P0168 - Obsessive-compulsive disorder and self-esteem: An exploratory study

Abstract

It has frequently been suggested that low self-esteem and low self-worth are closely related to psychological and emotional problems, particularly depression. In a retrospective study of “prodromal” symptoms of obsessive-compulsive disorder (OCD), Fava et al. (1996) noted that low self-esteem was one of a number of symptoms (including depression) reported as preceding the onset of OCD. Low self-esteem could also have the effect of predisposing people to the development of psychological problems regardless of type as a general vulnerability factor.

In a preliminary investigation of the link between self-esteem and obsessional problems, patients with OCD (n = 34) were compared with patients with social phobia (n = 29), diagnosed according to DSM IV. Standardized measures of self-esteem and clinical symptomatology were also administered: the Beck Depression Inventory (BDI), the Assertiveness Schedule of Rathus, the State Trait Inventory Anxiety, Yale Brown Obsessive Compulsive Scale (Y-BOCS) and Self-Esteem Inventory of Coopersmith (SEI).

Results:

Indicated that the OCD group differed significantly from the social phobia group on generalized self-esteem assessments (p<0.001). Both groups showed a lower self-esteem but there was some evidence of OCD specific effects; depressive cognitions altered significantly self-esteem in OCD patients (p<0.001). Obsessionals were more likely than anxious controls to link their self-worth to other people and their relationships. They also regarded the possibility of causing harm as likely to result in other people making extreme negative and critical judgements of them. The implications for future research and for treatment of OCD are discussed.