En Route to Depression: Self-Esteem Discrepancies and Habitual Rumination

The Lexical Association Technique: A randomized controlled trial with breast cancer patients

Low self-esteem is a vulnerability factor for depressive disorders, and the prevention of psychological disorders is essential in cancer patients. The enhancement of self-esteem in breast cancer patients may therefore be an appropriate clinical target. Previous studies have shown the efficacy of the Lexical Association Technique to enhance self-esteem in healthy subjects. This study aims to test the clinical efficacy and acceptability of the Lexical Association Technique on the self-esteem of cancer patients. A double-blind randomized controlled trial was conducted on 63 breast cancer patients during their radiotherapy treatment. Global self-esteem measures were taken using the Rosenberg Self-Esteem Scale before and after the Lexical Association Technique and 1 month after its end. The results showed a significant improvement in global self-esteem in patients immediately after performing the Lexical Association Technique compared to an active control group. However, the positive effects did not last 1 month. These results confirm the efficacy and suitability of the Lexical Association Technique for cancer patients. Avenues of research are proposed to extend the effects of the technique and increase its transdiagnostic applicability.

Trait Depression and Subjective Well-Being: The Chain Mediating Role of Community Feeling and Self-Compassion

Although subjective well-being has been widely discussed as being one of the important indicators of clinical depression, few studies have explored how it relates to trait depression. In particular, increasing the number of positive experiences has long been a potential goal for depression-related clinical interventions, but the mechanisms by which such interventions work in countering depression have been poorly studied. Grounded in the cognitive theory of depression, the current study aimed to address this specific gap by testing the mediating effects of community feeling and self-compassion between trait depression and subjective well-being. A survey of 783 college students found that trait depression was not only able to directly and negatively predict individual subjective well-being but also indirectly predict individual subjective well-being through the mediating role of community feeling and self-compassion alone and through the chain mediating role of self-compassion from community feeling. These findings reveal the internal mechanisms of trait depression that, to some extent, impede subjective well-being and offer certain guiding significance for the self-regulation of interventions for clinical and non-clinical individuals with trait depression.

Association between self-esteem and fear of cancer recurrence in cancer survivors: A cross-sectional study

PURPOSE

There may be a correlation between self-esteem as an important psychological resource for individuals and Fear of cancer recurrence (FCR), but the relationship between the two is unclear. The aim of our investigation was to evaluate the association of FCR and self-esteem in cancer survivors.

METHODS

Cross-sectional sampling was used to select cancer survivors. The study instruments used included: General information questionnaire, Rosenberg Self-Esteem Scale, Perceived Social Support Scale, Fear of Cancer Recurrence Inventory- Shorter Form. We used logistic regression, where models were adjusted considering confounding variables to determine odds ratios (ORs) with 95% confidence intervals (CIs) for the association of FCR with self-esteem.

RESULTS

Between February 2022 to July 2022, we screened 380 participants for eligibility, of whom 348 were included in the study. The percentage of cancer survivors who experienced clinical level of FCR was 73.9% and the self-esteem score was 27.73 ± 3.67 at a moderate level. The Pearson' s correlation coefficient indicated a significant inverse relationship between FCR and self-esteem (p < 0.001; r = -0.375). In a multivariable logistic regression model, FCR still has a negative correlation with self-esteem (OR, 0.812; 95%CI, 0.734-0.898). Subgroup analysis indicated that the correlation between FCR and self-esteem in cancer survivors was nearly the same in various strata, demonstrating its soundness and stability.

CONCLUSIONS

This study confirms that elevated self-esteem in individuals surviving cancer may be a protective factor for FCR. Improving the level of self-esteem in cancer survivors can be one of the important directions of clinical interventions for FCR.

How Should Self-Esteem Be Considered in Cancer Patients?

Numerous studies showed that cancer significantly increases the risk of developing depressive and anxious symptoms. It has been shown that self-esteem is an important psychological resource and is associated with many health behaviors. Furthermore, the vulnerability model of low self-esteem, which has received strong empirical support, highlights that low self-esteem is a real risk factor in the development of depressive disorders. This article aims at providing an overview of the involvement of self-esteem in the psychological adjustment to cancer. After briefly reviewing the literature, we suggest that its implication in the development of depressive disorders and its association with coping strategies and social support in cancer patients justify the consideration of self-esteem in oncology psychological care, especially in young adult patients and those with significant physical impairment following treatment.

Discrepant negative self-associations as a risk factor for depressive deterioration after outpatient psychotherapy

BACKGROUND AND OBJECTIVES

This paper examines the discrepancy between implicit and explicit negative self-associations (NSA) after cognitive psychotherapy for depression as a predictor of long-term outcome.

METHODS

One hundred and twenty patients completed an Implicit-Association Test relating the self with depressive attributes and a self-report questionnaire with identical item content, at the end of time-limited outpatient depression psychotherapy. At post-treatment and at 3-, 6-, and 12-month follow-up, patients completed the BDI-II. We used different strategies to operationalized implicit and explicit NSA discrepancies and three-level Hierarchical linear models to analyze the effects.

RESULTS

We found significant interactive effects of discrepancy between implicit and explicit NSA and the direction of the discrepancy on long-term outcome. In patients with a greater explicit than implicit NSA (a damaged self-esteem pattern) a greater absolute discrepancy was associated with worse long-term outcome in terms of BDI scores at the end of follow-up and rate of change during follow-up. Consistently, with an alternative method, we found that damaged self-esteem discrepancies were associated with worse estimated BDI-II scores at the end of follow-up.

LIMITATIONS

The inclusion in the sample of only treatment completers limits the generalizability of the results. Furthermore, the follow-up period captured only the first 12 months after treatment.

