Investigating Measures of Self-Concept

Quality of life and care burden among family caregivers of people with severe mental illness: mediating effects of self-esteem and psychological distress

BACKGROUND

Family caregivers are important allies for healthcare providers in facilitating the recovery process among people with mental illness (PWMI). The present study examined the factors associated with quality of life (QoL) among family caregivers of PWMI.

METHODS

A multi-center cross-sectional survey was conducted. Family caregivers of people with schizophrenia, major depressive disorder, and bipolar disorder were recruited using convenience sampling. A survey assessing their QoL, depression, anxiety, and self-esteem was completed with self-rated psychometric scales including the Rosenberg Self-Esteem Scale, Caregiver Burden Inventory, Taiwanese Depression Questionnaire, Beck Anxiety Inventory, and World Health Organization Quality of Life Instrument Short Form. A mediation model was constructed with QoL as the dependent variable, care burden as the independent variable, and psychological distress (including depression and anxiety) with self-esteem as mediating variables.

RESULTS

Family caregivers of people with schizophrenia had worse QoL compared with counterparts of people with major depression and bipolar disorder. The sociodemographic of both caregivers and PWMI had less impact on QoL when psychological factors were considered. Caregivers with lower self-esteem, higher levels of psychological distress, and heavier care burdens had poorer QoL. Care burden had a significant total effect on QoL. Both self-esteem and psychological distress were significant mediators.

CONCLUSION

The findings indicated that caregivers' psychological health and care burden influenced their QoL. Interventions that target family caregivers' self-esteem and psychological distress may attenuate the effect from care burden, and further improve their QoL.

The Influence of Perfectionism, Self-Esteem and Resilience on Young People's Mental Health

The current study explored whether maladaptive perfectionism and low self-esteem constituted reliable risk factors of student mental illness, as well as determining whether resilience moderates these predictive relationships. 434 University undergraduate students were recruited. Depression and anxiety were measured using the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder Assessment (GAD-7). Perfectionism, self-esteem and resilience were analyzed in relation to the PHQ9 and GAD-7 scores via a regression analysis. Perfectionism discrepancy, self-esteem and resilience all significantly predicted depression and anxiety. Hierarchical regression analysis revealed a statistically significant amount of additional variance to be explained by resilience for depression and anxiety, than for perfectionism and self-esteem alone. Maladaptive perfectionism and low self-esteem predispose an individual to depression and anxiety, though resilience may act as a protective factor against development of mental illness.

The Mediation Role of Self-Esteem for Self-Stigma on Quality of Life for People With Schizophrenia: A Retrospectively Longitudinal Study

Background: Among patients with schizophrenia, there is evidence of a negative association between self-stigma and subjective quality of life (SQoL), and self-esteem was an important mediator in the association. We attempted to use a longitudinal study to investigate the aforementioned mediation on a sample with schizophrenia. Methods: We used longitudinal data retrieved from medical records of a psychiatric centre between June 2014 and December 2015. In the data, we retrieved information of self-stigma using the Self-Stigma Scale — Short; SQoL, using the WHO questionnaire on the Quality of Life — Short Form; and self-esteem, using the Rosenberg Self-Esteem Scale. All the measures were evaluated five times. Linear mixed-effect models accompanied by Sobel tests were used to tackle the mediating effects. Results: Data from 74 patients (57 males) with schizophrenia were eligible for analysis; their mean ( SD) age was 39.53 (10.67); mean age of onset was 22.95 (8.38). Self-esteem was a mediator for patients in physical ( p = .039), psychological ( p = .003), and social SQoL ( p = .004), but not in environment SQoL ( p = .051). Conclusion: Based on our findings, mental health professionals could tailor different programs to patients with schizophrenia, such as self-stigma reduction and self-esteem improvement programs. However, treatment as a whole should be sensitive to both self-stigma and self-esteem. Also, we should consider individuals’ health and wellbeing from social perspectives of disability rather than the medical model of disability emphasising symptoms and medications.

