Psychological Bulletin Copyright 1991 by the American Psychological Association, Inc.

1991, \bl.HO.No. 3,538-543 0033-2909/91/53.00

On the Relationship Between Self-Focused Attention and

Psychological Disorder: A Critical Reappraisal

Tom Pyszczynski JeffGreenberg

University of Colorado University of Arizona
at Colorado Springs

James Hamilton Glen Nix

Hamilton College University of Colorado
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

at Colorado Springs
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A recent review of the literature on the role of self-focused attention in psychological dysfunction
(Ingram, 1990) is critically examined. This article (a) reexamines the evidence relevant to Ingranvs
proposal that self-awareness is a nonspecific factor involved in virtually all forms of psychopathol-
ogy and argues that this conclusion is not warranted by the existing evidence; (b) takes issue with his
premise that the fact that self-awareness is associated with a variety of psychological dysfunctions
poses a conceptual dilemma; (c) corrects several important inaccuracies and mischaracterizations
in his presentation of Carver and Sender's (1981) cybernetic control theory and Pyszczynski and
Greenberg's (1987) self-regulatory perseveration theory; and (d) critiques the "self-absorption"
model that he proposed as an alternative to extant theories and concludes that this conceptualiza-
tion does not add to the understanding of either self-awareness processes or psychopathology.

Over the last decade, there has been growing interest in the
role that self-focused attention and related self-regulatory pro-
cesses play in dysfunctional behavior. Ingram (1990) recently
reviewed this literature, noted several problems with it, and
presented a model that purports to help solve these problems.
Ingram's review serves the important function of drawing atten-
tion to several important clinical phenomena that appear to be
associated with self-attentional processes. There are, however,
significant interrelated problems with his review of the litera-
ture and the alternative self-absorption model that he pro-
posed. In this article, we provide an alternative perspective on
the existing literature on self-awareness and psychological dys-
function as well as a critique of Ingram's self-absorption model.
Ingram (1990) identified several premises from which he ar-
gued the need for a new and more genera] model of self-aware-
ness and psychopathology. He argued that (a) existing evidence
suggests an association between self-focused attention and psy-
chological disorder independent of the specific nature of the
disorder (based on this conclusion he proposed that heightened
self-focus is a contributing factor in all psychopathology); (b)
the presence of self-awareness as a contributing factor in a vari-
ety of different types of disorders poses a conceptual dilemma;
(c) extant theories fail to adequately integrate self-awareness and
psychopathology in a meaningful way. In an attempt to resolve
these alleged problems, Ingram described a conceptual variant
of self-awareness "that is proposed to invariably accompany
disordered functioning" (1990, p. 169), and he proposed a
model that attempts to account for the important distinctions
between various types of psychopathology.
Examining the Premises Underlying the Self-
Absorption Model
In this section, we question the validity of the major premises
on which the self-absorption model is based. Specifically, we
contend that (a) the data do not support the claim that height-
ened self-awareness is associated with all psychopathology; (b)
no conceptual dilemma would exist even if high self-awareness
were indeed present in all psychopathology; (c) Ingram's (1990)
critiques of Carver and Scheier's (1981) and Pyszczynski and
Greenbergls (1987) theories of the role of self-awareness in psy-
chopathology are based on a serious misunderstanding of these
formulations and a highly selective review of the existing evi-
dence.
Is Self-Awareness Ubiquitous in Psychological Disorder?
Ingram's (1990) thesis is based on the notion that self-aware-
ness has been linked to a wide variety of recognized psychologi-
cal disorders. He stated that
the weight of available data clearly suggests an association be-
tween disorder (or vulnerability to disorder) and self-focused at-
tention regardless of the particular disorder. Indeed, it appears dif-
ficult to find a psychological disorder that is not characterized by
a heightened degree of self-focused attention, (p. 165)

Correspondence concerning this article should be addressed to Tom Although we agree that self-awareness is associated with some
Pyszczynski, Department of Psychology, University of Colorado, Colo- disorders, we believe that Ingram greatly overstated the case.
