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Doos Ali Vand H, Hooman F, Sardarzehi R, Bastami M, Jansson-Fröjmark M. Prediction of insomnia severity based on early maladaptive schemas: a logistic regression analysis. Sleep Breath 2024; 28:919-927. [PMID: 37393219 DOI: 10.1007/s11325-023-02873-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 06/07/2023] [Accepted: 06/12/2023] [Indexed: 07/03/2023]
Abstract
BACKGROUND In spite of the major role of early maladaptive schemas in vulnerability to various psychological disorders, studies about the relationship between early maladaptive schemas and insomnia disorder are scarce. Hence, the aim of the current study was to explore the contribution of early maladaptive schemas in insomnia severity by comparing a sample of patients with chronic insomnia and good sleepers. METHODS Patients with chronic insomnia and good sleepers were evaluated using Young Schema Questionnaire-Short Form (YSQ-SF), Depression Anxiety and Stress Scale (DASS-21), and Insomnia Severity Index (ISI). RESULTS The study enrolled 117 patients with chronic insomnia and 76 good sleepers. All early maladaptive schemas (EMSs) except for enmeshment showed significant correlations with insomnia severity. After controlling for depression/anxiety symptoms, logistic regression analysis showed that the EMSs including emotional deprivation, vulnerability to harm, and subjugation schemas were significantly associated with insomnia severity. CONCLUSIONS These preliminary findings suggest that EMSs may constitute a vulnerability factor for developing insomnia. Early maladaptive schemas may require attention in the existing treatments of insomnia.
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Affiliation(s)
- Hoda Doos Ali Vand
- Behavioral Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Clinical Psychology, School of Medicine, Shahid Beheshti University of Medical Sciences, Taleghani Educational Hospital, Arabi Ave, Daneshjoo Blvd, Velenjak, Tehran, Iran
| | - Farzaneh Hooman
- Department of Psychology, Shiraz Branch, Islamic Azad University, Shiraz, Iran
| | - Reyhaneh Sardarzehi
- Behavioral Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Department of Psychology, Shiraz Branch, Islamic Azad University, Shiraz, Iran.
| | - Malek Bastami
- Faculty of Psychology and Educational Sciences, University of Tehran, Tehran, Iran
| | - Markus Jansson-Fröjmark
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute & Stockholm Health Care Services, Region Stockholm, Sweden
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Emami M, Moghadasin M, Mastour H, Tayebi A. Early maladaptive schema, attachment style, and parenting style in a clinical population with personality disorder and normal individuals: a discriminant analysis model. BMC Psychol 2024; 12:78. [PMID: 38360823 PMCID: PMC10870430 DOI: 10.1186/s40359-024-01564-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 01/29/2024] [Indexed: 02/17/2024] Open
Abstract
INTRODUCTION Researchers have shown various variables' role in forming personality disorders (PD). This study aimed to assess the role of early maladaptive schema (EMS), attachment style (AS), and parenting style (PS) in discriminating between personality disorders and normal individuals. METHODS In this study, 78 personality disorder patients and 360 healthy volunteers aged 18-84 were selected using convenience sampling. They completed the Schema Questionnaire-Short Form (SQ-SF), Revised Adult Attachment Scale (RAAS), and Baumrind's Parenting Styles Questionnaire (PSI). Data were analyzed using discriminant analysis with IBM SPSS 25. RESULTS The results showed higher mean scores in all early maladaptive schema domains, insecure attachment styles, and authoritarian parenting in the personality disorder group than in the normal group. Also, discriminant analyses revealed that the function was statistically significant and could distinguish between the two groups and a compound of essential variables, disconnection, impaired autonomy, and secure attachment, respectively, discriminating two groups. Given that all components were able to distinguish between the two groups. CONCLUSION Therefore, intervention based on these factors early in life may help reduce the characteristics of personality disorders. Also, considering the role of these factors, treatment protocols can be prepared.
