The nature of self-esteem and its relationship to anxiety and depression in adult acquired brain injury

ABSTRACT

Acquired brain injury (ABI) has a negative impact on self-esteem, which is in turn associated with mood disorders, maladaptive coping and reduced community participation. The aim of the current research was to explore self-esteem as a multi-dimensional construct and identify which factors are associated with symptoms of anxiety or depression. Eighty adults with ABI aged 17–56 years completed the Robson Self-Esteem Scale (RSES), of whom 65 also completed the Hospital Anxiety and Depression Scale; 57.5% of the sample had clinically low self-esteem. The RSES had good internal consistency (α = .89), and factor analysis identified four factors, which differed from those found previously in other populations. Multiple regression analysis revealed anxiety was differentially predicted by “Self-Worth” and “Self-Efficacy”, R² = .44, F(4, 58) = 9, p < .001, and depression by “Self-Regard”, R² = .38, F(4, 58) = 9, p < .001. A fourth factor, “Confidence”, did not predict depression or anxiety. In conclusion, the RSES is a reliable measure of self-esteem after ABI. Self-esteem after ABI is multidimensional and differs in structure from self-esteem in the general population. A multidimensional model of self-esteem may be helpful in development of transdiagnostic cognitive behavioural accounts of adjustment.

KEYWORDS:

• Brain injury
• self-esteem
• depression
• anxiety
• cognitive therapy patient group

Additional information

Funding

This paper presents independent research supported by the National Institute for Health Research (NIHR) Collaborations for Leadership in Applied Health Research and Care (CLAHRC) for Cambridgeshire and Peterborough and NIHR Flexibility and Sustainability Funding provided by Cambridgeshire Primary Care Trust. The views expressed are those of the author(s) and not necessarily those of the National Health Service, the NIHR or the Department of Health.