BA Thesis BP124-2023

ASSERTING SELF-RESPECT 1
PRE-REGISTRATION PLAN:
https://osf.io/7eqjv/?view_only=e1dd087403cd408b9aaaffa3c7b979e1
Abstract
Background
The literature shows that Sexual Minority Individuals (SMI) have severe societal
disadvantages as opposed to their heterosexual counterparts. The present study links this to
lower levels of psychological flexibility. A mediation mechanism is proposed based on
relational cultural theory, where assertiveness positively mediates the positive relationship
between self-respect and psychological flexibility. Because of this mechanism, the present
study hypothesises that the variables of all of these pathways are positively correlated with
each other. In addition to this, it is hypothesised that a mediation analysis will provide
evidence in support of the proposed mechanism.
Methods
The present study investigates an existing dataset consisting of 346 respondents that was
gathered by means of an online survey on a cross-sectional level. The relevant parts of this
survey for the present study are a demographic measure, the Multidimensional Psychological
Flexibility Inventory, Renger’s self-respect measure and the Assertiveness subscale of the
Interpersonal Competence Questionnaire.
Results
All of the analyses that were conducted found evidence in support of the proposed
hypotheses; significant positive Spearman's rank correlations were found for all of the
variable relationships of interest, and the mediation analysis was found to be (positively)
significant in its partial form as well. Small to medium effect sizes were found.
Conclusion
The findings in the present study provide evidence in support of the proposed mediation
mechanism where the positive relationship between self-respect and psychological flexibility
is partly positively mediated by assertiveness among the population of SMI. This knowledge
could guide interventions among this group of SMI.
Keywords: Sexual minority individuals, psychological flexibility, assertiveness,
self-respect, mediation
Contents
Introduction............................................................................................................................................ 3
Theoretical framework of present research....................................................................................... 4
Psychological flexibility.................................................................................................................... 5
Self-respect........................................................................................................................................ 7
Assertiveness..................................................................................................................................... 8
Present research................................................................................................................................. 9
Methods.................................................................................................................................................10
Respondents.....................................................................................................................................10
Measures.......................................................................................................................................... 11
Demographics measure............................................................................................................. 11
Multidimensional Psychological Flexibility Inventory.............................................................12
Renger’s self-respect measure.................................................................................................. 12
Assertiveness subscale of the Interpersonal Competence Questionnaire................................. 13
Procedure......................................................................................................................................... 14
Statistical analysis............................................................................................................................15
Results................................................................................................................................................... 17
Descriptive results........................................................................................................................... 17
Correlational analysis...................................................................................................................... 18
Mediation analysis...........................................................................................................................18
Discussion..............................................................................................................................................21
Limitations.......................................................................................................................................22
Strengths.......................................................................................................................................... 24
Future directions.............................................................................................................................. 25
Implications..................................................................................................................................... 26
Conclusion....................................................................................................................................... 27
Acknowledgements...............................................................................................................................27
References............................................................................................................................................. 29
Appendix A (Appendix 5 in pre-registration plan): Deviations from pre-registration plan.........38
Appendix B: Information Sheet..........................................................................................................43
Appendix C: Online Consent Form....................................................................................................45
Appendix D: Debriefing Sheet............................................................................................................ 46
Asserting Self-respect: Assessing The Mediating Role of Assertiveness in the

Relationship between Self-Respect and Psychological Flexibility among Sexual Minority
Individuals with Cross-sectional Data
Globally, an average of approximately one in every ten individuals does not identify
themselves as heterosexual (Rahman et al., 2019).23 The present study defines Sexual
Minority Individuals (SMI) as these individuals who do not identify as heterosexual,
including, among others, gay, lesbian, and bisexual people (Rahman et al., 2019).
Investigating this group is crucial due to the apparent societal disadvantages they experience,
which contribute to poorer mental health outcomes compared to heterosexuals. Extensive
research has consistently shown that SMI report greater levels of mental distress, have
increased odds of experiencing stressful life events, are more likely to be victimised in
various settings, experience impaired academic achievement, suffer from worse physical
health, are more likely to delay seeking healthcare, and experience higher rates of mental
health disorders18 (Balsam et al., 2005; Jackson et al., 2016; Martin-Storey et al., 2022;
Meyer, 2003; Przedworski et al., 2015). SMI were found to be more likely to report any
mental health disorder diagnosis when compared to their heterosexual counterparts,
including, among others, anorexia, depression, obsessive-compulsive disorder and
post-traumatic stress disorder (Przedworski et al., 2015).19
The present study will focus on three variables, namely: self-respect, psychological
flexibility, and assertiveness with particular attention paid to the former two variables, which
are relatively recent additions to the field of psychology, as noted by Kashdan and Rottenberg
(2010) and Renger (2017). Therefore, investigating a mechanism involving self-respect and
psychological flexibility will hopefully prove to be a valuable contribution to the existing
body of research by filling gaps in the literature.20 This knowledge could help guide future
research, which, in turn, could lead to the development of interventions that can be used in
the improvement of the well-being in practice.56, 17
Furthermore, there is a still limited understanding in the literature of protective
mechanisms for SMI.21 In this literature, there are numerous studies into what mechanisms
result in these adverse effects, e.g. the Minority Stress Model (Meyer, 2003). This model
draws from several theories in the fields of sociology and social psychology in an attempt to
describe stress processes, among which: the experience of prejudice events, expectations of
rejection, hiding and concealing, internalised homophobia, and ameliorative coping processes
among minority individuals and how these lead to detrimental consequences (Meyer, 2003).
Whilst such deficit approaches are crucial for advancing our knowledge, they offer only a
part of the complete picture. The current literature contains far fewer studies into the
mechanisms that underlie the large differences in susceptibility to these negative
consequences among the individuals within this group of SMI thus making it valuable to
identify what mechanisms seem to protect certain individuals from these negative
consequences but not others (Kapadia et al., 2019; Perrin et al., 2020). Therefore, the present
study aims to investigate a conceptual mechanism that may be in play, i.e. that self-respect is
positively related to psychological flexibility and that this relationship is (partially) positively
mediated by assertiveness. By doing this, it attempts to investigate the relationship between
these constructs as as a potential protective mechanism for this group of SMI.44 Having
knowledge of such a mechanism would most likely be highly beneficial for designing
interventions tailored to the needs of this disadvantaged group specifically.42 In addition to
increasing the knowledge we have about psychological flexibility and self-respect, the current
study thus aims to contribute to the still limited understanding of the literature on SMI as
well.
Theoretical framework of present research43
Theoretical support for the proposed conceptual mediation mechanism can be found
in the literature in the form of a theoretical framework, namely relational cultural theory.21
Relational cultural theory, as posited by Jordan (2017), suggests that individuals internalise
experiences of both connection and disconnection, which consequently give rise to the
development of so-called “relational images.” These relational images, as defined in the
theory, refer to perceptions of an individual regarding themselves in relation to others, as well
as their expectations regarding their interactions with others (Jordan, 2017; Mereish & Poteat,
2015b).64 This results in the fact that people often rely on multiple relational images, such as
relational schemas, to guide their behaviours and social interactions (Jordan, 2017; Mereish
& Poteat, 2015b).6 It is easy to see how SMI could be confronted with relatively poor
relational images as compared to heterosexuals given the fact that they deal with a
disproportionately large amount of negative stigma from the people around them (Jackson et
al., 2016).7 Relational cultural theory puts forward that growth-fostering relationships could
be associated with resilience to psychological distress and mental well-being among SMI
(Jordan, 2017; Mereish & Poteat, 2015a, 2015b). This is posited to work via the improvement
of these relational images that occurs when growth-fostering relationships teach SMI to
change these images within themselves (Jordan, 2017; Mereish & Poteat, 2015a, 2015b).44
Growth-fostering relationships are defined as being characterised by the relational elements
of empathy, mutuality, and empowerment (Jordan, 2017; Mereish & Poteat, 2015a). The
concept of mutualism, or an interaction between two or more individuals that results in
beneficial effects for both, is highly related to the concept of self-respect, or an individual’s
ability to see themselves as having identical rights and dignity as other people: one needs to
believe in their own equal rights to other people in order to engage in a relationship that is
beneficial to both members (Holland & Bronstein, 2008; Renger, 2017).
However, the mere belief in one's equal rights and dignity may not be enough to
guarantee mutualistic relationships. Assertiveness, or the ability to stand up for one's
legitimate rights, can be reasoned to mediate the relationship between self-respect and
mutualism (Gorman & Sultan, 2008). For a relationship to be mutualistic, the present study
proposes that it can be reasoned that one may need45 to have a sufficient level of self-respect
in order to increase one’s assertiveness. Self-respect may need45 to work “through”
assertiveness in a way because if one is not assertive, the higher level of self-respect might
not even show itself to the relationship partner and more or less stay in the person’s head.
This higher level of assertiveness may24 then (partially) lead to resilience to psychological
distress among SMI through mutual, growth-fostering relationships according to relational
cultural theory, and this concept of resilience is, in turn, closely related (by definition)57 to
psychological flexibility and a big part of mental well-being (Kashdan & Rottenberg, 2010;
Mereish & Poteat, 2015a, 2015b).23 For this reason, psychological flexibility can also be
implicated in this framework.44
Psychological flexibility
Psychological flexibility is a multifaceted concept that can be challenging to fully
comprehend. Kashdan and Rottenberg (2010) define psychological flexibility as a concept
that is transdiagnostic, involves a range of both inter- and intra-personal skills, and is
considered one of the cornerstones of mental health care because of its close relationship with
the concept of resiliency. Hayes et al. (2006) define it as the capacity to effectively and more
fully engage with the moment at hand as a cognizant individual, and to modify or maintain
conduct in accordance with the esteemed objectives. The concept of psychological flexibility
encompasses a wide range of abilities, i.e.: the recognising of and adapting to environmental
demands; the shifting of mindsets or behavioural repertoires when these strategies seem to be
detrimental to one’s personal or social functioning; the maintaining of a certain level of
balance among important domains of life; and the being aware of behaviours that are in line
with one’s with personal values (Kashdan & Rottenberg, 2010). One needs to be open and
committed to these behaviours as well to be considered psychologically flexible (Kashdan &
Rottenberg, 2010). In psychopathology, these flexibility abilities are often hindered (Kashdan
& Rottenberg, 2010; Nolen-Hoeksema et al., 2008). A person with high psychological
flexibility might encounter a stressful life event and think to themselves: “This particular
situation is bad but I will not let it ruin the other facets of my life.”, whilst a person with a
lower level of psychological flexibility might have more difficulty taking a step back in order
to see the bigger picture, and think to themselves in a similar situation: “This is bad and it
will surely ruin my entire week!” People with low levels of psychological flexibility are often
found to engage in experiential avoidance, which refers to a situation where an individual
chooses to refrain from engaging with specific adverse25 private experiences, such as, among
other things, bodily sensations, emotions, thoughts, or memories (Hayes et al., 1996; 2004;
2006). This reluctance to remain in personal contact with such experiences may lead them to
take measures to modify the frequency or form of these experiences, or even the situations
that give rise to them themselves (Hayes et al., 1996; 2004; 2006). Despite the detrimental
effects that these avoidance behaviours seem to have on their behaviour, the individuals often
persist to engage in such poor practices (Hayes et al., 1996; 2004; 2006).
Psychological flexibility has been implicated in the broader concept of mental health
(Kashdan & Rottenberg, 2010).66 Although the theories in the literature on what exactly
constitutes mental health are quite diverse, positive emotions and thoughts, strengths, and the
satisfaction of basic psychological needs for belonging, competence, and autonomy have
historically been seen as the undisputed aspects that make up one’s mental health
(Csikszentmihalyi, 1990; Deci & Ryan, 2000; Fredrickson & Losada, 2005; Kashdan &
Rottenberg, 2010). Whilst these factors are undoubtedly important, they fail to take into
account many of the fluctuating and conflicting forces that are common when people
navigate their environment and social world (Kashdan & Rottenberg, 2010). Research
findings provide evidence in support of the nature, correlates, and consequences of
psychological flexibility as an aspect of mental health58 (Kashdan & Rottenberg, 2010). In
addition to this, applied research provides details on possible interventions that appear to
have promising effects (Kashdan & Rottenberg, 2010).64 It is thus imperative that further
research is conducted on psychological flexibility to gain a more comprehensive
understanding of the broader concept of mental health and to inform us more about the
promising interventions guided by this concept.
Sarkova et al. (2013), found that, in their sample of students, assertiveness was
significantly and positively correlated with a host of indicators of mental health. This is clear
evidence in support of a positive relationship between assertiveness and psychological

