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Have We Underestimated the Harm Caused by Low Self-Esteem?

Low self-esteem is the prime driver of self-harm among gay and lesbian students.

Until now, there’s been surprisingly little research on the prime driving factors of self-harm among LGBTQ students who are statistically at a much higher risk of suicide and non-suicidal self-injury (NSSI) than their heterosexual counterparts. For the first time, a new study, “Psychological Correlates of Self-Harm within Gay, Lesbian and Bisexual UK University Students,” reports that low self-esteem may have a bigger influence on self-injury behaviors than depression or anxiety.

Sharon McCutcheon/Pexels
Source: Sharon McCutcheon/Pexels

Based on the cohort used for this study, almost two-thirds (65 percent) of students in their early 20s who self-identify as Lesbian, Gay, or Bisexual (LGB) had carried out non-suicidal self-harm over their lifetime. Tragically, 35 percent of LGB students in this survey reported an attempted suicide in their lifetime compared to 14 percent of non-LGB students.

Other types of NSSI self-harm are behaviors such as substance abuse, binge drinking, non-lethal overdoses, cutting, burning, scratching, and trichotillomania.

The authors explain the layout of their latest research on self-harm: "This study explores the association between lesbian, gay or bisexual (LGB) status and self-harm in UK students. There is currently limited data on this association, and the role psychological variables have in potentially explaining this link, in UK students. We examine whether LGB status is associated with self-harm (both non-suicidal self-injury [NSSI] and suicide attempts [SA]), and whether 4 psychological variables (depression, anxiety, belongingness, self-esteem) mediate this association.”

This study was a collaborative effort by researchers from the University of Manchester, Leeds Beckett University, Lancaster University, and Edith Cowan University in Australia.

"Surprisingly, there is little data on the psychological mechanisms that might explain the association between being lesbian, gay or bisexual, and self-harm in UK students. This data highlights how low self-esteem may leave some LGB students more at risk. Interestingly, anxiety and depressive symptoms did not appear to be important once self-esteem was taken into account,” first author Peter Taylor said in a statement.

Senior author Elizabeth McDermott of Lancaster University added: "Young people's mental health is a national concern and this study confirms that lesbian, gay or bisexual young people have elevated rates of suicidality and self-harm compared with heterosexual youth. We know much less about how LGB young people seek help for their mental health problems, or what type of support would be effective."

Anecdotally, I corroborate the conclusion by Peter Taylor et al. that low-self esteem puts lesbian, gay, and bisexual students at higher risk of self-harm. Based on my first-person experience as a gay student in the 1980s who suffered from a triple whammy of (1) clinical depression, (2) crippling anxiety, and (3) low self-esteem—I realized in adulthood that it was primarily my feelings of worthlessness and low-self esteem (more than depression or anxiety) that pushed me to the brink of taking my own life.

Can Physical Activity, Mental Toughness, and Sub-Clinical Narcissism Facilitate a “Sunny” Triad That Combats Low-Esteem?

For the second part of this blog post, I’m going to shift gears and present some prescriptive advice I’ve cobbled together based on a blend of the latest empirical evidence and personal life experience.

Because there’s such a dearth of evidence-based research on the link between low self-esteem and self-harm amongst members of the LGBTQ community, I’ve made myself a human guinea pig and deconstructed specific factors that helped me boost my self-esteem as a gay teen through the lens of the latest research on subclinical narcissism (SN) and the so-called “Dark Triad” (DT) of narcissism, psychopathy, and Machiavellianism.

After piecing together the latest findings on some adaptive benefits of subclinical narcissism over the past week, I’ve created a new term and coined it: “The Sunny Triad." The ST consists of physical activity (PA), mental toughness (MT), and healthy doses of subclinical narcissism (SN).

Source: djgis/Shutterstock
Source: djgis/Shutterstock

Last week, I wrote a Psychology Today blog post, “Don’t Believe the Hype! ‘Narcissists’ Aren’t Necessarily Evil" inspired by a study from Kostas Papageorgiou and colleagues at Queen’s University Belfast, “The Positive Effect of Narcissism on Depressive Symptoms Through Mental Toughness: Narcissism May Be a Dark Trait, but It Does Help with Seeing the World Less Grey,” published Nov. 1 in European Psychiatry.

