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RELATIONSHIPS AMONG SELF-ESTEEM, SELF-EFFICACY, AND FAITH IN PEOPLE IN CHINESE HEROIN ABUSERS [Social Behavior and Personality (New Zealand)](Social Behavior and Personality (New Zealand) Via Acquire Media NewsEdge) The relationships among self-esteem, self-efficacy, and faith in people in Chinese heroin abusers were investigated. We used 3 rating scales to survey a sample of 200 heroin abusers: the Self-esteem Scale (Rosenberg, 1965), the Self-efficacy Questionnaire for Chinese Drug Users (Geng & Han, 2008), and the Faith in People Scale (Rosenberg, 1956). A correlation analysis and a regression analysis were employed to analyze the data. The correlations among self-esteem, self-efficacy, and faith in people were significantly positive. Self-efficacy and faith in people results were found to be predictive of the self-esteem level of participants at a statistically significant level. Keywords: heroin abuse, self-esteem, self-efficacy, faith in people. Drag use and abuse is a major social problem all over the world, and has drawn a great deal of attention from all sectors of society. China has one of the highest levels of opiate use, with a reported 2,348,800 users in 2005 (United Nations Office on Drugs and Crime, 2008). In a survey conducted by Chinese researchers, nearly 87.5% of opiate addicts in China were found to be heroin addicts (Liu et al., 2002). Thus, heroin dependence can be seen as a major threat to the public health and social security of China, owing to its devastating medical effects, the associated risk of HIV/AIDS and link with criminal behaviors, the low rate of users achieving abstinence, and high rate of relapse. In addition, China's drug abuse problems appear to be worsening (Tang, Zhao, Zhao, & Cubells, 2006). The cessation of drug use is the optimal goal in rehabilitation of individuals, however, this is rarely accomplished by those who have been addicted. The relapse rate for drug abusers in China is currently about 90%, and even this figure may be an underestimate (He, 2004). There are some interventions that deal with physical factors, such as Methadone Maintenance Treatment (MMT), which effectively reduces many of the physical symptoms of withdrawal. However, because of the psychological dependency issues related to drug use, it is difficult for drug abusers to remain drag free. In this study we investigated three of these important psychological factors: self-esteem, self-efficacy, and faith hi people and the relationships among these three factors. Self-esteem has long been regarded as one of the major psychological constructs, and is defined as the individual's positive andlor negative attitudes toward the self (Rosenberg, 1965). Proponents of self-enhancement theory (S wann, 1987) describe self-esteem as a fundamental human motive, in that human beings universally have a desire to protect and enhance their self-esteem. The maintenance of self-esteem leads to self-protective motives, self-enhancement processes, a variety of coping processes, and the frustration of self-esteem enhancement generates some measure of psychological distress. The findings in a considerable number of studies are consistent with this theory, and some of these, specific to heroin addiction, demonstrate that self-esteem plays an important role in the addiction of heroin abusers. For example, in some studies it has been shown that low self-esteem is one of the characteristics of drug abusers (Kaplan & Meyerowitz, 1970), and that people with low self-esteem are more likely to use drags for the purpose of momentary self-enhancement. Some researchers have found that low self-esteem predisposes individuals toward depression (Robinson, Garber, & Hilsman, 1995), demonstrating that the failure to maintain self-esteem leads to psychological problems. The problem of depression is an important factor that might lead to relapse (Brewer, Catalano, Haggerty, Gainey, & Fleming, 1998). Thus, increasing knowledge of the factors that influence self-esteem and discovering ways to improve the self-esteem of drag abusers is of great importance, and may provide us a deeper understanding of addiction and relapse. In the field of drag addiction, self-efficacy is another crucial concept. In social cognitive theory, Bandura (1986) defined self-efficacy as "people's judgments of their capabilities to organize and execute courses of action required to attain designated types of performances" (p. 391). The self-efficacy of a heroin abuser indicates the level of confidence in his or her ability to refuse to use this drag. Some researchers have demonstrated that heroin abusers with higher levels of self-efficacy report lower levels of craving for the substance, and, thus, are less likely to experience a relapse (Gossop, Green, Phillips, & Bradley, 