1
|
Vieira C, Kuss DJ, Griffiths MD. Early maladaptive schemas and behavioural addictions: A systematic literature review. Clin Psychol Rev 2023; 105:102340. [PMID: 37776578 DOI: 10.1016/j.cpr.2023.102340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 09/06/2023] [Accepted: 09/22/2023] [Indexed: 10/02/2023]
Abstract
As observed in other mental health difficulties, behavioural addiction is a complex construct with several potential predisposing factors, which include biological factors (e.g., genetic predispositions), psychological factors (e.g., personality traits), and social factors (e.g., family, and social history). One factor that may play a significant role in both developing and perpetuating behavioural addiction is the activation of early maladaptive schemas (EMSs). The aim of the present review was to synthesize the evidence concerning the relationship between behavioural addiction and EMSs. A comprehensive literature search using keywords and subject headings was performed with three electronic databases, resulting in 20 studies that met the inclusion criteria. In relation to specific behavioural addiction, the 20 studies examined: binge-eating/food addiction (n = 6), sexual addiction/compulsive sexual behaviours (n = 3), multiple addictive behaviours (n = 2), internet addiction (n = 2), smartphone addiction (n = 2), social networking/Facebook addiction (n = 2), exercise dependence (n = 1), gambling (n = 1), and videogame addiction (n = 1). The patterns of association between EMS and behavioural addiction were examined in both clinical and non-clinical population. The 'Disconnection and Rejection' domain was the most strongly related schema domain across all addictive behaviours, followed by 'Impaired Limits'. The present review suggests a positive relationship between schema activation and several addictive behaviours, including addictions to gambling, gaming, social media use sex, exercise, and food. The clinical implications of the findings are discussed, but further research is needed to inform treatment plans and interventions for those who struggle with behavioural addictions.
Collapse
Affiliation(s)
- Claudio Vieira
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, 50 Shakespeare Street, Nottingham NG1 4FQ, UK.
| | - Daria J Kuss
- Psychology, Cyberpsychology Research Group, Psychology Department, Nottingham Trent University, 50 Shakespeare Street, Nottingham NG1 4FQ, UK.
| | - Mark D Griffiths
- Behavioural Addiction, International Gaming Research Unit Psychology Department, Nottingham Trent University, 50 Shakespeare Street, Nottingham NG1 4FQ, UK.
| |
Collapse
|
2
|
Bär A, Bär HE, Rijkeboer MM, Lobbestael J. Early Maladaptive Schemas and Schema Modes in clinical disorders: A systematic review. Psychol Psychother 2023; 96:716-747. [PMID: 37026578 DOI: 10.1111/papt.12465] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 03/07/2023] [Accepted: 03/27/2023] [Indexed: 04/08/2023]
Abstract
PURPOSE Although schema therapy has been predominantly applied to treat personality disorders, interest into its application in other clinical disorders is growing. Central to schema therapy are Early Maladaptive Schemas (EMS) and Schema Modes. Since existing EMS and Schema Modes were primarily developed in the context of personality disorders, their relevance for clinical disorders is unclear. METHODS We conducted a systematic review of the presence of EMS and Schema Modes in clinical disorders according to DSM criteria. Per disorder, we evaluated which EMS and Schema Modes were more pronounced in comparison with clinical as well as non-clinical control groups and which EMS and Schema Modes were most highly endorsed within the disorder. RESULTS Although evidence concerning EMS was scarce for several disorders, and only few studies on Schema Modes survived inclusion criteria, we identified meaningful relationships and patterns for EMS and Schema Modes in various clinical disorders. CONCLUSIONS The present review highlights the relevance of EMS and Schema Modes for clinical disorders beyond personality disorders. Depending on the theme of the representation, EMS act as vulnerabilities both across diagnoses and for specific disorders. Thus, EMS and resulting Schema Modes are potential, valuable targets for the prevention and treatment of clinical disorders.
Collapse
Affiliation(s)
- Andreas Bär
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Department of Clinical Psychology and Psychotherapy, University of Freiburg, Freiburg im Breisgau, Germany
| | - Hannah E Bär
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Department of Clinical Psychology and Psychotherapy, University of Freiburg, Freiburg im Breisgau, Germany
| | - Marleen M Rijkeboer
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Jill Lobbestael
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| |
Collapse
|
3
|
Rocha S, Fernández XM, Castro YR, Ferreira S, Teixeira L, Campos C, Rocha NB. Exploring the associations between early maladaptive schemas and impulsive and compulsive buying tendencies. Front Psychiatry 2023; 14:1157710. [PMID: 37484671 PMCID: PMC10362270 DOI: 10.3389/fpsyt.2023.1157710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 06/06/2023] [Indexed: 07/25/2023] Open
Abstract
The main purpose of this preliminary study was to investigate a potential relationship between early maladaptive schemas (EMSs) and impulsive and compulsive buying tendencies in a sample of young adults (college students). This research adds to the cognitive perspective of consumer behavior that the cognitive schemas putatively associated with early experiences may have a strong impact on impulsive and compulsive buying. Data was obtained from 365 participants in a cross-sectional study design. Participants completed an online survey with the following instruments: Young Schema Questionnaire; Impulsive Buying Tendency Measurement Scale; Richmond Compulsive Buying Scale; and Hospital Anxiety and Depression Scale. Using multiple linear hierarchical regressions, we confirmed that the domain of over vigilance and inhibition schemas was positively associated with impulsive and compulsive buying tendencies, while an opposite association was found for the domain of impaired limits. Being a female was also a predictor of impulsive buying and compulsive buying. The results were discussed in terms of the coping mechanisms to deal with negative emotions, as a way to obtain rewards, or as a way to escape painful self-awareness. Other mechanisms related to the internalization of perfectionist expectations and the propensity to shame were also explored.