flexibility, given the illustrated close relationship to the concept of mental health.
According to the psychological flexibility model, acceptance and commitment therapy
supports the understanding of the concept of psychological flexibility we have today because
the concept largely emerged to describe the results of this form of therapy (Hayes et al.,
2006). A study by Azadeh et al. (2015) shows that, among a sample of female high school
students with social anxiety disorder, acceptance and commitment therapy not only seems to
significantly improve one’s psychological flexibility but also problems with one’s
assertiveness. The fact that effective interpersonal communication and assertiveness methods
are taught in this form of therapy, and that this is proposed to help individuals with solving
problems resulting from not learning how to form proper relationships, directly links this
connection between psychological flexibility and assertiveness into the theoretical framework
proposed by relational cultural theory (Azadeh et al., 2015; Mereish & Poteat, 2015a,
2015b).44 The therapy that is meant to improve psychological flexibility thus heightens
assertiveness, which increases the amount of growth fostering relationships, which, in turn,
may45 lead to higher levels of psychological flexibility according to relational cultural theory
(Mereish & Poteat, 2015a, 2015b). This further supports the potential relationship between
assertiveness and psychological flexibility although it should be mentioned that alternative
explanations could be possible, e.g. assertiveness and psychological flexibility both increase
independently due to this therapy.
Self-respect
The concept of self-respect pertains to an individual's ability to perceive oneself as
having equivalent rights and dignity to the other people around them (Honneth, 1996, 2012;
Renger, 2017).
In a greatly influential theory of recognition, it has been proposed that the individual
tends to refer to oneself in three distinct dimensions, namely self-competence,
self-confidence and self-respect (Honneth, 1996, 2012; Renger, 2017). As noted by Renger
(2017), the first two concepts of this theory by Honneth (1996, 2012), self-competence and
self-confidence, are rather comparable to the definitions of self-competence and self-liking as
proposed by Tafarodi and Swann (2001), and have largely been implicated in past research in
the literature.59 Nevertheless, the third dimension, defined as an individual’s ability to see
themselves as someone who has the same basic rights and dignity as other people, or
self-respect, has not been covered by past psychological approaches to the self (Honneth,
1996, 2012; Renger, 2017). Because of this reason, the literature does currently not contain
much empirical research on this relatively new concept so novel ways will be used in order to
still make statements about its possible role in the conceptual mediation mechanism
proposed. Whilst Renger (2017) demonstrated that self-respect predicts assertiveness beyond
other self-scales, a common valence factor was found to possibly be present in these
self-scales, as evidenced by their high bivariate correlations. Self-esteem is one such
self-scale, and it has been proposed in previous psychological frameworks that self-respect is
a component of the broader construct of self-esteem, further indicating a close relationship
between these two constructs (Branden, 1988; Clucas, 2019; Orth & Robins, 2014). This
means that when self-esteem was measured in these studies, self-respect was inadvertently
also measured as a part of it. This is why self-esteem will be used as a proxy measure41 of
self-respect in the following section. Although this solution is imperfect, it appears to be the
best alternative available to stating more direct evidence given the limited literature available.
Fatemeh et al. (2016), Moss et al. (2021), and McAteer and Gillanders (2019) found a
positive correlation between self-esteem and psychological flexibility, which provides modest
support for a relationship between self-respect and psychological flexibility. The underlying
valence factor of self-esteem and self-respect may be implicated in this correlation,
suggesting that a similar relationship may exist between self-respect and psychological
flexibility. The fact that self-respect is traditionally also measured when self-esteem is, also
supports that this connection would hold for self-respect and psychological flexibility.
Moreover, it was found that self-esteem is directly associated with mental health and
resilience, which are both critical components of psychological flexibility, further supporting
the relationship between self-respect and psychological flexibility (Kashdan & Rottenberg,
2010; Perrin et al., 2020).
Self-esteem was found to be positively correlated to relationship satisfaction, tying it
into the proposed theoretical framework of relational cultural theory, given the fact that
relationship satisfaction is likely to be closely related to the growth-fostering relationships the
theory hinges upon (Mereish & Poteat, 2015a, 2015b; Moss et al., 2021).
Assertiveness
According to Gorman and Sultan (2008), assertiveness is commonly defined in the
literature as an individual's readiness to defend their legitimate rights. Renger's (2017)
research, which utilised cross-sectional and longitudinal analyses, suggests that self-respect
has a positive relationship with assertiveness. The sample that was used in this study was
comprised of a general group of participants gathered on social media (Renger, 2017).
Therefore, it would be interesting to investigate if the results hold for the specific group of
SMI as well. The study by Renger (2017), did, however, show that self-respect only predicted
assertiveness when the individual’s rights (to privacy and to property in this case) were
violated but not when this was not the case. Among two large independent general population
samples from the Netherlands, certain right violations were experienced more by SMI than by
heterosexuals, such as bullying, discrimination and trauma, which was even found to partly
mediate an association between SMI status and psychotic symptoms (Gevonden et al., 2013).
A study by Przedworski et al. (2015) also found disparities in facets such as minority stress,
stigma, and discrimination between heterosexuals and SMI. This indicates that the connection
between self-respect and assertiveness that was found by Renger (2017) when rights were
violated could also hold for this group given the fact that this group is confronted with
violations of their rights often.
There is evidence in the literature which ties this positive association between
self-respect and assertiveness into the theoretical framework of relational cultural theory as
well.54 Maladaptive beliefs associated with low levels of self-respect can be replaced with
more realistic, positive beliefs that will foster assertiveness by using assertiveness training,
resulting in an increase in self-evaluation in social circumstances, thereby impacting
relational images53 and thus relational cultural theory in the connection between these two
variables (Mereish & Poteat, 2015a, 2015b; Moss et al., 2021; Speed et al., 2017).
Present research26
As can be concluded from the preceding60 section, there is some (sometimes modest)
evidence in support of a relationship between self-respect and psychological flexibility that is
positively61 mediated by assertiveness. The limited evidence is likely to, at least partially,62
stem from the before-mentioned fact that there is not much research yet in this specific field
of study (SMI). The fact that the concepts of self-respect and psychological flexibility are
relatively new in the literature is also not likely to help in this matter (Kashdan & Rottenberg,
2010; Renger, 2017). It is thus very important that studies are conducted to further the
knowledge in this field by filling the gaps in the literature. Despite the evidence that can be
observed in the literature, no study seems to have been conducted to directly test the potential
mediation mechanism put forward in the present study. This confirmatory study will attempt
to resolve this issue of insufficient information in the research literature by looking for
evidence that is in support of this conceptual model.46
The present study aims to investigate the relationship between self-respect,
assertiveness, and psychological flexibility in SMI, as well as, if these are present, whether
assertiveness mediates the relationship between self-respect and psychological flexibility.

