title: Self-esteem as an outcome measure in studies of vocational rehabilitation for adults with severe mental illness.
abstract: OBJECTIVE
  Self-esteem is widely used as an outcome variable in studies of psychiatric rehabilitation, based on the assumption that improved functional status leads to higher self-esteem. Little is known, however, about the determinants of self-esteem among adults with severe mental illness. The utility of a popular measure of global self-esteem-the Rosenberg Self-Esteem Scale-as an outcome measure was examined in this population.
  
  
  METHODS
  A total of 143 participants enrolled in a study of vocational rehabilitation were assessed at baseline and six, 12, and 18 months later using measures of self-esteem, symptoms, life satisfaction, work status, housing status, and total income.
  
  
  RESULTS
  Scores on the Rosenberg Self-Esteem Scale did not vary with work status or other functional outcomes but instead were strongly related to measures of life satisfaction and affective symptoms.
  
  
  CONCLUSIONS
  The hypothesis that working leads to improved self-esteem for people with severe mental illness was not supported. For this population, self-esteem, as measured by the Rosenberg Self-Esteem Scale, appears to be a relatively stable trait that reflects general life satisfaction and affective symptoms rather than objective functional status.
authors.affiliation: Department of Psychiatry at Dartmouth Medical School in Hanover, New Hampshire, USA.
authors.forename: W C
authors.initials: WC
authors.lastname: Torrey
authors.forename: K T
authors.initials: KT
authors.lastname: Mueser
authors.forename: G H
authors.initials: GH
authors.lastname: McHugo
authors.forename: R E
authors.initials: RE
authors.lastname: Drake
mesh_terms: D000328:Adult; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000534:rehabilitation*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012050:Rehabilitation, Vocational / Q000379:methods; D012649:Self Concept; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric