Author Information
Anson Kai Chun Chau, University of Hong Kong, Hong KongEugene Lo, The Chinese University of Hong Kong, Hong Kong
Wai Tong Chien, The Chinese University of Hong Kong, Hong Kong
Kunhua Lee, National Tsing Hua University, Taiwan
Stanley Kam Ki Lam, The Chinese University of Hong Kong, Hong Kong
Hong Wang Fung, The Hong Kong Polytechnic University, Hong Kong
Abstract
Low self-esteem has been implicated in the onset of post-traumatic stress disorder (PTSD). Upon the inclusion of complex PTSD as a trauma-related disorder in ICD-11, the role of self-esteem in the development of complex PTSD, defined by disturbances in self-organization (DSO) symptoms in addition to classic PTSD symptoms, warrants further examination. Moreover, few longitudinal studies on self-esteem and complex PTSD have been conducted in non-Western settings. Therefore, based on five longitudinal samples of Chinese-speaking adults (combined N at baseline = 2665), we synthesized the evidence of the effects of self-esteem on the development of complex PTSD symptoms (i.e., classic PTSD and DSO symptoms) using a meta-analytic approach. We also explored the relationship between sample characteristics (i.e., study follow-up period, retention rate, and baseline symptom severity) and the magnitude of the effects. Across five samples, self-esteem at baseline predicted less severe classic PTSD (pooled b = -0.16, SE = 0.03, p <.001) and DSO (pooled b = -0.17, SE = 0.04, p <.001) symptoms at follow-up. Meta-regression suggested that a longer follow-up interval was associated with a stronger (negative) effect of self-esteem on DSO symptoms (Q(1) = 6.89, B = -0.00, p = .009). Retention rate and baseline symptom severity were not associated with the magnitude of effects across samples. Our findings offer converging evidence for the buffering role of self-esteem in the development of complex PTSD symptoms in non-Western settings. Self-esteem-enhancing interventions may improve complex PTSD symptoms, especially DSO symptoms with the potential for more substantial improvement over time.
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