Can low self-esteem cause depression in adolescents?

Ziyad Rahman
ID Number: 26100207

Can low self-esteem cause depression in adolescents?

The thesis that low self-esteem can cause depression has been questioned in a growing number of research. The conventional issue addressed is whether self-esteem is a cause or consequence of depression. The two prominent models approached are the vulnerability model, which states self-esteem is a causal factor and the scar model, which states self-esteem is a consequence of depression. Overall, there is greater empirical support for the vulnerability model demonstrating its validity. Therefore to implement such findings, society should be more sensitive to the environmental influences of self-esteem. Moreover treatment for depression should target to boost self-esteem as research has consistently shown it can be a root for depression.

Depression is the most common mental health disorder characterised by "lack of interest and pleasure in daily activities, significant weight loss or gain, insomnia or excessive sleeping, lack of energy, inability to concentrate, feelings of worthlessness or excessive guilt and recurrent thoughts of death or suicide"(American Psychological Association, 2013). Depression is strongly associated with self-esteem, which can be defined as a persons overall sense of self worth and value. Approximately 20% of youth will experience a depressive episode by 18 years old (Lewinsohn et al. 1998) and it is a psychological notion that adolescent years entail a season of social and cognitive adaptations causing greater sensitivity in self-esteem potentially becoming hazardous to mental health. Adolescents with moderate to high self-esteem are likely to believe they have the capability to engage in a healthy lifestyle whereas those with low self-esteem experience negative ideation on lifestyle supported by Rosenberg (1985) who concluded that adolescents with low self esteem reported greater levels of depression compared to those with high self-esteem (Rosenberg, 1985).

However researchers clash on the nature of this relationship. Two models are approached when studying low self-esteem and depression. One is the vulnerability model, proposing low self-esteem is a causal factor of depression. The model looks at our cognitive interpretation of life events and suggests individuals with low self-esteem are susceptible to see life events as reinforcing their negative sense of self. For example someone cancels a date with an individual, if the individual has low self-esteem they are more likely to conclude that the person doesn't want to be with them and that the relationship is over whereas individuals with moderate to high self esteem are likely to interpret a feasible reason for cancelation (person is busy). The individual's low self-esteem has caused a negative sense of self through this life event and an accumulation of such interpretations results in depressive symptoms such as feelings of worthlessness.

The alternative scar model insists the converse ideaology that self-esteem is not a causal factor but an outcome of depression. For example a depressed individual will question how likeable they are if their date was cancelled and this results in lower self-esteem. Such depressive episodes gradually degenerate an individuals sense of value, worth and will leave a 'scar' in their self-concept illustrating that low self-esteem is an outcome of depression.

Shahar and Davidson's (2003) examined depressed participants in an intervention study over 9 months. They concluded that in the first 4 months depression caused a decrease in self-esteem but in the following 5 months where the depressive symptoms terminated and participants were recovering there was minimal levels of low-self esteem. This supports the scar model as it shows that depression may determine low self-esteem (Shahar & Davidson, 2003). Moreover, (Block et al. 1991) found that low self-esteem at age 14 didn't predict depression at age 18 consequently rejecting the vulnerability model.

Nonetheless the majority of research favours the vulnerability model. Trzesniewski et al. (2006) recorded that low self-esteem scores in early adolescence (aged 11 to 15) predicted depression at age 26 supporting the vulnerability model (Trzesniewski et al. 2006). Southall and Roberts (2002) further this by reporting low self-esteem in adolescent's predicted depressive symptoms 3 months later (Southall & Roberts, 2002). There is also evidence for the short-term effect of self-esteem on depression as Metalsky et al. (1993) found students who received a poor grade (decreasing self-esteem), experienced depressive reactions in the following 5 days. Combining the research demonstrates that the vulnerability model can predict long and short-term depressive symptoms (Trzesniewski et al., 2006; Metalsky et al., 1993; Southall & Roberts, 2002).