rado Springs, Colorado 80933-7150. Ingram (1990) implicated high levels of self-awareness in

538
 SELF-FOCUS AND PSYCHOLOGICAL DISORDER
roughly five disorders. Of these five disorders, the case is strong
for depression and alcohol abuse and, by his own admission,
mixed for some of the anxiety disorders. On the other hand,
little evidence exists of an association between self-awareness
and schizophrenia or psychopathy For both of these disorders,
the only direct evidence cited providing a link to self-awareness
is a single study by Exner (1973). This same study found that
depressed patients were significantly less self-aware than non-
psychiatric control subjects, a finding that is highly inconsistent
with the vast majority of the current literature on this issue (e.g,
Ingram, Lumry, Cruet, & Sieber, 1987; Ingram & Smith, 1984;
Smith & Greenberg, 1981). Responding to this latter finding,
Ingram (1990) warned that "this study must be regarded
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cautiously . . . as raters were not blind to subject status and
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interrater reliability data were not reported" (p. 157). Presum-
ably, the same reservations should apply equally to Exner's
(1973) findings for the schizophrenic and psychopathic groups.
Further cause to question the link between self-awareness and
schizophrenia can be found in Knapp and Deluty's (1987) re-
port of no difference between schizophrenic patients and non-
psychiatric controls on private self-consciousness. We could
find no studies other than Exner's that address the issue of
self-awareness in psychopathy.
Even by a generous count, the five disorders that Ingram
(1990) claimed to be characterized by heightened self-aware-
ness constitute fewer than half of the wide array of disorders
recognized by the Diagnostic and Statistical Manual of Mental
Disorders (3rd ed., revised; American Psychiatric Association,
1987). Absent from Ingram's list are the bipolar disorders, dis-
sociative disorders, gender-identity disorders, complex anxiety
disorders (e.g., panic disorder, agoraphobia, posttraumatic
stress disorder), simple phobias, disorders of impulse control,
somatoform disorders, and all of the personality disorders ex-
cept antisocial personality. Even if there were strong evidence
linking heightened self-focus to all five of the disorders dis-
cussed in Ingram's review, it would not justify the claim that
heightened self-focus plays a role in all psychopathology.
Does the Alleged Ubiquity of Self-Awareness
Pose a Dilemma?
Given his conclusion that self-awareness is associated with
virtually all forms of psychopathology, Ingram (1990) argued
that a conceptual dilemma exists. He stated, "The actual theo-
retical and empirical utility of self-focused attention as a vari-
able in psychopathology is limited by its wealth of associations
to different disorders" (p. 160). Commenting on theories of self-
focus in specific disorders, Ingram stated that "it is not clear
from such theoretical approaches if self-focused attention is
meaningful in any real sense if it is not specific to the disorder"
(1990, p. 156). We strongly disagree with these conclusions.
None of the theories that Ingram (1990) cited suggest that
dysfunctional behavior is simply a matter of too much self-fo-
cus. Rather, for each theory, self-focus is part of a broader con-
ceptual framework that includes other dispositional and situa-
tional variables and statements about the relationships among
these variables and particular patterns of dysfunctional behav-
ior. Ingram failed to recognize that self-awareness is no differ-
ent from a host of other psychological constructs that have
proved useful in explaining clinical phenomena. Self-focus, in
539
and of itself, does indeed provide little useful information about
any particular disorder. The same can be said, however, of
causal attributions, reinforcers, social skills deficits, irrational
beliefs, or any other psychological variable. Each of these con-
structs has been usefully applied to a variety of disorders with-
out impeding progress in understanding those disorders.
For the theories of Hull, Carver and Scheier, and Pyszczynski
and Greenberg (all reviewed by Ingram), the role of self-aware-
ness, in particular dysfunctions, can be understood only by
considering how it is likely to interact with other factors. The
explanatory power of each theory depends on the conceptual
analysis that specifies how self-awareness interacts with other
variables to produce a given disorder. Ingram's (1990) argument
that self-focus lacks explanatory utility because it is associated
with various forms of dysfunction would be valid only if exist-
ing theories posited that excess self-focus is the sole and suffi-
cient cause of particular disorders; none of the theories re-
viewed by Ingram do that.
