Self-Esteem Deficits Predict Paranoia & Positive Symptoms


Researchers from Indiana University find, in a study of 57 individuals with schizophrenia diagnoses, that “decreases in self-esteem at any given time point were associated with an increase in persecutory beliefs and other positive symptoms at the following assessment. On the other hand, decreases in insight were not significantly associated with paranoia or positive symptoms, either as a stable trait of the mental illness or as a predictor of change over time.” Results appeared online in Clinical Schizophrenia & Related Psychoses on July 5, 2012.

Abstract → 

Erickson, M., Lysaker, P., “Self-Esteem and Insight as Predictors of Symptom Change in Schizophrenia: A Longitudinal Study.” Clinical Schizophrenia & Related Psychoses. online July 5, 2012

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Kermit Cole
Kermit Cole, MFT, founding editor of Mad in America, works in Santa Fe, New Mexico as a couples and family therapist. Inspired by Open Dialogue, he works as part of a team and consults with couples and families that have members identified as patients. His work in residential treatment — largely with severely traumatized and/or "psychotic" clients — led to an appreciation of the power and beauty of systemic philosophy and practice, as the alternative to the prevailing focus on individual pathology. A former film-maker, he has undergraduate and master's degrees in psychology from Harvard University, as well as an MFT degree from the Council for Relationships in Philadelphia. He is a doctoral candidate with the Taos Institute and the Free University of Brussels. You can reach him at [email protected].


  1. Of course people with low self-esteem are the ones who end up in psychiatric care; they have often been abused as children, rejected by partners, been unable to find jobs etc. difficult to have self-esteem in such circumstances. The “help” they get in psychiatric care is designed to snuf out every little bit of self-esteem they might have left-it is one long humiliation.

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