In my "Don't Believe the Hype!" blog post—which tries to dissuade people from indiscriminately throwing around the derogatory label "narcissist" without acknowledging that narcissism exists on a spectrum—I share my own stories of overcoming low self-esteem and adopting a “YES! Bring it on. I got this!” mindset as a gay teen. For me, the key to overcoming my tendency to inflict self-harm involved developing some healthy narcissism and a "sense of agency" at a time when I felt my life didn't matter.

Papageorgiou posits that healthy doses of SN are correlated with increased mental toughness, more Openness to Experience (OE) and fewer depressive symptoms (DS). I agree.

Notably, over the years, I've found that music can play a pivotal role in kick-starting an upward spiral of PA, SN, MT, and OE by creating motivation to break a sweat doing some moderate-to-vigorous physical activity (MVPA). For more, check out this "Subclinical Narcissists' Playlist" of 22 songs I curated to help generate more self-esteem and overall oomph.

As a side note: I realize that the growing list of acronyms herein is beginning to sound like alphabet soup... But each of these factors (SN, MT, OE, PA, etc.) are key elements that can be blended together into a psychosocial concoction that has the power to boost feelings of self-sufficiency, self-worth, higher self-esteem, and lower depression.

Coincidentally, after sharing my latest blog post on the possible upside of healthy doses of narcissism, Gregory Carter of York St. John University retweeted the link with a comment, “An interesting article that chimes with some of the positive outcomes (for the self) associated with aspects of sub-clinical narcissism, also reported in work by me and @DrMDDpsych and other papers with @DrRobertVaughan @YSJPsych.”

After reading Carter’s Tweet, I Googled his research and found a recent paper he’d done with Robert Vaughan, “Harder, Better, Faster, Stronger? Mental toughness, the Dark Triad, and Physical Activity,” (2018) which identified a positive relationship between mental toughness, sub-clinical narcissism, and higher levels of physical activity among elite-level athletes.

This paper by Gregory Carter and colleagues overlayed with the work of Kostas Papageorgiou et al. triggered an “Aha!” moment in my brain and was a catalyst for my realization that physical activity, mental toughness, and sub-clinical narcissism may be part of a “sunny triad” that can increase self-esteem. Based on my own life experience and the empirical evidence provided by the aforementioned researchers, I suspect that combining the "sunny triad" of three acronyms (PA + MT + SN) on a regular basis in day-to-day life may be a recipe for boosting self-esteem.

Over the past few days, I’ve been corresponding with Gregory Carter for a follow-up blog post and Q&A we’re collaborating on tentatively titled: ”Physical Activity May Brighten Aspects of the Dark Triad: Can physical activity, mental toughness, and sub-clinical narcissism create a "sunny" triad?”


Peter James Taylor, Katie Dhingra, Joanne M. Dickson, and Elizabeth McDermott. "Self-Harm within Gay, Lesbian and Bisexual UK University Students.” Archives of Suicide Research (First published online: November 19, 2018) DOI: 10.1080/13811118.2018.1515136

Kostas A. Papageorgiou, Foteini-Maria Gianniou, Paul Wilson, Giovanni B. Moneta, Delfina Bilello, Peter J. Clough. "The Bright Side of Dark: Exploring the Positive Effect of Narcissism on Perceived Stress Through Mental Toughness." Personality and Individual Differences (First published online: November 15, 2018) DOI: 10.1016/j.paid.2018.11.004

Kostas A. Papageorgiou, Andrew Denovan, Neil Dagnall. "The Positive Effect of Narcissism on Depressive Symptoms Through Mental Toughness: Narcissism May Be a Dark Trait but It Does Help with Seeing the World Less Grey." European Psychiatry (First published online: November 1, 2018) DOI: 10.1016/j.eurpsy.2018.10.002

Robert Vaughan, Gregory L. Carter, Danny Cockroft, Lucia Maggiorini. "Harder, Better, Faster, Stronger? Mental Toughness, the Dark Triad and Physical Activity." Personality and Individual Differences (First published online: May 4, 2018) DOI: 10.1016/j.paid.2018.05.002

James W. Moore. "What Is the Sense of Agency and Why Does it Matter?" Frontiers in Psychology (First published online: August 29, 2016) DOI: 10.3389/fpsyg.2016.01272

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