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Hypomanic vulnerability, terror management, and materialism
Personality and Individual Differences 38 (2005) 287–296 www.elsevier.com/locate/paid
Hypomanic vulnerability, terror management, and materialism Sheri L. Johnson a
a,*
, Coral Ballister b, Thomas E. Joiner Jr.
b
Department of Psychology, University of Miami, P.O. Box 248185, Coral Gables, FL 33146-2010, USA b Florida State University, USA Received 23 July 2003; received in revised form 27 February 2004; accepted 10 April 2004 Available online 1 June 2004
Abstract Studies of terror management have suggested that people demonstrate increased acceptance of cultural values when made aware of their own inevitable death. Recently, Kasser and Sheldon (2000) found that materialism, one value within capitalistic cultures, increased more after a mortality salience manipulation than after a control condition. Self-esteem protection is believed to be a central mechanism in terror management effects. A separate theory has suggested that mania is related to fragile self-esteem and defensive reactions to threat. In this study, we draw on terror management as a lens into self-esteem and reactions to threat among students who are vulnerable to hypomanic symptoms. Students ðN ¼ 225Þ completed self-report questionnaires, including the Hypomanic Personality Scale (HPS), and then were randomly assigned to write about death (mortality salience condition) or music (control condition). Then, students completed measures of materialism. As predicted, a significant interaction between hypomania and experimental condition was documented, in that individuals who were vulnerable to hypomania demonstrated greater materialism after the mortality salience manipulation compared to those with low vulnerability. 2004 Elsevier Ltd. All rights reserved. Keywords: Terror management; Hypomania; Bipolar disorder; Mortality salience
1. Introduction It is well-established that heritability is as strong for bipolar disorder as for any other psychiatric disorder (Hinshaw, 2002). Nonetheless, psychological triggers of episodes have become
*
Corresponding author. Tel.: +1-305-284-1592. E-mail address: [email protected] (S.L. Johnson).
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increasingly well-documented within the context of this strong biological diathesis (see Johnson & Meyer, 2004, for a review). One major psychological model, drawn from psychoanalytic theory, suggests that bipolar disorder is associated with subconscious insecurity and low self-esteem (Peven & Shulman, 1983). When threatened, people with bipolar disorder are expected to use defenses to ward off negative self-esteem and consequentially, to demonstrate exaggerated selfconfidence and manic symptoms. That is, defenses against low self-esteem have been seen as a central mechanism in the genesis of manic symptoms. These concepts have received attention within cognitive theory, as some have suggested that defensive self-esteem may be present among euthymic people with bipolar disorder (French, Richards, & Scholfield, 1996; Lyon, Startup, & Bentall, 1999; Winters & Neale, 1985). What is the empirical evidence for this model? Certainly, during periods of mania, high selfesteem and even grandiosity are common (APA, 2000). Research has also documented that labile self-esteem is associated with bipolar disorder (Ashworth, Blackburn, & McPherson, 1985; Johnson & Ruggero, in preparation; Winters & Neale, 1985). The central tenet of this model, however, is that self-esteem relevant defenses will increase following threat. There is some evidence that people with vulnerability to manic symptoms may demonstrate cognitive deficits (Ruggero, 2003) as well as prolonged cortisol dysregulation (Goplerud & Depue, 1985) in response to threat. Despite these findings, however, we are unaware of any studies that have attempted to assess defensiveness after to standardized threat among people who are vulnerable to bipolar disorder. In this paper, we draw from a terror-management paradigm to test reactivity to threat among people who are vulnerable to bipolar disorder. According to terror-management theory, awareness of mortality is believed to generate the potential for overwhelming anxiety (Pyszczynski, Greenberg, & Solomon, 1997). Research has focused on two processes believed to help defend against this potential anxiety: self-esteem preservation and investment in cultural ideals (Pyszczynski, Greenberg, & Solomon, 1999). Two major lines of evidence suggest that terror management effects are closely tied to selfesteem. First, defensive responses to mortality salience have been shown to be particularly strong among people with low self-esteem. That is, low self-esteem has been found to predict reactivity to mortality salience manipulations (Ben-Ari, 2000; Cozzarelli & Karafa, 1998; Harmon-Jones, Simon, Greenberg, & Pyszczynski, 1997). Second, experimental manipulations to boost self-esteem diminish the effects of mortality salience (Arndt & Greenberg, 1999; Ben-Ari, 2000). Hence, reactivity to mortality salience does appear closely tied to self-esteem. The terror management paradigm seems particularly apt for testing the defensive self-esteem model of bipolar disorder, because cognitive and psychodynamic theorists have suggested that self-esteem in bipolar disorder must be assessed using measures that do not rely on conscious selfevaluations (see Bentall & Kinderman, 1999). Indeed, when euthymic, people with bipolar disorder do not display consistent differences from nondisturbed controls on overt measures of self-esteem (Bentall & Kinderman, 1999; Johnson & Ruggero, in preparation). In a review of terror management effects, Pyszczynski and colleagues (1997) have reported, ‘‘The available evidence suggests that people are rarely, if ever, aware of the psychological forces underlying such motivated behavior’’ (p. 4). In this paper, we draw on findings that when people are made more aware of their eventual deaths, their identification with cultural values intensifies (cf. Greenberg, Porteus, Simon, Pysz-
