The Effectiveness of Transdiagnostic Applications of Competitive Memory Training (COMET) on Low Self-Esteem and Comorbid Depression: A Meta-analysis of Randomized Controlled Trials

Background Low self-esteem is a relevant transdiagnostic condition in the etiology, manifestation, and aggravation of different types of psychopathology. While low self-esteem is expected to ameliorate automatically after successful treatment of the principal emotional disorder the patient is suffering from, this does not always happen. Therefore, several specific interventions for enhancing low self-esteem have been developed, amongst them competitive memory training or COMET. The current meta-analysis investigated the efficacy of COMET in a variety of patient populations. Methods Several databases were simultaneously examined after which 11 randomized COMET studies were identified. They encompassed a total of 662 patients with a diversity of emotional disorders of whom 344 had been treated in the experimental COMET conditions. Effects of COMET were expressed as Hedges' g and were assessed on self-esteem and comorbid depression. When heterogeneity or publication bias were detected, original outcomes were corrected. Results Low self-esteem was enhanced (g = 0.50; after correction g = 0.61), while comorbid depression was reduced (g = 0.68; after correction g = 0.54). Conclusions COMET is a promising transdiagnostic intervention producing moderate enhancements in low self-esteem and moderate reductions in comorbid depression compared to control conditions in a variety of emotional disorders. Study Registration Prospero ID: CRD42021237905.