[The alcoholic's self-image: a comparative study between men and women].

Self-image is a central problem in alcoholism. Most theories about the relationships between the self-image of alcoholics and their behaviour have been derived from -clinical observations rather than empirical research. Most observations have pointed out that alcoholics are prone to underevaluation of themselves and that low self-image is the basis of much of the problem drinker's behaviour. All the research on self-image has concluded that alcoholics have a lower self-image than non-alcoholics. Some empirical research has been conducted on the self-image of alcoholics; it has, however, been carried out only a few times, restricted to small samples, and concerned with a limited number of aspects of self-image. Moreover, most of these studies are not recent, and it seems that this area of research is not well covered. Even though the hypothesis of a bad self-image in alcoholics was validated by various older studies, the representation of alcoholism has since changed. Because of this evolution, the ways in which the disease has been viewed have changed. One can question to what extent changes in society can influence the self-image of alcoholics. This question seems all the more pertinent for alcoholic women, given the evolution of the female condition since the Seventies. The objectives of this study are to evaluate the self-image of alcoholics and non-alcoholics, and to compare the self-image of male and female alcoholics. Our hypotheses are that: 1) the self-image of an alcoholic is more negative than that of a non-alcoholic, and that: 2) female alcoholics have a more negative self-image than male alcoholics. Two groups of 30 subjects each were made up: a group of alcoholics recruited in an alcohol-dependency unit and a group of non-alcoholics recruited in a public place. The comparison of socio-demographic data between the alcoholic group and the control group does not show a significant difference except for age and level of schooling. The average age of the control group is younger than that of the alcoholic group. The level of schooling of the control group is higher than that of the alcoholic group. These differences can be explained by the mode of recruitment of the participants. The significant differences between the alcoholic men and women are at the level of the number of Years of alcoholism, the age at which the disorder began and the number of detoxification episodes. These differences are probably due to cultural background. Indeed, the age at which alcoholism begins is later in women and they consult more quickly than men. The two groups were assessed using the Tennessee Self Concept Scale and the Self Esteem Inventory. Other tests were used to control factors capable of influencing self-image (depression, socio-demographic data). The results show that the alcoholics have a more negative self-image than the control group. The alcoholics perceived themselves significantly less favourably on the identity (what I am), self-satisfaction (how I feel about myself), and behaviour (what I do) scores than did those in the control group. The alcoholics also saw themselves in a significantly more negative light than did those in the control group on the scores relating to physical self (body, health.), moral-ethical self (moral worth), personal self (evaluation of personality), family self (adequacy and value as a family member) and social self (adequacy and worth in interaction with others). The self-criticism subscale provided further evidence that the alcoholics were more open and self-critical than were those in the control group. Female alcoholics had a lower self-image than male alcoholics, but not in every aspect. There was a significant difference between the scores of alcoholic women and alcoholic men, for three of the subscales measured by the Tennessee Self Concept Scale: "general self-image", "personal self" and "self-criticism". The alcoholic women perceived themselves more negatively when it came to "self-satisfaction", "personal self" and "social self". They were however more positive than the men in the sectors of "identity", "behaviour", "physical self", "moral-ethical self", and "family self". The alcoholic men were more openly self-critical than the alcoholic women. Our results confirm the conclusions of empirical studies and of clinical observations. Alcoholics see themselves as generally inadequate and unworthy of respect. The changes in representations of this disease seem to have influenced the alcoholic's self-image, but it remains however very negative. The alcoholics'negative self-image is generalised and not specific to personality and behaviour. The -representation of alcoholism seems to have contributed to an improvement in the self-esteem and self-image of alcoholics, and in particular of female alcoholics. Even if the self-image of alcoholic women remains more negative than that of alcoholic men, it tends to bring back the self-image of alcoholic women to a level close to that of the men.