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Bardakçı MR, Şahin Can M. Early maladaptive schemas in autogenous and reactive subtypes of obsessive-compulsive disorder. Nord J Psychiatry 2024:1-7. [PMID: 39002145 DOI: 10.1080/08039488.2024.2374416] [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: 03/06/2024] [Accepted: 06/24/2024] [Indexed: 07/15/2024]
Abstract
AIMS The aim of this study is to identify early maladaptive schemas in patients with obsessive-compulsive disorder (OCD) and to determine the use of these schemas in OCD autogenous and reactive subtypes. METHODS The study population included 40 healthy volunteers, and 90 patients diagnosed with OCD. The Yale-Brown Obsession-Compulsion Scale (Y-BOCS) was administered to the OCD group to determine the severity of the disorder, and the Y-BOCS Symptom Checklist was applied to determine the patients with autogenous (n = 37) and reactive (n = 53) subtypes of OCD. Young Schema Questionnaire-Short Form 3 (YSQ-SF3) scales were applied to all participants. RESULTS When autogenous and reactive subtype groups of OCD were compared with each other, the schema domains of disconnection (p = 0.004), high standards (p = 0.008), other-directedness (p < 0.001) and the schema dimensions of failure (p < 0.001), emotional deprivation (p < 0.001), defectiveness (p = 0.007), approval seeking (p = 0.007) and punishment (p = 0.001) were found to be more dominant in the autogenous group. CONCLUSIONS The findings of the study support that there are differences between autogenous and reactive subtypes of OCD in terms of dominant schemas. Therefore, its thought that the use of Schema Therapy methods in which schemas appropriate for subtypes are investigated in the treatment of OCD patients will contribute favorably to the treatment response.
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Affiliation(s)
| | - Merve Şahin Can
- Department of Psychiatry, Balıkesir University Faculty of Medicine, Balıkesir, Türkey
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2
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Canty AR, Windsor TD, Nixon RDV. Using experience sampling methodology (ESM) to improve our understanding of day-to-day intrusion frequency and related distress in survivors of trauma. J Behav Ther Exp Psychiatry 2024; 82:101921. [PMID: 37944379 DOI: 10.1016/j.jbtep.2023.101921] [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] [Received: 02/07/2023] [Revised: 10/02/2023] [Accepted: 10/25/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND AND OBJECTIVES Cognitive models of posttraumatic stress disorder (PTSD) suggest that appraisals of traumatic sequelae and subsequent distress drive the development and maintenance of PTSD. Posttraumatic research has relied heavily on macro-longitudinal designs, with weeks or months between assessments of trauma-related cognitions and symptoms. The present study uses experience sampling methodology (ESM) better understand the day-to-day experiences of trauma exposed individuals. METHODS One-hundred trauma exposed adults reported their posttraumatic symptoms, interpretations, and behaviours four times a day over a 10-day ESM period. RESULTS As anticipated, within-person fluctuations in negative appraisals of intrusions and maladaptive coping strategies (e.g., thought suppression) were significantly positively associated with intrusion frequency and related distress. In all cases, the associations for negative appraisals and maladaptive coping were stronger with intrusion related distress than intrusion frequency. LIMITATIONS The observed contemporaneous associations only demonstrate that variables reliably fluctuated together and cannot indicate causality. CONCLUSIONS The findings demonstrate that day-to-day fluctuations in trauma related perceptions and sequelae are significant and should be explored alongside broader individual differences to advance our understanding of the development, maintenance, and treatment of PTSD.
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Affiliation(s)
- Alexandra R Canty
- College of Education, Psychology, and Social Work, Flinders University, Adelaide, Australia.
| | - Tim D Windsor
- College of Education, Psychology, and Social Work, Flinders University, Adelaide, Australia; Flinders University Institute for Mental Health and Wellbeing, Adelaide, Australia
| | - Reginald D V Nixon
- College of Education, Psychology, and Social Work, Flinders University, Adelaide, Australia; Flinders University Institute for Mental Health and Wellbeing, Adelaide, Australia.
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3
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Saarijärvi P, Salmivalli C, Helmi S, Karukivi M. Early maladaptive schemas are associated with self-injury thoughts and behavior in adolescents. BMC Psychiatry 2023; 23:632. [PMID: 37644535 PMCID: PMC10466884 DOI: 10.1186/s12888-023-05127-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 08/22/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Early maladaptive schemas (EMSs) and self-harm have been firmly linked in adults, but research on these associations in adolescents remains scarce. Additionally, the links between EMSs and functions of self-injury has not been previously studied in this age group. Thus, the aim of the present study was to investigate the associations of EMSs with self-harm thoughts and behavior, as well as with self-harm functions, among adolescents in specialized health care. METHODS The participants were recruited from first-visit 12-22-year-old adolescent patients entering specialized mental health care or pediatric care. For 118 participants, complete data were available for the Young Schema Questionnaire Short Form 2-Extended (YSQ) when entering care and the Ottawa Self-Injury Inventory Functions scale (OSI-F) one year later. YSQ was used to measure the participants' EMSs and OSI-F their self-harm thoughts and behavior. The associations of EMSs and self-harm were investigated in three groups: no self-harm, self-harm thoughts only, and both self-harm thoughts and behavior. The associations of EMSs with self-injury behavior functions were assessed in four categories: Internal Emotional Regulation, External Emotional Regulation, Social Influence, and Sensation Seeking. Additionally, EMSs' associations with addictive features of self-injury behavior were assessed. The magnitudes of effect sizes of differences between the self-harm groups were evaluated with Cliff's Delta. The associations of EMSs with self-injury functions were analyzed with general linear modeling and with self-injury addictive features using logistic regression. RESULTS The differences between the self-harm groups were significant for the majority of the EMSs. The stronger the EMSs were, the more severe the manifestations of self-harm. The effect sizes ranged from small to large depending on the EMS. Considering self-injury functions, Internal Emotional Regulation was associated with Self-Sacrifice EMS (p = 0.021), and External Emotional Regulation both with Abandonment (p = 0.040) and Unrelenting Standards (p = 0.012) EMSs. Being addicted to self-injury was associated with Abandonment (p = 0.043) and Dependence (p = 0.025) EMSs. CONCLUSIONS The present study shows that significant associations between EMSs and both self-harm thoughts and behavior exist also in adolescents. Stronger EMSs are linked to more severe self-harm. Knowledge of these associations may help to improve the understanding and treatment of adolescents suffering from self-harm.
