Examining the Self-Schema within a Cognitive Vulnerability-Stress Framework of Mania
Abstract
This dissertation aimed to inform a cognitive vulnerability-stress theory of mania, which addresses both the content and structure of the self-schema, along with the conditions under which these self-relevant cognitions are activated. Extant research on mania has primarily considered self-schema content, or an individual’s actual beliefs (e.g., “I am incompetent”). Although these investigations have successfully identified maladaptive self-beliefs associated with bipolar disorder, this research has been prone to inconsistencies and limited in distinguishing between mania and related forms of psychopathology (e.g., unipolar depression). Furthermore, very little research on mania has considered the organization of self-schema beliefs, referred to here as self-schema structure. Accordingly, three studies of non-clinical samples examined self-schema structure, as well as content, in relation to mania risk (i.e., the Hypomanic Personality Scale). To address other assumptions of a cognitive vulnerability-stress model, the importance of mood priming and potential interactions between self-schema characteristics and life events were also explored. Results indicate that mania risk is associated with several types of self-schema content, including dysfunctional attitudes about achievement, multidimensional perfectionism, and obsessive passion. Some of these characteristics (e.g., cognitive distortions) showed greater relevance for depressive versus manic symptoms. Conversely, there was a distinct pattern of results for self-schema structure, in which mania risk and symptoms appear to correspond with highly interconnected, positive self-schema content. In particular, longitudinal findings suggest that positive self-schema structure predicts prospective increases in manic symptoms. Notably, mania risk also corresponded with greater temporal instability of self-schema structure. With respect to life events, measures of self-schema structure, but not content, interacted with positive life events to predict the course of manic symptoms. Across the three studies, findings were mixed as to whether certain domains (i.e., achievement or interpersonal) of self-schema structure show distinct patterns in relation to mania. Further, mood priming did not appear to play a significant role in the examination of self-schema characteristics. Overall, the present findings suggest that the manic self-schema may contain a structural component that predicts the course of manic symptoms and shows meaningful interactions with life events. Future research directions and clinical implications are then discussed.