Psychological Disorders
Conditions
Keywords
low self esteem, cognitive behavioural therapy, metacognitive therapy, depressive symptoms, anxiety symptoms
Brief summary
The goal for this clinical trial is to explore the effect of CBT/MCT on the treatment of low self esteem. 20 patients with low self-esteem will be selected and distributed into two either MCT or a CBT We aim in this study to (1) evaluate the accessibility and effectiveness of MCT and CBT in treating low self-esteem, (2) investigate the patterns of change and the mechanisms of action involved during treatment, and (3) examine the impact of meta-cognitions and neuropsychologial processes in the treatment response and any relapse prevention of low self-esteem.
Detailed description
The association between low self-esteem and psychiatric disorders indicates that low self-esteem is an important transdiagnostic construct. People who report having a low self-esteem seem to experience more mental health problems and a reduction in quality of life. There have been a few trials considering the effect of Cognitive Behavioural Therapy (CBT) for low self-esteem, however, there are few randomized controlled studies. Recently, Meta Cognitive Therapy (MCT) has been introduced as a new, specific treatment for MDD, showing promising and lasting results. This treatment approach also has proven more effective than CBT for GAD or worry disorder. So far, no study has examined MCT for low self-esteem in a randomized controlled trial. For the present clinical trial, 20 patients with low self-esteem will be selected and distributed into two treatment conditions. The first group (n=10) will be treated with MCT, whereas the second group (n = 10) will be treated with CBT. The patients will be assessed with different outcome measures at pre-treatment, at the end of treatment, and at six months follow up. In addition, they will also be assessed weekly using various measures. We aim in this study to (1) evaluate the accessibility and effectiveness of MCT and CBT in treating low self-esteem, (2) investigate the patterns of change and the mechanisms of action involved during treatment, and (3) examine the impact of meta-cognitions and neuropsychologial processes in the treatment response and any relapse prevention of low self-esteem.
Interventions
BEHAVIORALCognitive behavioral therapy
The CBT is based on the treatment manual written by Fennell (1997). The patients receiving CBT will be treated for 8 sessions, with weekly session of 45-60 minutes duration.
BEHAVIORALMetacognitive therapy
The meta-cognitive treatment program is based on Wells's metacognitive therapy (Wells, 2013). The patients receiving meta-cognitive therapy will be treated for 8 sessions, with weekly session of 45-60 minutes duration.
Sponsors
Norwegian University of Science and Technology
University of Oslo
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
The first group (n=10) will be treated with MCT, whereas the second group (n = 10) will be treated with CBT
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Signed written informed consent obtained prior to entry in the study. 2. Scores below 15 on the Rosenberg Self-esteem Scale (RSE) 3. 18 years or older.
Exclusion criteria
1. Psychosis 2. Bipolar type 1 3. Current suicide intent 4. PTSD 5. Cluster A or cluster B personality disorder 6. Substance dependence
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Rosenberg Self Esteem Scale | Baseline scores each week over two weeks before pre-treatment, pre-treatment, each session each week over 8 weeks , post-treatment (8 weeks), and six months follow up | The purpose of the 10 item RSE scale is to measure self-esteem.The scale ranges from 0-30. Scores between 15 and 25 are within normal range; scores below 15 suggest low self-esteem |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| GAD-7 | Baseline scores each week over two weeks before pre-treatment, pre-treatment, each session each week over 8 weeks, post-treatment (8 weeks) and six months follow up | The Generalised Anxiety Disorder Assessment (GAD-7) is a seven-item instrument that is used to measure or assess the severity of generalised anxiety disorder (GAD). Each item asks the individual to rate the severity of his or her symptoms over the past two weeks. Response options include not at all, several days, more than half the days and nearly every day. Scores of 5, 10, and 15 are taken as the cut-off points for mild, moderate and severe anxiety, respectively. |
| PHQ-9 | Baseline scores each week over two weeks before pre-treatment, pre-treatment, each session each week over 8 weeks , post-treatment (8 weeks) and six months follow up | The PHQ-9 is a multipurpose instrument for screening, diagnosing, monitoring and measuring the severity of depression. Total scores of 5, 10, 15, and 20 represent cutpoints for mild, moderate, moderately severe and severe depression, respectively |
Other
