The Relationship between Self-Esteem and Depression when Controlling for Neuroticism

Dynamic risk for first onset of depressive disorders in adolescence: does change matter?

BACKGROUND

Risk factors for depressive disorders (DD) change substantially over time, but the prognostic value of these changes remains unclear. Two basic types of dynamic effects are possible. The 'Risk Escalation hypothesis' posits that worsening of risk levels predicts DD onset above average level of risk factors. Alternatively, the 'Chronic Risk hypothesis' posits that the average level rather than change predicts first-onset DD.

METHODS

We utilized data from the ADEPT project, a cohort of 496 girls (baseline age 13.5-15.5 years) from the community followed for 3 years. Participants underwent five waves of assessments for risk factors and diagnostic interviews for DD. For illustration purposes, we selected 16 well-established dynamic risk factors for adolescent depression, such as depressive and anxiety symptoms, personality traits, clinical traits, and social risk factors. We conducted Cox regression analyses with time-varying covariates to predict first DD onset.

RESULTS

Consistently elevated risk factors (i.e. the mean of multiple waves), but not recent escalation, predicted first-onset DD, consistent with the Chronic Risk hypothesis. This hypothesis was supported across all 16 risk factors.

CONCLUSIONS

Across a range of risk factors, girls who had first-onset DD generally did not experience a sharp increase in risk level shortly before the onset of disorder; rather, for years before onset, they exhibited elevated levels of risk. Our findings suggest that chronicity of risk should be a particular focus in screening high-risk populations to prevent the onset of DDs. In particular, regular monitoring of risk factors in school settings is highly informative.

Cyberbullying victimization and depression: self-esteem as a mediator and approach coping strategies as moderators

Objective: The percentage of victims of cyberbullying among college students seems to increase. However, research on the mechanisms by which cyberbullying victimization (CV) suffer from depression is scarce. This study has purpose to figure out the mediating role of self-esteem (SE) as well as the moderating role of approach coping strategies in the association between CV and depression among Vietnamese college students. Methods: A total of 606 Vietnamese university students completed the Self-Esteem Scale, The Self-Report Coping Scale, The cyberbullying victimization scale, DASS 21. Results: The results indicated that SE partially mediated the relation between CV and depression among Vietnamese college students as well as approach coping strategies moderated the involvement between CV and depression among Vietnamese college students. Conclusions: Our findings can help psychological service providers identify the methods by which cyberbullying sufferers related to depression and provide interventions to reduce depression for cyberbullying victims.

Personality traits and college students' internet addiction: The mediating roles of general health and self-esteem

This research aimed to explore the gender-related differences in Internet addiction levels, the associated factors behind Internet addiction, and the mediating roles of general health and self-esteem in the relationship between personality traits and Internet addiction among college students. A total of 318 college students in Iran participating in this study completed sociodemographic information form and self-report measures of Internet addiction, personality traits, general health, and self-esteem. The results showed higher frequencies of low and moderate-severe levels of addiction among female and male students, respectively. Further, younger age, male gender, singleness, high scores on neuroticism, poor general health, and low self-esteem might be linked to Internet addiction. The overall hypothesis that general health and self-esteem mediated the effect of neuroticism on Internet addiction was also supported. Our findings highlighted the necessity of evaluating general health and self-esteem among Internet-addicted students. Further, these variables can be targeted by psychiatrists and psychologists for effective cognitive-behavioral therapy among Internet-addicted students.

Cognitive-behavioral group therapy in major depressive disorder with focus on self-esteem and optimism: an interventional study

BACKGROUND

Major depressive disorder is a common psychological condition that can lead to negative individual and social consequences, the management of which is very important in treating the patients. The present study aimed to determine the effect of cognitive-behavioral group therapy on self-esteem and optimism in patients with major depressive disorder.

