Self-esteem and Symptoms in Individuals at Clinical High Risk for Psychosis

Abstract

Individuals with psychotic symptoms often report low global self-esteem (GSE). However, it remains unclear whether the low GSE is linked to the presence of psychotic symptoms or it is present before the onset of psychosis. In addition, the specific subdomains of GSE in these populations are unknown. To address this question, we conducted a cross-sectional study comparing global and SE elements among individuals at clinical high risk for psychosis (CHR; n = 36), individuals with schizophrenia (SCZ; n = 43), and healthy controls (HCs; n = 40). We then examined among CHR individuals the association between GSE, subdomains, and symptoms. CHR individuals displayed significantly lower GSE compared to HCs, at a level comparable with those for individuals with SCZ. The low GSE was driven primarily by self-perceptions of work and interpersonal relationships abilities. Lower GSE was associated with overall negative and disorganized symptoms severity, but not positive ones. The authors discuss the implications of the findings to intervention development.

Patient-Reported Outcome Measures in Clinical High Risk for Psychosis: A Systematic Review

“…Six studies measured self-esteem, 3 used the Rosenberg Self-Esteem Scale, 30 , 63 , 64 2 studies used the Self-Esteem Rating Scale 62 (one used the short-form version 65 ) and one study used the Self-Perception Profile for Adults. 66 Across several studies, CHR individuals were found to have lower self-esteem relative to healthy controls, 30 , 62 , 64 , 66 and a longitudinal study reported that self-esteem in CHR did not significantly improve over time. 65 …”

Self‐esteem in individuals at ultra‐high risk for psychosis: A systematic review and meta‐analysis

“…After discarding duplicates, 542 studies were identified in the initial search, 81 articles were read in full. After excluding studies that did not meet eligibility criteria, six papers were included in the meta-analysis (Atkinson et al, 2017;Benavides, Brucato, & Kimhy, 2018;Jongeneel et al, 2018;Park, Bang, Kim, Lee, & An, 2018;Pruessner et al, 2011;Shi et al, 2016). Study details are provided in Table 1.…”

“…The most commonly used scale for assessment of self-esteem was the Rosenberg's Self-Esteem Scale [RSES: (Rosenberg, 1965)], used in three studies (Atkinson et al, 2017;Park et al, 2018;Shi et al, 2016), two studies (Jongeneel et al, 2018;Pruessner et al, 2011) employed the Self-Esteem Rating Scale [SERS; (Nugent & Thomas, 1993)] and one study (Benavides et al, 2018) used the Harter's Self-Perception Profile for Adults [SPPA; (Messer & Harter, 2012)]. The choice of measures is consistent with a recent review noting that the RSES and SPPA are among the most commonly used in published studies (Donnellan, Trzesniewski, & Robins, 2015).…”

“…In contrast, UHR groups in both studies using the SERS (Jongeneel et al, 2018;Pruessner et al, 2011) obtained mean scores that were substantially lower than the suggested cut-off (total score <43) for identifying problematic levels of self-esteem (Nugent & Thomas, 1993), although mean scores in the control group were also below threshold in the study by Jongeneel and colleagues. As we are not aware of any suggested thresholds for the SPPA, it is not possible to determine whether the mean score for UHR participants in the study using this measure (Benavides et al, 2018) is indicative of LSE.…”

Spanish adaptation of the abbreviated form for the Self-Esteem Rating Scale

“…Por todos estos motivos, diferentes autores consideran que el entrenamiento en autoestima debería incluirse en los protocolos de tratamiento de la esquizofrenia (Benavides, Brucato & Kimhy, 2018;Costa et al, 2018), ya que una buena autoestima puede actuar como factor de protección en la evolución de la enfermedad (Benavides et al, 2018;Jongeneel et al, 2018).…”