Contemporary Nurse

ISSN: 1037-6178 (Print) 1839-3535 (Online) Journal homepage: http://www.tandfonline.com/loi/rcnj20

Self-esteem and optimism in rural youth: Gender

differences
Kathryn R Puskar, Lisa Marie Bernardo, Dianxu Ren, Tammy M Haley, Kirsti
Hetager Tark, Joann Switala & Linda Siemon
To cite this article: Kathryn R Puskar, Lisa Marie Bernardo, Dianxu Ren, Tammy M Haley, Kirsti
Hetager Tark, Joann Switala & Linda Siemon (2010) Self-esteem and optimism in rural youth:
Gender differences, Contemporary Nurse, 34:2, 190-198, DOI: 10.5172/conu.2010.34.2.190
To link to this article: http://dx.doi.org/10.5172/conu.2010.34.2.190

Published online: 17 Dec 2014.

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Copyright eContent Management Pty Ltd. Contemporary Nurse (2010) 34(2): 190198.

Self-esteem and optimism in rural

youth: Gender differences
KATHRYN R PUSKAR
Professor, University of Pittsburgh, School of Nursing, Pittsburgh, PA, USA

LISA MARIE BERNARDO

Associate Professor, University of Pittsburgh, School of Nursing, Pittsburgh, PA, USA

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DIANXU REN
Assistant Professor, University of Pittsburgh, School of Nursing, Pittsburgh, PA, USA

TAMMY M HALEY
Assistant Professor, University of Pittsburgh, Bradford Campus, Bradford, PA, USA

KIRSTI HETAGER TARK

Project Director, University of Pittsburgh, School of Nursing, Pittsburgh, PA, USA

JOANN SWITALA
Research Specialist, University of Pittsburgh, School of Nursing, Pittsburgh, PA, USA

LINDA SIEMON
Staff Nurse, Emergency Department, Somerset Hospital, Somerset, PA, USA

ABSTRACT
Aim: To identify and describe gender-related differences in the self-esteem and optimism levels of rural
adolescents. Background: Self-esteem and optimism have been broadly examined and are associated
with health-practices, social interaction, attachment, resiliency, and personal identity. Information
describing the relationship of self-esteem and optimism as it relates to gender is limited. Methods:
Using a cross-sectional survey design, students (N = 193) from three high-schools in rural Pennsylvania,
USA completed the Rosenberg Self-Esteem Scale and the Optimism Scale-Life Orientation TestRevised as part of a National Institute of Health, National Institute of Nursing Research funded
study. Results: Both instruments mean scores were in the range of average for this population, with
females scoring lower than males in both self-esteem (p < 0.0001) and optimism (p < 0.0001). The
results of this study have nursing implications for evidenced based interventions that target self-esteem
and optimism. Attention to self-esteem and optimism in female youth is recommended.
Keywords: adolescents; nursing; optimism; rural; self-esteem

INTRODUCTION

elf-esteem is dened as a favorable or unfavorable attitude toward the self (Rosenberg,

1965) and is a feeling of pride in yourself
(Websters Online Dictionary, 2008). Self-esteem

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is an essential component of an ego-identity

which is the cornerstone of successful adolescent
psychosocial development and self-care (Cantrell
& Lupinacci, 2004). High self-esteem had been
shown to be associated with better mental health

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Self-esteem and optimism in rural youth: Gender differences

outcomes, better coping ability, and a lower incidence of depression in both adolescents and adults
(Birndorf, Ryan, Auinger, & Aten, 2005).
Optimism can be dened as an inclination
to anticipate the best possible outcome (Carver,
Scheier, & Segerstrom, 2010). Optimists are
dened as people who tend to make the most of
their life by having a positive attitude in regard to
their future and accepting problems by adapting in
various ways, such as active positive problem solving, redening the situation in a positive manner,
and using constructive emotional strategies like
the use of humor. Dispositional optimism is a personality characteristic that is relatively stable and is
dened when the persons overall expectations are of
good outcomes in life (Carver et al., 2010; Scheier
& Carver, 1992; Scheier, Carver, & Bridges, 1994).
Although optimism is felt to be relatively stable, evidence supports that an optimistic orientation can
be enhanced or manipulated with appropriate intervention (Fosnaugh, Geers, & Wellman, 2009).
The purpose of this descriptive cross-sectional
study was to identify relationships between selfesteem and optimism in rural youth. The research
questions were: (1) Are there gender differences in
self-esteem reported by rural adolescents and (2)
Are there gender differences in optimism reported
by rural adolescents? This study offers nurses information about rural youths self-esteem and optimism. Gender ndings are of interest due to the
past history of inequalities between the genders.

