title: Competitive Memory Training (COMET) for low self-esteem in patients with personality disorders: a randomized effectiveness study.
abstract: BACKGROUND
  Self-esteem is a major concern in the treatment of patients with personality disorders in general. In patients with borderline personality disorder, low self-esteem is associated with factors contributing to suicidal and self-injurious behaviour. At the moment there are no well-proven interventions that specifically target low self-esteem. Recently, a new approach, Competitive Memory Training or COMET, aimed at the enhancement of retrieving beneficial information from memory, appeared to be successful in addressing low self-esteem in different patient populations.
  
  
  OBJECTIVE
  To assess whether COMET for low self-esteem is also an effective intervention for patients with personality disorders.
  
  
  METHODS
  91 patients with personality disorders who were already in therapy in a regular mental health institution were randomly assigned to either 7 group sessions of COMET in addition to their regular therapy or to 7 weeks of ongoing regular therapy. These latter patients received COMET after their “7 weeks waiting period for COMET”. All patients that completed COMET were contacted 3 months later to assess whether the effects of COMET had remained stable.
  
  
  RESULTS
  Compared to the patients who received regular therapy only, patients in the COMET + regular therapy condition improved significantly and with large effect sizes on indices of self-esteem and depression. Significant differential improvements on measures of autonomy and social optimism were also in favour of COMET, but had small to intermediate effect sizes. The therapeutic effects of COMET remained stable after 3 months on three out of the four outcome measures.
  
  
  CONCLUSIONS
  COMET for low self-esteem seems to be an efficacious trans-diagnostic approach that can rather easily be implemented in the treatment of patients with personality disorders.
authors.affiliation: Parnassia-Bavo Psychiatric Centre, The Hague, The Netherlands.
authors.forename: Kees
authors.initials: K
authors.lastname: Korrelboom
authors.forename: Marlies
authors.initials: M
authors.lastname: Marissen
authors.forename: Tanja
authors.initials: T
authors.lastname: van Assendelft
mesh_terms: D000328:Adult; D001244:Association; D001364:Awareness; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D004644:Emotions; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007092:Imagination; D033182:Intention; D007389:Internal-External Control; D008297:Male; D011939:Mental Recall; D008875:Middle Aged; D010554:Personality Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D010555:Personality Inventory / Q000706:statistics & numerical data; D011594:Psychometrics; D011615:Psychotherapy, Group / Q000379:methods*; D055500:Resilience, Psychological; D012153:Retention, Psychology; D012649:Self Concept; D012919:Social Behavior