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Affiliation(s)
- Maryam Emami
- Department of Clinical Psychology, Faculty of Psychology and Educational Sciences, Kharazmi University, Tehran, Iran
| | - Maryam Moghadasin
- Department of Clinical Psychology, Faculty of Psychology and Educational Sciences, Kharazmi University, Tehran, Iran.
| | - Haniye Mastour
- Department of Medical Education, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Afshin Tayebi
- Department of Psychology, Faculty of Psychology, Islamic Azad University, Karaj, Iran
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Semeniuc S, Sterie MC, Soponaru C, Butnaru S, Gavrilovici O. Therapists' problematic experiences when working with obsessive-compulsive disorder: a qualitative investigation of schema modes, mode cycles, and strategies to return to healthy adult mode. Front Psychiatry 2023; 14:1157553. [PMID: 38161727 PMCID: PMC10755009 DOI: 10.3389/fpsyt.2023.1157553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 11/22/2023] [Indexed: 01/03/2024] Open
Abstract
Introduction Obsessive-compulsive disorder (OCD) is one of the most challenging pathologies for therapists, being chronic and often characterized by frequent relapses. The therapeutic relationship plays a critical role in the outcome of therapy. The dynamic interaction between therapist and client schema modes determines the quality of the relationship. The objective of the present qualitative research is to investigate and conceptualize the triggers for therapists when working with OCD clients, the therapists' schema modes that are activated, and the strategies they use to get back into the Healthy Adult mode. Method Using the in-depth interview technique, we interviewed 15 psychotherapists of various therapeutic orientations. After several demographic items, the therapists answered some introductory questions about their general perceptions of working with this pathology. They were then guided to go through a specific therapeutic situation in imagery that they identified as particularly difficult to manage in the therapeutic relationship. For data analysis, we used the interpretative phenomenological analysis (IPA) method and thematic analysis. Results For therapists working with clients with OCD, two main categories of triggers have been identified: Perceived resistance to change and Superiority. Two other categories, Client immobilized by conflict and Abusive, emerged from our analysis. Therapists' reactions to triggers were synthesized into mode processes that (1) were not acted on and (2) were displayed in relation with the client. For mode processes that therapists did not explicitly act on, there was triggering of the Vulnerable Child in relationship with a Demanding Parent, followed by various coping modes, depending on the category of trigger, and in the displayed mode, most therapists operated in the Healthy Adult mode. With respect to the process, strategies used by therapists to return to Healthy Adult mode that stood out were: focusing on the process, self-acceptance, self-compassion, and somatic grounding strategies, and focusing on the client's resources.
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Affiliation(s)
- Suzana Semeniuc
- Faculty of Psychology and Education Sciences, Alexandru Ioan Cuza University, Iasi, Romania
| | - Maria Cristina Sterie
- “Constantin Rădulescu-Motru” Institute of Philosophy and Psychology, Department of Psychology, Romanian Academy, Bucharest, Romania
| | - Camelia Soponaru
- Faculty of Psychology and Education Sciences, Alexandru Ioan Cuza University, Iasi, Romania
| | - Simona Butnaru
- Faculty of Psychology and Education Sciences, Alexandru Ioan Cuza University, Iasi, Romania
| | - Ovidiu Gavrilovici
- Faculty of Psychology and Education Sciences, Alexandru Ioan Cuza University, Iasi, Romania
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Panagiotopoulos A, Despoti A, Varveri C, Wiegand MCA, Lobbestael J. The Relationship Between Early Maladaptive Schemas and Cluster C Personality Disorder Traits: A Systematic Review and Meta-Analysis. Curr Psychiatry Rep 2023; 25:439-453. [PMID: 37870687 PMCID: PMC10627891 DOI: 10.1007/s11920-023-01439-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/13/2023] [Indexed: 10/24/2023]
Abstract
PURPOSE OF REVIEW We systematically reviewed and meta-analyzed the literature on the relationship between early maladaptive schemas (EMSs) and Cluster C personality disorders (PDs). Our aim was to clarify which of the 18 EMSs exhibit the strongest associations and are most frequently endorsed in clinical and non-clinical samples with Cluster C PDs and traits. RECENT FINDINGS After initially screening 2622 records, 12 studies were selected with 5310 participants. Meta-analyses of the raw correlation coefficients for each EMS-Cluster C PD link (3-8 studies per meta-analysis) indicated that the 18 EMSs were significantly related to all three Cluster C PDs with r's ranging from .13 to .63. However, when considering endorsement rates among multiple regression studies that controlled for the EMSs intercorrelations and the effects of other PD traits and demographics, specific EMS constellations emerged for each Cluster C PD. Overall, the findings of the current paper suggest that Cluster C PDs might be conceptualized on the basis of a hybrid EMS model, in which all EMSs contribute to global personality dysfunction whereas specific EMS patterns reflect unique personality disorder style expressions. Longitudinal research with appropriate methodology is needed to draw more definite conclusions on the EMSs-Cluster C PDs relationships.
