Share and Cite:. Galanakis, M. Psychology , 7 , Received 12 December ; accepted 13 May ; published 16 May 1. Stress Stress is defined by Professor G. Self-Esteem The concept of self-esteem has elicited a large body of theoretical accounts and empirical research Baumeister, Stress and Self-Esteem 4.
Self-Esteem and Cortisol Secretion Reviewing the current literature, we notice that the stress is associated with self-esteem in multiple ways. Self-Esteem and Academic Stress Students with high self-esteem seem to be less stressed than those who have low self-esteem and have high stress Reilly et al. Techniques of Stress Management and Self-Esteem Several studies show that the stress management techniques in addition to reducing stress, improve self-esteem.
Conclusions In this literature review, several studies are presented that show the relationship of stress and self-esteem at multiple levels. Conflicts of Interest The authors declare no conflicts of interest. References [ 1 ] Avison, R.
Journals Menu. Contact us. All Rights Reserved. Avison, R. Baumeister, R. Berjot, S. Besser, A. Birndorf, S. Blom, V. Brown, J. Caldwell, K. Carter, J. Chrousos, G. Cooley, C. Feldman, L. Goffman, E. James, W. Kandemir, M. Lazarus, R. Leary, M. Lee-Flynn, S. Liu, S. Mead, G. Nima, A. Orth, U. Pruessner, J. Reilly, E. Rhee, K. Robins, R. Rosenberg, M. Schramla, K. Sethi, J. Stieger, S. Suzuki, H. Taylor, S. It is seen to actively promote healthy functioning as reflected in life aspects such as achievements, success, satisfaction, and the ability to cope with diseases like cancer and heart disease.
Conversely, an unstable self-concept and poor self-esteem can play a critical role in the development of an array of mental disorders and social problems, such as depression, anorexia nervosa, bulimia, anxiety, violence, substance abuse and high-risk behaviors. These conditions not only result in a high degree of personal suffering, but also impose a considerable burden on society. As will be shown, prospective studies have highlighted low self-esteem as a risk factor and positive self-esteem as a protective factor.
To summarize, self-esteem is considered as an influential factor both in physical and mental health, and therefore should be an important focus in health promotion; in particular, mental health promotion. Health promotion refers to the process of enabling people to increase control over and improve their own health WHO, Subjective control as well as subjective health, each aspects of the self, are considered as significant elements of the health concept.
Recognizing the existence of different views on the concept of mental health promotion, Sartorius Sartorius, , the former WHO Director of Mental Health, preferred to define it as a means by which individuals, groups or large populations can enhance their competence, self-esteem and sense of well-being.
This view is supported by Tudor Tudor, in his monograph on mental health promotion, where he presents self-concept and self-esteem as two of the core elements of mental health, and therefore as an important focus of mental health promotion.
The first section presents a review of the empirical evidence on the consequences of high and low self-esteem in the domains of mental health, health and social outcomes. The section also addresses the bi-directional nature of the relationship between self-esteem and mental health.
The second section discusses the role of self-esteem in health promotion from a theoretical perspective. How are differentiations within the self-concept related to self-esteem and mental health? How does self-esteem relate to the currently prevailing theories in the field of health promotion and prevention?
What are the mechanisms that link self-esteem to health and social outcomes? Several theories used in health promotion or prevention offer insight into such mechanisms. We discuss the role of positive self-esteem as a protective factor in the context of stressors, the developmental role of negative self-esteem in mental and social problems, and the role of self-esteem in models of health behavior.
Finally, implications for designing a health-promotion strategy that could generate broad-spectrum outcomes through addressing common risk factors such as self-esteem are discussed. In this context, schools are considered an ideal setting for such broad-spectrum interventions. Some examples are offered of school programs that have successfully contributed to the enhancement of self-esteem, and the prevention of mental and social problems. Empirical studies over the last 15 years indicate that self-esteem is an important psychological factor contributing to health and quality of life Evans, Recently, several studies have shown that subjective well-being significantly correlates with high self-esteem, and that self-esteem shares significant variance in both mental well-being and happiness Zimmerman, Self-esteem has been found to be the most dominant and powerful predictor of happiness Furnham and Cheng, According to Tudor Tudor, , self-concept, identity and self-esteem are among the key elements of mental health.
The relationship between self-esteem and academic achievement is reported in a large number of studies Marsh and Yeung, ; Filozof et al. In the critical childhood years, positive feelings of self-esteem have been shown to increase children's confidence and success at school Coopersmith, , with positive self-esteem being a predicting factor for academic success, e.
