Evaluation of expressed self-contempt in psychotherapy: an exploratory study

Abstract

ABSTRACT Self-contempt may be a frequent but overlooked clinical phenomenon, associated with a number of psychological problems such as increased sadness and shame. It was shown that self-contempt interferes with productive emotional processing and the quality of therapeutic alliance. This study aims to develop a reliable measure of expressed self-contempt given that a previous three-point assessment may be too restrictive in range, resulting in non-significant results. Thus, the present study applied an extended observer-rated scale to different participant groups in different contexts. This explorative phase focuses on a sample of N = 61 participants divided into three groups, including n = 20 controls, n = 21 patients with a diagnosis of borderline personality disorderand n = 20 patients with a diagnosis of major depressive disorder. Levels of self-contempt are compared between the groups and are associated with symptom indicators. Reliability of the instrument is analysed using inter-rater reliability and internal consistency, which are sufficient. The level of expressed self-contempt is not related to symptom intensity. Patients with borderline personality disorder do not express more self-contempt than the other groups. While further research should establish full validity of the scale, reliability is satisfactory and the use of the scale can be recommended.