1

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

Relationship between Self-Respect and Psychological Flexibility among Sexual Minority
Individuals1, 2

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Introduction
Globally, an average of approximately one in every ten individuals does not identify
themselves as heterosexual across 28 countries (Rahman et al., 2019). 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 disorders17 (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).18
In the 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 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;
 2

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. It attempts to
investigate the relationship between these constructs as they may act as a protective
mechanism for this group of SMI. Having knowledge of such a mechanism would
undoubtedly be beneficial for designing interventions tailored to the needs of this
disadvantaged group. A study by Zavala and Waters (2022) illustrates this perfectly by
showing that an intervention based on another protective mechanism (one based on parental
bond) demonstrated a promising effect regarding psychological growth and the strength of
the parent-child bond. The current study aims to contribute to the still limited understanding
of the literature on SMI.
Furthermore, as mentioned before, 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.19
Theory
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.20
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
relational cultural theory, refer to perceptions of an individual regarding themselves in
relation to others, as well as their expectations regarding their interactions with others,
resulting 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 This theory
puts forward that growth-fostering relationships could be associated with resilience to
psychological distress among SMI under specific conditions though these relational images
(Jordan, 2017; Mereish & Poteat, 2015a, 2015b). Growth-fostering relationships are defined
as being characterised by the relational elements of empathy, mutuality, and empowerment
 3

(Jordan, 2017; Mereish & Poteat, 2015a). Of course, 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 (Holland & Bronstein, 2008; Renger,
2017). One needs to believe in their own equal rights in order to engage in a relationship that
is beneficial to both members.
However, the mere belief in one's equal rights and dignity is not 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 needs to have a sufficient level of self-respect in order to increase one’s
assertiveness. Self-respect needs 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 then
(partially) leads to resilience to psychological distress among SMI through mutual, growth-
fostering relationships according to relational cultural theory, and as mentioned before, this
concept of resilience is closely related to psychological flexibility and a big part of mental
well-being (Kashdan & Rottenberg, 2010; Mereish & Poteat, 2015a, 2015b).
Overall, this theory thus supports the existence of a mechanism where a higher level
of self-respect leads to a higher level of psychological flexibility that is (partially) positively
mediated by assertiveness.
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
 4

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 and
seeing 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 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. 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).
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 and applied research provides
details on possible interventions that appear to have promising effects (Kashdan &
Rottenberg, 2010). 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 its close relationship to the concept of mental health. According to the
psychological flexibility model, acceptance and commitment therapy supports the
 5

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 is proposed to help individuals with solving problems
resulting from not learning how to make relationships and communicate and indecisiveness,
directly linking this relationship to the theoretical framework proposed by relational cultural
theory (Azadeh et al., 2015; Mereish & Poteat, 2015a, 2015b). The therapy that is meant to
increase psychological flexibility thus increases assertiveness, which increases the amount of
growth fostering relationships, which, in turn, increases 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 (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 similar to the definitions of
self-competence and self-liking as proposed by Tafarodi en Swann (2001). 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). 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
 6

relationship between these two constructs (Branden, 1988; 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 judged to be a measure of self-
respect as well 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. This finding provides strong evidence in
support of a positive relationship between self-respect and 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 this
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
 7

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.
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 growth-
fostering relationships and thus relational cultural theory in the connection between these two
variables (Mereish & Poteat, 2015a, 2015b; Moss et al., 2021; Speed et al., 2017).
As can be concluded from this section, there is some (sometimes modest) evidence in
support of a relationship between self-respect and psychological flexibility that is mediated
by assertiveness. The limited evidence is likely to 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 fill this gap in the literature as well by
looking for evidence of this conceptual model.
Research questions
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 relationship between self-
respect and psychological flexibility.
To test these, correlational analyses as well as a mediation analysis will be carried out
Methods
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The present study involves a secondary data analysis of a dataset that was gathered by
a team of Bachelor Psychology students from Leiden University as part of their bachelor
project. Respondents were invited to take part in it by completing an online survey. In the
original study, the general aim was to obtain more knowledge about the factors implicated in
the well-being of SMI.
The research question that guided this original study is as follows: how could the
variables of self-respect, assertiveness, identity achievement, identity affirmation, internalised
homonegativity, parental acceptance, attachment style, and religiosity possibly contribute to a
strength-based model of psychological well-being in SMI. Additionally, this study sought to
determine whether these factors increase the likelihood of psychological well-being among
the individuals in this specific population, and if so, how?
Respondents
This study attempts to make judgements about SMI. Because of this fact, one of the
exclusion criteria was that a subject cannot identify oneself as being heterosexual. The two
other exclusion 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.
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.
The original study included 522 respondents but the present study will only include
346 respondents because respondents that did not complete (one of) the questionnaires that
are looked at in this study are excluded. In addition to this, respondents that matched the
exclusion criteria are excluded as well.9
The following attributes of the respondents: Age, Gender, Nationality, Level of
Education and Sexual Orientation will constitute the assessed demographics of this group.
They are displayed in Table 1. All these attributes are measured by means of self-reported
items of the questionaire8
 9