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cynski, & Solomon, 1995; Greenberg et al., 1990). For example, after their own mortality is made salient, people demonstrate harsher evaluations of people who are critical of cultural values, more aggression towards people with dissimilar attitudes, and increased discomfort with behaviors that violate cultural norms (see Pyszczynski et al., 1999 for a review). Because the cultural worldview in capitalistic countries embraces the ideals of wealth and materialistic success, people from the United States might be expected to manifest greater investment in wealth and material security when the prospect of their death is raised. Kasser and Sheldon (2000) examined whether awareness of one’s inevitable death increased materialistic behavior. To manipulate mortality salience, individuals were randomly assigned to write short essays about either their death or music, an experimental procedure initially developed by Rosenblatt, Greenberg, Solomon, Pyszczynski, and Lyon (1989). After the essays, materialism was assessed using a questionnaire about future wealth. The mortality salience condition was associated with higher materialism scores than the music condition was. This paper focuses on the effects of mortality salience on materialism among people who are vulnerable to lifetime hypomanic symptoms. Lifetime vulnerability to hypomania was assessed using a well-validated self-report measure, the Hypomanic Personality Scale (HPS; Eckblad & Chapman, 1986). We randomly assigned individuals to write essays about either their death or music. Then, we gathered a measure of materialism (Kasser & Sheldon, 2000). We hypothesized that individuals in the mortality salience condition (who wrote about their own death) would demonstrate more materialism than those who wrote about music. More importantly, HPS and mortality salience were expected to interact, such that high HPS individuals in the mortality salience condition would demonstrate the highest levels of materialism. Such a finding would support the idea that vulnerability to hypomania is related to defensive reactions to threat. As a check of whether individuals internalized cultural values of materialism, we included a questionnaire concerning extrinsic aspirations (values of success and wealth). Extrinsic aspirations were hypothesized to moderate materialistic reactions to mortality salience. Undoubtedly, there are disadvantages to using analog samples to study clinical processes. The study of self-esteem, however, presents special issues that may interfere with the ability to interpret findings from clinical samples. That is, it is well-established that bipolar disorder is associated with dramatic highs and lows in social and occupational functioning (Hammen & Cohen, 2004). Given this, studies of self-evaluation will need to account for the dramatically different histories of accomplishment and loss associated with recurrent bipolar episodes. For this reason, attempts to develop theoretical models of bipolar disorder need to consider the nature of self-esteem in both clinical and analog samples. To the extent that psychological correlates of bipolar disorder are less present in analog samples, one would expect greater difficulty in documenting defensive reactions to threat in the current study.
2. Methods 2.1. Participants Participants were 236 introductory psychology students who received partial credit in their Introduction to Psychology classes in exchange for participation. Of these, 225 (77 males)
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completed the measures and were included in this report. Participants were recruited from two schools: 123 participants were students at the University of Miami, and 102 were students at Florida State University. One hundred and forty of the students described themselves as Caucasian (non-Hispanic), 45 as Hispanic, 20 as African-American, 15 as Asian-American, and the remainder as other. Just over 50% were 18 years of age, 44% were 19–21, and the remaining participants were above age 21. 2.2. Procedures and materials When participants arrived at the laboratory, an experimenter greeted them, obtained informed consent, and provided instructions. Participants completed demographic questions, the HPS, and the Aspirations index before the experimental manipulation, so that the manipulation would not interfere with responses. Participants were randomly assigned to one of two experimental conditions: the mortality salience condition, in which they were asked to write about the experience of their own death, or the control condition, in which they were asked to write about the experience of listening to music. Although previous studies have asked control participants to write about TV, Kasser and Sheldon (2000) asked control participants to write about music, because TV often delivers consumer messages. The format of the questions was maintained across experimental conditions with the exception of grammatical demands to describe death or music. Participants assigned to the mortality salience condition answered the following questions in short essay form, ‘‘Please briefly describe the emotions that the thought of your own death arouse in you. Please describe, as specifically as you can, what you think will happen to you as you physically die and once you are physically dead.’’ Control participants answered a parallel set of questions about music (‘‘Please describe, as specifically as you can, what happens to you physically as you listen to music. . .’’). Eight individuals who did not write at least 20 words on either the mortality or music essay were excluded from analyses due to concerns about whether they had actually focused on either mortality or music. Previous research has suggested that cultural worldviews are defended more readily if a brief delay is included after the mortality salience manipulation (Greenberg, Arndt, Simon, Pyszczynski, & Solomon, 2000). To provide a brief delay, participants were asked to imagine their future life for several minutes after they completed the essays. Then, participants completed the financial questionnaire (described below). After completing study procedures, participants were debriefed. 2.3. Measures The Hypomanic Personality Scale (HPS; Eckblad & Chapman, 1986). The HPS was originally developed to identify people at risk for bipolar disorder. The self-report format contains 48 true– false questions. Examples include: ‘‘There have often been times when I had such an excess of energy that I felt little need to sleep at night’’ (keyed true), and ‘‘I can’t imagine that anyone would ever write a book about my life’’ (keyed false). In previous research, more than 78% of individuals with HPS scores above 36 were found to meet diagnostic criteria for bipolar spectrum disorders (Eckblad & Chapman, 1986), and predictive validity for bipolar diagnoses over a 10-year follow-