Results of a longitudinal study among elementary school children indicate that children with high self-esteem have higher cognitive aptitudes Adams, Furthermore, research has revealed that core self-evaluations measured in childhood and in early adulthood are linked to job satisfaction in middle age Judge et al. This is reflected in observations of chronically ill individuals. It has been found that a greater feeling of mastery, efficacy and high self-esteem, in combination with having a partner and many close relationships, all have direct protective effects on the development of depressive symptoms in the chronically ill Penninx et al.
Self-esteem has also been shown to enhance an individual's ability to cope with disease and post-operative survival. Research on pre-transplant psychological variables and survival after bone marrow transplantation Broers et al. Chang and Mackenzie Chang and Mackenzie, found that the level of self-esteem was a consistent factor in the prediction of the functional outcome of a patient after a stroke.
To conclude, positive self-esteem is associated with mental well-being, adjustment, happiness, success and satisfaction. It is also associated with recovery after severe diseases. The evolving nature of self-esteem was conceptualized by Erikson Erikson, in his theory on the stages of psychosocial development in children, adolescents and adults.
According to Erikson, individuals are occupied with their self-esteem and self-concept as long as the process of crystallization of identity continues. If this process is not negotiated successfully, the individual remains confused, not knowing who s he really is.
Identity problems, such as unclear identity, diffused identity and foreclosure an identity status based on whether or not adolescents made firm commitments in life. The development of self-esteem during childhood and adolescence depends on a wide variety of intra-individual and social factors. Approval and support, especially from parents and peers, and self-perceived competence in domains of importance are the main determinants of self-esteem [for a review, see Harter, ]. Attachment and unconditional parental support are critical during the phases of self-development.
This is a reciprocal process, as individuals with positive self-esteem can better internalize the positive view of significant others. For instance, in their prospective study among young adolescents, Garber and Flynn Garber and Flynn, found that negative self-worth develops as an outcome of low maternal acceptance, a maternal history of depression and exposure to negative interpersonal contexts, such as negative parenting practices, early history of child maltreatment, negative feedback from significant others on one's competence, and family discord and disruption.
Other sources of negative self-esteem are discrepancies between competing aspects of the self, such as between the ideal and the real self, especially in domains of importance. The larger the discrepancy between the value a child assigns to a certain competence area and the perceived self-competence in that area, the lower the feeling of self-esteem Harter, Furthermore, discrepancies can exist between the self as seen by oneself and the self as seen by significant others.
As implied by Harter Harter, , this could refer to contrasts that might exist between self-perceived competencies and the lack of approval or support by parents or peers. Finally, negative and positive feelings of self-worth could be the result of a cognitive, inferential process, in which children observe and evaluate their own behaviors and competencies in specific domains self-efficacy.
The poorer they evaluate their competencies, especially in comparison to those of their peers or to the standards of significant others, the more negative their self-esteem. Such self-monitoring processes can be negatively or positively biased by a learned tendency to negative or positive thinking Seligman et al. The outcomes of negative self-esteem can be manifold. Poor self-esteem can result in a cascade of diminishing self-appreciation, creating self-defeating attitudes, psychiatric vulnerability, social problems or risk behaviors.
The empirical literature highlights the negative outcomes of low self-esteem. However, in several studies there is a lack of clarity regarding causal relations between self-esteem and problems or disorders Flay and Ordway, This is an important observation, as there is reason to believe that self-esteem should be examined not only as a cause, but also as a consequence of problem behavior. For example, on the one hand, children could have a negative view about themselves and that might lead to depressive feelings.
On the other hand, depression or lack of efficient functioning could lead to feeling bad, which might decrease self-esteem. Although the directionality can work both ways, this article concentrates on the evidence for self-esteem as a potential risk factor for mental and social outcomes.
Three clusters of outcomes can be differentiated. The first are mental disorders with internalizing characteristics, such as depression, eating disorders and anxiety. The second are poor social outcomes with externalizing characteristics including aggressive behavior, violence and educational exclusion.
The third is risky health behavior such as drug abuse and not using condoms. Self-esteem plays a significant role in the development of a variety of mental disorders. According to the Diagnostic and Statistical Manual of Mental Disorders DSM IV , negative or unstable self-perceptions are a key component in the diagnostic criteria of major depressive disorders, manic and hypomanic episodes, dysthymic disorders, dissociative disorders, anorexia nervosa, bulimia nervosa, and in personality disorders, such as borderline, narcissistic and avoidant behavior.