Self-focus may be associated with several different disorders
because, as suggested by several contemporary theories, self-fo-
cus plays a central role in self-regulation, and many disorders
result from the inappropriate application of normally adaptive
self-regulatory strategies (cf. Carver & Scheier, 1981; Pyszc-
zynski, Hamilton, Greenberg, & Becker, 1991). As we argued
elsewhere (Pyszczynski et al, 1991), the three disorders that
have been clearly linked to self-attentional processes frequently
co-occur in the same person; depressed individuals are prone to
experience both anxiety and abuse alcohol. To understand any
particular pattern of dysfunction, one needs to understand how
specific historical and contemporary factors combine to pro-
duce such maladaptive self-regulatory responses.
Inaccuracies in Ingram's Discussion of Existing Theories
In the course of presenting his own model, Ingram (1990)
compared his framework with several existing theories. Unfor-
tunately, his characterizations of the Carver and Scheier (1981)
and Pyszczynski and Greenberg (1987) theories are inaccurate
and misleading. More important, the overall sense of the role
that self-focus plays in these conceptualizations is obscured by
his presentation.
Cybernetic control theory. In describing Carver and Scheier's
(1981) control theory approach to dysfunction, Ingram (1990)
stated that, "in the case of dysfunction, Carver and Scheier
proposed a sequential process where self-focused attention nec-
essarily and invariably leads to a focus on outcome expectan-
cies." He then contrasted this characterization with his own
model: "Whereas Carver and Scheier suggested that self-focus
inevitably leads to expectancy assessment, the current model
views expectancies as just one of a number of content dimen-
sions that can become salient when an individual is self-fo-
cused" (1990, p. 170). There are at least two problems with this
discussion of Carver and Scheier's model.
The first problem is that Carver and Scheier (1981) never
claimed that expectancy assessment is an inevitable conse-
quence of self-focused attention. Rather, their model posits that
a comparison with standards occurs if a behavioral standard is
salient and that an assessment of the likelihood of successful
discrepancy reduction occurs if there is a disruption in ongoing
behavior aimed at reducing a perceived discrepancy (Carver &
 540 PYSZCZYNSKI, GREENBERG, HAMILTON, AND NIX
Scheier, 1981, pp. 184-201). In contrast to Ingram's (1990) char-
acterization, their model can readily account for cases in which
self-focus leads to neither expectancy assessment nor compari-
sons with standards. The flowcharts presented in Carver (1979,
pp. 1256-1257), Carver and Scheier (1981, p. 194), and Scheier
and Carver (1988, p. 324) clearly depict their conceptualization
of the roles played by self-standard comparisons and expec-
tancy assessments in self-regulation. From the presentation in
Ingram's review, it appears that expectancy assessment is the
only variable in Carver and Scheier's model. This is simply not
the case. Carver and Scheier did, quite reasonably, posit that
negative outcome expectancies play an important role in anxi-
ety; however, their analysis of the role of expectancies is consid-
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erably more complex than Ingram's characterization would
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lead one to believe.
The second problem is that, although Ingram (1990) ched
three sets of studies that appear to be only partially supportive
of Carver and Scheier's (1981) application of their model to
dysfunction,1 a great deal of evidence concerning their model is
simply ignored. In fact, Carver and Scheier amassed much evi-
dence supporting various components of their model, includ-
ing the notion that the influence of outcome expectancies on
affect and behavior is greatly amplified by heightened self-
awareness (e.g., Carver, Blaney & Scheier, 1979a, 1979b). Ingram
did not address or even acknowledge the existence of this body
of evidence.
Self-regulatory perseveration theory. Ingram (1990) similarly
provided an inaccurate and misleading depiction of our own
self-regulatory perseveration theory of depression (Pyszczynski
& Greenberg, 1987). Ingram stated that, "in short, Pyszczynski
and Greenberg suggested that self-focusing is the central and
integrative process in virtually every category of depressive
symptoms and features." He contrasted our analysis with his
model, which "does not view attentional focus as the central
process in virtually all depressive symptomatology that is sug-
gested by the perseveration model" (1990, p. 171). We find a
number of problems with this presentation.
First, although we do indeed posit that self-focus plays an
important role in depression, self-focus per se is not the only
nor even the most central process posited by our theory. The
core assumption of our theory is that depressive episodes are
instigated when, "after the loss of a central source of self-worth,
the individual is unable to exit a self-regulatory cycle focused on
regaining what was lost" (Pyszczynski & Greenberg, 1987, p.
