































Graduate Student Journal of Psychology          Copyright 2012 by the Department of Counseling and Clinical Psychology 
2012, Vol. 14               Teachers College, Columbia University 

3 
 

 
Fragmented Selves: Recall of Self-Referenced Adjectives and the Self-

Schema in Schizophrenia 
 

Fahad Rahman 
Lahore University of Management Sciences 

 
The self-schema has been implicated in the social and cognitive disabilities found in people 
diagnosed with schizophrenia. It is hypothesized that the self-schema is relatively disorganized and 
unstable in schizophrenia patients compared to healthy individuals. Few studies have examined this 
hypothesis in the literature, as the self-schema in schizophrenia is not yet fully understood. Testing 
this hypothesis, mean recall for 20 adjectives was compared between 20 adult male participants 
with schizophrenia and 20 adult male nonclinical participants under two levels of processing: 
semantic and self-referential. Results showed that self-referencing facilitated memory (i.e., the self-
reference effect). There was a significant difference in the mean recall of the nonclinical 
participants under the two encoding conditions, but this difference was not significant for 
schizophrenia patients. That is, schizophrenia patients showed a global impairment in word recall 
compared to the nonclinical participants, and the self-reference effect was not shown. Accordingly, 
treatment should aim to ameliorate these deficits in self-concept and social cognition in addition to 
the standard rehabilitation repertoire. 

 
 

 The self is a concept that has stirred much passionate 
debate in philosophical and psychological literature.  Renee 
Descartes (1641) put forth the idea that the ability to have 
self-awareness (i.e., being able to reflect on one’s own inner 
cognitive and emotional states, and monitor one’s behavior), 
is a necessary condition to gain the status of full personhood 
and is a proof of one’s own existence. Kihlstrom et al. (1988) 
have defined the self as a mental representation of everything 
a person knows about him or herself.  A person’s self-
knowledge can be roughly divided into perception-based 
knowledge (i.e., self-image) and meaning-based knowledge 
(i.e., self-concept).  The self consists of a memory structure 
that has abstract representations of all the past experiences of 
an individual. If there are deficits in the self of an individual, 
that may affect the mental health of that person in substantial 
ways.  Therefore, understanding the specific nature of the 
self-schema in schizophrenia may allow us to prevent and 
treat the disorder more effectively. 
 
The Self-Reference Memory (SRM) Effect 

The role of the self-schema in memory processes is often 
investigated using the depth of processing (DOP) incidental 
recall paradigm (Craik & Tulving, 1975), in which 
participants process a list of words at different levels of depth.  
Depth refers to the extent or amount of processing that a 
stimulus receives, and it is positively correlated with the 
strength and subsequent recall of the stimulus.  For example, 

                                                 
Fahad Rahman, Department of Humanities and Social Science, 

Lahore University of Management Sciences.  
Fahad Rahman is now at the Department of Counseling and 

Clinical Psychology, Teachers College, Columbia University. 
Correspondence concerning this article should be addressed to 

Fahad Rahman, 500 Riverside Drive, Apartment 605, New York, 
NY 10027. Email: fr2275@tc.columbia.edu 

the structural coding task involves rating whether a given 
word is written with capital letters or lowercase letters.  Other 
words are rated according to either phonemic or semantic 
rating tasks, which involves processing whether the word 
rhymes with another word or processing the meaning of the 
word, respectively.  After the rating task the participants are 
asked to recall the words they remember in a surprise recall 
test i.e., the participants are not told about the recall test in 
advance.   

An influential meta-analysis of the self-reference effect 
by Symons and Johnson (1997) analyzed various studies on 
the SRM effect in order to investigate whether there is a 
unique mnemonic advantage to the role of the self in recall.  
Their analysis showed that the SRM effect was indeed shown 
in majority of the studies and was a robust phenomenon.  The 
authors argued that self-referential coding was 
sufficient―although not necessary―to promote superior 
recall of information because it promotes the processing of 
new information and helps relate it to previously stored 
related information.  Furthermore, the involvement of the 
self-schema in the encoding stage provides superior recall by 
providing a compatible retrieval condition involving the same 
related self-schema items that were present during encoding.  
Rogers, Kuiper, and Kirker (1977) wrote that it was the well-
structured and relatively stable nature of the self-schema that 
makes it such a powerful memory structure, stating that “in 
order for the self-reference to be such a useful encoding 
process, the self must be a uniform, well-structured concept” 
(p. 686).   
 
Self-Schema Deficits in Schizophrenia 

The exploration of the SRM effect in different 
populations, especially among those with psychopathology, 
can provide us with information about the nature of their self-
schema and executive abilities.  For instance, the nature of 



RAHMAN 
 

4 
 

schizophrenia involves the fragmentation and disorganization 
of numerous cognitive processes, such as attention, 
perception, memory and appraisal (Carter & Flesher, 1995).  
The disorganization and fragmentation of the self-schema and 
self-experience among schizophrenia patients is considered a 
crucial and important aspect of the disorder (Guller, 1966; 
Mishara, 2007).  Therefore, the DOP paradigm can elucidate 
the nature of these self-related cognitive deficits and 
potentially provide us with targets for therapeutic 
interventions.   

Although there has not been much research on self-
schema deficits in people with schizophrenia, there is some 
preliminary support for the hypothesis that the self-schema 
may play an important role in schizophrenia.  For instance, 
schizophrenia patients often report having unclear self-
awareness or self-concept.  Guller (1966) investigated the 
stability of the self-concept of people with schizophrenia and 
found that their self-concept was very variable and resulted in 
inconsistent self-descriptions.  Guller (1966) claimed that 
schizophrenia has an important “self-concept disorder” (p. 
279) component, which contributes to a number of the 
symptoms found in schizophrenia, such as an inability to plan 
ahead, and difficulties in effectively communicating or 
anticipating other’s reactions.  .   