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Affiliation(s)
- Pauliina Saarijärvi
- Department of Psychology and Speech-Language Pathology, University of Turku, Publicum building, 4th floor, 20014, Turku, Finland
- Department of Psychiatry, HUS Helsinki University Hospital and University of Helsinki, Adolescent Psychiatry, Finland
- Psychiatric Care Division, Satasairaala Hospital, Pori, Finland
- University of Turku, INVEST Research Flagship, Publicum building, 4th floor, 20014, Turku, Finland
| | - Christina Salmivalli
- Department of Psychology and Speech-Language Pathology, University of Turku, Publicum building, 4th floor, 20014, Turku, Finland
- University of Turku, INVEST Research Flagship, Publicum building, 4th floor, 20014, Turku, Finland
| | - Saija Helmi
- Faculty of Social Sciences (SOC), Tampere University, Welfare Sciences, Psychology, 33014, Finland
| | - Max Karukivi
- Psychiatric Care Division, Satasairaala Hospital, Pori, Finland.
- Department of Adolescent Psychiatry, University of Turku and Turku University Hospital, Kunnallissairaalantie 20, Turku, 20700, Finland.
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Grażka A, Strzelecki D. Early Maladaptive Schemas and Schema Modes among People with Histories of Suicidality and the Possibility of a Universal Pattern: A Systematic Review. Brain Sci 2023; 13:1216. [PMID: 37626572 PMCID: PMC10452338 DOI: 10.3390/brainsci13081216] [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: 07/18/2023] [Revised: 08/01/2023] [Accepted: 08/08/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND The identification of variables affecting suicidality and the search for interventions to reduce suicide risk are priorities among mental health researchers. A promising direction for such research is schema therapy and its two main constructs, i.e., early maladaptive schemas (EMSs) and schema modes. METHODS This systematic review was designed in accordance with the PRISMA guidelines. It summarizes the studies conducted to date that describe the relationship between EMSs and schema modes and measures of suicidality in individuals over the age of 16. RESULTS The review confirmed that there are many significant associations between EMSs (especially from the Disconnection/Rejection domain) and suicide risk. Although only one study was found that explores the association between schema modes and suicidality, the correlations it identified are also confirmed here. DISCUSSION The results show the unquestionable importance of EMSs and schema modes in assessing suicide risk. The co-occurrence of these variables represents the first step in further assessing causality and introducing schema therapy techniques into work with patients who are at risk of suicide. This issue requires more extensive experimental research.
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Affiliation(s)
| | - Dominik Strzelecki
- Department of Affective and Psychotic Disorders, Medical University of Lodz, 92-216 Lodz, Poland;
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5
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Özmen A. Anger and psychological symptoms relationship: mediator role of maladaptive schemas. Front Psychol 2023; 14:1183618. [PMID: 37533718 PMCID: PMC10390636 DOI: 10.3389/fpsyg.2023.1183618] [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: 03/10/2023] [Accepted: 06/16/2023] [Indexed: 08/04/2023] Open
Abstract
Trait anger is the strong predictor of various psychological symptoms like anxiety, depression, and hostility. Explaining how and why this relationship occurs is crucial to come up with more effective prevention and intervention strategies in the field. To this end, the current study aimed to reveal the mediating effect of early maladaptive schemas, which is the basic concept of schema therapy, on the relations of trait anger and psychological symptoms. Data was collected from 301 university students by using the measurement tools of Brief Symptom Inventory, Trait Anger Scale and Young Schema Scale. Findings revealed that trait anger positively predicted psychological symptoms. Secondly, a set of predictive models were prepared to detect the mediating effect of early maladaptive schemas. According to the analysis in the last stage, early maladaptive schemas fully mediated the relationship between trait anger and psychological symptoms.
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Sanwald S, Montag C, Kiefer M. Association between parental separation, childhood trauma, neuroticism, and depression: a case control study. Front Psychiatry 2023; 14:1112664. [PMID: 37229385 PMCID: PMC10204799 DOI: 10.3389/fpsyt.2023.1112664] [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: 11/30/2022] [Accepted: 04/17/2023] [Indexed: 05/27/2023] Open
Abstract
Background Parental separation has been suggested to be associated with depression development in offspring. The new family constellation subsequent to separation could be associated with elevated scores of childhood trauma, shaping more emotionally instable personalities. This could ultimately be a risk factor for mood disorders and particularly the development of depression in life. Methods To test this hypothesis, we investigated the associations between parental separation, childhood trauma (CTQ) and personality (NEO-FFI) in a sample of N = 119 patients diagnosed with depression and N = 119 age and sex matched healthy controls. Results While parental separation was associated with elevated scores of childhood trauma, there was no association between parental separation and Neuroticism. Furthermore, in a logistic regression analysis, Neuroticism and childhood trauma were found to be significant predictors for depression diagnosis (yes/no), but not parental separation (yes/no). Conclusion Parental separation might be associated with depression only indirectly via childhood trauma. Childhood trauma or Neuroticism seem more directly related to the development of depression. However, it is worthwhile to install prevention programs helping parents and children to cope with parental separation in order to minimize the impact of separation and associated stressors.