Specifically, it is hypothesised that:
Hypothesis 1: Self-respect is positively correlated to assertiveness.
Hypothesis 2: Assertiveness is positively correlated to psychological flexibility.
Hypothesis 3: Self-respect is positively correlated to psychological flexibility.
Hypothesis 4: Assertiveness (partially) positively mediates the positive63 relationship between
self-respect and psychological flexibility.
To test these, correlational analyses as well as a mediation analysis will be carried out.
Methods
The present study is27 a secondary data analysis of an existing dataset.23 Only
measures relevant to the current study will be discussed but the original procedure will be
explained.51 In the present study, the focus lies on psychological flexibility, self-respect and
assertiveness because these are the variables involved in the conceptual mechanism that was
researched. Because of this, only the questionnaires that attempted to measure these variables
were examined in more detail.55
Respondents
In order to gather a sample that was compatible with the intended goals, the original
study implemented a number of inclusion criteria.40 The first of the inclusion29 criteria for the
original, and thus present study40 was that a subject cannot identify oneself as being
heterosexual.23 The two other inclusion29 criteria were that respondents had to be aged 18 or
older and that they had to be proficient in the use of the English language. All respondents
who met these criteria were invited to complete the online survey that constituted the
data-gathering part of the study.
The original study included 522 respondents, but the present study only includes 346
respondents because respondents that did not complete (one of) the questionnaires that were
looked at in this study were excluded. In addition to this, respondents that did not match the
inclusion29 criteria were excluded as well.9, 47
Demographic information of the present sample30 is displayed in Table 1.8, 23
Measures28
Demographics measure35, 36
All of the demographic information that was measured in the original study was
assessed first when respondents filled out the questionnaire. They were all assessed on the
basis of self-reported answers to questions that were either multiple choice (e.g. highest level
of education) or open answer (e.g. nationality).
Multidimensional Psychological Flexibility Inventory35