Similarly, the self-schema of schizophrenia patients 
seems to be less stable over time when compared to the self-
schema of non-clinical individuals.  Boulanger, Dethier, 
Jacob, Gendre, and Blairy (2009, September) compared the 
stability of the self-schema of individuals with schizophrenia 
to those with no identifiable psychopathology by asking them 
to define themselves on two parallel versions of a 
questionnaire with trait adjectives.  Individuals with 
schizophrenia had a significantly less stable self-schema than 
non-clinical individuals. The individuals with schizophrenia 
also showed more depression and anxiety, but the difference 
in the stability of the self-schema remained even when these 
other factors were statistically accounted for.   

Furthermore, individuals with schizophrenia also have 
difficulty in temporal aspects of self-referential memory, such 
as recalling specific events in their past and generating 
specific thoughts about future events (D’Argembeau, Raffard, 
& Van der Linden, 2008).  This distorted sense of continuity 
of the self over time in individuals with schizophrenia may be 
partly associated with impairments in self-awareness and the 
self-schema. 

Scharfetter (1981) classified dimensions of ego-
consciousness and postulated that impairment in the 
dimension of ego-consistency was the core feature of 
schizophrenia.  The impairment of ego-consistency has been 
described as “the destruction of the coherence of one’s self, 
the body and the soul, as a unitary being” (Kircher & David, 
2003, p. 460). Therefore, ego-consistency seems to be 
fragmented in individuals with schizophrenia, and it is a 
crucial concept in understanding the nature of this disorder.   

 The SRM effect shown in nonclinical samples can be 
attributed partly to how the self is spontaneously invoked and 
involved in the processing of personally relevant information 

(Foley, Belch, Mann, & McLean, 1999).  Weckowisz and 
Sommer (1960) showed that participants with schizophrenia 
used self-references less than nonclinical controls.  It seems 
that the self-schema in schizophrenia is not spontaneously 
invoked or a well-rehearsed structure for personally relevant 
processing of information.   

People with schizophrenia show deficits in executive and 
organizational abilities and this may be another important 
factor in explaining why they do not show a normal SRM 
effect.  A study comparing patients with schizophrenia with 
those with bipolar disorder and a group of non-clinical 
individuals revealed that patients with schizophrenia showed 
poorer performance than bipolar patients in generating 
definitions of words and then later recalling them (Rossel and 
Batty, 2008).  The authors concluded that patients with 
schizophrenia have impairments in their executive and 
organizational abilities as well as greater deficits in their 
search and retrieval strategies.  Bower and Gilligan (1979) 
claimed that the self-schema provided efficient search and 
retrieval strategies and this explains why a self-reference 
effect is observed.  Therefore, if schizophrenia is marked by 
deficits in search and retrieval, as well as by deficits in 
organization, there might be a lack of a self-reference effect 
in people with schizophrenia.   

Additionally, schizophrenia patients show difficulty in 
maintaining category boundaries, leading to the formation of 
vague and overextensive categories (Lawrence, Doughty, Al-
Mousawi, Clegg, & Done, 2007).  This may be due to the 
inability of schizophrenia patients to exclude contextually 
irrelevant items from categories.  Thus, it seems that the self-
concept as a category would suffer from the same 
documented distortions and it might be difficult for 
schizophrenia patients to maintain a proper self-concept or 
schema.  Since the self-reference effect depends primarily on 
the unity and coherence of the self-schema this might be 
another reason why patients with schizophrenia may lack the 
SRM effect.   

The nature of the cognitive deficits related to the self-
schema in people with schizophrenia can be a very fruitful 
domain of experimental inquiry because it will help explain 
some vexing questions about the nature, etiology, and 
treatment of this disorder.  Experimental studies on 
nonclinical populations have shown repeatedly that the depth-
of-processing experimental design is useful for tapping into 
the self-schema and understanding how the self is involved in 
normal social cognition and self-cognition.  Similarly, this 
experimental design has elucidated the nature of the self-
schema in other forms of psychopathology, such as 
depression (Davis & Unruh, 1981; Derry & Kuiper, 1981); 
therefore, we can expect to find interesting and useful insights 
into the self and the social cognition of schizophrenia patients 
using this procedure.   

In fact, a recent study used a personality adjectives 
recognition DOP paradigm in order to examine whether 
patients with schizophrenia show the mnemonic advantage of 
self-referential encoding as compared to structural and social 
desirability (i.e., a type of semantic encoding) encoding 



SELF-SCHEMA IN SCHIZOPHRENIA 
 

5 
 

(Harvey, Lee, Horan, Ochsner, & Green, 2011).  
Interestingly, patients with schizophrenia had similar memory 
recognition of personality adjectives compared to the controls 
in the structural and social desirability conditions, but they 
had significantly less memory recognition than controls in the 
self-referential condition. This points to a specific self-
cognition deficit, presumably in the self-schema, rather than 
depicting broader social cognition impairments or 
neurocognitive impairments in executive functions. 
 
A Cognitive Model of Schizophrenia 

Schizophrenia usually develops in vulnerable individuals 
during the transitory phase between late adolescence and 
young adulthood (Carter & Flesher, 1995).  According to Erik 
Erikson’s (1968) stages of life theory, this period is marked 
by a need to define one’s identity and the expanding of social 
roles.  The expanded social roles that a person occupies put 
increased demand on the individual to develop an 
increasingly complicated and extensive self-schema.  Thus, 
considerable cognitive skill and energy is involved in the 
formation of a self-schema.  These developmental demands 
can produce a good deal of stress and anxiety in individuals 
(Carter & Flesher, 1995).  

According to the vulnerability theory of schizophrenia 
(Zubin & Springer, 1977), certain individuals have 
neuropsychological and cognitive deficits that make them 
vulnerable to schizophrenia, such as attention deficits and 
lack of cognitive flexibility.  These cognitive deficits are 
implicated in the emergence of schizophrenia precisely during 
the phase of life in which the individual is expected to form a 
complicated self-schema that makes him or her functional in 
adult society.  It is hypothesized that psychotic breaks may 
affect the already vulnerable self-schemas of individuals and 
can lead to distorted appraisals, beliefs and thoughts, which 
may contribute to dysfunctional moods and behaviors.  These 
processes may lead to a downward spiral eventually resulting 
in the individual developing schizophrenia.   

