Self-Esteem Instability in Current, Remitted, Recovered, and Comorbid Depression and Anxiety
- 131 Downloads
Self-esteem has not only been observed to be generally low in depression and anxiety, but also unstable. Few studies have looked at unstable self-esteem in clinical samples. The present study compared self-reported self-esteem instability across current depression (n = 60), anxiety (n = 111), and comorbid depression/anxiety (n = 71), remitted depression (n = 41), and anxiety (n = 29), recovered depression (n = 136) and anxiety (n = 98), and a never clinically depressed or anxious comparison group (n = 382). The comparison group had more stable self-esteem than all groups. Once controlling for overall levels of self-esteem, differences with current depression or anxiety, remitted depression, and recovered depression or anxiety remained, but disappeared for the comorbid group. The current findings are consistent with the view that not only enduring low self-esteem per se, but also high self-esteem reactivity may contribute to the aetiology of affective disorders.
KeywordsSelf-esteem Instability Anxiety Depression Comorbid
The funding was supported by Nederlandse Organisatie voor Wetenschappelijk Onderzoek (Grant No.: 451-15-026).
The infrastructure for the NESDA study (http://www.nesda.nl) is funded through the Geestkracht program of the Netherlands Organisation for Health Research and Development (ZonMw, Grant Number 10-000-1002) and financial contributions by participating universities and mental health care organizations (VU University Medical Center, GGZ inGeest, Leiden University Medical Center, Leiden University, GGZ Rivierduinen, University Medical Center Groningen, University of Groningen, Lentis, GGZ Friesland, GGZ Drenthe, Rob Giel Onderzoekscentrum).
Compliance with Ethical Standards
Conflict of Interest
Lonneke A. van Tuijl, Klaske A. Glashouwer, Claudi L. H. Bockting, Brenda W. J. H. Penninx and Peter J. de Jong declare that they have no conflict of interest.
All procedures followed were in accordance with the Helsinki Declaration of 1975, as revised in 2000.
Informed consent was obtained from all patients for being included in the study.
This article does not contain any studies with animal subjects performed by the any of the authors.
- Aiken, L. S., & West, S. G. (1991). Multiple regression: Testing and interpreting interactions. Thousand Oaks, CA: SAGE. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=1991-97932-000&site=ehost-live&scope=site.
- Beck, A. T. (2002). Cognitive models of depression. In R. L. Leahy & E. T. Dowd (Eds.), Clinical advances in cognitive psychotherapy: Theory and application (pp. 29–61). New York, NY: Springer Publishing Co.Google Scholar
- de Man, A. F., Gutiérrez, B. I. B., & Sterk, N. (2001). Stability of self-esteem as moderator of the relationship between level of self-esteem and depression. North American Journal of Psychology, 3(2), 303–308.Google Scholar
- Frank, E., Prien, R. F., Jarrett, R. B., Keller, M. B., Kupfer, D. J., Lavori, P. W., … Weissman, M. M. (1991). Conceptualization and rationale for consensus definitions of terms in major depressive disorder: Remission, recovery, relapse, and recurrence. Archives of General Psychiatry, 48(9), 851–855. https://doi.org/10.1001/archpsyc.1991.01810330075011.CrossRefPubMedGoogle Scholar
- Kleiman, E. M., & Riskind, J. H. (2012). Cognitive vulnerability to comorbidity: Looming cognitive style and depressive cognitive style as synergistic predictors of anxiety and depression symptoms. Journal of Behavior Therapy and Experimental Psychiatry, 43(4), 1109–1114. https://doi.org/10.1016/j.jbtep.2012.05.008.CrossRefPubMedGoogle Scholar
- Penninx, B. W. J. H., Beekman, A. T. F., Johannes, H. S., Zitman, F. G., Nolen, W. A., et al. (2008). The Netherlands Study of Depression and Anxiety (NESDA): Rationale, objectives and methods. International Journal of Methods in Psychiatric Research, 17(3), 121–140. https://doi.org/10.1002/mpr.256.CrossRefPubMedGoogle Scholar
- Penninx, B. W. J. H., Nolen, W. A., Lamers, F., Zitman, F. G., Smit, J. H., et al. (2011). Two-year course of depressive and anxiety disorders: Results from the Netherlands Study of Depression and Anxiety (NESDA). Journal of Affective Disorders, 133(1–2), 76–85. https://doi.org/10.1016/j.jad.2011.03.027.CrossRefPubMedGoogle Scholar
- Roberts, J. E., Shapiro, A. M., & Gamble, S. A. (1999). Level and perceived stability of self-esteem prospectively predict depressive symptoms during psychoeducational group treatment. British Journal of Clinical Psychology, 38(4), 425–429. https://doi.org/10.1348/014466599162917.CrossRefPubMedGoogle Scholar
- Robins, L. N., Wing, J., Wittchen, H. U., Helzer, J. E., Babor, T. F., Burke, J., … Regier, D. A. (1988). The composite international diagnostic interview: An epidemiologic instrument suitable for use in conjunction with different diagnostic systems and in different cultures. Archives of General Psychiatry, 45(12), 1069–1077.CrossRefGoogle Scholar
- Rosenberg, M. (1989). Society and the adolescent self-image (revised edition). Middletown: Wesleyan University Press.Google Scholar
- van Tuijl, L. A., Glashouwer, K. A., Bockting, C. L. H., Tendeiro, J. N., Penninx, B. W., et al. (2016). Implicit and explicit self-esteem in current, remitted, recovered, and comorbid depression and anxiety disorders: The NESDA study. PLoS ONE, 11(11), e0166116. https://doi.org/10.1371/journal.pone.0166116.CrossRefPubMedPubMedCentralGoogle Scholar