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The Dynamics of Self-Esteem in Cognitive Therapy for Avoidant and Obsessive–Compulsive Personality Disorders: An Adaptive Role of Self-Esteem Variability?

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Abstract

Self-esteem variability is often associated with poor functioning. However, in disorders with entrenched negative views of self and in a context designed to challenge those views, variable self-esteem might represent a marker of change. We examined self-esteem variability in a sample of 27 patients with Avoidant and Obsessive–Compulsive Personality Disorders who received Cognitive Therapy. A therapy coding system was used to rate patients’ positive and negative views of self expressed in the first ten sessions of a 52-week treatment. Ratings of negative (reverse scored) and positive view of self were summed to create a composite score for each session. Self-esteem variability was calculated as the standard deviation of self-esteem scores across sessions. More self-esteem variability predicted more improvement in personality disorder and depression symptoms at the end of treatment, beyond baseline and average self-esteem. Early variability in self-esteem, in this population and context, appeared to be a marker of therapeutic change.

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Notes

  1. We use the term variability, because larger standard deviations indicate more variability. This index has also been labeled self-esteem lability or stability by others.

  2. In addition, we examined self-esteem variability as a predictor of personality symptoms and depression over and above baseline levels of self-esteem. In these models, self-esteem variability remained a significant predictor of both personality and depressive symptoms.

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Acknowledgments

This research was supported by National Institute of Mental Health grant R21MH062662 awarded to Adele M. Hayes.

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Authors and Affiliations

  1. Department of Psychology, University of Saskatchewan, Saskatoon, SK, Canada

    Jorden A. Cummings

  2. Department of Psychology, University of Delaware, Newark, DE, 19716, USA

    Adele M. Hayes

  3. Department of Psychology, LaSalle University, Philadelphia, PA, USA

    LeeAnn Cardaciotto

  4. Center for Cognitive Therapy, University of Pennsylvania, Philadelphia, PA, USA

    Cory F. Newman

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  1. Jorden A. Cummings
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  2. Adele M. Hayes
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Correspondence to Adele M. Hayes.

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Cummings, J.A., Hayes, A.M., Cardaciotto, L. et al. The Dynamics of Self-Esteem in Cognitive Therapy for Avoidant and Obsessive–Compulsive Personality Disorders: An Adaptive Role of Self-Esteem Variability?. Cogn Ther Res 36, 272–281 (2012). https://doi.org/10.1007/s10608-011-9375-x

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