This cognitive model of psychosis addresses the role of 
automatic appraisals, which are driven by schemas in the 
onset and maintenance of psychosis.  For instance, 
individuals who develop symptoms of hallucinations are more 
likely to go on to develop schizophrenia if they develop 
depressive symptoms after their hallucinatory experiences 
(Krabbendam et al., 2005).  This suggests that there might be 
intervening beliefs that may affect self- and other-schemas 
and thereby lead to depression and psychosis (Krabbendam et 
al., 2005).   

The specific research question addressed by this study is 
whether or not people diagnosed with schizophrenia have the 
self-reference effect.  If they do, this study will address how it 
is similar or different from the self-reference effect found 
with nonclinical people.  Such investigations could be 
particularly important given speculations that the self-schema 
may play a role in moderating the onset of schizophrenic 
symptomatology.   

Due to the deficits in schizophrenia related to executive 
functions (i.e., organization and search and retrieval 

strategies), and to the self-schema (i.e., fragmentation, 
instability and cognitive distortions), it is predicted that the 
result of the standard DOP incidental recall paradigm will be 
different in people with schizophrenia, as compared to the 
nonclinical participants, in the self-reference task.  It is 
predicted that the mean recall of the adjectives will not 
significantly improve in participants with schizophrenia in the 
self-reference task as compared to their mean recall of the 
adjectives in the semantic task.  Specifically, it is 
hypothesized that either the SRM effect will not be 
demonstrated in participants with schizophrenia or it will be 
significantly weaker as compared to the SRM effect observed 
in the nonclinical participants.   

 
Method 

 
Design 

A 2 x 2 between-groups design was used in this study.  
One of the independent variables used was the level of 
processing.  This was a manipulated experimental factor with 
two levels: semantic processing and self-referential 
processing.  The other independent variable was the 
psychiatric status of the participants.  This was a subject 
factor, rather than an experimentally manipulated factor, that 
had two groups: people diagnosed with schizophrenia and 
nonclinical participants. The participants with schizophrenia 
were randomly allocated, using the block randomization 
technique, to both conditions of the level of processing factor 
(semantic and self-referential) in a way to ensure that exactly 
half (n = 10) were divided across both levels.  The same 
random allocation technique was done for the nonclinical 
participants, so that four groups were made in total with 10 
participants in each group.  The dependent variable used was 
the number of correct items recalled under free recall 
conditions.  
 
Participants 

Twenty adult male participants diagnosed with 
schizophrenia were selected from the Punjab Institute of 
Mental Health (PIMH) and from the Fountain House Institute 
in Lahore, Pakistan to participate in the research project.  All 
schizophrenia subtypes were included in the study, except 
schizophrenia patients who had ever experienced an episode 
of drug-induced psychosis.  The participants with 
schizophrenia had no known history of brain injury, epilepsy, 
neurological illness, intellectual disabilities, co-existing 
psychiatric disorders, or drug or alcohol abuse or dependence.  
The participants with schizophrenia used in the study were 
clinically stable, chronic inpatients in a residential setting 
with mild to moderate symptom levels, allowing them to 
participate properly in the experiment.  All of the participants 
with schizophrenia were on an antipsychotic medication for at 
least six months. The schizophrenia patients were recruited by 
informing the psychiatric administrators of the required type 
of patients for the research project.  The authorities selected 
suitable patients with schizophrenia, who were evaluated for 
their capacity to give informed consent. These participants 



RAHMAN 
 

6 
 

either agreed or disagreed to participate in the research 
project after information about the experiment was given.  
Overall, half of the selected schizophrenia patients gave their 
consent to participate in the study, and there were no 
significant differences between those who declined to 
participate and those who consented to participate. 

Only male volunteers were recruited for the study as 
access to female patients with schizophrenia was difficult to 
obtain due to cultural norms regarding gender segregation, 
making it difficult for a male researcher to interview female 
patients with schizophrenia. Therefore, an equivalent all-male 
nonclinical sample was also required to ensure comparability 
of the schizophrenic and nonclinical samples.  Thus, 20 adult 
male nonclinical participants were selected from the general 
population.  Ten nonclinical participants were recruited from 
the undergraduate student population at Lahore University of 
Management Sciences (LUMS) by sending a mass email 
calling for male participants for a psychology cognitive 
experiment.  The other ten of the 20 nonclinical participants 
were recruited through purposeful sampling from different 
socio-economic classes, language/ethnic groups, and age 
groups.  Therefore, the participants with and without 
schizophrenia were matched on age, gender, and ethnicity.  
Attempts were made to match the groups on socioeconomic 
status (SES) by using the last attained educational degree as 
one indicator.  Despite matching the educational attainment 
levels, the living conditions and unemployment among the 
patients with schizophrenia suggest that the current 
socioeconomic levels (personal or familial) of the two groups 
were significantly different.   

The nonclinical participants were asked to self-report any 
history of psychiatric illnesses, substance abuse or 
dependency, head injury, or neurological disorders and only 
those who reported none were recruited for the study.  
Furthermore, the nonclinical participants were asked to report 
if there was any history of schizophrenia among their first-
degree relatives and only those with no such history were 
selected. 
 
Materials 

A list of 20 Urdu and Punjabi adjectives was prepared 
and tested on samples of randomly selected patients and 
students.  These samples were different from the samples 
used during the interventions.  A sample of 40 inpatients was 
randomly selected from the hospital records of the two 
psychiatric institutions and 40 LUMS students were randomly 
selected from the university admission records.  They were 
asked to judge whether these words were familiar to them 
and, in their opinion, to others in order to verify that these 
adjectives would be equally familiar to all experimental 
participants involved, regardless of educational qualification, 
first language, or mental health status.   