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Affiliation(s)
- Simon Sanwald
- Department of Psychiatry and Psychotherapy III, Ulm University, Ulm, Germany
| | | | - Christian Montag
- Department of Molecular Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Markus Kiefer
- Department of Psychiatry and Psychotherapy III, Ulm University, Ulm, Germany
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Wong YJ. The Catalyst Model of Change: Gratitude Interventions with Positive Long-Term Effects. AFFECTIVE SCIENCE 2023; 4:152-162. [PMID: 37070004 PMCID: PMC10104986 DOI: 10.1007/s42761-022-00136-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 06/20/2022] [Indexed: 11/07/2022]
Abstract
How can gratitude interventions be designed to produce meaningful and enduring effects on people's well-being? To address this question, the author proposes the Catalyst Model of Change-this novel, practical, and empirically testable model posits five socially oriented behavioral pathways that channel the long-term effects of gratitude interventions as well as how to augment gratitude experiences in interventions to boost treatment effects and catalyze these behavioral pathways. Specifically, interventions that enhance the frequency, skills, intensity, temporal span, and variety of gratitude experiences are likely to catalyze the following post-intervention socially oriented behaviors: (a) social support-seeking behaviors, (b) prosocial behaviors, (c) relationship initiation and enhancement behaviors, (d) participation in mastery-oriented social activities, and (e) reduced maladaptive interpersonal behaviors, which, in turn, produce long-term psychological well-being. A unique feature of the Catalyst Model of Change is that gratitude experiences are broadly conceptualized to include not just gratitude emotions, cognitions, and disclosures, but also expressing, receiving, witnessing, and responding to interpersonal gratitude. To this end, gratitude interventions that provide multiple opportunities for social experiences of gratitude (e.g., members expressing gratitude to each other in a group) might offer the greatest promise for fostering durable, positive effects on people's psychological well-being.
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Affiliation(s)
- Y. Joel Wong
- Counseling & Educational Psychology Department, Indiana University, 201 N. Rose Ave, Bloomington, IN 47401 USA
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Yalcin O, Marais I, Lee CW, Correia H. The YSQ-R: Predictive Validity and Comparison to the Short and Long Form Young Schema Questionnaire. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1778. [PMID: 36767144 PMCID: PMC9914719 DOI: 10.3390/ijerph20031778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/15/2023] [Accepted: 01/16/2023] [Indexed: 06/18/2023]
Abstract
The capacity of the Young Schema Questionnaire (YSQ) to predict psychopathology in specific clinical groups has consistently produced mixed findings. This study assessed three versions of the Young Schema Questionnaire (YSQ), including the long form (YSQ-L3), short form (YSQ-S3), and the recent Rasch-derived version, the YSQ-R, and their subscales, in predicting psychological distress in three different psychiatric groups and a non-clinical group. Test equating techniques were first applied to derive a common metric to ensure that each YSQ version was directly comparable. In the second stage, multiple regression analyses were employed to assess the predictive validity of each YSQ version and their subscales. The YSQ-R and YQ-L3 and their respective subscales were similar in their predictive power across all groups and conditions. The YSQ-S3 could not predict pre-treatment Early Maladaptive Schemas (EMS) and global symptom severity in the PTSD group, nor could it predict pre-treatment EMS and changes in global symptom severity in the Alcohol and Substance Use group. This was the first study to assess the predictive validity of three different versions of the YSQ. Our findings suggest that YSQ-R has the breadth of the YSQ-L3 and the shortness of the YSQ-S3, making it an ideal tool for assessing EMS across research and clinical settings.
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Affiliation(s)
- Ozgur Yalcin
- School of Psychology and Exercise Science, Murdoch University, Murdoch, WA 6150, Australia
| | - Ida Marais
- Department of Psychiatry, Faculty of Health and Medical Sciences, University of Western Australia, Crawley, WA 6009, Australia
| | - Christopher William Lee
- Department of Psychiatry, Faculty of Health and Medical Sciences, University of Western Australia, Crawley, WA 6009, Australia
| | - Helen Correia
- School of Psychology and Exercise Science, Murdoch University, Murdoch, WA 6150, Australia
- Discipline of Psychological Sciences, Australian College of Applied Professions, Northbridge, WA 6003, Australia
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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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Alaftar İ, Uzer T. Understanding intergenerational transmission of early maladaptive schemas from a memory perspective: Moderating role of overgeneral memory on adverse experiences. CHILD ABUSE & NEGLECT 2022; 127:105539. [PMID: 35151211 DOI: 10.1016/j.chiabu.2022.105539] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 01/31/2022] [Accepted: 02/01/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Previous studies demonstrated that early maladaptive schemas (EMSs) are transmitted from mothers to children through adverse childhood experiences, such as maltreatment and unfulfilled core needs. The traumatic memory literature demonstrated that people with a history of trauma recall their traumatic and/or other negative experiences as categories of events-a phenomenon called overgeneral autobiographical memory (OGM)-to avoid the accompanying intense negative feelings. In the long run, OGM originating from an affect-regulation process after childhood traumatic experiences can facilitate the development of EMSs in children. OBJECTIVE This study expands the previous literature by studying whether OGM facilitates the transmission of EMSs by strengthening maladaptive thinking patterns after traumatic experiences. PARTICIPANTS AND SETTINGS A total of 120 mothers and late adolescents participated in this study. The mothers filled out the forms online through a link sent to their e-mail addresses, and the adolescents completed the forms online through a link posted on social media. METHOD Late adolescents completed the Autobiographical Memory Recall Task, Young Schema Questionnaire-Short Form-3 (YSQ-SF3), Childhood Trauma Questionnaire, and Beck Depression Inventory (BDI). Mothers filled out the YSQ-SF3 and BDI. RESULTS The results confirmed that adverse childhood experiences significantly mediated the relationship between mothers' and children's disconnection and rejection schemas. Furthermore, this relationship was stronger, especially for children with a higher tendency of overgeneral retrieval of negative experience (β = 0.26 (0.10), 95% CI [0.09, 0.49]). CONCLUSIONS The present study provides evidence that OGM facilitates the transmission of early maladaptive schemas.