Negative self-esteem is also found to be a risk factor, leading to maladjustment and even escapism. Lacking trust in themselves, individuals become unable to handle daily problems which, in turn, reduces the ability to achieve maximum potential. This could lead to an alarming deterioration in physical and mental well-being.
A decline in mental health could result in internalizing problem behavior such as depression, anxiety and eating disorders. The outcomes of low self-esteem for these disorders are elaborated below. The clinical literature suggests that low self-esteem is related to depressed moods Patterson and Capaldi, , depressive disorders Rice et al. Correlational studies have consistently shown a significant negative relationship between self-esteem and depression Beck et al. Campbell et al.
Low self-esteem subjects rated their daily events as less positive and negative life events as being more personally important than high self-esteem subjects. Individuals with high self-esteem made more stable and global internal attributions for positive events than for negative events, leading to the reinforcement of their positive self-image.
Subjects low in self-esteem, however, were more likely to associate negative events to stable and global internal attributions, and positive events to external factors and luck Campbell et al. There is a growing body of evidence that individuals with low self-esteem more often report a depressed state, and that there is a link between dimensions of attributional style, self-esteem and depression Abramson et al.
Some indications of the causal role of self-esteem result from prospective studies. In longitudinal studies, low self-esteem during childhood Reinherz et al. Shin Shin, found that when cumulative stress, social support and self-esteem were introduced subsequently in regression analysis, of the latter two, only self-esteem accounted for significant additional variance in depression. In addition, Brown et al. Brown et al. There appears to be a pathway from not living up to personal standards, to low self-esteem and to being depressed Harter, , ; Higgins, , ; Baumeister, Alternatively, another study indicated that when examining the role of life events and difficulties, it was found that total level of stress interacted with low self-esteem in predicting depression, whereas self-esteem alone made no direct contribution Miller et al.
To conclude, results of cross-sectional and longitudinal studies have shown that low self-esteem is predictive of depression. His research indicates that teaching children to challenge their pessimistic thoughts whilst increasing positive subjective thinking and bolstering self-esteem can reduce the risk of pathologies such as depression Seligman, ; Seligman et al.
Although low self-esteem is most frequently associated with depression, a relationship has also been found with other internalizing disorders, such as anxiety and eating disorders. Research results indicate that self-esteem is inversely correlated with anxiety and other signs of psychological and physical distress Beck et al. For example, Ginsburg et al. Ginsburg et al. Self-esteem was shown to serve the fundamental psychological function of buffering anxiety, with the pursuit of self-esteem as a defensive avoidance tool against basic human fears.
This mechanism of defense has become evident in research with primary Ginsburg et al. In addition, empirical studies have shown that bolstering self-esteem in adults reduces anxiety Solomon et al. The critical role of self-esteem during school years is clearly reflected in studies on eating disorders. At this stage in life, weight, body shape and dieting behavior become intertwined with identity.
Researchers have reported low self-esteem as a risk factor in the development of eating disorders in female school children and adolescents Fisher et al. Low self-esteem also seems predictive of the poor outcome of treatment in such disorders, as has been found in a recent 4-year prospective follow-up study among adolescent in-patients with bulimic characteristics van der Ham et al.
The significant influence of self-esteem on body image has led to programs in which the promotion of self-esteem is used as a main preventive tool in eating disorders St Jeor, ; Vickers, ; Scarano et al.
To sum up, there is a systematic relation between self-esteem and internalizing problem behavior. Moreover, there is enough prospective evidence to suggest that poor self-esteem might contribute to deterioration of internalizing problem behavior while improvement of self-esteem could prevent such deterioration. For more than two decades, scientists have studied the relationship between self-esteem and externalizing problem behaviors, such as aggression, violence, youth delinquency and dropping out of school.
The outcomes of self-esteem for these disorders are described below. While the causes of such behaviors are multiple and complex, many researchers have identified self-esteem as a critical factor in crime prevention, rehabilitation and behavioral change Kressly, ; Gilbert, In a recent longitudinal questionnaire study among high-school adolescents, low self-esteem was one of the key risk factors for problem behavior Jessor et al.
