Changing self-esteem in children and adolescents: A roadmap for future interventions

Self-esteem is an important construct that is related to academic achievement, social functioning and psychopathology in children and adolescents. Therefore, it is not surprising that many interventions have tried to change levels of self-esteem in this population. In this article a theoretical overview of self-esteem in children and adolescents is presented, in which recent research on different aspects of self-esteem will be discussed. Subsequently, research on treatment and primary prevention programs to change self-esteem in children and adolescents is reviewed. It is argued that self-esteem interventions will be more effective when they are theoryand evidence-based and tailored to the specific needs of different target groups. Finally, a roadmap for the development of theoryand evidence-based interventions is presented and some recommendations for future self-esteem interventions are provided. Self-esteem interventions 3 Self-esteem is a central concept that is related to academic achievement, social functioning and psychopathology of children and adolescents. With respect to academic achievement, various studies indicate that children with low self-esteem are less successful at school (Mann, Hosman, Schaalma, & De Vries, 2004). With regard to social functioning, research demonstrated that children with low self-esteem are usually less accepted by their peers (e.g., Donders & Verschueren, 2004). Finally, many studies have shown that low self-esteem is related to child psychopathology, including anxiety (Beck, Brown, Steer, Kuyken, & Grisham, 2001; Muris, Meesters, & Fijen, 2003), depression (Harter, 1993; Mann et al., 2004) and eating pathology (e.g. Muris, Meesters, Van de Blom, & Mayer, 2005; Stice, 2002). There is still much debate about the relation between self-esteem and externalising problems such as aggression, antisocial behaviour and delinquency. Whereas some researchers have argued that externalising problems are related to high self-esteem and result from threatened egotism (e.g., Baumeister, Smart, & Boden, 1996), others have found a strong relation between low self-esteem and externalising problems (Donnellan, Trzesnieuwski, Robins, Moffitt, & Caspi, 2005). Given the importance of self-esteem in the development and general functioning of youths, it is not surprising that many interventions have been developed to change selfesteem in youths. The present article reviews research on treatment and primary prevention programs to change self-esteem in youths. It is argued that theoryand evidence-based self-esteem interventions will be most successful in changing self-esteem in children and adolescents. A systematic approach for such interventions will be presented. Self-esteem interventions 4 Self-esteem in children and adolescents Self-esteem refers to an overall evaluation of one’s worth or value as a person (Harter, 2003). Global self-esteem is distinguished from domain-specific self-esteem, such as scholastic competence, athletic competence, peer likeability, physical appearance and behavioural conduct (Harter, 1999; 2003). The ability to make global self-evaluations does not occur until middle childhood. Younger children are able to judge their ability in specific domains, but they are not able to make overall judgments about their self-worth (Harter, 1999). In adolescence, self-evaluations become more differentiated and other domains become relevant, such as close friendship, romantic appeal, and job competence (Harter, 2003). In general, people are motivated to maintain high levels of self-esteem and to defend their self-esteem when it comes under threat (Pyszczynski, Greenberg, Solomon, Arndt & Schimel, 2004). According to Terror Management Theory people strive for positive self-evaluations, because self-esteem provides a buffer against death-related anxiety (Greenberg, Pyszczynski, & Solomon, 1986). Several studies have provided empirical evidence for the anxiety-buffering properties of self-esteem (see Pyszczynski et al., 2004). According to Sociometer Theory (Leary & Baumeister, 2000), however, selfesteem serves as a monitor of social belongingness. It tells us how valued and socially accepted we are in the eyes of others. Children easily adopt the views that others, like caregivers and other relevant adults, have about them (Leary & MacDonald, 2003). Thus, parents who are approving, responsive and nurturing are likely to build high levels of self-esteem in their children, whereas disapproving, unresponsive and uninterested parents may break down self-esteem levels in their children. In adolescence the link Self-esteem interventions 5 between parenting style and self-esteem is still quite strong, but approval of peers becomes the most important predictor of self-esteem. Sociometer Theory acknowledges the importance of competence related beliefs for high self-esteem (e.g., academic achievement or athletic competence), but argues that the impact