CBT has been shown to improve self-esteem, and is well established as a treatment for anxiety and depression (both proposed as key maintaining processes within low self-esteem). However, the cognitive model described here, and the treatment program derived from it, have not yet been subject to controlled test. The treatment package may prove difficult to evaluate, given the range of presenting problems among patients with low self-esteem. Nonetheless, it forms part of a cross-diagnostic trial of CBT for eating disorders currently under way (Fairburn, Cooper, & Shafran, 2003).
Research supports a number of elements hypothesized by the model, including:
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The relationship between early experience, subsequent low self-esteem, and a range of psychological difficulties (e.g., Abramson et al., 2002)
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The responsiveness of self-esteem to variations in circumstances (positive and negative life events)
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The degree to which events triggering psychopathology are central to people’s sense of self-worth
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The biases in processing (selection and distortion of incoming information, memory biases) that maintain unhelpful perspectives
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The relationship between anxious predictions, physical symptoms, and maladaptive behavior evident in a range of anxiety disorders
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The reciprocal relationship between self-critical thinking, hopelessness, and depressed mood
Keywords
- low self-esteem
- core beliefs
- rules for living
- anxious predictions
- self-criticism