METHODS

This is a single-blinded, randomized controlled trial in which a total of 64 patients with major depressive disorder were recruited using convenience sampling and then randomly assigned to two groups of Cognitive-Behavioral Group Therapy (CBGT) and Treatment-As-Usual (TAU). Data collection tools consisted of a demographic questionnaire, the Rosenberg Self-Esteem Scale (RSES), and the Revised Life Orientation Test (LOT-R). In the pretest stage, participants in both groups completed the above questionnaires before the intervention. Patients in the CBGT group received eight 90-min sessions of cognitive-behavioral therapy during four weeks (two sessions a week). Then participants re-completed RSES and LOT-R immediately, three months, and six months after the intervention. Data were analyzed with SPSS software version 16.0 using chi-squared test, independent-samples t-test, and repeated measures Analysis of Variance. The significance level (p-value) was considered to be less than 0.05.

RESULTS

It was indicated that there was a statistically significant difference in the mean scores of self-esteem and optimism between the two groups immediately, three months, and six months after the intervention (p < .05). The mean scores of self-esteem and optimism in the CBGT group increased significantly after the intervention compared to before it, although these scores gradually decreased over the three measurement time points after the intervention.

CONCLUSIONS

Based upon the results, it was concluded that the level of optimism and self-esteem increased significantly in the CBGT group after the intervention, although the levels of the above variables dropped again in the long run after the intervention due to the discontinuity of CBGT sessions. Therefore, it is necessary to take particular measures to regularly hold the sessions of CBGT for patients with major depressive disorder.

TRIAL REGISTRATION NUMBER

IRCT20140212016564N15 , The date of registration: 20-09-2021, Retrospectively registered.

Depression: Determinants That Influence the Mental Health of Older People (60 Years +) in Botswana

Correlates of depression in older people were explored in this study. The prevalence of depression was also calculated. Data were collected using a cross-sectional study stratified by district in urban and rural Botswana using the Patient Health Questionnaire. A snowballing technique was utilized to recruit older participants (N = 378; age = 71.8; SD = 9.1) with low to high incomes. Univariate and multivariate analyses were used to investigate the associations among demographics, individual, social, and environmental factors, and depression. The prevalence of depression and social impairment in older people was 7.8% and 20.6%. The correlates significantly associated with depression in Model 2 were education, income earned, resilience, and self-esteem (F (6, 358) = 19.5, p < .001; R2 = 23%) after adjusting for all influencing factors. Self-perceived health was associated with depression in Model 3 [F (11,340) = 12.5, p < .001; R2 = 28%]. In the final model, resilience, quality of life (QOL), and leisure were significantly associated with depression (p < .001), followed by anxiety, somatic symptoms, and social impairment (p < .05) [F (20,214) = 9.2, p < .001; R2 = 46%]. Findings provide preliminary information on the determinants of depression for further review by the research community. Stakeholders should also take cognizance of these correlates during their practice to curb depression in older people.

Prevalence of COVID-19 Pandemic, Self-Esteem and Its Effect on Depression Among University Students in Saudi Arabia

Background and Aims

University students are commonly identified as susceptible, suffering from higher anxiety, stress, and depression than the overall population. During the Corona Virus Disease pandemic (COVID), education was shifted to the virtual learning environment. Students' ambiguity regarding academic accomplishment, imminent careers, changes in social life, and other concerns all these factors played a role in amplifying their stress levels, anxiety, and depression worldwide. This study investigates university students' self-esteem and depressions after they have been online learning for over 1 year due to the COVID-19 pandemic in Saudi Arabia.

Methods

For this research, an adapted questionnaire of Rosenberg (Self-Esteem Scale) and Zung (Self-Rating Depression Scale) was used to get the responses of the participants of public and private universities in Saudi Arabia during March-April 2021. We received a total of 151 valid responses from respondents. For data analysis, we used descriptive statistics, ANOVA, multiple regression and binary logistic regression.

Findings

The results showed that 75% of the students experienced different levels of depressions, with half (37.5%) having moderate to extreme levels of depression. A total of 41% of students experienced low self-esteem (38% females and 45% males). The regression results indicated depressive symptoms for low self-esteem. Furthermore, results of logistic regression showed that high self-esteem reduces the chances of getting depressive symptoms by 17%. The depressive symptoms were higher in female students than their male counterparts; furthermore, males experienced depressive symptoms less than females by 38%.