Comparing Affiliate Stigma Between Family Caregivers of People With Different Severe Mental Illness in Taiwan

The family caregivers of people with mental illness may internalize the public stereotypes into the affiliate stigma (i.e., the self-stigma of family members). This study aimed to compare the affiliate stigma across schizophrenia, bipolar disorder, and major depressive disorder, and to investigate potential factors associated with affiliate stigma. Each caregiver of family members with schizophrenia (n = 215), bipolar disorder (n = 85), and major depressive disorder (n = 159) completed the Affiliate Stigma Scale, Rosenberg Self-Esteem Scale, Caregiver Burden Inventory, Taiwanese Depression Questionnaire, and Beck Anxiety Inventory. After controlling for potential confounders, the hierarchical regression models showed that caregivers of a family member with schizophrenia had a higher level of affiliate stigma than those of bipolar disorder (β = -0.109; p < 0.05) and major depressive disorder (β = -0.230; p < 0.001). Self-esteem, developmental burden, and emotional burden were significant factors for affiliate stigma. The affiliate stigma of caregivers is associated with their self-esteem, caregiver burden, and by the diagnosis.

Factor Structure of Sizing Me Up, a Self-Reported Weight-Related Quality of Life Instrument, in Community Children across Weight Status

BACKGROUND

To further understand the psychometric properties of the Sizing Me Up-a newly developed quality of life (QoL) instrument related to weight status. We extended the target population to a community sample, including obese, overweight, normal-weight, and underweight children.

METHODS

Based on the data of 497 students in third to sixth grades, we used the following approaches: analysis of variance to detect the QoL scores among groups; confirmatory factor analysis (CFA) to examine the original structure; and Rasch analysis to test the misfit items, disordered response descriptors, and differential item functioning (DIF) items.

RESULTS

Obese children had the lowest QoL total score; overweight children had lower QoL total score than normal-weight children; and underweight children had lower QoL in social avoidance than normal-weight children (all p < 0.01). CFA suggested that the factor structure is acceptable. Rasch corroborated that there were no misfit items; however, 10 items showed disordered thresholds in response descriptors and 6 items displayed significant DIF.

CONCLUSIONS

Sizing Me Up can be applied to underweight children in the community and it can yield valid and reliable scores. Future studies are needed to explore the issues of disordered response descriptors and DIF items. Additional revisions for the Sizing Me Up may be warranted.

Age and Birth Cohort Differences in Self-Esteem: A Cross-Temporal Meta-Analysis

A meta-analytic review finds that college students' self-esteem increased substantially between 1968 and 1994 when measured using the Rosenberg Self-Esteem Scale (RSE). Children's scores on the Coopersmith Self-Esteem Inventory (SEI) show a curvilinear pattern over time, decreasing from 1965 to 1979 and increasing from 1980 to 1993. Children's SEI scores are directly correlated with social statistics (e.g., divorce rate, unemployment) for the corresponding years. Analyses for age differences find that SEI scores decrease slightly during the transition from elementary school to junior high and then rise progressively through high school and college. RSE scores increase steadily with age. Results are discussed in terms of the antecedents of self-esteem, including social acceptance, competencies, and the culture of self-worth.

An Item Response Theory Analysis of the Rosenberg Self-Esteem Scale

The Rosenberg Self-Esteem Scale, a widely used self-report instrument for evaluating individual self-esteem, was investigated using item response theory. Factor analysis identified a single common factor, contrary to some previous studies that extracted separate Self-Confidence and Self-Depreciation factors. A unidimensional model for graded item responses was fit to the data. A model that constrained the 10 items to equal discrimination was contrasted with a model allowing the discriminations to be estimated freely. The test of significance indicated that the unconstrained model better fit the data-that is, the 10 items of the Rosenberg Self-Esteem Scale are not equally discriminating and are differentially related to self-esteem. The pattern of functioning of the items was examined with respect to their content, and observations are offered with implications for validating and developing future personality instruments.

An application of the LC-LSTM framework to the self-esteem instability case

The present research evaluates the stability of self-esteem as assessed by a daily version of the Rosenberg (Society and the adolescent self-image, Princeton University Press, Princeton, 1965) general self-esteem scale (RGSE). The scale was administered to 391 undergraduates for five consecutive days. The longitudinal data were analyzed using the integrated LC-LSTM framework that allowed us to evaluate: (1) the measurement invariance of the RGSE, (2) its stability and change across the 5-day assessment period, (3) the amount of variance attributable to stable and transitory latent factors, and (4) the criterion-related validity of these factors. Results provided evidence for measurement invariance, mean-level stability, and rank-order stability of daily self-esteem. Latent state-trait analyses revealed that variances in scores of the RGSE can be decomposed into six components: stable self-esteem (40 %), ephemeral (or temporal-state) variance (36 %), stable negative method variance (9 %), stable positive method variance (4 %), specific variance (1 %) and random error variance (10 %). Moreover, latent factors associated with daily self-esteem were associated with measures of depression, implicit self-esteem, and grade point average.