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up was quite high (Kwapil et al., 2000). The scale correlates well with other screening instruments for mania (General Behavior Inventory: r ¼ 0:47, n ¼ 768) (Eckblad & Chapman, 1986). As expected, the HPS demonstrates moderate correlations with scales of positive affect, current hypomania, and lifetime depression, as well as personality traits that have been found to be elevated among people with bipolar I disorder, including sensitivity to reward (Johnson, Ruggero, & Carver, under review) and impulsivity (Meyer & Hautzinger, 2001; Meyer, 2002). Familial aggregation of HPS scores has been demonstrated, consistent with the strong heritability of bipolar disorder (Meyer & Hautzinger, 2001). The HPS is not correlated with overt self-esteem scales (Johnson & Ruggero, in preparation), nor the Crowne–Marlow Scale for Social Desirability, r ¼ 0:05, n ¼ 768 (Eckblad & Chapman, 1986). As one would expect for a measure of lifetime vulnerability, correlations with current depression and mood states are modest, r’s < 0.30 (Johnson et al., in preparation). The measure has high reliability (15-week test–retest reliability ¼ 0.81; alpha ¼ 0.87). In this sample, internal consistency was also high, alpha ¼ 0.83. A cut-off score of 1 standard deviation above the mean (raw score P 29.39) was used to demarcate a high HPS group (n ¼ 35, 14.8%). Of these high scorers, 14 were randomly assigned to the music condition, and 21 were randomly assigned to the death condition. The low HPS group consisted of all persons with scores below this cut-off score ðn ¼ 190Þ. Aspirations index (Kasser & Ryan, 1996). This scale assesses a range of life goals to provide an index of extrinsic orientation relative to intrinsic orientation. This index was used to assess internalized ideals of materialistic success. Participants were provided with a list of 9 different goals and asked to rate the importance of each goal on a scale of 1 (not at all) to 5 (very much). Items concerning financial success (‘I will be financially successful’), social recognition (‘I will be recognized by lots of people’) and appearance (‘I will successfully hide the signs of aging’) were averaged to form a single index of Extrinsic Aspirations, and items reflecting self-acceptance (‘I will choose what I do, instead of being pushed along by life’), community investment (‘I will work for the betterment of society’), and emotional intimacy (‘I will have a committed, intimate relationship’) were averaged to form a single index of Intrinsic Aspirations. Because previous research suggests that extrinsic aspirations are more predictive when out of proportion to intrinsic aspirations (Sheldon & McGregor, 2000), the Intrinsic subscale was subtracted from the Extrinsic subscale. This Aspirations index has been shown to predict materialistic behavior (Kasser & Ryan, 1996). For analyses, individuals with scores of 0 or above were considered high on extrinsic aspirations. Because individuals who emphasized extrinsic values would be expected to demonstrate related behaviors more robustly, we conceptualized extrinsic aspirations as a moderator of the mortality salience effect on materialism. Materialism Questionnaire (Kasser & Sheldon, 2000). Items concerning predicted financial success in 15 years were used to assess materialism, the dependent variable for this study. Items covered expectations for salary (‘‘How much money do you expect to be making 15 years from now?’’), spouse’s salary, home value, value of possessions, automobiles, and investments, and budgets for travel, entertainment, leisure, and clothing. Congruent with Kasser and Sheldon (2000), three individuals with z-scores above 15 on specific items were removed from analyses. Although a factor analysis in the validation sample yielded three subscales, factor analyses within this study did not support these subscales. We computed a scale total that reflected the mean of the standardized scores for each item. Internal consistency for this scale was adequate, alpha ¼ 0.75.
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3. Results Students at the University of Miami and FSU did not differ significantly on vulnerability to hypomania (HPS), t ¼ 1:14, df ¼ 223, p ¼ 0:25, or Extrinsic Aspirations, t ¼ 1:23, df ¼ 222:76, p ¼ 0:220. Students from Miami obtained higher materialism scores than those from FSU, t ¼ 2:448, df ¼ 155:42, p ¼ 0:02. Ethnic groups did not differ on vulnerability to hypomania, Extrinsic Aspirations, nor materialism. After eliminating people who wrote less than 20 words, number of words per mortality essay was unrelated to materialism scores, r ¼ 0:14, p > 0:05. Descriptive statistics for the independent and dependent variables are shown in Table 1. To examine whether hypomanic vulnerability was related to reactions to the experimental manipulation, we conducted an analysis of variance (ANOVA) with materialism as the dependent variable. The independent variables included vulnerability to hypomania (low or high), the experimental condition (death or music essay), and aspirations (extrinsic or intrinsic). A fully saturated model, including the three-way interaction and each two-way interaction was computed. As shown in Table 2, only one effect was significant: the interaction of experimental condition and hypomanic vulnerability. To partition the significant interaction term, we examined the effect of the experimental induction separately for individuals who were high and low on the HPS. For both groups, the experimental manipulation was significant, Flow HPS ¼ 3:93, df ¼ 1, 170, p ¼ 0:05, Fhigh HPS ¼ 5:21, df ¼ 1, 34, p ¼ 0:03. High and low HPS groups demonstrated opposite responses to the experimental condition. That is, individuals with low HPS scores did not respond in the expected direction to mortality salience: they obtained lower materialism scores after writing about death compared to music, Mndeath ¼ 0:09, SD ¼ 0:48, Mnmusic ¼ 0:10, SE ¼ 0:42. Individuals with high Table 1 Means and standard deviations for key variables HPS External Aspirations Materialism
Minimum
Maximum
Mean
SD
2.00 )3.67 )0.28
40.00 1.33 3.02
20.92 )0.91 )0.04
8.44 0.85 0.40
Note. HPS ¼ hypomanic personality scale.
Table 2 Effects of Condition, Hypomanic Vulnerability, and External Aspirations on Materialism Scores Independent variable
F
P
Condition HPS Aspirations Condition · HPS Condition · Aspirations HPS · Aspirations Condition · HPS · Aspirations
0.005 0.255 1.937 4.537 0.036 0.003 2.356
0.944 0.614 0.165 0.034 0.849 0.958 0.126
Note. For each effect, df ¼ 1, 217. HPS ¼ Hypomania Personality Scale.