Conclusions

Based on the current research results, it is concluded that the presence of the COVID-19 pandemic has dramatically increased the depressive symptoms in students, especially in female students. The findings suggested instant consideration and support for students. It is also suggested to the quest for potential managing policies that have been known and effective during the pandemic. Moreover, training should be provided for students to shift their educational experience mindset to an adaptive mindset, which can help them adapt to the new ways of learning and education.

'Faking it': Exploring adolescent perceptions of depression (in)authenticity and 'attention seeking'

OBJECTIVES

Attitudes towards peers who are not perceived to be legitimately depressed, or whose depression 'authenticity' is questioned, represent a current gap in adolescent depression stigma research. This research study, therefore, investigated how perceptions of depression inauthenticity are framed in adolescent Reddit communities.

METHODS

This observational study used an internet-mediated, qualitative methodology to analyse forum posts from April 2019 to January 2020 on three adolescent-based subreddits. Posts were extracted using the Baumgartner Reddit Corpus. Identifiable information was removed to protect anonymity.

RESULTS

Inductive thematic analysis identified two overarching themes, namely, public stigma and self-stigma associated with depression inauthenticity. Public stigma could be further dissected into five subthemes: (i) dichotomy between 'real' and 'fake depression'; (ii) aggression towards 'fakers'; (iii) stereotypes; (iv) attention; and (v) diagnosis. On the other hand, the theme of self-stigma consisted of subthemes: (i) self-doubt and (ii) validation and invalidation.

CONCLUSIONS

Adolescents framed a dichotomy between so-called 'real' and 'fake depression', with hostility directed at peers perceived to be 'fake depressed'. Perceptions of depression inauthenticity were confused and inconsistent. Public and self-stigma towards depression inauthenticity enforced barriers to help-seeking. While future research should investigate to what extent these observations based on online forums mimic stigma in real-life settings, our findings have highlighted the needs for 'fake depression' stigma to be addressed by adolescent depression literacy and stigma interventions. Recent movements towards reconceptualizing depression as a dimensional construct may help to challenge these stigmatizing views of a dichotomy between 'real' and 'fake' depression.

PRACTITIONER POINTS

There is widespread stigma concerning perceived inauthenticity related to depression in these online adolescent communities, with vitriol targeted at peers perceived to be so-called 'fake depressed'. Adolescent depression literacy and stigma programmes should tackle stigma towards perceived inauthenticity and promote the message that all adolescent distress deserves attention and help. This involves challenging perceptions that only supposedly 'authentic', diagnosed, or diagnosable, depression is worthy of attention and support. Prevention Programmes should work to mitigate barriers to help-seeking posed by misunderstandings that distress which is kept secret is more 'authentic', and tackle gender and age stereotypes surrounding perceived inauthenticity. There is a need for clinically approved online resources targeted at adolescents who feel unsure about whether their symptoms could be indicators of depression, and to make professional advice and help more accessible for young people.

Mediators of the association between psychotic experiences and future non-suicidal self-injury and suicide attempts: results from a three-wave, prospective adolescent cohort study

Psychotic experiences (PEs) are robustly associated with subsequent non-suicidal self-injury (NSSI) and suicide attempts, but questions remain as to the temporal relation and underlying cause of this association. Most investigations have incorporated only two waves of data, and no study has comprehensively investigated mediating pathways. This study aimed to investigate both the PE-NSSI and PE-suicide attempt association, and their relevant mediators, across three waves of prospective data. Participants were from an Australian prospective longitudinal cohort of 1100 adolescents (12-17 years); data were collected at three time points over 2 years. NSSI and suicide attempts were measured using the Self-Harm Behaviour Questionnaire. Items from the Diagnostic Interview Schedule for Children were used to assess four PE subtypes (auditory hallucinatory experiences [HEs] and three delusional experiences). Potential mediators of interest included: psychological distress, self-reported mental disorders, self-esteem, recent traumatic life events (e.g. bullying, sexual assault), emotion regulation, and impulsivity/other personality traits. Analyses were adjusted for sociodemographics and substance use. Auditory HEs were indirectly associated with future NSSI and suicide attempts via recent traumatic life events, high psychological distress, and low self-esteem, across three waves of data. Other PE subtypes were generally not associated with incident NSSI/suicide attempts at 1- and 2-year follow-up, either directly or indirectly. These findings highlight the importance of screening for auditory HEs when assessing a young person's self-harm/suicide risk. Clinical assessment would be further enhanced by a comprehensive review of recent interpersonal traumatic events, as well as levels of self-esteem and distress.