Psychological flexibility, as the Multidimensional Psychological Flexibility Inventory
(MPFI) attempts to measure, has been defined by Rolffs et al. (2016) as a set of essential
strategies that individuals can use to modify the function of their internal experiences by
responding to negative thoughts, emotions, and events in a flexible manner, which in turn
contributes to their overall well-being.23 The concept of psychological flexibility was
operationalised in this study by means of this MPFI. This inventory is a freely-available
questionnaire that measures six flexibility and six inflexibility subscales (Rolffs et al., 2016).
Each subscale consists of five questions (e.g. In the last two weeks, I was attentive and aware
of my emotions) (Rolffs et al., 2016). For the study at hand, the 12-item flexibility composite
of MPFI was used. This is a shortened version of this inventory where only the first two items
of each flexibility subscale are used, rated from 1 (Never true) to 6 (Always true) (Rolffs et
al., 2016). No reverse scoring of items was used for this questionnaire. The scores for the
items can be averaged in order to gain a score for each specific subscale and these scores on
each subscale can, in turn, be averaged to create a composite representing global flexibility
(Rolffs et al., 2016). Higher scores reflect higher levels of the dimension being assessed,
including the global composite score (Rolffs et al., 2016). For the full MPFI, the original
authors found excellent3 Cronbach's alpha values ranging from .96 to .97 (Rolffs et al., 2016).
Overall, Cronbach’s alpha values ranging from .75 to .92, covering the range of acceptable3
to excellent3 were found for the subscales of the short version of the MPFI specifically
(Grégoire et al., 2020). It was found that this short version of the MPFI had good convergent
and concurrent validity (Grégoire et al., 2020). In the dataset used for this study, an excellent3
Cronbach’s alpha value of .86 was observed. For this and subsequent Cronbach’s alpha tests
that were conducted on the basis of the dataset used in the present study, outliers, as were
standardly assessed in based on the 3rd quartile + 1.5*interquartile range or the 1st quartile –
1.5*interquartile range,11 were removed given the fact that extreme cases like this can
severely inflate Cronbach’s alpha values (Liu et al., 2010). The Cronbach’s alpha value would
have been an excellent3 and only marginally higher value (before rounding) of .86 if the
outliers were not removed. Cronbach’s alpha values in the present study were interpreted in
accordance with the interpretation guidelines put forward by Azimi and Calver (2018)3, 22, 23
Renger’s self-respect measure35
The concept of self-respect, as measured by Renger’s self-respect measure, pertains to
an individual's ability to perceive oneself as having equivalent rights and dignity to the other
people around them (Honneth, 1996, 2012; Renger, 2017). The concept of self-respect was
operationalised by means of this self-respect measure in the present study. Respondents were
asked to score how much four different statements apply to their life (e.g. In everyday life I
always see myself as a person with equal rights) (Renger, 2017). They were asked to score
them on a 7-point Likert scale ranging from 1 (being not true at all) to 7 (being completely
true) (Renger, 2017). No reverse scoring of items was used for this questionnaire. After
completion, the Likert scale scores were averaged for all four statements to receive a final
and mean31 score of self-respect where higher scores equate to a higher level of self-respect
(Renger, 2017). Renger (2017) found great indicators for internal consistency for her48
self-respect measure23, namely excellent3 Cronbach's alpha values of .91 for the first time it
was used in the study and .95 for the second time. A study by Clucas et al. (2022) provides
evidence for the divergent and convergent validity of the self-respect measure proposed by
Renger (2017) by showing that measuring recognition of oneself as a person with equal rights
and worth, or recognition self-respect, as was intended to be assessed by this measure is
distinct from measuring the related but different concept of appraisal self-respect. The items
assessed by this study appeared to load most highly on their intended factors (recognition
self-respect or appraisal self-respect) (Clucas et al., 2022). Items that theoretically related to
both of these factors appeared to load on both, supplying evidence for acceptable convergent
and divergent validity of this measure (Clucas et al., 2022). Moreover, Renger (2017) found
in her48 study that high scores on her48 measure of self-respect predicted higher levels of
assertiveness beyond the other self-scales assessed, providing additional evidence for a good
level of divergent validity. In the dataset used for this study, a slightly lower but still
excellent3 Cronbach’s alpha value of .83 was observed for this measure. This value would
have been a somewhat higher, excellent3 value of .85 if the outliers were not removed.22
Assertiveness subscale of the Interpersonal Competence Questionnaire35
Assertiveness, as measured by the assertiveness subscale of the Interpersonal
Competence Questionnaire (ICQ), is defined as someone’s ability to assert personal rights
(Buhrmester et al., 1988). Assertiveness was operationalized in the present study by means of
this assertiveness subscale of the ICQ. Respondents were asked to answer eight questions
(e.g. How good are you at getting people to go along with what you want?) with a five-point
Likert scale ranging from 1 (I’m poor at this; I’d feel so uncomfortable and unable to handle
this situation, I’d avoid it if possible) to 5 (I’m extremely good at this; I’d feel very
comfortable and could handle this situation very well) (Buhrmester et al., 1988). No item
reversal was used for this questionnaire. Mean31 scores were calculated by averaging the
scores of every item with higher scores equating to a higher level of assertiveness
(Buhrmester et al., 1988). Cronbach’s alpha for the different scales ranged from the
acceptable3 value of .72 to the excellent3 value of .86 for the Polish version of the ICQ
(Górska, 2011). Buhrmester et al. (1988) found Cronbach’s alpha values for these different
scales to range from acceptable3 to excellent3 as well with values covering .77 to .86. (for the
original test in English) and Kanning (2006) too found them to range from acceptable3 to
excellent3 with values ranging from .72 to .84 (for this questionnaire translated in German).
When investigating the construct validity of the ICQ (in Polish) concerning the NEO-FFI and
information on the respondent’s relationship experiences and satisfaction with life, it was
found that most of the ICQ scales correlated positively with extraversion and
conscientiousness and negatively with neuroticism and that participants who had never been
in a romantic relationship were less interpersonally competent according to the ICQ than
participants with such an experience, indicating proper convergent and divergent validity
(Górska, 2011). In addition to this, the competence score was found to be related to both the
number of relationships and the duration of the longest relationship one has had (Górska,
2011). Life satisfaction was found to be correlated positively with the majority of ICQ scales
as well, further supporting the convergent validity of this questionnaire (Górska, 2011).6 In
the dataset used for this study, an excellent3 Cronbach’s alpha value of .80 could be observed
for the assertiveness subscale of50 this questionnaire. This value would have been an
excellent3 value of .84 if the outliers were not removed.22
Procedure
Respondents were invited to take part in it by completing an online Qualtrics survey
(www.qualtrics.com) that took roughly 15 minutes. In the original study, the general aim was
to obtain more knowledge about the factors implicated in the well-being of SMI.23, 52
Participation in the study was entirely voluntary, and the respondents always had the option
to withdraw from the research at any point in time without a reason being necessary or
without there being any negative consequences for the respondents.52
The survey used for the original study attempted to measure the constructs of
self-respect, assertiveness, sexual minority identity achievement & affirmation, parental
acceptance, attachment style, religiosity, psychological well-being, psychological flexibility,
resilience, internalised homonegativity, age, gender, nationality, level of education, sexual
orientation and disclosure of sexual orientation.37 There were a number of ways of recruiting
respondents both online and offline but primarily through Leiden University. The
cross-sectional study was listed on SONA (www.sona-systems.com), an online platform
where, in order to earn credits, first-year students can take part in studies. In addition to this,
posters, which displayed a brief description of the original study, the selection criteria used,
and a QR code that people could scan to be directed to the survey were distributed throughout
the faculties and libraries of the university. The posters were also distributed outside of the
university in LGBTQIA+ community settings within the Netherlands (e.g. bars and pubs).
COC Amsterdam (https://www.cocamsterdam.nl), an association advocating for the rights of
LGBTQIA+ individuals, advertised the study on their website as well. Finally, a digital
version of the poster was posted on various social media platforms. Viewers were asked to
contact one of the researchers if they were interested in contributing to the study by filling out
the survey and only then, were provided with the link to the cross-sectional survey. This was
done as a precaution for possible bots. After completing the online 15-minute online survey,
respondents were rewarded with either one SONA credit or an entry in a lottery (20 Euros
was raffled among every 20 respondents). The information sheet and consent form that were
given to the respondents before starting the survey are displayed in Appendix B and C
respectively and the debriefing form that was given to the respondents after the survey was
completed is displayed in Appendix D. The ethics approval code for the larger research that
the original study is a part of is as follows: 2022-01-27-M.S. Tollenaar-V1-3700. The
approval was obtained at the Psychology Research Ethics Committee of Leiden University.49
The original cross-sectional study was pseudo-anonymized by means of a key-code survey.
Informed consent was also obtained from all respondents.
Statistical analysis10
All of the analyses that are mentioned in the present study were conducted via IBM
SPSS Statistics (version 27.0.1.) with the PROCESS computational tool (version 4.3) by
CCRAM expert Hayes (n.d.)34 added. The model within PROCESS that was used to test the
mediation mechanism mentioned in hypothesis 4 was model number 4.33 All of the tests in the
following section are conducted with an alpha value of p <.05.11, 23
For hypotheses 1, 2 and 3, the (Pearson's r or Spearman’s rank12) correlation between
scores on the self-respect measure and scores on the assertiveness subscale of the ICQ, scores
on the assertiveness subscale of the ICQ and scores on the MPFI and scores on the
self-respect measure and scores on the MPFI were assessed respectively. Two-tailed tests
were conducted given the fact that the possibility of both positive and negative effects will be
taken into account this way (even though a positive relationship is hypothesised).13
The assumptions assessed for testing for a Pearson’s r correlation are: the two
variables correlated are continuous23, there is a linear relationship between the two variables,
the distribution of the scores is approximately normally distributed (bivariate normality), and
the scores have been obtained in fully independent pairs (independent cases) (Havlicek &
Peterson, 1976). These assumptions are checked by looking at the questionnaires that are
used in this study, by plotting the two variables of interest to the hypothesis that is being
assessed in a scatterplot, and by means of the Shapiro-Wilk test of normality for each variable
separately. The results of this were as follows: no violations were found for any of these
assumptions except for the last one. The mean31 scores on the measures of psychological
flexibility, assertiveness and self-respect all have a significant Shapiro-Wilk test of normality
(with a p value of .015, <.001 and <.001 respectively) indicating that none of these meets the
bivariate normality assumption. This was not a problem, however, given the fact that the
sampling distribution of the mean is practically always normal, regardless of how values are
distributed in the population for studies with a sample larger than 20 due to the phenomenon
known as the central limit theorem, which, consequently means that many test results are
unaffected by even the largest violations of normality (Van Den Berg, n.d.).4 This includes
these correlation analyses.65 The scores on the variables were also checked for outliers in
SPSS. The results of this check were that a single outlier was found on the mean31 scores of
both psychological flexibility and assertiveness, but not on the mean31 score of self-respect.
These two outliers were explicitly mentioned and investigated in the results section.23
It was decided that in case of non-linearity and/or outliers, Spearman’s rank
correlation was used to assess whether or not these variables are correlated, instead of the
Pearson r correlation. Because outliers were, indeed, found on the mean scores of
psychological flexibility and assertiveness, Spearman’s rank correlation was ultimately
used.38 This way of testing for a correlation relies on the assumption of a monotonic
relationship (Hauke & Kossowski, 2011). This was checked in the present study by means of
visually inspecting a scatterplot of the two variables of interest for the hypothesis at hand.23
The results of this were as follows: none of the relationships appears to violate the
monotonicity assumption.
Next, it was assessed in hypothesis 4, in case all of the previously mentioned