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Affiliation(s)
- Angelos Panagiotopoulos
- Department of Psychology, National and Kapodistrian University of Athens, Athens, Greece
- Institute of Behavioural Research and Therapy, Athens, Greece
| | - Akylina Despoti
- Clinical Ergospirometry, Exercise and Rehabilitation Laboratory, 1st Intensive Care Department, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Marie C A Wiegand
- Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, University single 40, 6229 ER, Maastricht, the Netherlands
| | - Jill Lobbestael
- Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, University single 40, 6229 ER, Maastricht, the Netherlands.
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Weme AV, Sørensen KD, Binder PE. Agency in avoidant personality disorder: a narrative review. Front Psychol 2023; 14:1248617. [PMID: 37790232 PMCID: PMC10543493 DOI: 10.3389/fpsyg.2023.1248617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 09/05/2023] [Indexed: 10/05/2023] Open
Abstract
Objectives Avoidant personality disorder (AvPD) is a highly prevalent personality disorder, especially in clinical settings, yet scarcely researched. People diagnosed with AvPD have severe impairments in functioning and suffer greatly, yet we still lack meta-analytic evidence for therapy and only a few RCTs are conducted. Patient factors are the most important for outcome in therapy, in general. Lack of agency might be a core deficit in people diagnosed with AvPD. Their conditions might be improved if we understand their agency better. We review previous research regarding psychological mechanisms and interpersonal relationships that facilitate or hinder agency in AvPD in daily life and psychotherapy. Methods Summarizing original literature in a narrative review with reflexive thematic analysis. Results People diagnosed with AvPD seem to have significant impairments in their sense of agency due to a lack of emotional awareness, an overweight of inhibiting vs. activating emotions, and difficulties regulating emotions. Difficulties also seem related to high levels of attachment avoidance and fear, creating strong ambivalence in social needs, in addition to a strong tendency to subordinate to others. A weak sense of self with a poor narrative, self-doubt, and harsh self-critique makes a reflexive and intentional stand increasingly difficult for these people. Conclusion This review gives a clinically meaningful understanding of core strengths and deficits in the personality functioning of AvPD that can help clinicians map out important therapeutic work, identify barriers to client-agency in therapy, and work through relational difficulties in the therapeutic alliance.
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Affiliation(s)
- Andrea Varga Weme
- Group Therapy Team, Voss Outpatient District Psychiatric Unit NKS Bjørkeli AS, Voss, Norway
- Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Kristine Dahl Sørensen
- Group Therapy Team, Aust-Agder Country Outpatient Psychiatric Unit, Sørlandet Hospital, Arendal, Norway
| | - Per-Einar Binder
- Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
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Sójta K, Juraś-Darowny M, Margulska A, Jóźwiak-Majchrzak W, Grażka A, Strzelecki D. Resilience and Strategic Emotional Intelligence as Mediators between the Disconnection and Rejection Domain and Negative Parenting among Female Intimate Partner Violence Victims. Brain Sci 2023; 13:1290. [PMID: 37759891 PMCID: PMC10526309 DOI: 10.3390/brainsci13091290] [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: 07/30/2023] [Revised: 08/30/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
(1) Background: The exposure of children to intimate partner violence (IPV) is associated with a wide range of negative effects on children's development, where as parenting practice is considered to be one of the key factors mediating and mitigating this. Studies have found mixed results regarding the impact of female IPV victimization on maternal parenting practice; however, the most frequently tested hypothesis suggests that the cumulative stress of the IPV experience may emotionally deregulate the mother, contributing to an increased risk of neglected and abusive parenting practices. Little is still known about the factors determining the observed differences in maternal parenting practices among IPV victims. Thus, in our study, we use mediation models to provide preliminary results exploring the role of resilience and strategic emotional intelligence in the relationship between women's disconnection and rejection (D/R) schema domain and maternal parenting practice among IPV victims. (2) Methods: A total of 48 female survivors of IPV and 48 age-matched women with no prior experience of IPV completed a set of tests examining parenting practices, the D/R domain, resilience and emotional intelligence. (3) Results: IPV victimization was associated with significantly higher rates of negative parenting practices. The D/R domain was found to be a significant predictor of parental autonomy attitude and level of parental competence, and these relationships were fully mediated by resilience with strategic emotional intelligence and resilience, respectively. (4) Conclusions: The results shed light on the under-researched relationship between early maladaptive schemas and parenting behavior in the context of IPV. The implications for clinical practice and further research can be drawn based on the study findings.
