Bridge Livia, Langford Katie, McMullen Katrina, Rai Lovedeep, Smith Patrick, Rimes Katharine A
Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Clin Psychol Psychother. 2023 Sep 13. doi: 10.1002/cpp.2911.
Low self-esteem can impair daily functioning and is a risk or maintenance factor for several mental health problems. Sexual minority young adults, for example, those identifying as lesbian, gay or bisexual, on average have lower self-esteem than their heterosexual peers. Compassion-based interventions for low self-esteem might be especially beneficial for sexual minority young adults, whose higher levels of shame and self-criticism are likely to be contributing to maintenance of their low self-esteem. This study explored the acceptability, feasibility and preliminary efficacy of a new compassion-based cognitive behavioural intervention for low self-esteem tailored to sexual minority young adults. Participants were a community sample of 24 sexual minority young adults aged 16-24 experiencing clinically significant low self-esteem. An uncontrolled pre-/post-design was used with qualitative feedback and quantitative outcomes. Self-report standardised measures were completed at baseline, pre-intervention, intervention mid-point, post-intervention and 2-month follow up. Preliminary efficacy was examined through post-intervention changes in self-esteem, functioning, anxiety and depression. Potential mechanisms of change were examined through changes in self-compassion, self-criticism and unhelpful coping responses to minority stress. Results showed good acceptability and feasibility and preliminary evidence of intervention efficacy for improving self-esteem, functioning, depression and anxiety. There was evidence for improvement in self-compassion and reduction in self-criticism, and these constructs could be investigated in future studies as treatment mediators. Randomised controlled studies are needed to further examine efficacy of the intervention.
低自尊会损害日常功能，并且是多种心理健康问题的风险因素或维持因素。例如，性少数青年，即那些认同自己为女同性恋、男同性恋或双性恋的人，平均自尊水平低于异性恋同龄人。针对低自尊的基于同情的干预措施可能对性少数青年特别有益，他们较高水平的羞耻感和自我批评可能导致其低自尊的持续存在。本研究探讨了一种专门为性少数青年量身定制的基于同情的新型认知行为低自尊干预措施的可接受性、可行性和初步疗效。参与者是来自社区的24名年龄在16至24岁之间、临床上存在显著低自尊的性少数青年。采用了非对照的前/后设计，并结合定性反馈和定量结果。在基线、干预前、干预中期、干预后和2个月随访时完成自我报告标准化测量。通过干预后自尊、功能、焦虑和抑郁的变化来检验初步疗效。通过自我同情、自我批评的变化以及对少数群体压力的无益应对反应来检验潜在的变化机制。结果显示出良好的可接受性和可行性，以及干预对改善自尊、功能、抑郁和焦虑疗效的初步证据。有证据表明自我同情得到改善，自我批评减少，这些构念可在未来研究中作为治疗调节因素进行调查。需要进行随机对照研究以进一步检验该干预措施的疗效。
