersonal competence; humor styles; differential effects
16.  The Relation of Self-Esteem and Illegal Drug Usage in High School Students 
Adolescence is the period of stress and strain. Researchers have shown that adolescents without strong social supports would have tendency towards smoking and drug abuse.
This study aimed to evaluate the relationship between low self-esteem and illegal drug abuse.
Materials and Methods
Participants were 943 grades nine to 12 high school students, from Sarakhs during 2010 - 2011. Adolescents participated in the study, completed two self-report questionnaires. The first questionnaire included questions about individual and family information, smoking and illegal drug abuse history, and the second was the Rosenberg's self-esteem scale.
53.8% of participants were male (507 individuals). The mean Rosenberg self-esteem score was 19.8 + 5.2, and the most frequent obtained scores were from 22 to 30. The difference of Rosenberg self-esteem score test between students who did not use any substance and those who had a history of smoking or drug abuse like heroin, pills, alcohols, betel nut (Nas) and other drugs (such as Pan and Hookah) was significant (P < 0.001). But this difference was not significant for marijuana (hashish) and opium. The difference of mean self-esteem scores between adolescents who lived with both or one of the parents, and those who did not live with any of parents, was significant (P = 0.04). There was also a significant association between the number of children in the family and self-esteem score.
The current study showed significant association between the Rosenberg self-esteem test results and smoking, and illegal drug abuse like heroin, pills, alcohol, Nas, and other substances. Therefore, increasing self-esteem is essential for preventing the adolescents’ emotional and behavioral disorders. This fact could guide us to the new approaches for smoking and drug-abuse prevention in adolescents.
PMCID: PMC3971778  PMID: 24719686
Self-Concept; Adolescent; Street Drugs
17.  Money Attitude, Self-esteem, and Compulsive Buying in a Population of Medical Students 
This study tried to determine the prevalence of compulsive buying (CB) and to identify among compulsive buyers a specific relation to money, a different buying style, and a lowered level of self-esteem. We included 203 medical students and diagnosed CB with the Mc Elroy criteria and a specific questionnaire. The money attitude was characterized by the Yamauchi and Templer's scale and self-esteem with the Rosenberg scale. 11% of the medical students presented compulsive buying (CB+). Sex ratio and mean ages were comparable in the CB+ and control groups. CB+ students drank less alcohol and smoked an equivalent number of cigarettes. Compulsive buyers had higher scores of distress (tendency to be hesitant, suspicious, and doubtful attitude toward situations involving money) and bargain missing (fear of missing a good opportunity to buy an item). They bought more often gifts for themselves, items they use less than expected and choose goods increasing their self-esteem. Their score of self-esteem was not different from the one from controls.
PMCID: PMC3089994  PMID: 21556283
compulsive buying; addiction; self-esteem; money
18.  Fluid Intelligence and Psychosocial Outcome: From Logical Problem Solving to Social Adaptation 
PLoS ONE  2011;6(9):e24858.
While fluid intelligence has proved to be central to executive functioning, logical reasoning and other frontal functions, the role of this ability in psychosocial adaptation has not been well characterized.
Methodology/Principal Findings
A random-probabilistic sample of 2370 secondary school students completed measures of fluid intelligence (Raven's Progressive Matrices, RPM) and several measures of psychological adaptation: bullying (Delaware Bullying Questionnaire), domestic abuse of adolescents (Conflict Tactic Scale), drug intake (ONUDD), self-esteem (Rosenberg's Self Esteem Scale) and the Perceived Mental Health Scale (Spanish adaptation).
Lower fluid intelligence scores were associated with physical violence, both in the role of victim and victimizer. Drug intake, especially cannabis, cocaine and inhalants and lower self-esteem were also associated with lower fluid intelligence. Finally, scores on the perceived mental health assessment were better when fluid intelligence scores were higher.
Our results show evidence of a strong association between psychosocial adaptation and fluid intelligence, suggesting that the latter is not only central to executive functioning but also forms part of a more general capacity for adaptation to social contexts.
PMCID: PMC3177863  PMID: 21957464
19.  Body image satisfaction and self-esteem status among the patients with polycystic ovary syndrome 
Background: Most previous research has focused on polycystic ovary syndrome (PCOS) characteristics and their association with psychological disorders, such as anxiety and depression.
Objective: In the present study, our aim was to study whether PCOS characteristics are associated with several aspects of psychological well-being namely self-esteem and body satisfaction.
Materials and Methods: This was a cross-sectional study of 300 women with PCOS that was carried out in Kashan, Iran. Main outcome measures were the Body Image Concern Inventory (BICI) and the Rosenberg’s Self-Esteem Scale and clinical information of PCOS. Major clinical PCOS features including obesity (BMI), excessive body hair (hirsutism score), acne, menstrual cycle disturbances and infertility.
