Striving for self-esteem - DiVA-Portal (PDF)

Striving for self-esteem Conceptualizations and role in burnout Victoria Blom  ©Blom, Victoria, Stockholm 2011 ISBN 978-91-7447-265-3 Printed in Sweden by Printers name, Stockholm 2011 Distributor: Department of Psychology, Stockholm University Cover Photo:Shutterstock images  To my family - for filling my life with so much joy!  Abstract When self-esteem is dependent on competence individuals invest a great deal of effort in their accomplishments in order to validate them- selves. The aim of the present thesis was to develop a theoretically sound and valid concept and measure of contingent self-esteem de- pendent on competence, and examine its vulnerable implications and role in burnout. In Study I a concept and measure of contingent self- esteem dependent on competence, termed competence-based self- esteem (CBSE), was developed. Confirmatory factor analyses showed its distinctiveness from other sources of self-esteem and revealed two dimensions comprising behaviors referring to: i) Self-esteem condi- tional upon competence and ii) Frustrated self-critical strivings. The new scale showed high reliability and gained both convergent and discriminative validity through different methods in different samples. Study II set out to experimentally test the vulnerable implications of CBSE in a performance situation. The results showed that high, as compared to low, scorers on the scale exhibited stronger physiological reactivity and momentary exertion coupled with frustrated mood. Study III focused on the role of self-esteem contingent on competence in the burnout process and its association with work- and private-life stressors over time in working women and men. The analyses showed that contingent self-esteem was a predictor of burnout. In addition, women scored higher on both contingent self-esteem and burnout and reported higher general life stress than did men, whereas men showed stronger associations between work stressors and burnout. The results of the three studies suggest that contingent self-esteem, where out- comes of one‟s acts and performance serve to compensate an impove- rished basic self-worth, facilitates the understanding of stress-related vulnerability and ill-health.  Acknowledgements Many people contribute to making me love my work, and I want to thank those who have helped and supported me through my thesis work and made it such a pleasant task. First, Petra Lindfors, you have no idea how much I appreciate your work as a co-supervisor and your admirable knowledge and endless energy, and for always having time for my stupid questions. Further, I am deeply indebted to my supervi- sor Maarit Johnson for your help in getting me into PhD studies in the first place, and for your always so careful feedback on my work. I also want to thank Geoffrey Patching, co-author in one of the manuscripts in the thesis. My great appreciation also goes to the Department of Psychology for being such a nice and inspiring workplace. Thanks for all the laughs and interesting conversations in the lunch room. I am particularly deeply grateful for having had the opportunity to work at the Division of Work and Organizational Psychology. Thank you for providing such an extraordinarily warm and friendly climate, and not least for your great sense of humor! I want to thank Magnus Sverke, Gunnar Aronsson, Claudia Bernard-Oettel, Lars Häsänen, Katharina Näswall, Gunn Johansson, Anne Richter, Erik Berntson, Kristina Danilov, Ma- rie Gustafsson, Christin Mellner, Ulla Gautam, Eva Mauritzson Sand- berg, Johnny Hellgren, Ingemar Torbiörn, Malin Mattsson, Teresia Stråberg, Stephan Baraldi, Hanna Kusterer, Ann Fridner, Sofia Sjöberg, Eva Bejerot, Stefan Annell, Wanja Astvik, Lena Låstad, Ma- rika Melin, Ulrika von Thiele Schwarz, Cornelia Wulff and many more. I also want to thank my colleagues at the Department of Neuroscience at Karolinska institutet, Pia Svedberg, Lennart Hallsten, Lennart Bo- din, and Gunnar Bergström, who introduced me to the fascinating field of genetics, and a twin project about the heredity of burnout. In particular, I am deeply grateful to Lennart Hallsten, who has been an invaluable support throughout my thesis work.  My thoughts also go to my parents, Anita and Ulf, and my husband‟s parents Eva-Maria and Nils, for your great support, in particular dur- ing the last couple of months. You made it so much easier to combine thesis work and three children. I am also grateful to my dear sister Bella and brother Calle, as well as my friends, who have asked some really good questions about my research that have made me think in other ways. Of course, in particular, I want to give the most important in my life, my own little family, a big hug. Thank you Bille for your endless love and support and for being you, and a huge hug to my three children Nike, Lukas and Frank, for filling my life with so much love and for being an endless source of joy! Victoria Blom Stockholm, March 2011  List of Studies I. Johnson, M., & Blom, V. (2007). Development and vali- dation of two measures of contingent self-esteem. Indi- vidual Differences Research, 5, 300-328. II. Blom, V., Johnson, M., & Patching, G. R. (in press). Physiological and behavioral reactivity when one's self- worth is staked on competence. Individual Differences Research. III. Blom, V. (in press). Contingent self-esteem, stressors, and burnout in working women and men. WORK: A Journal of Prevention, Assessment, & Rehabilitation.  Contents Introduction .....................................................................................................1 The aim of the thesis.....................................................................................................1 Demands in today’s working life .....................................................................3 Stress and health ............................................................................................5 The physiology of stress and health..............................................................................5 Stress and health in women and men ...........................................................................6 Burnout............................................................................................................9 Explanations for burnout .............................................................................................11 High work involvement in burnout – the role of self-esteem ........................................13 Self-esteem ...................................................................................................16 Non-contingent self-esteem ........................................................................................18 Contingent self-esteem ...............................................................................................18 Competence-based self-esteem .................................................................................21 Origins of competence-based self-esteem.............................................................22 Other contingencies of self-worth...........................................................................23 Competence-based self-esteem as motivator........................................................25 Consequences of competence-based self-esteem on adjustment and health........26 Competence-based self-esteem in women and men .............................................28 The role of self-esteem in the relationship between stressors and burnout .30 Summary of empirical studies.......................................................................33 Study I Development and validation of two measures of contingent self-esteem ........33 Background and aim..............................................................................................33 Method ..................................................................................................................34 Main findings and conclusions ...............................................................................34 Study II Physiological and behavioral reactivity when one’s self-worth is staked on competence ................................................................................................................36 Background and aim..............................................................................................36 Method ..................................................................................................................36 Main findings and conclusions ...............................................................................37 Study III Contingent self-esteem, stressors, and burnout in working women and men 37  Background and aim..............................................................................................37 Method ..................................................................................................................38 Main findings and conclusions ...............................................................................39 Discussion.....................................................................................................40 Competence-based self-esteem as a concept and measure.......................................40 Competence-based self-esteem and Performance-based self-esteem..................43 Physiological and behavioral reactivity of competence-based self-esteem .................43 Contingent self-esteem, stressors, and burnout ..........................................................46 Contingent self-esteem and burnout in women and men ............................................49 Redirecting the destructive drive in competence-based self-esteem to prevent burnout ....................................................................................................................................51 Prevention in the workplace...................................................................................52 Prevention and treatment on an individual level.....................................................52 Methodological considerations and future research .....................................54 Contingent self-esteem ...............................................................................................54 Burnout .......................................................................................................................56 Concluding remarks ......................................................................................58 Svensk sammanfattning................................................................................59 Appendix 1 CBSE scale and PBSE scale.....................................................61 References....................................................................................................62  1 Introduction A growing focus on individuality and achievements is considered a major factor underlying the rise of stress-related health problems, par- ticularly in young people in Sweden (Swedish Ministry of Education, Research and Culture, 2006). In this respect, Beck and Beck-Gernstein (2002) have posed that the ethic of individual self-fulfillment and achievement is the most powerful current in modern society. This fo- cus is suggested to promote increased demands and pressure in people to gain social recognition through accomplishments. Accordingly, as one‟s worth as an individual must be demonstrated, proven, or earned the result is increased strivings for self-esteem. The present thesis fo- cuses on contingent self-esteem referring to self-worth dependent on external sources. This kind of conditional self-view is considered vul- nerable with consequences for wellbeing (Crocker & Wolfe, 2001). In particular, people whose self-esteem is defined by achievements are compelled to invest a great deal of effort in their work. This strong involvement is likely to incline to stress and health problems such as burnout (Albertsen, Rugulies, Garde, & Burr, 2010; Hallsten, 2005). The aim of the thesis The aim of the present thesis is to develop a theoretically sound con- cept and measure of self-esteem dependent on competence, as well as to investigate its vulnerable implications and role in burnout in work- ing women and men in relation to environmental stressors. There are three specific aims: i) To develop a valid concept and meas- ure of self-esteem dependent on competence, based on established self-esteem theory; ii) To experimentally test the vulnerable implica- tion of the new construct and scale of self-esteem by investigating the physiological and behavioral reactivity of this disposition in a perfor- mance situation; iii) To investigate the role of self-esteem dependent  2 on competence in the burnout process and its association with work and private-life stressors over time in working women and men. The new concept developed in Studies I and II is termed competence- based self-esteem. Study III utilizes a concept termed performance- based self-esteem.  