Among the participants involved in the four experimental 
conditions of the study, 40% of participants’ first language 
was Urdu and 60% of participants’ first language was 
Punjabi, although all participants spoke and understood both 
languages.  An equal number of adjectives had positive and 

negative traits or valence, and they were listed in random 
order.  This was used to prevent the response acquiescence 
bias (i.e., a tendency to choose yes as an option or select a 
positive option without careful consideration).  This was also 
necessary to allow the adjectives to tap both the positive and 
negative traits that might be represented in the self-schemas 
of the various participants.  Derry and Kuiper (1981) have 
pointed out the importance of making sure that the 
experimental traits are relevant to the self-schemas under 
investigation.  They explained that the content-specificity 
component of the self-as-a-schema model predicts superior 
recall for words that are already present in the self-schema.  
Therefore, it was necessary to ensure that the word list did not 
have only positive or only negative words, as that might not 
effectively represent the self-schemas of participants.  
Furthermore, the average number of letters and syllables in 
the positive and negative words was kept equivalent. 

The semantic processing condition had the same 20 
adjectives, as well as either correct or incorrect definitions of 
each word. Therefore, the participants had to determine 
whether the definition given for a word was correct or 
incorrect.  This was done to obtain both “yes” and “no” 
answers and prevent a response bias in the semantic 
processing conditions.   
 
Procedure 

Each participant was read the initial list individually for 
encoding and then tested for recall individually.  A 
standardized protocol was observed to keep the experimental 
conditions as similar as possible and to avoid any 
confounding demand characteristics.  Standardized 
instructions were given to each participant in Urdu, and the 
instructions were different for the semantic and self-
referential levels but the same across the mental status 
groups.  The participant then answered either “yes” or “no” 
after each of the 20 adjectives according to the instructions 
given, i.e., whether the adjectives described them or not (self-
referential encoding), or whether the definitions of the 
adjectives were correct or not (semantic encoding).  All 
participants were given a maximum of 30 seconds, monitored 
by the researcher on a stopwatch, to answer after the 
researcher spoke each word.   

After the last adjective was answered, one minute was 
allowed to pass before a surprise recall test was administered 
and the participants were asked to verbally recall as many of 
the adjectives (not the definition sentences) as possible, in 
any order.  The entire procedure was verbal for all 
participants as some of the participants were illiterate.  All 
participants were given a maximum of three minutes for this 
task.  After the recall test all participants were suitably 
debriefed.  All participants were given 40 rupees 
(approximately $1 at the time of study, but is worth more in 
terms of purchasing power) as a compensation for 
participating in the study.  The methodology, purpose and 
implementation of this study was approved and monitored by 
the Lahore University of Management Sciences (LUMS) 
senior research study advisors. 



SELF-SCHEMA IN SCHIZOPHRENIA 
 

7 
 

Results 
 

Analysis of variance (ANOVA) for four independent 
samples was used to analyze differences in participants’ ages.  
The mean age of the participants was 29.25 years (SD = 
7.61).  There was no significant difference in the age of 
participants in different groups, F(3,36) = 0.26, p = .85.   

The data were also analyzed with a 2 (schizophrenic and 
non-clinical) x 2 (semantic and self-referential) ANOVA.  
The level of alpha was set at .05 and it was single-tailed 
because the limited power of the study prevented using a two-
tailed alpha level.  The mean recall across all conditions for 
semantic processing was 5.40 (SD = 2.23; min = 4, max = 9), 
and across all conditions for self-referential processing was 
6.75 (SD = 3.00; min= 6, max= 13).  The difference was 
significant and a main effect for level of processing was 
found, F(1, 36) = 4.97, p = .032, ηp

2 = .12.  The mean recall 
across all conditions for the nonclinical participants was 7.80 
(SD = 2.39; min = 2, max = 7), which was higher than the 
mean recall across all conditions for the patients with 
schizophrenia (M = 4.35, SD = 1.72; min = 2, max = 7).  A 
highly significant main effect was found for mental status, 
F(1, 36) = 32.48, p < .001, ηp

2 = .47.  A significant interaction 
effect occurred between mental status and the level of 
processing, F(1, 36) = 4.26, p = .046, ηp

2 = .11.   
A simple effect analysis (independent samples t-test) of 

the level of processing in the participants with schizophrenia 
showed that even though the mean recall for the self-

referencing group was slightly higher than the mean recall of 
the semantic group the difference between the means was not 
significant, t(18) = -0.13, p = .90, d = .061, while for the 
nonclinical participants there was a significant difference, 
t(18) = -2.84, p = .011, d = 1.34, between the means of the 
semantic condition and the self-referential condition (see 
Figure 1).  Descriptive statistics are given in Table 1, which 
shows that the difference in mean scores across the levels of 
processing was much higher for the nonclinical groups than 
the schizophrenic groups.   

 
 
Table 1 
 
Mean and Standard Deviation of Recalled Adjectives as a 
Function of Level of Processing and Mental Status of 
Participants. 
 

Level of 
Processing 

Schizophrenic 
M (SD) 

Nonclinical 
M (SD) 

Semantic 
Processing 

4.30 (2.00) 6.50 (1.96) 

Self-Referential 
Processing 

4.40 (1.50) 9.10 (2.13) 

 
 

 
 

 
Figure 1. The self-referencing of trait adjectives leads to a memory boost, relative to semantic processing of the 
same trait adjectives, only in non-clinical participants.  