Collapse
Affiliation(s)
- Susana Rocha
- Centre for Social and Organizational Studies (CEOS.PP), ISCAP - Porto Accounting and Business School, Polytechnic University of Porto, Porto, Portugal
- Faculty of Education and Social Work, University of Vigo, Vigo, Spain
| | - Xosé Manuel Fernández
- Centre for Social and Organizational Studies (CEOS.PP), ISCAP - Porto Accounting and Business School, Polytechnic University of Porto, Porto, Portugal
| | - Yolanda Rodríguez Castro
- Centre for Social and Organizational Studies (CEOS.PP), ISCAP - Porto Accounting and Business School, Polytechnic University of Porto, Porto, Portugal
| | - Simão Ferreira
- Center for Translational Health and Medical Biotechnology Research, School of Health, Polytechnic of Porto, Porto, Portugal
| | - Liliana Teixeira
- Center for Translational Health and Medical Biotechnology Research, School of Health, Polytechnic of Porto, Porto, Portugal
- Center for Innovative Care and Health Technology, School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal
| | - Carlos Campos
- Neurocognition Group | LabRP, Center for Rehabilitation Research, School of Health, Polytechnic Institute of Porto, Porto, Portugal
- Digital Human‑Environment Interaction Lab (HEI‑LAB), Lusófona University, Porto, Portugal
| | - Nuno Barbosa Rocha
- Center for Translational Health and Medical Biotechnology Research, School of Health, Polytechnic of Porto, Porto, Portugal
| |
Collapse
|
4
|
Bilge Y, Yılmaz M, Hüroğlu G, Akan Tikici Z. The Effects of Adverse Childhood Experiences and Early Maladaptive Schemas on Relationship Obsessive–Compulsive Disorder. TRENDS IN PSYCHOLOGY 2022. [DOI: 10.1007/s43076-022-00245-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
5
|
Ostovar S, Bagheri R, Griffiths MD, Mohd Hashima IH. Internet addiction and maladaptive schemas: The potential role of disconnection/rejection and impaired autonomy/performance. Clin Psychol Psychother 2021; 28:1509-1524. [PMID: 33687117 DOI: 10.1002/cpp.2581] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 02/20/2021] [Accepted: 03/01/2021] [Indexed: 01/02/2023]
Abstract
INTRODUCTION AND OBJECTIVES Problematic internet use (PIU) has become public health concern, particularly among adolescents and emerging adults. There is growing interest concerning the potential impacts of early maladaptive schemas (EMSs) on PIU and its most severe manifestation internet addiction (IA). However, a deeper understanding of these relationships is needed regarding of effects of schemas on IA. The purpose of the present study was to explore the role of EMSs among adults. METHODS The sample comprised 714 Iranian participants who completed a self-report survey comprising sociodemographic variables, the Internet Addiction Test (IAT), and the Young Schema Questionnaire-Short Form (YSQ-SF). The data were analysed using partial least squares structural equation modelling (PLS-SEM). RESULTS Findings indicated that there was a positive and significant relationship between EMS domains and IA. The results confirmed that disconnection/rejection schema domains and impaired autonomy/performance schema domains were significantly related with IA. The results of the analysis of convergent validity and discriminant validity were acceptable among the nine reflective constructs. CONCLUSION Findings of the present study indicated that existence of underlying EMSs may be a vulnerability factor for developing IA and adds to the growing body of cyberpsychology literature that has examined the relationships between the EMSs and IA.
