Multi-dimensional self-esteem and magnitude of change in the treatment of anorexia nervosa
Open accessAbstract
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.
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The finding that people with AN strongly endorse a negative problem orientation and have a weaker positive problem orientation mirrors the low levels of self-confidence and self-esteem common in people with AN.
“The finding that people with AN strongly endorse a negative problem orientation and have a weaker positive problem orientation mirrors the low levels of self‐confidence and self‐esteem common in people with AN (Collin et al., 2016).”
From Do anxiety, depression, and intolerance of uncertainty contribute to social problem solving in adult women with anorexia nervosa? (2020) · cites this paper as Collin et al., 2016
Cites
Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,841 · see citing works
Controlling the False Discovery Rate: A Practical and Powerful Approach to Multiple Testing
Benjamini, Y., & Hochberg, Y. (1995) · Journal of the Royal Statistical Society Series B: Statistical Methodology · doi:10.1111/j.2517-6161.1995.tb02031.x · Cited by 109,482 · see citing works
Tabachnick, B. G., & Fidell, L. S. (1983) · Cited by 79,888 · see citing works
Structured Clinical Interview for DSM-IV Axis I Disorders
Spitzer, R. L., First, M. B., & Gibbon, M. (1997) · Medical Entomology and Zoology · Cited by 3,582 · see citing works
Diagnostic and Statistical Manual of Mental Disorders
Siegel, L. J., & Fletcher‐Janzen, E. (2014) · Wiley eBooks · doi:10.1002/9781118660584.ese0728 · Cited by 3,438 · see citing works
Blascovich, J., & Tomaka, J. (1991) · Measures of Personality and Social Psychological Attitudes · doi:10.1016/b978-0-12-590241-0.50008-3 · Cited by 1,833 · see citing works
Cooper, Z., & Fairburn, C. G. (1987) · International Journal of Eating Disorders · doi:10.1002/1098-108x(198701)6:1 · Cited by 1,367 · see citing works
Measures of Personality and Social Psychological Attitudes:
Jordan, R. P. (1992) · Behavioral & Social Sciences Librarian · doi:10.1300/j103v11n02_05 · Cited by 1,360 · see citing works
Lobbestael, J., Leurgans, M., & Arntz, A. (2011) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.693 · Cited by 1,124 · see citing works
Handbook of treatment for eating disorders
(1997) · Choice Reviews Online · doi:10.5860/choice.35-2151 · Cited by 1,074 · see citing works
Enhancing motivation for change in treatment-resistant eating disorders
Vitousek, K. M., Watson, S., & Wilson, G. T. (1998) · Clinical Psychology Review · doi:10.1016/s0272-7358(98)00012-9 · Cited by 721 · see citing works
Tafarodi, R. W., & Swann Jr., W. B. (1995) · Journal of Personality Assessment · doi:10.1207/s15327752jpa6502_8 · Cited by 714 · see citing works
Risk Factors for Anorexia Nervosa
Fairburn, C. G., Cooper, Z., Doll, H., & Welch, S. L. (1999) · Archives of General Psychiatry · doi:10.1001/archpsyc.56.5.468 · Cited by 612 · see citing works
Personality variables and disorders in anorexia nervosa and bulimia nervosa.
Vitousek, K. M., & Manke, F. P. (1994) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.103.1.137 · Cited by 451 · see citing works
A cognitive-behavioral approach to anorexia nervosa
Garner, D. M., & Bemis, K. M. (1982) · Cognitive Therapy and Research · doi:10.1007/bf01183887 · Cited by 429 · see citing works
Predictors of Treatment Acceptance and Completion in Anorexia Nervosa
Halmi, K. A., Agras, W. S., Crow, S. J., Mitchell, J. D., Wilson, G. T., Bryson, S. W., & KRAEMER, H. C. (2005) · Archives of General Psychiatry · doi:10.1001/archpsyc.62.7.776 · Cited by 315 · see citing works
The patient's account of relapse and recovery in anorexia nervosa: a qualitative study
Federici, A., & Kaplan, A. S. (2007) · European Eating Disorders Review · doi:10.1002/erv.813 · Cited by 230 · see citing works
Cervera, S., Lahortiga‐Ramos, F., Martínez‐González, M. Á., Gual, P. L., de Irala, J., & Alonso, Y. (2003) · International Journal of Eating Disorders · doi:10.1002/eat.10147 · Cited by 199 · see citing works
