Self-Esteem and Psychosis: A Pilot Study investigating the Effectiveness of a Self-Esteem Programme on the Self-Esteem and Positive Symptomatology of Mentally Disordered Offenders

Abstract

The importance of self-esteem in the development and maintenance of psychotic experiences has been shown in previous research. However, there has been little research into the role this plays in individuals with psychosis and forensic histories. The current study investigated the effectiveness of a standardized group programme for improving self-esteem in individuals with psychosis living in high security settings. Fifteen participants were included in the group programme and measures were taken to record changes in self-esteem and symptomatology. The results demonstrated significant improvements in self-esteem over the course of the group intervention, with some effects maintained at 3-month follow-up. Improvements in depressed mood were also found. The results demonstrated the effectiveness of a group intervention for self-esteem in individuals with psychosis. The findings of this study, alongside implications for further research, are discussed.

Cognitive factors maintaining persecutory delusions in psychosis: The contribution of depression.

“…One further paper (Lecomte et al, 1999) reported on a trial of a self esteem therapy intervention that was similar to the four reviewed above (Hall & Tarrier, 2003;Knight, Wykes, & Hayward, 2006;Laithwaite et al, 2007;Laithwaite et al, 2009). White et al (2011) reported on a randomised controlled trial of Acceptance and Commitment Therapy (ACT) for emotional dysfunction following psychosis, which was published too late to be included in the above study pool.…”

“…Psychological therapy trials involved longer follow-up periods (up to two years) than pharmacological trials, and the majority found that reductions in depression achieved were paralleled with improvements in positive psychotic symptoms. Most of these had not sought to reduce depression specifically, although four did target self esteem (Hall & Tarrier, 2003;Laithwaite et al, 2009;Laithwaite et al, 2007;Knight et al, 2006 …”

“…All but one of the trials reviewed that achieved reductions in depression by targeting self esteem also reported corresponding reductions in positive psychotic symptoms (Hall & Tarrier, 2003;Laithwaite et al, 2007;Knight et al, 2006). The only trial targeting self esteem that didn't find positive symptom reductions had started with a participant group with already minimal positive symptoms, as mentioned above (Laithwaite et al, 2009).…”

“…As discussed in more detail in Chapter 2, several trials have used self esteem interventions for people with psychosis (Hall & Tarrier, 2003;Knight et al, 2006;Laithwaite et al, 2009;Laithwaite et al, 2007), and most of these achieved concurrent reductions in depression and in positive psychotic symptoms. This convergent evidence supports the proposal that negative beliefs about the self can contribute to the persistence both of depression and of delusional persecutory beliefs.…”

“…The six items of the Self Negative subscale of the Brief Core Schema Scales (BCSS; Fowler et al, 2006) are reproduced in Figure 8.1 to illustrate the content of the measure. symptoms as well as in depression (Hall & Tarrier, 2003;Lecomte et al, 1999;Laithwaite et al, 2009;Laithwaite et al, 2007;Knight et al, 2006). This strengthens the case for a causal effect of schematic beliefs on psychopathology.…”