Materials and measuring instruments

In the original study, the variables of Self-Respect, Assertiveness, SM 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
were measured through a Qualtrics survey (www.qualtrics.com) that took roughly 15
minutes. 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 is
being researched. Because of this, only the questionnaires that attempted to measure these
variables will be examined in more detail.
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
 10

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. Psychological flexibility enables individuals to remain
receptive to such experiences and deal with them while also making deliberate behavioural
choices in line with the areas of their life that hold significance to them (Rolffs et al., 2016).
The concept of psychological flexibility will be operationalised by means of this MPFI in the
present study. This inventory is a freely-available questionnaire that measures six flexibility
and six inflexibility subscales (Rolffs et al., 2016). Each subscale consists of 5 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 is 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 is
used for this questionnaire. The scores for the items can 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 excellent 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 acceptable 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 .858 could
be observed. For this and subsequent Cronbach’s alpha tests that are conducted on the basis
of the dataset used in the present study, outliers (as will standardly be asseseds in this paper
based on the 3rd quartile + 1.5*interquartile range or the 1st quartile – 1.5*interquartile
range)11 will be 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 slightly higher value of .863 if the outliers were not removed. Cronbach’s
alpha values in the present study are interpreted in accordance with the interpretation
guidelines put forward by Azimi and Calver (2018), namely: α=1.00 is Perfect, 1.00 > α ≥
0.80 is Excellent, 0.80 > α ≥ 0.60 is Acceptable, 0.60 > α ≥ 0.50 is Poor, 0.5 > α is
Unacceptable.3, 21
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
 11

people around them (Honneth, 1996, 2012; Renger, 2017). The concept of self-respect will be
operationalised by means of this self-respect measure in the present study. Respondents are
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 are 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 is used for this questionnaire. After
completion, the Likert scale scores are averaged for all four statements to receive a final and
total 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 the self-respect
measure he proposed, 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 his study that high scores on his measure of self-respect predicted higher levels of
assertiveness beyond other 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 .833 could be observed for this measure. This value
would have been a somewhat higher, excellent3 value of .845 if the outliers were not
removed.
Assertiveness, as measured by the assertiveness subscale of the Interpersonal
Competence Questionnaire (ICQ), is defined as the someone’s ability to assert personal
rights. Assertiveness is thus operationalized in the present study by means of the
assertiveness subscale of the ICQ. Respondents are asked to answer 8 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. Total scores are calculated by averaging the scores
 12

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 0.72 to
the excellent3 value of 0.86 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 acceptable
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 acceptable 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). Competence
was also found to be related to both the number of relationships and the duration of the
longest relationship one has had and 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). In the dataset used for this study, an acceptable3 Cronbach’s
alpha value of .799 could be observed for this questionnaire. This value would have been an
excellent3 value of .839 if the outliers were not removed.
Procedure
There were a number of ways of recruiting respondents both online and offline but
primarily through the university. The 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 right 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 survey. This was done as a precaution for possible bots. After completing the online
15-minute online survey, respondents were rewarded with either 1 SONA credit or an entry
 13

