The role of self-perception in mental health: current insights on self-esteem and self-schemas

Background: Self perception includes both self-esteem and self-schema and is an important factor in determining an individual's mental health. This is particularly true in contexts that have been affected by war or conflict, such as post-conflict Mosul, Iraq. The city of Mosul has experienced long term exposure to trauma, displacement and social economic hardship; these experiences will likely cause disruption to the personal and community identities of residents. Therefore, it is necessary to understand how self-perception relates to mental health in order to develop effective interventions. Aim: This research aims to investigate the relationship between self-perception (self-esteem and self-schema) and mental health in adults living in Mosul. Additionally, we aim to identify cultural and context factors which may influence the relationship between self-perception and mental health. Methods: Using a cross-sectional mixed-methods design, 232 adults who live in Mosul participated in our research. We used three quantitative instruments: the Rosenberg Self Esteem Scale, the Self Schema Questionnaire, and the General Health Questionnaire-28 to collect quantitative data. The qualitative data were collected via 20 semi-structured interviews with participants who were purposefully selected from our sample of 232. Descriptive statistics, Pearson correlation and multiple linear regression were used to analyze quantitative data. Thematic analysis was used to analyze qualitative data. Results: Low self-esteem was reported by 41.4% of participants, and over half (52.6%) showed signs of possible psychological distress. Self-esteem (r = 0.52, p < 0.001) and positive self-schemas (r = 0.48, p < 0.001) were positively correlated with mental health, while negative self-schemas were negatively correlated (r = -0.55, p < 0.001). Multiple regression identified self-esteem (β = 0.37, p < 0.001), negative self-schemas (β = -0.34, p < 0.001), and employment status (β = 0.19, p = 0.014) as significant predictors of mental health, explaining 46.2% of the variance. Qualitative findings revealed three themes: identity reconstruction after conflict, cultural pressures on self-perception, and resilience through community support. Conclusion: Perceptions of oneself are an important predictor of mental health in adults living in Mosul, Iraq. Enhancing positive self-esteem and reducing maladaptive self schemas may increase psychological resilience in post-conflict settings. Culturally sensitive interventions that incorporate community and family support systems are recommended.