Furthermore Ormel et al (2004) investigated self-esteem and depressive episodes in a large Dutch sample for 3 years (including adolescents). Findings showed individuals with low self-esteem at Year 1 had a greater chance of experiencing a depressive episode at Year 2 and 3, supporting the vulnerability model. They did not find evidence of depression determining low self-esteem as individuals who experienced an episode at year 2 were less probable to decline in self-esteem in year 3 year subsequently rejecting the scar model. (Ormel et al, 2004).

Beevers et al (2007) compared depressed female adolescents with a non-depressed female group and found the depressed group reported greater levels of low self-esteem (Beevers et al. 2007). Results rejected the scar hypothesis as low-self esteem elevated before and after depressive episode but not during the episode implying that depression didn't cause low self-esteem. This trend conveys low self-esteem as a chronic risk factor for major depressive disorder in adolescents, supporting the vulnerability model. Notably the sample only consisted of females thus unreliable to generalise to males indicating the research is incomplete in evidencing the vulnerability model. However there is a stronger link between females and depression, as girls are more susceptible to low-self esteem than boys due to commonly experiencing insecurity and self-doubt, causing a decline in self-esteem.

Sowislo and Orth (2013) compared the strength of the two models through a meta-analysis of 53 longitudal studies, 77 samples, over 35,000 participants examined from childhood to adulthood. Their was statistical significance for both models however their was outstanding support for the vulnerability model. They reported that "the vulnerability effect is twice as large as the scar effect" (Sowislo & Orth 2013) concluding that the effect of low self-esteem on depression was significantly greater than the effect of depression on self-esteem consistently across all ages and genders. This suggests that low self-esteem is a significant risk factor for depression more so than depression being a risk for low-self esteem. However research within the meta-analysis are correlational studies thus we cannot establish a causal relationship and feasibly claim low self-esteem determines depression. Therefore some research has investigated mediating factors in the relationship between self-esteem and depression.

One example is Abela and Skitch (2007) who carried out a yearlong study on adolescents, assessing them every 6 weeks. They found that adolescents with high levels of low self-esteem reported greater depressive symptoms compared with adolescents who had not reported depressive symptoms (Abela & Skitch 2007). However the researchers also found that adolescents who experienced depressive symptoms had high levels of dysfunctional attitudes and elevations in hassles compared to others. Thus these variables may have been the root for the depressive symptoms or worked simultaneously with self-esteem to cause depressive symptoms. Similarly Kuster Olrich and Mier (2012) reported "rumination partially mediated the prospective effect of low self-esteem on depression" (Kuster, Olrich & Mier 2012). Such research demonstrates that it is invalid to suggest that self-esteem on its own determines depressive symptoms with possible mediating variables present and consequently challenges the validity of the vulnerability model.

However there are inconsistencies within research on mediating factors as Sowislo et al (2013) investigated if stability and contingency may mediate the link between self-esteem and depression. The evidence suggests that low self-esteem is a vulnerability factor but not contingency or stability.

In Conclusion there is overwhelming support for the vulnerability model, which allows us to strongly reinforce that low self-esteem, can cause depression in adolescents. Such findings have beneficial implications in treating and reducing the chances of depression. For example intervention techniques should focus on boosting ones self-esteem to reduce the possibility of depression. There are also social implications as publication of vulnerability research may raise awareness of the importance of self-esteem in adolescents and increase the publics sensitivity towards adolescent self-esteem by making them re-think the consequences of their behaviours, i.e. discriminating an adolescents appearance. However there are limitations in research supporting the vulnerability model, as they examine western, individualistic cultures. Individualistic cultures stress the importance of self-esteem whereas collectivist cultures individuals work in groups and are less likely to stress the importance of self-esteem. Therefore we cannot apply the vulnerability model on a universal scale, which can be solved by increasing the number of future indigenous research examining low self-esteem and depression in collectivist cultures. Future research should continue on assessing mediating factors within the relationship between self-esteem and depression. Current research shows inconsistencies therefore further research is needed to look at other mediating factors such as nurturing, as it may be important for intervention techniques. Despite this, research rejects the scar model and supports the vulnerability model proposing that low self-esteem can cause depression in adolescents.

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References

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