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ROLE OF SELF-ESTEEM AND GENDER IN SELF-REPORT DEPRESSIVE SYMPTOMS AMONG ADOLESCENTS

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CHAPTER ONE

 INTRODUCTION

Depression is a common mental illness that affects a lot of people all over

the world. It is a universal experience and it is said to be the common cold of psychopathology in Europe and America (Oladimeji 1995). In Africa as well, depression has been found, in its various forms, to be high on the list of common problems in psychiatric clinics and hospitals (Gentian 1968; Ebie, 1972).

Depression can be viewed in three separate ways as a biological disease, as a reaction to life situations, and as a means of interpersonal communication. Expounding depression as a reaction to life situations, Nolen-Hoeksema (2004) defined depression as a state marked by either a sad mood or a loss of interest in one’s usual activities, as well as feelings of hopelessness, suicidal ideation, psychomotor agitation or retardation and trouble concentrating.

Investigators recently have begun to develop models that attempt to integrate cognitive and interpersonal processes in understanding vulnerability to depression. With respect to cognitive dysfunctions, depression is marked by a variety of negative thought patterns, including dysfunctional attitudes (Barnett & Gotlib, 1992). Importantly, such negative thinking is associated with relapse of depression (Simons, Murphy, Levine, & Wetzel, 1986) and its absence predicts recovery from the disorder (Brown, Bifulco, & Andrew, 1990.) With respect to interpersonal difficulties, depression has been linked to interpersonal rejection (Gotlib & Robinson, 1982), inadequate social support in times of crisis (Brown, Bifulco, Harris & Bridge, 1986) and marital conflict (Beach, Sandeen, & O’Leary, 1990). Furthermore, relapse in depression is associated with family criticism (Hooley, Orley & Teasdale, 1986), whereas speed and likelihood of recovery is predicted by low levels of family conflict, and positive overall family functioning (Corney, 1987).

In recent years, a variety of new and innovative models of depression have been proposed (Beck, 1972). The author analyzed depression from a social learning or behavioural point of view. The various symptoms of clinical depression are seen as maladaptive behaviours, to a considerable degree acquired through learning principles. Emphasis is on the roles of environmental antecedents and consequences of depressed behaviour and faulty patterns maintenance of depression.

Symptom, according to Harriman (1977) is any observed characteristic or change indicating the presence or onset of a pathological condition. The symptoms of depression, within the behavioural framework, are classified by their mode of expression into the physiological, overt-motor and verbal-cognitive categories (Lang, 1968 as cited in Oladimeji, 1995), According to American Psychiatric Association (2000), depression includes a variety of emotional, physiological, behavioural, and cognitive symptoms. Emotional Symptoms include; sadness, depressed mood, loss of interest or pleasure in usual activities, irritability (particularly in children and adolescents).

Physiological and Behavioural Symptoms include: sleep disturbance (hypersomnia or insomnia), appetite disturbances, psychomotor retardation or agitation, catatonia (Unusual behaviours ranging from complete lack of movement to excited agitation), fatigue and loss of energy. Cognitive Symptoms include: poor concentration and attention, indecisiveness, sense of worlhlessness or guilt, poor self-esteem, hopelessness, suicidal thoughts, delusion and hallucinations with depressive themes.

Diagnostic and  Statistical Manual four (DSM-IV) of the American

Psychiatric Association (2003) categorized major depressive episodes and stated

that five  (or more)  of the nine  symptoms  ——  depressed mood;  marked

diminished interest or pleasure in all or almost all activities most of the day;

significant   weight   loss   when   not   dieting,   or  weight   gain;   insomnia  or

hyposomnia nearly  every  day;  psychomotor agitation  or retardation nearly

everyday; fatigue or loss of energy nearly everyday; feelings of worthlessness or

excessive or inappropriate guilt; diminished ability to think or concentrate or

indecisiveness, nearly everyday; and recurrent thought of death or recurrent suicidal ideation —- should be present during the same 2 – week period and

represent a change from previous functioning. (APA, 2003).

Self- esteem, according to Edelman and Remond (2005), is the way one

looks at oneself: If one has good self – esteem, it means that one likes oneself

and has positive feeling as everyone else. If one has poor self- esteem, it means that one does not have positive feeling about him / herself or that he / she is inferior to others (Edelman & Remond, 2005),

Self – esteem is a term used in psychology to reflect a person’s overall evaluation or appraisal of his or her own worth. Self – esteem encompasses belief (e.g., “I am competent” or “I am incompetent”) and emotions, such as’ triumph, despair, pride and shame, Self – esteem can apply specifically to a particular dimension (e.g., “I believe I am a good writer, and feel proud of that in particular”) or have global extent (e.g., “I believe I am a good person and feel proud of myself in general.”) People who have poor self-esteem tend to focus on and magnify their perceived shortcomings, and ignore their strengths and achievements.

