Self-esteem: A comparison study between eating disorders and social phobia
Clinique des Maladies Mentales et de l'Encéphale, Hôpital Sainte-Anne, et Université René Descartes, Paris IV, Faculté de Médecine Cochin-Port-Royal, 75014 Paris. L Encéphale
(Impact Factor: 0.7).
Eating disorder patients evidenced very often a low self-esteem. Self-esteem in eating disorder patients is excessively based on body dissatisfaction. In eating disorders there seems to be a link between body image dissatisfaction and social anxiety. We hypothesised: self-esteem would be as low in eating disorder patients as in social phobia patients; self-esteem would be lower in eating disorder patients with social phobia than in patients with social phobia alone; self-esteem would be lower in eating disorder patients with depressive cognitions than in social phobia patients with depressive cognitions; self-esteem could have different characteristics in the two disorders; self-esteem would be as low in anorexia as in bulimia; 103 eating disorder patients (33 restrictive anorectics, 34 anorectics-bulimics, 36 bulimics) and 26 social phobia patients diagnosed according to DSM IV and ICD-10 criteria have been investigated by the Self-Esteem Inventory of Coopersmith, the Assertiveness Schedule of Rathus, the Fear Survey Schedule of Wolpe (FSS III) and the Beck Depression Inventory (BDI). Patients were free of medication and presented no episode of major depression according to DSM IV criteria. Evaluations took place before any psychotherapy. Self-esteem in eating disorder patients is reduced at the same level as in social phobia patients; 86.1% of the total sample and 84.5% of the eating disorder patients have a very low self-esteem (score 33 in the SEI). Eating disorder patients have significantly higher scores in the Social (p=0.016) and Professional (p=0.0225) sub-scales of the SEI than social phobia patients. Eating disorder patients show higher scores on the Assertiveness Schedule of Rathus (p=0.0013) than social phobia patients. Eating disorder patients disclose higher scores on the BDI (p=0.0003) but eating disorder patients with depressive cognitions do not differ from social phobia patients with depressive cognitions in the level of self-esteem. The FSS III scores are significantly lower in eating disorder patients (p<0.0001). There is a difference in the nature of the deficit of self-esteem between the two patient populations. Self-esteem is not influenced by the Body Mass Index (BMI) and is identically reduced in all groups of eating disorder patients. Whereas eating disorder patients have the same complaints compared to social phobia, they differ significantly from social phobia patients in their characteristics of social phobia and self-esteem.
Available from: PubMed Central
- "It was indicated that the presence of a psychiatric disorder in adolescents is associated with decreased self-esteem . Mendelson  and Eiber  observed low self-esteem in adolescents and young adults with eating disorders, while Roberts  found that adults with depression similarly had low self-esteem. Gayman  noted that low self-esteem was linked to the history and timing of depression in young adults. "
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ABSTRACT: Self-esteem is the "feeling of self-appreciation" and is an indispensable emotion for people to adapt to society and live their lives. For children, in particular, the environment in which they are raised contributes profoundly to the development of their self-esteem, which in turn helps them to adapt better to society. Various psychologists have provided definitions of self-esteem, and examined methods of objectively evaluating self-esteem. Questionnaire-style assessment methods for adult include Rosenberg Self-Esteem Scale and Janis-Field Feeling of Inadequacy Scale, and these for children include Coopersmith Self-Esteem Inventory, Pope's 5-Scale Test of Self-Esteem for children, and Kid- KINDL®. Other methods include Ziller Social Self-Esteem Scale and Implicit Association Test. The development of children's self-esteem is heavily influenced by their environment, that is, their homes, neighborhoods, and schools. Children with damaged self-esteem are at risk of developing psychological and social problems, which hinders recovery from low self-esteem. Thus, to recover low self-esteem, it is important for children to accumulate a series of successful experiences to create a positive concept of self. Evaluating children's self-esteem can be an effective method for understanding their past and present circumstances, and useful to treat for children with psychosomatic disorders.
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ABSTRACT: Low self-assertion has been noted as an important feature among patients with eating disorders.
To verify, in a female population, if assertiveness is related or has a predictive capacity for the development of eating disorders.
An structured clinical interview, the Eating Attitudes Test (EAT-40) and the Rathus Assertiveness Scale (RAS) were administered to 62 patients that fulfilled the DSM-IV diagnostic criteria for eating disorders and to 120 female students without eating problems.
Patients with eating disorders ranked significantly higher on the EAT-40 and its factors (p <0.001) and showed a lower level of assertiveness on the RAS (p <0.001). Assertiveness measured by RAS and its factors was inversely related to EAT-40 and its items (r= -0.21). The predictive capability of the lack of self-assertion in the development of an eating disorder reached 53%, when patients with eating disorders and subjects at risk were considered together and compared to students without such disorder.
Lack of assertiveness is a significant trait in patients with eating disorders; it may worsen its outcome and even perpetuate symptoms. Low self-assertion may be considered a predictive factor in the development of an eating disorder and must be managed from a preventive or therapeutic point of view.
Available from: Anna Brytek-Matera
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ABSTRACT: Aim: This study sought to determine the dimensions of self-esteem, coping strategies, anger expression and anger control among French women diagnosed with anorexia nervosa. Material and method: A clinical group of 32 females suffering from anorexia and 57 healthy females com-pleted an anonymous questionnaire form concerning family life, their state of health and/or the course of their illness, the Self Esteem Inventory, the Brief COPE evaluation, and the Self-Expression Control Scale. Results: Compared with controls, French anorexic adolescents showed low social, familial and general self-esteem. Eating-disordered women used emotional methods of coping more often than the control group and they conceptualised their anger against themselves. Conclusions: We concluded that anorexia nervosa is inseparably connected with low self-esteem, as well as an inability to cope with one's own emotions, personal problems and feelings.
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