Self-Esteem, Anxiety, and Depression in Older People in Nursing Homes

Background: Social environment and type of care may influence mental health in late life. The aim of this study was to assess the associations between depression, anxiety, and self-esteem in older people. Methods: The study evaluated mental health in people older than 65 years of age in Zadar County, Croatia. The participants were interviewed using the Patient Health Questionnaire, the Generalized Anxiety Disorder Scale, and the Rosenberg Self-Esteem Scale. Multiple linear regressions were used to assess the correlations between depression, anxiety, and self-esteem. Results: Compared with elderly people living in their own homes, elderly people in nursing homes reported lower self-esteem, higher depression, and higher anxiety. The level of self-esteem decreased with increased levels of depression. Anxiety was significantly associated with depression, while depression strongly increased with an increase in anxiety. Older age was associated with depression, while widowhood was a negative predictor of self-esteem. Institutionalization was borderline significantly associated with anxiety, while gender was associated with anxiety. Conclusions: The study found associations between self-esteem, anxiety, and depression in the elderly. The strategy of humanization in nursing care for older people should be applied equally in nursing homes and in community-dwelling states. Public health programs aimed at maintaining the mental health of older people are needed.

On the link of self-esteem, life satisfaction, and Neuroticism

OBJECTIVE

Self-esteem (SE) and life satisfaction (LS) are highly correlated but little is known about the sources of this association. Both characteristic adaptations are negatively correlated with Neuroticism (N). We investigated the relationship between SE, LS, and N and the degree to which shared variance was explained by N from a behavior genetic perspective.

METHOD

We analyzed more than 2,000 German same-sex twin pairs and their siblings. Twins were 17 and  23 years old and siblings were M = 21.6 years old. The sample was balanced regarding gender. We applied multivariate twin-sibling Cholesky models to obtain genetic and environmental correlations and estimated the impact N had on genetic and environmental correlations of SE and LS.

RESULTS

The genetic correlation between SE and LS was .99 and 47% of this phenotypic correlation was explained by genetics. About 28% of the common genetic variance between SE and LS was explained by shared genes with N.

CONCLUSIONS

Our findings suggest that N is not a common factor of SE and LS. The results are not in line with theories assuming that N is a basic tendency whose genetic factors account for most of the genetic variance between the assumed characteristic adaptations SE and LS.

Trauma-related cognitions predict treatment response in smokers with PTSD: Evidence from cross-lagged panel analyses

OBJECTIVE

Compared to smokers without posttraumatic stress disorders (PTSD), smokers with PTSD smoke more heavily and are less successful in quitting smoking. However, limited research has examined the cognitive pathways underlying this heightened comorbidity. The current study is the first to simultaneously model the cross-sectional and lagged relationships between trauma-related cognitions and cigarette smoking, as well as between trauma-related cognitions and PTSD severity, in smokers with comorbid PTSD receiving treatment.

METHOD

Participants (n = 142) were seeking treatment for smoking cessation and PTSD as part of a randomized controlled trial of varenicline and smoking cessation counseling with or without adjunctive Prolonged Exposure (varenicline + PE vs. varenicline only) (Foa et al., 2017). Data were available for both baseline and end-of-treatment assessments of trauma cognitions severity of cigarette smoking and PTSD symptoms. We conducted both cross-sectional and lagged analysis to simultaneously examine the bidirectional relationship from trauma cognitions and 1) cigarette smoking and 2) PTSD symptoms.