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 is displayed in
Appendix 2 and 3 respectively and the debriefing form that was given to the respondents after
the survey was completed is displayed in Appendix 4. 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.
Statistical analysis10
All of the analyses that are mentioned in the present study are conducted via IBM
SPSS Statistics (version 27.0.1.) with the PROCESS computational tool (version 4.3) by
CCRAM expert Hayes (n.d.) added. The model within PROCESS that was used to test the
mediation mechanism mentioned in hypothesis 4 was model number 4.
All of the tests in the following section are conducted with an alpha value of p <.05
given the fact that this is the norm in the field.11
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 is assessed respectively. Two-tailed tests are
conducted given the fact that statements are made about the strength of the relationship and
not about its direction.13
The assumptions of testing for a Pearson’s r correlation are: the two variables
correlated are continuous (i.e. they should be measured at the interval or ratio level), 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). The first assumption of
continuous variables can already be checked by looking at the questionnaires that are used in
this study. All three questionnaires produce continuous scores which means that this
assumption is met. The assumption of linearity of the relationship is checked by plotting the
two variables of interest to the hypothesis that is being assessed in a scatterplot. The plots are
inspected visually to check for linearity. The results of this are as follows: For hypothesis 1
(Self-respect is positively correlated to assertiveness), the scatterplot of the total score of self-
respect and the total score of assertiveness does not seem to indicate any violations of the
linearity assumption as can be seen in figure 1. For hypothesis 2 (Assertiveness is positively
correlated to psychological flexibility), the same type of scatterplot also does not seem to
indicate any violations of the linearity assumption as can be seen in figure 2 and the same
 14

holds for hypothesis 3 (Self-respect is positively correlated to psychological flexibility) as

can be seen in figure 3. The bivariate normality assumption is checked by means of the
Shapiro-Wilk test of normality for each variable separately. The results of this are as follows:
the total 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 is
not a problem, however, given the fact that the sampling distribution of the mean is 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 The scores on the variables are also checked for outliers in
SPSS. The results of this check are that outliers are found on the total scores of psychological
flexibility and assertiveness, but not on the total score of self-respect (as shown in figures 4, 5
and 6). Outliers are explicitly mentioned and investigated in the results section.
In case of non-linearity and/or outliers, it is decided that instead of the Pearson r
correlation, Spearman’s rank correlation is used to assess whether or not these variables are
correlated. This way of testing for a correlation relies on the assumption of a monotonic
relationship (Hauke & Kossowski, 2011). This is checked in the present study by means of
visually inspecting a scatterplot of the two variables of interest for the hypothesis at hand if
necessary (the relationship between the two variables is not approximately linear). The results
of this are as follows: none of the relationships appear to violate the monotonicity assumption
as can be observed in figures 1, 2 and 3.
Next, it will be assessed in hypotheses 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 is tested by, firstly (a), assessing if scores on the self-
respect measure are positively regressed on scores on the assertiveness subscale of the ICQ.
Next (b), it will be assessed if scores on the assertiveness subscale of the ICQ are positively
regressed on scores on the MPFI controlling for scores on the self-respect measure when
tested. Finally (c), it will be assessed if scores on the self-respect measure are 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) turn out to be statistically significant, it
can be concluded that there is evidence in support of the proposed mediation mechanism in
its partial mediation form. If, on the other hand, only the first two (a and b) turn out to be
 15

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) will be conducted with a one-tailed test because these hypotheses not only
aim to make a statement about the strength of the relationship but also about its direction
(positive).
The assumptions that will be investigated in order to perform the simple and multiple
regression analyses are linearity of the relationship between the variables, approximate
normality of distribution of errors around zero, homoscedasticity where the variance of the
errors is the same for any combination of values of independent variables and independence
of errors (Ernst & Albers, 2017). The linearity assumption for these regression tests will
already have been checked for the previous hypotheses, resulting in no indication of
violations of this assumption.5 The second assumption, normality of error distribution, is
checked visually by looking if a histogram of these errors approximately matches a
superimposed normal curve in SPSS resulting in the fact that, for (a), and (b) and (c) together
the standardized residuals appear to be approximately normally distributed as can be
observed in figures 8 and 9 respectively. The homoscedasticity assumption is checked by
means of a scatterplot of the residuals. Variances along the line of best fit should remain
comparable for all points of that line. The results of this check are that no violation of this
assumption appeared to be present in any of the scatterplots as can be observed in figures 10,
11 and 12. The assumption of independent errors is assessed by inspecting the same
scatterplot of the residuals where the correlation should be approximately non-existent. This
check resulted in no obvious violations as can be seen in the same figures.
The scores on the variables are also previously checked for outliers in SPSS. The
existing outliers will be taken out of the dataset before the regression analyses are conducted
in order to not skew the results based on a single or small number of extreme cases. The
results of this procedure are as follows (as mentioned before): outliers are found on the total
scores of psychological flexibility and assertiveness, but not on the total score of self-respect
(as shown in figures 4, 5 and 6). Although the final dataset that is used to make statements
about hypothesis 4 is the one with the outliers taken out, the analyses that are performed on
this dataset will also be performed on a secondary data set where the outliers still remain in
order to observe what the results would have been if the outliers were not taken out.
Results
 16