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Affiliation(s)
- İdil Alaftar
- TED University, Psychology Department, Ziya Gokalp Blv. No. 48, 06420 Çankaya/Ankara, Turkey
| | - Tuğba Uzer
- TED University, Psychology Department, Ziya Gokalp Blv. No. 48, 06420 Çankaya/Ankara, Turkey.
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Faustino B, Vasco AB, da Silva AN, Matos M. Preliminary Psychometric Properties of the Portuguese Version of the Personality Belief Questionnaire—Short Form in a Community Sample. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2022. [DOI: 10.1007/s10942-022-00448-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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12
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Velásquez MM, Gómez-Maquet Y, Ferro E, Cárdenas W, González-Nieves S, Lattig MC. Multidimensional Analysis of Major Depression: Association Between BDNF Methylation, Psychosocial and Cognitive Domains. Front Psychiatry 2021; 12:768680. [PMID: 34970165 PMCID: PMC8712447 DOI: 10.3389/fpsyt.2021.768680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 11/22/2021] [Indexed: 11/29/2022] Open
Abstract
Major Depression is a complex disorder with a growing incidence worldwide and multiple variables have been associated with its etiology. Nonetheless, its diagnosis is continually changing and the need to understand it from a multidimensional perspective is clear. The purpose of this study was to identify risk factors for depression in a case-control study with 100 depressive inpatients and 87 healthy controls. A multivariate logistic regression analysis was performed including psychosocial factors, cognitive maladaptive schema domains, and specific epigenetic marks (BDNF methylation levels at five CpG sites in promoter IV). A family history of depression, the cognitive schemas of impaired autonomy/performance, impaired limits, other-directedness, and the methylation level of a specific CpG site were identified as predictors. Interestingly, we found a mediating effect of those cognitive schemas in the relationship between childhood maltreatment and depression. Also, we found that depressive patients exhibited hypomethylation in a CpG site of BDNF promoter IV, which adds to the current discussion about the role of methylation in depression. We highlight that determining the methylation of a specific region of a single gene offers the possibility of accessing a highly informative an easily measurable variable, which represents benefits for diagnosis. Following complete replication and validation on larger samples, models like ours could be applicable as additional diagnostic tools in the clinical context.
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Affiliation(s)
- María Marcela Velásquez
- Centro de Investigaciones Genéticas en Enfermedades Humanas, Departamento de Ciencias Biológicas, Universidad de los Andes, Bogotá, Colombia
| | | | - Eugenio Ferro
- Instituto Colombiano del Sistema Nervioso, Clínica Montserrat, Bogotá, Colombia
| | - Wilmer Cárdenas
- Centro de Investigaciones Genéticas en Enfermedades Humanas, Departamento de Ciencias Biológicas, Universidad de los Andes, Bogotá, Colombia
| | - Silvia González-Nieves
- Centro de Investigaciones Genéticas en Enfermedades Humanas, Departamento de Ciencias Biológicas, Universidad de los Andes, Bogotá, Colombia
| | - María Claudia Lattig
- Centro de Investigaciones Genéticas en Enfermedades Humanas, Departamento de Ciencias Biológicas, Universidad de los Andes, Bogotá, Colombia
- SIGEN alianza Universidad de los Andes – Fundación Santa Fe de Bogotá, Bogotá, Colombia
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Ezawa ID, Murphy ST, Whelen ML, Strunk DR. When Are Therapists' Efforts to Bring about Cognitive Change Effective? Considering Interpersonal Vulnerabilities as Contextual Factors. Int J Cogn Ther 2021; 14:623-638. [PMID: 34900081 PMCID: PMC8654211 DOI: 10.1007/s41811-021-00117-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/18/2021] [Indexed: 11/25/2022]
Abstract
We examined interpersonal variables as moderators of the relation between therapists' use of cognitive change (CC) strategies and CC in a sample of 125 adults who participated in cognitive behavioral therapy for depression. We measured self-reported maladaptive personality characteristics, interpersonal problems, and social skills at intake. Observers rated therapist adherence to cognitive methods for the first five sessions. Patients reported in-session CC following each session. Cognitive methods predicted greater CC. The relation between cognitive methods and CC was moderated by maladaptive personality traits; this relation was stronger for patients with greater maladaptive personality traits. We encourage future research investigating moderators of therapist interventions of putative therapeutic mechanisms.
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Affiliation(s)
- Iony D Ezawa
- Department of Psychology, The Ohio State University, Columbus, OH, United States
| | - Samuel T Murphy
- Department of Psychology, The Ohio State University, Columbus, OH, United States
| | - Megan L Whelen
- Department of Psychology, The Ohio State University, Columbus, OH, United States
| | - Daniel R Strunk
- Department of Psychology, The Ohio State University, Columbus, OH, United States
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Stangier U, Frick A, Thinnes I, Arens EA, Hofmann SG. Metta-Based Therapy for Chronic Depression: a Wait List Control Trial. Mindfulness (N Y) 2021; 12:2929-2942. [PMID: 38665227 PMCID: PMC11044848 DOI: 10.1007/s12671-021-01753-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/07/2021] [Indexed: 10/20/2022]
Abstract
Objectives Current treatments for chronic depression have focused on reducing interpersonal problems and negative affect, but paid little attention to promoting prosocial motivation and positive affect. Following this treatment focus, the objective of the present study was to examine whether the combination of metta (Loving Kindness) group meditation and subsequent tailored individual therapy focusing on kindness towards oneself and others (metta-based therapy, MBT) shows greater improvements in depressive symptoms than a wait list control group in patients with chronic depression. Methods Forty-eight patients with DSM-5 persistent depressive disorder were randomly assigned to MBT or a wait list control condition. Outcome was assessed after group meditation, after subsequent individual therapy, and at 6-month follow-up. The primary outcome measure was an independent blind rating of depressive symptoms at post-test. Secondary outcome included changes in self-reported depression, behavioral activation, rumination, social functioning, mindfulness, compassion, and clinician-rated emotion regulation. Results Mixed-design analyses showed significant differences between MBT and WLC in changes from pre- to post-test in clinician-rated and self-rated depression, behavioral activation, rumination, social functioning, mindfulness, and emotion regulation. Most of the changes occurred during group meditation and were associated with large effect sizes. Improvements were maintained at 6-month follow-up. Conclusions The results provide preliminary support for the effectiveness of MBT in treating chronic depression. Trial Registration ISRCTN, ISRCTN97264476.
