Transcript
Using Self-Talk 1
Running head: ACT BEHAVIOR MODIFICATION TO IMPROVE SELF-ESTEEM
Using Self-Talk to Improve Self-Esteem:
An Experiment in Support of ACT Behavior Modification
Nancy N. Frishkorn
California University
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Abstract
This experiment studied the effect of self-talk on self-esteem when it was combined with positive
reinforcement and acceptance training using behavioral modification practices. Ten young adult
females (ages 18-28) were randomly placed in either a control or an experimental group, and
tested before and after a ten day period to determine if reported explicit self-esteem of the test
group improved due to experiental acceptance homework assignments that encouraged
nonjudgmental descriptions of the participants overt and covert thoughts/behaviors combined
with positive reinforcement daily as compared to the control group. The active participants
shared their experiences and reported increased efficaciousness in self-awareness and confidence
that encouraged them to translate their cogitations into concrete goals and improved personal
relations. Data analysis revealed significant interaction effect size, consistent with predictions,
and potential existential therapeutic treatment indications for several disorders, including but not
limited to addiction, emotional and eating disorders, warrants further discovery from interpretive
findings.
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Using Self-Talk to Improve Self-Esteem:
An Experiment in Support of ACT Behavior Modification
It is theorized that self-esteem is a determinative factor in the successes and failures of young
adult women and men within the western culture. Self-esteem is an integral part of everyone's
lives; it is not only how we see ourselves, but also how important we believe we are to others.
Statements that we make not only to others, but to ourselves, are taken literally by the brain.
Saying "I'm just going to DIE!" before giving a presentation in class can cause the sympathetic
nervous system to react in obvious physical ways, such as elevated heart rate, perspiration,
queasy stomach and desire to escape or flee the immediate situation. This absolute processing of
our brain can lead to catastrophic thinking, overgeneralization and ultimately stress, anxiety, and
low self-esteem; this process is known as dichotomous thinking.
Recent studies have focused on stress and anxiety factors of college students as a potential
factor in self-esteem and have used music therapy as a positive variable for increasing student's
perceptions of themselves (Sharma & Jagdev, 2012). Although this study produced significant
results, it may have been culturally biased and also was extremely time-consuming and distracted
students from their normal or routine schedule. Other studies are specifically targeting inpatient
mental health settings and the significant effectiveness of Cognitive Behavioral Therapy (CBT)
on low self-esteem and its relationship to psychiatric disorders (Waite, McManus & Shafran,
2012). This in-depth process requires hours of psychotherapy in addition to numerous homework
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assignments; it has statistical significance for improving thought disorders short-term, but the
follow-up tests revealed a gradual decline in effectiveness that, if discontinued for any extended
period of time, could result in spontaneous recovery of the self-defeating cognitions and
behaviors.
Another more aggressive approach to dichotomous thinking was developed by Albert Ellis in
1962 and theorized that self-defeating statements could be replaced with positive statements
through coaching. This cognitive therapy technique is known as Rational Emotive Behavior
Therapy (REBT) and has gained acceptance over time; it has recently been released in print form
as a tool for enhancing performance, alleviating procrastination and stress issues while
improving self-esteem and motivation techniques (Cognitive Behavioural Coaching, 2012). The
fast paced acceptance and implication of such therapy without the supervision of a professionally
trained individual can be more damaging to the individual than one might expect. Although these
types of therapies suffice for controlled or group environment settings under the direction of a
trained professional, they are not applicable for the general population in either cost or
availability to the average or "normal" population.