128). Self-focus is part of this self-regulatory cycle and is posited
to contribute to depressive symptoms in individuals who are
unable to withdraw from focus on an irreducible discrepancy
We do not claim that self-focused attention, in and of itself,
causes depression. Rather, we view self-focus as part of a nor-
mal self-regulatory process that, under certain conditions, can
lead to depression.2
In fact, on the basis of a large body of evidence concerning
the effects of self-awareness, we argued that heightened self-fo-
cus is not necessarily maladaptive, even among those who re-
cently experienced a loss or failure; it is maladaptive only to the
extent that one has experienced an irreversible loss and that one
lacks alternative means of meeting the function formerly pro-
vided by the lost object. In support of this point, several studies
(among those not discussed in Ingram's review) showed that
although reductions in self-focus reduce depressive symptoms
in depressed subjects, increases in self-focus do not increase
depressive symptoms in nondepressed subjects (e.g., Pyszc-
zynski, Hamilton, Herring, & Greenberg, 1989; Pyszczynski,
Holt, & Greenberg, 1987).
Second, we proposed that self-regulatory perseveration leads
to the development of a depressive self-focusing style in which
self-focus is relatively high in response to negative outcomes but
relatively low in response to positive outcomes. Thus, we did
not posit that depressed individuals are simply high in self-focus
at all times. Three studies found support for the existence of a
depressive self-focusing style. Most relevant to this discussion,
two separate experiments (Greenberg & Pyszczynski, 1986;
Pyszczynski & Greenberg, 1986) found that, after success, de-
pressed individuals were actually less self-focused than their
nondepressed counterparts.
To summarize, rather than simply suggesting that self-focus
causes depression, we presented a complex theory that posits
that self-regulatory perseveration on a lost source of self-worth
instigates depressive episodes and that the consequent develop-
ment of a unique style of attention allocation then contributes
to the maintenance of the depressed state. All of the major
propositions of our theory follow from well-established empiri-
cal findings concerning the effects of self-awareness and the
symptoms of depression. Although Ingram expressed skepti-
cism concerning our theory, the conceptual basis for his con-
cerns was never specified, and he offered no arguments to re-
fute any of the particular theoretical propositions that we po-
sited.
As with cybernetic control theory, Ingram (1990) did cite
some empirical grounds for questioning the validity of our
theory. Specifically, he noted that three studies failed to show
relationships between self-focus and depressive symptoms such
as negative attributions3 and self-esteem (Gibbons et al., 1985;
' Ingram cited research by Strack, Blaney, Ganellen, and Coyne
(1985) and Burgio, Merluzzi, and Pryor (1986) as casting doubt on
Carver and Scheier's (1981) model. In fact, the only study reported by
Strack et al. that manipulated self-focus found a significant interaction
between attentional focus and expectancies that was highly supportive
of the Carver and Scheier model. Burgio et al. also found an interaction
on their primary dependent measure of social skill performance that
was supportive of the Carver and Scheier model.
2
Ingram (1990) erroneously stated that "Pyszczynski and Greenberg
(1987) further speculated that the depressive self-focusing style can
account for "negative automatic thoughts, anxiety, sleeplessness, poor
concentration, anger, aches and pains, fatigue, and psychomotor retar-
dation" (p. 170). In fact, we cautiously speculated that self-regulatory
perseveration might play a role in the production of these symptoms.
3
As yet unpublished data suggest that depressive self-focusing ten-
dencies may indeed mediate depressed individuals' patterns of attribu-
tions (Greenberg et al, 1988). In this study, subjects received success or
failure feedback on an ego-relevant test, were induced to focus either
internally or externally, and were asked to make attributions for their
performance. The data revealed that when either depressed or nonde-
pressed subjects were induced to focus in the manner typically found
among nondepressed subjects (self-fbcus-success, external focus-fail-
ure), they exhibited a self-serving bias much as nondepressed persons
typically do. Likewise, when nondepressed persons were induced to
focus in a manner typically found among depressed subjects (external
focus-success, internal focus-failure), they failed to exhibit a self-serv-
ing bias just as depressed persons typically fail to do.
 SELF-FOCUS AND PSYCHOLOGICAL DISORDER
Smith, Ingram, & Roth, 1985) and that there is little research on
many of the hypothesized relationships. First, it must be
pointed out that we proposed that the pattern of attentional
focus that depressed persons typically exhibit produces their
depressive symptoms. An appropriate test of our hypothesis is,
therefore, to examine the effect of changes in this pattern on the
manifestation of the symptoms in question. This requires a
condition in which depressed individuals are encouraged to
focus their attention externally.
