The cost of lower self-esteem: testing a self- and social-bonds model of health.

The authors draw upon social, personality, and health psychology to propose and test a self-and-social-bonds model of health. The model contends that lower self-esteem predicts health problems and that poor-quality social bonds explain this association. In Study 1, lower self-esteem prospectively predicted reports of health problems 2 months later, and this association was explained by subjective reports of poor social bonds. Study 2 replicated the results of Study 1 but used a longitudinal design with 6 waves of data collection, assessed self-reports of concrete health-related behaviors (i.e., number of visits to the doctor and classes missed due to illness), and measured both subjective and objective indicators of quality of social bonds (i.e., interpersonal stress and number of friends). In addition, Study 2 showed that poor-quality social bonds predicted acute drops in self-esteem over time, which in turn predicted acute decreases in quality of social bonds and, consequently, acute increases in health problems. In both studies, alternative explanations to the model were tested.