Questioning the vulnerability model: Prospective associations between low self-esteem and subsequent depression ratings may be spurious

Abstract

BackgroundAccording to the vulnerability model, low self-esteem makes people more depressed. Support for the vulnerability model comes almost exclusively from analyses using cross-lagged panel models, showing a negative effect of initial self-esteem on subsequent depression ratings when adjusting for initial depression. However, it is well known that such adjusted effects are susceptible to regression toward the mean. MethodsData from four waves of measurements in five different samples (total N = 2703) were analyzed with two different cross-lagged panel models, two different random intercept cross-lagged panel models, and two different latent change score models, predicting change forwards as well as backwards in time. ResultsHigh initial self-esteem predicted both decreased and increased depression ratings between measurements and an increase in self-esteem between measurements predicted a concurrent decrease in depression ratings. LimitationsOnly data from two western countries, Switzerland and USA, were analyzed. Whether the main finding, that a prospective effect of self-esteem on subsequent depression ratings might be spurious, applies to other countries and cultures remains an open question. ConclusionsDue to the incongruent results, any causal effect of self-esteem on depression ratings, and thus the vulnerability model as such, cannot be corroborated by the data and models analyzed here. Instead, we propose, tentatively, that prospective associations between self-esteem and depression ratings may be spurious due to a combination of reasons, including regression toward the mean. The indication that depression might not be affected by measures to improve individuals' self-esteem is of clinical relevance.