correlations were found,16 if the positive relationship between scores on the self-respect
measure and scores on the MPFI is (partially) positively mediated by scores on the
assertiveness subscale of the ICQ. This was tested by, firstly (a), assessing if scores on the
self-respect measure were positively regressed on scores on the assertiveness subscale of the
ICQ. Next (b), it was assessed if scores on the assertiveness subscale of the ICQ were
positively regressed on scores on the MPFI controlling for scores on the self-respect measure
when tested. Finally (c’), it was assessed if scores on the self-respect measure were positively
regressed on scores on the MPFI controlling for scores on the assertiveness subscale of the
ICQ.15 If all of these regression analyses (a, b and c’) turned out to be statistically significant,
it could be concluded that there was evidence found in support of the proposed mediation
mechanism in its partial mediation form. If, on the other hand, only the first two (a and b)
turned out to be significant, this could be considered evidence in support of a full mediation
version of the proposed mechanism.14 All these simple (the first test) and multiple regression
analyses (the latter two tests) were conducted with a one-tailed test because these hypotheses
not only aimed to make a statement about the strength of the relationship but also about its
direction (positive). In addition to this, the effect of self-respect on psychological flexibility
with the mediator unaccounted for was assessed as well as pathway c.
The assumptions that were investigated in order to perform the simple and multiple
regression analyses were linearity of the relationship between the variables, approximate
normality of distribution of errors around zero, homoscedasticity where the variance of the
errors had to be the same for any combination of values of independent variables and
independence of errors (Ernst & Albers, 2017). These assumptions were checked by
inspecting the previously made plot of the two variables of interest to the hypothesis that is
being assessed,5 by visually looking at a histogram of the errors, and by means of inspecting a
scatterplot of the residuals. No violations of assumptions were observed.23 The scores on the
variables were also previously checked for outliers in SPSS. The existing outliers were taken
out of the dataset before the regression analyses were conducted in order to not skew the
results based on a single or small number of extreme cases. The results of this procedure were
as follows (as mentioned previously): outliers were found on the mean31 scores of
psychological flexibility and assertiveness, but not on the mean31 score of self-respect.
Although the final dataset that was used to make statements about hypothesis 4 was the one
with the outliers taken out, the analyses that were performed on this dataset were also
performed on a secondary data set where the outliers still remained in order to observe what
the results would have been if the outliers were not taken out.
Finally, the two variables of age and gender were added as covariates to the mediation
analysis. This is done in order to investigate whether taking into account these two variables
alters the results in any way.39
Results
Descriptive results
Firstly, the mean total score on the MPFI of the sample used in the present study is 3.6
with a standard deviation of 0.7. This score is above the middle of the 6-point scoring scale
used for this inventory, indicating a somewhat average, perhaps slightly above average level
of psychological flexibility in this sample. Secondly, the mean total score of the sample on
the self-respect measure was 5.4 with a standard deviation of 1.4. This mean score falls
somewhat above the middle of the 7-point scoring scale used for this questionnaire,
indicating a somewhat higher-than-average level of self-respect in this sample (Renger,
2017). Finally, the mean total score of the sample on the assertiveness subscale of the ICQ is
3.2 with a standard deviation of 0.7. This mean score falls somewhat above the middle of the
5-point scoring scale used for this questionnaire as well, indicating a somewhat
higher-than-average level of assertiveness in this sample.
Correlational analysis
For hypotheses 1, 2 and 3, a Spearman’s rank correlation was computed.23 The first
correlation (for hypothesis 1) was computed to assess the relationship between self-respect
and assertiveness. There was a significant positive correlation between the two variables,
r(344) = .32, p < .001. The second correlation (for hypothesis 2) was computed to assess the
relationship between assertiveness and psychological flexibility. There was a significant
positive correlation between the two variables, r(344) = .42, p < .001. The third correlation
(for hypothesis 3) was computed to assess the relationship between self-respect and
psychological flexibility. There was a significant positive correlation between the two
variables, r(344) = .29, p < .001. All of these findings are in line with the proposed
hypotheses. According to Cohen (1988), the first two of these constitute medium effect sizes
and the last one constitutes a small effect size when interpreting them as a Cohen’s d statistic.
Mediation analysis
As mentioned in the research question, hypothesis 4, or whether assertiveness
mediates the relationship between self-respect and psychological flexibility, was to be
assessed if these correlations were found. The results of the mediation analysis of hypothesis
4 with the outliers removed (and thus the final results of the present study) are displayed in
Figure 1.1. What the results of this analysis would have been if the outliers would not have
been removed from the dataset can be observed in Figure 1.2. The correlation coefficients
displayed in the Figures are unstandardized regression weights.
The results of the regression analysis of pathway c with and without outliers removed
are displayed in Figures 1.3 and 1.4 respectively.
Only two outliers were removed from the dataset, reducing the number of respondents
from 346 to 344. One of these had an extremely high mean score on the MPFI of 5.9 and the
other had an extremely low mean score of 1.1 on the assertiveness subscale of the ICQ. As
can be observed in Figure 1.1 until 1.4, the removal of these two only had a negligible effect
on the final results.
Because of the fact that all of these regression analyses, and thus pathways (a, b and
c’) turn out to be highly statistically significant, as can be observed in Figure 1.1, it can be
concluded that there is evidence in support of the proposed mediation mechanism in its
partial mediation form. This is in line with hypothesis number 4. The same conclusion can be
drawn for the dataset with the outliers removed, as can be observed in Figure 1.2. With a
Cohen's f2 value of .09 for path a, .13 for path b and .04 for path c’. According to Cohen
(1988), these all constitute small effect sizes.
The addition of both age and gender as covariates to the model did not change the
model’s statistical significance. All of the pathways are still highly significant with a p value
of < .001. Age and gender were both found to not be a significant influence on pathways a
and c with a p value of .718 and .276 respectively. Gender appears to have a significant
influence on pathway b, however, with a significant p value of .016. Age appears to not have
a significant influence on pathway b with a p value of .420.
Discussion
In the present study, significant positive associations were found between self-respect
and assertiveness, assertiveness and psychological flexibility, and self-respect and
psychological flexibility. Assertiveness was found to partially mediate the positive
relationship between self-respect and psychological flexibility as well. The mediation of
assertiveness was found to be in the positive direction. These findings are in line with the
hypotheses. The effect sizes observed ranged from small to medium.
The finding of these positive associations is in line with the literature, given the fact
that studies like the ones by Fatemeh et al. (2016), Moss et al. (2021), McAteer and
Gillanders (2019), Renger (2017) and Sarkova et al. (2013) supported the individual
relationships between these variables. Even though the literature supported the positive
individual associations between the variables of interest, no attempt has been made to
investigate all of them in a conceptual mechanism as the present study proposes. The
structure of this particular mechanism, or how exactly these variables are related to one
another, was based on a prominent theoretical framework in the literature.
As indicated in the present study, the proposed conceptual mediation mechanism finds
theoretical support within the existing literature through a theoretical framework known as
relational cultural theory. Jordan (2017) posits relational cultural theory, which suggests that
individuals internalise experiences of both connection and disconnection, leading to the
development of "relational images." These relational images, as defined by the theory,
encompass individuals' perceptions of themselves in relation to others and their expectations
for interpersonal interactions. Consequently, individuals often rely on multiple relational
images, to guide their behaviours and social interactions (Jordan, 2017; Mereish & Poteat,
2015b).
Considering the disproportionate negative stigma faced by sexual and gender minority
individuals (SMI) from their surrounding social contexts, it becomes evident how they may
encounter relatively poorer relational images compared to heterosexual individuals (Jackson
et al., 2016). In this regard, relational cultural theory suggests that growth-fostering
relationships, characterised by empathic, mutual, and empowering elements, could be
associated with resilience to psychological distress among SMI, as mediated by these
relational images (Jordan, 2017; Mereish & Poteat, 2015a, 2015b). Here, it is worth noting
that the concept of resilience is by definition closely associated with psychological flexibility
and that it is a significant component of mental well-being (Kashdan & Rottenberg, 2010;
Mereish & Poteat, 2015a, 2015b).
The concept of mutualism, which pertains to interactions benefiting all involved
parties, is reasoned to be closely intertwined with self-respect, or the belief in one's equal
rights and dignity as other individuals (Holland & Bronstein, 2008; Renger, 2017). This
positive relationship between mutualism and self-respect can then be seen as evidence in
support of the direct effect of self-respect on psychological flexibility.
However, simply believing in one's equal rights and dignity does not guarantee the
conception of mutualistic relationships. The present study posits that assertiveness, or the
ability to assert one's legitimate rights, may serve as a partial mediator between self-respect
and mutualism (Gorman & Sultan, 2008). Thus, for a relationship to be mutualistic, it can be
reasoned that a sufficient level of self-respect is necessary to enhance assertiveness.
Self-respect must then work "through" assertiveness because, without assertiveness, a higher
level of self-respect may only remain partially internalised, failing to manifest itself to the
relationship partner. This increased assertiveness, in turn, may (partially) contribute to
resilience to psychological distress among SMI through mutual, growth-fostering
relationships, in accordance with relational cultural theory. This, in turn, may lead to higher
levels of psychological flexibility as well. This part of the theory is in support of the indirect
positive effect of self-respect on psychological flexibility via assertiveness.
The findings of the present study are thus in line with the theoretical framework of
relational cultural theory.
It is worth noting that gender was found to be a significant covariate in this
model.
Limitations
Of course, like any other research study, the present study has its limitations.
Important to note is the fact that the sample used is not entirely representative of a general
SMI population on a number of different facets. The sample used was for instance mostly
within the youngest age group of 18 through 25 years of age (91.9%), female (68.5%), with a
Dutch nationality (50.0%), and bisexual (56.9%). The highest level of education of the
majority of the sample used was secondary education (67.1%). This can be reasoned to be
partially due to the relatively young age of the respondents, given the fact that they are most
likely still following education, however. The mean scores on the concepts of self-respect,
psychological flexibility and assertiveness were also all found to be above average on the
scales used. A study by Lippa (2007), showed that bisexual individuals, the group making up
the majority of the sample used in the present study, have an above-average level of
assertiveness explaining these somewhat higher levels. A study by Bridge et al. (2022), found
that self-esteem and thus self-respect, and mental well-being and thus psychological
flexibility (with self-esteem and mental well-being being used as proxy variables) are
supposed to be lower than average for this group of SMI. When making claims about the
general SMI population based on the present study, it is important to take note of the fact that
some of the aforementioned demographics and scores of the sample that is used do not match
up perfectly with this population. Because of this, the external validity, or how well findings
can be generalised to the population, is being called into question for this study. A more
representative sample could thus have led to differing results.
Another possible limitation of the study at hand is the self-selection bias.
Self-selection bias is a type of bias that arises in research studies when the group of
individuals who choose to participate in the study is not comparable, based on the research
criteria, to the group that chooses not to participate (Glen, 2017). It could have been the case
that the above-average scores on the concepts that were mentioned before, for instance, are
due to this phenomenon because more psychologically flexible individuals and individuals
with a higher level of self-respect could be more likely to sign up to participate in this study.
