Self-esteem is a popular and important construct in the social sciences and in everyday life. The State of California has actually established a "Commission on Self-Esteem," presumably to devise and implement policies to increase feelings of self-worth among its citizens. Most Americans believe intuitively that "poor" or "low" self-esteem is undesirable, and indeed research links low self-esteem with loneliness (Peplau & Perlman, 1982), depression (Shaver & Brennan, this volume, Chap. 6), social anxiety (Leary, 1983), and alienation (Johnson, 1973). The popular notion of self-esteem is straightforward. According to the dictionary definition, "To esteem a thing is to prize it, to set a high mental valuation upon it; when applied to persons, esteem carries also the warmer interest of approval, cordiality, and affection" (Williams, 1979, p. 309). In common parlance, then, self-esteem is the extent to which one prizes, values, approves, or likes oneself. In the social sciences, self-esteem is a hypothetical construct that is quantified, for example, as the sum of evaluations across salient attributes of one's self or personality. It is the overall affective evaluation of one's own worth, value, or importance. This conception underlies the assumption that measuring attitudes toward, or evaluations of, one's self reflects a person's self-esteem. The concept of self-esteem goes by a variety of names (e.g., self-worth, self-regard, self-respect, self-acceptance) all of which are compatible with the dictionary definition of "esteem" ascribed to the self. Regardless of the exact definition or label one chooses to employ, self-esteem is usually thought to be the evaluative component of a broader representation of self, the self-concept, the latter being a more inclusive construct than self-esteem, one that contains cognitive and behavioral components as well as affective ones. As a result, cognitions about the self (contained in the self-concept) may or may not influence self-esteem. For example, believing that one is a terrible singer may be a part of one's self-concept but may not bear any relation to one's feelings of self-worth. Feeling mildly or severely depressed because one cannot sing, however, is a matter of self-esteem, as is the behavioral consequence of jumping off the roof of an 18-story building to end one's humiliation over this deficiency. According to current models of affect and attitudes (e.g., Frijda, 1986; Lazarus, 1984; Weiner, 1986), appraisals or judgments (e.g., " I 'm attractive/unattractive," "intelligent/unintelligent," "hardworking/lazy") underlie positive or negative feelings about the self. To the extent that such evaluations cover a relatively broad spectrum of personal attributes, self-esteem is an appropriate label. Over time, consistency in such judgments results in a relatively stable affective appraisal that is readily accessible to the individual

Measures of self-esteem.

Culture and Experience.

An exact permutation test for analyzing and/or dredging multi-response data at the ordinal or higher levels is presented. The associated test statistic is based on the average distance (or any specified norm) between points within a priori disjoint subgroups of a finite population of points in an r-dimensional space (corresponding to r measured responses from each object in a finite population of objects). Alternative approximate tests based on the beta and normal distributions are provided. Two detailed examples utilizing actual social science data are considered, including comparisons of the approximate tests. An additional example describes the behavior of these tests under a variety of conditions, including extreme data configurations

Multi-response permutation procedures for a priori classifications

Background Patient-reported outcomes in cosmetic and reconstructive breast surgery are increasingly important for clinical research endeavors. Traditional surgical outcomes, centered on morbidity and mortality, remain important but are no longer sufficient on their own. Quality of life has become a crucial research topic augmenting traditional concerns focused on complications and survival. Given this, reliable and valid patient questionnaires are essential for aesthetic and reconstructive breast surgeons. Methods The authors performed a systematic literature review to identify patient-reported outcome measures developed and validated for use in cosmetic and reconstructive breast surgery patients. Qualifying instruments were assessed for adherence to international guidelines for health outcomes instrument development and validation. Results The authors identified 227 health outcomes questionnaires used in breast surgery studies. After 135 generic instruments, 65 ad hoc instruments, seven oncologic instruments, 11 education questionnaires, and two non-English-language questionnaires were excluded, seven measures remained. Detailed analysis revealed that six of the seven measures had undergone limited development and validation. Only one measure, the Breast-Related Symptoms Questionnaire, demonstrated adequate development and validation in its target population. It had, nevertheless, significant content limitations. Conclusions Valid, reliable, and responsive instruments to measure patient-reported outcomes in cosmetic and reconstructive breast surgery are lacking. To demonstrate the benefits of aesthetic and reconstructive breast surgery, future research to rigorously develop and validate new cosmetic and reconstructive breast surgery-specific instruments is needed.

Measuring quality of life in cosmetic and reconstructive breast surgery: a systematic review of patient-reported outcomes instruments

Outcomes research examines the end results of medical interventions, taking into account patients' experiences, preferences, and values. The purpose of assessing outcomes is to provide evidence on which to base clinical decisions. The assessment of outcomes in aesthetic surgery is especially pertinent because patient satisfaction is the predominant factor in determining success. In cosmetic surgery, various scales have been used to assess outcomes. Unfortunately, none of these methods has achieved widespread use. The adoption of broadly accepted, relevant scales to measure outcomes would be advantageous, because this would allow the comparison of techniques, quantification of positive effects, and identification of patients unlikely to benefit from surgery. The purpose of this study was to critically review the present literature to identify the appropriate instruments to assess outcomes in aesthetic surgery. After a comprehensive review of aesthetic surgery outcome instruments, the authors identified body-image and quality-of-life measures to be of the greatest value in determining aesthetic surgery outcomes. These conclusions were based on a critical evaluation of the feasibility, validity, reliability, and sensitivity to change of these measures. The Multidimensional Body-States Relations Questionnaire (MBSRQ), a psychological assessment of body image, was selected as a potential candidate for further study. Two additional body-image assessment instruments, the Facial Appearance Sorting Test (FAST) and the Breast Chest Ratings Scale (BCRS), may be useful in the assessment of rhinoplasty and breast surgery, respectively. The Derriford Scale (DAS59), an instrument that assesses appearance-related quality of life, was also selected. In addition, the authors recommend the use of a generic, utility-based quality-of-life instrument, such as the Health Utilities Index (HUI) or the EuroQol (EQ-5D).

Measuring outcomes in aesthetic surgery: a comprehensive review of the literature.

/pdf/self-esteem-a-self-social-construct-1s39qay8p9.pdf

Joan Hagey

Papers

Self-esteem: a self-social construct.