A recent theory has been proposed based upon the initial ideas of CBT and REBT; it is a
more acceptance based approach and employs constructive action and behavior therapy rather
than the ruled-based cognitive approach employed by Beck and Ellis. This revised theory, called
Acceptance and Commitment Therapy (ACT), views irrational or maladaptive ideas and
cognitions as mere precursors to the responsive thoughts and emotions that cause emotional and
behavioral disorders, and attempts to control these thoughts are "experiential avoidance" (Biglan,
Hayes, Pistorello 2008). Hayes employs a technique first observed in Buddhist's religion that
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teaches a person to focus on their actions and behaviors and consciously perceive them as but a
reflection of a moment in time--and learn to accept to one's self by not judging the whole person
based upon those sensations. This acceptance is part of what is known as "mindfulness" training
and has been studied in many several self-control domains such as obesity, impulse-control and
anxiety disorders (Lillis et al., 2009). Although many view ACT as an existentialist approach to
therapeutic application, the impact of this three step outline may very well be the necessary
construct for "cognitive specificity" implicated in certain maladaptive cerebrations (Beck, Haaga,
1992).
To become self-assured one has to be accepting of not only themselves, but of those around
them. Self-esteem is a factor in relationships, trust, personal strengths and limitations,
confidence, cooperation and problem solving and just about every other area of a person's life.
Low self-esteem can lead to anxiety, depression and a plethora of other emotional and health
issues that can directly affect the person's ability to function at their fullest potential. Studies
have shown that there is no difference between men and women in the projected development of
self-esteem during young adulthood (Erol & Orth, 2011). To that end, this experiment will focus
solely on young single adult women, ages 18-28; the choice not to include individuals in a
relationship or married, as well as specifying the specific gender, will assist in extraneous
variable control.
Single, adult women face many decisions and challenges in our society; the choice between
either career or family no longer applies, and many are managing as professional businesswomen
while simultaneously caring for and supporting their families. Women that perceive themselves
as valuable not only in the home, but also in the work force may have an advantage in securing
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stable employment and relationships, furthering their success and broadening their views and
goals. Perceptions that are not positive can become not only hindering, but sometimes
detrimental, and block one's ability to reach their fullest potential. This maladaptive thinking can
be addressed using behavior modification techniques known as cognitive restructuring; self-
esteem is no exception.
As a social cognition, self-esteem expresses in two ways: implicit, or affective, unconscious,
reactive evaluation, and explicit, propositional, evaluative, reasoning judgments (Dentale et al.,
2011). It is hypothesized that implicit self-esteem is non-conscious, but there is "no definitive
evidence" that this assumption is true or correct (Shimizu, Pelham 2011). Information
processing, both conscious and unconscious, has been studied since the 1950's, and is now
considered a dual-process, with affect of implicit upon explicit expression (Epstein, 1994).
Explicit self-esteem is only weakly correlated to implicit self-esteem, and some studies suggest
that explicit self-esteem changes more readily due to social adaptive necessity and response
(Shimizu, Pelham 2011).
Self-Talk is a sub-vocal speech that leads to respondent emotion; as children we vocalize
readily but very quickly we learn to keep these thoughts more private or covert in nature. For this
experiment we will encourage (selected) participants to engage in auditory self-talk, but the
positive reinforcement will remain the same should the individual chose not to do so. The
purpose of this experiment is to determine if self-talk, used as a reinforcer, will have an indirect
effect on improving self-esteem when paired with the conditioned reinforcer of hand washing
before any meal (unconditioned consumable reinforcer). Although this experiment is designed to
be self-directed, it will serve to support the theory of ACT as proposed by Hayes in 1999 in that
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it will encourage mindfulness and acceptance of the self on a non-conscious level and express
consciously though explicit self-esteem scoring.