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vulnerability to hypomania showed the predicted mortality salience effect: they obtained higher materialism scores when they wrote about death compared to music, Mndeath ¼ 0:04, SD ¼ 0:35, Mnmusic ¼ 0:14, SD ¼ 0:15. Parallel ANOVA analyses were computed with location and gender added as independent variables (along with each of the above independent variables). None of the interactions of location or gender with other variables were significant, nor were the main effects.
4. Discussion Hypomanic vulnerability and the mortality salience condition interacted to predict materialism scores. Traditional terror management effects were not observable among individuals with low vulnerability to hypomania. Among individuals with hypomanic vulnerability, those who wrote about their own death showed significantly more materialism than those who wrote about music. Before discussing some implications of our findings, we consider potential limitations inherent in the methodology. Within the low HPS subgroup, the Kasser and Sheldon (2000) findings did not replicate. Individual differences seem important to consider. Even though we attempted to control for extrinsic values, other authors have found that the Extrinsic Aspirations scale did not moderate the effects of mortality salience (Kasser & Sheldon, 2000). Other variables, such as reflectiveness, may help predict who becomes materialistic when faced with thoughts about their death. It is also possible that our outcome measures are poor indices. Materialism is not likely to be a universally endorsed value, even within a relatively capitalistic culture. Other outcomes or measures, such as investment in mate selection, may be more closely tied to terror management (Hirschberger, Florian, & Mikulincer, 2002). Another possible explanation for the null results within the low hypomanic group is that music may not be a neutral stimulus. Given the powerful influence of music on mood (Vaestfjaell, 2002), generating essays about music could have increased positive affect, thereby contributing to an optimistic bias regarding financial prospects (Johnson & Tversky, 1983; MacLeod & Campbell, 1992). In short, our methods are not precisely the ones that have dominated the terror management literature, and more research is needed to assess these particular approaches. Current results also may not generalize to a sample of individuals with clinically diagnosed bipolar disorder. We relied on a scale designed to capture vulnerability and used a cut-off score on this scale that was relatively low. It will be important to examine defensiveness in a clinical population. Despite the limitations of this study, we did find support for our main hypothesis. Persons with a lifetime vulnerability to hypomania demonstrated more materialism when they wrote about death compared to music. As such, the current study provides some support for a long-standing model that manic vulnerability is related to defensive reactions to threat. As described above, low self-esteem has been found to predict more robust effects of mortality salience manipulations. Current results, then, are congruent with the theory that vulnerability to hypomania is related to low self-esteem. Although previous studies have shown that self-esteem is labile within bipolar disorder (Ashworth et al., 1985; Johnson & Ruggero, in preparation; Winters & Neale, 1985), this is the first study that has examined reactions to threat in the context of hypomanic vulnerability. Although congruent with predictions from models of defensive self-esteem, there are many competing explanations for the pattern of results. For example, similar patterns of increased
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reactivity to mortality salience have been shown among individuals with mild depression (Simon, Greenberg, Harmon-Jones, & Solomon, 1996). Between 66% and 75% of individuals with bipolar disorder experience lifetime episodes of depression (Karkowski & Kendler, 1997; Kessler, Rubinow, Holmes, Abelson, & Zhao, 1997). However, given the low correlations of the HPS scale with current depression in other studies (Johnson et al., under review), it is unlikely that depression fully accounts for the effects within this study. Assuming that confounds do not explain the current findings, why would hypomanic vulnerability relate to defensive reactions? In the general population, terror management effects have been hypothesized to defend against negative affect. Manic episodes and hypomanic symptoms have been found to relate to a greater propensity to negative affect (Lovejoy & Steuerwald, 1995; Ruggero, 2003) as well as increased cortisol reactivity (Goplerud & Depue, 1985) in response to threatening stimuli. This greater affective reactivity could hypothetically be related to the genetic vulnerability to disorder (Johnson, under review). Given the affective reactivity, it is not surprising that this population would demonstrate more reactivity to manipulations that could induce negative affect if not defended. This study, though, is the first to document this defensiveness. Some might find the current findings paradoxical however, in that previous studies suggest more affective reactivity associated with vulnerability, whereas the current study suggests greater likelihood of defensiveness in response to threat. One possibility is that defensive strategies are not always used; another possibility is that defensive strategies are not always effective. To understand reactivity and defensiveness in relation to manic vulnerability, researchers will need to conduct studies of multiple stressors, the mechanisms involved in defensive reactions, and the effectiveness of these mechanisms. In sum, current results provide support for defensive reactions to threat among those vulnerable to bipolar disorder. But, there is no evidence yet that defensive reactions actually contribute to the genesis of manic episodes. The materialistic reactions to mortality salience appear to mirror the excessive spending sprees that are a symptom of manic episodes (APA, 2000), but this is only one of a host of symptoms that form the syndrome of mania. Much more detailed research is needed on defensive processes and manic symptoms, and whether these processes can be integrated with biological vulnerability. In conclusion, although a broad range of research has demonstrated that mortality salience leads to increases in cultural identification, less is known about materialism. The current study suggests that materialism is not increased after a mortality salience manipulation for all individuals. Nonetheless, vulnerability to hypomania was related to greater materialism in reaction to mortality salience. Although these findings are consistent with early theory linking mania to defensive reactions to threat, they must be viewed as tentative. There is a need for much more research on individual differences and mechanisms that may explain the links between hypomanic vulnerability and defensiveness. The terror management approach, though, may provide a helpful foothold in that quest.