Another limitation of the present study is the fact that only small effect sizes were
found in the partial mediation mechanism. This means that the findings of this study could
have relatively limited real-world applications. The mechanism could exist but the effect of it
might be too small to be useful. Even though this is certainly a limitation, it is also important
to note that even small effects can be useful. This is especially the case when considering the
importance of finding such a mechanism that was illustrated in this study. Finding a way of
increasing the psychological flexibility of SMI is greatly beneficial, even if it only increases
in small increments.
The present study utilises cross-sectional data, which involves gathering information
at a specific point in time without the manipulation of the variables at hand. Even though this
design allows researchers to obtain a snapshot of a sample's variables of interest, it is crucial
to note that cross-sectional data does not allow causation to be inferred. The absence of
causality arises from the nature of the design, as it does not involve the changing of variables
or the observation of changes over time. Instead, cross-sectional studies focus on assessing
the relationship between the variables at a single point in time. As a result, while
cross-sectional data can provide evidence in support of certain relationships between the
variables, such as the proposed mediation mechanism of the present study, it cannot provide
proof of cause-and-effect relationships. In order to make inferences about causality, a
different research design, such as a longitudinal or experimental design, is required. Because
of this, it is very important to interpret the findings of cross-sectional studies like the present
study cautiously, recognizing that the observed associations or correlations between variables
do not allow for causation to be inferred. Instead, studies like the present one serve as a
starting point for generating hypotheses aimed at exploring relationships that can guide
further research.
Strengths
Besides limitations, the present study does have several strengths as well. One of
these strengths is its novelty. This study investigates a number of variables, namely,
self-respect and psychological flexibility, that have relatively only scarcely been implicated in
past research in the literature. The study is also conducted on the specific group of SMI,
which is an under-researched group in and of itself. The findings of this study are thus a
valuable contribution to the field due to their ability to fill gaps in the literature, which could
ultimately lead to interventions being developed, increasing the quality of life of SMI.
Another strength of this study is the fact that it uses a relatively large sample of 346.
This is especially impressive given the fact that SMI only constitute a specific group among
the general population with only 10 per cent of individuals identifying as such (Rahman et
al., 2019).
Related to the previous strength, another strength of the present study is its statistical
power. Because most researchers in the field appear to assess the power of their tests using
0.80 as a standard for adequacy, this was done in the present study as well. When using the
G*Power programme to conduct a post hoc analysis of the achieved power of the Spearman’s
rank correlation analyses that were conducted shows that they are all well above this value of
0.80, namely a power value of 1.00 for hypotheses 1, 2, and 3 (Faul et al., 2009). When
conducting a post hoc analysis using G*Power for the mediation mechanism that was
conducted for hypothesis 4, it can be observed that the power values for all the pathways are
well above this value of 0.80 as well (Faul et al., 2009). Pathways a and b appeared to have a
power value of 1.00, and pathway c’ one of 0.92. These high levels of statistical power
provide strong evidence for a high probability that these significant tests will detect a
deviation from the null hypothesis, should a deviation like this be true in the real world.
Another strength of the study at hand is its transparency and representativeness. It
makes use of a pre-registration plan which was published before the dataset was observed.
This pre-registration plan is in line with Open Science Framework’s standards for its
pre-registered badge (OSF, 2013). This allows readers to determine which aspects were
conducted as pre-determined, and which aspects were changed. A document, Appendix A,
was also added in order to explain the rationale behind any deviation from the published
pre-registration plan. The present study is in line with the fact that a number of scientists in
the field propose more pre-registration as a solution to worries about the representativeness of
research reports in the published literature (Van ’t Veer & Giner-Sorolla, 2016; Wagenmakers
et al., 2012). Reflecting this development, journals in psychology and neuroscience have
recently shown an increased preparedness to adopt pre-registered studies as a submission
category, to designate a special issue of articles featuring pre-registered research specifically,
and to implement a system of badges meant to make pre-registered research easy identifiable
(Eich, 2014; OSF, 2013; Van ’t Veer & Giner-Sorolla, 2016).
Future directions
The present study provides a starting point on which future research could build to
provide evidence in support of the proposed mechanism that could perhaps aid in our
understanding of it. Perhaps new factors can be implicated in it or conditions for it to work
can be discovered.
Future research could be conducted in order to address the limitations of the present
study. An example of this could be conducting a similar study to the one at hand on a
different sample of the population in an attempt to see if the results hold for these respondents
as well. This way, it could be investigated if the results would hold for an older age group, for
instance, by actively looking for participants over the age of 25. A positive result would
provide evidence in support of the proposed mechanism in the more general population of
SMI and not just among respondents in the youngest age group.
Another way of addressing the limitations of the present study would be an attempt of
reducing the self-selection bias. Although complete elimination of this bias would be nigh
impossible, there are ways of reducing its impact on the results. Firstly, the design of the
study could be altered from spreading a survey amongst a multitude of channels and making
it the potential respondents' responsibility to either participate or not to one where the
researchers actively seek out participants, e.g. by going from door to door (Glen, 2017). This
could displace the responsibility of deciding whether to participate or not partly from the
potential respondents towards the researchers. This is not a perfect solution given the fact that
the final choice of whether to participate or not still remains with the potential respondents. In
situations where self-selection bias cannot be sufficiently eliminated by means of the design
of the study, it may be necessary to employ weighting techniques to adjust the results (Glen,
2017). This involves assigning a higher weight to sample points that are less probable to have
been included in the study, compared to those more likely to self-select (Glen, 2017).
Future research could also be conducted in an experimental manner. This can be done
by attempting to manipulate variables and observing the results of this. Interventions that
have shown the ability to increase one’s self-respect could, for instance, be implemented to
observe whether the resulting values of assertiveness and psychological flexibility are in line
with the mediation mechanism proposed by the present study. This would allow causation to
be inferred.
Implications
The discovery of a mediation mechanism where assertiveness positively mediates a
positive relationship between self-respect and psychological flexibility has important
implications. Knowing of such a mechanism could be beneficial for designing interventions
tailored to the needs of the disadvantaged group of SMI. Therapies designed to improve one’s
self-respect could for instance be used amongst SMI individuals with a lacking level of
psychological flexibility and assertiveness to improve these two dimensions and in turn
overall well-being. Cognitive behavioural therapy aimed at increasing one’s ability to see the
self as someone who has the same basic rights and dignity as others by changing mental
schemes, for instance, could be extremely beneficial in these cases (Bennett-Levy et al.,
2010; Renger, 2017). Limited research has been conducted on interventions aimed at
increasing one’s self-respect. The fact that it has been proposed in previous psychological
frameworks that self-respect is a component of the broader construct of self-esteem could
help address this issue (Branden, 1988; Clucas, 2019; Orth & Robins, 2014). Given the fact
that much more research looking into ways of improving one’s self-esteem exists, and
improving one’s self-esteem is linked directly to improving one’s self-respect due to
self-respect being a component of self-esteem, interventions aimed at improving self-esteem,
like the four-lesson self-esteem enhancement program put forward by Dalgas-Pelish (2006),
could hold the key to implementing the proposed mediation mechanism in practice. Seeing if
an intervention like this one would provide support for the proposed mediation mechanism in
future experimental research would also resolve the limitation of the present study that no
causation can be inferred.
There is also much research on assertiveness training which could be implemented in
the investigation of pathway b of the mechanism in future research (Eslami et al., 2016).
Using implementing assertiveness training as an intervention, the gender differences in
pathway b could also be further investigated in future experimental research.
Conclusion
In conclusion, the present study contributes to the existing literature of the field by
providing evidence in support of a potential protective mechanism which could shield SMI
from the severe societal disadvantages they experience in comparison to their heterosexual
counterparts. This study establishes a connection between these disadvantages and lower
levels of psychological flexibility within the SMI population. Drawing on relational cultural
theory, a mediation mechanism is proposed, highlighting assertiveness as a positive mediator
between self-respect and psychological flexibility. This mechanism fills a crucial gap in the
literature and is supported by the utilisation of data from a sample of 346 respondents,
gathered through an online survey. The findings provide substantial evidence in support of
the mediation mechanism, suggesting that assertiveness plays a positive and partial mediation
role in facilitating the positive relationship between self-respect and psychological flexibility
among SMI individuals. These results encourage future research to address the limitations of
this study and expand the understanding of the proposed mechanism. Ultimately, this
knowledge may guide interventions aimed at enhancing the quality of life for this
marginalised population, thereby addressing their societal disadvantages.
Acknowledgements
I would like to express my sincerest gratitude to my supervisor, A.K. Reinken, for her
invaluable guidance and support throughout the writing of this Bachelor’s thesis. Her
expertise, patience, and encouragement have been instrumental in shaping this research study
and bringing it to completion. Reinken's unwavering commitment to academic excellence and
her meticulous attention to detail have greatly enhanced the quality of the present study. Her
insightful feedback, constructive criticism, and thought-provoking discussions have played a
pivotal role in refining my ideas and strengthening the overall coherence of this work.
Because of this, I am deeply grateful to Reinken for her mentorship. Her dedication to
fostering intellectual curiosity and her willingness to invest time in nurturing my academic
growth have been truly inspiring. Her guidance has not only enriched my understanding of
the subject matter but has also helped me develop valuable research and analytical skills that
will serve me well in my future endeavours.
Furthermore, I would also like to express my gratitude to the entire faculty and staff
of the Faculty of Social Sciences of Leiden University for creating an intellectually
stimulating environment conducive to research and learning. Their contributions and
dedication to academic excellence have nurtured an atmosphere of growth and inspired me to
push the boundaries of knowledge. Leiden University also supplied the dataset the present
study was built upon.
There are no financial, personal, political, religious, ideological, academic,
intellectual and/or other competing interests to declare for the present study.
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Appendix A (Appendix 5 in pre-registration plan): Deviations from pre-registration
plan
1. The tense of the parts of the thesis that have been completed at the time of its
finalization was changed into the past tense in order to follow grammar and style
conventions.
2. Spelling and grammar mistakes which were found in the text of the pre-registration
plan that did not influence the content of the text were corrected with no specific
mention.
3. Interpretation guidelines for Cronbach’s alpha values were added in order to make the
values more easily interpretable and to centralize the interpretation used in the present
study, e.g. a Cronbach’s alpha value of .75 would have been interpreted as acceptable,
regardless of where in the paper it was mentioned.
4. This part was added to aid in the interpretation of the significant Shapiro-Wilk tests
that seem to indicate that the bivariate normality assumption is violated.
5. The assumption of linearity has already been checked for all of the regression
analyses in the tests of the previous hypotheses.
6. An explanation of the concept of relational images was added to more thoroughly