 



RAHMAN 
 

8 
 

Discussion 
 

The results of this study supported the hypothesis that the 
participants with schizophrenia would show impairments in 
their self-schema.  The results showed that the individuals 
diagnosed with schizophrenia did not seem to show a self-
reference effect, while there was a significant difference in 
mean recall between the two levels of processing for the 
nonclinical participants.  The interaction effect between 
mental status and levels of processing was significant and 
demonstrated that the mnemonic advantage of the self is 
observed in nonclinical participants, whereas no such 
substantial advantage is seen in participants with 
schizophrenia.  There was a significant main effect for the 
levels of processing; overall, self-referencing of personal 
information lead to a better recall than semantic association.  
However, the significant interaction effect between the 
participants’ mental status and their relative ability to recall 
under different levels of processing is of greater interest.  
There was a small difference in the mean recall of patients 
with schizophrenia between the semantic and self-referential 
conditions, but inferential analysis showed that this was a 
nonsignificant difference.   
 
The Self-Memory System (SMS) Model 

According to the self-memory system (SMS) model, the 
reduced SRM effect in patients with schizophrenia may be 
explained by deficits in the self-schema, cognitive distortions 
within the self-schema, and executive function deficits.  
Autobiographical memories have been proposed to be a part 
of the self-memory system (SMS), which involves different 
sets of self-schemas that are activated and brought into 
consciousness according to the goals of the working self (i.e., 
the part of the self-concept accessible consciously at a 
particular moment) (Conway & Pleydel-Pearce, 2000).  The 
activated self-schema brings with it a sense of continuity and 
coherence because it has an attached autobiographical 
memory bank.  The working-self is primarily composed of 
the various executive functions involved in coordinating 
cognitions (including memories), emotions, and behaviors.  
Therefore, when individuals with schizophrenia have 
difficulty forming a sense of self-continuity and lack a well-
developed and coherent self-schema, it could partly be due to 
deficits in the executive functions that coordinate goals and 
memories associated with relevant self-schemas.  In addition 
to executive functions, this model also suggests that 
individuals with schizophrenia may have deficits in self-
schemas due to lack of effective encoding, storage, retention, 
and retrieval, as well as distorted cognitions. 

Autobiographical and episodic memories are often 
considered the same type of memory, but recent research has 
shown that these can be classified as closely linked but 
separate memory systems (Gilboa, 2004; Wheeler, Stuss, & 
Tulving, 1997). These two memory systems share many 
neural correlates but also show distinct differences (Gilboa, 
2004).  Autobiographical memory has a larger significance 
for the individual in terms of self and identity than episodic 

memory (Gilboa, 2004).  Episodic memories are generally 
information stored about events in the past together with the 
context in which events occurred, and are often focused on 
relatively recent events (Wheeler et al., 1997).  These events 
can be any information that the individual was exposed to, 
while autobiographical memory focuses more on information 
related to the self.  Therefore, autobiographical memory is 
essentially tied to the self-schema of an individual and deals 
with broader, more generalized memories, which can be very 
old.  The self-schema takes significant self-related episodic 
memories and processes the information to create multiple 
retrieval cues and associations with other data points within 
the self-schema.  Hence, autobiographical memories can be 
cued by a diverse and general set of situations, while episodic 
memory cues are generally more specific. 

The established explanation of how the self-schema 
facilitates word recall is that it not only elaborates and 
organizes data, but also provides similar conditions during 
retrieval as those found during encoding.  Additionally, it is a 
spontaneous and well-rehearsed structure in the processing of 
trait adjectives; therefore it has a natural advantage as a 
mnemonic device compared to any other memory structure 
(Bower & Gilligan, 1979; Klein & Loftus, 1988).  This study 
found that the schizophrenia patients did not show a self-
reference effect to the same extent that nonclinical 
participants did, and this result can be interpreted according 
to the self-as-a-schema theoretical framework presented 
above.  Presumably, not only is the self-schema disorganized 
in patients with schizophrenia, but it is apparently not a well-
rehearsed and spontaneous structure in the processing of 
personally relevant information.  It may not provide suitable 
retrieval cues and conditions, and hence is not rich enough to 
provide elaboration of personal information (Mishara, 2007; 
Scharfetter, 1981).  
 
Executive Abilities Deficit in Schizophrenia 

Patients with schizophrenia have been shown to have 
impairments in organizational and executive abilities, which 
might also partly explain why they do not organize personal 
data efficiently (Lawrence et al, 2007; Rossell & Batty, 
2008).  This hypothesis is supported by our results, which 
showed a highly significant difference in the overall mean 
recall of the trait adjectives between the participants with 
schizophrenia and the nonclinical participants.  The 
nonclinical participants, across both levels of processing, 
performed much better than the participants with 
schizophrenia did under each of the two conditions.  Thus 
there was a strong main effect of the mental status of the 
participants as the schizophrenia patients showed an overall 
lower recall rate of the trait adjectives.  This result is not 
surprising as it is known that patients with schizophrenia 
suffer from widespread organizational and information-
processing deficits (Neuchterlein & Dawson, 1984).  There 
are general deficits in attention and an inability to selectively 
attend only to relevant information, leading to over-inclusive 
and incoherent categories (Lawrence et al., 2007). 
Furthermore, patients with schizophrenia not only show 



SELF-SCHEMA IN SCHIZOPHRENIA 
 

9 
 

marked deficits in self-schema but also in semantic memory.  
Many psychologists have concluded from the evidence 
accumulated that “abnormalities in semantic memory are 
commonly proposed to be central to cognitive abnormalities 
in schizophrenia” (Rossell & Batty, 2008, p. 63).  Semantic 
deficits have been shown in a wide variety of semantic tasks, 
such as categorization (Rossell & David, 2006), verbal 
fluency (Rossell, Rabe-Hesketh, Shapleske, & David, 1999) 
and priming (Rossell, Shapleske, & David, 2000).   

Furthermore, it is plausible that the anti-psychotic 
medications that the participants with schizophrenia were 
taking might have affected their overall attention, memory 
and other executive abilities resulting in an overall lower 
recall of adjectives.  These results point to broader executive 
and attentional deficits among the participants with 
schizophrenia but the low SRM effect is probably not due to 
these other factors alone.  Harvey et al.’s (2011) study shows 
that patients with schizophrenia show a boost in recognition 
memory from structural to semantic level encoding but they 
lack the mnemonic boost for the self-reference encoding 
level.  This suggests that the lack of mnemonic boost is more 
than just the attentional and organizational deficits that lead to 
the overall lower recall level of patients with schizophrenia.  
Furthermore, our study supports the results from Havey et 
al.’s (2011) study and provides evidence that these results are 
seen even when using a recall paradigm.   
 