Method
Participants
This experiment was conducted in two different settings; the campus of California University
of Pa, specifically Morgan hall, and at a boarding barn facility located at 168 Manor drive
Zelienople, Pa., 16063. Only single female adults of Caucasian and African American descent
were selected from the average population within the eastern United States; enrollment in
secondary education was not a prerequisite. All participants were selected and randomly placed
in either a control group or an experiment group after signing a consent form; no participant
received any compensation for participation. Participants from the young adult age range (18-28)
were specifically solicited for this experiment with a mode and median of 20 years of age, the
mean was 20.9. Initial data was collected from a total of 13 participants; 7 were placed in a
control group and 6 in the experiment group. Three of the participants did not follow-up with the
researcher for completion of the second testing required to fulfill the requirements of data
collection; two of the participants in the experiment group admitted that they did not follow the
directions for daily hand washing as directed for the self-talk exercise. A total of 5 participants
completed the experiment with this exception and provided all the required data necessary for
computations from the experiment group, and a total of 5 control group participants also
completed both series of required testing protocols. The result was an equal number of
participants for each group (N=10) which provided equivalence for data compilations. A total of
5 control group and 5 experiment group participant's data was collected and computed for effect
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size of self-talk on self-esteem variables. All participants who completed the experiment
indicated their relationship status was single (not married) and 8 were students in some capacity
with only one in each group as non-student working full time and non-student working part time.
Of the 8 students, three attended school full time without employment; 4 attended school full
time and worked part time and 1 attended school part time and worked part time. Every
participant was born an American citizen, and 20% of each group was African American; all
participants were from the Eastern United States.
Measures
Explicit self-esteem was measured using a self-reports; the most commonly used test for this
purpose is the Rosenberg Self-Esteem Scale (RSES), so this testing instrument was selected to
provide data for this experiment. This psychometric report measure's the individual's overall
sense of self-worth (Rosenberg, 1989) and consists of ten questions, five positively worded, and
five negatively worded (see appendix A). The RSES is in Likert scale and can be completed
within approximately two minutes; it is reverse scored; items 1,2,4,6 and 7 strongly agree as 3
down to strongly disagree as 0, and items 3,5 8,9 and 10 the opposite (University of Maryland,
2013). This test has high test-retest reliability (.82-.88) and revealed high internal consistency
across cultures (.81) according to Schmitt and Allik (2005). This high value should result in
participant's scores that are consistent over time; this test provided a fair evaluation of the effect
size of the dependent variable in this experiment of behavior modification. This test was scored
by hand as well as online using confidential reporting methods, unless otherwise indicated by
participants in the informed consent, to ensure proper scoring of test results and contribute to the
collection process ongoing for the RSES.
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Procedure
Participants were selected and volunteered to be randomly placed in one of two sample
groups; the first group was a control group that only took the RSES at the beginning of the
experiment, and then again after ten days (one the 11th day) from the date of their first test; the
second group took the RSES and then once a day for the next ten days they were instructed to
write down three positive statements about themselves ( either a positive deed/ action or self-
compliment/appraisal) once daily and read those three items (preferably aloud), before washing
their hands in preparation for any meal of their choosing. In behavior terms as set forth by
Skinner and Watson, this would be expressed as: Written statements=Operant discriminative
stimulus ( SD), Self-Talk=R, hand-washing=CR, meal=UR, food in mouth=US. In addition to
reading the three positive statements the participants had written, they also read silently a quote
that was included on the paper they were provided to record the thirty (total) statements; this
quote said: "You, yourself, as much as anyone in the entire universe, deserve your love and
affection. Buddha." A total of thirty statements was documented and returned to the researcher
upon completion of the ten day period at which time (on the 11th day) they took the RSES again.
Both groups experienced the repeated measures testing and were equally susceptible to the
Hawthorn Effect.
Group assignment was determined at random by having the participants choose a chip out of a
brown bag; black chips were placed in the control group, red chips were placed in the experiment
group. Informed consent was collected prior to any participation, and each individual received
the same instruction for their assigned group which was read to the participant by the
experimenter prior to any testing. A debriefing was also provided to each participant upon
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completion of the second testing procedure which provided behavioral modification
counterbalancing protocol for the experiment group. The following excerpt is from the
instruction that was provided in the debriefing to the experimental participants:
This experiment had very minimal risk associated with its participation…If you found that this
task made you uncomfortable in any way, or that you now feel a desire to eat every time you
think something positive about yourself, there are several steps you can take to return to your
normal behavior as it was before participation took place.
