Depression Prevention and Self-Esteem Discussed During PSPI Symposium

Depression and high self-esteem are the two polar opposites of self-image, and two recent reports in the APS journal Psychological Science in the Public Interest looked at these two contradictory aspects of mental health. The findings were presented at the APS Annual Convention in Atlanta.

Depression is one of the most common and debilitating psychiatric disorders and is a leading cause of suicide. Most people who become depressed will have multiple episodes, and some depressions are chronic. Given the recurrent nature of the disorder, it is important not just to treat the acute episode, but also to protect against its return.

The November 2002 issue of PSPI, “Treatment and Prevention of Depression,” looked at the different treatments available for depression. The report’s lead author, Steven Hollon of Vanderbilt University, discussed the findings during the APS Annual Convention.

The report examined the effectiveness of several different types of treatments, including medication, interpersonal psychotherapy, cognitive behavior therapy, and family therapy. Hollon said his team’s analysis found, “good evidence that cognitive behavior therapy produces an enduring effect. People seem to learn something in treatment that serves them well after treatments are over.” He also said “Medications are clearly effective, good interventions, but [they] do little to reduce risk. They work as long as you keep taking them.”

The report concluded that the most effective long-term treatment for depression was a combination of medication and therapy intervention.

The second PSPI report, from May 2003, looked at the possible benefits and drawbacks of high self-esteem. The report, “Does High Self-esteem Cause Better Performance, Interpersonal Success, Happiness, or Healthier Lifestyles?” questioned the long-held assumption that high self-esteem causes positive outcomes and benefits. The report took an objective scientific look at the effects of self-esteem on many outcomes and behaviors, including school performance, job performance, violence, happiness, childhood experimentation, and other areas where it has been generally assumed that increased self-esteem leads to achievement.

The report did not find the benefits of high self-esteem that people had assumed. They discovered that “efforts to boost the self-esteem of pupils have not been shown to improve academic performance and may sometimes be counterproductive.” The report’s lead author, Roy F. Baumeister, of Florida State University, said, “There are benefits of self-esteem and they fall within two categories. One is that people with high self-esteem seem to have high initiative. And second, high self-esteem operates as a stock of good feelings. Beyond that, however, there is very little sign that self-esteem plays a causal role in producing any sort of positive sign.”

The authors of the report concluded, “We have not found evidence that boosting self-esteem causes benefits…Our findings do not support continued widespread efforts to boost self-esteem in the hope that it will by itself foster improved outcomes.”

Baumeister concluded the talk with some new directions for research. “What I think researchers are beginning to do, and I would encourage people to do that more, not simply take high self-esteem as your focus group but look at narcissism, look at the stability of self-esteem, and look at other things that may cut large pie of self-esteem into smaller slices, which may be more meaningful and will ultimately produce more significant results and more positive outcomes.”