Exploring the link between self-compassion and body image in university women

The purpose of the present research was to examine the relationships between self-compassion and women's body image. In Study 1, female undergraduates (N=142) completed three measures of body image and measures of self-esteem and self-compassion. Results showed that high self-compassion predicted fewer body concerns independently of self-esteem. Moreover, when both self-compassion and self-esteem were included as predictors, self-compassion accounted for unique variance in body preoccupation and weight concerns whereas self-esteem did not. In Study 2, this finding was partially replicated with one component (self-judgment) of self-compassion uniquely predicting body preoccupation in undergraduate women (N=187). High scores on self-compassion also predicted less eating guilt independent of self-esteem. Additionally, self-compassion was shown to partially mediate the relationship between body preoccupation and depressive symptoms. The findings highlight the possibility that a consideration of self-compassion for body image may contribute to identifying who is most at risk for body/shape concerns.

The efficacy of a brief motivational intervention for individuals with eating disorders: a randomized control trial

OBJECTIVE

Individuals with eating disorders are often ambivalent about recovery, and previous research has shown that readiness for change predicts enrollment in intensive treatment, symptom change, dropout, and relapse. Given the demonstrated importance of readiness for change, researchers and clinicians have turned to investigating interventions designed to enhance motivation. The purpose of this research was to determine the efficacy of Readiness and Motivation Therapy (RMT), a five-session individual preparatory intervention for individuals with eating disorders.

METHOD

Participants completed the Readiness and Motivation Interview and measures of eating disorder symptomatology, self-esteem, and psychiatric symptoms at intake. One hundred eighty-one participants were randomly assigned to the treatment (RMT) or wait-list control condition and were reassessed at 6-week and 3-month follow-up; 113 completed assessments at all three time points and primary analyses were based on these individuals.

RESULTS

Surprisingly, improvements in readiness for change, depression, drive for thinness, and bulimia symptoms occurred over time in both RMT and control conditions. However, at post and at follow-up, individuals who received RMT were less likely to have high ambivalence than were those from the control condition.

DISCUSSION

RMT may be of benefit to highly reluctant, clinically challenging patients and help them make better use of future, action-oriented treatment.

The Disqualification of Positive Social Outcomes Scale: a novel assessment of a long-recognized cognitive tendency in social anxiety disorder

Socially anxious individuals frequently tend to disqualify positive social experiences and outcomes. However, no formal measure of Disqualificationof Positive Social Outcome (DPSO)-related tendencies has yet been reported. The purpose of the present series of studies was to develop the Disqualification ofPositive Social Outcomes Scale (DPSOS) and examine its psychometric profile across several independent samples, including a large (n=585) undergraduate sample; a clinical sample of individuals diagnosed with social anxiety disorder (n=14), and a demographically-equivalent sample of non-socially anxious control participants (n=14). The factorial validity, internal consistency, and construct validity of the DPSOS subscales were examined. Results provide preliminary support for the psychometric properties of the DPSOS. Implications of DPSO as to assessment and treatment of social anxiety disorder are discussed.

Factors associated with improvements in readiness for change: low vs. normal BMI eating disorders

OBJECTIVE

To examine factors associated with improvements in readiness for change as a function of body mass index (BMI) in individuals assessed for eating disorders treatment.

METHOD

Participants (n = 128) completed the Readiness and Motivation Interview (RMI) and measures of psychiatric and eating disorder symptoms, quality of life, and self-esteem at baseline and at 5-month follow-up.

RESULTS

Participants whose readiness for change showed improvements in psychiatric symptom severity, global self-esteem, and in the importance of friendships as a determinant of self-esteem. Only those with a normal baseline BMI (20 kg/m(2) or greater) improved in eating disorder symptoms and quality of life, and reported increased importance of personal development and decreased importance of shape and weight as determinants of self-esteem.

CONCLUSION

Correlates of readiness differed between low and normal BMI participants, suggesting that weight status may be an important variable to consider in preparing highly ambivalent individuals for treatment.