introduce the relational cultural theory.
7. An explanation was added of how relational images might be different in SMI as

compared to heterosexuals to better relate relational cultural theory to the specific
group of SMI.
8. The assessed demographics were decided to be displayed in a table, given the fact that
this appears to be more suitable for the large amount of data that needs to be presented
as opposed to mentioning it all in the text itself.
9. The part mentioning the number of respondents of the study was moved before the
part about its demographics given the fact that this creates a more logical progression
through the presented information in this part of the text.
10. Sections were reordered to follow a more logical structure.
11. Parts in the methods section were summarized to display the necessary information in
a more concise manner (e.g. the fact that all of the tests are conducted with an alpha
value of p <.05 is only mentioned once and not multiple times as before).
12. Spearman’s rank was added between the brackets to make clear that Spearman’s rank
correlation will be assessed if outliers are present and/or the correlations are not
linear.
13. An explanation was added of why two-tailed testing is conducted.
14. Extension was added to the interpretation of the regression analyses which allows for
interpretation of a full mediation.
15. The part: “Looking if scores on the self-respect measure are positively regressed on
scores on the MPFI” was reworded because this is not a necessity for a mediation
mechanism to be present.
16. This part was added to reiterate the fact that the tests for hypothesis 4 were to be
conducted only if the previous tests all indicated correlations to be present, as was
mentioned in the research question.
17. The point of psychological flexibility and self-respect being fairly new was moved
before the limited research on SMI point.
18. Mental health disorder section was moved to the end of the sentence to more clearly
link it to the next section about specific mental health disorders.
19. Number of mental health disorders was condensed into a smaller number in order to
create a more readable text.
20. Explanation was added of why it is important to investigate new concepts (in order to
fill gaps in the literature).
21. Sentence was reworded in order to better link it to the previous text.
22. In the materials and measuring instruments section, the structure of each measurement
was changed into: definition of construct, scale name, example items, item scoring by
participants (Likert scale from 1 (xxx) to 6 (xxx)), reverse items or not, scoring of
total or mean score with higher scores meaning xy, Cronbach’s alpha of scale in
original paper or other past literature, validity of scale, current Cronbach’s alpha.
23. Some non-essential information removed in order to make the text more streamlined.
24. “May” added to emphasize the fact that this mechanism is conceptual.
25. “Adverse” was added in order to indicate what type of private experiences are
referred to.
26. Additional subheading was added in order to add more structure to the text.
27. “involved” was changed to “is” because the entire study is a secondary data analysis.
28. “Materials and measuring instruments” was changed to “Measures” in order to more
accurately match the design of the present study.
29. “Exclusion criteria” was corrected to “inclusion criteria”.
30. “Demographic information of the present sample” was added to more clearly explain
what information is displayed in table 1.
31. “Total score” was corrected to “mean score”.
32. Disclaimer was added about the interpretation of the respondents’ nationality.
33. Specific process model specified.
34. Reference for Hayes was added.
35. Subheadings added for individual measures.
36. Demographic measures section was added.
37. Constructs measured in the original study moved from the measures to the procedure
section.
38. Decision of whether Spearman’s rank correlation or Pearson’s r correlation was used
was added.
39. The fact that covariates were investigated as well was added to the statistical analysis
section.
40. Explanation of inclusion criteria added.
41. Information was added about the fact that the variable will be used as a proxy
measure.
42. Zavala point was left out.
43. Theory was changed to Theoretical framework of present research in order to better
match the content of this section.
44. Reworded in order to improve clarity.
45. Reworded to better match speculative nature of this section.
46. Subheading Research questions was left out.
47. Assessed demographics are left out given the fact they are already mentioned in Table
1.
48. His was changed to her due to misgendering.
49. Full name of the ethics committee: “Psychology Research Ethics Committee of
Leiden University” was added.
50. Clarification added that the assertiveness subscale is assessed.
51. Introduction added to the methods section.
52. Sections moved to the procedure section.
53. Growth fostering relationships was corrected to relational images.
54. Sentence added to smooth out the connection between this paragraph and the previous
paragraph.
55. Section moved to the introduction of the methods section.
56. Explanation of why filling gaps in the literature is important.