Recent studies confirm that high self-esteem is significantly associated with less violence Fleming et al. Results of a nationwide study of bullying behavior in Ireland show that children who were involved in bullying as either bullies, victims or both had significantly lower self-esteem than other children Schoen, Adolescents with low self-esteem were found to be more vulnerable to delinquent behavior.
Interestingly, delinquency was positively associated with inflated self-esteem among these adolescents after performing delinquent behavior Schoen, According to Kaplan's self-derogation theory of delinquency Kaplan, , involvement in delinquent behavior with delinquent peers can increase children's self-esteem and sense of belonging. It was also found that individuals with extremely high levels of self-esteem and narcissism show high tendencies to express anger and aggression Baumeister et al.
To conclude, positive self-esteem is associated with less aggressive behavior. Although most studies in the field of aggressive behavior, violence and delinquency are correlational, there is some prospective evidence that low self-esteem is a risk factor in the development of problem behavior. Interestingly, low self-esteem as well as high and inflated self-esteem are both associated with the development of aggressive symptoms. Dropping out from the educational system could also reflect rebellion or antisocial behavior resulting from identity diffusion an identity status based on whether or not adolescents made firm commitments in life.
For instance, Muha Muha, has shown that while self-image and self-esteem contribute to competent functioning in childhood and adolescence, low self-esteem can lead to problems in social functioning and school dropout. The social consequences of such problem behaviors may be considerable for both the individual and the wider community. Several prevention programs have reduced the dropout rate of students at risk Alice, ; Andrews, All these programs emphasize self-esteem as a crucial element in dropout prevention.
The impact of self-esteem is also evident in risk behavior and physical health. In a longitudinal study, Rouse Rouse, observed that resilient adolescents had higher self-esteem than their non-resilient peers and that they were less likely to initiate a variety of risk behaviors.
Positive self-esteem is considered as a protective factor against substance abuse. Adolescents with more positive self-concepts are less likely to use alcohol or drugs Carvajal et al. Carvajal et al. Although many studies support the finding that improving self-esteem is an important component of substance abuse prevention Devlin, ; Rodney et al.
The risk level increases in cases where subjects have low self-esteem and where their behavior reflects efforts to be accepted by others or to gain attention, either positively or negatively Reston, Lower self-esteem was also related to sexual risk-taking and needle sharing among homeless ethnic-minority women recovering from drug addiction Nyamathi, Abel Abel, observed that single females whose partners did not use condoms had lower self-esteem than single females whose partners did use condoms.
To summarize, the literature reveals a number of studies showing beneficial outcomes of positive self-esteem, and conversely, negative outcomes of poor self-esteem, especially in adolescents.
Prospective studies and intervention studies have shown that self-esteem can be a causal factor in depression, anxiety, eating disorders, delinquency, school dropout, risk behavior, social functioning, academic success and satisfaction.
The mean self-esteem score was The scores for boys and girls were similar Based on all scores, nearly a fifth Table 2 Factors associated with low self-esteem: multivariate logistic regression analyses. In the multivariate regression analysis with the backward Wald method , not accounting for effect modification, four variables remained correlated to low self-esteem, either in a negative or positive direction. As shown in Table 3 , four variables—self-esteem, anxiety, depression, and educational stress—were related to each other.
Self-esteem was negatively correlated to anxiety, depression, and educational stress, while educational stress was positively correlated to anxiety and depression.
Table 3 Pearson correlations between self-esteem, anxiety, depression, and educational stress. One of the purposes of the study was to identify the impact of self-esteem on mental health problems. The results of univariate logistics indicate that low self-esteem contributed significantly to anxiety, depression, and suicide among adolescents.
Compared to students who reported normal self-esteem, the students who reported low self-esteem had twice the odds of having anxiety symptoms [ Students with low self-esteem also were significantly more likely to have considered or attempted suicide Table 4.
We investigated the prevalence of low self-esteem among secondary school students, the characteristics associated with low self-esteem, and the relationships among self-esteem and anxiety, depression, and suicide.
These results are in line with some previous studies 12 , 28 , but inconsistent with others 6 , Cultural and social differences in the study populations could explain some of the differences. The results of this study cannot provide precise reasons for the higher prevalence of lower self-esteem among females; however, a number of possible causes for the gender differences are worth discussing.
Although gender equality has improved in recent years in Vietnam and is clearly legislated, gender issues within the family and society remain a challenge for most Vietnamese, who are strongly influenced by traditional culture and custom There is an association between female gender and emotionally unstable personality 30 , As a result, women are more prone to develop emotionally unstable personality e.