Body Dissatisfaction Prospectively Predicts Depressive Mood and Low Self-Esteem in Adolescent Girls and Boys

This research examined whether body dissatisfaction prospectively predicted depressive mood and low self-esteem in adolescent girls and boys 5 years later. Participants were early-adolescent girls (n = 440, Time 1 M age = 12.7 years) and boys (n = 366, Time 1 M age = 12.8 years) and midadolescent girls (n = 946, Time 1 M age = 15.8 years) and boys (n = 764, Time 1 M age = 15.9 years). After controlling for Time 1 of the relevant dependent variable, ethnicity, socioeconomic status, and body mass index, Time 1 body dissatisfaction was a unique predictor of Time 2 depressive mood and low self-esteem in early-adolescent girls (depressive mood: F = 4.80, p < .05; self-esteem: F = 9.64, p < .01) and midadolescent boys (depressive mood: F = 12.27, p < .001; self-esteem: F = 9.38, p < .01) but not in early-adolescent boys or midadolescent girls. These findings are consistent with the hypothesis that body dissatisfaction is a risk factor for depressive mood and low self-esteem in both girls and boys but in different phases of adolescence.

Development of the Self-Image Profile for Adults [SIP-AD]

Self-esteem is an important notion within clinical practice, yet despite numerous initiatives in measuring the concept, most scales lack a theoretical foundation and are methodologically questionable, being author generated and psychometrically tested on small samples of college students. The Self-Image Profile for adults (SIP-AD), developed and validated on a large British population, is a brief measure (30 items) of both self-esteem and self-image. Through a cross sectional survey of 1,462 adults (17-65 years) across all regions of the United Kingdom, factor structure and convergent validity was assessed. Factorial validity revealed six factors, renamed Aspects of Self, confirmed through oblique rotation, in line with a theoretical position of multidimensionality of self-construing. Measures of internal consistency were 0.898 for Cronbach's coefficient α. Both self-esteem and self-image scores correlated significantly with the Rosenberg Self-Esteem Scale (.418 and -.424 respectively) and Tennessee Self-Concept Scale-2 (.557 and -.512). The format of the SIP-AD, with a visually available profile, fosters collaboration between respondent and clinician, which befits its employment in clinical practice.

Self Esteem/Self Concept Scales for Children and Adolescents: A Review

There remains a flourishing interest in self esteem/self concept both in academic and clinical circles and popular literature. This paper elaborates various notions of the self and discusses the principles underpinning ways of measuring self esteem/self concept with children and adolescents. A review over the last 20 years indicates a raft of scales currently employed. The 14 most frequently cited are considered, with the top six measures and the latest British scale discussed in detail. The paper highlights issues and themes emerging from a comprehensive analysis of these scales, with a conclusion framed around assisting the reader to make an informed choice.

Validity of Test Score Interpretations for Three Self-Concept Measures Based on Differing Theoretical Models

Three theoretical models have been proposed to represent self-concept: (a) unidimensional; (b) multidimensional; (c) multidimensional hierarchical. Inventories have been developed under each of the three competing theoretical models; which model best represents self-concept is unclear. Typically, self-concept construct validation has utilized various approaches including correlational, multitrait-multimethod, and factor analytic methods. Another method, however, for assessing validity would be to determine the consequences of score interpretations using different measures specific to each of the theoretical models. This paper examined Messick's notion (1989) of the validity of test-score interpretations as applied to three of the most widely used measures derived under each of the three different theoretical models of self-concept. Results suggest that overall multidimensional measures are more consistent in classifying individual's self-concept than unidimensional measures.

Psychological functioning and quality of life in lung transplant candidates and recipients

OBJECTIVE

The purpose of this study was to examine the psychological functioning and quality of life (QOL) of lung transplant candidates and recipients.

METHODS

The following measures were completed by 36 lung transplant candidates (the pretransplant group [PRE]) and 73 recipients (the posttransplant group [POST]): the Rand-36 Item Health Survey 1.0 (RAND-36), visual analog scale of overall QOL (OQOL), Brief Symptoms Inventory (BSI), Derogatis Sexual Functioning Inventory (DSFI), Hospital Anxiety and Depression Scale (HAD), Rosenberg Self-Esteem Scale (RSES), and Body Cathexis Scale (BC).