In the Gibbons et al. (1985, Experiment 2) study, depressed
subjects were simply exposed or not exposed to a mirror while
completing the measures; thus, rather than investigating the
effect of reducing self-focus among chronically self-focused de-
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pressed persons, this research examined the effect of further
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increases in self-focus. The Smith et al. (1985) study was purely
correlational. Thus, none of the studies cited by Ingram (1990)
even attempted to create the external focusing conditions neces-
sary to test our hypotheses concerning attentional processes
and depressive symptoms. In addition, it should be noted that
Gibbons et al. combined depressed subjects with other psychiat-
ric subjects in his primary analyses; in subsidiary analyses of
depressed subjects, cell numbers were very low (7 and 8 per
cell). There are, of course, always a variety of plausible explana-
tions for null results, and the studies cited by Ingram are clearly
no exceptions.
We do agree with Ingram (1990) that additional research on
the role of self-focus in the production of depressive symptoms
is needed. However, the existing evidence is not nearly as scarce
as he implied. In addition to the studies that he reviewed,
Pyszczynski et al. (1987) showed that depressive pessimism is
greatly reduced when depressed subjects are encouraged to
focus externally. Pyszczynski et al. (1989) showed in two studies
that depressive memory biases are reduced or eliminated when
depressed subjects are encouraged to focus externally, and Fen-
nell, Teasdale, and colleagues (Fennell & Teasdale, 1984; Fen-
nell, Teasdale, Jones, & Damle, 1987; Teasdale & Rezin, 1978)
showed that distractions (presumably from self-referent
thought) reduce the depressive content of thought and affect.
More recently, Morrow and Nolen-Hoeksema (1990) showed
that, after a depressive mood induction, externally focusing
tasks are more effective in remediating the depressed mood
than are self-focusing tasks, and Nix, Pyszczynski, and Green-
berg (1990) showed that inducing external focus in depressed
subjects reduces their depressive affect. Although additional re-
search on the role of self-focus in other depression-related phe-
nomena is clearly needed, the available evidence seems, at least
to us, to be quite encouraging, especially given the relatively
short time since the inception of our theory.
In summary, the extant theories that have addressed the role
of self-awareness in psychopathology have proposed that
various specific situational and dispositional variables combine
with heightened self-awareness to produce particular symp-
toms of psychopathology None suggest that heightened self-
awareness alone produces these symptoms. Furthermore, these
situational and dispositional variables are used explicitly to ex-
plain how particular symptoms result from heightened self-
awareness. Perhaps this is the major difference between the
previous theories and the one that Ingram (1990) proposed in
response to this earlier work. In addition, in contrast to pre-
vious theories, the self-absorption model does not posit specific
541
relationships between self-focus and other causally relevant psy-
chological variables, does seem to propose that some form of
heightened self-focus, in and of itself, plays a role in all psycho-
pathology, and does not generate testable hypotheses about spe-
cific symptoms of particular disorders.
Critique of the Self-Absorption Model
Ingram (1990) argued that "modifications building on the
basic construct of self-focused attention are necessary to pro-
pose a meaningful contribution of this process to psychopathol-
ogy" (P-166)- He outlined a series of assumptions about atten-
tional capacity, directional process, and content of self-focus
and then applied these assumptions to a descriptive classifica-
tion scheme. More specifically, he suggested that it is important
to distinguish between the proportion of attention that is fo-
cused on the self, the amount of time attention is focused on the
self, and the flexibility of the individual's attentional allocation.
In this section, we examine the utility of this framework.
First, Ingram (1990) argued that existing conceptualizations
are problematic because they are based on a fixed-capacity
model that views attention as capable of focusing on only one
object at a time. He proposed an alternative, flexible-capacity
model in which attention can be divided among several objects
and implied that this distinction has important theoretical and
empirical implications.
