Journal of Behavior Therapy and Experimental Psychiatry
Implicit and explicit self-esteem as concurrent predictors of suicidal ideation, depressive symptoms, and loneliness
Highlights
► Explicit self-esteem is negatively associated with internalizing problems. ► Implicit self-esteem is not associated with internalizing problems. ► Interaction implicit × explicit self-esteem is associated with suicidal ideation. ► Damaged self-esteem (implicit se > explicit se) is associated with internalizing problems.
Introduction
Developmental change and exploration of possible life directions characterize the transition from late adolescence to early adulthood (Arnett, 2000). During this stage, adolescents make life choices often with long-lasting consequences, and strive for a greater independence from parents, which changes the relationships with parents and friends (Arnett, 2000, Arnett, 2007). Schulenberg, Bryant, and O’Malley (2004; p.1119) described the developmental task of this period as ‘trying to take hold of some kind of life.’ For a substantial number of adolescents, this phase is associated with internalizing psychological problems (Costello, Mustillo, Erkanli, Keeler, & Angold, 2003). Several theorists have proposed that explicit self-esteem plays a crucial role in the onset and maintenance of these internalizing problems (Brage and Meredith, 1994, Evans et al., 2004, Harter, 1993, Prinstein and La Greca, 2002). Recently, it has been suggested that implicit self-esteem (De Raedt, Schacht, Franck, & De Houwer, 2006), or the discrepancy between implicit and explicit self-esteem (Schröder-Abé, Rudolph, & Schütz, 2007), could also relate to internalizing problems. However, research on implicit self-esteem and the discrepancy between implicit and explicit self-esteem is still scarce. Therefore, the purpose of this study was to gain more insights into the relationship of explicit self-esteem, implicit self-esteem, and the discrepancy between implicit and explicit self-esteem with internalizing psychological problems in female young adults.
Previous research suggests that various internalizing problems occur frequently during adolescence (Fleming and Offord, 1990, Fergusson et al., 2000, Heinrich and Gullone, 2006). More specifically, three common internalizing problems in this period of life are depression (Fleming & Offord, 1990), suicidal ideation (Fergusson et al., 2000), and loneliness (Heinrich & Gullone, 2006). Compared with childhood, adolescence is associated with significant increases in the prevalence of depressive disorders (Petersen, Kennedy, & Sullivan, 1991). Studies show that one third of all adolescents show significant depressed moods (Petersen et al., 1993) and that the prevalence of clinical depression in adolescence is between 4% and 8% (Birmaher et al., 1996). Furthermore, adolescent depression may have serious consequences. Adolescent depression is associated with depression and anxiety disorders later on in life (Ferguson & Woodward, 2002), poor psychosocial and academic outcome, and an increased risk for substance abuse (Birmaher et al., 1996). In addition, depression is the most frequently reported risk factor associated with adolescent suicide (Pagliaro, 1995).
Furthermore, longitudinal studies suggest that suicidal ideation also increases during adolescence (Fergusson et al., 2000, Kerr et al., 2008). Suicidal ideation is defined as thoughts that serve as a means to foster one’s own death (American Psychiatric Association, 2003). It can vary from thoughts about the worthlessness of life and a death wish to concrete suicide plans and an obsession with self-destruction. Suicidal ideation predicts suicide attempts (Evans, Hawton, Rodham, & Deeks, 2005) and is an important risk factor for completed suicide (King, 1997).
Next, an increased feeling of loneliness in adolescence is common (Sippola & Bukowski, 1999). Loneliness has been defined as an emotional aversive response to the discrepancy between the desired and the perceived interpersonal relationships of the individual (Peplau & Perlman, 1982). Loneliness has an important intrapersonal element because it reflects the discrepancy between the perception of one’s social relationships and the desired social relationships (Heinrich & Gullone, 2006). Feelings of loneliness are associated with psychological and physical health problems as well as behavioural pathologies (Baumeister & Leary, 1995).