First, should you feel you need to speak with someone regarding your self-esteem or impulse
control due to participation in this experiment , it is recommended that you seek free counseling
at the health center located on the campus of California University. If you are not currently a
student at California University, there is a free clinic locator near Zelienople where you met with
me to volunteer; please contact The Center for Community Resources at 121 Sunnyview Circle
Butler, Pa. (724) 431-0095.
Secondly, should you feel you do not need or want services, but would prefer to "extinguish" this
connection yourself, you can use a method called "counter-conditioning" which would involve
simply reading your positive statements before exercising instead of before a meal; this should
alleviate any desires to eat or feelings of hunger that may have resulted from pairing your self-
talk with hand washing and eating rituals.
Lastly, just do nothing. If you stop self-talk practices altogether you will eventually feel just as
you did beforehand.
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Results
Data collection was computed using a 2 (independent sample of participants randomly placed
in groups) X 2 (related sample repeated measures testing) mixed factorial analysis of variance
(ANOVA) in a complete factorial design to measure their self- esteem as indicated by the self -
test index (RSES). Data analysis revealed significant interaction, F(1,8) =11.538, p < .05, which
was consistent with prediction but requires further interpretation. The main effect over the ten
day period (factor 1= time) was F(1,8)=3.282 ,p >.05; the effect of each level indicates that self-
esteem is relatively stable over a short time period; it is also important to note that no marginal
significance was observed for any level. The main effect of group difference (level = control or
experimental) was F(1,8)=1.032, p >.05; this indicating no significant difference between
experimental and control groups. A post hoc Wilks' Lambda was used to obtain the significant
effect (.009) of interaction which is contradictory to the both main effects conclusion. This
unconfounded comparison allows us to draw some inferences about the significant interaction;
rejection would constitute an alpha (Type I) error because the results are compromised most
likely due to good participant effect. It should be noted that the results would have indicated
significance even if the experiment-wise error rate was set at 99% (p<.01) despite no change
occurring in one experimental participants (20%) pre and post test scores. The personality scale
has high validity and reliability so I am confident that it is not the determining factor, but rather
the expectations of the researchers influence upon the selected participants, diffusion of
treatments and interactions with selection.
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Table 1Effects of Self-Talk on Self-Esteem Using Behavioral Modification Technique for Ten Days
RSES Scores
Group Pre-Test Post-Test
Experimental M 18.4 23 SD 1.35 2.12
Control M 22.8 21.4 SD 2.08 1.83
Note: RSES ratings are on a scale from 1 to 30 with a score of 15 or below indicating low self-esteem.
*These means (averages) indicate that, although explicit self-esteem may differ, there is no significant difference
either improving or reducing levels of measurement when practicing self-talk exercises.
Discussion
This experiment found no significant increase of explicit self-esteem after a ten day period,
but there are many considerations that need be mentioned. First, this was a very small sample
that consisted of a normal population, therefore, the implications for its findings may differ if
another sample consisting of individuals with identifiable disorders or recognized low self-
esteem are tested; the sample size additionally decreased the overall power of this results. Of the
five individuals who participated in the ACT/behavior modification practices, four reported
significant differences with their overall sense of wellbeing, confidence and improve self-
efficacy. One in particular told this researcher that she was able to stop using a controlled
substance and intended to continue the experimental practices daily and had found a social
support system to attend daily to help her overcome her addiction. Another, who was near the
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score required for low self-esteem on the RSES, reported that she had been in an abusive
relationship and had been inspired to seek the assistance necessary to terminate the relationship
since she had "found a new sense of self-worth." A third began an exercise program and was
inspired to lose weight because she realized that, although it was difficult at first, she was able to
look herself in the mirror daily and realize that she had "some good qualities" as well. This
person stated that she could not remember the last time she had actually just looked at herself
without thinking negative thoughts, and that by learning to recognize the good things she did
daily, she was able to see herself in a more positive and accepting way. The fourth person
reported that it was really hard for her to complete three items a day for the first two days, but by
the end of the ten day period she was able to say many positive things about herself and was
getting more classwork done and "actually getting dressed for class instead of coming in my
pajamas." These statements indicate a personal change that may not have been elucidated by the
RSES, but may on another, more comprehensive test.