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Affiliation(s)
- Klaudia Sójta
- Department of Affective and Psychotic Disorders, Medical University of Lodz, Czechoslowacka Street 8/10, 92-216 Lodz, Poland; (K.S.); (A.G.)
| | - Małgorzata Juraś-Darowny
- Institute of Psychology, Faculty of Educational Sciences, University of Lodz, Rodziny Scheiblerów 2, 90-128 Lodz, Poland;
| | - Aleksandra Margulska
- Department of Adolescent Psychiatry, Medical University of Lodz, Czechoslowacka Street 8/10, 92-216 Lodz, Poland;
| | - Wioletta Jóźwiak-Majchrzak
- Department of Applied Sociology and Social Work, University of Lodz, Rewolucji 1905 41/43, 90-214 Lodz, Poland;
| | - Anna Grażka
- Department of Affective and Psychotic Disorders, Medical University of Lodz, Czechoslowacka Street 8/10, 92-216 Lodz, Poland; (K.S.); (A.G.)
| | - Dominik Strzelecki
- Department of Affective and Psychotic Disorders, Medical University of Lodz, Czechoslowacka Street 8/10, 92-216 Lodz, Poland; (K.S.); (A.G.)
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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.
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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
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Tracy M, Sharpe L, Bach B, Tiliopoulos N. Connecting DSM-5 and ICD-11 trait domains with schema therapy and dialectical behavior therapy constructs. Personal Ment Health 2023; 17:208-219. [PMID: 36575608 DOI: 10.1002/pmh.1574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 10/23/2022] [Accepted: 11/30/2022] [Indexed: 12/29/2022]
Abstract
The DSM-5 Section III alternative model of personality disorder (AMPD) and the International Classification of Diseases - 11th Edition's (ICD-11) personality disorder classification allow clinicians to identify individual trait domains in which people score highly. However, how these domains relate to constructs associated with efficacious treatment approaches is unclear. The current study aimed to determine whether constructs from two evidence-based treatments (schema therapy [ST] and dialectical behavior therapy [DBT]) were associated with maladaptive personality traits in a way consistent with underlying theories. We examined associations between ST constructs, DBT skill use and maladaptive coping styles, and personality traits in a sample of 525 adults. Bivariate intercorrelations and a series of multiple regression analyses were conducted to investigate the associations. As hypothesized, maladaptive coping was strongly associated with all trait domains. Surprisingly, poor DBT-skill use was only associated with negative affectivity, detachment, and disinhibition trait domains. Specific schema domains were associated with each personality trait domain, supporting trait domain-schema domain specificity. The current study highlights the potential clinical utility of the AMPD and ICD-11 trait models and ultimately contributes to the dearth of evidence on their likely usefulness for treatment selection, planning, and applications.
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Affiliation(s)
- Mikaela Tracy
- School of Psychology, Faculty of Science, The University of Sydney, Camperdown, New South Wales, Australia
| | - Louise Sharpe
- School of Psychology, Faculty of Science, The University of Sydney, Camperdown, New South Wales, Australia
| | - Bo Bach
- Center for Personality Disorder Research (CPDR), Psychiatric Research Unit, Mental Health Services, Region Zealand, Denmark
| | - Niko Tiliopoulos
- School of Psychology, Faculty of Science, The University of Sydney, Camperdown, New South Wales, Australia
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Sójta K, Margulska A, Jóźwiak-Majchrzak W, Grażka A, Grzelczak K, Strzelecki D. Cognitive-Affective Risk Factors of Female Intimate Partner Violence Victimization: The Role of Early Maladaptive Schemas and Strategic Emotional Intelligence. Brain Sci 2023; 13:1118. [PMID: 37509048 PMCID: PMC10377412 DOI: 10.3390/brainsci13071118] [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: 06/21/2023] [Revised: 07/11/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
(1) Background: Intimate partner violence (IPV) is a pervasive and destructive phenomenon. There is a need for an integrated and comprehensive approach to IPV in order to align prevention, support and treatment. Still little is known about the cognitive and affective markers of IPV that are modifiable. Such knowledge, therefore, can support the effectiveness of prevention and intervention programs. In this study, we put forward a hypothesis that, after accounting for the influence of sociodemographic variables, the domains of early maladaptive schemas (EMS) and strategic emotional intelligence would provide additional information for predicting female IPV victimization. (2) Methods: 48 female survivors of IPV and 48 age-matched women with no prior experience of IPV completed the Young Schema Questionnaire-Short Form 3 (YSQ-SF3) and The Emotional Understanding Test (TRE). (3) Results: The domains of disconnection and rejection and impaired limits were significant predictors of IPV victimization, but the results did not support the predictive value for impaired autonomy, other-directedness and strategic emotional intelligence. (4) Conclusions: Our findings add to the emerging evidence of a link between disconnection and rejection domain and IPV victimization. As a consequence, maladaptive beliefs that interpersonal relationships are unstable and insecure and expose to the risk of humiliation and harm, and that basic emotional needs cannot be satisfied in close relationships, are associated with a higher risk of intimate partner violence. In this context, schema therapy appears to be a promising support for IPV victims.
