Self-Esteem and Problematic Drinking in China: A Mediated Model

Background: Although self-esteem is related to problematic drinking, the mechanisms by which it affects drinking remain unclear. The purpose of this study was to determine whether coping mechanisms mediate the relationship between self-esteem and problematic drinking among Chinese men and women with alcohol use disorders and to recommend appropriate interventions for drinking problems. Methods: A cross-sectional survey was conducted in Harbin, Heilongjiang Province, China. A sample of 5,689 community residents was screened, and 517 male and 172 female problematic drinkers were chosen to participate in this study. A self-esteem scale, a coping questionnaire and an alcohol use disorder identification test were completed in order to assess participants’ self-esteem, coping mechanisms and alcohol use disorders, respectively. Participants’ socio-demographic data were also gathered at this stage. The resulting data were examined via descriptive statistics, correlations and bootstrap analyses. Results: Lower self-esteem levels were related to problematic drinking, and there were no gender differences in the relationship between self-esteem and problematic drinking. A relationship between low self-esteem and negative coping was observed only in men. Negative coping thus mediated the relationship between self-esteem and problematic drinking among men, but this was not the case for women. Positive coping did not mediate the relationship between self-esteem and problematic drinking among the participants, regardless of gender. Conclusions: Self-esteem and coping strategies are correlated among problematic drinkers. In addition, there are gender differences in the manners in which negative coping mediates the relationship between self-esteem and problematic drinking. Problematic drinking interventions directed at males should simultaneously address low self-esteem and negative coping.