A transdiagnostic model of low self-esteem: pathway analysis in a heterogeneous clinical sample

Abstract

Background: Low self-esteem (LSE) has been associated with several psychiatric disorders, and is presumably influenced by transdiagnostic factors. Our study was based both on investigations of the relationship between depression and LSE (vulnerability, scar, reciprocal models) and on theories of cognitive factors contributing to the development and maintenance of LSE, such as Melanie Fennell’s model, the catalyst model and the Self-Regulatory Executive Function model. Aims: Based on the theories above, in our cross-sectional study we aimed at understanding more specifically the transdiagnostic factors that can maintain LSE in a heterogeneous clinical sample. Method: Six hundred and eleven out-patients were assessed by SCID-I and self-report questionnaires. The model was tested by structural equation modelling. Results: Based on the fit indices, the hypothesis model did not fit the data; therefore, a modified transdiagnostic model was emerged. This model made a good fit to the data [χ2 (12, n=611)=76.471, p<.001; RMSEA=.080, CFI=.950, TLI=.913] with a strong explanatory power (adj R2=.636). Severe stressful life events and depressive symptoms lead to LSE indirectly. Self-blame, perfectionism, seeking love and hopelessness have been identified as mediating factors in the relationship between depressive symptoms and LSE. Although there was a significant correlation between state-anxiety and LSE, as well as LSE and rumination, these two factors did not fit into the model. Conclusions: The new transdiagnostic model of LSE has great potential in the treatment of various mental conditions and may serve as a guide to developing more focused and more effective therapeutic interventions.

Low self-esteem: a refined cognitive behavioural model

“…For example, people with negative social connection core beliefs may develop beliefs and associated behaviours relating to compensation in a personal adequacy domain where it feels potentially possible to gain success and respect from others. Kresznerits et al (2021) found that seeking love and perfectionism were significant mediating factors in the relationship between depressive symptoms and low self-esteem. Someone with a minority sexual orientation may believe that although their sexuality is likely to be considered unacceptable to others, they may try to increase their personal achievements in an area that is socially valued, such as at work, sport or a hobby (Pachankis and Hatzenbuehler, 2013).…”

“…Kresznerits et al . (2021) found that seeking love and perfectionism were significant mediating factors in the relationship between depressive symptoms and low self-esteem. Someone with a minority sexual orientation may believe that although their sexuality is likely to be considered unacceptable to others, they may try to increase their personal achievements in an area that is socially valued, such as at work, sport or a hobby (Pachankis and Hatzenbuehler, 2013).…”

The Joys and Sorrows of Parenting: Parental Burnout and Parental Involvement in Chinese and German Parents From a Demands-Resources Perspective

“…In this study, we focused on parents' global self-esteem and assigned it to the resource category of psychosocial characteristics in the demands-resources framework (see Figure 1). The selection of self-esteem was motivated by its etiological role in various clinical affective disorders worldwide, highlighting the need for further research and therapeutic attention (Kresznerits et al, 2022;Zeigler-Hill, 2011). Self-esteem refers to a person's global evaluation of their personal worth (Harter, 1983;Rosenberg, 1979).…”

What if parental love is conditional …? Children’s self-esteem profiles and their relationship with parental conditional regard and self-kindness

“…Self-esteem (SE) is a central issue in the aetiology of various clinical disorders and thus requires significant attention in the context of therapeutic interventions [ 1 , 2 ]. For example, in research on the development of depression, there is substantial empirical support for the vulnerability model, in which low SE is assumed to be the central vulnerability factor in the emergence of rumination and the development of depression [ 3 , 4 ].…”

“…On the other hand, positive self-image acts as a resilience factor and weakens the link between critical life events and depression [ 5 ]. Although the complexity of aetiological models should not be underestimated, it is not only the development of depression that can be traced back to dysfunctional self-image and the individual’s own value attributions: SE also plays a central role in the development of personality and eating disorders, as well as addictive disorders (to name just a few examples; [ 1 , 6 ]). SE manifests itself as early as childhood and adolescence [ 7 , 8 ], during which parents are the most important caregivers for their children and serve as a significant source of resonance.…”