Self-esteem and schizophrenia: the relationship with social support, expressed emotion and life events and the clinical relevance of associated cognitions

Abstract

Self esteem is recognised as a major contributory factor in mental health. Research has focused on the association with depression but there has been relatively little interest in the role of self esteem in schizophrenia. Literature on social and cognitive models of depression together with findings of research into relapse in schizophrenia indicate that self esteem may have an important role in the outcome of schizophrenia. This study investigates this role particularly in relation to factors which have previously been identified as relevant to the course of the illness. Subjects with a diagnosis of schizophrenia, were assessed on levels of self esteem, expressed emotion from a relative/partner, social support and experience of major life events. Data analysis establishes associations between these variables. Associated psychological factors including perceived control and illness attributions are included in the analysis. In addition patients dysfunctional core beliefs about self, others and their illness are identified and examined in relation to the variables measured. The thesis discusses the findings in relation to the existing literature and explores theoretical issues including the place of self esteem within the vulnerability stress model and the likelihood of self esteem as a mediator between expressed emotion and relapse. The potential of cognitive therapy to target self esteem in this population is also discussed.