Social Cognitive Perspective 

The self-schema is a very important construct that is 
associated with effective interpersonal skills, patterns of adult 
attachments, goals, emotions, identity development, and 
psychopathology in different disorders (Conway & Pleydel-
Pearce, 2000).  For instance, the cognitive model for 
depression has been used in research studies over the last two 
decades in order to highlight the role of the self-schema, and 
researchers now have a deeper understanding of the 
mediating role of self- and other-evaluations in depression 
(Clark, Beck, & Alford, 1999).  Similarly, research has begun 
to explore the role of the self-schema in PTSD (Brewin, 
2003) and eating disorders (Fairburn, Cooper, & Shafran, 
2003).  Negative evaluations of the self and others have also 
been incorporated in cognitive models of psychosis and used 
to explain different symptoms, such as paranoia, 
hallucinations and delusions (Fowler, 2000; Fowler et al., 
2006; Freeman, Garety, Kuipers, Fowler, & Bebbington, 
2002).  Therefore, the self-schema in schizophrenia patients is 
potentially an important concept to explore because it may be 
amenable to interventions designed to ameliorate its 
potentially negative role in the etiology and/or maintenance 
of schizophrenia.   

This social cognitive perspective on schizophrenia 
provides another potentially useful understanding of the 
nature of the disorder and its causal pathways.  It can also 
help devise new and effective treatment and rehabilitation 
options for patients with schizophrenia.  The cognitive model 
of psychosis claims that if cognitive appraisals and 
underlying schemata are modified through CBT, then it may 

be result in an improvement in the psychotic symptoms of 
schizophrenia.  Furthermore, there are some encouraging 
results concerning the use of cognitive therapy, which targets 
self-and other-schemas, on individuals who are at high risk 
for developing psychosis, potentially preventing full-blown 
psychosis (Gould, Mueser, Bolton, Mays, & Goff, 2001; 
Morrison et al., 2004). 
 
Rehabilitative Interventions 

Currently, most rehabilitative interventions for patients 
with schizophrenia focus on teaching them social skills.  
Social skills can be defined as discrete behaviors that can be 
standardized and rehearsed.  Unfortunately, these 
interventions frequently do not lead to better social 
functioning (Carter & Flesher, 1995).  Improved social skills 
do not sufficiently help in the navigation of a complex, fluid 
and dynamic social world that requires one to have mastered 
the art of role-taking that secondary socialization teaches.  
New interventions should be designed that activate secondary 
socialization processes (i.e., empathy, mind-reading, 
perspective-taking) and fill the gaps in secondary 
socialization skills in schizophrenia patients.  Carter and 
Flesher (1995) describe socialization as “a far more inclusive 
construct referring to the ongoing process of adaptation of 
individuals to a variety of social contexts” (p. 210).  A 
disorder-specific socialization program can be more effective 
in improving the social functioning of patients with 
schizophrenia than just focusing on social skills.  The specific 
deficiencies shown in the self-schema and organizational 
abilities of patients with schizophrenia have to be adequately 
addressed and attempts should be made to teach individuals 
with schizophrenia techniques to compensate for these 
specific cognitive deficits.  For instance, therapy can address 
the issue of the self-concept of people diagnosed with 
schizophrenia by helping them gain a clearer and more 
coherent concept of who they are.  They could be encouraged 
to regularly write a journal and note their likes, dislikes, 
values, and habits in it and then examine the entries to find 
out stable patterns and traits.  Patients can also practice 
different exercises designed to boost their secondary 
socialization skills, like empathy.  For instance, guessing 
what a character is feeling based on their pictures or 
expressions.  These interventions can help the patients during 
social interactions by being more aware of what they want 
and what other people may be thinking or desiring. Similarly, 
information processing techniques should be taught, including 
the use of mnemonics, to practice and develop efficient 
memory structures, and compensate for the lack of 
organizational and search and retrieval deficits.   
 
Limitations 

While there are several benefits of this study’s findings, 
several limitations were also present.  The small sample size 
may have been a major limitation of this study and further 
studies should replicate this study with larger samples in 
order to get greater power.  Furthermore, this study was not 
designed to take into consideration the effects of intelligence 



RAHMAN 
 

10 
 

(IQ) on recall performance.  The IQ, intellectual and 
cognitive functioning of the participants with schizophrenia 
and nonclinical participants were only indirectly measured or 
matched in the research design by looking at educational 
attainment levels.  IQ might have some role to play in the 
differences in the two mental status groups in the self-
reference condition.  Furthermore, IQ is probably related to 
the main effect of mental status on recall of adjectives and 
might have contributed to the overall lower recall of 
adjectives in patients with schizophrenia.   

Another limitation of this study is the lack of equivalence 
of the non-clinical and schizophrenic groups in terms of 
socio-economic status (SES).  It is possible that SES may 
play a role in the development of the self-schema in 
individuals and may result in differences in the self-schema 
amongst different SES groups.  Future studies should explore 
whether distinct SES groups show differences in the self-
reference memory (SRM) effect.  Similarly, studies should 
compare participants with and without schizophrenia on the 
SRM effect with SES being controlled as a variable.  Gender 
may also have distinct effects on self-schema development 
and on the SRM effect.  It would be interesting to design 
studies to explore how the variable of gender is related to the 
SRM effect. 