Pretreatment motivational enhancement therapy for eating disorders: A pilot study
Feld, R., Woodside, D. B., Kaplan, A. S., Olmsted, M. P., & Carter, J. C. (2001) · International Journal of Eating Disorders · doi:10.1002/eat.1035 · Cited by 158 · see citing works
Associations of multiple domains of self-esteem with four dimensions of stigma in schizophrenia
Lysaker, P. H., Tsai, J., Yanos, P. T., & Roe, D. (2007) · Schizophrenia Research · doi:10.1016/j.schres.2007.09.035 · Cited by 146 · see citing works
Gual, P. L., Pérez-Gaspar, M., Martínez‐González, M. Á., Lahortiga‐Ramos, F., de Irala, J., & Cervera‐Enguix, S. (2002) · International Journal of Eating Disorders · doi:10.1002/eat.10040 · Cited by 146 · see citing works
Patching, J., & Lawler, J. (2009) · Nursing Inquiry · doi:10.1111/j.1440-1800.2009.00436.x · Cited by 110 · see citing works
Specificity of self‐concept disturbances in eating disorders
Jacobi, C., Paul, T., de Zwaan, M., Nutzinger, D. O., & Dahme, B. (2004) · International Journal of Eating Disorders · doi:10.1002/eat.10240 · Cited by 84 · see citing works
Vanderlinden, J., Buis, H., Pieters, G., & Probst, M. (2006) · European Eating Disorders Review · doi:10.1002/erv.768 · Cited by 83 · see citing works
Girls with anorexia nervosa as young adults: Personality, self‐esteem, and life satisfaction
Halvorsen, I., & Heyerdahl, S. (2006) · International Journal of Eating Disorders · doi:10.1002/eat.20248 · Cited by 81 · see citing works
The Role of Shape and Weight in Self-Concept: The Shape and Weight Based Self-Esteem Inventory
Geller, J., Johnston, C., & Madsen, K. (1997) · Cognitive Therapy and Research · doi:10.1023/a:1021812124937 · Cited by 71 · see citing works
Is chronic low self-esteem the cause of eating disorders?
Silverstone, P. H. (1992) · Medical Hypotheses · doi:10.1016/0306-9877(92)90054-g · Cited by 57 · see citing works
Wilksch, S. M., & Wade, T. D. (2004) · International Journal of Eating Disorders · doi:10.1002/eat.10273 · Cited by 49 · see citing works
A Mediational Model of Autonomy, Self-Esteem, and Eating Disordered Attitudes and Behaviors
Frederick, C. M., & Grow, V. M. (1996) · Psychology of Women Quarterly · doi:10.1111/j.1471-6402.1996.tb00468.x · Cited by 47 · see citing works
Low Self-Esteem in Eating Disordered Patients in the Absence of Depression
Silverstone, P. H. (1990) · Psychological Reports · doi:10.2466/pr0.1990.67.1.276 · Cited by 47 · see citing works
Self‐esteem in patients treated for anorexia nervosa
Karpowicz, E., Skärsäter, I., & Nevonen, L. (2009) · International Journal of Mental Health Nursing · doi:10.1111/j.1447-0349.2009.00621.x · Cited by 46 · see citing works
Binge eating before the onset of dieting: A distinct subgroup of bulimia nervosa?
Haiman, C., & Devlin, M. J. (1999) · International Journal of Eating Disorders · doi:10.1002/(sici)1098-108x(199903)25:2 · Cited by 45 · see citing works
Attributions of Self-Esteem as a Function of Duration of Eye Contact
Droney, J. M., & Brooks, C. I. (1993) · The Journal of Social Psychology · doi:10.1080/00224545.1993.9713927 · Cited by 43 · see citing works
The effectiveness of, and predictors of response to, inpatient treatment of anorexia nervosa
Collin, P., Power, K., Karatzias, T., Grierson, D., & Yellowlees, A. (2010) · European Eating Disorders Review · doi:10.1002/erv.1026 · Cited by 34 · see citing works
Self-citationPredicting the outcome of eating disorders using structural equation modeling
Fichter, M. M., Quadflieg, N., & Rehm, J. T. (2003) · International Journal of Eating Disorders · doi:10.1002/eat.10193 · Cited by 32 · see citing works
Self‐liking and self‐competence: relationship to symptoms of anorexia nervosa
Surgenor, L. J., Maguire, S., Russell, J. D., & Touyz, S. W. (2006) · European Eating Disorders Review · doi:10.1002/erv.734 · Cited by 29 · see citing works
Empirical scrutiny of a familiar narrative: sense of control in anorexia nervosa
Surgenor, L. J., Horn, J., & Hudson, S. M. (2003) · European Eating Disorders Review · doi:10.1002/erv.499 · Cited by 28 · see citing works
