Abstract
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 Award | 1 Oct 2021 |
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| Original language | English |
| Awarding Institution |
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| Supervisor | Katharine Rimes (Supervisor) & Patrick Smith (Supervisor) |