BACKGROUND
Self-esteem and optimism are broadly studied concepts throughout the literature, in both
national and international arenas. They have been
studied from many aspects including: family communication, development, parental attachment,
resilience, identity style, bullying, self-harm, and
criminal behaviors. Gender differences have not
been consistently addressed.

Self-esteem
The link between self-esteem and externalizing
problems, such as aggression, antisocial behavior

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and delinquency was explored by Donnellan,

Trzesniewski, Robins, Moftt, and Caspi (2005).
Rosenbergs 10-item Self-Esteem scale was used
in two consecutive studies conducted by the
Donnellan et al. (2005). In the combined reporting of these studies conducted with a sample of
children (N = 292) from two schools in Northern
California, USA and two consecutive birth cohort
samples from New Zealand who were 11 years of
age (N = 812) and 13 years of age (N = 736), a
relationship was found between low self-esteem
and externalizing problems. No gender issues
were noted. One example of their ndings was
that 11-year-olds with low self-esteem tended
to increase in aggression by age 13 (Donnellan
et al., 2005, p. 333).
In a longitudinal examination of self-esteem
and bullying behavior among fth and sixth
grade children (N = 307) in the northeast United
States, Pollastri, Cardemil, and ODonnell (2009),
reported that boys overall had higher self-esteem
than girls regardless of the level of bullying behavior. They further identied that the lowest levels
of self-esteem were reported by children who
were both bully/victim, followed by those who
were pure victims and those that were pure bullies. The highest levels of self-esteem were noted
in the children who were not involved in bullying
at any level. While the overall levels of self-esteem
remained comparatively low for females over the
course of the study, those who were reported to
be pure bullies were found to have statistically signicant increases in self-esteem over time. These
changes were not noted in the male participants. In
a separate cross sectional analysis of Australian secondary school students (N = 1,284), between 40%
and 50% of students reported being bullied while
at school (Delfabbro et al., 2006). When compared
to students who were never bullied, those often
bullied by either peers or by teachers were found to
have signicantly lower levels of self esteem.
Trzesniewski et al. (2006) further studied self-esteem and found that weak self-esteem has detrimental consequences. Adolescents with low self-esteem
have poorer mental health, physical health, worse

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Kathryn R Puskar, Lisa Marie Bernardo, Dianxu Ren, Tammy M Haley, et al.