Clinton, D. N. (2010) · European Eating Disorders Review · doi:10.1002/erv.986 · Cited by 28 · see citing works
Anorexia nervosa—irony, misnomer and paradox
Lask, B. D., & Frampton, I. J. (2009) · European Eating Disorders Review · doi:10.1002/erv.933 · Cited by 25 · see citing works
Mehl, A., Tomanová, J., Kuběna, A. A., & Papežová, H. (2012) · Journal of Family Therapy · doi:10.1111/j.1467-6427.2011.00579.x · Cited by 24 · see citing works
The impact of a self‐esteem group for people with eating disorders: an uncontrolled study
Newns, K., Bell, L., & Thomas, S. (2003) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.352 · Cited by 24 · see citing works
A mediational model of self‐esteem and social problem‐solving in anorexia nervosa
Paterson, G., Power, K., Collin, P., Greirson, D., Yellowlees, A., & Park, K. (2010) · European Eating Disorders Review · doi:10.1002/erv.1021 · Cited by 19 · see citing works
Self-citationGeneral psychopathology in anorexia nervosa: the role of psychosocial factors
Karatzias, T., Chouliara, Z., Power, K., Collin, P., Yellowlees, A., & Grierson, D. (2010) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.701 · Cited by 15 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Glashouwer, K. A., van der Veer, R. M. L., Adipatria, F., de Jong, P. J., & Vocks, S. (2019) · Clinical Psychology Review · doi:10.1016/j.cpr.2019.101771 · Cited by 147 · see citing works
Self-esteem Interventions in Adults – A Systematic Review and Meta-analysis
Niveau, N., New, B., & Beaudoin, M. (2021) · Journal of Research in Personality · doi:10.1016/j.jrp.2021.104131 · Cited by 97 · see citing works
Linardon, J., Phillipou, A., Castle, D. J., Newton, R., Harrison, P., Cistullo, L. L., Griffiths, S., Hindle, A., & Brennan, L. (2018) · Eating Behaviors · doi:10.1016/j.eatbeh.2018.03.002 · Cited by 48 · see citing works
Linardon, J., Kothe, E. J., & Fuller‐Tyszkiewicz, M. (2019) · European Eating Disorders Review · doi:10.1002/erv.2662 · Cited by 48 · see citing works
Salerno, L., Ingoglia, S., & Coco, G. L. (2017) · Personality and Individual Differences · doi:10.1016/j.paid.2017.02.063 · Cited by 42 · see citing works
Kästner, D., Löwe, B., & Gumz, A. (2018) · International Journal of Eating Disorders · doi:10.1002/eat.22975 · Cited by 42 · see citing works
Neuropsychological and Cognitive Correlates of Recovery in Anorexia Nervosa
Harper, J. A., Brodrick, B. B., Enkevort, E. A. V., & McAdams, C. J. (2017) · European Eating Disorders Review · doi:10.1002/erv.2539 · Cited by 38 · see citing works
Ahmadpanah, M., Arji, M., Arji, J., Haghighi, M., Jahangard, L., Bahmani, D. S., & Brand, S. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16214236 · Cited by 35 · see citing works
Sternheim, L., Danner, U., van Elburg, A., & Harrison, A. (2020) · Brain and Behavior · doi:10.1002/brb3.1588 · Cited by 24 · see citing works
“The finding that people with AN strongly endorse a negative problem orientation and have a weaker positive problem orientation mirrors the low levels of self-confidence and self-esteem common in people with AN (Collin et al., 2016).”
BackgroundVoica, S. A., Kling, J., Frisén, A., & Piran, N. (2021) · Body Image · doi:10.1016/j.bodyim.2021.06.006 · Cited by 23 · see citing works
Assessment of Family Functioning and Eating Disorders – The Mediating Role of Self-Esteem
Kroplewski, Z., Szczęśniak, M., Furmańska, J., & Gójska, A. (2019) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.00921 · Cited by 20 · see citing works
Self-Esteem and Symptoms of Eating-Disordered Behavior Among Female Adolescents
Sani, S. H. Z., Fathirezaie, Z., Gerber, M., Pühse, U., Bahmani, D. S., Bashiri, M., Pourali, M., & Brand, S. (2020) · Psychological Reports · doi:10.1177/0033294120948226 · Cited by 20 · see citing works
de Boer, K., Johnson, C., Wade, T. D., Radünz, M., Fernando, A. N., Babb, J., Stafrace, S., & Sharp, G. (2023) · Clinical Psychology Review · doi:10.1016/j.cpr.2023.102354 · Cited by 18 · see citing works
Self-Esteem Group: Useful Intervention for Inpatients with Anorexia Nervosa?