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Affiliation(s)
- Klaudia Sójta
- Department of Affective and Psychotic Disorders, Medical University of Lodz, Czechoslowacka Street 8/10, 92-216 Lodz, Poland
| | - Aleksandra Margulska
- Department of Adolescent Psychiatry, Medical University of Lodz, Czechoslowacka Street 8/10, 92-216 Lodz, Poland
| | - Wioletta Jóźwiak-Majchrzak
- Department of Applied Sociology and Social Work, University of Lodz, Rewolucji 1905 41/43, 90-214 Lodz, Poland
| | - Anna Grażka
- Department of Affective and Psychotic Disorders, Medical University of Lodz, Czechoslowacka Street 8/10, 92-216 Lodz, Poland
| | | | - Dominik Strzelecki
- Department of Affective and Psychotic Disorders, Medical University of Lodz, Czechoslowacka Street 8/10, 92-216 Lodz, Poland
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Faustino B, Pilkington P, Pascoal PM. Dialectical Core Schemas Mediate the Relationships Between Dissociative Experiences and Symptomatology in a Community Sample. Psychol Rep 2023:332941231175065. [PMID: 37217316 DOI: 10.1177/00332941231175065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
BACKGROUND Maladaptive cognitions about the self and others are associated with a wide array of dysfunctional responses and psychopathological symptoms in non-clinical and clinical samples. Dissociative experiences (e.g., depersonalization and derealization) as a coping response to stressful situations lie on a continuum from healthy to unhealthy but are generally elevated in individuals experiencing mental illness. However, the extent to which Dialectical Core Schemas explain the relationship between dissociative experiences and symptomatology is unclear. Therefore, this study aimed to investigate the mediating role of Dialectical Core Schemas on the relationship between dissociative experiences and symptomatology. METHODS A community sample of 179 participants were recruited (Mage = 21.2 years, SD = 8.2). Data were gathered through self-report questionnaires using a cross-sectional design. RESULTS Maladaptive core schemas about self and others correlated positively with all dissociative experiences (e.g., depersonalization/derealization, amnesia), while adaptive core schemas about the self correlated negatively with depersonalization/derealization and distractibility. Maladaptive core schemas mediated the relationship between dissociative experiences and symptomatology. CONCLUSIONS The relationships between dissociative experiences and symptomatology are bi-directional. Exploring the mediating factors may help clinicians and researchers better understand how to enhance case conceptualization and clinical decision-making.
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Affiliation(s)
- Bruno Faustino
- Lusófona University, HEI-Lab: Digital Human-Environment Interaction Labs, Portugal
- Faculdade de Psicologia da Universidade de Lisboa, Lisboa, Portugal
| | | | - Patrícia M Pascoal
- Lusófona University, HEI-Lab: Digital Human-Environment Interaction Labs, Portugal
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Steylaerts B, Dierckx E, Schotte C. Relationships Between DSM-5 Personality Disorders and Early Maladaptive Schemas from the Perspective of Dimensional and Categorical Comorbidity. COGNITIVE THERAPY AND RESEARCH 2023. [DOI: 10.1007/s10608-023-10349-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
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12
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Sójta K, Strzelecki D. Early Maladaptive Schemas and Their Impact on Parenting: Do Dysfunctional Schemas Pass Generationally?-A Systematic Review. J Clin Med 2023; 12:jcm12041263. [PMID: 36835799 PMCID: PMC9963559 DOI: 10.3390/jcm12041263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/31/2023] [Accepted: 02/03/2023] [Indexed: 02/08/2023] Open
Abstract
There are several factors that play a key role in the development of early maladaptive schemas, i.e., temperament, unmet core emotional needs, and adverse childhood events (e.g., traumatization and victimization, overindulgence, overprotection). Thus, the parental care that a child experiences has a substantial impact on the potential development of early maladaptive schemas. Negative parenting can range from unconscious neglect to overt abuse. Previous research supports the theoretical concept that there is a clear and close relationship between adverse childhood experiences and the development of early maladaptive schemas. Maternal mental health problems have been proven to be a factor that has strengthened the link between a mother's history of negative childhood experiences and subsequent negative parenting. Consistent with the theoretical background, early maladaptive schemas are associated with a wide variety of mental health problems. Clear links have been found for EMSs and personality disorders, depression, eating disorders, anxiety disorders, obsessive-compulsive disorder, and post-traumatic stress disorder. In light of these theoretical and clinical connections, we decided to summarize the available literature on the multigenerational transmission of early maladaptive schemas, which is also an introduction to our research project.
