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Health Education Research Advance Access originally published online on June 15, 2004
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Health Education Research, Vol. 19, No. 4, 357-372, August 2004
© 2004 Oxford University Press

Self-esteem in a broad-spectrum approach for mental health promotion

Michal (Michelle) Mann1,2,3, Clemens M. H. Hosman1,2, Herman P. Schaalma1 and Nanne K. de Vries1,2

1 Department of Health Education and Promotion, Maastricht University, Maastricht and 2 Prevention Research Center on Program Development and Effect Management, The Netherlands

3 Correspondence to: M. Mann, Department of Health Education and Promotion (GVO), PO Box 616, 6200 MD Maastricht, The Netherlands; E-mail: michalcmann{at}yahoo.com

Self-evaluation is crucial to mental and social well-being. It influences aspirations, personal goals and interaction with others. This paper stresses the importance of self-esteem as a protective factor and a non-specific risk factor in physical and mental health. Evidence is presented illustrating that self-esteem can lead to better health and social behavior, and that poor self-esteem is associated with a broad range of mental disorders and social problems, both internalizing problems (e.g. depression, suicidal tendencies, eating disorders and anxiety) and externalizing problems (e.g. violence and substance abuse). We discuss the dynamics of self-esteem in these relations. It is argued that an understanding of the development of self-esteem, its outcomes, and its active protection and promotion are critical to the improvement of both mental and physical health. The consequences for theory development, program development and health education research are addressed. Focusing on self-esteem is considered a core element of mental health promotion and a fruitful basis for a broad-spectrum approach.


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