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7-A-Dyadic-Partner-Schema.Pdf Clinical Psychology Review 70 (2019) 13–25 Contents lists available at ScienceDirect Clinical Psychology Review journal homepage: www.elsevier.com/locate/clinpsychrev Review A dyadic partner-schema model of relationship distress and depression: T Conceptual integration of interpersonal theory and cognitive-behavioral models ⁎ Jesse Lee Wilde, David J.A. Dozois Department of Psychology, The University of Western Ontario, London, ON, Canada HIGHLIGHTS • Presents a new theoretical framework – the dyadic partner-schema model of depression • Partner-schema structures affect biased cognitions about one's partner, which lead to maladaptive interpersonal behaviors • Reviews theoretical and empirical support for the model's proposed processes • Discusses implications for research and clinical applications ARTICLE INFO ABSTRACT Keywords: Difficulties in romantic relationships are a prominent part of the disorder for many individuals with depression. Depression Researchers have called for an integration of interpersonal and cognitive-behavioral theories to better under- Interpersonal difficulties stand the role of relational difficulties in depression. In this article, a novel theoretical framework (the dyadic Partner-schemas partner-schema model) is presented. This model illustrates a potential pathway from underlying “partner- Romantic relationships schema” structures to romantic relationship distress and depressive affect. This framework integrates cognitive- Schema behavioral mechanisms in depression with research on dyadic processes in romantic partners. A brief clinical Cognitive theory Interpersonal theory case example is presented to illustrate the utility of the dyadic partner-schema model in conceptualizing the Complementarity treatment of depression. The implications of the model are discussed, and areas for future research are explored. 1. Introduction Researchers have called for the integration of cognitive-behavioral and interpersonal theories of depression to understand potential con- Depression is associated with significant interpersonal difficulties, tributors to interpersonal dysfunction in the disorder (Dobson, Quigley, particularly within the context of romantic relationships (see Rehman, & Dozois, 2014; Rehman et al., 2008). Cognitive-behavioral theories of Gollan, & Mortimer, 2008, for a review). An emerging literature stemming depression suggest that negatively biased representations of the self and from cognitive and interpersonal models of the disorder suggests that in- others may contribute to both interpersonal difficulties and depressive terpersonal difficulties are both contributors to, and consequences of, symptoms (e.g., Dobson et al., 2014; Evraire & Dozois, 2014). These depression. That is, relationship distress has been shown to longitudinally cognitive representations, referred to as schemas, are a central compo- predict later depressive symptoms, and vice versa (Beach & O'Leary, 1993; nent in cognitive models of depression (e.g., Beck, Rush, Shaw, & Du Rocher, Papp, & Cummings, 2011; Najman et al., 2014; Rehman, Emery, 1979). Briefly, schemas can be defined as the cognitive struc- Ginting, Karimiha, & Goodnight, 2010; Sheets & Craighead, 2014; tures that an individual develops based on past experiences that are Whisman & Bruce, 1999). Given that relationship distress is also linked to subsequently used as a framework to guide the processing of incoming poorer treatment response (Quilty, Mainland, McBride, & Bagby, 2013; information. To date, most of the elaboration and research on schematic Renner et al., 2012) and increased risk for relapse (Jacobson, Fruzzetti, representations in depression have focused on self-schema structures, Dobson, Whisman, & Hops, 1993; Whisman, 2001) in depression, a thor- whereas the role of schema structures held for significant others has ough understanding of the interplay between factors contributing to re- been largely neglected. The relatively poor understanding of schemas lationship distress and depressive symptoms is critical. held for significant others is problematic because interpersonal ⁎ Corresponding author at: Westminster Hall, Rm. 313E, 361 Windermere Rd., London, ON N6A 3K7, Canada. E-mail address: [email protected] (D.J.A. Dozois). https://doi.org/10.1016/j.cpr.2019.03.003 Received 7 May 2018; Received in revised form 3 March 2019; Accepted 4 March 2019 Available online 06 March 2019 0272-7358/ © 2019 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/BY-NC-ND/4.0/). J.L. Wilde and D.J.A. Dozois Clinical Psychology Review 70 (2019) 13–25 difficulties are the most powerful predictors of depression (e.g., Sheets more tightly interconnected (and therefore strongly associated in & Craighead, 