Hostile resentful contra repressive avoidant behaviors, widely associated with different health processes, are considered to arise from people’s specific contingent self-esteem strategies. The present study examines competence-based self-esteem (CBSE), referring to self-critical strivings, and relation-based self-esteem (RBSE), referring to rejection sensitivity and compliance, in three groups of outpatients (n = 85) and healthy controls (n = 37). Patients diagnosed with exhaustion syndromes displayed significantly higher CBSE and RBSE than all other groups. Patients diagnosed with cardiac type of disease showed significantly higher CBSE than those with immunological type of disease and healthy controls, whereas the immunological group reported significantly higher RBSE than the cardiac group and healthy controls. Further, cardiac patients displayed significantly higher CBSE than RBSE, whereas immunological patients reported significantly higher RBSE than CBSE. A discriminant analysis, incorporating the theoretical constituents of the contingent SE scales, showed that the four groups could be predicted by their SE profiles. The systematic patterns found in the present results shed light on the role of self-esteem contingency for differential psychosocial coping and health processes.