Across the continuum: Associations between (fluctuations in) momentary self-esteem and psychotic experiences

TY - JOUR

T1 - Across the continuum

T2 - Associations between (fluctuations in) momentary self-esteem and psychotic experiences

AU - Postma, Mary Rose

AU - van Amelsvoort, Therese

AU - Myin-Germeys, Inez

AU - Gayer-Anderson, Charlotte

AU - Kempton, Matthew J.

AU - Valmaggia, Lucia

AU - McGuire, Philip

AU - Murray, Robin M.

AU - Garety, Philippa

AU - Wykes, Til

AU - Morgan, Craig

AU - Reininghaus, Ulrich

N1 - Funding Information: This work was supported by a Postdoctoral Research Fellowship of the UK National Institute for Health Research ( NIHR-PDF-201104065 to U.R.); a Heisenberg professorship from the German Research Foundation (grant no. 389624707 to U.R.); financial support from the National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health at South London and Maudsley NHS Foundation Trust and King's College London; the ESRC Centre for Society and Mental Health at King's College London (ESRC Reference: ES/S012567/1 ); and the ZonMw research programme for the SELFIE study (grant no. 636310006 ). The funders of the study had no role in study design; in the collection, analysis and interpretation of the data; in the writing of the paper; or in the decision to submit the manuscript for publication. Funding Information: All authors have declared that there are no conflicts of interest in relation to the subject of this study. This work was supported by a Postdoctoral Research Fellowship of the UK National Institute for Health Research (NIHR-PDF-201104065 to U.R.); a Heisenberg professorship from the German Research Foundation (grant no. 389624707 to U.R.); financial support from the National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health at South London and Maudsley NHS Foundation Trust and King's College London; the ESRC Centre for Society and Mental Health at King's College London (ESRC Reference: ES/S012567/1); and the ZonMw research programme for the SELFIE study (grant no. 636310006). Publisher Copyright: © 2021 The Authors

PY - 2021/12

Y1 - 2021/12

N2 - Objective: Low self-esteem has been suggested as a putative mechanism in the development and maintenance of psychosis. Uncertainty still exists about how unstable self-esteem relates to psychotic experiences. The present study examines the potential (temporal) associations between momentary self-esteem, fluctuations in self-esteem, and psychotic experiences in daily life. Methods: Experience sampling data were collected from 46 individuals presenting with an at-risk mental state (ARMS), 51 individuals with first-episode psychosis (FEP), and 53 controls, to investigate associations between (fluctuations in) self-esteem and psychotic experiences within and across FEP, ARMS, and controls, using linear mixed models. Results: In all three groups we found that lower momentary self-esteem was associated with a greater intensity of psychotic experiences (adj. βFEP = −0.15, 95% CI -0.20 to −0.10, p = 0.000; adj. βARMS = −0.20, 95% CI -0.26 to −0.15, p = 0.000; adj. βcontrols = −0.12, 95% CI -0.17 to −0.07, p = 0.000). Variability in momentary self-esteem was associated with a greater intensity of psychotic experiences only in ARMS (adj. βARMS = 0.08, 95% CI 0.04 to 0.11, p = 0.000) and controls (adj. βcontrols = 0.04, 95% CI 0.01 to 0.08, p = 0.023). For instability this association held only in controls (adj. βcontrols = 0.03, 95% CI 0.00 to 0.05, p = 0.020). Furthermore, findings may suggest a reciprocal temporal association between self-esteem and psychotic experiences. Conclusions: Our findings suggest that self-esteem may be an important mechanism targetable by ecological momentary interventions to reduce the intensity of psychotic experiences and potentially prevent illness progression at an early stage.

AB - Objective: Low self-esteem has been suggested as a putative mechanism in the development and maintenance of psychosis. Uncertainty still exists about how unstable self-esteem relates to psychotic experiences. The present study examines the potential (temporal) associations between momentary self-esteem, fluctuations in self-esteem, and psychotic experiences in daily life. Methods: Experience sampling data were collected from 46 individuals presenting with an at-risk mental state (ARMS), 51 individuals with first-episode psychosis (FEP), and 53 controls, to investigate associations between (fluctuations in) self-esteem and psychotic experiences within and across FEP, ARMS, and controls, using linear mixed models. Results: In all three groups we found that lower momentary self-esteem was associated with a greater intensity of psychotic experiences (adj. βFEP = −0.15, 95% CI -0.20 to −0.10, p = 0.000; adj. βARMS = −0.20, 95% CI -0.26 to −0.15, p = 0.000; adj. βcontrols = −0.12, 95% CI -0.17 to −0.07, p = 0.000). Variability in momentary self-esteem was associated with a greater intensity of psychotic experiences only in ARMS (adj. βARMS = 0.08, 95% CI 0.04 to 0.11, p = 0.000) and controls (adj. βcontrols = 0.04, 95% CI 0.01 to 0.08, p = 0.023). For instability this association held only in controls (adj. βcontrols = 0.03, 95% CI 0.00 to 0.05, p = 0.020). Furthermore, findings may suggest a reciprocal temporal association between self-esteem and psychotic experiences. Conclusions: Our findings suggest that self-esteem may be an important mechanism targetable by ecological momentary interventions to reduce the intensity of psychotic experiences and potentially prevent illness progression at an early stage.

KW - Ecological momentary assessment

KW - First-episode psychosis

KW - Mechanism

KW - Prodrome

KW - Self-esteem

UR - http://www.scopus.com/inward/record.url?scp=85118991912&partnerID=8YFLogxK

U2 - 10.1016/j.schres.2021.09.010

DO - 10.1016/j.schres.2021.09.010

M3 - Article

AN - SCOPUS:85118991912

SN - 0920-9964

VL - 238

SP - 188

EP - 198

JO - Schizophrenia Research

JF - Schizophrenia Research

ER -