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Affiliation(s)
- Klaudia Sójta
- Department of Affective and Psychotic Disorders, Central Teaching Hospital, Medical University of Łódź, ul. Czechosłowacka 8/10, 92-216 Łódź, Poland
| | - Dominik Strzelecki
- Department of Affective and Psychotic Disorders, Central Teaching Hospital, Medical University of Łódź, ul. Czechosłowacka 8/10, 92-216 Łódź, Poland
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Early Maladaptive Schemas and Mental Disorders in Adulthood: a Systematic Review and Meta-analysis. Int J Cogn Ther 2022. [DOI: 10.1007/s41811-022-00149-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
AbstractEarly maladaptive schemas (EMSs) are broad and pervasive themes regarding oneself and one’s relationships with others originating from adverse childhood experiences. Although the concept of EMSs was initially developed for the treatment of personality disorders, the associations of EMSs with a variety of other mental disorders have been investigated. The goal of the present study was to summarize and analyze the EMSs-disorder associations in studies in which patients with specific psychiatric diagnoses were compared to healthy controls. Of the 28 studies that met the inclusion criteria, 27 were included in a meta-analysis. Across diagnoses, all EMSs were elevated in the clinical groups. The largest effect sizes were observed for the social isolation, the negativity/pessimism, the defectiveness/shame, and social undesirability schemas. Depression (n = 8), borderline personality disorder (n = 5), and obsessive–compulsive disorder (n = 5) were the most frequently studied mental disorders. Heterogeneity between studies was high. Results suggest that mental disorders are not characterized by specific EMSs.
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Negative cognitive schema modification as mediator of symptom improvement after electroconvulsive therapy in major depressive disorder. J Affect Disord 2022; 310:156-161. [PMID: 35490877 DOI: 10.1016/j.jad.2022.04.088] [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: 08/12/2021] [Revised: 02/20/2022] [Accepted: 04/13/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Electroconvulsive therapy (ECT) is a potent option for treatment-resistant major depressive disorder (MDD). Cognitive models of depression posit that negative cognitions and underlying all-or-nothing negative schemas contribute to and perpetuate depressed mood. This study investigates whether ECT can modify negative schemas, potentially via memory reactivation, and whether such changes are related to MDD symptom improvement. METHOD Seventy-two patients were randomized to either an emotional memory reactivation electroconvulsive therapy (EMR-ECT) or control memory reactivation electroconvulsive therapy (CMR-ECT) intervention prior to ECT-sessions in a randomized controlled trail. Emotional memories associated with patients' depression were reactivated before ECT-sessions. At baseline and after the ECT-course, negative schemas and depression severity were assessed using the Dysfunctional Attitude Scale (DAS) and Hamilton Depression Rating Scale HDRS. Mediation analyses were used to examine whether the effects of ECT on HDRS-scores were mediated by changes in DAS-scores or vice versa. RESULTS Post-ECT DAS-scores were significantly lower compared to baseline. Post-ECT, the mean HDRS-score of the whole sample (15.10 ± 8.65 [SD]; n = 59) was lower compared to baseline (24.83 ± 5.91 [SD]). Multiple regression analysis showed no significant influence of memory reactivation on schema improvement. Path analysis showed that depression improvement was mediated by improvement of negative cognitive schemas. CONCLUSION ECT is associated with improvement of negative schemas, which appears to mediate the improvement of depressive symptoms. An emotional memory intervention aimed to modify negative schemas showed no additional effect.