Acknowledgements Thanks to Adam Kuenfeld for data support and Charles Carver for editorial suggestions.
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Hypomanic vulnerability, terror management, and materialism Sheri L. Johnson a
a,*
, Coral Ballister b, Thomas E. Joiner Jr.
b
Department of Psychology, University of Miami, P.O. Box 248185, Coral Gables, FL 33146-2010, USA b Florida State University, USA Received 23 July 2003; received in revised form 27 February 2004; accepted 10 April 2004 Available online 1 June 2004
Abstract Studies of terror management have suggested that people demonstrate increased acceptance of cultural values when made aware of their own inevitable death. Recently, Kasser and Sheldon (2000) found that materialism, one value within capitalistic cultures, increased more after a mortality salience manipulation than after a control condition. Self-esteem protection is believed to be a central mechanism in terror management effects. A separate theory has suggested that mania is related to fragile self-esteem and defensive reactions to threat. In this study, we draw on terror management as a lens into self-esteem and reactions to threat among students who are vulnerable to hypomanic symptoms. Students ðN ¼ 225Þ completed self-report questionnaires, including the Hypomanic Personality Scale (HPS), and then were randomly assigned to write about death (mortality salience condition) or music (control condition). Then, students completed measures of materialism. As predicted, a significant interaction between hypomania and experimental condition was documented, in that individuals who were vulnerable to hypomania demonstrated greater materialism after the mortality salience manipulation compared to those with low vulnerability. 2004 Elsevier Ltd. All rights reserved. Keywords: Terror management; Hypomania; Bipolar disorder; Mortality salience
1. Introduction It is well-established that heritability is as strong for bipolar disorder as for any other psychiatric disorder (Hinshaw, 2002). Nonetheless, psychological triggers of episodes have become
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increasingly well-documented within the context of this strong biological diathesis (see Johnson & Meyer, 2004, for a review). One major psychological model, drawn from psychoanalytic theory, suggests that bipolar disorder is associated with subconscious insecurity and low self-esteem (Peven & Shulman, 1983). When threatened, people with bipolar disorder are expected to use defenses to ward off negative self-esteem and consequentially, to demonstrate exaggerated selfconfidence and manic symptoms. That is, defenses against low self-esteem have been seen as a central mechanism in the genesis of manic symptoms. These concepts have received attention within cognitive theory, as some have suggested that defensive self-esteem may be present among euthymic people with bipolar disorder (French, Richards, & Scholfield, 1996; Lyon, Startup, & Bentall, 1999; Winters & Neale, 1985). What is the empirical evidence for this model? Certainly, during periods of mania, high selfesteem and even grandiosity are common (APA, 2000). Research has also documented that labile self-esteem is associated with bipolar disorder (Ashworth, Blackburn, & McPherson, 1985; Johnson & Ruggero, in preparation; Winters & Neale, 1985). The central tenet of this model, however, is that self-esteem relevant defenses will increase following threat. There is some evidence that people with vulnerability to manic symptoms may demonstrate cognitive deficits (Ruggero, 2003) as well as prolonged cortisol dysregulation (Goplerud & Depue, 1985) in response to threat. Despite these findings, however, we are unaware of any studies that have attempted to assess defensiveness after to standardized threat among people who are vulnerable to bipolar disorder. In this paper, we draw from a terror-management paradigm to test reactivity to threat among people who are vulnerable to bipolar disorder. According to terror-management theory, awareness of mortality is believed to generate the potential for overwhelming anxiety (Pyszczynski, Greenberg, & Solomon, 1997). Research has focused on two processes believed to help defend against this potential anxiety: self-esteem preservation and investment in cultural ideals (Pyszczynski, Greenberg, & Solomon, 1999). Two major lines of evidence suggest that terror management effects are closely tied to selfesteem. First, defensive responses to mortality salience have been shown to be particularly strong among people with low self-esteem. That is, low self-esteem has been found to predict reactivity to mortality salience manipulations (Ben-Ari, 2000; Cozzarelli & Karafa, 1998; Harmon-Jones, Simon, Greenberg, & Pyszczynski, 1997). Second, experimental manipulations to boost self-esteem diminish the effects of mortality salience (Arndt & Greenberg, 1999; Ben-Ari, 2000). Hence, reactivity to mortality salience does appear closely tied to self-esteem. The terror management paradigm seems particularly apt for testing the defensive self-esteem model of bipolar disorder, because cognitive and psychodynamic theorists have suggested that self-esteem in bipolar disorder must be assessed using measures that do not rely on conscious selfevaluations (see Bentall & Kinderman, 1999). Indeed, when euthymic, people with bipolar disorder do not display consistent differences from nondisturbed controls on overt measures of self-esteem (Bentall & Kinderman, 1999; Johnson & Ruggero, in preparation). In a review of terror management effects, Pyszczynski and colleagues (1997) have reported, ‘‘The available evidence suggests that people are rarely, if ever, aware of the psychological forces underlying such motivated behavior’’ (p. 4). In this paper, we draw on findings that when people are made more aware of their eventual deaths, their identification with cultural values intensifies (cf. Greenberg, Porteus, Simon, Pysz-