It is important to note that, due to the nature of the 
experimental design, only those patients with schizophrenia 
who were able to perform the cognitive tests and interact 
adequately with the experimenter were included.  Hence, the 
schizophrenia participants in our sample were chronically ill 
and were not in an acute phase or highly symptomatic.  
Therefore, this research design should be replicated in order 
to establish the degree of generalizability of these results and 
to ascertain that the interaction effect is a reliable finding.  
Further research should be conducted specifically to see 
whether these results are obtained from participants with 
schizophrenia who are in the acute phase of this disorder 
and/or with those not taking anti-psychotic medications.  It 
has been shown that reactive schizophrenia, in which there is 
an intense and sudden onset of the symptoms, has a better 
prognosis for recovery than a slow and insidious development 
of schizophrenia symptoms (Chapman, Day, & Burstein, 
1961).  It might be the case that the self-schema disturbances 
in the acute and chronic types of schizophrenia are different.  
This suggests that a slow and insidious development of 
schizophrenia symptoms involves a chronic, inherently 
fragmented self-schema, while in reactive schizophrenia there 
is only a temporary disturbance in the functioning and 
structure of the self-schema.  Future research should compare 
the SRM effects between these two types of patients with 
schizophrenia, as it could help to explain why chronic 
schizophrenia has a worse prognosis for recovery.   
 
Conclusion 

Schizophrenia is a serious mental disorder whose 
symptoms and etiologies are complex and multiply 
determined.  This study attempted to utilize the research 
methodology and concepts developed by cognitive 

psychologists, especially in the domain of self- and social-
cognition, to lift this shroud a bit and see what lies beneath.  
The self can be considered a schema that is actively involved 
in the processing of self-related information.  This self-
schema organizes, elaborates and provides a facilitative 
retrieval atmosphere for personally relevant information.  
This study confirms previous findings that schizophrenia is 
marked by numerous cognitive deficits, including specific 
problems with the self-schema and organizational processes.  
The self-schema in people diagnosed with schizophrenia 
seems not to be a well-rehearsed, stable and functional 
structure and so it does not act effectively as a superordinate 
schema that facilitates recall of self-related information.  This 
study intended to highlight the importance of the self in 
schizophrenia, as it is a concept that is associated with 
numerous adaptive socio-cognitive functions and may lead to 
insights that can change how we prevent, treat and understand 
this disorder.  

 
References 

 
Boulanger, M., Dethier, M., Jacob, N., Gendre, F., & Blairy, 

S. (2009, September). The self-schema stability in 
schizophrenia. Poster presented at the 39th Annual 
EABCT Congress, Dubrovnik, Croatia. Abstract 
retrieved from http://hdl.handle.net/2268/31555 

Bower, G. H., & Gilligan, S. G. (1979). Remembering 
information related to one's self. Journal of Research in 
Personality, 13, 420-432. doi:10.1016/0092-6566(79) 
90005-9 

Brewin, C. R. (2003). Posttraumatic stress disorder: Malady 
or myth? New Haven, CT: Yale University Press.  

Carter, M. & Flesher, S. (1995). The neurosociology of 
schizophrenia: Vulnerability and functional disability. 
Psychiatry, 58, 209-224.  

Chapman, L. J., Day, D., & Bustein, A. (1961). The process-
reactive distinction and prognosis in schizophrenia. The 
Journal of Nervous and Mental Disease, 133, 383-391 

Clark, D. A., Beck, A. T., & Alford, B. A. (1999). Scientific 
foundations of the cognitive theory and therapy of 
depression. New York, NY: John Wiley. 

Conway, M. A., & Pleydel-Pearce, C. (2000). The 
construction of autobiographical memories in the self-
memory system. Psychological Review, 107, 261-288. 
doi:10.1037/0033-295X.107.2.261 

Craik, F. I. M., & Tulving, E. (1975). Depth of processing 
and the retention of words in episodic memory. Journal 
of Experimental Psychology: General, 104, 268-294. 
doi:10.1037/0096-3445.104.3.268  

D’Argembeau, A., Raffard, S., & Van der Linden, M. (2008). 
Remembering the past and imagining the future in 
schizophrenia. Journal of Abnormal Psychology, 117, 
247-251. doi:10.1037/0021-843X.117.1.247  

Davis, H., & Unruh, W. R. (1979). The development of the 
self-schema in adult depression. Journal of Abnormal 
Psychology, 90, 125-133. doi:10.1037/0021-843X.90.2. 
125  



SELF-SCHEMA IN SCHIZOPHRENIA 
 

11 
 

Derry, P. A., & Kuiper, N. A. (1981). Schematic processing 
and self-reference in clinical depression. Journal of 
Abnormal Psychology, 90, 286-297. doi:10.1037/0021-
843X.90.4.286  

Descartes, R. (1641/1996). Meditations On First Philosophy 
(Rev. ed.). New York, NY: Cambridge University Press. 
(Originally published in 1641)  

Erikson, E. H. (1968). Identity: Youth and crisis. New York, 
NY: Norton.  

Fairburn, C. G., Cooper, Z., & Shafran, R. (2003). Cognitive 
behaviour therapy for eating disorders: A 
‘transdiagnostic’ theory and treatment. Behaviour 
Research & Therapy, 41, 509-528. doi:10.1016/S0005-
7967(02)00088-8  

Foley, M. A., Belch, C., Mann, R., & McLean, M. (1999). 
Self-referencing: How incessant the stream? The 
American Journal of Psychology, 112, 73-96.  

Fowler, D. (2000). Psychological formulation of early 
episodes of psychosis: A cognitive model. In M. 
Birchwood, D. Fowler, & C. Jackson (Eds.), Early 
interventions in psychosis: A guide to concepts, evidence 
and interventions (pp. 101-127). Chichester, UK: John 
Wiley & Sons. 

Fowler, D., Freeman, D., Smith, B., Kuipers, E., Bebbington, 
P., Bashforth, H., . . . Garety, P. (2006). The Brief Core 
Schema Scales (BCSS): Psychometric properties and 
associations with paranoia and grandiosity in non-clinical 
and psychosis samples. Psychological Medicine, 36, 749-
59.  