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Simonsen S, Popolo R, Juul S, Frandsen FW, Sørensen P, Dimaggio G. Treating Avoidant Personality Disorder With Combined Individual Metacognitive Interpersonal Therapy and Group Mentalization-Based Treatment: A Pilot Study. J Nerv Ment Dis 2022; 210:163-171. [PMID: 34710894 DOI: 10.1097/nmd.0000000000001432] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Avoidant personality disorder (AvPD) is a severe but understudied condition. The current pilot project reports data on acceptability and outcomes of a novel treatment combining biweekly individual metacognitive interpersonal therapy (MIT) and weekly mentalization-based therapy (MBT) group therapy. A total of 30 patients with AvPD were consecutively included in the program. The primary outcome was AvPD-specific personality functioning measured by self-report after treatment. Secondary outcomes were symptom distress, interpersonal problems, quality of life, and psychosocial functioning. Twenty-two patients completed treatment, with a mean duration of 13 months. On the primary outcome, effect sizes were generally moderate to large (effect size range: 0.59-1.10). On secondary outcomes, effect sizes were large (effect size range: 0.77-2.3). Both in terms of acceptability and outcomes, results are promising for the combination of MIT and MBT for AvPD. The approach is a strong candidate for further investigation in future large-scale randomized controlled trial.
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Affiliation(s)
- Sebastian Simonsen
- Stolpegaard Psychotherapy Centre, Mental Health Services, Capital Region of Denmark, Gentofte, Denmark
| | | | - Sophie Juul
- Stolpegaard Psychotherapy Centre, Mental Health Services, Capital Region of Denmark, Gentofte, Denmark
| | | | - Per Sørensen
- Stolpegaard Psychotherapy Centre, Mental Health Services, Capital Region of Denmark, Gentofte, Denmark
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16
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Faustino B. Minding my brain: Fourteen neuroscience-based principles to enhance psychotherapy responsiveness. Clin Psychol Psychother 2022; 29:1254-1275. [PMID: 35112428 DOI: 10.1002/cpp.2719] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 12/21/2021] [Accepted: 01/28/2022] [Indexed: 11/12/2022]
Abstract
Intersections between psychotherapy and neurosciences are at its dawn. The quest to understand the neural underpinnings of psychological processes has led several generations of scientists to explore neural correlates between mind, brain, and behavior. Neuroscience methods and research has given psychology new perspectives and insights about the structure and function of complex neural pathways, that underly human functioning (cognition, emotion, motivation, and interpersonal behavior). By translating neuroscientific findings into psychotherapeutic principles of change, it is possible to promote responsiveness towards brain dysfunction that underlies patients' psychological malfunctioning. In psychotherapy, responsiveness is a core aspect of the therapeutic change process, especially to adapt psychological interventions to patients' motivational stages and preferences, coping styles, neurobehavioral modes, and emotional needs. Within a transtheoretical and translational approach, contemporary neuroscientific findings are revised, discussed, and used to attempt to build-on fourteen theoretical brain-based principles that may be applied to psychotherapy. Translating these empirical findings into practical principles, clinical strategies and tasks is expected to enhance psychotherapy responsiveness grounded on a science-based knowledge of brain functioning.
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Affiliation(s)
- Bruno Faustino
- Faculdade de Psicologia da Universidade de Lisboa, Portugal.,HEI-Lab, Lusófona University, Lisbon, Portugal
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17
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Faustino B, Vasco AB, Delgado J, Farinha-Fernandes A, Guerreiro JC. Early maladaptive schemas and COVID-19 anxiety: The mediational role of mistrustfulness and vulnerability to harm and illness. Clin Psychol Psychother 2022; 29:1297-1308. [PMID: 34989057 PMCID: PMC9015275 DOI: 10.1002/cpp.2706] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/28/2021] [Accepted: 12/29/2021] [Indexed: 12/18/2022]
Abstract
Background Early maladaptive schemas (EMS), as lifelong psychological structures, tend to be associated with psychopathological symptomatology. Previous research has suggested that schemas act as psychological vulnerabilities to stressful life situations, such as the present worldwide COVID‐19 pandemic. In this context, anxiety and psychological distress have been documented as two of the main psychological symptoms associated with the COVID‐19 pandemic. However, the associations between specific EMS and COVID‐19 anxiety remain unexplored. Therefore, this study aims to explore the relationships between EMS, COVID‐19 anxiety as well as other mental health variables such as psychological well‐being, distress and life satisfaction. Methods In a cross‐sectional design, 249 individuals (M = 34.2, SD = 12.0) completed several self‐report measures. Results EMS from different schematic domains were positively associated with COVID‐19 anxiety and psychological distress and negatively associated with psychological well‐being and life satisfaction. An EMS hierarchical regression model predicted COVID‐19 anxiety. Mistrustfulness and vulnerability to harm and illness mediated the relationships between COVID‐19 anxiety, psychological distress and life satisfaction. Conclusions According to these results, mistrustfulness and vulnerability to harm and illness can act as underlying variables for the decrease in mental health associated with the COVID‐19 pandemic.