For hypothesis 1, 2 and 3, a Spearman’s rank correlation was computed in order to

resolve the issue of the outliers that were found on the total scores of psychological
flexibility and assertiveness.
The first correlation (for hypothesis 1) was computed to assess the relationship
between self-respect and assertiveness. There was a 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
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 positive correlation between the two variables, r(344) =
.29, p < .001.
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 corelations were found. The results of the mediation analysis of hypothesis 4
with the outliers removed (and thus the final results of the present study) were 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.
 17

References
Azadeh, S. M., Kazemi-Zahrani, H., & Besharat, M. A. (2015). Effectiveness of

Acceptance and Commitment Therapy on Interpersonal Problems and Psychological

Flexibility in Female High School Students With Social Anxiety Disorder. Global

Journal of Health Science, 8(3), 131. https://doi.org/10.5539/gjhs.v8n3p131

Azimi, J. & Calver, J. H. (2018). Multi-Factor and Dimensional Approach in Data

Analysis. Lambert Academic Publishing

Balsam, K. F., Rothblum, E. D., & Beauchaine, T. P. (2005). Victimization Over the

Life Span: A Comparison of Lesbian, Gay, Bisexual, and Heterosexual Siblings.

Journal of Consulting and Clinical Psychology, 73(3), 477–487.

https://doi.org/10.1037/0022-006x.73.3.477

Branden, N. (1988). How to Raise Your Self-Esteem: The Proven Action-Oriented

Approach to Greater Self-Respect and Self-Confidence (Reissue). Bantam.

Buhrmester, D., Furman, W., Wittenberg, M. T., & Reis, H. T. (1988). Five domains

of interpersonal competence in peer relationships. Journal of Personality and Social

Psychology, 55(6), 991–1008. https://doi.org/10.1037/0022-3514.55.6.991

 18

Clucas, C., Corr, P. J., Wilkinson, H., & Schepman, A. (2022). Appraisal self-respect:

Scale validation and construct implications. Current Psychology.

https://doi.org/10.1007/s12144-022-03093-z

Csikszentmihalyi, M. (1990). Flow: the psychology of optimal experience. Choice

Reviews Online, 28(01), 28–0597. https://doi.org/10.5860/choice.28-0597

Deci, E. L., & Ryan, R. M. (2000). The “What” and “Why” of Goal Pursuits: Human

Needs and the Self-Determination of Behavior. Psychological Inquiry, 11(4), 227–

268. https://doi.org/10.1207/s15327965pli1104_01

Ernst, A., & Albers, C. J. (2017). Regression assumptions in clinical psychology

research practice—a systematic review of common misconceptions. PeerJ, 5, e3323.

https://doi.org/10.7717/peerj.3323

Fatemeh, G., Pouran, T., Naval, H., & Marzieh, A. (2016). Investigating the

Relationship between Self-Esteem, Assertiveness and Academic Achievement in

Female High School Students. International Journal of Current Medical And Applied

Sciences, 11(1), 51–56.

https://www.ijcmaas.com/images/archieve/IJCMAAS_JUNE_2016_VOL11_ISS1_14

.pdf

Fredrickson, B. L., & Losada, M. F. (2005). Positive Affect and the Complex

Dynamics of Human Flourishing. American Psychologist, 60(7), 678–686.

https://doi.org/10.1037/0003-066x.60.7.678

Gevonden, M. J., Selten, J. P., Myin-Germeys, I., de Graaf, R., ten Have, M., van

Dorsselaer, S., van Os, J., & Veling, W. (2013). Sexual minority status and psychotic

symptoms: findings from the Netherlands Mental Health Survey and Incidence

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

https://doi.org/10.1017/s0033291713000718
 19

Grégoire, S., Gagnon, J. E., Lachance, L., Shankland, R., Dionne, F., Kotsou, I.,

Monestès, J., Rolffs, J. L., & Rogge, R. D. (2020). Validation of the english and

french versions of the multidimensional psychological flexibility inventory short form

(MPFI-24). Journal of contextual behavioral science, 18, 99–110.

https://doi.org/10.1016/j.jcbs.2020.06.004

Gorman, L. M., & Sultan, D. (2008). Psychosocial Nursing for General Patient Care.