Secondly, this experiment was limited in duration and the full effects of ACT behavior
practices should be evaluated over an extended period of time. According to a recent study in
The European Journal of Social Psychology, it takes 66 days for habit formation to integrate into
one's daily living (Lally, van Jaarsveld, Potts, Wardle, 2010). Given the limited duration for
project completion, the present study could be extended had appropriate time and application
procedures been implemented.
Third, this experiment could not be conducted in a controlled facility, therefore there is no
way of knowing for sure not only if the practices were completed fully, but also if they were
performed in the subsequent required order. This experiment was designed to utilize a natural
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reinforcer (food) after the self-talk exercise was performed, and if the participants did not 1)
wash their hands as a reinforcer or 2) eat a healthy meal after the practice, the full effects of the
behavior modification would be moot. Future studies could incorporate conduction in a facility
that encourages acceptance and mindfulness training while the person is under supervision to
control for extraneous and other variables, as well as inclusion of participants varying in age and
ethnicity. In that regard, there are several other questions as to the construct and constancy of this
design that need brought to mention.
Due to the nature of this experiment and the various locations required for collection of data,
the question of constancy must be addressed. Despite the randomization used to establish
equivalence, the selection of available participants coupled with the gender and age limitations
also contributes to a lack of constancy overall. Unavoidable carryover and testing effects may
also have been influenced by the good participant effect, subsequently a noticeable bias appears
in the participants responses; this appears most evident on one particular participant whose score
increased 9 points in only eleven days. The internal validity has also been subject to history
influence, as we don't know the environmental contingencies of each participant, as well as
mortality due to nearly 8% (7.69) of the participants dropping out of the experiment. Extension
to a more diverse sample and supervision of participants for extended periods could offer much
needed support for ACT CBT (combined with behavior modification) as a cognitive specificity
for a diversity of maladaptive cognitive dysfunctions and psychological predispositions.
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References
Biglan, A., Hayes, S., & Pistorello, J. (2008). Acceptance and commitment: implications for
prevention science. Prevention Science: The Official Journal Of The Society For
Prevention Research, 9(3), 139-152. doi:10.1007/s11121-008-0099-4
Beck, A. T., & Haaga, D. F. (1992). The future of cognitive therapy. Psychotherapy: Theory,
Research, Practice, Training, 29(1), 34-38. doi:10.1037/0033-3204.29.1.34
Cognitive behavioural coaching in practice: An evidence based approach (paperback) -
Routledge Mental Health. (2012). Retrieved from http://www.routledgementalhealth.
com/cognitive-behavioural-coaching-in-practice-9780415472630
Dentale, F., Vecchione, M., De Coro, A., & Barbaranelli, C. (2012). On the relationship between
implicit and explicit self-esteem: The moderating role of dismissing attachment.
Personality And Individual Differences, 52(2), 173-177. doi:10.1016/j.paid.2011.10.009
Epstein, S. (1994). An integration of the cognitive and psychodynamic unconscious. The
American Psychologist, 49, 709–724.