economic prospects, and higher levels of criminal

behavior during adulthood when compared to
adolescents with high self-esteem. Low self-esteem
during adolescence was shown to predict negative
real-world consequences during adulthood.
Laible, Carlo, and Roesch (2004) noted the relation between parent attachment and self-esteem was
signicantly stronger for males than for females. The
direct and indirect effects of parent and peer attachment on self-esteem in late adolescence was examined. For females, self-esteem may be more strongly
affected by indirect inuences such as social behaviors. For males, self-esteem may be more directly
linked to parental attachment. Parental attachment
had the most direct effects on self-esteem.
Self-esteem changes were studied in a random
sample of teenagers (N = 16,489) from the National
Education Longitudinal Study (Birndorf et al.,
2005). High versus low self-esteem was measured
by seven items from Rosenbergs self-esteem scale.
Factors common to both male and female adolescents included positive family communication, baseline self-esteem, and feelings of safety. Adolescents
reporting high self-esteem in grade eight were three
times more likely to report high self-esteem in grade
twelve. Male youth reported higher self-esteem than
female youth at all grade levels.
Further gender issues have been noted in the
following literature. Robins and Trzesniewski
(2005) noted on average self-esteem is relatively
high in childhood. Self-esteem drops during adolescence (particularly for girls) then rises gradually
throughout adulthood and declines sharply in old
age. Evidence further supports that the self-esteem
of female youth is regulated differently than the
self-esteem of male youth (Raevuori et al., 2007).
Sung, Puskar, and Sereika (2006) evaluated rural
adolescents self-esteem using the Rosenberg SelfEsteem Scale. Descriptive results indicated that
there were gender differences with signicantly
higher self-esteem noted in male youth. Overall,
these results were suggested to have implications
for nurses and underscored the importance of
assessing and bolstering self-esteem in adolescents, particularly female adolescents.
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Optimism
Puskar, Sereika, Lamb, Tusaie-Mumford, and
McGuinness (1999) studied optimism and its
relationship to depression, coping, anger and
life events in 624 rural adolescents in western
Pennsylvania, USA. The Optimism Scale-Life
Orientation Test-Revised (LOT-R) measure was
used and revealed that females had slightly lower
mean scores than males, no signicant difference
between genders was noted. Huan, Yeo, Ang, and
Chong (2006) studied optimism and gender on
adolescents perception of academic stress using the
Life Orientation Test (LOT) measure. They found
that a signicant negative relationship between
optimism and academic stress, noting that gender
was not a signicant predictor of academic stress.
The concept of optimism was claried by Tusaie
and Patterson (2006) from a study of 132 rural adolescents attending public school who were between
14 and 18 years of age. Participants completed the
LOT-R and the Optimistic Bias Scale (OBS). In
general, adolescents did not believe they were vulnerable to bad experiences. Females were found
to believe that they were more likely to experience
too much stress as compared to males. Results suggested that the inclusion of strategies to maximize
optimistic thinking in situations holds the potential
to inuence the level of resilience in adolescents.
To examine the relationship of optimism to
social support and positive health practices Mahon,
Yarcheski, Yarcheski, and Hanks (2007) utilized
regression analysis to evaluate a sample of 128 adolescents, 1214 years of age. Optimism was found
to be a weak mediator for the relationship between
social support and positive health practices.

Self-esteem and optimism

Yarcheski, Mahon, and Yarcheski (2004) measured
self-esteem, optimism, hopefulness and coping
skills and found they are positively correlated with
positive health practices in adolescents. In another
correlation study, Puskar, Ren, Bernardo, Haley,
and Stark (2008) found self-esteem and optimism
negatively correlated with anger. Higher self-esteem
and optimism scores were correlated to higher anger

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Self-esteem and optimism in rural youth: Gender differences

control scores and lower anger scores in the remaining subscales of Spielbergers (1999) State-trait Anger
Expression Inventory (STAXI-2). Therefore, lower
self-esteem and optimism scores were correlated to
higher anger scores, higher suppression of anger
(self-esteem 0.438, optimism 0.329, p < 0.01),
and lower anger control scores. All of these ndings
were noted to have potential clinical implications
for practitioners who are working with adolescents
in either the clinical or community setting.
In a 21-year longitudinal study by Heinonen,
Raikkonen, and Keltikangas-Jarvinen (2005), selfesteem was found to predict dispositional optimism
in a sample of youth in Finland. At 12 years of age,
no signicant differences were noted between genders in the level of self-esteem. By age 18, females
reported a higher level of self-esteem than males.
No gender variations were noted with associations
between the changes in self-esteem and optimismpessimism. Regression analyses of self-esteem found
a signicantly higher level of pessimism by 33 years
of age in those participants that had any type of
change in their self-esteem between 1218 years of
ages, versus those who had consistently high selfesteem over this developmental period. They suggested further studies are needed to evaluate their
nding of a bi-directional relationship between selfesteem and optimismpessimism. The researchers
expressed concerned that negative changes in selfesteem during the adolescent period could have
severe consequences on optimism.
In an examination of psychosocial variables and
their relationship to adolescent identity style, Phillips
and Pittman (2007) used the Rosenberg scale to
measure self-esteem and a single item to measure
optimism. No signicant interaction was noted
among gender and identity styles with self-esteem
and optimism. However, those participants with an
avoidant identity style were found be less optimistic
and have lower levels of self-esteem as evidenced by
signicantly lower mean scores than those with normative or informational identity styles.
The prevalence of self-harm among adolescents
and the factors associated with self-harm were
explored in a study of N = 2008 young people in

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west and central Scotland (OConnor, Rasmussen,