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cynski, & Solomon, 1995; Greenberg et al., 1990). For example, after their own mortality is made salient, people demonstrate harsher evaluations of people who are critical of cultural values, more aggression towards people with dissimilar attitudes, and increased discomfort with behaviors that violate cultural norms (see Pyszczynski et al., 1999 for a review). Because the cultural worldview in capitalistic countries embraces the ideals of wealth and materialistic success, people from the United States might be expected to manifest greater investment in wealth and material security when the prospect of their death is raised. Kasser and Sheldon (2000) examined whether awareness of one’s inevitable death increased materialistic behavior. To manipulate mortality salience, individuals were randomly assigned to write short essays about either their death or music, an experimental procedure initially developed by Rosenblatt, Greenberg, Solomon, Pyszczynski, and Lyon (1989). After the essays, materialism was assessed using a questionnaire about future wealth. The mortality salience condition was associated with higher materialism scores than the music condition was. This paper focuses on the effects of mortality salience on materialism among people who are vulnerable to lifetime hypomanic symptoms. Lifetime vulnerability to hypomania was assessed using a well-validated self-report measure, the Hypomanic Personality Scale (HPS; Eckblad & Chapman, 1986). We randomly assigned individuals to write essays about either their death or music. Then, we gathered a measure of materialism (Kasser & Sheldon, 2000). We hypothesized that individuals in the mortality salience condition (who wrote about their own death) would demonstrate more materialism than those who wrote about music. More importantly, HPS and mortality salience were expected to interact, such that high HPS individuals in the mortality salience condition would demonstrate the highest levels of materialism. Such a finding would support the idea that vulnerability to hypomania is related to defensive reactions to threat. As a check of whether individuals internalized cultural values of materialism, we included a questionnaire concerning extrinsic aspirations (values of success and wealth). Extrinsic aspirations were hypothesized to moderate materialistic reactions to mortality salience. Undoubtedly, there are disadvantages to using analog samples to study clinical processes. The study of self-esteem, however, presents special issues that may interfere with the ability to interpret findings from clinical samples. That is, it is well-established that bipolar disorder is associated with dramatic highs and lows in social and occupational functioning (Hammen & Cohen, 2004). Given this, studies of self-evaluation will need to account for the dramatically different histories of accomplishment and loss associated with recurrent bipolar episodes. For this reason, attempts to develop theoretical models of bipolar disorder need to consider the nature of self-esteem in both clinical and analog samples. To the extent that psychological correlates of bipolar disorder are less present in analog samples, one would expect greater difficulty in documenting defensive reactions to threat in the current study.
2. Methods 2.1. Participants Participants were 236 introductory psychology students who received partial credit in their Introduction to Psychology classes in exchange for participation. Of these, 225 (77 males)
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completed the measures and were included in this report. Participants were recruited from two schools: 123 participants were students at the University of Miami, and 102 were students at Florida State University. One hundred and forty of the students described themselves as Caucasian (non-Hispanic), 45 as Hispanic, 20 as African-American, 15 as Asian-American, and the remainder as other. Just over 50% were 18 years of age, 44% were 19–21, and the remaining participants were above age 21. 2.2. Procedures and materials When participants arrived at the laboratory, an experimenter greeted them, obtained informed consent, and provided instructions. Participants completed demographic questions, the HPS, and the Aspirations index before the experimental manipulation, so that the manipulation would not interfere with responses. Participants were randomly assigned to one of two experimental conditions: the mortality salience condition, in which they were asked to write about the experience of their own death, or the control condition, in which they were asked to write about the experience of listening to music. Although previous studies have asked control participants to write about TV, Kasser and Sheldon (2000) asked control participants to write about music, because TV often delivers consumer messages. The format of the questions was maintained across experimental conditions with the exception of grammatical demands to describe death or music. Participants assigned to the mortality salience condition answered the following questions in short essay form, ‘‘Please briefly describe the emotions that the thought of your own death arouse in you. Please describe, as specifically as you can, what you think will happen to you as you physically die and once you are physically dead.’’ Control participants answered a parallel set of questions about music (‘‘Please describe, as specifically as you can, what happens to you physically as you listen to music. . .’’). Eight individuals who did not write at least 20 words on either the mortality or music essay were excluded from analyses due to concerns about whether they had actually focused on either mortality or music. Previous research has suggested that cultural worldviews are defended more readily if a brief delay is included after the mortality salience manipulation (Greenberg, Arndt, Simon, Pyszczynski, & Solomon, 2000). To provide a brief delay, participants were asked to imagine their future life for several minutes after they completed the essays. Then, participants completed the financial questionnaire (described below). After completing study procedures, participants were debriefed. 2.3. Measures The Hypomanic Personality Scale (HPS; Eckblad & Chapman, 1986). The HPS was originally developed to identify people at risk for bipolar disorder. The self-report format contains 48 true– false questions. Examples include: ‘‘There have often been times when I had such an excess of energy that I felt little need to sleep at night’’ (keyed true), and ‘‘I can’t imagine that anyone would ever write a book about my life’’ (keyed false). In previous research, more than 78% of individuals with HPS scores above 36 were found to meet diagnostic criteria for bipolar spectrum disorders (Eckblad & Chapman, 1986), and predictive validity for bipolar diagnoses over a 10-year follow-
