Self-esteem in sexual minority young adults: an investigation of factors affecting self-esteem and development of a new psychological intervention to improve low self-esteem

Student thesis: Doctoral ThesisDoctor of Philosophy


This PhD project investigated self-esteem in sexual minority young adults and the development of a new psychological intervention aimed at improving low self-esteem in this population.
First, a systematic review and meta-analysis is presented which examined whether sexual minority individuals, and in particular young adults, have lower self-esteem than heterosexual individuals. A meta-analysis of 24 observational studies that compared level of global self-esteem in a sexual minority and a heterosexual sample was conducted for men and women separately. Sub-group analyses explored potential moderators of self-esteem differences. Results showed that self-esteem was significantly lower for sexual minority individuals compared to heterosexual individuals for both men and women across age groups. This disparity in self-esteem appeared to be larger for men and bisexual individuals.
The next two studies used a semi-structured qualitative interview design to gain an in-depth understanding of sexual minority young adults’ self-esteem. Twenty sexual minority young adults were interviewed, and asked questions related to factors or experiences that had affected their self-esteem. The first qualitative study explored the experiences and factors which adversely affect self-esteem from the perspectives of sexual minority young adults. Thematic analysis identified three overarching themes including:
“Striving and failing to meet standards”; “Negative sexual identity processes”; and “Negative social evaluations and reduced belonging”. The second qualitative study explored factors or strategies which promote self-esteem resilience in sexual minority young adults and identified six themes including: “Helpful responses to minority stress”, “Sexuality acceptance”, “Positive LGBTQ+ (Lesbian, Gay, Bisexual, Transgender, Queer+)experiences”, “Positive social relationships and evaluation”, “Successes and positive qualities”, and
“General coping strategies for low self-esteem”.
The findings from the first three studies were used to inform the final study. This involved the development of a new compassion-based cognitive-behavioural intervention tailored to ameliorate low self-esteem in sexual minority young adults. A feasibility and acceptability study for this intervention was conducted using an uncontrolled pre/post design with a mixture of qualitative feedback and quantitative outcome measures in a sample of 24 sexual minority young adults aged 16-24. Preliminary investigation of potential efficacy of the intervention was examined through post-intervention changes in self-report measures of self-esteem, functioning, anxiety, and depression. Results showed good acceptability and feasibility and preliminary evidence of possible intervention efficacy for improving self-esteem, depression, and anxiety.
Finally, a revised cognitive behavioural model of low self-esteem is presented, drawing on findings across the four studies. Theoretical implications of findings and clinical implications of the revised model are discussed.
Date of Award1 Oct 2021
Original languageEnglish
Awarding Institution
  • King's College London
SupervisorKatharine Rimes (Supervisor) & Patrick Smith (Supervisor)

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