RESULTS

Trauma cognitions (specifically, negative beliefs about the self and the world) were significantly associated with cigarette/day at the end of treatment for participants who received varenicline only. However, baseline trauma cognitions did not predict post-treatment cigarettes/day. Baseline trauma cognitions (specifically negative beliefs about the self and world) were associated with PTSD severity at both baseline and end of treatment; furthermore, these negative cognitions at baseline positively and prospectively predicted end-of-treatment PTSD severity, but not vice versa. Wald tests revealed that there were no treatment effects on these cross-lagged relationships. Conclusions These findings provide novel empirical support for the importance of addressing trauma-related cognitions in the smoking cessation treatment efforts for patients with comorbid PTSD and cigarette smoking.

The long-term effects of perceived community disorder and social stigma on depressive symptoms among adolescent school dropouts using multivariate latent growth modeling

The purpose of this study was to examine the long-term effects of perceived community disorder and social stigma on depressive symptoms among adolescent school dropouts. This study used 2–4 wave data of a Longitudinal Survey and Support Plan for Dropouts. Multivariate latent growth modeling indicated that social stigma was associated with greater number of depressive symptoms and had an indirect influence on depressive symptoms through self-esteem. In addition, perceived community disorder was related to greater number of depressive symptoms. Finally, self-esteem was negatively related to depressive symptoms and female adolescents reported more depressive symptoms than male adolescents. This study suggests that policy and social efforts are needed to reduce perceived community disorder and social stigma to prevent the depression in adolescent school dropouts.

Self-esteem, symptom severity, and treatment response in adolescents with internalizing problems

BACKGROUND

Adolescents with low self-esteem often experience internalizing psychopathology (i.e., anxiety, depression). Self-esteem may therefore be a clinically relevant construct for assessment and treatment outcomes. We examined whether general and domain-specific (family, peer, academic) self-esteem are related to adolescents' internalizing symptom severity and response to cognitive behavioural therapy (CBT).

METHOD

Participants were 89 adolescents ages 14 to 18 years (M = 16.3, 70% females) from an outpatient clinic who were referred for CBT. Adolescents completed measures of self-esteem at baseline and measures of internalizing symptoms at baseline and at the end of a manualized group CBT intervention.

RESULTS

Lower peer and family self-esteem, but not academic self-esteem, were associated with more internalizing symptoms at baseline, after controlling for general self-esteem. However, only higher general self-esteem, and not any of the specific self-esteem domains, predicted lower internalizing symptoms at posttreatment. Follow-up analyses revealed differential associations between family and peer self-esteem domains and anxious and depressive symptoms.

LIMITATIONS

Only self-report measures were used. The relatively small sample size may have limited power to detect small effects.

CONCLUSIONS

Self-esteem in domains regarding family and peer relationships may be important in the evaluation of adolescents with internalizing problems. Adolescents with low general self-esteem may benefit less from CBT than other adolescents. Addressing negative self-perceptions may be necessary to reduce internalizing symptoms for adolescents with low self-esteem.

Causal Factors of Anxiety and Depression in College Students: Longitudinal Ecological Momentary Assessment and Causal Analysis Using Peter and Clark Momentary Conditional Independence

BACKGROUND

Across college campuses, the prevalence of clinically relevant depression or anxiety is affecting more than 27% of the college population at some point between entry to college and graduation. Stress and self-esteem have both been hypothesized to contribute to depression and anxiety levels. Although contemporaneous relationships between these variables have been well-defined, the causal relationship between these mental health factors is not well understood, as frequent sampling can be invasive, and many of the current causal techniques are not well suited to investigate correlated variables.

OBJECTIVE

This study aims to characterize the causal and contemporaneous networks between these critical mental health factors in a cohort of first-year college students and then determine if observed results replicate in a second, distinct cohort.

METHODS

Ecological momentary assessments of depression, anxiety, stress, and self-esteem were obtained weekly from two cohorts of first-year college students for 40 weeks (1 academic year). We used the Peter and Clark Momentary Conditional Independence algorithm to identify the contemporaneous (t) and causal (t-1) network structures between these mental health metrics.