3 Demands in today‟s working life In contemporary western working life, individuals‟ internalization of demands and achievement strivings are fuelled by a working life with unclear boundaries and in which the individual has an increased re- sponsibility over where, when and how to work (Allvin, 2008; Allvin, Aronsson, Hagström, Johansson, & Lundberg, 2005). The positive aspects of modern working life have been found to involve increased freedom and high individual influence and flexibility. The negative aspects can include a lack of well defined goals and unclear work roles, which leads to a situation in which the employee does not know when the work is good enough and what is expected of her (Hellgren, Sverke, & Näswall, 2008; Härenstam et al., 2005). In addition, there seems to be less time for support, reflection and exchange of expe- rience as a result of increased work intensity, outsourcing trends and result-orientated management systems (Allvin & Aronsson, 2003). In a working life with less structured work, carried out anywhere at any time of the day, the individual has to draw her own boundaries between work and family and determining when the work is good enough, as well as decide what is included in her work role. These new demands individuals face are supposedly internalized by those who put higher and more ambitious demands on themselves to be high-performing in all spheres in life. As a consequence, individual characteristics are considered to be of increased importance in today‟s working life, where for example overachievers and workaholics risk pushing themselves too hard and put their own health at risk. In particular, stress-related health prob- lems like burnout, are considered potential health risks (Allvin et al., 2005). Furthermore, as the individual increasingly defines her own work tasks, goals and demands, individual characteristics become im- portant when studying work-related stress problems. In this respect, in order to benefit from the new work life, one needs to be creative, so- cial, able to carry one‟s own competence, open to changes and, not  4 least, be able to draw one‟s own limits (Allvin et al., 2005; Hellgren et al., 2008). Therefore, individual characteristics such as self-esteem staked on competence and excessive performance orientation are considered increasingly important to examine further as explanations of stress- related ill-health in today‟s society. The present thesis focuses on con- ceptualizing self-worth staked on achievements as well as investigat- ing its implications and role in stress reactivity and burnout in women and men. Therefore, it was considered important to introduce a review of stress and health including gender-related aspects.  5 Stress and health Most stress definitions focus on the notion of balance and the idea of returning to a state of psychological or physiological balance via be- havioral or psychological responses. If an individual is exposed to the stressors for a shorter time, which is followed by a period of lower stress and recovery, there is usually nothing harmful about this. It can even be beneficial and improve performance as the cognitive func- tions, such as memory and concentration, are improved. However, when the stress exposure continues for a longer period with a lack of recovery the body reacts in the opposite way, with impaired cognitive functioning as well as worsened immune functioning and various phy- siological symptoms (Lundberg, 2005; McEwen, 2004). A particularly important component in the stress mechanism is the ability to shut off worries concerning past and future activities, as worries keep the stress on a higher level even if one is not objectively exposed to the stressors (Sapolsky, 1994). Whether or not the stressful situation has negative health effects on the individual depends on a complex interaction between developmen- tal, environmental, genetic, physiological, personality and behavioral factors (McEwen, 2004). But it also depends on an individual‟s evalu- ation of the value of a specific situation (e.g., if achievement is impor- tant for a person‟s self-esteem, she is particularly stressed by failure) as well as available internal and external resources for handling the situation. This subjective appraisal of one‟s ability to handle a situa- tion determines the cognitive-motivational actions, such as avoidance of the situation or active problem-solving, referred to as coping strate- gies (Lazarus & Folkman, 1984). Situations perceived as threatening to one‟s self-worth are particularly psychologically stressful (DiPaula & Campbell, 2002). The physiology of stress and health  6 If a situation is perceived as stressful, a physiological reaction is set into motion, with increased activity of different bodily systems. The physiological link between stress and health goes through two fundamental body systems, the sympathetic-adrenomedullary (SAM) system and the hypothalamic-pituitary-adrenocortical (HPA) system. Acute stress and anxiety activate the SAM system, which stimulates cardiovascular activity with the secretion of epinephrine and norepi- nephrine (Lundberg & Cooper, 2010). This is adaptive and increase the individual‟s readiness to respond to and act on a stressful situation. However, stress also activates the HPA system and releases corticoste- roids from the adrenal cortex, increasing the levels of triglycerides, cortisol and cholesterol in the blood. This reinforces the SAM reac- tion. Over time, a prolonged physiological activity is considered to wear down bodily resources (McEwen, 2002). As a consequence, in- dividual health and well-being is compromised and the risk for nega- tive health effects, including burnout, increases. As for burnout, asso- ciations have been found with cortisol (Melamed et al., 1999), choles- terol, lipoprotein and glucose (Melamed et al., 1992), known physio- logical risk factors for cardiovascular disease. The cardiovascular system consists of the heart, the systemic circula- tion and the pulmonary circulation, of which the primarily function is to supply blood and thereby oxygen, nutrients and substances like hormones to different organs in the body. The most commonly meas- ured cardiovascular responses to stress are elevated systolic and dias- tolic blood pressure and heart rate, but also arterial pressure and heart rate variability. When blood is pumped from the heart into circulation, it creates a blood pressure on its journey through the body before re- turning to the heart. The peak of the pressure is called systolic blood pressure and the lowest level that is followed by this peak is referred to as diastolic blood pressure (Lundberg & Cooper, 2010). During normal conditions, both heart rate and blood pressure are highest dur- ing the day at work, lower at home and lowest during sleep, and are highly affected by physical activity and body posture. Stress and health in women and men Women are over-represented in stress-related health problems in Swe- den (Swedish National Board of Health and Welfare, 2009). This is