RESULTS

Compared to the PRE, POST patients had significantly better scores on the following measures: RAND-36 total, physical health, role limitations due to physical health, general health, vitality, and social functioning subscales (all p < 0.0001); visual analog scale of OQOL (p < 0.0001); BSI (p < 0.05); BC (p < 0.05); HAD anxiety (p < 0.05) and depression (p < 0.0001); and RSES (p < 0.05). Despite better scores, some areas did not differ between the PRE and the POST, and many patients continued to experience impairments in psychological functioning. Specifically, the RAND-36 emotional health and role limitations due to emotional health subscale scores did not differ between the PRE and the POST and they remained lower than published norms. A significant proportion of patients in both groups (44% of PRE patients and 28% of POST patients) had borderline or clinical levels of anxiety (ie, the HAD). Finally, PRE and POST mean scores were significantly lower than published norms on the RSES (p < 0.05) and the body image scale of the DSFI (p < 0.05).

CONCLUSIONS

Although lung transplant recipients have better general, physical, and psychological health than their pretransplant counterparts, the present research suggests that both groups experience impairment in several areas of psychological functioning. Future research into the QOL of the lung transplant population should be aimed at recognizing, intervening, and improving patients' psychological and emotional well-being.

The relationship between psychosocial well-being and alcohol and drug use following substance misuse treatment

The relationship between psychosocial status and alcohol and drug use at 12-month follow-up was evaluated for clients of two addictions treatment programs (90 treated for alcohol; 51 for drugs or drugs and alcohol). Psychosocial status at follow-up was mostly unrelated to alcohol use among clients who were not using drugs prior to treatment. Among drug users, returning to both alcohol and drug use was strongly associated with poorer psychosocial status, with partial correlational analyses indicating that (a) drug use was the main factor associated with poorer status and (b) poorer status was likely a consequence rather than a precursor of drug use. The implications of these findings are discussed.

Modification of the cognitive model for bulimia via path analysis on a Brazilian adolescent sample

Eating disturbances in middle-class Brazilian adolescents attending three high schools (one Military, two Private schools) were investigated. Participants from both Private schools were similar to U.S. samples on the EAT-26. Path analysis on the Private schools revealed the following. Higher body weight leads to weight concerns most strongly through greater discrepancy from the ideal, but it also leads directly to weight concern. Thus, both the reality of being heavier and the perception that one is larger than ideal (which could be due to being heavier and/or having a thin ideal) contribute to weight concern. Greater weight concern is associated most directly with lower self-esteem, which in turn is associated with endorsing greater importance of weight and shape. Importance of weight and shape contributes most powerfully to eating pathology through dieting, but this variable has a modest direct effect as well. These paths were not significant for the Military school sample in which participants reported lower levels of weight concern, dieting, body dissatisfaction, and a larger ideal figure. However, the Military sample rated importance of weight and shape as high as did Private-school participants. The results provide support for variables identified as important in the cognitive model of bulimia and suggest the model may be enhanced by including body weight and one's perceived ideal body shape as additional variables.

Construct Validity of the Culture-Free Self-Esteem Inventory for Children

The present study examined the construct validity of three subscales from the Culture-free Self-esteem Inventory for Children (Battle, 1981). Subjects were 62 youth who participated in a local community social-service program between 1981 and 1985. Three subscales (Academic, Parent, and Social) of the inventory were compared with data recorded in case files. Data in the case files were quantified into scales according to the frequency and intensity of target behaviors derived from the literature. Correlation between scores on the inventory subscales and on the corresponding constructed scales were –.49, –.46, and –.11 for the academic, parent, and social dimensions, respectively. Correlations among the three subscales of the inventory and the noncorresponding constructed scales were all nonsignificant, giving support for discriminant validity among the subscales.

Measuring Adolescent Self-Concept: Factorial Validity and Equivalency of the SDQ III Across Gender

Exploratory (EFA) and confirmatory (CFA) factor analyses were used to investigate the factorial validity of the Self Description Questionnaire III (SDQ III) subscales measuring general, school, English, and mathematics self-concepts for a sample of 991 (455 males, 446 females) grades 11 and 12 students. EFA was used to to examine the initial factor structure, and CFA, to validate and test the invariance of this structure across gender -- three incrementally powerful tests of factorial validity. The EFA results yielded a remarkably well-defined 4-factor structure that was validated by the CFA analyses. Tests of invariance demonstrated equivalence for all but two item-pair measurements of general self-concept. Overall, in light of the stringency of LISREL CFA procedures, the SDQ III demonstrated exceptionally superior psychometric properties.