Psychologists usually regard self-esteem as enduring personality characteristics (“trait” self-esteem), though normal, short term variations (“state” self- esteem) also exist (lleasoner, 2010).

Edelman and Remond (2005) suggest how self-esteem affects ones life. According to them, self – esteem can affect how one feels, how one relates to other people, how one deals with challenges and how relaxed and safe one feels in one’s daily life. In order to be happy, a person needs to like himself. If one believes that he has no positive feeling, or if he is constantly putting himself down, he is more likely to feel depressed, anxious, or miserable than someone who has a positive view of himself.

Low self- esteem can influence the way one behaves with other people. For Instance, one might find oneself being unassertive (not saying what one thinks, feels or wants), and doing things one doesn’t want to do, or one might find oneself trying too hard to please other people – agreeing with them and offering to do things for them in order to “earn” their friendship. Low self-esteem might also cause one to seek reassurance from friends, because deep down, one may not be sure that they like him. One might allow others to “walk all over him” because he believes he has no rights, and that his need doesn’t matter. Being treated badly by other people can reinforce and can lower one self-esteem even more.

Trying new things and moving out of our “comfort zone” at times is, important for, growing and developing as a person. Low self-esteem might hold

one back from new experiences because one becomes overly concerned with the possibility of failure or looking stupid. When one’s self-esteem is low, it is difficult to feel relaxed and comfortable in daily situations. For instance, if one. believes that one is not good, one might feel awkward and self-conscious in many situations. One might worry too much about what others think of him, and might be constantly on the lookout for signs that people.do not like him. If someone does not acknowledge him, he might immediately assume that they do not like him. . .

Low self-esteem can become a bit of a vicious circle. For example, if one. does not have positive feeling, one might often withdraw from people and give out unfriendly relationships and not look people in the eye, and not smile or initiate conversation. This kind of behaviour might make one appear cold and distant, and as a result, people might make little effort to be friendly toward him: One may then probably detect that people are not friendly toward him, and his belief that he is not very likeable would be reinforced. This is called “self-fulfilling prophecy” because one’s negative feeling affects one’s behaviour towards others, which in turn cause people to be distant towards him, .which reinforces his belief that he has no positive self-concept.

Between the ages of three and ten years, the child starts to concentrate on his feelings about himself. Children who feel good about themselves and see themselves as valued persons develop high self-esteem, while those who’ consistently have negative or bad feelings about themselves tend to have low self-esteem. These feelings are developed through the feedback the children receive from their environment especially their parents. It is from parents that children receive their earliest feedback as to what kind of a person they are. Parents of high esteem children are reported to be warm and accepting towards their children, while parents of low self- esteem children are reported to be either openly hostile or indifferent and inattentive in their relationships with their children-paying little or no interest in their children’s interests, ideas and wishes.

According to Dobson (1980), the feelings of self-worth and acceptance, which provide the corner stone of a healthy personality, can be obtained from only one source. It cannot be bought or manufactured. Self-esteem is only generated by what we see reflected about ourselves in the eyes of other people or in the eye of God. In other words, evidence of our worthiness must be generated outside of ourselves. It is only when others respect us that we respect ourselves. It is only when others love us that we love ourselves. It is only when others find us pleasant and desirable and worthy that we come to terms with our own egos. Occasionally a person is created with such towering self-confidence that he doesn’t seem to need the acceptance of other people, but he is indeed a rare bird. The vast majority of us are dependent on our association for emotional

sustenance each day.

Gender is a classification according to sex of being male or female. It is obvious that males and females differ not only biologically but also psychologically and socially. Gender difference is the psychological and social difference between male and female as boys and girls grow up in different’ psychological environment that shape their view of the world. Girls’ rate of ‘ depression escalate dramatically over the course of puberty, but boys’ rate do not Although there is some evidence that girls’ increase in depressive symptoms

correlated with the hormonal changes of puberty, the observable physical changes of adolescence may have more to do with the emotional development of girls and boys than hormonal development because these characteristics affect boys’ and girls’ self- esteem differently.

Beginning in the 1970s and continuing today, gender has become an important variable in understanding depression (Bird & Ricker, 1999; Kuchner 2003). In 1990, Nolen-Hocksema published a book Sex Differences in Depression, which reviewed studies of depression and gender and found a mean 2; female – 1: male ratio of depression in countries throughout the world. However, Rutz studies on the Swedish Island of Gotland in the 1980s suggested that depression may be under-diagnosed in males. Based on the Gotland studies, Rulz (1999) postulated a “male depressive syndrome,” with symptoms among males.’ He developed a-13 question scale, the Gotland Scale for Male Depression, to assess depression in depressed men.

A number of clinical researchers (Cochran & Rabinowitz, 2000; Diamond, 2004) suggest that women often “act in” as a result of gender, role conditional that emphasizes both the expression of feelings and focus on internals judgments of their own inadequacies. Men, on the other hand, are conditional to “act out” and thus men’s depression is more likely to be expressed through chronic anger, self-destructiveness, drug use, gambling, womanizing and workaholism (Lynch & Kilmarlin, 1999; Rutz, 1999). Underlying these behaviours are experiences of loss and persistent feelings of hopelessness, helplessness, and worthlessness, the hallmarks of depression (Kilmartin, 2005).