Erol, R. Y., & Orth, U. (2011). Self-esteem development from age 14 to 30 years: A longitudinal
study. Journal of Personality and Social Psychology, 101(3), 606-619. doi:
10.1037/a0024299
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Lally, P., van Jaarsveld, C. H. M., Potts, H. W. W. and Wardle, J. (2010). How are habits
formed: Modelling habit formation in the real world. European Journal of Social
Psychology, 40: 998–1009. doi: 10.1002/ejsp.674
Lillis, J., Hayes, S., Bunting, K., & Masuda, A. (2009). Teaching acceptance and mindfulness to
improve the lives of the obese: a preliminary test of a theoretical model. Annals Of
Behavioral Medicine: A Publication Of The Society Of Behavioral Medicine, 37(1), 58-
69. doi:10.1007/s12160-009-9083-x
Rosenberg, M. (1989). Society and the adolescent self-image (rev ed.). Middletown, CT,
England: Wesleyan University Press.
Schmitt, D. P., & Allik, J. (2005). Simultaneous administration of the Rosenberg self-esteem
scale in 53 nations: Exploring the universal and culture-specific features of global self-
esteem. Journal of Personality and Social Psychology, 89, 623-642.
Sharma, M., & Jagdev, T. (2012). Use of music therapy for enhancing self-esteem among
academically stressed adolescents . Pakistan Journal of Psychological Research, 27(1),
53-64. Retrieved from http://ehis.ebscohost.com.navigator-cup.passhe.edu/eds/results.
Shimizu, M., & Pelham, B. W. (2011). Liking for positive words and icons moderates the
association between implicit and explicit self-esteem. Journal of Experimental Social
Psychology, 47(5). Retrieved from http:// www. e lsevier.com/locate/jesp
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University of Maryland Department of Sociology. (2013). College of Behavioral and Social
Sciences. Retrieved from http://www.bsos.umd.edu/socy/research/rosenberg.htm
Waite, P., McManus, F., & Shafran, R. (2012). Cognitive behavior therapy for low self-esteem:
A preliminary randomized. Journal of Behavior Therapy and Experimental Psychology,
43, 1049-1057. Retrieved from http://www.elsevier.com/locate/jbtep
Appendix A.
This is a free version of the Rosenberg Self Esteem Scale.
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ValidityThis scale is the most widely used measure of self- esteem for research purposes but it is NOT a diagnostic aid for any for any psychological issues of states. If you are worried that your self- esteem may reflect poor mental health please consult your doctor. The scale has been used in more than one hundred research projects.
Because the concept of self- esteem is one most people should be familiar with, this test will probably not tell you anything you do not already know. You should have a pretty good grasp of your results just by asking yourself the question, "do I have low self -esteem?" The scale can however give you a better picture of your state in relation to other people. Your results will also include a little bit more about the relationship between self- esteem and life outcomes.
ProcedureThe scale consists of ten statements that you could possibly apply to you that you must rate on how much you agree with each. The items should be answered quickly without overthinking, your first inclination is what you should put down.
ParticipationIn addition to being offered for public education purposes, this survey is being used as part of a research project and your answers will be recorded. By starting this test you are agreeing to have any data you enter used for research.
Your scores will be entered manually and anonymously into the free online data base to ensure potential scoring errors and contribute said scores into the database for research purposes. Your name will never be used, but if you chose NOT to contribute to the data collection for the RSES, please initial this paragraph so that the researcher will know to ONLY score your results manually for the purpose of the school project experiment which you have agreed to participate in by signing the consent form.
The school project has been approved by the California University of Pennsylvania Institutional Review Board effective January 28, 2013 to May 17, 2013; by initialing this paragraph you agree that you have been asked to complete this test during these dates and that you are a single woman between the ages of 19-29.
Strongly disagree
Disagree Agree Strongly agree
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I feel that I am a person of worth, at least on an equal plane with others.
I feel that I have a number of good qualities.
All in all, I am inclined to feel that I am a failure.
I am able to do things as well as most other people.
I feel I do not have much to be proud of.
I take a positive attitude toward myself.
On the whole, I am satisfied with myself.
I wish I could have more respect for myself.
I certainly feel useless at times.
At times I think I am no good at all.
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