What constitutes vulnerable self-esteem? Comparing the prospective effects of low, unstable, and contingent self-esteem on depressive symptoms

A growing body of longitudinal studies suggests that low self-esteem is a risk factor for depression. However, it is unclear whether other characteristics of self-esteem, besides its level, explain incremental or even greater variance in subsequent depression. We examined the prospective effects of self-esteem level, instability (i.e., the degree of variability in self-esteem across short periods), and contingency (i.e., the degree to which self-esteem fluctuates in response to self-relevant events) on depressive symptoms in 1 overarching model, using data from 2 longitudinal studies. In Study 1, 372 adults were assessed at 2 waves over 6 months, including 40 daily diary assessments at Wave 1. In Study 2, 235 young adults were assessed at 2 waves over 6 weeks, including about 6 daily diary assessments at each wave. Self-esteem contingency was measured by self-report and by a statistical index based on the diary data (capturing event-related fluctuations in self-esteem). In both studies self-esteem level, but not self-esteem contingency, predicted subsequent depressive symptoms. Self-esteem instability predicted subsequent depressive symptoms in Study 2 only, with a smaller effect size than self-esteem level. Also, level, instability, and contingency of self-esteem did not interact in the prediction of depressive symptoms. Moreover, the effect of self-esteem level held when controlling for neuroticism and for all other Big Five personality traits. Thus, the findings provide converging evidence for a vulnerability effect of self-esteem level, tentative evidence for a smaller vulnerability effect of self-esteem instability, and no evidence for a vulnerability effect of self-esteem contingency

Music therapy for children and adolescents with behavioural and emotional problems: a randomised controlled trial.

Background: Although music therapy (MT) is considered an effective intervention for young people with mental health needs, its efficacy in clinical settings is unclear. We therefore examined the efficacy of MT in clinical practice. Methods: Two hundred and fifty-one child (8-16 years, with social, emotional, behavioural and developmental difficulties) and parent dyads from six Child and Adolescent Mental Health Service community care facilities in Northern Ireland were randomised to 12 weekly sessions of MT plus usual care [n = 123; 76 in final analyses] or usual care alone [n = 128; 105 in final analyses]. Follow-up occurred at 13 weeks and 26 weeks postrandomisation. Primary outcome was improvement in communication (Social Skills Improvement System Rating Scales) (SSIS) at 13 weeks. Secondary outcomes included social functioning, self-esteem, depression and family functioning. Results: There was no significant difference for the child SSIS at week 13 (adjusted difference in mean 2.4; 95% CI -1.2 to 6.1; p = .19) or for the guardian SSIS (0.5; 95% CI -2.9 to 3.8; p = .78). However, for participants aged 13 and over in the intervention group, the child SSIS communication was significantly improved (6.1, 95% CI 1.6 to 10.5; p = .007) but not the guardian SSIS (1.1; 95% CI -2.9 to 5.2; p = .59). Overall, self-esteem was significantly improved and depression scores were significantly lower at week 13. There was no significant difference in family or social functioning at week 13. Conclusions: While the findings provide some evidence for the integration of music therapy into clinical practice, differences relating to subgroups and secondary outcomes indicate the need for further study. ISRCTN Register; ISRCTN96352204

The intra-day dynamics of affect, self-esteem, tiredness, and suicidality in Major Depression

Despite growing interest in the temporal dynamics of Major Depressive Disorder (MDD), we know little about the intra-day fluctuations of key symptom constructs. In a study of momentary experience, the Experience Sampling Method captured the within-day dynamics of negative affect, positive affect, self-esteem, passive suicidality, and tiredness across clinical MDD (N= 31) and healthy control groups (N= 33). Ten symptom measures were taken per day over 6 days (N= 2231 observations). Daily dynamics were modeled via intra-day time-trends, variability, and instability in symptoms. MDD participants showed significantly increased variability and instability in negative affect, positive affect, self-esteem, and suicidality. Significantly different time-trends were found in positive affect (increased diurnal variation and an inverted U-shaped pattern in MDD, compared to a positive linear trend in controls) and tiredness (decreased diurnal variation in MDD). In the MDD group only, passive suicidality displayed a negative linear trend and self-esteem displayed a quadratic inverted U trend. MDD and control participants thus showed distinct dynamic profiles in all symptoms measured. As well as the overall severity of symptoms, intra-day dynamics appear to define the experience of MDD symptoms

Relationships between Reading Ability and Child Mental Health: Moderating Effects of Self-Esteem

