Electronic Thesis and Dissertation Repository

Thesis Format

Monograph

Degree

Doctor of Philosophy

Program

Psychology

Supervisor

Kuiper, Nicholas A.

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.

Summary for Lay Audience

Researchers have long been interested in how self-beliefs play a role in the development and maintenance of psychological disorders. The cognitive vulnerability-stress model theorizes that sources of ‘cognitive vulnerability’ (e.g., negative beliefs about oneself) lead to psychological disorders (e.g., depression), when a person also experiences certain stressful life events (e.g., social rejection). Limited research, however, informs a cognitive vulnerability-stress model of mania (a feature of bipolar disorder). In particular, little is known about how beliefs about the self may be organized. For example, if an individual’s negative beliefs were highly interconnected, a situation triggering a negative thought (e.g., failing an exam and thinking “I am stupid”) would likely trigger a similar negative thought (e.g., “No one will ever love me”). Therefore, if beliefs are more highly interconnected, a larger emotional response would be triggered. Studying the organization of self-beliefs is important, since evidence suggests that, at least in cases of depression, this is associated with the severity of symptoms and occurrence of symptoms following negative life events. Thus, this project examined both the nature and organization of self-beliefs associated with mania, within community and university student samples. Participants fell along a continuum in terms of their ‘risk for mania’; that is, whether they showed certain personality features/experiences that have strongly predicted future development of (hypo)manic episodes. Across three studies, it was found that individuals at higher risk for mania showed unhelpful beliefs about goal attainment (e.g., “I need to excel at everything I do”), perfectionistic attitudes, and obsessiveness regarding a valued activity. Notably, individuals at high mania risk also displayed highly interconnected, positive self-beliefs. This organizational pattern was associated with greater manic symptoms, particularly when higher-risk individuals also experienced certain positive events (e.g., achievements). Conversely, their actual beliefs did not predict manic symptoms following these life events. Importantly, it appeared that the organization of self-beliefs among higher-risk individuals was subject to change over time, whereas this seemed stable among others. Overall, these findings allude to the problematic organization of self-beliefs among individuals at high risk for mania, which would correspond with unstable views and feelings about oneself.

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