1990). In terms of the relationship between self-esteem and self-efficacy, researchers have reported mixed results. Bandura (1986) wrote that self-efficacy (perceived capabilities) and self-esteem (perceived self-worth) do not necessarily have a predictable relationship but proponents of core self-evaluation theory (Judge, Locke, & Durham, 1997) suggest that general self-efficacy and self-esteem (together with neuroticism and locus of control) should be treated as a unitary construct. We did not locate any research on the topic of the relationship between self-esteem and self -efficacy in heroin abusers. Thus, in the present study the aim was to help fill this gap. Not only the attitude toward self, like self-esteem, but also the attitude of the individual about human nature affects the rehabilitation of drug abusers. The quality of faith in people, as described by Rosenberg (1956), is seen as a generalized attitude towards human nature, and the degree to which an individual trusts in human nature can influence the way he/she perceives and behaves toward others. That is to say, faith in people is likely to affect the individual's interpersonal relationships (Robinson, Shaver, Wrightsman, & Andrews, 1991). Some researchers have indicated that drug abusers in China have less faith in people than have nonusers of drugs (Zhu, Chen, & Delexat, 2005). This distrust may cause them to experience difficulty hi establishing close and warm relationships with others and may result in them perceiving less social support. In some other studies it has been shown that perceiving a higher level of social support indicates that heroin abusers believe that they have people around them who can motivate and care for them, who have confidence in them, who show respect for them, and who have expectations of them, all of which cause them to have more self-esteem and self-efficacy than those who perceive that they have less social support (Chong & Lopez, 2005). Although the quality of faith in people has been found to be very important in heroin abusers, few researchers have, as far as we know, conducted research into this quality and its relationship with self-efficacy and self-esteem. In this study we explored these relationships. Self-esteem, self-efficacy, and faith in people can also be examined from a more holistic perspective. Swann, Chang-Schneider, and McClarty (2007) described how people's self- views, behaviors, and social environment are embedded in cycles in which each element influences and constrains the other elements in profound ways. In the present study, self-esteem, self-efficacy, and faith in people constitute the self-views of Chinese heroin abusers. As self-efficacy relates to behavior, so faith in people relates to social environment. These two elements affect self-esteem, which is the most fundamental manifestation of one's self-view (Judge et al., 1997). Because social environment correlates with behavior, there is also a relationship between self-efficacy and faith in people. Therefore, in the current study we tested three hypotheses. First, a high level of self-efficacy will predict a high level of self-esteem. Second, a high level of faith in people will predict a high level of self-esteem. Third, self-efficacy will correlate with faith in people. METHOD PARTICIPANTS A randomized, multistage sampling method was used to select a representative sample of the general population of drug addicts in Nanjing, China. We recruited 200 heroin abusers to participate hi this research, all of whom had been diagnosed with "abuse or harmful use of heroin" according the criteria of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2000). According to the findings of some Chinese scholars, some Axis 1 mental disorders such as mood disorders (8.1%), schizophrenia and other psychiatric disorders (5.7%), and anxiety disorders (4.0%) are prevalent among Chinese heroin abusers (Chen, Fan, Du, Sun, & Zhao, 2009). Antisocial personality disorders (44.7%) and borderline personality disorder (13.9%) were the most common Axis II personality disorders (Zhao, Yang, Zhao, Hao, & Yang, 2001). In this study, we used the General Health Questionnaire-12 (GHQ-12; Goldberg et al., 1997), a short instrument for the detection of psychiatric morbidity, and found that 19.2% of our participants had a mental disorder. MATERIALS AND MEASURES Demographic factors and heroin use condition A questionnaire was used to collect general demographic information, including age, gender, education, and employment situation. Heroin use was also measured in order to obtain the concrete conditions of heroin use. For example, participants were asked: "When did you first use heroin?", "When did you become addicted to heroin?", "How many times have you been in compulsory drug rehabilitation?", and "How long has it been