of these beliefs on selfesteem is mediated by perceived relational value (Leary & MacDonald, 2003). Development of global self-esteem in childhood and adolescence Whereas the level of global self-esteem is generally relatively high during childhood, it drops dramatically when children enter adolescence (Robins, Trzesniewski, Tracy, Gosling, & Potter, 2002; Major, Barr, Zubek, & Babey, 1999). The enormous decrease of global self-esteem during adolescence can be attributed to significant changes that take place during the transition from childhood to adolescence. Clearly, adolescence is a stressful developmental stage with marked biological, cognitive, social, psychological, and academic changes (Finkenauer, Engels, Meeus, & Oosterwegel, 2002; Robins et al., 2002). First, girls and boys become reproductively mature in early adolescence. Second, they acquire the capacity of formative thinking. Third, adolescents spend less time with their family, and friendships and romantic or sexual relationships become increasingly important. Therefore, adolescents become vulnerable to feelings of social inadequacy. Finally, they experience the transition from elementary school to high school. Research on gender differences in childhood self-esteem has yielded inconsistent results. Some studies have indicated that boys have a higher self-esteem than girls (Kling, Hyde, Showers, & Buswell, 1999), whereas other studies have found no gender differences (Major et al., 1999; Robins et al., 2002). During adolescence, however, the Self-esteem interventions 6 picture seems clear. Most studies have demonstrated that self-esteem decreases more sharply in adolescent girls than in adolescent boys (Robins et al., 2002). Different aspects of self-esteem For a long time many researchers have focused on the general level of self-esteem in youngsters. In the past ten years, however, research has identified various important aspects of self-esteem (Harter, 2003; Kernis, 2002). One important aspect is self-esteem stability. Unstable self-esteem refers to shortterm fluctuations in one’s self-esteem and reflects fragile feelings of self-worth (Kernis & Goldman, 2003). Correlations between level of self-esteem and self-esteem stability are generally low, suggesting that these are independent manifestations of self-esteem. Further, research has demonstrated that self-esteem level and self-esteem stability are both related to psychological well-being (Kernis & Goldman, 2003; Paradise & Kernis, 2002). Self-esteem stability is low during childhood and early adolescence, but becomes more stable throughout adolescence (Trzesniewski, Donnellan, & Robins, 2003). Interestingly, boys and girls do not differ in their self-esteem stability in childhood or adolescence (Trzesniewski et al., 2003). Another concept that is closely related to self-esteem stability is contingent selfesteem, which refers to the extent to which self-esteem is contingent upon outcomes and achievements (Kernis, 2002). People with contingent self-esteem are preoccupied by their performance and by evaluations of others. Their levels of self-esteem fluctuate depending on success or failure. Contingent self-esteem also reflects fragile self-esteem: people with contingent self-esteem continuously have to be successful in order to feel good about Self-esteem interventions 7 themselves. A distinction can be made between global contingent self-esteem and domain-specific contingent self-esteem. People with domain-specific contingent selfesteem base their self-esteem on outcomes and achievements in certain domains, such as academics, approval from others, appearance, and athletics (Crocker & Wolfe, 2001; Jansen & Vonk, 2005). It is conceivable that domain-specific contingent self-esteem (e.g., appearance) is related to psychopathology in children or adolescents (e.g., eating disorders), but most research on contingent self-esteem has been conducted among students or adults. A final important aspect of self-esteem is implicit self-esteem. Many researchers use self-report scales to measure self-esteem in children and adolescents (see for an overview: Butler & Gasson, 2005). However, these measures of explicit self-esteem measure conscious perceptions of the self. Implicit self-esteem is a non-conscious form of self-esteem that is based on automatic self-evaluative processes (Dijksterhuis, 2004; Greenwald & Banaji, 1995). It is an automatic attitude towards the self that influences self-evaluations and evaluations of self-relevant objects (Baccus, Baldwin, & Packer, 2004; Greenwald & Farnham, 2000). Implicit and explicit self-esteem are generally weakly correlated, suggesting that both forms of self-esteem reflect independent processes (Baccus et al., 2004; Hoffman, Gawronski, Gschwender, Le & Schmitt, 2005). Implicit self-esteem is related to lower levels of aspiration after failure and seems a better predictor of anxiety during a very personal interview. In addition, people with high levels of explicit self-esteem and low levels of i