Interestingly, Duval and Wicklund (1972), Wicklund (1975),
and Carver and Scheier (1981) all discussed the relative merits
of these two approaches and concluded that, for the purposes of
understanding self-awareness and self-regulation, the distinc-
tion is inconsequential. Both Duval and Wicklund (1972) and
Carver and Scheier (1981) presented their theories using the
language of a structuralist model of attention allocation out of
expository convenience. Both acknowledged that over a period
of time as short as even 1 s, one could say either that half of the
individual's attention was focused on the self or that the individ-
ual was self-focused for half of that second. We agree with these
prior theorists that whether one thinks in terms of the percent-
age of attention focused on the self or the proportion of time
attention is focused on the self, the implications for the individ-
ual's behavior are the same. What is meant by heightened self-
awareness and related terms is simply a period of time during
which either longer and more frequent shifts toward self-fo-
cused attention occur or during which a greater proportion of
the individual's processing capacity is devoted to self-relevant
information. Although Ingram (1990) himself admitted that
rapid shifts between self and external focus may "blur the dis-
tinction" between parallel and serial processing models, he in-
sisted that this distinction "has important empirical and theo-
retical implications" (1990, p. 167). Unfortunately, he neverspec-
ified what the implications of this distinction are for
self-attention-related behavior.
In principle, Ingram's (1990) distinctions among the degree,
duration, and flexibility of self-focused attention are all plausi-
ble. Indeed, many other such distinctions could be offered. The
utility of such distinctions depends, however, on how they are
related to the phenomena that the model purports to explain.
For example, if a distinction between extent and duration of
focus is to be useful, the model would need to specify how these
variables are differentially related to self-regulatory and clinical
phenomena. Unfortunately, Ingram provided no such specinca-
 542 PYSZCZYNSKI, GREENBERG, HAMILTON, AND NIX
tion. Indeed, no mention is made of how these variables are
related to any of the other variables involved in self-regulatory
processes.
In attempting to develop a model of self-awareness in psycho-
pathology, Ingram (1990) arrived at a subtype of self-awareness,
called self-absorption, that he denned as consisting of "shifts to
internal, sustained, and inflexible attention" (p. 169). He ar-
gued that it is not heightened self-focus in general but rather
self-absorption that characterizes all forms of psychopathology.
We fail to see how this reformulation is distinguishable from
existing conceptualizations except for Ingram's claim that self-
absorption occurs in all psychopathology. According to In-
gram, the key factor that differentiates pathological self-absorp-
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tion from "normal" self-focused attention is the former's in-
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transigence. This, of course, is very similar to our description of
the state of self-regulatory perseveration (Pyszczynski &
Greenberg, 1987) except that we posited a variety of specific
antecedents to and consequences of this state.
In addition, it would be difficult (if not impossible) to distin-
guish someone who is self-absorbed from one who is simply
chronically self-focused or high in private self-consciousness.
Such people are presumed to think about themselves, their feel-
ings, attributes, goals, and standards more often than other
people. According to Ingram (1990), a self-absorbed person fo-
cuses a large proportion of attention on the self, has such inter-
nal attention sustained for protracted periods of time, and rig-
idly focuses internally across a variety of situations. Any dis-
tinctions one might attempt to make between these constructs
would be both conceptually problematic and methodologically
troublesome.
Ultimately, then, self-absorption is an unnecessary new
name for an established phenomenon that fails to add to our
understanding of self-awareness or its relationship to psychopa-
thology. It is also a misleading term in that it implies a phenome-
non qualitatively different from self-focus, whereas theory and
research strongly suggest that depressives, people prone to us-
ing alcohol to avoid self-focus, and anxious people in evaluative
situations are not in a qualitatively different state but are simply
especially high in dispositions! or state self-awareness in situa-
tions where such self-focus is maladaptive.
Recall that Ingram's (1990) major complaint with existing
conceptualizations was the wide range of psychopathological
states that seem to be associated with self-awareness. Ironically,
his self-absorption model posits that all such disturbances are
characterized by the same pattern of attentional allocation (if.,
self-absorption). In an attempt to account for some of the vari-
ability across disorders, he suggested that "the key to cogni-
tively differentiating these states lies in the particular schema,
or cognitive-affective network that is accessed" (p. 160). Thus,
depression results when a person with a depressive schema be-
comes self-absorbed, schizophrenia results when a person with
a schizophrenic schema becomes self-absorbed, and so on. This
seems, to us, to be begging the question in that it provides no
clues as to what determines the content of these schemata. At-
tempting to explain the variability across disorders with an un-
explained construct of this type amounts to little more than
attempting to explain a disorder by giving it a label and adds
nothing to our understanding of particular disorders. For a dis-
cussion of the various epistomological problems with this Aris-
totelian mode of theorizing, see Lewin (1935) or Wicklund
(1990).