since you last used heroin?" Self-esteem Scale (SES) The Chinese version of the SES (Rosenberg, 1965; adapted into Chinese by Wang, Wang, & Ma, 1 999) was used to assess self-esteem. Participants were asked to indicate their agreement with statements on a scale of 1 (strongly disagree) to 4 (strongly agree). This scale is one of the most widely used measures of self-esteem because it has been proven to be reu able and valid. The internal consistency coefficient alphas of the Chinese version of the SES have been reported by many Chinese researchers to be above .70. The strong correlation with the Feeling of Inadequacy Scale (FIS) (r = .68), which is an equally commonly used scale measuring self-esteem supports its validity (Tian, 2006). The internal consistency coefficient alpha obtained from our sample was .80. The Self-efficacy Questionnaire for Chinese Drug Users (SEQD) The SEQD, developed by Geng and Han (2008), is rated on a 5-point Likert-type scale ranging from 1 (totally disagree) to 5 (totally agree). Our aim when using this measure was to assess the level of self-efficacy in refusing drug use, to evaluate the severity of the drug addiction, and to estimate the probability of the drug abusers' relapse. The higher the score, the higher the participant's self-efficacy. The SEQD has a strong interrater reliability (a = .92), and test-retest reliability over a one-month period (a = .70). And the validity was demonstrated by a strong relationship with the General Self-Efficacy Scale (GSES; Zhang & Schwarzer, 1995) (r = .58). In our investigation, the internal consistency coefficient alpha was .95. Faith in People Scale (FPS) The Rosenberg Faith in People Scale (1956), also called the misanthropy scale, is used to assess one's degree of confidence in the trustworthiness, honesty, goodness, generosity, and brotherliness of people in general. It contains five items. Favorable psychometric evidence for the scale has been presented, and the coefficient of reproducibility on this scale is 0.92 (Rosenberg, 1956). The Chinese version of this scale adapted by Fan (1999) was used in our research. PROCEDURE The survey forms were distributed individually to each of the 200 participants. Valid completed forms were received from 182 participants (response rate = 91%). The other 18 forms had some values missing in the crucial instruments. The responses were processed using SPSS version 18.0. A regression analysis and Pearson correlation analysis were employed to analyze the data obtained in the research. RESULTS SOCIODEMOGRAPfflC CHARACTERISTICS AND DRUG USE CONDITIONS OF PARTICIPANTS The mean age of the heroin abusers who took part in our study was 36.75 ± 6.38 years (71.5% males). Sociodemographic characteristics of participants are shown in Table 1. THE SES, SEQD, AND FPS SCORES WITH RESPECT TO VARIOUS WORK SITUATIONS The mean scores (with standard deviations in brackets) of SES, SEQD, and FPS were 26.54 (4.43), 65.38 (16.81), and 3.93 (1.18), respectively. Compared with the scores of nonusers of drugs recorded by Zhu et al. (2005), the heroin abusers in this study had significantly lower levels of self-esteem and faith in people than did nonusers (p < .001). The differences in the scores of SES, SEQD, and FPS with respect to the various sociodemographic characteristics and drag use conditions as set out above were assessed using one-way analyses of variance (ANOVAs). Work situation differences were significant in SES (F = 3.06, p < .05) and FPS (F = 3.61, p < .05). As shown in Table 2, the mean scores of SES for the drag abusers who had full-time jobs were found to be significantly higher than those of the drag abusers were unemployed (p < .05). The mean scores of FPS for drag abusers who had full-time jobs or temporary or part-time jobs were found to be significantly higher than those of the drag abusers who had no job (p <. 05). CORRELATION BETWEEN SELF-ESTEEM, SELF-EFFICACY, AND FAITH IN PEOPLE The Pearson correlations among all the pairs of the three variables are shown in Table 2. A significantly positive relationship (r = .41, p < .01) was found between self-esteem and self-efficacy. These two are modestly related. Significantly positive relationships were found (r = .26, p < .01) between both self-esteem and faith hi people and (r = .17, p < .05) between self-efficacy and faith in people. MULTIPLE REGRESSION ANALYSIS A multiple regression analysis was performed to determine the effects of self-efficacy and faith in people on self-esteem. The results are given in Table 3. We found that self-efficacy and faith in people have a significant effect on self-esteem and explain 22% of self-esteem variance (p < .001, F = 23.69). We found that the scores on the SEQC (t = 5.66, p < .001), and FPS (t = 2.90, p < .01) significantly predicted the self-esteem level of our