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01-12-2018 | Original Article

Self-Esteem Instability in Current, Remitted, Recovered, and Comorbid Depression and Anxiety

Authors: Lonneke A. van Tuijl, Klaske A. Glashouwer, Claudi L. H. Bockting, Brenda W. J. H. Penninx, Peter J. de Jong

Published in: Cognitive Therapy and Research | Issue 6/2018

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.

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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Title: Self-Esteem Instability in Current, Remitted, Recovered, and Comorbid Depression and Anxiety
Authors: Lonneke A. van Tuijl
Klaske A. Glashouwer
Claudi L. H. Bockting
Brenda W. J. H. Penninx
Peter J. de Jong
Publication date: 01-12-2018
Publisher: Springer US
Published in: Cognitive Therapy and Research / Issue 6/2018
Print ISSN: 0147-5916
Electronic ISSN: 1573-2819
DOI: https://doi.org/10.1007/s10608-018-9926-5

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Self-Esteem Instability in Current, Remitted, Recovered, and Comorbid Depression and Anxiety

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