Miles, & Hawton, 2009). Self harm was three
times more likely to be reported by girls than boys
(OR = 3.37. 95% CI 2.54.54, p < 0.001). Those
who reported self-harm regardless of gender were
noted to have lower levels of self-esteem and lower
levels of optimism. Similar ndings were reported
in a study of Irish youth. McMahon et al. (2010)
found that lower self-esteem was an important
factor associated with deliberate self-harm among
adolescents (N = 3881). The study further identied that reported self-harm occurred three times
more often in girls than boys.
In summary, low self-esteem is correlated with
externalizing problems (Donnellan et al., 2005);
poor mental and physical health, higher levels of
criminal behavior during adulthood and other realworld consequences (Trzesniewski et al., 2006);
avoidant identity style (Phillips & Pittman, 2007);
increased anger scores, anger suppression and
decreased anger control (Puskar et al., 2008); and
an increased prevalence of self-harm (McMahon
et al., 2010; OConnor et al., 2009). Parental
attachment was found to have the most direct effect
on self-esteem in late adolescence (Laible et al.,
2004) and optimistic thinking was found to inuence the level of resilience in adolescents (Tusaie
& Patterson, 2006). The literature illustrates mixed
ndings on self-esteem and optimism in relation
to gender. Some researchers have identied that
self-esteem and optimism are higher in adolescent
males (Birndorf et al., 2005; Puskar et al., 1999;
Sung et al., 2006), while others reported no difference dependent on the level of development when
initially assessed (Heinonen et al., 2005). In both
genders, common factors such as family communication and safety were noted to signicantly impact
self-esteem (Birndorf et al., 2005).

METHOD
This descriptive cross-sectional study used a survey design to measure self-esteem and optimism in
adolescents from three rural western Pennsylvania
high schools, USA. These data were collected
at baseline as part of a longitudinal randomized

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Kathryn R Puskar, Lisa Marie Bernardo, Dianxu Ren, Tammy M Haley, et al.

controlled study to assess the effectiveness of a targeted intervention designed for rural youth. The
school sites were located in areas dened as rural
by the Pennsylvania Department of Rural Health,
USA (Pennsylvania Ofce of Rural Health, 2005).

the remainder enrolled in vocational, business, or

remedial programs. They were largely Caucasian
(86.5%, n = 167) and female (53.4%, n = 103).
Approximately one third of the sample (28.5%,
n = 55) were reported to be currently employed
an average of 14.1-h per week.

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Procedure and participants

Consent was received from the school administrators and the Universitys Institutional Review Board
to conduct this study. The research team presented
information at each school site. The students
reported to the auditorium where the research team
introduced themselves and described the project.
Informed consent was obtained. Questions were
addressed and consent forms were distributed.
Directions included encouraging parents to call
the principal investigator for further questions as
needed before signing the consent forms. A packet
of the data collection instruments was available
at the school for parents to review. The consent
forms were signed and returned by parents, with
students providing assent prior to study participation. Only those students with consents completely signed and initialed by both student and
parents/guardians were in the study. The survey
instruments, included measures of self-esteem and
optimism, and were administered in a group setting during school time. The students were paid
$10 for completing the measures. Anonymity of
the individual ndings was preserved.

Sample and setting

Male and female students (N = 193) from three
Western Pennsylvania, USA rural-area public high
schools who were in the ninth tenth or eleventh
grade participated in the study. Only those students with the ability to read and write in English
fullled the inclusion criteria. The sample has
been previously described in other publications
(Puskar et al., 2006, 2008).
Participants who completed the self-report
measures at baseline were 1418-years old
(mean = 15.57) and were enrolled in high-school.
The majority of the participants were registered
for academic programs (88.6%, n = 171) with
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Measures
Rosenbergs Self-Esteem Scale was developed to
measure adolescents global feelings of self-worth or
self-acceptance (Rosenberg, 1965). It includes ten
items that are scored using a four-point response
ranging from strongly disagree to strongly agree.
Rosenberg (1965) tested 5,024 students to check
the reliability of the self-esteem scale. Internal consistency with Cronbachs alpha was found to be
0.77. Coefcients of reproducibility were 0.91; testretest reliability was 0.85. Scale ranges from 030
and average range is 1525 (Rosenberg, 1965).
Optimism was measured by the Life
Orientation Test Revised (LOT-R). The LOT-R
was designed by Scheier et al. (1994) to measure
optimism by assessing the generalized outcome
expectancies of individuals. The scale consists of
10 items. Each item is scaled on a 5-point Likert
scale with responses ranging from strongly agree
(4 points) to strongly disagree (0 points) with
reverse scoring (on items 3, 7 and 9). The range
is 024 possible points with no normative values.
Greater optimism is represented by higher scores.
The Cronbachs alpha was 0.78, level of internal
consistency acceptable. Data were analyzed using
descriptive and inferential statistical tests. The
level of signicance was set at p < 0.05.