Objective: Children with reading difficulties are at elevated risk for externalising (e.g., conduct disorder) and internalising (e.g., anxiety and depression) mental health problems. Reading ability is also negatively associated with self-esteem, a consistent predictor of child and adolescent mental health more broadly. This study examined whether self-esteem moderated and/or mediated relationships between reading ability and mental health. Method: One hundred and seventeen children (7-12 years) completed standardised reading assessments (Castles and Coltheart Test 2; CC2) and self-report measures of mental health (Strengths and Difficulties Questionnaire; SDQ) and self-esteem (Coopersmith Self-esteem Inventory). Non-verbal intelligence (IQ) was measured using the block design and matrix reasoning subscales of the Wechsler Abbreviated Scale of Intelligence, and was controlled for in all multivariate analyses. Results: Reading ability was negatively associated with internalising symptoms. This relationship was not moderated by self-esteem. Poor readers also reported more total difficulties and externalising symptoms, but only at low levels of self-esteem. There was no evidence that self-esteem mediated relationships between reading ability and mental health. Conclusions: Poor reading was associated with internalising symptoms. Self-esteem moderated the impact of reading ability on total difficulties and externalising symptoms, with high self-esteem buffering against negative impacts of poor reading. However, the reliability of the self-esteem scale used in the study was poor and findings need replication using a reliable and valid self-esteem measure, as well as other measures of child mental health. If replicated, future research should examine whether interventions aiming to improve self-esteem can reduce the risk of externalising problems in children with reading difficulties

Psychosocial Factors and Chronic Illness as Predictors for Anxiety and Depression in Adolescence

Adolescence is a challenging time when emotional difficulties often arise. Self-esteem, good relationships with peers, and emotional competences can buffer the effects of these difficulties. The difficulties can be even greater when coupled with the presence of a chronic physical illness (CD). Our goal is to analyze psychosocial factors and CD as predictors for anxiety and depression. It was compared the results of structural equation models (SEM) with models based on qualitative comparative analysis (QCA) to analyze the possible influence of these variables on levels of anxiety-depression in adolescents with and without CD. The sample consisted of 681 adolescents, between 12 and 16 years old (M = 13.94, SD = 1.32). 61.50% were girls and 13.40% (n = 222) presented a CD (mainly pneumo-allergic and endocrine). They were evaluated by the Hospital Anxiety and Depression Scale, the Self-esteem Questionnaire, the Emotional Competences Questionnaire and the Strengths and Difficulties Questionnaire. The results obtained by SEM show that low self-esteem, problems with peers and low emotional competencies predict anxiety in 41% of the variance and depression in 72%. The results obtained by QCA show that the different combinations of these variables explain between 24 and 61% of low levels of anxiety and depression and 47-55% of high levels. Our data show how the presence of a CD, low self-esteem, problems with peers and problems in emotional skills play a fundamental role in explaining levels of anxiety and depression. These aspects will help provide increased resources for emotional adjustment in the educational context, facilitating the transitions to be made by adolescents

Facing Anxiety, Growing Up. Trait Emotional Intelligence as a Mediator of the Relationship Between Self-Esteem and University Anxiety

The current study analyzed how trait emotional intelligence (trait EI) mediates the relationship between self-esteem and state anxiety and trait anxiety. The sample was composed of 153 undergraduate students from the University of Cádiz, Spain (71.9% women and 28.1% men). Students completed measures of self-esteem, state anxiety, trait anxiety, and trait EI. Mediation analyses were completed with three trait EI dimensions (EA, emotional attention; EC, emotional clarity; and MR, mood repair) as mediating variables, self-esteem as the independent variable, and state anxiety and trait anxiety as the dependent ones. Our results confirmed that self-esteem scores explained and predicted both, state and trait anxiety values (13% for state and 21% for trait anxiety). This explanatory capacity is increased by 8% when accounting for all trait EI dimensions. Considering state anxiety, the results of the direct effects showed that a decrease in their levels is predicted through the increases in the levels of both, self-esteem and MR. Regarding trait anxiety, the results of the direct effects showed that a decrease in their levels is predicted, in addition to an increment of self-esteem and MR values, by an increase of EC and a decrease of EA. Conversely, indirect effects revealed that higher levels of self-esteem were associated with worse scores in EA and worse MR, which in turn would enhance both state and trait anxiety levels. Moreover, regarding trait anxiety higher levels of self-esteem were associated with worse scores in EA and worse EC, therefore increasing trait anxiety levels. As shown, the negative association found between self-esteem and EA becomes a key element. The effect of self-esteem on EA and the influence that the latter had on EC and MR exerts an indirect mediated effect with the power to invert the influence that self-esteem wields on both types of anxiety. In this sense, the apparent protective role of self-esteem changed, turning into a risk factor that promotes higher anxiety values

The role of metacognition in self-critical rumination: an investigation in individuals presenting with low self-esteem

