Neurocognitive Model of Schema-Congruent and -Incongruent Learning in Clinical Disorders: Application to Social Anxiety and Beyond

Abstract

Negative schemas lie at the core of many common and debilitating mental disorders. Thus, intervention scientists and clinicians have long recognized the importance of designing effective interventions that target schema change. Here, we suggest that the optimal development and administration of such interventions can benefit from a framework outlining how schema change occurs in the brain. Guided by basic neuroscientific findings, we provide a memory-based neurocognitive framework for conceptualizing how schemas emerge and change over time and how they can be modified during psychological treatment of clinical disorders. We highlight the critical roles of the hippocampus, ventromedial prefrontal cortex, amygdala, and posterior neocortex in directing schema-congruent and -incongruent learning (SCIL) in the interactive neural network that comprises the autobiographical memory system. We then use this framework, which we call the SCIL model, to derive new insights about the optimal design features of clinical interventions that aim to strengthen or weaken schema-based knowledge through the core processes of episodic mental simulation and prediction error. Finally, we examine clinical applications of the SCIL model to schema-change interventions in psychotherapy and provide cognitive-behavior therapy for social anxiety disorder as an illustrative example.

Beyond the Positivity Bias: The Processing and Integration of Self-relevant Feedback is Driven by its Alignment with Pre-Existing Self-Views

“…Therefore, unravelling congruence and valence effects might help in understanding their neural and behavioral responses to self-relevant information. Finally, the insights extracted from our work could enhance novel approaches based on the modification of maladaptive schemas through schema-incongruent learning in clinical populations (Moscovitch et al, 2023), potentially opening the door to more effective interventions.…”

Predictors of Excessive Reassurance Seeking in Social Anxiety

“…These interventions aim to strengthen positive self-perceptions and weaken negative self-schemas, which are deeply ingrained cognitive structures that shape how individuals perceive and interpret themselves. Specifically, self-updating involves actively incorporating positive information into one's self-concept to update negative self-beliefs (see Moscovitch et al, 2023). Similarly, self-schema updating focuses on modifying the underlying cognitive structures that influence self-perception, emphasizing positive aspects and minimizing the influence of negative self-beliefs.…”

“…Moreover, Gillett and Mazza (2018) emphasized the significance of cognitive schemas and core beliefs in provoking doubts and uncertainty when seeking reassurance. Specifically, individuals whose schemas tend to narrowly attend to threatening and/or negative information may disregard reassurance offered to them due to an inconsistency between their schema and the reassurance provided (see Moscovitch, Moscovitch, & Sheldon, 2023). As a result, persistent reassurance seeking tends to be ineffective at reducing the underlying threat.…”

To update or to create? The influence of novelty and prior knowledge on memory networks

“…Connections between the anterior hippocampus and vmPFC support the interaction between gist elements of the event and the assimilation of common elements from past related experiences into the vmPFC-mediated schema network [20,[25][26][27]. The development of the schematic representation or framework for the event does not replace the episodically detailed representation of each unique event experience within the hippocampus but rather can serve to guide the memory construction and elaboration processes as these representations interact dynamically during encoding and retrieval [28,29]. In this case, an activated schematic framework helps in rapidly understanding and guiding the encoding of new related experiences, while the new related experiences also contribute to the ongoing development and adaptation of the schematic representation for a class of events [28,29].…”