The role of cognitive schemas in personal recovery, symptom severity, and functioning in schizophrenia-spectrum...

Negative cognitive schemas about the self and others are prevalent in schizophrenia-spectrum disorders (SSDs) and are associated with symptom severity. Recent conceptualizations of recovery emphasize functional and personal outcomes in addition to symptoms. The current study examined the effects of schemas on domains of symptoms, functioning, and personal recovery.

71 individuals diagnosed with SSDs were included in the present study. Data presented in this study were collected as part of the baseline assessment for a clinical trial evaluating remotely delivered cognitive behavioural therapy for psychosis. Participants completed measures of core schemas, symptom severity, psychosocial functioning, and personal recovery.

Cognitive schemas accounted for significant variance in personal recovery (65%), symptom severity (27%), and psychosocial functioning (18%). Negative-self schemas were associated with poorer social functioning, lower personal recovery, and greater overall symptom severity (ps = 0.034-0.036; BH-adjusted ps = 0.073). Positive-other schemas were associated with greater social functioning (p = .018; BH-adjusted p = .072) and personal recovery (p and BH-adjusted p < .001). Positive-self schemas were associated with greater personal recovery (p and BH-adjusted p < .001). Associations between schemas and personal recovery largely persisted after the influence of the other recovery domains was accounted for (ps < 0.001-0.062).

Cognitive schemas demonstrated associations with symptoms, psychosocial functioning, and personal recovery in individuals with SSDs, with negative-self evaluations in particular showing trend-level associations across all three domains. Greater personal recovery was associated with higher positive self- and other-evaluations, independent of symptom severity and functioning, underscoring their relevance for recovery-oriented interventions.