Background: No research, to date, has directly investigated the role of metacognition in self-critical rumination and low self-esteem. Aim: To investigate the presence of metacognitive beliefs about self-critical rumination; the goal of self-critical rumination and its stop signal; and the degree of detachment from intrusive self-critical thoughts. Method: Ten individuals reporting both a self-acknowledged tendency to judge themselves critically and having low self-esteem were assessed using metacognitive profiling, a semi-structured interview. Results: All participants endorsed both positive and negative metacognitive beliefs about self-critical rumination. Positive metacognitive beliefs concerned the usefulness of self-critical rumination as a means of improving cognitive performance and enhancing motivation. Negative metacognitive beliefs concerned the uncontrollability of self-critical rumination and its negative impact on mood, motivation and perception of self-worth. The primary goal of engaging in self-critical rumination was to achieve a better or clearer understanding of a given trigger situation or to feel more motivated to resolve it. However, only four participants were able to identify when this goal had been achieved, which was if the trigger situation were not to occur again. Participants unanimously stated that they were either unable to detach from their self-critical thoughts or could do so some of the time with varying degrees of success. More often than not, though, self-critical thoughts were viewed as facts, would rarely be seen as distorted or biased, and could take hours or days to dissipate. Conclusions: These findings provide preliminary evidence that specific facets of metacognition play a role in the escalation and perseveration of self-critical rumination

Self-harm in young people with perinatal HIV and HIV negative young people in England: cross sectional analysis.

BACKGROUND: Self-harm in adolescents is of growing concern internationally but limited evidence exists on the prevalence of self-harm in those living with HIV, who may be at higher risk of poor mental health outcomes. Therefore our aim was to determine the prevalence and predictors of self-harm among young people with perinatally-acquired HIV (PHIV) and HIV negative (with sibling or mother living with HIV) young people living in England. METHODS: 303 PHIV and 100 HIV negative young people (aged 12-23 years) participating in the Adolescents and Adults Living with Perinatal HIV cohort study completed an anonymous self-harm questionnaire, as well as a number of standardised mental-health assessments. Logistic regression investigated predictors of self-harm. RESULTS: The median age was 16.7 years in both groups, and 40.9% of the PHIV and 31.0% of the HIV negative groups were male. In total 13.9% (56/403) reported having ever self-harmed, with no difference by HIV status (p = 0.089). Multivariable predictors of self-harm were female sex (adjusted odds ratio (AOR) 5.3, (95% confidence interval 1.9, 14.1), p = 0.001), lower self-esteem (AOR 0.9 (0.8, 0.9) per 1 point increase, p < 0.001) and having ever used alcohol (AOR 3.8 (1.8, 7.8), p < 0.001). Self-esteem z-scores for both PHIV and HIV negative participants were 1.9 standard deviations below the mean for population norms. CONCLUSIONS: Self-harm is common among PHIV and HIV negative adolescents in England. Reassuringly however, they do not appear to be at an increased risk compared to the general adolescent population (15-19% lifetime prevalence). The low level of self-esteem (compared to available normative data) in both groups is worrying and warrants further attention

Exploring the Role of Explicit and Implicit Self-Esteem and Self-Compassion in Anxious and Depressive Symptomatology Following Acquired Brain Injury

[EN] Objectives Acquired brain injury (ABI) can lead to the emergence of several disabilities and is commonly associated with high rates of anxiety and depression symptoms. Self-related constructs, such as self-esteem and self-compassion, might play a key role in this distressing symptomatology. Low explicit (i.e., deliberate) self-esteem is associated with anxiety and depression after ABI. However, implicit (i.e., automatic) self-esteem, explicit-implicit self-discrepancies, and self-compassion could also significantly contribute to this symptomatology. The purpose of the present study was to examine whether implicit self-esteem, explicit-implicit self-discrepancy (size and direction), and self-compassion are related to anxious and depressive symptoms after ABI in adults, beyond the contribution of explicit self-esteem. Methods The sample consisted 38 individuals with ABI who were enrolled in a long-term rehabilitation program. All participants completed the measures of explicit self-esteem, implicit self-esteem, self-compassion, anxiety, and depression. Pearson's correlations and hierarchical regression models were calculated. Results Findings showed that both self-compassion and implicit self-esteem negatively accounted for unique variance in anxiety and depression when controlling for explicit self-esteem. Neither the size nor direction of explicit-implicit self-discrepancy was significantly associated with anxious or depressive symptomatology. Conclusions The findings suggest that the consideration of self-compassion and implicit self-esteem, in addition to explicit self-esteem, contributes to understanding anxiety and depression following ABI.Lorena Desdentado is supported by a FPU doctoral scholarship (FPU18/01690) from the Spanish Ministry of Universities. 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The Relation of Pro-Sociality to Self-Esteem: The Mediational Role of Quality of Friendships

The present longitudinal study examined the role of quality of friendship in mediating the relation of pro-sociality to self-esteem over time. Participants were 424 Italian young adults (56% females) assessed at two waves (Mage  = 21.1 at Time 1; Mage  = 25 at Time 2). An autoregressive cross-lagged panel model was used to test the mediational model. Self- and friend-report measures of pro-sociality, quality of friendship, and self-esteem were included in the analyses. Results were in line with the hypothesized paths, with quality of friendship mediating the relation of pro-sociality to later self-esteem above and beyond its high stability. Self-esteem, in turn, predicted pro-sociality 4 years later. Overall, the present findings support the potential benefits of behaving pro-socially for an actor in terms of increased perceived self-worth and also expand previous work by outlining the specific mediational role of the quality of friendships. The theoretical and practical implications of these results are discussed