Collapse
Affiliation(s)
- Shahla Ostovar
- School of Social Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Reyhaneh Bagheri
- Centre for Research on Women and Gender (KANITA), Universiti Sains Malaysia, Penang, Malaysia
| | - Mark D Griffiths
- Psychology Department, Nottingham Trent University, Nottingham, UK
| | | |
Collapse
|
6
|
Bilge Y, Balaban G. The Relationships between Personality Disorders and Early Maladaptive Schemas and the Moderating Role of Gender. ALPHA PSYCHIATRY 2021; 22:12-18. [PMID: 36426207 PMCID: PMC9590611 DOI: 10.5455/apd.114935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 08/23/2020] [Indexed: 06/16/2023]
Abstract
OBJECTIVE The aims of this study were to examine the relationship between personality disorders (PDs) and early maladaptive schemas, to determine the early maladaptive schemas that predict PDs, and to investigate the moderating role of gender in the relationship between PDs and early maladaptive schemas. METHODS The sample consisted of 654 participants, 368 (56.4%) women and 286 (43.6%) men, aged 18-75 years, determined by the convenience sampling method. Data were collected using Coolidge Axis II Inventory Plus Turkish Short Form and Young Schema Questionnaire-Short Form 3. RESULTS From regression analysis, it was determined that each PD had a specific early maladaptive schema profile. According to the analysis, the schema that predicts the most for paranoid, schizotypal, schizoid, antisocial, borderline, obsessive-compulsive, and avoidant PDs is social isolation/mistrust; for histrionic and narcissistic PDs, the schema is approval seeking, and for dependent PD, it is failure. The analysis related to the moderating role of gender indicated that for women, the emotional deprivation schema is a risk factor for paranoid PD, and the schemas of self-sacrifice, punitiveness, and unrelenting standards are the risk factors for avoidant PD. CONCLUSION This study discovered that some early maladaptive schemas were predictors of PDs and that gender had a moderating role in the relationship between these variables. It is thought that paying attention to the moderating role of gender and considering the specific schema profiles of each PD will be beneficial for intervention programs for early maladaptive schemas and understanding the etiology of PDs.
Collapse
Affiliation(s)
- Yusuf Bilge
- Department of Psychology, İstanbul Sabahattin Zaim University, School of Humanities and Social Sciences,
İstanbul,
Turkey
| | - Gülşah Balaban
- PhD Program, Department of Psychology, İstanbul Sabahattin Zaim University,
İstanbul,
Turkey
| |
Collapse
|
7
|
Kunst H, Lobbestael J, Candel I, Batink T. Early maladaptive schemas and their relation to personality disorders: A correlational examination in a clinical population. Clin Psychol Psychother 2020; 27:837-846. [PMID: 32358901 PMCID: PMC7754466 DOI: 10.1002/cpp.2467] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 04/28/2020] [Accepted: 04/29/2020] [Indexed: 11/14/2022]
Abstract
Personality disorder (PD) pathology has been linked to early maladaptive schemas (EMSs). Because of a large heterogeneity in study populations, sample size, statistical analyses and conceptualizations in the literature, the exact relationships between PDs and EMSs are still unclear. The current study examined the relationship between borderline, dependent, avoidant and obsessive–compulsive PDs, represented dimensionally as number of traits, and 15 different EMSs as measured by the Young Schema Questionnaire (YSQ). A total of N = 130 inpatients took part in the study (Mage = 43.6, gender = 51.5% female). Stepwise regressions indicated that borderline, dependent, avoidant and obsessive–compulsive PD traits were partly characterized by specific EMSs and EMSs grouped as domains (i.e., other‐directedness domain for dependent PD and overvigilance for obsessive–compulsive PD) and that relations with a variety of domains and EMSs were overlapping for the PD dimensions (i.e., disconnection and rejection for both borderline and avoidant PDs). This suggests that PDs are reflected by a hybrid model of EMSs, with some EMSs and domains that relate to a broader vulnerability factor for PDs, and other domains that differentially relate to the independent PDs. Findings are informative for clinicians, as various EMSs per PD may be targeted in therapy.
Collapse
Affiliation(s)
- Hannah Kunst
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, The Netherlands.,The University of Sydney, NSW, Australia
| | - Jill Lobbestael
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, The Netherlands
| | - Ingrid Candel
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, The Netherlands
| | - Tim Batink
- U-Center, Heerlen, The Netherlands.,Open Universiteit, Epen, AH, The Netherlands
| |
Collapse
|
8
|
Abstract
PURPOSE OF REVIEW Schema therapy conceptualizes personality disorders in terms of modes and underlying schemas. This article reviews the literature on schema therapy conceptualization of personality disorder functioning and traits, and proposes how these findings apply to novel personality disorder classification in ICD-11 and the DSM-5 Alternative Model of Personality Disorders (AMPD). RECENT FINDINGS Maladaptive schemas and modes are generally associated with personality dysfunction and traits in conceptually coherent ways. The healthy adult mode, a transdiagnostic core concept in schema therapy, corresponds to the ICD-11 and DSM-5-AMPD features of core personality functioning. Modes and underlying schemas substantially overlap with specific ICD-11 and DSM-5-AMPD traits, which denote individual themes and styles of personality dysfunction. SUMMARY The dimensional personality disorder framework in ICD-11 and DSM-5-AMPD is largely compatible with the schema therapy model. The ICD-11 and DSM-5-AMPD provide a scientifically derived and theory-free framework for all practitioners, which may be connected to clinical theory of schema therapy in a coherent manner. Level of personality functioning can be conceptualized as healthy adult functioning (e.g. sense of identity, self-worth, emotion regulation, intimacy, and fulfillment), which inform intensity of treatment. Trait qualifiers can be conceptualized by associated modes (e.g., compliant surrender) and underlying schemas (e.g. abandonment), which inform focus and style of treatment.
Collapse
|