Introduction
Psychological theories provide multiple viewpoints and models for analyzing a person’s behavior. Among the different psychological models and theories of mental disorders, cognitive and interpersonal approaches remain the most prominent. In particular, cognitive schema modeling and the interpersonal circumplex paradigm have resulted in the most empirical studies of psychological disorders in past years (Marčinko et al., 2021).
Discussion
In cognitive models, probabilities are frequently used to codify hypotheses about psychological processes (Lee & Vanpaemel, 2018). As such, the concept of a cognitive schema, applied in this paper, appears to be an important theoretical construct employed by scholars. A schema is a knowledge structure that helps individuals perceive and comprehend their surroundings by structuring each person’s experience. The study of depressed self-schemas exemplifies one particular application of a schema (Pace, 2018). The interpersonal theory describes a recursive within-situation interpersonal pattern of motivations, feelings, and behaviors, which is especially important for analyzing dysfunctional processes (Hopwood, 2018). The interpersonal circumplex is a cyclical model of a personality’s interpersonal domain used to investigate and analyze individual variations in interpersonal traits (Gurtman, 2020). The paper explores Suzanne’s story within cognitive and interpersonal frameworks and their corresponding models.
One of the applications of the chosen frameworks and models for the case study is analyzing depression causes and their relation to Suzanne’s experiences. Namely, several studies have shown that negative self-schemas, especially for interpersonal elements, are highly ordered and appear to be persistent risk factors for depression (Cherry & Lumley, 2019; Dozois, 2021). More specifically, depression cognitive models argue that adversely prejudiced self-referent perception and attention play significant roles in the disease (Beevers et al., 2019). It is proposed that negative fundamental beliefs about oneself underpin all dysfunctional self-schemas, although those about others could be involved in autonomous self-schemas (Otani et al., 2018). These findings indicate that depressed people have deep core beliefs that they are inept. When life stress activates this schema, the individual is more prone to participate in cognitive processing biases. Aside from self-schemas, highly ordered negative partner-schema patterns lead to biased cognitions regarding one’s romantic relationship, which leads to dysfunctional behavioral reactions toward that partner. Therefore, the negative self-schema model explains Suzanne’s depression as a result of thoughts about her incompetence, fostered by the distress, which also caused Suzanne’s relationship to end.
Interpersonal approaches to depression highlight the importance of the interpersonal context in the onset and resolution of symptoms. For example, several authors relate interpersonal aggression to the emergence of depression in individuals. Interpersonal peer victimization and interpersonal violence in preschool, as well as overt aggressiveness for females, determine the circumstances under which social experiences and depressive symptoms are related (Berg et al., 2019; Krygsman, 2018). Moreover, parental depression symptoms have been proven to predict conflict with teenage children, but other parental interpersonal issues, characterized by interpersonal circumplex, may also play a role, such as aggression in father-adolescent interactions (Kim & Lee, 2021; Rognli et al., 2020). Furthermore, depression and poor self-esteem negatively influence how people feel others perceive them in new acquaintanceships and hence may play a significant role in forming interpersonal relationships (Fiorilli et al., 2019; Moritz & Roberts, 2018). Therefore, the interpersonal perspective relates to the case of Suzanne: while peer bullying, father aggressiveness, and maternal depression are predictors of the symptoms, poor self-esteem is the consequence of the disorder.
The next experience that is described in the case study concerns hearing voices, and both theoretical approaches provide an analysis of this phenomenon. In cognitive psychology, hearing voices others do not hear is typically related to psychosis (Iudici et al., 2019). The psychological impact differs from person to person: for some, voices may be domineering and upsetting. The cause of why some people find voices upsetting is distress, which can heighten the intensity and aggression of votes (Dudley et al., 2018). Moreover, findings reveal strong evidence of negative cognitive self-schemas mediating the link between childhood trauma and psychosis (Gawęda et al., 2018). Childhood trauma, interpersonal connection, and larger self-representations may all play a role in harmful voice-hearing content (Scott et al., 2020). This shows that the linkages between altered self-experience, defective information processing, traumatic life experiences, and feelings of shame are essential in developing psychosis (Alameda et al., 2020; Bortolon et al., 2021). Thus, the cognitive psychology and self-schemas model, in particular, relate Suzanne’s experience to the early childhood trauma and distress to psychosis, which results in voice-hearing with destructive content.
Similarly to the cognitive approach, the interpersonal model views voice-hearing as an output of psychosis. More specifically, psychotic experiences and actions emerge in alienating interpersonal and social circumstances, such as psychiatric interaction (Kamens, 2019). Moreover, according to the findings, there is a significant positive association between isolation and psychosis (Rocha et al., 2018). People who have psychosis frequently struggle to form and maintain functional relationships. Various processes might relate isolation to psychotic symptoms, including hallucinations. Loneliness, for example, can directly raise anxiety and despair, which can worsen psychotic symptoms. Another possibility is “anthropomorphism,” in which social isolation and loneliness lead to greater detection of human action in one’s immediate surroundings, increasing the chance of hearing voices (Rocha et al., 2018). Finally, it is claimed that self-talk transmits a range of interpersonal styles, indicating various ways of speaking to oneself (Le et al., 2019; Lefebvre et al., 2022). These styles may be understood using the interpersonal circumplex. Hence, the interpersonal approach proposes that Suzanne’s voice-hearing is related to psychosis, which might be caused by social isolation due to her inability to maintain relationships.
Conclusion
To conclude, the research into two psychological frameworks (cognitive and interpersonal) has provided meaningful results about the experience of Suzanne in the case study. The combination of both theories seems to be enough to examine and relate Suzanne’s background and emotions to her depression and voice-hearing, as well as determine their causes. For depression, the cognitive model supposes that negative self-schemas influence the emergence of symptoms, while the interpersonal approach relates them to childhood traumas. As for audial hallucinations, both theories connect them to psychosis caused by traumatic experiences, peer aggression, and loneliness.
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