A high prevalence of low self-esteem among the secondary school students should be considered as an important mental health problem not only by parents, school teachers, and principals but also by policy makers in the education and health sectors in Vietnam. In fact, health care related to psychological disorders has not received adequate consideration yet in Vietnam Therefore, it is important to take mental health care into account when developing a policy framework to improve general school health services, such as directive no.
In addition, educational characteristics such as the school environment, academic performance, and high educational stress were strongly associated with self-esteem. Students who attended one or more supplementary classes appeared to be at lower risk of having poor self-esteem.
In Vietnam, these students are usually from a family with a higher socioeconomic status. Attending supplementary class may reduce the stress of workload and academic pressure for those students. It would be useful to confirm this with further studies in the Vietnamese context, but this kind of support is unlikely to be available to families who cannot pay for it. Low self-esteem in the adolescents in Cantho City was associated with poor academic performance. Aryana 14 reported that high self-esteem among preuniversity students was an important factor in predicting high academic achievement.
Our finding also highlights that self-esteem plays an important role in predicting academic achievement, although a cross-sectional study design is unable to demonstrate causality; a prospective study to identify causality of the low self-esteem would be appropriate in future research.
With regard to mental health, the results of Pearson correlation analysis showed that self-esteem was negatively correlated to anxiety, depression, and educational stress, while the results of univariate logistic regression illustrated that low self-esteem contributed to a high risk of anxiety, depression, and suicidal ideation.
These results are comparable to others showing that low self-esteem was associated with depression 19 , 20 , 37 and identifying a relationship between self-esteem and anxiety 10 , 21 , as well as a relationship between low self-esteem and suicidal ideation and suicide attempts among adolescents 18 , Screening for low self-esteem in adolescents is a possible strategy to help identify secondary school students at risk of anxiety, depression, and suicide.
In addition, our previous study 25 showed an association between mental health problems and academic pressure, resulting from an overloaded curriculum and pressure from teachers and parents to succeed. The development of a website to provide psychoeducation designed to meet the needs of young Vietnamese and of school-based counselling services for students, possibly by collaborating with volunteers from the Youth Union, the largest sociopolitical Vietnamese youth organization, at local universities, teachers, and parents, will be explored as one of the solutions Around Nevertheless, one of the challenges to using a digital health intervention is that young Vietnamese with a higher perceived stress level were significantly less likely to use such interventions One limitation of this study relates to the sample and its generalizability.
Another limitation concerns the study design, which specified collection of data from adolescents by self-reporting using standardised questionnaires. Also, the exploration of potential causes of low self-esteem as self-reported by subjects was not included in the survey. Another limitation is that the cross-sectional study design does not permit detection of links between covariates; longitudinal studies on this topic are still needed.
Finally, the self-esteem, anxiety, and CES-D scales, like other screening instruments, cannot be viewed as diagnostic tools, but only as screening tests to identify members of groups at risk for these conditions. The results tell us how the students perceive their health but are not in themselves evidence of medical concerns.
Moreover, there is no assessment of stress coping and stress levels, obesity 40 , and chronic medical illness e. Finally, in a cross-sectional study, the cause—effect relationship cannot be measured; that requires a longitudinal cohort or a randomised controlled study. A first draft of the manuscript was prepared by DN under the guidance of CD. See what resonates with you, and give them a try. If you are able to develop the ability to see the glass as half-full, this can contribute to feelings of self-efficacy as well as overall happiness and peace of mind.
Moreover, there are many proven benefits to optimism , so developing a greater sense of it, creating thinking habits that skew toward optimism, can provide these benefits for your health and general happiness. Optimism involves more than simply "looking on the bright side," however; it is a trait that can be developed by shifting your focus and self-talk, but there need to be specific ways in which you view the world.
Learn more about how to become an optimistic thinker. The following resources can help you to better understand your self-talk and alter it to a more positive way of thinking, helping you to see yourself and the world in a more positive way. Even simply becoming immersed in hobbies can help with self-esteem Learning what you are able to do well can provide you with a new view of yourself and a new level of self-respect.
Hobbies can also help you to relieve stress, so hobbies can provide a double-win. We can all feel negative from time to time, but some friends can tear you down instead of building you up, and those people can wear away at your self-esteem more than you may realize. Learning to identify and create boundaries with those who drain us of our self-esteem can help. Identifying and cultivating relationships with more supportive friends can build us up immensely as well.
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