2014). As such, interpersonal theory (Coyne, 1976; memory) the negative nodes are within the partner-schema, the more Kiesler, 1996; Leary, 1957) offers valuable insight into the dyadic quickly negative information is activated and floods conscious aware- nature of depression, and how an individual's cognition, affect, and ness. Thus, the way in which positive and negative information about a behavior may influence (and be influenced by) significant others. partner is organized in underlying schema structures has important im- As such, the purpose of this article is twofold: (1) to assert that plications for cognitive and affective responses to a partner. Conse- partner-schemas play an important role in depression, and (2) to present quently, though schemas operate outside of conscious awareness, they a model delineating the pathway through which partner-schemas con- have a profound influence on one's consciously experienced thoughts, tribute to relationship distress and depression, integrating both cogni- emotions, and ultimately behaviors (Beck, 1967; Beck et al., 1979). tive and interpersonal theories. To provide context for the model, key To illustrate one operationalization of schema structure in the lit- concepts in cognitive and interpersonal theories are first reviewed. erature, the Psychological Distance Scaling Task (PDST; Dozois & Following this, an overview of the current model and its proposed Dobson, 2001) is reviewed briefly. In the PDST, individuals place a series processes, axioms, and tenets are presented. A review of the relevant of positive and negative adjectives (e.g., kind, rejecting, friendly, cold) theoretical and empirical support for the model's hypothesized me- within a square grid on a computer monitor. In the middle of the grid is a chanisms is then provided. We conclude by discussing the clinical and horizontal line, anchored with the statements Not at all like me on the left theoretical implications of the dyadic partner-schema model. side of the grid and Very much like me on the right. An intersecting vertical line is also shown in the middle of the grid with the anchors Very 2. Cognitive models of depression: The role of schemas and positive at the top of the grid and Very negative at the bottom. As such, the information processing x-axis represents an adjective's degree of self-reference, and the y-axis reflects the adjective's valence. Adjectives are presented one at atimein The schema concept has been referred to across a variety of disciplines. the centre of the grid, and respondents are instructed to place the ad- Although its definition varies somewhat across fields, schemas canbe jective in the position on the grid that best characterizes the degree of defined as “the basic structural components of cognitive organization self-relevance and degree of valence of the word. In order to provide a through which humans come to identify, interpret, categorize, and eval- metric for the degree of schema organization, the x/y coordinate point uate their experiences” (Schmidt, Schmidt, & Young, 1999, p. 129). That for each adjective is used to calculate the average interstimulus distances is, schemas act as cognitive templates used to guide the processing of one's between adjectives (see Dozois & Dobson, 2001). The physical space or current experience. Schemas are thought to develop over time based on distance between adjectives on the grid is assumed to reflect the psy- one's personal history of experiences, thereby reflecting a highly in- chological space or distance (i.e., how closely the concepts are associated dividualized lens through which an individual interprets and experiences in memory) between concepts (nodes) within an individual's cognitive his or her current surroundings (Beck et al., 1979). Theory and research in schema. Thus, greater distance among adjectives is believed to indicate the field of social cognition has long suggested that individuals use less interconnectedness of information, whereas less distance is thought schemas of self, others, and the relationships between them to navigate to reflect greater interconnectedness (Dozois, 2007). interpersonal interactions (Baldwin, 1992, 1995). These relational schemas Within the context of depression specifically, research shows that in- are thought to allow individuals to predict which self-generated behaviors dividuals with the disorder have highly negative cognitive representations will elicit which types of responses from a partner (e.g., an individual's of the self (Dozois & Beck, 2008). For instance, compared to healthy relational schema may include the script of “If I get angry, my partner will controls, individuals with depression tend to endorse pervasive negative reject me”;
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