The predictive value of early maladaptive schemas in paranoid responses to social stress

TY - JOUR

T1 - The predictive value of early maladaptive schemas in paranoid responses to social stress

AU - Sundag, Johanna

AU - Ascone, Leonie

AU - Lincoln, Tania M

N1 - Copyright © 2017 John Wiley & Sons, Ltd.

PY - 2018/1

Y1 - 2018/1

N2 - BACKGROUND: Social stress and negatively valenced cognitive representations of the self (self-schemas) play an important role in the formation of delusions. However, it has not been investigated whether and which self-schemas explain paranoid responses to social stress. Building on the framework of schema theory, the aim of this study was thus to investigate whether more pronounced early maladaptive schemas (EMSs) were associated with increased paranoid ideation after a social stress induction in patients with persecutory delusions (PD).METHOD: Patients with PD (n = 20) and healthy controls (n = 40) were assessed for EMSs with the Young Schema Questionnaire. They were then exposed to a social stress situation in which they were socially excluded in a Cyberball paradigm. Prior to and after the social stress induction, paranoid symptoms were assessed.RESULTS: Patients with PD responded with a stronger increase in paranoia and revealed a significantly higher EMS total score compared to the healthy controls. As expected, higher increases in paranoia following the social stress were accounted for by higher EMS total scores. Exploratory analyses showed that particularly the specific EMSs Defectiveness/Shame and Enmeshment/Undeveloped Self were associated with the increase in paranoia.CONCLUSIONS: EMSs are associated with stress-related symptom increases in patients with PD. It thus seems worthwhile to further investigate the relevance of specific schemas for paranoia. The findings also suggest that addressing EMSs in psychological treatment of patients with PD holds potential.

AB - BACKGROUND: Social stress and negatively valenced cognitive representations of the self (self-schemas) play an important role in the formation of delusions. However, it has not been investigated whether and which self-schemas explain paranoid responses to social stress. Building on the framework of schema theory, the aim of this study was thus to investigate whether more pronounced early maladaptive schemas (EMSs) were associated with increased paranoid ideation after a social stress induction in patients with persecutory delusions (PD).METHOD: Patients with PD (n = 20) and healthy controls (n = 40) were assessed for EMSs with the Young Schema Questionnaire. They were then exposed to a social stress situation in which they were socially excluded in a Cyberball paradigm. Prior to and after the social stress induction, paranoid symptoms were assessed.RESULTS: Patients with PD responded with a stronger increase in paranoia and revealed a significantly higher EMS total score compared to the healthy controls. As expected, higher increases in paranoia following the social stress were accounted for by higher EMS total scores. Exploratory analyses showed that particularly the specific EMSs Defectiveness/Shame and Enmeshment/Undeveloped Self were associated with the increase in paranoia.CONCLUSIONS: EMSs are associated with stress-related symptom increases in patients with PD. It thus seems worthwhile to further investigate the relevance of specific schemas for paranoia. The findings also suggest that addressing EMSs in psychological treatment of patients with PD holds potential.

KW - Adult

KW - Female

KW - Germany

KW - Humans

KW - Male

KW - Paranoid Disorders/psychology

KW - Self Concept

KW - Social Behavior

KW - Stress, Psychological/psychology

KW - Surveys and Questionnaires

U2 - 10.1002/cpp.2128

DO - 10.1002/cpp.2128

M3 - SCORING: Journal article

C2 - 28840642

VL - 25

SP - 65

EP - 75

JO - CLIN PSYCHOL PSYCHOT

JF - CLIN PSYCHOL PSYCHOT

SN - 1063-3995

IS - 1

ER -