An Exploration of Early Maladaptive Schemas, Schema Modes and Attentional Control in Psychosis Spectrum

Abstract

Alterations in subjective experiencing of the self are increasingly recognised as important features of psychosis. Therapeutic models that conceptualise and address these alterations could enhance treatment of psychosis. Schema Therapy (ST) and its underlying theory offer a needs-based developmental and structural model of the self that may be relevant in this area. Schema theory proposes that the fulfilment of the core emotional needs in childhood is essential for future psychological wellbeing and the development of a coherent sense of self. Insufficiently fulfilled emotional needs give rise to early maladaptive schemas, which are trait-like internal psychological structures. These structures phenomenologically cluster into schema modes (SMs). SMs are dynamic, transient personality states that are associated with symptoms of psychological problems and deficits in self-integration. To investigate whether the main propositions of schema theory apply to the non-clinical end of the psychosis spectrum, 299 adult participants were recruited from the general population and completed an online survey measuring the levels of childhood emotional invalidation, SMs, self- concept clarity (SCC), and psychotic-like experiences (PLEs). Relationships between these constructs were analysed using correlational analysis.
Additionally, three SMs were examined as mediators on the pathway between childhood invalidation and specific PLEs. The results demonstrated that childhood emotional invalidation was associated with increased levels of maladaptive SMs, diminished SCC, and increased PLEs. The impact of childhood invalidation on persecutory ideation was partially mediated by the Vulnerable Child and Punitive Critic modes, while the impact on perceptual abnormalities was partially mediated by the Detached Protector mode. These results offer initial support for the applicability of schema theory to the conceptualisation of PLEs and invite future research on the investigated constructs in the wider psychosis spectrum.

Date of Award	5 Nov 2024
Original language	English
Awarding Institution	University of Roehampton
Supervisor	Leigh Gibson (Director of Studies) & George Georgiou (Co-Supervisor)