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Affiliation(s)
- Ulrich Stangier
- Clinical Psychology and Psychotherapy, Department of Psychology, Goethe University Frankfurt, Varrentrappstr. 40–42, 60486 Frankfurt am Main, Germany
| | - Artjom Frick
- Clinical Psychology and Psychotherapy, Department of Psychology, Goethe University Frankfurt, Varrentrappstr. 40–42, 60486 Frankfurt am Main, Germany
| | - Isabel Thinnes
- Clinical Psychology and Psychotherapy, Department of Psychology, Goethe University Frankfurt, Varrentrappstr. 40–42, 60486 Frankfurt am Main, Germany
| | - Elisabeth A. Arens
- Clinical Psychology and Psychotherapy, Department of Psychology, Goethe University Frankfurt, Varrentrappstr. 40–42, 60486 Frankfurt am Main, Germany
| | - Stefan G. Hofmann
- Department of Psychological and Brain Sciences, Boston University, Boston, USA
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Yalcin O, Marais I, Lee C, Correia H. Revisions to the Young Schema Questionnaire using Rasch analysis: the YSQ-R. AUSTRALIAN PSYCHOLOGIST 2021. [DOI: 10.1080/00050067.2021.1979885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Ozgur Yalcin
- Department of Psychology, Murdoch University, Perth, Australia
| | - Ida Marais
- Medical School, University of Western Australia, Perth, Australia
| | - Christopher Lee
- Medical School, University of Western Australia, Perth, Australia
| | - Helen Correia
- Department of Psychology, Murdoch University, Perth, Australia
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Karagöl A, Törenli Kaya Z. Evaluating early maladaptive schemas and depression levels in living kidney and liver donors. PSYCHOL HEALTH MED 2021; 27:2161-2170. [PMID: 34545761 DOI: 10.1080/13548506.2021.1981409] [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] [Indexed: 10/20/2022]
Abstract
Living organ donation is a stressful process, both in terms of physical and mental consequences after the operation. Studies have found that cumulative depression prevalence in 5-year follow-up after the organ donation is 4.2% in 1 year and 11.5% in 5 years. The aim of the present study was to find out early maladaptive schemas (EMS) and depression levels of living kidney and liver donors. Ninety-three patients who have become living kidney or liver donors in Baskent University Hospital between 2015 and 2019 and accepted to participate in the study are included. Interviews were conducted via telephone or face-to-face and socio-demographic information form, Young Schema Questionnaire Short Form-3 and Beck Depression Inventory were given to the participants. The first three schemas with the highest average scores in living donors were self-sacrifice, punitiveness and approval seeking. The Sschema domain with the highest score is 'other directedness' among living donors. The donors who had depression revealed higher scores in the schema domains of 'abandonment and rejection' and 'impaired autonomy' when compared to those who did not have depression. As the donors had higher scores in the 'other directedness' schema domain and 'self-sacrifice' and 'approval seeking' schemas, overthinking and acting accordingly for the others with the expectation of being praised is thought to be the underlying pattern (motivation) of being a living donor. Culture could have an important impact in this particular way of thinking and acting. There is a cultural and religious impact as well in the high scores of 'punitiveness' schema of the donors. Being adequately informed pre-operatively, feeling safe and independent during the decision process and getting enough social support post-operatively seem to be the important factors of tackling depression for living organ donors.
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Affiliation(s)
- Arda Karagöl
- Department of Psychiatry, Başkent University Hospital, Ankara, Turkey
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17
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Karaarslan C, Eldogan D, Yigit I. Associations between early maladaptive schema domains of parents and their adult children: The role of defence styles. Clin Psychol Psychother 2021; 28:1043-1054. [PMID: 33624909 DOI: 10.1002/cpp.2579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 02/18/2021] [Accepted: 02/19/2021] [Indexed: 12/15/2022]
Abstract
Although existing research recognized the associations between early maladaptive schemas (EMSs) of parents and their adult children, the mechanisms that underpin these associations were not fully understood. Therefore, the purpose of the current study was to explore the role of defence styles (DSs) on the associations between two EMS domains (Disconnection/Rejection and Impaired Autonomy) of parents and their adult children. Two hundred and fifteen families (i.e., mother, father, and their adult children) participated in the study. Both parents and their adult children were asked to complete Young Schema Questionnaire-Short Form (YSQ-SF) and Defence Style Questionnaire (DSQ) to assess their EMS domains and DSs. According to the results of the current study, there were significant associations between Disconnection/Rejection and Impaired Autonomy EMS domains of parents and their adult children, and these associations were mediated by only immature DS of parents and their adult children in a serial mediation model. These results contributed to our understanding of the associations between EMS domains of parents and their adult children through immature DSs. Moreover, our findings highlighted the importance of synthesizing the concepts of different theories to enhance our understanding of mental representations in families.
