title: Self-esteem, life stress and psychiatric disorder.
abstract: Using a special subsample from a survey of women in Edinburgh investigations were carried out into (a) which types of life event are associated with lowered self-esteem; (b) the role of life events and self-esteem in onset of psychiatric disorder; and (c) the additional significance of prior psychiatric consultation in determining onset. Stressors involving impaired relationships with others were the only ones clearly associated with lowered self-esteem. Minor psychiatric illness was predicted by stress of uncertain outcome, and, to a lesser extent, by impaired relationship stress. Onset of major depression was best predicted by an interaction between total stress experienced and low self-esteem. There was evidence that such onset involves a pre-existing low level of self-esteem on which life stress impinges, rather than life stress generating low self-esteem and then onset. A small group of subjects characterised by low self-esteem, prior psychiatric consultation and maladaptive coping seemed to be fluctuating in and out of psychiatric illness irrespective of stress.
authors.affiliation: MRC Unit for Epidermiological Studies in Psychiatry, Royal Edinburgh Hospital, Morningside Park, U.K.
authors.forename: P M
authors.initials: PM
authors.lastname: Miller
authors.forename: N B
authors.initials: NB
authors.lastname: Kreitman
authors.forename: J G
authors.initials: JG
authors.lastname: Ingham
authors.forename: S P
authors.initials: SP
authors.lastname: Sashidharan
mesh_terms: D000275:Adjustment Disorders / Q000523:psychology; D000293:Adolescent; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000523:psychology*; D003866:Depressive Disorder / Q000523:psychology*; D005239:Fear; D005260:Female; D006801:Humans; D008016:Life Change Events; D008875:Middle Aged; D010200:Panic; D011581:Psychological Tests; D012017:Referral and Consultation; D012307:Risk Factors; D012649:Self Concept