Discrepancies between explicit and implicit self-esteem and their relationship to symptoms of depression and mania




Self-esteem is a key feature of bipolar symptomatology. However, so far no study has examined the interaction between explicit and implicit self-esteem in individuals vulnerable to bipolar disorder.


Cross-sectional design was employed.


Thirty children of parents with bipolar disorder and 30 offspring of control parents completed Hamilton Rating Scale for Depression, the Bech-Rafaelson Mania Scale, the Self-esteem Rating Scale and the Implicit Association Test.


No differences between groups were revealed in levels of explicit or implicit self-esteem. However, bipolar offspring showed increased levels of symptoms of depression and mania. Furthermore, depressive symptoms were associated with low explicit self-esteem, whilst symptoms of mania were associated with low implicit self-esteem. When self-esteem discrepancies were examined, damaged self-esteem (i.e., low explicit but high implicit self-esteem) was associated with depression, whilst no associations between mania and self-esteem discrepancies were found.


Not only explicit, but also implicit self-esteem, and the interactions between the two are of relevance in bipolar symptoms. Clinical implications and future research directions are discussed.

Practitioner points

  • Explicit as well as implicit SE, and particularly their relationship, are relevant for mental health.
  • Fluctuations in implicit SE may serve as an early indicator for risk of bipolarity.
  • Psychotherapeutic approaches may be more suitable for one kind of SE challenge than the other.