Self-esteem and depression. III. Aetiological issues.

This is the last of a series of three papers dealing with the role of self-esteem in the onset of clinical depression. On the basis of a longitudinal population enquiry a comprehensive psychosocial model of depression is developed. It is concluded that self-esteem (primarily in terms of a negative measure) does play a significant role. However, this can be only properly interpreted in the light of the full model. This highlights: 1. the importance of the occurrence of both a negative environmental factor (negative interaction with children or husband for married or negative interaction with children or lack of a very close tie for single mothers) and a negative psychological factor (low self-esteem or chronic subclinical condition); and 2. how a relatively small group of high risk women in these terms (23% of total at risk based on measures collected well before any onset) contain three-quarters of all instances of onset of depression occurring over a 12 month period.