When considering the issue of gender on depression, Dobson (1980) slated that depression occurs less frequently in men and was apparently more crisis – oriented. In other words, men get depressed over specific problems such as a business setback or an illness. However, they are less likely to experience the vague, generalized, almost indefinable feeling of discouragement which many women encounter on a regular basis. Even a cloudy day may be enough to bring on a physical and emotional slow down for those who are particularly vulnerable to depression. (Dobson, 1980).

Coleman (1980) stated that women are more likely to suffer from depression just prior to a menstrual period. That more than half of all accidents which involve women occur in the few days before their periods are due and over half of all female suicides occur pre-menstrually.

Nolen Hoekema (2002) stated that many people have argued over the years that women’s greater vulnerability to depression was tied to hormones, estrogen and progesterone. That the idea came from evidence that women were more prone to depression during the premenstrual period of the menstrual cycle, the postpartum period, and menopause. According to her, these were times when level of estrogen and progesterone change dramatically. After decades of research, it is still not clear to what extent hormones play a role in women’s depression (Nolen Hoeksema, 2002; Young & Korzun, 1998.)

In the 1950s, physician Katherine Delton labelled the depression, anxiety, and physical discomfort some woman report during their premenstrual periods, premenstruclural syndrome (PMS). That was a name given to depression, anxiety and physical discomfort some women report during their premenstrual periods. Old studies suggested that the majority of women are regularly incapacitated by depression, anxiety, and physical discomfort during their premenstrual periods (Reid & Yen; 1981). However, these studies relied on faulty methods as the women reported retrospectively on their most recent menstrual cycle. According to Abplanap, Haskert and Rose (1979), the daily mood ratings of these same women showed no relationship between cycle phase and moods. More recent studies (Angst, 1999) have found that it is possible to identify a small group of women, about 3 percent of the population who frequently experience increases in depressive symptoms during the premenstrual phase, and that many of these women also have a history of frequent major depressive episodes or anxiety disorders with no connection to the menstrual cycle or of other psychiatric disorders.

Even among women who clearly do have PMS, there is little evidence that their symptoms are due to changes in levels of estrogen or progesterone across the menstrual cycle (Young & Korszun; 1998) as many studies have found no differences in levels of estrogen or progesterone between women with PMS and those without PMS. There clearly is something about the menstrual cycle that is worsening mood in women with PMS, but it appears that estrogen or progesterone does not have consistent direct effects on mood. Statement of the Problem

A lot of research work have been carried out in respect of depression with adult population (Nolen-Hoeskema, 1995, 2002; Seligman, 1995; Beck, 1967). Before 1970, people thought that adolescent boys and girls should not be considered as candidates for depression as the Freudian notions about the unconscious had stated that depression effected in adults only. The childhood depression was thought to be masked by other conditions, (Huq & Afroz, 2005), but Lamarine (1995) reported that childhood depression was widely recognized by the physicians and psychiatrics. He also stated that depression in adolescents was common in school environment and that poor interpersonal relationships between teachers and the students resulted in low self-esteem in the adolescent boys and girls. The researcher therefore seeks to know the role of self-esteem and gender in self-report depressive symptoms among adolescents. The questions asked are:

  1. Will self-esteem (high and low) have a role in self-report depressive symptoms among adolescents?
  2. Will gender (male and female) have a role in self-report depressive symptoms among adolescents?

Purpose of Study

Following the issues raised earlier in the statement of the problem, this study’s purpose or objective includes:

  1. To ascertain whether high and low self-esteem have a role in self-report depressive symptoms.
  2. To ascertain whether   gender   has   a  role   in   self-report   depressive symptoms among adolescents.

Operational Definition of Terms: Self-Esteem

A term used in psychology to reflect a person’s overall evaluation or appraisal of worth as measured by Index of Self – Esteem (ISE), a scale developed by Hudson (1982) and adapted for Nigerian use by Onighaiye (1996).

High self-esteem (male) = scores below Nigerian norm of 32.04 High self-esteem (female) = scores below Nigerian norm of 30.89 Low self-esteem (male) = scores above Nigerian norm of 32.04 Low self-esteem (female) = scores above Nigerian norm of 30.89. Depression

This refers to the presence of depressive symptoms which can be determined by the participants scores on Center for Epiderniologic Studies Depression Scale (CES – D) developed by Radloff (1977).

Low depression (male and female) = scores below cut off point of 16. High depression (male and female) = scores above cut off point of 16.

Gender

This refers to classification according to sex of being male or female determined by random selection method.

Adolescence

This refers to the period from puberty to maturity, roughly the early teens (10s) to the early twenties (20s).

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