Self-esteem is associated with premorbid adjustment and positive psychotic symptoms in early psychosis

Kristin Lie Romm,Ole A Andreassen,Elisabeth Haug,Charlotte Fredslund Hansen,Jan Ivar Rossberg,Ingrid Melle

doi:10.1186/1471-244x-11-136

Kristin Lie Romm, Ole A Andreassen + Show 4 more

Open Access

https://doi.org/10.1186/1471-244x-11-136

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Abstract

BackgroundLow levels of self-esteem have been implicated as both a cause and a consequence of severe mental disorders. The main aims of the study were to examine whether premorbid adjustment has an impact on the subject's self-esteem, and whether lowered self-esteem contributes to the development of delusions and hallucinations.MethodA total of 113 patients from the Thematically Organized Psychosis research study (TOP) were included at first treatment. The Positive and Negative Syndrome Scale (PANSS) was used to assess present symptoms. Premorbid adjustment was measured with the Premorbid Adjustment Scale (PAS) and self-esteem by the Rosenberg Self-Esteem Scale (RSES).ResultsPremorbid social adjustment was significantly related to lower self-esteem and explained a significant proportion of the variance in self-esteem. Self-esteem was significantly associated with the levels of persecutory delusions and hallucinations experienced by the patient and explained a significant proportion of the variance even after adjusting for premorbid functioning and depression.ConclusionThere are reasons to suspect that premorbid functioning is an important aspect in the development of self- esteem, and, furthermore, that self-esteem is associated with the development of delusions and hallucinations.

Highlights

Low levels of self-esteem have been implicated as both a cause and a consequence of severe mental disorders
Self-esteem was significantly associated with the levels of persecutory delusions and hallucinations experienced by the patient and explained a significant proportion of the variance even after adjusting for premorbid functioning and depression
There are reasons to suspect that premorbid functioning is an important aspect in the development of self- esteem, and, that self-esteem is associated with the development of delusions and hallucinations

Summary

Introduction

Low levels of self-esteem have been implicated as both a cause and a consequence of severe mental disorders. Average or trait level of self-esteem, while their momentary, or ‘state’, judgments of self-esteem can fluctuate around this level dependent on social feed-back and selfjudgment It is the person’s interpretation of the event or circumstance, and its relevance to his or her contingencies of self-worth, that determines both if and how strongly it will affect state self-esteem [12,13]. It appears that treatment failures, functional loss, demoralization and stigmatization may lower self-esteem in patients with severe mental illnesses. This is of importance both for the understanding of the mechanisms behind the development of psychotic symptoms and for improving treatment as self-esteem can be influenced by therapeutic interventions [14,15]

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