participants. DISCUSSION We found a modest relationship between the qualities of self-esteem and self-efficacy among this sample of drug abusers in China, and that self-efficacy partially predicted level of self-esteem. This indicates that, among Chinese heroin abusers, self-esteem and self-efficacy are two distinct concepts, but they still correlate with each other. Rosenberg, Schooler, Schoenbach, and Rosenberg (1995) argue that the effect of specific self-esteem on global self-esteem is affected by the degree to which the relevant role or behavior is personally valued and that the concept of specific self-esteem, which relates to some area of competence, has much in common with self-efficacy. In our study, self-efficacy as measured by the SEQD represents the perception of heroin abusers about whether or not they can refuse the drug. Thus, the effect of self-efficacy on self-esteem in the Chinese heroin abusers in our study indicates that abstaining from use of heroin is crucial in their lives. Valuing the ability to refuse heroin increases the effect of an individual's self-efficacy on their self-esteem. In short, self-efficacy indicates the level of an individual's confidence in his or her ability to refuse heroin and has an effect on both behavior and self-esteem. We also found that heroin abusers with greater faith in other people had greater self-esteem, and that faith in people can partially predict level of self-esteem. On one hand, as explained above, faith in people, which influences an individual's perception of and behavior towards others, also impacts that individual's interpersonal relationships and social support (Mortenson, 2009). In some studies it has been found that social support for drug abusers is significantly related to their self-esteem (Chong & Lopez, 2005). Consequently, having more faith in people leads to better interpersonal relationships and more social support, which, in turn, affects self-esteem. On the other hand, interpersonal trust is associated with appropriate help seeking, which, in turn, predicts the likelihood of displaying emotional distress in front of friends (Mortenson, 2009). This is an effective way to relieve pressure and depression caused by some Stressors that would impact on self-esteem, because self-esteem and depression significantly affect each other (Rosenberg et al., 1995). For our participants self-efficacy was correlated with faith in people. We considered that there are two aspects to this result. Firstly, faith in people has a connection with social support. Havassy, Hall, and Wasserman (1991) found that social integration and abstinence-specific functional support predicted a lower risk of relapse. Being in a state of abstinence can improve self-efficacy. Moreover, the greater serf-efficacy of heroin users leads to the lower probability of relapse (Gossop et al., 1990) which, in turn, enhances the possibility that a user will return to a normal life without drugs and will then develop more trust in others and get more social support. This can be confirmed by the results of our study, which show that drug users who had full-time or temporary jobs had much greater faith in other people than did those who were unemployed. In fact, our results showed that having a job was a necessary step for drug users to return to normal life and significantly increased the drug users' faith in other people. Thus we found that self-efficacy and faith in others were correlated in the group of Chinese heroin users we studied. Some researchers in the field of drag addiction focus on the relapse behavior. They use psychological factors and social factors to predict relapse. However, from a more holistic perspective there is no simple causal relationship between these two factors and behavior. Reciprocal causation is involved. If lasting changes in an abuser 's behavior are to take place, corresponding changes in their self-view and social conditions must also occur and vice versa (Swann et al., 2007). Therefore, psychological and social factors should be studied as both predictor variables and outcome variables. Our results are a preliminary step toward probing into some important psychological factors and their mutual relationships in heroin abusers in China. From a more holistic perspective, there is a need to think deeply about the relationship of these psychological factors to behavior and social environment. 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Appreciation is due to reviewers including: Kristian Aleman, Karolinska Institutet, Solna, Sweden, Email: [email protected] Please address correspondence and reprint requests to: Liuna Geng, Department of Psychology, School of Social and Behavioral Sciences, Nanjing University, Nanjing, PRC 210093. Email: [email protected] (c) 2011 Society for Personality Research, Incorporated |