RESULTS
Analysis of the summative total score for the
Rosenbergs Self-Esteem Scale revealed that
the mean score for male respondents (n = 90,
M = 21.988, SD = 4.916) was higher than the
mean score of female respondents (n = 103,
M = 19.13, SD = 4.795). This nding was noted
to be statistically signicant (t = 4.08, p < 0.0001).
Table 1 outlines the results of Rosenbergs SelfEsteem Scale for this sample by gender.

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TABLE 1: GENDER DIFFERENCES FOR ROSENBERG SELF-ESTEEM SCALE (RSES) AND LIFE ORIENTATION TEST SCORES
(LOT-R)

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Male

Female

Mean

Standard deviation

Mean

Standard deviation

p value

RSES

21.988

4.916

19.132

4.795

p < 0.0001

LOT-R

14.9

3.48

12.637

4.242

p < 0.0001

On the Optimism Scale Life Orientation Test

(LOT-R) males again scored signicantly higher
(n = 90, M = 14.9, SD = 3.48) than females
(n = 103, M = 12.64, SD = 4.24) (t = 4.01,
p < 0.0001) (Table 1). There was also noted to be
a moderate positive correlation between optimism
and self-esteem in this sample of rural adolescents
(r = 0.637, p < 0.000 2-tailed).

DISCUSSION
The results of this study are felt to provide further
evidence for the presence of gender differences in
the level of self-esteem and optimism among rural
adolescents. While the mean scores for self-esteem
and optimism were noted to be within the average
range for adolescents, there was a troubling trend
for signicantly lower scores in rural female adolescents when compared to rural male adolescents.
These ndings are noted to be consistent with
previous research reporting signicantly higher
levels of self-esteem in male youth (Sung et al.,
2006) and lower levels of self esteem in female
youth at all grade levels when compared to their
male counterparts (Birndorf et al., 2005).
In the current study, rural female adolescents
were also noted to have signicantly lower mean
scores for optimism as compared to their male
counterparts. Tusaie and Patterson (2006) found
the same pattern of response with the male participants reporting slightly lower trait optimism
(M = 14.2 SD = 4.4) and the female participants reporting slightly higher levels of optimism
(M = 13.3, SD = 3.1) than those noted in the current examination of rural adolescents. The current study identied that participants scores were
on average neutral (M = 13.69, SD = 4.05) on

the LOT-R Optimism Scale. Puskar et al. (1999)

found comparable on average neutral scores on
the LOT-R in their study in rural youth (n = 624,
M = 13.16, SD = 4.16). Similarly, Tusaie and
Pattersons (2006) study of 132 adolescents found
a mean score for trait optimism of M = 13.6,
SD = 3.7 when using the LOT-R measure.
Given these ndings, rural female adolescents
may be especially vulnerable to potential negative
outcomes and negative health behaviors associated with lower levels of self-esteem and optimism
when compared to rural males. The recognition
of these differences provides additional support
for the creation of gender specic interventions
targeting the enhancement of self-esteem and
optimism for rural youth.

IMPLICATIONS FOR PRACTICE

Globally, those residing in rural areas struggle
with issues of access, availability, and appropriateness of health services (Dolea, 2009; McGorry
et al., 2007). With 11% of residents in Australia
and 18% of residents in the United States residing in areas identied as rural (United Nations
Statistics Division, 2009), nurses practicing in
rural settings are well positioned to help provide
early assessment and intervention to those at risk
for low self-esteem and reduced optimism. Recent
government funded initiatives in Australia such
as MindMatters and headspace have placed an
increased focus on an organized, evidence based
approach to improving the mental health and
well being of children and adolescents (Hodges,
OBrien, & McGorry, 2007; Rowling, 2007).
Because self-esteem, optimism, hopefulness
and coping skills are positively correlated with