CONCLUSIONS

Our results support the notion that a discrepancy between implicit and explicit negative self-associations may pose a risk factor for deterioration after psychotherapy for depression.

Death thoughts predict increased depression for those with low self-worth

Terror management theory specifies that a sense of self-worth is necessary to prevent the awareness of death from undermining psychological well-being. We tested the theory's claims about well-being within the context of depression, by measuring self-worth, death-thought accessibility, and depression in an online study (N = 365). Consistent with the theory, death-thought accessibility predicted increased depression, but only among those with low, not high, self-worth. Our findings support existential clinical theorists' claims for psychological therapies to appreciate the underlying reasons for the need for self-worth.

Low Chronic Self-Esteem and Low Situational Self-Esteem: a literature review

OBJECTIVE

to develop a literature review about low self-esteem and components of the nursing diagnoses Low Chronic Self-Esteem and Low Situational Self-Esteem in patients with depressed mood.

METHOD

an integrative literature review carried out in the Pubmed portal and in the Scopus and Web of Science electronic bibliographic databases. Depression and self-esteem descriptors were used, resulting in 32 articles.

RESULTS

literature indicated 7 clinical indicators and 14 etiological factors for low self-esteem.

CONCLUSION

The clinical indicators Suicidal ideation and Ineffective treatment were more prevalent in the study. The etiological factors Stressful events and Stigmatization were the most frequent, both of which were suggested as new related factors for low self-esteem. Nursing diagnosis recognition can contribute to intervention strategy elaboration by the nurse, according to the urgent diagnostic and the individual's particularities.

Emotionally aligned: Preliminary results on the effects of a mindfulness-based intervention for depression on congruence between implicit and explicit mood

BACKGROUND

Mindfulness-based interventions (MBIs) are effective in treating major depression. Because mindfulness involves monitoring and accepting current experiences, it may lead people resolve incongruencies between emotional responses that would otherwise remain unnoticed. Mindfulness may thus foster congruence between implicit and explicit emotions. The current randomized controlled trial tested this notion.

METHODS

N = 39 patients with an acute depressive episode were randomly assigned to an 8-week MBI (n = 24) or a psychopharmacological consultation condition (n = 15). Explicit and implicit mood and depressive symptoms were assessed before treatment and at the end of treatment.

RESULTS

Compared with the control condition, patients receiving MBI demonstrated higher congruence between implicit and explicit negative mood after treatment. There was no such difference in congruence of implicit and explicit positive mood. Additional analyses showed that only within the MBI group, individual differences in explicit mood became less stable. In contrast, individual differences in implicit mood remained stable in both groups.

LIMITATIONS

There was no control group including an active psychological intervention, the sample was small, and emotional congruence was not assessed within persons.

CONCLUSIONS

These findings correspond with the idea that mindfulness reduces incongruencies between implicit and explicit emotional responses. We found preliminary evidence for this effect for negative emotional responses. There was suggestive evidence that congruence arose from the alignment of explicit responses (which became less stable) to implicit responses (which remained stable). Studying the interplay between implicit and explicit processes may shed light on the working mechanisms of clinical-psychological interventions.

Self-esteem consistency predicts the course of therapy in depressed patients

Previous studies on self-esteem and depression demonstrated the usefulness of both implicit and explicit self-esteem as well as their congruence (also known as self-esteem consistency) to predict future depressive symptoms. High self-esteem consistency describes when implicit and explicit self-esteem match (e.g., both high or both low). In the current study, we investigated if implicit and explicit self-esteem and self-esteem consistency predict the course of treatment efficacy of a cognitive behavioral depression therapy. Explicit self-esteem was assessed by the Rosenberg Self-Esteem Scale, implicit self-esteem by a priming task. Participants were 31 patients with a major depressive or recurrent depressive disorder receiving cognitive behavioral therapy treatment in an inpatient setting. Self-esteem measures were administered before treatment. The development of depression symptoms during treatment and at the 4-month follow-up was measured on the Beck Depression Inventory. Implicit and explicit self-esteem did not predict the course of the therapy. Patients with congruent self-esteem, however, improved faster and showed lower severity of symptoms throughout treatment. In contrast, neither explicit nor implicit self-esteem nor self-esteem consistency predicted the stability of effects after treatment. Practical implications such as targeting discrepancies in self-esteem during treatment are discussed.

Implicit and explicit self-esteem in remitted depressed patients

BACKGROUND AND OBJECTIVES

Low self-esteem is a symptom of depression and depression vulnerability. Prior research on self-esteem has largely focused on implicit (ISE) and explicit self-esteem (ESE) as two separate constructs, missing their interaction. Therefore, the current study investigated the interaction between ISE and ESE in a depression-vulnerable group (remitted depressed patients; RDs), compared to never-depressed controls (ND).

METHODS

Seventy-five RDs and 75 NDs participated in the study. To measure ESE, the Rosenberg Self-Esteem Scale (RSES) was used. The Implicit Association Test (IAT) and the Name Letter Preference Task (NLPT) were used to assess ISE.

RESULTS

RDs reported lower ESE than NDs. However, the two groups did not differ on ISE. RDs exhibited a damaged self-esteem or a low-congruent self-esteem, similar to what has been found in currently depressed patients. Moreover, damaged self-esteem was associated with residual depressive symptoms.

LIMITATIONS

The results need to be interpreted with care because the IAT and NLPT did not reveal the same associations with the clinical measures.

CONCLUSIONS

Implicit and explicit self-esteem may be different constructs in depression and studying the combination is important. The present study provides evidence indicating that damaged self-esteem may be more detrimental than low congruent self-esteem.