Depression, suicidal ideation, and loneliness are separate but related constructs (Boergers, Spirito, & Donaldson, 1998: Cacioppo, Hughes, Waite, Hawkley, & Thisted, 2006). According to cognitive theories, such forms of internalizing problems are the result of dysfunctional (self) schemas existing in memory (Clark et al., 1999, Ellis, 2006, Mahon et al., 2006). Schemas develop based on early life experiences and become stable cognitive structures that shape emotions, thoughts, and behaviour of individuals. Moreover, people tend to process information in a way that is congruent with their perspective of the world and themselves (Beck, 1967). Accordingly, dysfunctional and negative self-schemas bias information processing and lead to negative beliefs towards ‘the self’, as self-relevant information is processed in a typical negative manner (Clark et al., 1999). To date, research has mainly focused on self-schemas that are explicit in the sense that they are available to conscious introspection. One example is explicit self-esteem. Explicit self-esteem can be defined as an individual’s conscious feeling of self-worth and acceptance (Rosenberg, 1965). Consistent with the assumptions and predictions of the cognitive theory, previous studies consistently showed that explicit self-esteem has a strong inverse relationship with depression (Harter, 1993), suicidal ideation (Evans et al., 2004), and loneliness in adolescence (Prinstein & La Greca, 2002).
Recently, it has been suggested that implicit self-esteem could relate to internalizing psychological problems. Implicit self-esteem is defined as relatively automatic, overlearned, and nonconscious evaluation of the self that guides spontaneous reactions to self-relevant stimuli (Greenwald & Banaji, 1995). Moreover, according to dual-process models, we can distinguish between two information-processing modes with different operating principles, the cognitive and the experiential mode (Epstein, 1994). Explicit self-esteem reflects a product of the cognitive mode, shaped through rational and conscious processing of self-relevant stimuli, whereas implicit self-esteem refers to the experiential mode, shaped through automatic, intuitive processing of affective experiences (Dijksterhuis, 2006, Epstein and Morling, 1995). Schemas in the experiential mode are ‘generalizations about what the world and the self are like’, based on ‘synthesis of emotional significant experiences’ (Teglasi & Epstein, 1998). In line with this, the experiential belief (e.g. implicit self-esteem) reflects a relatively automatic, affective evaluation of the self that may exist outside of awareness (Bosson, Swann, & Pennebaker, 2000). Implicit self-evaluations are presumably more automatic, meaning that they are relatively more unconscious, unintentional, efficient, and uncontrollable than explicit self-evaluations (Bargh, 1994). Theorists assume that implicit self-esteem develops earlier and is more primitive than explicit self-esteem (Bosson et al., 2003, Koole et al., 2001), and stems, at least partly, from early social interactions (DeHart, Pelham, & Tennen, 2006). In line with this, implicit self-evaluations are likely to be produced by rather primitive self-enhancement mechanisms, whereas explicit self-evaluations are assumed to be more sophisticated cognitive judgments of the self (Swann & Schroeder, 1995).
Although research on implicit self-esteem is scarce, few studies that do exist have provided valuable information. In contrast to the cognitive theory, high levels of implicit self-esteem seem to be associated with depression in adults (De Raedt et al., 2006, Franck, Dereu et al., 2007, Franck, De Houwer et al., 2008, Gemar et al., 2001). Similarly, implicit self-esteem, but not explicit self-esteem, has been found to relate positively to future depressive symptoms at six months follow-up (Franck, De Raedt, & De Houwer, 2007). On the other hand, recent findings of Bos, Huijding, Muris, Vogel, and Biesheuvel (2010) suggest there is no association between implicit self-esteem and internalizing problems (e.g. depression and anxiety) in adolescents. To date, the relationship of implicit self-esteem with depressive symptoms, suicidal ideation and loneliness in early adulthood has not received any attention in previous research.