F.A. Davis Company.

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

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

27(3), 186–192. https://doi.org/10.1027/1015-5759/a000066

Hauke, J., & Kossowski, T. (2011). Comparison of Values of Pearson’s and

Spearman’s Correlation Coefficients on the Same Sets of Data. QUAGEO, 30(2), 87–

93. https://doi.org/10.2478/v10117-011-0021-1

Havlicek, L. L., & Peterson, N. (1976). Robustness of the Pearson Correlation against

Violations of Assumptions. Perceptual and Motor Skills, 43(3_suppl), 1319–1334.

https://doi.org/10.2466/pms.1976.43.3f.1319

Hayes, A. F. (n.d.). Andrew F. Hayes, Ph.D. Andrew F. Hayes, Ph.D. Retrieved April 12,

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

Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance

and Commitment Therapy: Model, processes and outcomes. Behaviour Research and

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

Hayes, S. C., Strosahl, K. D., Wilson, K. G., Bissett, R. T., Pistorello, J., Toarmino,

D., Polusny, M. A., Dykstra, T. A., Batten, S. V., Bergan, J. J., Stewart, S. H.,

Zvolensky, M. J., Eifert, G. H., Bond, F. W., Forsyth, J. P., Karekla, M., & McCurry,
 20

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

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

Hayes, S. C., Wilson, K. G., Gifford, E. J., Follette, V. M., & Strosahl, K. D. (1996).

Experiential avoidance and behavioral disorders: A functional dimensional approach

to diagnosis and treatment. Journal of Consulting and Clinical Psychology, 64(6),

1152–1168. https://doi.org/10.1037/0022-006x.64.6.1152

Holland, J., & Bronstein, J. (2008). Mutualism. Elsevier eBooks, 2485–2491.

https://doi.org/10.1016/b978-008045405-4.00673-x

Honneth, A. (1996). Struggle For Recognition: The Moral Grammar of Social

Conflicts. Amsterdam University Press.

Honneth, A. (2012). The I in We: Studies in the Theory of Recognition. Polity. Press

Jackson, C. L., Agénor, M., Johnson, D. A., Austin, S. B., & Kawachi, I. (2016).

Sexual orientation identity disparities in health behaviors, outcomes, and services use

among men and women in the United States: a cross-sectional study. BMC Public

Health, 16(1). https://doi.org/10.1186/s12889-016-3467-1

Jordan, J. V. (2017). Relational-Cultural Therapy. American Psychological

Association.

Kapadia, F., D’Avanzo, P. A., Cook, S. H., Barton, S., Halkitis, S. N., & Halkitis, P.

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

Sexual Minority Males: The P18 Cohort Study. Behavioral Medicine, 45(4), 304–313.

https://doi.org/10.1080/08964289.2018.1536644

Kashdan, T. B., & Rottenberg, J. (2010). Psychological flexibility as a fundamental

aspect of health. Clinical Psychology Review, 30(7), 865–878.

https://doi.org/10.1016/j.cpr.2010.03.001
 21

Liu, Y., Wu, A. D., & Zumbo, B. D. (2010). The Impact of Outliers on Cronbach’s

Coefficient Alpha Estimate of Reliability: Ordinal/Rating Scale Item Responses.

Educational and Psychological Measurement, 70(1), 5–21.

https://doi.org/10.1177/0013164409344548

Martin-Storey, A., Garon-Carrier, G., Déry, M., & Temcheff, C. (2022). Sexual

Minority Status and Academic Achievement During the Transition to Adolescence

Among Youth With Childhood Conduct Problems. Youth & Society,

0044118X2211405. https://doi.org/10.1177/0044118x221140515

McAteer, G., & Gillanders, D. (2019). Investigating the role of psychological

flexibility, masculine self‐esteem and stoicism as predictors of psychological distress

and quality of life in men living with prostate cancer. European Journal of Cancer

Care, 28(4). https://doi.org/10.1111/ecc.13097

Mereish, E. H., & Poteat, V. P. (2015a). A relational model of sexual minority mental

and physical health: The negative effects of shame on relationships, loneliness, and

health. Journal of Counseling Psychology, 62(3), 425–437.

https://doi.org/10.1037/cou0000088

Mereish, E. H., & Poteat, V. P. (2015b). The conditions under which growth-fostering

relationships promote resilience and alleviate psychological distress among sexual

minorities: Applications of relational cultural theory. Psychology of Sexual

Orientation and Gender Diversity, 2(3), 339–344. https://doi.org/10.1037/sgd0000121

Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and

bisexual populations: Conceptual issues and research evidence. Psychological

Bulletin, 129(5), 674–697. https://doi.org/10.1037/0033-2909.129.5.674

Moss, J. G., Firebaugh, C. M., Frederick, H., Morgan, S. M., & Mozes-Carmel, A.