| Measure | Time frame | Description |
|---|---|---|
| Robson Self Concept Questionnaire | Pre-, post-treatment (8 weeks) and six months follow up after treatment | The SCQ is a self-report scale measuring self-esteem. It consists of 30 items (e.g., I have control over my life, I feel emotionally mature, I can like myself even if others don't.It consists of 30 statements to which respondents indicate their level of agreement on a 7-point scale. The typical mean score in control samples being around 140 with a standard deviation of 20. |
| Metacognitive Questionnaire-30 | Pre-, post-treatment (8 weeks) and six months follow up after treatment | The Metacognitions Questionnaire 30- (MCQ-30) \[7\] assesses metacognitive beliefs and processes. It comprises five subscales: 'Positive beliefs about worry'; 'Negative beliefs about worry'; 'Cognitive confidence'; 'Need to control thoughts'; and 'Cognitive self-consciousness.Each item is scored on a 4-point scale ranging from 1 (do not agree) to 4 (agree very much). Higher scores reflect more dysfunction with the item in question |
| BRIEF-A | Pre-, post-treatment (8 weeks) and six months follow up after treatment | The BRIEF-A is composed of 75 items within nine theoretically and empirically derived clinical scales that measure various aspects of executive functioning; Inhibit, Self-Monitor, Plan/Organise, Shift, Initiate,, Task Monitor, Emotional Control, Working Memory, Organisation of Materials. The clinical scales form two broader indexes: Behavioral Regulation (BRI) and Metacognition (MI), and these indexes form the overall summary score, the Global Executive Composite (GEC). The BRIEF- A also includes three validity scales (Negativity, Inconsistency, and Infrequency). All 75 items are rated in terms of frequency on a 3-point scale: 0 (never), 1 (sometimes), 2 (often). Raw scores for each scale are summed and T scores (M = 50, SD = 10) are used to interpret the individual's level of executive functioning. |
| Penn State Worry Questionnaire | Pre-, post-treatment (8 weeks) and six months follow up | The PSWQ is a 16-item self-report scale designed to measure the trait of worry in adults. Worry is regarded as a dominant feature of generalised anxiety disorder (GAD). The scale measures the excessiveness, generality, and uncontrollable dimensions of worry.cores range from 16 to 80 with higher scores indicative of higher levels of trait worry. Scores can be in the following severity ranges. 29 or less: Not anxious or a worrier 30-52: Bothered by worries but below clinical range for worry 52-65: Currently have some problems with worry and may benefit from treatment 66 or more: Chronic worrier and in need of treatment to target this problem |
| CANTAB Spatial Working Memory | Pre-, post-treatment (8 weeks) and six months follow up after treatment | The test examines the ability to remember and manipulate visuospatial information |
| CANTAB Stop Signal Task | Pre-, post-treatment (8 weeks) and six months follow up after treatment | The test examines the ability to stop a response (response inhibition). |
| CANTAB Intra-Extra Dimensional Set Shift | Pre-, post-treatment (8 weeks) and six months follow up after treatment | The test investigates the processes involved in categorizing stimuli into sets (visual discrimination of shapes vs. lines) and flexible response (shifting of attention) to changes in stimuli. |
| Inventory of Interpersonal Problems (IIP-64) | Pre-, post-treatment (8 weeks) and six months follow up after treatment | The Inventory of Interpersonal Problems (IIP) is a self-report instrument that identifies a person's most salient interpersonal difficulties.The questionnaire is divided into two parts. The first part consists of statements about behavior inhibitions commenced 'It's hard for me to…' and the second part includes items that focus on behavioral excesses, 'Things that I do too much…'. The participant responds to the items on a 5-point Likert scale, ranging from 0 = 'Not at all' to 4 = 'Extremely'. Higher scores indicate more interpersonal distress. The items are grouped into eight subscales (with eight items each) corresponding to the octants in the interpersonal circumplex: domineering/controlling (PA), vindictive/self-centered (BC), cold/distant (DE), socially inhibited (FG), non-assertive (HI), overly accommodating (JK), self-sacrificing (LM) and intrusive/needy (NO). |
| Ruminative Response Scale | Pre-, post-treatment (8 weeks) and six months follow up after treatment | The RRS was developed to more directly and reliably assess rumination that is related to, but not confounded by depression. The 22 items of the RRS measure two aspects of rumination, brooding and reflective pondering.The total score ranges from 22-88, with higher scores indicating increased tendency to ruminate. |
Countries
Norway
Contacts
Primary ContactRoger Hagen, Professor
Backup ContactLeif Edward Ottesen Kennair, Professor
Outcome results
None listed