In addition to the unique associations of implicit and explicit self-esteem with indices of internalizing symptoms, it may be of value to consider the discrepancy between implicit and explicit self-esteem as relevant for understanding psychopathology. Implicit and explicit self-esteem are separate but related constructs (Bosson et al., 2000). To understand the role of implicit self-esteem in internalizing problems, the relationship between implicit and explicit self-esteem appears to be important. First, implicit self-esteem might moderate (i.e., buffer or change the nature of) the association between explicit self-esteem and each internalizing outcome. Alternatively, the discrepancy between implicit and explicit self-esteem may be important to consider. Asymmetric changes of self-schemas (for example increases in implicit self-esteem and decreases in explicit self-esteem) may lead to discrepancies between implicit and explicit self-esteem, assuming that different processes influence implicit and explicit self-esteem (Gawronski & Bodenhausen, 2006). More specifically, we can distinguish between two forms of implicit and explicit self-esteem discrepancies: a) defensive (Jordan, Spencer, Zanna, Hoshino-Browne, & Correll, 2003) or fragile self-esteem (Bosson et al., 2003) reflecting high explicit and low implicit self-esteem and b) damaged self-esteem (Schröder-Abé, Rudolph, Wiesner, & Schütz, 2007) consisting of high implicit and low explicit self-esteem.
To explain why discrepancies between implicit and explicit self-esteem are a source of psychological problems, Schröder-Abé, Wiesner et al. (2007) hypothesized that both types of discrepancies are maladaptive because they indicate a lack of integration in self-representation. Franck, De Houwer et al. (2007) suggested that implicit self-esteem might be indicative of the ‘ideal self,’ whereas explicit self-esteem may represent the ‘actual self.’ People with damaged self-esteem feel trapped between their goals and the ‘reality.’ Due to the discrepancy between their goals and the ‘reality,’ which is experienced as disturbing, people feel entrapped, which in turn may lead to psychological problems. Furthermore, according to the buffer hypothesis, implicit self-esteem buffers the effects of low explicit self-esteem and functions as a defence mechanism against ego-threats (Bosson et al., 2003). In line with this, Jordan et al. (2003) argued that implicit self-esteem motivates individuals to restore their positive self-views.
Theoretically, it can be expected that not only explicit and implicit self-esteem but also the discrepancy between implicit and explicit self-esteem relate to psychopathology. Indeed, previous studies suggest that discrepancies between implicit and explicit self-esteem relate to defensive behaviour (Schröder-Abé, Rudolph et al., 2007, Schröder-Abé, Wiesner et al., 2007), psychological conflict (Petty, Tormala, Briñol, & Jarvis, 2006), anger suppression, depressive attributional style, and nervousness (Schröder-Abé, Rudolph et al., 2007). To date, research on discrepancies between implicit and explicit self-esteem is scarce, and little is known about the relationship with depressive symptoms, loneliness, and suicidal ideation.
In sum, the aim of the present study was to investigate whether implicit self-esteem, explicit self-esteem and their interaction relate to depressive symptoms, suicidal ideation, and loneliness. Next, we examined the main effects of the discrepancy between explicit and implicit self-esteem and the direction of the discrepancy, as well as the interaction between these measures.
Section snippets
Participants
Ninety-five female undergraduate students of the College for Higher Education Arnhem/Nijmegen (HAN), in The Netherlands participated in this study. Their mean age was 21.2 years (SD = 1.88, Range = 19–30). Students participated voluntarily to the study.
Procedure
In order to recruit the College’s students for this study, we contacted the principal of the College for Higher Education Arnhem/Nijmegen and asked his consent. After the principal consented, we provided the outline of the study to the teachers
Demographic characteristics
Table 1 displays the descriptive statistics of all primary variables. Paired samples t-test showed that the mean ratings of the participants’ non-initials differed significantly from the ratings of their initials, t (94) = 17.26, p < .001. This indicates that participants evaluated the initials of their names more positively than they evaluated non-initials. Table 2 includes intercorrelations among all study measures. The data on suicidal ideation did not have normal distribution. A logarithmic
Discussion
The objective of this study was to investigate whether explicit self-esteem, implicit self-esteem and their interaction were associated with depressive symptoms, suicidal ideation, and loneliness. Subsequently, we examined the main effects of the discrepancy between explicit and implicit self-esteem and the direction of the discrepancy, as well as the interaction between these measures. The results showed that explicit self-esteem has an inverse relationship with depressive symptoms, suicidal
Conflict of interest
None.
Acknowledgements
Funding for this study was provided by grants from GGz Oost-Brabant and The Olim Foundation. The authors are grateful to dr. Mike Rinck, dr. William Burke, and dr. Ad. Vermulst for providing useful feedback and their specific expertise on statistics.
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