Abstract
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.
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Notes
We used these cut-offs as these were more readily available within the study. It should be noted that what defines, for example, a depression in remission varies across studies. Frank et al. (1991) recommends that remission be considered as a depression-free period of 2–6 months, with longer than 6 months considered a recovery. Our cut-offs are not too far from this. Cut-offs for ADs are dependent on the type of AD; however we apply the same cut-offs as used for MDD for consistency when comparing the groups and creating comorbid groups.
In the interest of keeping NESDA measurements as concise as possible, two items were selected based on face validity that they related to the conceptual understanding of self-esteem stability, and were not completely overlapping. As such, a positively phrased item and a negatively phrased item were selected. Excluded items were “The extent to which I value myself may vary at different times”, “A certain event can make me value myself more, or less than how much I valued myself before the event”, and “I often switch between ‘feeling extremely positive about myself’ and ‘seeing only the bad things about myself, and feeling like a failure”.
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Acknowledgements
The funding was supported by Nederlandse Organisatie voor Wetenschappelijk Onderzoek (Grant No.: 451-15-026).
Funding
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).
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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.
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All procedures followed were in accordance with the Helsinki Declaration of 1975, as revised in 2000.
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Informed consent was obtained from all patients for being included in the study.
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This article does not contain any studies with animal subjects performed by the any of the authors.
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van Tuijl, L.A., Glashouwer, K.A., Bockting, C.L.H. et al. Self-Esteem Instability in Current, Remitted, Recovered, and Comorbid Depression and Anxiety. Cogn Ther Res 42, 813–822 (2018). https://doi.org/10.1007/s10608-018-9926-5
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DOI: https://doi.org/10.1007/s10608-018-9926-5