Freeman, D., Garety, P., Kuipers, E., Fowler, D., & 
Bebbington, P. E. (2002). A cognitive model of 
persecutory delusions. British Journal of Clinical 
Psychology, 41, 331-347. doi:10.1348/014466502760 
387461  

Gilboa, A. (2004). Autobiographical and episodic memory—
one and the same? Evidence from prefrontal activation in 
neuroimaging studies. Neuropsychologia, 42, 1336-1349. 
doi:10.1016/j.neuropsychologia.2004.02.014  

Gould, R., Mueser, K., Bolton, E., Mays, V., & Goff, D. 
(2001). Cognitive therapy for psychosis in schizophrenia: 
An effect size analysis. Schizophrenia Research, 48, 335-
342.  

Guller, I. B. (1966). Stability of self-concept in schizophrenia. 
Journal of Abnormal Psychology, 71, 275-279. doi:10. 
1037/h0023594 

Harvey, P. O., Lee, J., Horan, W. P., Ochsner, K., & Green, 
M. F. (2011). Do patients with schizophrenia benefit 
from a self-referential memory bias? Schizophrenia 
Research, 127, 171-177. doi:10.1016/j.schres.2010. 
11.011 

Kihlstrom, J. F., Cantor, N., Albright, J. S., Chew, B. R., 
Klein, S. B., & Niedenthal, P. M. (1988). Information 
processing and the study of the self, Advances in 
Experimental Social Psychology, 21, 145-178. 
doi:10.1016/S0065-2601(08)60226-9  

Kircher, T., & David, A. (2003). Self-consciousness: An 
integrative approach from philosophy, psychopathology 

and the neurosciences. In T. Kircher & A. David (Eds.), 
The self in neuroscience and psychiatry (pp. 445-473). 
New York, NY: Cambridge University Press.  

Klein, S. B., & Loftus, J. (1988). The nature of self-referent 
encoding: The contributions of elaborative and 
organizational processes. Journal of Personality & Social 
Psychology, 55, 5-11. doi:10.1037/0022-3514.55.1.5  

Krabbendam, L., Myin-Germeys, I., Hanssen, M., De Graaf, 
R., Vollebergh, W., Bak, M., & Van Os, J. (2005). 
Development of depressed mood predicts onset of 
psychotic disorder in individuals who report 
hallucinatory experiences. British Journal of Clinical 
Psychology, 44, 113-125. doi:10.1348/014466504X 
19767  

Lawrence, V. A., Doughty, A., Al-Mousawi, A., Clegg, F., & 
Done, D. J. (2007). Do overinclusion and distorted 
semantic boundaries in schizophrenia arise from 
executive dysfunction? Schizophrenia Research, 94, 172-
179. doi:10.1016/j.schres.2007.04.012 

Mishara, A. L. (2007). Is minimal self preserved in 
schizophrenia? A subcomponent view. Consciousness 
and Cognition: An International Journal, 16, 715-721. 
doi:10.1016/j.concog.2007.07.009 

Morrison, A. P., French, P., Walford, L., Lewis, S. W., 
Kilcommons, A., Green, J., . . . & Bentall, R. P. (2004). 
Cognitive therapy for the prevention of psychosis in 
people at ultra-high risk. The British Journal of 
Psychiatry, 185, 291-297. doi:10.1192/bjp.185.4.291  

Neuchterlain, K. H., & Dawson, M. E. (1984). Information 
processing and attentional functioning in the 
developmental course of schizophrenic disorders. 
Schizophrenia Bulletin, 10, 160-203. Retrieved from 
http://schizophreniabulletin.oxfordjournals.org 

Rogers, T. B., Kuiper, N. A., & Kirker, W. S. (1977). Self 
reference and the encoding of personal information. 
Journal of Personality & Social Psychology, 35, 677-
688. doi:10.1037/0022-3514.35.9.677 

Rossell, S. L., Rabe-Hesketh, S., Shapleske, J., & David, A. 
S. (1999). Is semantic fluency differentially impaired in 
schizophrenia with delusions? Journal of Clinical and 
Experimental Neuropsychology, 21, 629-642. 

Rossell, S. L., Shapleske, J., & David, A. S. (2000). Direct 
and indirect semantic priming with neural and emotional 
stimuli in schizophrenia: Relationship with delusions. 
Cognitive Neuropsychiatry, 5, 271-292. 

Rossell, S. L., & David, A. S. (2006). Are semantic deficits in 
schizophrenia due to problems with access or storage? 
Schizophrenia Research, 82, 121-134. doi:10.1016/ 
j.schres.2005.11.001  

Rossell, S. L., & Batty, R. A. (2008). Elucidating semantic 
disorganisation from a word comprehension task: Do 
patients with schizophrenia and bipolar disorder show 
differential processing of nouns, verbs and adjectives? 
Schizophrenia Research, 102, 63-68. doi:10.1016/ 
j.schres.2008.04.008  



RAHMAN 
 

12 
 

Scharfetter, C. (1981). Ego-psychopathology: The concept 
and its empirical evaluation. Psychological Medicine, 11, 
273-280.  

Symons, C. S., & Johnson, B. T. (1997). The self-reference 
effect in memory: A meta-analysis. Psychological 
Bulletin, 121, 371-394. doi:10.1037/0033-2909.121. 
3.371  

Weckowisz, T. E., & Sommer, R. (1960). Body image and 
self-concept in schizophrenia. Journal of Mental Science, 

106, 17-39. doi:10.1192/bjp.106.442.17  
Wheeler, M. A., Stuss, D. T., & Tulving, E. (1997). Toward a 

theory of episodic memory: The frontal lobes and 
autonoetic consciousness. Psychological Bulletin, 121, 
331-354.  

Zubin, J., & Springer, B. (1977). Vulnerability: A new view 
of schizophrenia. Journal of Abnormal Psychology, 86, 
103-126. doi:10.1037/0021-843X.86.2.103 

 
 


