Associations between self-esteem and abuse of alcohol and psychoactive substances have been documented in empirical studies involving high school and college students. No research exists that addresses whether this association generalizes to adult homeless substance users. The current study uses secondary data analysis methodology to evaluate an experimental design study involving 305 homeless men, assigned randomly to the treatment or control group. Control subjects were referred to community-based services. Experimental subjects were exposed to individual and group interventions, life-skills, and relapse prevention training while residing in a 24-hour shelter, for three months. Trained graduate students collected data using standardized questions to interview subjects. Three hypotheses were tested. Hypothesis I that the interventions would contribute toward increased self-esteem at T2, T3, T4 and T5 was not supported. The preponderance of findings pertaining to Hypothesis II, that higher self esteem would be associated with lower alcohol and drug use in treatment subjects, and Hypothesis III, that these associations would be greater among treatment than control subjects over time, were not confirmed, although a few results were consistent with these hypotheses. Overall, results indicated that self-esteem was not increased in treatment subjects despite decreases in alcohol and drug use. The role of serf-esteem in this population appears different from its importance in high school and college students. Possible reasons for this apparent difference are explored.
Key words: substance abuse; self-esteem; homeless males
Self-esteem has long been believed to play an important role in the use of alcohol and psychoactive substances (Charalampous, Ford, and Skinner; 1976; Donnelly, 2000). Several researchers have argued that low self-esteem poses high risk for substance abuse in some populations, including adolescents, college students (Mitic, 1980; Yanish, and Battle 1985), young females (Beckman, 1978; Engs, and Hanson 1989) and African Americans (Grills, and Longshore 1996). Results of these studies have led researchers to promote the theory that if levels of self-esteem can be determined, it may be possible to predict, change, or improve the lives of some people (Gross 1970; Jessor, and Jessor 1977; Laflin et al., 1994). Yet no corresponding studies could be found that had rigorously investigated the relationship between levels of self-esteem and substance abuse among the homeless. Most of what is "known about the relationship between self-esteem and substance abuse is based on studies that involved alcohol use by students in high school or college, thereby severely limiting the generalizability of findings to more mature populations, such as the chronically homeless substance-abusing men living in urban settings (Segal, Rhenberg, and Sterling 1975). Greater knowledge about inverse relationships between self-esteem and substance use disorder in more mature and older adults is needed so that budgets are not wasted on implementing costly, ineffective interventions that have little or no proven long-lasting results (Watson, 1991).
Homeless substance abusing men are of special interest because studies have found that they consume twice as much alcohol as women. They also tend to have different reasons for abusing drugs and alcohol and exhibit different course and consequences of addiction than do women (Allen, 1969; Kaplan, 1996). In addition, Nielsen and Scarpitti (1997) found that man), homeless substance abusers had low self-esteem, low self-worth and were lacking in self-confidence. Research has also found that homeless individuals often suffer from lethal, abusive, or destructive personalities, self-defeating behaviors and underdeveloped personal skills (Break, 1987).
Homeless individuals pose special challenges for treatment providers because many suffer with disaffiliation, a mistrust of institutions, have multiple problems and tend to be highly mobile (Breaky, 1987). …