Finally, and perhaps most important, although we agree with
Ingram (1990) that the available data indicate that self-aware-
ness processes play a role in depression, anxiety, and alcohol
abuse, the evidence concerning these disorders is inconsistent
with his conceptualization of self-absorption. Ingram's model
suggests that people suffering from each of these disorders are
excessively, chronically, and rigidly self-focused. However, there
is ample evidence that in each of these disorders, heightened
self-awareness occurs only under specified conditions and there-
fore is neither rigid nor intransigent.
Pyszczynski and Greenberg (1985,1986,1987; Greenberg &
Pyszczynski, 1986) presented substantial empirical support for
the proposition that although relatively high in private self-
consciousness and highly self-focused after negative outcomes,
depressives are low in self-focus after positive outcomes; thus,
they do not appear to be simply rigidly self-focused. The anxi-
ety literature is equally inconsistent with Ingram's (1990) con-
cept of self-absorption. Although the evidence concerning pri-
vate self-consciousness and various anxiety problems is mixed,
with some studies finding a relationship and others not (e.g.,
Smith et al., 1985, reported that self-focused attention was
correlated with depression but not test anxiety), the evidence is
clear that people with anxiety problems become especially high
in self-focus in the situations that make them anxious (e.g, Def-
fenbacher, 1978). In other words, they too are not simply rigidly
self-focused across all situations. It may also be worth noting
that a substantial subset of the alcoholics studied by Hull,
%ung, and Jouriles (1986) were actually relatively low in pri-
vate self-consciousness.
Thus, the data for depression and anxiety contradict the self-
absorption model. The available data on alcohol abuse do not
speak to the question of whether alcoholics are excessively,
chronically, and rigidly self-focused. It is clear, however, that
vulnerability to relapse is a joint function of high private self-
consciousness and negative life events. As noted earlier, there is
little or no empirical support for a relationship between self-
awareness of any kind and other disorders. Ingram's (1990) con-
clusion that "it is possible to describe a conceptual variant of
this normal process, self-absorption, that is proposed to invari-
ably accompany psychopathological functioning" (p. 173) ap-
pears to be incorrect and is certainly unwarranted by the
current evidence.
Summary
In summary, although Ingram's (1990) review highlights the
increasingly important role that self-focused attention is play-
ing in theories of dysfunctional behavior, we have serious
qualms about many of his conclusions. Rather than posing an
interpretational dilemma, we argue that the possibility that
self-focus is associated with a variety of disorders is consistent
with Carver and Scheier's (1981) contention that self-focus plays
a central role in behavioral self-regulation. Like any other vari-
able that plays a central role in a very basic process, self-focus is
indeed likely to be implicated in a diverse array of pathologies.
It is not the variable per se but rather the theoretical framework
within which it is embedded that ought to be useful in discrimi-
nating among various types of dysfunction.
We also have serious qualms about the utility of the model of
self-absorption that Ingram (1990) proposed. Although many
distinctions among self-attentional variables could be pro-
posed, only those clearly linked to the variables and processes
 SELF-FOCUS AND PSYCHOLOGICAL DISORDER
central to the domain of the theory provide useful refinements.
The self-absorption model does not even attempt to explicate
such linkages, nor is it consistent with the available evidence
concerning serf-awareness and disorder.
We do not wish to imply that improvements in our under-
standing of the role of self-focused attention in psychological
dysfunction are not needed. Indeed, many important theoreti-
cal and empirical questions about these processes remain unan-
swered. However, we strongly disagree with the contention that
in order for a theory of a particular form of dysfunction to be
useful it must account for all forms of psychopathology What is
needed to enhance our understanding of the role of self-aware-
ness and self-regulatory processes in psychopathology is not a
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
single theory that encompasses all forms of disturbance but
This document is copyrighted by the American Psychological Association or one of its allied publishers.
rather careful study of the role played by such processes in
particular disorders that take into account the diversity of dis-
positional and situational factors that are likely to lead to such
problems.
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Received August 10,1990
Accepted January 7,1991 •