Contingent self-esteem structures related to cardiac, exhaustive, and immunological disease: A comparison between groups of outpatients

Abstract

Hostile resentful contra repressive avoidant behaviors, widely associated with different health processes, are considered to arise from people’s specific contingent self-esteem strategies. The present study examines competence-based self-esteem (CBSE), referring to self-critical strivings, and relation-based self-esteem (RBSE), referring to rejection sensitivity and compliance, in three groups of outpatients (n = 85) and healthy controls (n = 37). Patients diagnosed with exhaustion syndromes displayed significantly higher CBSE and RBSE than all other groups. Patients diagnosed with cardiac type of disease showed significantly higher CBSE than those with immunological type of disease and healthy controls, whereas the immunological group reported significantly higher RBSE than the cardiac group and healthy controls. Further, cardiac patients displayed significantly higher CBSE than RBSE, whereas immunological patients reported significantly higher RBSE than CBSE. A discriminant analysis, incorporating the theoretical constituents of the contingent SE scales, showed that the four groups could be predicted by their SE profiles. The systematic patterns found in the present results shed light on the role of self-esteem contingency for differential psychosocial coping and health processes.

Keywords:

• self-esteem contingency
• habitual behaviors
• cardiac disease
• immunological disease
• burnout

Public Interest Statement

When everyday situations trigger early founded emotional structures, related to self-value, we react habitually to defend or protect our own worth. Compulsive, hostile strivings result if self-value is staked on performances, whereas passive repressive behaviors, to avoid rejection, result if self-value is attached to emotional security. These two types of behaviors are widely discussed for their role in disease processes linked to heart versus immune function, but the motivational implications of these chronic patterns have not been examined. This study found systematic and distinctive patterns of relations between contingent self-esteem types and different groups of outpatients. High competence-dependent self-esteem appears related to cardiac (e.g. heart condition) and exhaustive (e.g. burnout) types of problems, whereas high relation-dependent self-esteem appears related to immunological type of disease (e.g. arthritis). The results increase awareness of the nature and mechanisms of differentially unhealthy habitual behaviors important for developing relevant prevention and treatment practices.

Competing Interests

The authors declare no competing interest.

Additional information

Funding

Funding. The authors received no direct funding for this research.

Notes on contributors

Maarit Johnson

Maarit Johnson is an associate professor at Stockholm University conducting research on self-esteem, personality, and well-being. Her work emphasizes dynamic view of self-esteem functioning, with importance for vulnerability and resilience. A major interest in her research project has been developing and validating reliable measurement tools and integrated personality–health models providing deeper understanding of psychosocial health processes. Other interests include psychometric studies of response bias. Shahnaz Rasouli has completed her master’s degree at Stockholm University.