57. By definition was added to explain why variables are related.
58. Clarification added that evidence is supplied for psychological flexibility as an aspect
of mental health.
59. Part added abtout the two concepts being implicated in past literature.
60. This was corrected to The preceding.
61. Direction of mediation was added.
62. “At least partially” was added.
63. “Positively” was added.
64. Sentence split into two for readability.
65. “This includes these correlation analyses” was added.
66. Sentence added to smooth out the connection between the paragraphs.
Appendix B: Information Sheet
Invitation
This study is conducted by a team of Bachelor Psychology students from Leiden University
for their final year project. You are being invited to take part in it by filling in an online
survey.
Brief Summary
We are looking to learn more about factors implicated in sexual minority individuals’
wellbeing. The term sexual minority individual refers to anybody whose sexual orientation is
not heterosexual. Two of the factors that we are interested in are how you see yourself and
how you relate to others.
Who can participate?
Anybody who does not identify as heterosexual, aged 18 or older, and proficient in
English can participate.
What’s involved if I agree to take part?
This study is entirely online and takes approximately 15 minutes to complete. You will be
asked to fill out a set of questionnaires.
You can choose to receive 1 SONA credit or enter our lottery (20 Euros per every 20
participants) as compensation for your participation.
Participation is entirely voluntary, and you can withdraw from the research at any point
without giving a reason and any negative consequences.
Confidentiality: Ways to protect your identity and data
Data is obtained for research purposes only. All your responses will be handled with
complete confidentiality, stored securely, and coded anonymously. This means we will
allocate an identity number to your data instead of your name and keep identity information
(participant name, identity number allocation) in a separate document to the data. All identity
information will be deleted after 10 years (minimal amount of year for good research
conduct). The results of this study may be published in an academic journal.
If you enter the lottery and are successful, we will contact you and ask for information, such
as your bank details, BSN (if Dutch) and date of birth. This is necessary for the university’s
financial services to pay you.
If you have questions about privacy issues, please contact privacy@bb.leidenuniv.nl.
What are the possible disadvantages and risks of taking part?
We hope that you will find taking part in our research to be a worthwhile activity. However,
there is a risk that some questionnaires may lead to some discomfort. If you experience
severe discomfort, please immediately contact your GP or a helpline (e.g., 0800-0113).
If you have any questions or complaint, please contact the principal investigator Marieke
Tollenaar (m.s.tollenaar@fsw.leidenuniv.nl).
Appendix C: Online Consent Form
By ticking the box below, I declare that I have read and understood the information letter of
this study.
By ticking the box below, I declare that I am willing to participate voluntarily in this study
and offer permission to use the data for the purpose described in the information letter,
including publication in an academic journal.
By ticking the box below, I declare that I understand that this study will be conducted for
scientific purposes.
By ticking the box below, I declare that I understand that data will be collected and processed
in a coded way. There will be no connection made between my name and any other
information which could identify me and the data in this study.
By ticking the box below, I declare that I understand that I can withdraw from the study at
any point without any negative consequences and I acknowledge that I have been informed
who to contact in case of questions.
By ticking the box below, I declare that I also understand that Leiden University and the
research group can use the obtained data for other (future) studies and research, but that the
same conditions apply as explained above.
Appendix D: Debriefing Sheet
Thank you very much for your participation! Your participation is greatly valued.
Sexual minority individuals (i.e., individuals of other than heterosexual sexual orientation)
are at high risk of experiencing poor mental health. For instance, they are more likely than
their heterosexual counterparts to report depressive and anxiety symptoms and have suicidal
thoughts. The Minority Stress Model is the most used model to explain sexual minorities’
mental health, positing that sexual minority individuals experience unique stressors related to
their minority status (e.g., discrimination, internalised homophobia), which have detrimental
effects on their mental health. However, the model is criticised for its deficit-based approach
to sexual minority mental health. Thus, recent research endeavours have shifted towards
conceptualising and validating strength-based models of resilience in sexual minority
individuals. Nevertheless, this research is in its infancy. Thus, this research was conducted to
explore the role of self-respect (i.e., believing one has equal rights to others), assertiveness,
identity achievement (i.e., exploring the meaning of one’s identity), identity affirmation (i.e.,
developing positive feelings and a sense of belonging to one’s group), internalised
homonegativity, parental acceptance, attachment style and religiosity in wellbeing of
individuals who do not identify as heterosexual. We hope that this research informs a
strength-based model of psychological wellbeing and resilience in sexual minority
individuals.
Because of the sensitive nature of some questions, you may have experienced some
discomfort. If you are experiencing severe discomfort, please contact your GP or a helpline
immediately (e.g., 0800-0133).
If you have any further questions or if you do not want your data to be used for these research
purposes, please contact the principal investigator Marieke Tollenaar
(m.s.tollenaar@fsw.leidenuniv.nl).
Thank you again for your time!

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ASSERTING SELF-RESPECT 1

Asserting Self-respect: Assessing The Mediating Role of Assertiveness in the

evidence in support of a positive relationship between assertiveness and psychological

assertiveness mediates the relationship between self-respect and psychological flexibility.

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(NEMESIS). Psychological Medicine, 44(2), 421–433.

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Journal of contextual behavioral science, 18, 99–110.

Górska, M. (2011). Psychometric Properties of the Polish Version of the Interpersonal

Competence Questionnaire (ICQ-R). European Journal of Psychological Assessment,

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2023, from http://www.afhayes.com/

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Therapy, 44(1), 1–25. https://doi.org/10.1016/j.brat.2005.06.006

(2004). Measuring experiential avoidance: A preliminary test of a working model.

Psychological Record, 54(4), 553–578. https://doi.org/10.1007/bf03395492

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Amsterdam University Press.

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(2019). Positive Development and Changes in Self-Rated Health Among Young

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