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up was quite high (Kwapil et al., 2000). The scale correlates well with other screening instruments for mania (General Behavior Inventory: r ¼ 0:47, n ¼ 768) (Eckblad & Chapman, 1986). As expected, the HPS demonstrates moderate correlations with scales of positive affect, current hypomania, and lifetime depression, as well as personality traits that have been found to be elevated among people with bipolar I disorder, including sensitivity to reward (Johnson, Ruggero, & Carver, under review) and impulsivity (Meyer & Hautzinger, 2001; Meyer, 2002). Familial aggregation of HPS scores has been demonstrated, consistent with the strong heritability of bipolar disorder (Meyer & Hautzinger, 2001). The HPS is not correlated with overt self-esteem scales (Johnson & Ruggero, in preparation), nor the Crowne–Marlow Scale for Social Desirability, r ¼ 0:05, n ¼ 768 (Eckblad & Chapman, 1986). As one would expect for a measure of lifetime vulnerability, correlations with current depression and mood states are modest, r’s < 0.30 (Johnson et al., in preparation). The measure has high reliability (15-week test–retest reliability ¼ 0.81; alpha ¼ 0.87). In this sample, internal consistency was also high, alpha ¼ 0.83. A cut-off score of 1 standard deviation above the mean (raw score P 29.39) was used to demarcate a high HPS group (n ¼ 35, 14.8%). Of these high scorers, 14 were randomly assigned to the music condition, and 21 were randomly assigned to the death condition. The low HPS group consisted of all persons with scores below this cut-off score ðn ¼ 190Þ. Aspirations index (Kasser & Ryan, 1996). This scale assesses a range of life goals to provide an index of extrinsic orientation relative to intrinsic orientation. This index was used to assess internalized ideals of materialistic success. Participants were provided with a list of 9 different goals and asked to rate the importance of each goal on a scale of 1 (not at all) to 5 (very much). Items concerning financial success (‘I will be financially successful’), social recognition (‘I will be recognized by lots of people’) and appearance (‘I will successfully hide the signs of aging’) were averaged to form a single index of Extrinsic Aspirations, and items reflecting self-acceptance (‘I will choose what I do, instead of being pushed along by life’), community investment (‘I will work for the betterment of society’), and emotional intimacy (‘I will have a committed, intimate relationship’) were averaged to form a single index of Intrinsic Aspirations. Because previous research suggests that extrinsic aspirations are more predictive when out of proportion to intrinsic aspirations (Sheldon & McGregor, 2000), the Intrinsic subscale was subtracted from the Extrinsic subscale. This Aspirations index has been shown to predict materialistic behavior (Kasser & Ryan, 1996). For analyses, individuals with scores of 0 or above were considered high on extrinsic aspirations. Because individuals who emphasized extrinsic values would be expected to demonstrate related behaviors more robustly, we conceptualized extrinsic aspirations as a moderator of the mortality salience effect on materialism. Materialism Questionnaire (Kasser & Sheldon, 2000). Items concerning predicted financial success in 15 years were used to assess materialism, the dependent variable for this study. Items covered expectations for salary (‘‘How much money do you expect to be making 15 years from now?’’), spouse’s salary, home value, value of possessions, automobiles, and investments, and budgets for travel, entertainment, leisure, and clothing. Congruent with Kasser and Sheldon (2000), three individuals with z-scores above 15 on specific items were removed from analyses. Although a factor analysis in the validation sample yielded three subscales, factor analyses within this study did not support these subscales. We computed a scale total that reflected the mean of the standardized scores for each item. Internal consistency for this scale was adequate, alpha ¼ 0.75.
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3. Results Students at the University of Miami and FSU did not differ significantly on vulnerability to hypomania (HPS), t ¼ 1:14, df ¼ 223, p ¼ 0:25, or Extrinsic Aspirations, t ¼ 1:23, df ¼ 222:76, p ¼ 0:220. Students from Miami obtained higher materialism scores than those from FSU, t ¼ 2:448, df ¼ 155:42, p ¼ 0:02. Ethnic groups did not differ on vulnerability to hypomania, Extrinsic Aspirations, nor materialism. After eliminating people who wrote less than 20 words, number of words per mortality essay was unrelated to materialism scores, r ¼ 0:14, p > 0:05. Descriptive statistics for the independent and dependent variables are shown in Table 1. To examine whether hypomanic vulnerability was related to reactions to the experimental manipulation, we conducted an analysis of variance (ANOVA) with materialism as the dependent variable. The independent variables included vulnerability to hypomania (low or high), the experimental condition (death or music essay), and aspirations (extrinsic or intrinsic). A fully saturated model, including the three-way interaction and each two-way interaction was computed. As shown in Table 2, only one effect was significant: the interaction of experimental condition and hypomanic vulnerability. To partition the significant interaction term, we examined the effect of the experimental induction separately for individuals who were high and low on the HPS. For both groups, the experimental manipulation was significant, Flow HPS ¼ 3:93, df ¼ 1, 170, p ¼ 0:05, Fhigh HPS ¼ 5:21, df ¼ 1, 34, p ¼ 0:03. High and low HPS groups demonstrated opposite responses to the experimental condition. That is, individuals with low HPS scores did not respond in the expected direction to mortality salience: they obtained lower materialism scores after writing about death compared to music, Mndeath ¼ 0:09, SD ¼ 0:48, Mnmusic ¼ 0:10, SE ¼ 0:42. Individuals with high Table 1 Means and standard deviations for key variables HPS External Aspirations Materialism
Minimum
Maximum
Mean
SD
2.00 )3.67 )0.28
40.00 1.33 3.02
20.92 )0.91 )0.04
8.44 0.85 0.40
Note. HPS ¼ hypomanic personality scale.
Table 2 Effects of Condition, Hypomanic Vulnerability, and External Aspirations on Materialism Scores Independent variable
F
P
Condition HPS Aspirations Condition · HPS Condition · Aspirations HPS · Aspirations Condition · HPS · Aspirations
0.005 0.255 1.937 4.537 0.036 0.003 2.356
0.944 0.614 0.165 0.034 0.849 0.958 0.126
Note. For each effect, df ¼ 1, 217. HPS ¼ Hypomania Personality Scale.