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positive health practices in adolescents (Cantrell

& Lupinacci, 2004; Yarcheski et al., 2004), it is
appropriate for nurses to assess and improve these
factors as part of health promotion interventions.
It has been noted that interventions promoting
optimism are needed in schools, communities, and
institutions in order to stimulate the development
of optimism and other psychological strengths
in young people (Gillham & Reivich, 2004). In
addition to the design and implementation of
interventions to build self-esteem and optimism,
nurses in daily professional practice can conduct
screening of self-esteem and optimism in children
and adolescents to identify those who may be
at risk, with referral to a mental health nurse or
other mental health professional if needed.
Parental involvement should not be overlooked
by nurses when designing interventions to promote
positive health practices through the augmentation
of self-esteem and optimism. It has been found that
positive communication, with a child up to middle school may result in higher self-esteem by the
time the child is in the 12th grade (Birndorf et al.,
2005). Parents need to be cognizant of the environment they create for their children whether it
is positive or negative. The analyses of family problems and the resolutions achieved are important
to the family network. With the recognized gender differences in self-esteem and optimism noted
by this study and evidence that the association of
self-esteem and parental involvement may differ by
gender (Laible et al., 2004) the creation of gender
specic interventions should be considered.
Apart from parental involvement, parenting
styles warrant exploration by nurses aiming to
increase self-esteem. Assessment of authoritarian
parenting styles could lead to interventions that
teach promotion of self-esteem. A sample of adolescents (N = 1,456, 1316 years of age) in Spain
that had indulgent parents showed the highest
self-esteem scores in contrast to adolescents from
authoritarian parents who were found to have lower
levels of self-esteem (Martinez & Garcia, 2007).
The relationship of bullying and lower selfesteem has been well described (Delfabbro et al.,
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2006; Pollastri et al., 2009). Community nurses

working in collaboration with school counselors can provide education and interventions to
increase self-esteem and reduce these negative
behaviors. Nurses are well positioned to raise community awareness of the high prevalence of bullying behavior, empower parents to become involved
if they suspect their child is being bullied, and
help promote supportive peer relationships among
adolescents keeping in mind that young girls are
potentially more highly affected by these behaviors
due to their lower levels of reported self-esteem.
Evidence supports that females who suffer
from low levels of self-esteem and optimism are
at increased risk of negative health behaviors such
as self-injury (McMahon et al., 2010; OConnor
et al., 2009) and recurrent episodes of binge eating
and extreme weight control behaviors (Hay, 2007).
Nurses may need to pay special attention to these
issues in rural females given the identied lower levels of self-esteem reported. Increased attention by
nurses to screening and early intervention, as well as
the creation of evidence based, gender specic interventions in this population may be warranted.

Limitations
Limitations of the study include the use of a sample
who were predominately Caucasian and enrolled in
academic programs. The participants were limited
to three rural high schools in western Pennsylvania,
USA. Future research may be done on a greater
number of schools over a larger geographic area
with more racial and academic diversity.

CONCLUSIONS
This study provides further evidence of the presence
of gender differences in childhood and adolescence
with regard to self-esteem and optimism. Consistent
with published reports, rural females were noted to
have lower levels of both selfesteem and optimism
when compared to rural dwelling male youth. The
screening of children and adolescents for low self-esteem and decreased levels of optimism may be indicated to help curb potentially negative outcomes
associated with low levels of these characteristics.

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Self-esteem and optimism in rural youth: Gender differences

Community mental health nurses as well as those
nurses in the inpatient, outpatient and school setting are well suited to play a central role in the creation and implementation of such services.
As outlined by the aims of the headspace initiative, early detection and early involvement with the
use of evidence-based interventions to stem mental
disorders in children and adolescents is imperative (Hodges et al., 2007; McGorry et al., 2007).
Young females appear to be especially vulnerable to
the negative outcomes of low levels of self-esteem
and optimism which may include poor school performance, decreased levels of mental and physical
health, and increased potential for self-harm. The
creation of evidenced based nursing interventions
that target female youth with the goal of increasing
self-esteem and optimism may be benecial in helping to limit or reduce these negative outcomes.

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Received 01 July 2008

Volume 34, Issue 2, February/March 2010

Accepted 23 March 2010