Self-esteem in schizophrenia: relationships between self-evaluation, family attitudes, and symptomatology.

Participants with schizophrenia (N = 59) were assessed on self-evaluation, symptomatology, and positive and negative affect (expressed emotion) from significant others. An interview-based measure of self-evaluation was used and two independent dimensions of self-esteem were derived: negative and positive evaluation of self. As predicted, negative self-evaluation was strongly associated with positive symptoms, a more critical attitude from family members was associated with greater negative self-evaluation, and analyses supported a model whereby the impact of criticism on patients' positive symptoms was mediated by its association with negative self-evaluation. The interview-based method of self-esteem assessment was found to be superior to the questionnaire because its predictive effects remained after depressed mood was accounted for.