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vulnerability to hypomania showed the predicted mortality salience effect: they obtained higher materialism scores when they wrote about death compared to music, Mndeath ¼ 0:04, SD ¼ 0:35, Mnmusic ¼ 0:14, SD ¼ 0:15. Parallel ANOVA analyses were computed with location and gender added as independent variables (along with each of the above independent variables). None of the interactions of location or gender with other variables were significant, nor were the main effects.
4. Discussion Hypomanic vulnerability and the mortality salience condition interacted to predict materialism scores. Traditional terror management effects were not observable among individuals with low vulnerability to hypomania. Among individuals with hypomanic vulnerability, those who wrote about their own death showed significantly more materialism than those who wrote about music. Before discussing some implications of our findings, we consider potential limitations inherent in the methodology. Within the low HPS subgroup, the Kasser and Sheldon (2000) findings did not replicate. Individual differences seem important to consider. Even though we attempted to control for extrinsic values, other authors have found that the Extrinsic Aspirations scale did not moderate the effects of mortality salience (Kasser & Sheldon, 2000). Other variables, such as reflectiveness, may help predict who becomes materialistic when faced with thoughts about their death. It is also possible that our outcome measures are poor indices. Materialism is not likely to be a universally endorsed value, even within a relatively capitalistic culture. Other outcomes or measures, such as investment in mate selection, may be more closely tied to terror management (Hirschberger, Florian, & Mikulincer, 2002). Another possible explanation for the null results within the low hypomanic group is that music may not be a neutral stimulus. Given the powerful influence of music on mood (Vaestfjaell, 2002), generating essays about music could have increased positive affect, thereby contributing to an optimistic bias regarding financial prospects (Johnson & Tversky, 1983; MacLeod & Campbell, 1992). In short, our methods are not precisely the ones that have dominated the terror management literature, and more research is needed to assess these particular approaches. Current results also may not generalize to a sample of individuals with clinically diagnosed bipolar disorder. We relied on a scale designed to capture vulnerability and used a cut-off score on this scale that was relatively low. It will be important to examine defensiveness in a clinical population. Despite the limitations of this study, we did find support for our main hypothesis. Persons with a lifetime vulnerability to hypomania demonstrated more materialism when they wrote about death compared to music. As such, the current study provides some support for a long-standing model that manic vulnerability is related to defensive reactions to threat. As described above, low self-esteem has been found to predict more robust effects of mortality salience manipulations. Current results, then, are congruent with the theory that vulnerability to hypomania is related to low self-esteem. Although previous studies have shown that self-esteem is labile within bipolar disorder (Ashworth et al., 1985; Johnson & Ruggero, in preparation; Winters & Neale, 1985), this is the first study that has examined reactions to threat in the context of hypomanic vulnerability. Although congruent with predictions from models of defensive self-esteem, there are many competing explanations for the pattern of results. For example, similar patterns of increased
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reactivity to mortality salience have been shown among individuals with mild depression (Simon, Greenberg, Harmon-Jones, & Solomon, 1996). Between 66% and 75% of individuals with bipolar disorder experience lifetime episodes of depression (Karkowski & Kendler, 1997; Kessler, Rubinow, Holmes, Abelson, & Zhao, 1997). However, given the low correlations of the HPS scale with current depression in other studies (Johnson et al., under review), it is unlikely that depression fully accounts for the effects within this study. Assuming that confounds do not explain the current findings, why would hypomanic vulnerability relate to defensive reactions? In the general population, terror management effects have been hypothesized to defend against negative affect. Manic episodes and hypomanic symptoms have been found to relate to a greater propensity to negative affect (Lovejoy & Steuerwald, 1995; Ruggero, 2003) as well as increased cortisol reactivity (Goplerud & Depue, 1985) in response to threatening stimuli. This greater affective reactivity could hypothetically be related to the genetic vulnerability to disorder (Johnson, under review). Given the affective reactivity, it is not surprising that this population would demonstrate more reactivity to manipulations that could induce negative affect if not defended. This study, though, is the first to document this defensiveness. Some might find the current findings paradoxical however, in that previous studies suggest more affective reactivity associated with vulnerability, whereas the current study suggests greater likelihood of defensiveness in response to threat. One possibility is that defensive strategies are not always used; another possibility is that defensive strategies are not always effective. To understand reactivity and defensiveness in relation to manic vulnerability, researchers will need to conduct studies of multiple stressors, the mechanisms involved in defensive reactions, and the effectiveness of these mechanisms. In sum, current results provide support for defensive reactions to threat among those vulnerable to bipolar disorder. But, there is no evidence yet that defensive reactions actually contribute to the genesis of manic episodes. The materialistic reactions to mortality salience appear to mirror the excessive spending sprees that are a symptom of manic episodes (APA, 2000), but this is only one of a host of symptoms that form the syndrome of mania. Much more detailed research is needed on defensive processes and manic symptoms, and whether these processes can be integrated with biological vulnerability. In conclusion, although a broad range of research has demonstrated that mortality salience leads to increases in cultural identification, less is known about materialism. The current study suggests that materialism is not increased after a mortality salience manipulation for all individuals. Nonetheless, vulnerability to hypomania was related to greater materialism in reaction to mortality salience. Although these findings are consistent with early theory linking mania to defensive reactions to threat, they must be viewed as tentative. There is a need for much more research on individual differences and mechanisms that may explain the links between hypomanic vulnerability and defensiveness. The terror management approach, though, may provide a helpful foothold in that quest.
Acknowledgements Thanks to Adam Kuenfeld for data support and Charles Carver for editorial suggestions.
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