(2021). Assertiveness, Self-Esteem, and Relationship Satisfaction. International

 22

Journal of Arts and Social Science, 4(2), 235–245.

https://www.ijassjournal.com/2021/V4I2/4146575515.pdf

Nolen-Hoeksema, S., Wisco, B. E., & Lyubomirsky, S. (2008). Rethinking

Rumination. Perspectives on Psychological Science, 3(5), 400–424.

https://doi.org/10.1111/j.1745-6924.2008.00088.x

Orth, U., & Robins, R. W. (2014). The Development of Self-Esteem. Current

Directions in Psychological Science, 23(5), 381–387.

https://doi.org/10.1177/0963721414547414

Perrin, P. B., Sutter, M. E., Trujillo, M. A., Henry, R. S., & Pugh, M. (2020). The

minority strengths model: Development and initial path analytic validation in

racially/ethnically diverse LGBTQ individuals. Journal of Clinical Psychology, 76(1),

118–136. https://doi.org/10.1002/jclp.22850

Przedworski, J. M., VanKim, N. A., Eisenberg, M. E., McAlpine, D. D., Lust, K. A.,

& Laska, M. N. (2015). Self-Reported Mental Disorders and Distress by Sexual

Orientation. American Journal of Preventive Medicine, 49(1), 29–40.

https://doi.org/10.1016/j.amepre.2015.01.024

Rahman, Q., Xu, Y., Lippa, R. A., & Vasey, P. L. (2019). Prevalence of Sexual

Orientation Across 28 Nations and Its Association with Gender Equality, Economic

Development, and Individualism. Archives of Sexual Behavior, 49(2), 595–606.

https://doi.org/10.1007/s10508-019-01590-0

Renger, D. (2017). Believing in one’s equal rights: Self-respect as a predictor of

assertiveness. Self and Identity, 17(1), 1–21.

https://doi.org/10.1080/15298868.2017.1313307

Rolffs, J. L., Rogge, R. D., & Wilson, K. G. (2016). Disentangling Components of

Flexibility via the Hexaflex Model: Development and Validation of the

 23

Multidimensional Psychological Flexibility Inventory (MPFI). Assessment, 25(4),

458–482. https://doi.org/10.1177/1073191116645905

Sarkova, M., Bacikova-Sleskova, M., Orosova, O., Geckova, A. M., Katreniakova, Z.,

Klein, D. N., Van Den Heuvel, W. J. A., & Van Dijk, J. P. (2013). Associations

between assertiveness, psychological well-being, and self-esteem in adolescents.

Journal of Applied Social Psychology, 43(1), 147–154. https://doi.org/10.1111/j.1559-

1816.2012.00988.x

Singh, S., Pant, S. B., Dhakal, S., Pokhrel, S., & Mullany, L. C. (2012). Human rights

violations among sexual and gender minorities in Kathmandu, Nepal: a qualitative

investigation. BMC International Health and Human Rights, 12(1).

https://doi.org/10.1186/1472-698x-12-7

Speed, B. C., Goldstein, B. L., & Goldfried, M. R. (2017). Assertiveness training: A

forgotten evidence‐based treatment. Clinical Psychology-science and Practice, 25(1).

https://doi.org/10.1111/cpsp.12216

Tafarodi, R. W., & Swann, W. C. (2001). Two-dimensional self-esteem: theory and

measurement. Personality and Individual Differences, 31(5), 653–673.

https://doi.org/10.1016/s0191-8869(00)00169-0

Van Den Berg, R. G. (n.d.). SPSS Shapiro-Wilk Test - The Ultimate Guide. Spss-tutorials.

Retrieved April 10, 2023, from https://www.spss-tutorials.com/spss-shapiro-wilk-test-

for-normality/

Zavala, C., & Waters, L. (2022). "It's a family matter": A strengths-based intervention

for parents of sexual minority individuals. Journal of Gay & Lesbian Mental Health,

ahead-of-print(ahead-of-print), 1–22. https://doi.org/10.1080/19359705.2022.2113948

24