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Affiliation(s)
- Cemre Karaarslan
- Department of Psychology, Faculty of Science and Letters, Başkent University, Ankara, Turkey
| | - Dilay Eldogan
- Kavaklıdere Psychological Counseling Center, Ankara, Turkey
| | - Ibrahim Yigit
- Department of Psychology, Faculty of Economics, Administrative and Social Sciences, Ankara Medipol University, Ankara, Turkey
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18
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Paetsch A, Moultrie J, Kappelmann N, Fietz J, Bernstein DP, Kopf-Beck J. Psychometric Properties of the German Version of the Young Positive Schema Questionnaire (YPSQ) in the General Population and Psychiatric Patients. J Pers Assess 2021; 104:522-531. [PMID: 34431747 DOI: 10.1080/00223891.2021.1966020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Early adaptive schemas (EAS) are resilience-oriented counterparts to early maladaptive schemas (EMS), which are central in schema therapy. The Young Positive Schema Questionnaire (YPSQ) was developed as a measure of EAS but has been evaluated neither in relation to a clinical population nor in a German-speaking sample. Objectives of this study were therefore the psychometric validation of a German YPSQ in a community sample and the comparison of EAS to psychiatric patients. Participants were 1,418 individuals from a community sample and 182 psychiatric patients with a main diagnosis of major depressive disorder. A factor structure of 10 EAS, instead of the original 14, demonstrated satisfactory factorial validity and internal consistency in both samples. EAS exhibited divergent validity to EMS, childhood trauma, and psychopathology. Convergent validity was evident with resilience, self-efficacy, and satisfaction with life. Support for incremental validity beyond EMS was especially shown for resilience, self-efficacy, and satisfaction with life, and was also evident for several dimensions of psychopathology. Individuals in the community sample exhibited more pronounced EAS compared to psychiatric patients with the exception of empathic consideration. Especially for concepts associated with mental health, the YPSQ has the potential to be a highly valuable addition to current research and practice.
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Affiliation(s)
- Andreas Paetsch
- Max Planck Institute of Psychiatry, Munich, Germany.,Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands
| | - Josefine Moultrie
- Max Planck Institute of Psychiatry, Munich, Germany.,Department of Psychology, LMU Munich, Munich, Germany
| | - Nils Kappelmann
- Department of Research in Translational Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany.,International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
| | - Julia Fietz
- Department of Research in Translational Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany.,International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
| | - David P Bernstein
- Expertise Center for Forensic Psychiatry, De Rooyse Wissel Forensic Psychiatric Center, Forensic Psychology Section, Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands
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19
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Tariq A, Reid C, Chan SWY. A meta-analysis of the relationship between early maladaptive schemas and depression in adolescence and young adulthood. Psychol Med 2021; 51:1233-1248. [PMID: 34109934 DOI: 10.1017/s0033291721001458] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Early maladaptive schemas (EMS) are broad, pervasive themes and patterns of emotions, memories, cognition and physical sensations that impede the goal of individuals. Maladaptive behaviours can occur as a response to maladaptive or negative schemas, often culminating in depression or anxiety. The current meta-analysis integrates the existing literature to estimate the magnitude of effect of association between EMS and depression among adolescents and young adults. A systematic search of seven different databases including Embase, CINAHL, Medline, ASSIA, Psych INFO, Scopus and Web of Science was carried out identifying 24 relevant studies of adolescents (10-18 years) and young adults (19-29 years). The random-effect model estimate for association between overall EMS and depression was r = 0.56 (95% CI 0.49-0.63, Z = 12.88, p ≤ 0.0001), suggesting higher predominant EMS significantly linked to higher levels of depressive symptoms, with a large effect size. Separate meta-analytical results with schema domains indicated moderately stronger associations between schemas of disconnection/rejection, impaired autonomy/performance and other-directedness with depression. Age and gender were not found to have any significant moderating effect on the associations. The findings suggest that it is vital for clinicians to identify specific maladaptive schemas contributing towards depression, to have a better understanding of underlying cognitive processes and in turn promote psychological health, well-being and resilience in adolescents and young adults. Furthermore, findings will also assist clinicians to focus more on the content of three significant schema domains, which emerged as particularly salient factors underlying adolescent depression.
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Affiliation(s)
- Asnea Tariq
- School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - Corinne Reid
- Chancellery, Victoria University, Melbourne, Australia
| | - Stella W Y Chan
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, UK
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20
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Golińska PB, Cieślak M, Hubert O, Bidzan M. Mental Health and the Symptoms of PTSD in People with Depression and Anxiety Disorders during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5542. [PMID: 34067315 PMCID: PMC8196908 DOI: 10.3390/ijerph18115542] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/17/2021] [Accepted: 05/20/2021] [Indexed: 02/03/2023]
Abstract
The purpose of this study was to examine the severity of post-traumatic stress disorder (PTSD) symptoms related to the COVID-19 pandemic in people with no diagnosis of mental illness, as well as in people who were diagnosed with depression or anxiety. Moreover, this study aimed to investigate the interplay between PTSD symptoms and self-assessed mental health associated with well-being. The 210 participants were divided into 3 groups: mentally healthy, participants with diagnosed depression, and participants with anxiety disorders. To evaluate the subjective well-being of the participants, the Polish adaptation of the Mental Health Continuum-Short Form (MHC-SF) was applied. The Impact Event Scale-Revised (IES-R) was used to measure the severity of PTSD symptoms. At least a moderate worsening of PTSD symptoms was observed in participants of all groups. The results were as follows: healthy participants M = 37.35 (SD = 18.46); participants with depression M = 36.05 (SD = 18.02); participants with anxiety M = 44.52 (SD = 18.08). The participants diagnosed with depression showed the lowest level of mental well-being M = 41.58 (SD = 15.02). Conclusion: People diagnosed with depression had both the lowest level of well-being and the lowest severity of symptoms specific to PTSD. In all three groups, lower emotional well-being was linked to greater PTSD symptoms.