Results: The findings of regression analysis indicated that infertile women had lower levels of self-esteem (=-0.11, p=0.049) and poorer body satisfaction (=0.121, p=0.036) compared with PCOS women without infertility. Furthermore, hirsute women experienced poorer self-esteem than women without hirsutism (=-0.124, p=0.032). Women with menstrual irregularities had higher body dissatisfaction (=0.159, p=0.005). Moreover, women with higher body mass index scores had poorer body satisfaction (=0.151, p=0.009) but were not associated with self-esteem.
Conclusion: The emotional well-being of the patients presenting with the syndrome needs to be recognized more fully, particularly in relation to the low self-esteem, poor body image, and struggles with weight, menstrual irregularities, hirsutism and infertility. The results of this study raise implications for clinical practice and suggest that a multidisciplinary approach to the management of women with PCOS.
This article extracted from Ph.D. thesis. (Fatemeh Bazarganipour)
PMCID: PMC3941334  PMID: 24639704
Polycysticovarysyndrome; Self-esteem; Bodyimage.
20.  The association of self-esteem, depression and body satisfaction with obesity among Turkish adolescents 
BMC Public Health  2007;7:80.
The purpose of this study was to determine the prevalence of overweight and obesity and to examine the effects of actual weight status, perceived weight status and body satisfaction on self-esteem and depression in a high school population in Turkey.
A cross-sectional survey of 2101 tenth-grade Turkish adolescents aged 15–18 was conducted. Body mass index (BMI) was calculated using weight and height measures. The overweight and obesity were based on the age- and gender-spesific BMI cut-off points of the International Obesity Task Force values. Self-esteem was measured using the Rosenberg Self-Esteem Scale, and depression was measured using Children's Depression Inventory. Logistic regression analysis was used to examine relationships among the variables.
Based on BMI cut-off points, 9.0% of the students were overweight and 1.1% were obese. Logistic regression analysis indicated that (1) being male and being from a higher socio-economical level were important in the prediction of overweight based on BMI; (2) being female and being from a higher socio-economical level were important in the prediction of perceived overweight; (3) being female was important in the prediction of body dissatisfaction; (4) body dissatisfaction was related to low self-esteem and depression, perceived overweight was related only to low self-esteem but actual overweight was not related to low self-esteem and depression in adolescents.
The results of this study suggest that school-based adolescents in urban Turkey have a lower risk of overweight and obesity than adolescents in developed countries. The findings of this study suggest that psychological well-being of adolescents is more related to body satisfaction than actual and perceived weight status is.
PMCID: PMC1888702  PMID: 17506879
21.  Body dissatisfaction and body mass in girls and boys transitioning from early to mid-adolescence: additional role of self-esteem and eating habits 
BMC Psychiatry  2012;12:35.
In the transition from early to mid-adolescence, gender differences in pubertal development become significant. Body dissatisfaction is often associated with body mass, low self-esteem and abnormal eating habits. The majority of studies investigating body dissatisfaction and its associations have been conducted on female populations. However, some evidence suggests that males also suffer from these problems and that gender differences might already be observed in adolescence.
To examine body dissatisfaction and its relationship with body mass, as well as self-esteem and eating habits, in girls and boys in transition from early to mid-adolescence.
School nurses recorded the heights and weights of 659 girls and 711 boys with a mean age of 14.5 years. The Rosenberg Self-Esteem Scale and the Body Dissatisfaction subscale of the Eating Disorder Inventory were used as self-appraisal scales. Eating data were self-reported.
The girls were less satisfied with their bodies than boys were with theirs (mean score (SD): 30.6 (SD 12.2) vs. 18.9 (SD 9.5); p < 0.001). The girls expressed most satisfaction with their bodies when they were underweight, more dissatisfaction when they were of normal weight and most dissatisfaction when they had excess body weight. The boys also expressed most satisfaction when they were underweight and most dissatisfaction when they had excess body weight. The boys reported higher levels of self-esteem than did the girls (mean (SD): 31.3 (4.8) vs. 28.0 (5.9); p < 0.001). The adolescents self-reporting abnormal eating habits were less satisfied with their bodies than those describing normal eating habits (mean (SD): 33.0 (12.9) vs. 21.2 (10.2); p < 0.001).
Body mass, self-esteem and eating habits revealed a significant relationship with body dissatisfaction in the transitional phase from early to mid-adolescence in girls and boys, but significant gender differences were also found.
PMCID: PMC3370989  PMID: 22540528
22.  Applying an Educational-participatory Program based on the PRECEDE Model for Promoting Self-esteem and Mental Health of Students in Iran 
The students’ vulnerability to different problems can have an impact on their mental health. Regarding the lack of evidence on the effectiveness of interventional programs based on health education planning models in this area in developing countries, an educational-participatory program based on the PRECEDE model was used, to promote the medical science students’ self-esteem and mental health status, in Iran.
