title: Multi-dimensional self-esteem and magnitude of change in the treatment of anorexia nervosa.
abstract: Self-esteem improvement is one of the main targets of inpatient eating disorder programmes. The present study sought to examine multi-dimensional self-esteem and magnitude of change in eating psychopathology among adults participating in a specialist inpatient treatment programme for anorexia nervosa. A standardised assessment battery, including multi-dimensional measures of eating psychopathology and self-esteem, was completed pre- and post-treatment for 60 participants (all white Scottish female, mean age=25.63 years). Statistical analyses indicated that self-esteem improved with eating psychopathology and weight over the course of treatment, but that improvements were domain-specific and small in size. Global self-esteem was not predictive of treatment outcome. Dimensions of self-esteem at baseline (Lovability and Moral Self-approval), however, were predictive of magnitude of change in dimensions of eating psychopathology (Shape and Weight Concern). Magnitude of change in Self-Control and Lovability dimensions were predictive of magnitude of change in eating psychopathology (Global, Dietary Restraint, and Shape Concern). The results of this study demonstrate that the relationship between self-esteem and eating disorder is far from straightforward, and suggest that future research and interventions should focus less exclusively on self-esteem as a uni-dimensional psychological construct.
authors.affiliation: NHS Tayside Eating Disorders Service/Psychological Therapies Service, Dundee, UK.
authors.forename: Paula
authors.initials: P
authors.lastname: Collin
authors.affiliation: Edinburgh Napier University, Faculty of Health, Life & Social Sciences, Edinburgh, UK; NHS Lothian, Rivers Centre for Traumatic Stress, Edinburgh, UK. Electronic address: t.karatzias@napier.ac.uk.
authors.forename: Thanos
authors.initials: T
authors.lastname: Karatzias
authors.affiliation: NHS Tayside Eating Disorders Service/Psychological Therapies Service, Dundee, UK; Stirling University, School of Natural Sciences, Stirling, UK.
authors.forename: Kevin
authors.initials: K
authors.lastname: Power
authors.affiliation: Edinburgh Napier University, Faculty of Health, Life & Social Sciences, Edinburgh, UK.
authors.forename: Ruth
authors.initials: R
authors.lastname: Howard
authors.affiliation: Priory Hospital Glasgow, Glasgow, UK.
authors.forename: David
authors.initials: D
authors.lastname: Grierson
authors.affiliation: Priory Hospital Glasgow, Glasgow, UK.
authors.forename: Alex
authors.initials: A
authors.lastname: Yellowlees
mesh_terms: D000328:Adult; D000856:Anorexia Nervosa / Q000523:psychology* / Q000628:therapy*; D001068:Feeding and Eating Disorders; D005260:Female; D006801:Humans; D011613:Psychotherapy / Q000379:methods*; D012649:Self Concept; D016896:Treatment Outcome; D055815:Young Adult
keywords: Anorexia nervosa; Inpatient treatment; Self-esteem; Treatment outcome