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Affiliation(s)
| | - Mariusz Cieślak
- Institute of Psychology, University of Lodz, 90-136 Lodz, Poland;
| | - Olimpia Hubert
- Faculty of Psychology, University of Social Sciences and Humanities, 81-745 Sopot, Poland;
| | - Mariola Bidzan
- Institute of Psychology, University of Gdansk, 80-557 Gdansk, Poland;
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21
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Yalcin O, Lee C, Correia H. Factor Structure of the Young Schema Questionnaire (Long Form‐3). AUSTRALIAN PSYCHOLOGIST 2021. [DOI: 10.1111/ap.12458] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Ozgur Yalcin
- School of Psychology and Exercise Science, Murdoch University, Perth, Western Australia, Australia,
| | - Christopher Lee
- School of Psychology and Exercise Science, Murdoch University, Perth, Western Australia, Australia,
- Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia,
| | - Helen Correia
- School of Psychology and Exercise Science, Murdoch University, Perth, Western Australia, Australia,
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22
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STROIAN PI. Emotional Needs and Schematic Functioning in Depression: A Narrative Review. JOURNAL OF EVIDENCE-BASED PSYCHOTHERAPIES 2021. [DOI: 10.24193/jebp.2021.1.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
"Grounded in cognitive theory, the schema therapy model of psychopathology
proposes a set of maladaptive cognitive structures, called early maladaptive
schemas, resulting from the invalidation of emotional needs. More recently,
the schema therapy model has been adapted for use with depressed clients.
However, the utility of addressing emotional needs in the psychotherapeutic
treatment of depression has not been established. The present paper aims to
provide a narrative review of the current literature on basic needs as
motivational factors in depression and their relation to schematic
functioning. Theoretical considerations and practical evidence on the use of
constructs related to basic motivation in depression are drawn from the
literature on the cognitive and schema therapy-based models of depression.
The implications for the theoretical understanding of needs are discussed, as
are future directions for the research of schematic functioning in depression."
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Affiliation(s)
- Paula I. STROIAN
- Evidence-Based Assessment and Psychological Interventions” Doctoral School, Babeș-Bolyai University, Cluj-Napoca, Romania The International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeș-Bolyai University, Cluj-Napoca, Romania"
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23
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Koppers D, Van H, Peen J, Dekker JJM. Psychological symptoms, early maladaptive schemas and schema modes: predictors of the outcome of group schema therapy in patients with personality disorders. Psychother Res 2020; 31:831-842. [PMID: 33272104 DOI: 10.1080/10503307.2020.1852482] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Objective: This naturalistic study examined the outcomes of group schema therapy for patients with personality disorders (PD) and the effect of psychological symptoms, early maladaptive schemas (EMS) and schema modes on outcome.Method: Assessments were made of 194 patients at baseline, during treatment, at treatment termination and at three-month follow-up. We used the Symptom Checklist-General Severity Index (SCL-GSI) to measure the remission-rate of global psychological distress and as a dependent variable in a multilevel model to conduct univariate and multiple variate analyses.Results: The research sample achieved medium symptom reduction (pre-post d = 0.65, 95% CI [0.39-0.91]) and the remission rate was about 30% after 60 sessions. These results remained stable at three-month follow-up (pre-follow-up d = 0.61, 95% CI [0.29-0.94]; 28.9%). Higher baseline scores on the SCL scale interpersonal sensitivity, the EMS defectiveness/shame and all the maladaptive schema modes together predicted improvements in global psychological distress after treatment.Conclusions: A long-term form of group schema therapy proved effective for a broad group of patients with PD. Internalizing symptoms seems predictive for improvement at outcome. Almost a third of the patients achieved remission. There is therefore room for improvement, possibly by increasing dose or intensity in combination with individual sessions.
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Affiliation(s)
- David Koppers
- Research Department, Arkin Mental Health Care Institute, Amsterdam, Netherlands
| | - Henricus Van
- Research Department, Arkin Mental Health Care Institute, Amsterdam, Netherlands.,NPI Centre for Personality Disorders, Arkin Mental Health Care Institute, Amsterdam, Netherlands
| | - Jaap Peen
- Research Department, Arkin Mental Health Care Institute, Amsterdam, Netherlands
| | - Jack J M Dekker
- Research Department, Arkin Mental Health Care Institute, Amsterdam, Netherlands.,Department of Clinical Psychology, Free University Amsterdam, Amsterdam, Netherlands
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24
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Flink N, Honkalampi K, Lehto SM, Viinamäki H, Koivumaa‐honkanen H, Valkonen‐korhonen M, Lindeman S. Early maladaptive schemas in chronically depressed patients: A preliminary investigation. CLIN PSYCHOL-UK 2020. [DOI: 10.1111/cp.12151] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Niko Flink
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland,
| | - Kirsi Honkalampi
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland,
| | - Soili M. Lehto
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland,
- Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland,
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland,
| | - Heimo Viinamäki
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland,
- Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland,
| | - Heli Koivumaa‐honkanen
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland,
- Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland,
| | - Minna Valkonen‐korhonen
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland,
- Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland,
| | - Sari Lindeman
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland,
- Central Finland Health Care District, Jyväskylä Central Hospital, Jyväskylä, Finland,
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25
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Outcome of First-admission Depression Treated in a Specialized Mood Disorders Service. J Psychiatr Pract 2020; 26:461-471. [PMID: 33275383 DOI: 10.1097/pra.0000000000000509] [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: 11/26/2022]
Abstract
OBJECTIVE Few studies have described the treatment or outcome of depression in specialized mood disorders units (MDUs). Previous studies have focused on cohorts of patients with highly treatment-resistant illness who are likely to have a poor prognosis even with intensive treatment. This study describes the treatment and medium-term outcomes of a cohort of first-admission depressed patients with less treatment-resistant illness treated in a specialized MDU. METHODS A cohort of 137 consecutive first-admission depressed patients, referred to an MDU over 2 years, were interviewed using standardized schedules and followed up prospectively from admission for ∼18 months to describe baseline characteristics, treatment, outcome, and predictors of outcome. Times to recovery and recurrence were evaluated using survival analyses and predictors of outcome were examined using bivariate and multivariate regression analyses. RESULTS On admission, 75% of the 137 patients had depression that had been found to be resistant to pharmacological treatment, and 34% had been chronically depressed (>2 y). Over half of the patients had likely maladaptive personality traits and one third had at least 1 comorbid psychiatric disorder. By discharge, a significantly higher proportion of the patients were being prescribed very high (P<0.01) or high doses (P<0.05) of antidepressants, augmentation therapy (P<0.001), or a combination of antidepressants (P<0.001) or were engaged in individual psychotherapy (P<0.001), compared with baseline. With intensive treatment, 62% of the patients recovered by 6 months and 76% by 12 months, with 83% overall recovering and patients found to be asymptomatic during almost 60% of the follow-up period. However, 48% suffered a recurrence over the course of the follow-up. Chronicity of mood episodes (P<0.01) and the presence of psychiatric comorbidity (P<0.05) predicted recurrence. CONCLUSIONS This prospective, naturalistic, medium-term study describes better outcomes, in terms of recovery and symptomatology over time, in a cohort of first-admission depressed patients than previous first-admission studies after continuous, intensive treatment, although the proportion of patients who experienced recurrences remained high.