Adamson, J., Özenç, C., Baillie, C., & Tchanturia, K. (2019) · Brain Sciences · doi:10.3390/brainsci9010012 · Cited by 18 · see citing works
Sarfan, L. D., Clerkin, E. M., Teachman, B. A., & Smith, A. R. (2018) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2018.08.005 · Cited by 13 · see citing works
Biney, H., Giles, E., Hutt, M., Matthews, R., & Lacey, J. H. (2021) · Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity · doi:10.1007/s40519-021-01161-0 · Cited by 13 · see citing works
Disordered eating: The psychometric properties of the Persian version of the Eating Attitudes Test-8
Asl, E. M., Khanjani, S., Mahaki, B., & Mohammadian, Y. (2020) · Journal of Education and Health Promotion · doi:10.4103/jehp.jehp_193_20 · Cited by 11 · see citing works
Okamoto, Y., Miyake, Y., Nagasawa, I., & Shishida, K. (2017) · Journal of Eating Disorders · doi:10.1186/s40337-017-0182-y · Cited by 11 · see citing works
Asl, E. M., Mahaki, B., Bardezard, Y. A., & Mohammadian, Y. (2021) · International Journal of Preventive Medicine · doi:10.4103/ijpvm.ijpvm_355_19 · Cited by 9 · see citing works
Cella, S., Iannaccone, M., Cipriano, A., & Cotrufo, P. (2020) · Weight Management · doi:10.5772/intechopen.91063 · Cited by 4 · see citing works
Valenta, S. T., Campanile, G., Albert, U., Marcolini, F., Faedi, G., Ronchi, D. D., & Atti, A. R. (2024) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2024.152481 · Cited by 4 · see citing works
Kwon, M., Li, M., & Chang, O. D. (2022) · Journal of Personality Assessment · doi:10.1080/00223891.2022.2051532 · Cited by 3 · see citing works
Wyssen, A., Balsiger, N., Djurdjevic, A., Munsch, S., & Trier, S. N. (2021) · Psychiatrische Praxis · doi:10.1055/a-1348-9358 · Cited by 1 · see citing works
EATING DISORDER PATIENTS EVOLUTION THREE YEARS AFTER INTAKE IN DAY HOSPITAL
Escandón‐Nagel, N., Dada, G., Grau, A., Soriano, J., & Feixas, G. (2017) · REVISTA ARGENTINA DE CLINICA PSICOLOGICA · doi:10.24205/03276716.2017.1005
Técnica de la Rejilla como instrumento de evaluación en trastornos de la conducta alimentaria
Gascón, E. M. P., Calmaestra, N. G., & Vacas, M. R. (2020) · Dialnet (Universidad de la Rioja)
Wyssen, A., Balsiger, N., Djurdjevic, A., Munsch, S., & Trier, S. N. (2021) · doi:10.48350/152975
Psychological Factors in Eating Disorders
Portingale, J., Krug, I., & Dang, A. B. (2024) · Springer eBooks · doi:10.1007/978-3-030-97416-9_32-1
Winesa, S. A., & Rifameutia, T. (2024) · G-Couns Jurnal Bimbingan dan Konseling · doi:10.31316/gcouns.v8i3.6076
Psychological Factors in Eating Disorders
Portingale, J., Krug, I., & Dang, A. B. (2024) · Springer eBooks · doi:10.1007/978-3-031-46096-8_32
Desnot, L., Bertrand, M., Laurencin‐Dalicieux, S., Brayer, S., Ritz, P., Vergnes, J., & Thomas, C. (2025) · Journal of Eating Disorders · doi:10.1186/s40337-025-01396-7
- Authors
- Collin, P., Karatzias, T., Power, K., Howard, R., Grierson, D., & Yellowlees, A.
- Affiliations
- National Health Service (GB)
- NHS Lothian (GB)
- University of Stirling (GB)
- Edinburgh Napier University (GB)
- NHS Greater Glasgow and Clyde (GB)
- Corresponding author
- Karatzias, Thanos
- Venue
- Psychiatry Research
- Publisher
- Elsevier BV
- Published
- 2016-03
- Volume
- 237
- Pages
- 175-181
- ISSN
- 0165-1781 (ISSN-L)
- OpenAlex
- W2283754337
- Cited by
- 31
- References
- 43
- Citations by year
- 2025: 1 · 2024: 4 · 2023: 1 · 2022: 1 · 2021: 6 · 2020: 5 · 2019: 5 · 2018: 3 · 2017: 5
- FWCI
- 5.80
- Type
- journal article
- Language
- en
- Open access
- Licence
- cc-by-nc-nd
- www.elsevier.com/tdm/userlicense/1.0/ (tdm)
- Locations
- Psychiatry Research (publishedVersion)
- PubMed (publishedVersion)
- Research Output (Edinburgh Napier University) (submittedVersion, cc-by-nc-nd)
- Edinburgh Napier Research Repository (Edinburgh Napier University) (submittedVersion, cc-by-nc-nd)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- anorexia nervosa, self-esteem, eating disorder psychopathology, treatment outcomes, shape concern, weight concern, dietary restraint, self-control, women
- MeSH terms
- Adult, Anorexia Nervosa, Feeding and Eating Disorders, Female, Humans, Psychotherapy, Self Concept, Treatment Outcome, Young Adult
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