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Affiliation(s)
- Bruno Faustino
- Faculdade de Psicologia da, Universidade de Lisboa, Lisboa, Portugal
| | | | - João Delgado
- Faculdade de Psicologia da, Universidade de Lisboa, Lisboa, Portugal
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18
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Marčinko D, Jakšić N, Šimunović Filipčić I, Mustač F. Contemporary psychological perspectives of personality disorders. Curr Opin Psychiatry 2021; 34:497-502. [PMID: 34292181 DOI: 10.1097/yco.0000000000000732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW The aim of this study was to review the recent literature on contemporary psychological perspectives of personality disorders, including novel psychotherapeutic interventions aimed at these vulnerable individuals. RECENT FINDINGS Among the various psychological theories and models of personality disorders, still the most popular and researched are psychodynamic, cognitive and interpersonal perspectives. More specifically, object relations theory, cognitive schema conceptualization and interpersonal circumplex model have produced the most empirical investigations of personality disorders in recent years. Latest work has suggested that all three perspectives have contributed to and are compatible with the dimensional personality disorders framework in DSM-5-AMPD and ICD-11 (including level of personality functioning and personality traits). These models have yielded specific psychological treatments of personality disorders; although most psychotherapies have been constructed for patients with borderline personality disorder (BPD), there is an increasing number of treatment modalities aimed at individuals with other forms of personality disorder, such as those with narcissistic or antisocial traits/disorders. More research into their effectiveness and long-term benefits is necessary. SUMMARY Novel research keeps updating our knowledge on the cause, manifestations and psychological treatments of personality disorders, particularly from psychodynamic, cognitive and interpersonal perspectives.
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Affiliation(s)
- Darko Marčinko
- Department of Psychiatry and Psychological Medicine, University Hospital Center Zagreb
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Nenad Jakšić
- Department of Psychiatry and Psychological Medicine, University Hospital Center Zagreb
| | | | - Filip Mustač
- Department of Psychiatry and Psychological Medicine, University Hospital Center Zagreb
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Siahmoshtei J, Delavar A, Borjali A. A preliminary study: designing and validating projective images of Young's early maladaptive schema (EMS) domains. BMC Psychol 2021; 9:16. [PMID: 33509281 PMCID: PMC7841900 DOI: 10.1186/s40359-021-00514-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 01/12/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND This study aims to design and validate ten projective images of Young's Early Maladaptive Schema (EMS) domains. For this purpose, two questions are to be addressed. (1) How is the factorial structure of the projective images of EMS domains? (2) Do the images designed in the domains of disconnection and rejection, impaired autonomy and performance, impaired limits, other-directedness, and over-vigilance and inhibition have sufficient validity? METHODS This is an applied mixed-methods exploratory study, in which the statistical population consisted of psychologists from Tehran Province in the qualitative section (n = 8) as well as other individuals aged between 18 and 65 years (mean age = 33) from Qazvin in the quantitative section (n = 102) in 2018. The research questions were analyzed through principal axis factoring with a varimax rotation, confirmatory factor analysis, Pearson correlation coefficient, and Cronbach's alpha. RESULTS According to the results, ten images and five domains of Young's EMSs contribute to a simple structure. Accounting for 70.35% of the total variance of EMSs, the five dimensions include disconnection and rejection, impaired autonomy and performance, impaired limits, other-directedness, and over-vigilance and inhibition. CONCLUSIONS The results indicated that the designed projective images yielded acceptable construct validity.
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Wuth A, Mishra S, Beshai S, Feeney J. Experiences of developmental unpredictability and harshness predict adult cognition: An examination of maladaptive schemas, positive schemas, and cognitive distortions. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-020-01274-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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21
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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.
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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
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22
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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.
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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
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