In this experimental study, 154 students from the universities of medical sciences in the north east of Iran were selected by stratified random sampling method. Then, they were randomly assigned to two groups of case and control. The questionnaires, including the enabling, reinforcing, and predisposing factors, the Rosenberg self-esteem scale, and the GHQ-28 were used for data collection. Then, an intervention plan, including focus group discussions and training of selected life skills, based on the PRECEDE model, was conducted for the case group.
The predisposing, reinforcing, and enabling factors, and the self-esteem and mental health of the students showed a significant difference between the case and control groups. The Pearson correlation coefficient showed that there was a correlation between mental health and knowledge (P =0.008), between self-esteem and knowledge (P =0.02), self-esteem and attitude (P =0.01), and mental health and attitude (P = 0.03).
Health promotion planning by using life skills training based on the PRECEDE model can result in participation and empowerment, in order to promote the self-esteem and mental health of the students.
PMCID: PMC3354393  PMID: 22624080
Mental health; PRECEDE model; self-esteem; students
23.  Self-Esteem Modulates the Time Course of Self-Positivity Bias in Explicit Self-Evaluation 
PLoS ONE  2013;8(12):e81169.
Researchers have suggested that certain individuals may show a self-positivity bias, rating themselves as possessing more positive personality traits than others. Previous evidence has shown that people evaluate self-related information in such a way as to maintain or enhance self-esteem. However, whether self-esteem would modulate the time course of self-positivity bias in explicit self-evaluation has never been explored. In the present study, 21 participants completed the Rosenberg self-esteem scale and then completed a task where they were instructed to indicate to what extent positive/negative traits described themselves. Behavioral data showed that participants endorsed positive traits as higher in self-relevance compared to the negative traits. Further, participants’ self-esteem levels were positively correlated with their self-positivity bias. Electrophysiological data revealed smaller N1 amplitude and larger late positive component (LPC) amplitude to stimuli consistent with the self-positivity bias (positive-high self-relevant stimuli) when compared to stimuli that were inconsistent with the self-positivity bias (positive-low self-relevant stimuli). Moreover, only in individuals with low self-esteem, the latency of P2 was more pronounced in processing stimuli that were consistent with the self-positivity bias (negative-low self-relevant stimuli) than to stimuli that were inconsistent with the self-positivity bias (positive-low self-relevant stimuli). Overall, the present study provides additional support for the view that low self-esteem as a personality variable would affect the early attentional processing.
PMCID: PMC3855207  PMID: 24339908
24.  Associations of multiple domains of self-esteem with four dimensions of stigma in schizophrenia 
Schizophrenia research  2007;98(1-3):194-200.
Research suggests global self-esteem among persons with schizophrenia may be negatively affected by stigma or stereotyped beliefs about persons with severe mental illness. Less clear however, is whether particular dimensions of self-esteem are linked to particular domains of stigma. To examine this we surveyed a range of self-esteem dimensions including lovability, personal power, competence and moral self-approval and four domains of stigma: Stereotype endorsement, Discrimination experience, Social withdrawal and Stigma rejection. Participants were 133 adults with diagnoses of schizophrenia or schizoaffective disorder. Stepwise multiple regressions controlling for a possible defensive response bias suggested that aspects of self-esteem related to lovability by others were more closely linked with lesser feelings of being alienated from others due to mental illness. Aspects of self-esteem related to the ability to manage one’s own affairs were more closely associated with the rejection of stereotypes of mental illness. A sense of being able to influence others was linked to both the absence of discrimination experiences and the ability to ward off stigma. Implications for treatment are discussed.
PMCID: PMC3208262  PMID: 18029145
Schizophrenia; Self-esteem; Stigma; Recovery; Self; Function
25.  Self-esteem in adolescent patients with attention-deficit/hyperactivity disorder during open-label atomoxetine treatment: psychometric evaluation of the Rosenberg Self-Esteem Scale and clinical findings 
To report on (1) psychometric properties of the Rosenberg Self-Esteem Scale (SES) studied in adolescents with ADHD, (2) correlations of SES with ADHD scale scores, and (3) change in patient-reported self-esteem with atomoxetine treatment. ADHD patients (12–17 years), treated in an open-label study for 24 weeks. Secondary analyses on ADHD symptoms (assessed with ADHD-RS, CGI, GIPD scales) and self-esteem (SES) were performed. One hundred and fifty-nine patients were treated. A dichotomous structure of the SES could be confirmed. Reliability and internal consistency were moderate to excellent. Highest coefficients were found for the correlation between SES and GIPD scores. Self-esteem significantly increased over time, accompanied by an improvement of ADHD symptoms and related perceived difficulties. The Rosenberg SES was shown to be internally consistent, reliable, and sensitive to treatment-related changes of self-esteem. According to these findings, self-esteem may be an important individual patient outcome beyond the core symptoms of ADHD.
PMCID: PMC2837234  PMID: 20234829
ADHD; Atomoxetine; Self-esteem; Self-confidence; Self-liking

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