RESULTS

All reported results are significant at P<.001 unless otherwise stated. Depression was causally influenced by self-esteem (t-1 r_p, cohort 1 [C1]=-0.082, cohort 2 [C2]=-0.095) and itself (t-1 r_p, C1=0.388, C2=0.382) in both cohorts. Anxiety was causally influenced by stress (t-1 r_p, C1=0.095, C2=0.104), self-esteem (t-1 r_p, C1=-0.067, C2=-0.064, P=.002), and itself (t-1 r_p, of C1=0.293, C2=0.339) in both cohorts. A causal link between anxiety and depression was observed in the first cohort (t-1 r_p, C1=0.109) and only observed in the second cohort with a more liberal threshold (t-1 r_p, C2=0.044, P=.03). Self-esteem was only causally influenced by itself (t-1 r_p, C1=0.389, C2=0.393). Stress was only causally influenced by itself (t-1 r_p, C1=0.248, C2=0.273). Anxiety had positive contemporaneous links to depression (t r_p, C1=0.462, C2=0.444) and stress (t r_p, C1=0.354, C2=0.358). Self-esteem had negative contemporaneous links to each of the other three mental health metrics, with the strongest negative relationship being stress (t r_p, C1=-0.334, C2=-0.340), followed by depression (t r_p, C1=-0.302, C2=-0.274) and anxiety (t r_p, C1=-0.256, C2=-0.208). Depression had positive contemporaneous links to anxiety (previously mentioned) and stress (t r_p, C1=0.250, C2=0.231).

CONCLUSIONS

This paper is an initial attempt to describe the contemporaneous and causal relationships among these four mental health metrics in college students. We replicated previous research identifying concurrent relationships between these variables and extended them by identifying causal links among these metrics. These results provide support for the vulnerability model of depression and anxiety. Understanding how causal factors impact the evolution of these mental states over time may provide key information for targeted treatment or, perhaps more importantly, preventative interventions for individuals at risk for depression and anxiety.

Body Image Distortion Following Social Rejection or Acceptance Cues

Introduction: Body image has been shown to be subject to explicit, body-related feedback influences, yet little attention has been paid to subtle feedback about overall social acceptability. The current study tested competing hypotheses regarding women's body image after being primed with cued social rejection or acceptance. Whereas sociometer theory predicts that women will perceive their bodies more negatively following a social rejection prime, self-enhancement theory predicts the opposite.

Method: A total of 105 female undergraduate students underwent a conditioning procedure in which distinctive tones were paired with signs of social rejection or acceptance. After this, body distortion (measured by a participant-adjusted virtual image), self-reported body satisfaction and affect were measured, while one of the tones sounded repeatedly in the background.

Results: Compared with the acceptance condition, rejection condition participants reported greater state negative affect, F(1, 103) = 4.41, p = .04, greater state positive affect, F(1, 103) = 5.52, p = .02, and perceived their bodies as being smaller, F(1, 103) = 6.53, p = .01, consistent with the expectations of self-enhancement theory.

Discussion: Implications of these findings are discussed regarding improved understanding of body image disturbance as well as development of novel clinical treatments.

Dispositional negativity, cognition, and anxiety disorders: An integrative translational neuroscience framework

When extreme, anxiety can become debilitating. Anxiety disorders, which often first emerge early in development, are common and challenging to treat, yet the underlying mechanisms have only recently begun to come into focus. Here, we review new insights into the nature and biological bases of dispositional negativity, a fundamental dimension of childhood temperament and adult personality and a prominent risk factor for the development of pediatric and adult anxiety disorders. Converging lines of epidemiological, neurobiological, and mechanistic evidence suggest that dispositional negativity increases the likelihood of psychopathology via specific neurocognitive mechanisms, including attentional biases to threat and deficits in executive control. Collectively, these observations provide an integrative translational framework for understanding the development and maintenance of anxiety disorders in adults and youth and set the stage for developing improved intervention strategies.