A transdiagnostic model of low self-esteem: pathway analysis in a heterogeneous clinical sample

Background: Low self-esteem (LSE) has been associated with several psychiatric disorders, and is presumably influenced by transdiagnostic factors. Our study was based both on investigations of the relationship between depression and LSE (vulnerability, scar, reciprocal models) and on theories of cognitive factors contributing to the development and maintenance of LSE, such as Melanie Fennell’s model, the catalyst model and the Self-Regulatory Executive Function model. Aims: Based on the theories above, in our cross-sectional study we aimed at understanding more specifically the transdiagnostic factors that can maintain LSE in a heterogeneous clinical sample. Method: Six hundred and eleven out-patients were assessed by SCID-I and self-report questionnaires. The model was tested by structural equation modelling. Results: Based on the fit indices, the hypothesis model did not fit the data; therefore, a modified transdiagnostic model was emerged. This model made a good fit to the data [χ2 (12, n=611)=76.471, p<.001; RMSEA=.080, CFI=.950, TLI=.913] with a strong explanatory power (adj R2=.636). Severe stressful life events and depressive symptoms lead to LSE indirectly. Self-blame, perfectionism, seeking love and hopelessness have been identified as mediating factors in the relationship between depressive symptoms and LSE. Although there was a significant correlation between state-anxiety and LSE, as well as LSE and rumination, these two factors did not fit into the model. Conclusions: The new transdiagnostic model of LSE has great potential in the treatment of various mental conditions and may serve as a guide to developing more focused and more effective therapeutic interventions.

An Emotional Neglect–Personality Disorder Approach: Quantifying a Dimensional Transdiagnostic Model of Trauma-Related and Personality Disorders

Are personality disorders (PDs) associated with emotional neglect? Draijer (2003) developed a dimensional model of trauma-related disorders and PD. The first dimension consists of the severity of the trauma endured. The second dimension consists of emotional neglect, which is assumed to be related primarily to personality pathology. In this article, we investigate whether an association between retrospective reports of emotional neglect and the presence and severity of PD exists. A sample of 150 patients was systematically assessed. Results indicate that there is little evidence to support a link between emotional neglect and problematic personality functioning at the disorder level; however, there might be a link between emotional neglect and problematic personality functioning in a dimensional way. Findings indicate a relationship between lack of parental warmth and problematic personality functioning, supporting the existence of the emotional neglectaxis of the proposed model in a dimensional framework of viewing personality pathology.

From Text to Therapy: Dealing with Anxiety Conceptual Integration Based on Philippians 4:5–9

A heuristic derived from an appeal to Scripture as an epistemological source of data is proposed, from which principles are extracted and interpreted, and integrated with psychological theory and research. It represents an effort to expand the utilization of conceptual integration in the domain of Christian counseling in particular. A key text is drawn from the apostle Paul’s letter to first-century Christians (Philippians 4:5–9) in view of its relevance in treating anxious conditions from a transdiagnostic perspective. The distinction is made between the scriptural use of the construct “anxiety” in the neo-testamentary context and present-day definitions framed in DSM-5 terms. The authors postulate the need to develop a faith-based heart-mindset, entrained and anchored in God—a relational subject and love object—that may provide a believer with intrinsic assurance of God’s peace that “surpasses understanding” and empowers their mindful, metacognitive-executive control system, potentiating an adaptive coping process. This approach draws from CBT, MC, and ACT principles, and resonates with Barlow’s transdiagnostic model in particular. An integrated, emergent dimension is introduced—“perichoretic thirdness”—defined in theological-psychological terms, where reliance on God’s transcending/immanent, coparticipatory presence empowers the metacognitive-executive feedforward control system of a believer in enacting purposive, adaptive responses vs. anxiety.