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27
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Heeren A, Bernstein EE, McNally RJ. Bridging maladaptive social self-beliefs and social anxiety: a network perspective. J Anxiety Disord 2020; 74:102267. [PMID: 32599433 DOI: 10.1016/j.janxdis.2020.102267] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 06/13/2020] [Accepted: 06/17/2020] [Indexed: 12/29/2022]
Abstract
The Clark and Wells (1995) model of social anxiety disorder postulates that three types of maladaptive social self-beliefs (high standard, conditional, and unconditional beliefs) play a crucial role in the development of fear and avoidance of social-evaluative situations-i.e., the hallmark symptoms of social anxiety disorder. In this project, we examined associations between the three types of maladaptive social self-beliefs and fear and avoidance of social-evaluative situations in a nonclinical community sample (n = 389). We used network analysis to estimate functional relations among aspects of maladaptive self-beliefs, fear, and avoidance and computed two different network models, a graphical Gaussian model (GGM) and a directed acyclic graph (DAG). Each model estimates edges and the importance of nodes in different ways. Both GGM and DAG pointed to fear and conditional beliefs as especially potent bridges between maladaptive social self-beliefs and social anxiety in our nonclinical sample. Altogether, these results offer data-driven heuristics in the field's larger, ongoing effort to illuminate pathways at play in the development of social anxiety. We situate this study within novel network approaches for developing theory-driven models and tests of the instigation and interactions of maladaptive social self-beliefs and social anxiety. However, because this is the first study to combine GGM and DAG in social anxiety research, we also discussed the caveats to this approach to help to usher the field forward.
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Affiliation(s)
- Alexandre Heeren
- Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium; Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium.
| | - Emily E Bernstein
- Department of Psychology, Harvard University, Cambridge, MA, United States
| | - Richard J McNally
- Department of Psychology, Harvard University, Cambridge, MA, United States
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28
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Zeynel Z, Uzer T. Adverse childhood experiences lead to trans-generational transmission of early maladaptive schemas. CHILD ABUSE & NEGLECT 2020; 99:104235. [PMID: 31759288 DOI: 10.1016/j.chiabu.2019.104235] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 09/30/2019] [Accepted: 10/14/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND According to schema theory, early maladaptive schemas (EMSs) are formed due to unsatisfied core emotional needs in childhood. However, there is limited research about the association between parent's EMS and the child's EMS. OBJECTIVE The current study investigated the mechanisms underlying the relationship between the parent's disconnection and rejection schemas and the child's disconnection and rejection schemas. PARTICIPANTS AND SETTING One hundred seventy-nine mother-late adolescent dyads participated in the study. Mothers filled out the forms at home, and adolescents completed the forms in the classroom. METHODS The adolescents completed the Young Schema Questionnaire-Short Form-3 (YSQ-SF3), Childhood Trauma Questionnaire, Father Involvement Scale, and Resilience Scale. The mothers completed only the YSQ-SF3. RESULTS Mothers' EMSs related to the disconnection and rejection domain predicted their children's EMS in the same domain. Adverse childhood experiences also significantly mediated this relationship only when father involvement was low (β = .08, SE = .04, 95% CI [.01, .18]). CONCLUSIONS The current study provides evidence that EMSs are passed on from one generation to the next through adverse childhood experiences especially when fathers do not provide enough support in childrearing.
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Affiliation(s)
- Zeynep Zeynel
- Department of Psychology, TED University, Ziya Gokalp Blv. No: 48, 06420 Kolej, Cankaya, Ankara, Turkey
| | - Tugba Uzer
- Department of Psychology, TED University, Ziya Gokalp Blv. No: 48, 06420 Kolej, Cankaya, Ankara, Turkey.
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Abstract
PURPOSE OF REVIEW To provide an update on the epidemiology and the clinical consequences of depression complicated by comorbid personality disorders, and to discuss optimal treatment options. RECENT FINDINGS Studies have confirmed the frequent co-occurrence of depression and personality disorders. These comorbid states are consistently associated with unfavourable clinical indicators such as duration of episode, symptom severity and recurrence of depression, as well as a negative effect on treatment outcome. Nevertheless, this is a neglected theme and there are hardly any well designed treatment studies available. SUMMARY We advocate considering depression and personality as being more closely related and argue in favour of the development of integrated treatment options tailored to understanding symptoms as being interwoven with a variety of long-standing disturbing personality patterns. Both clinically and conceptually, psychodynamic and schema-focused approaches provide good opportunities to adjust available therapies and they could optimize outcomes in this complex patient group. Given the risk of treatment resistance and chronicity, a combination of psychotherapy and medication should always be considered.
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Faustino B, Vasco AB. Early Maladaptive Schemas and Cognitive Fusion on the Regulation of Psychological Needs. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2019. [DOI: 10.1007/s10879-019-09446-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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31
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Early maladaptive schemas as predictors of maternal bonding to the unborn child. BMC Psychol 2019; 7:23. [PMID: 30975192 PMCID: PMC6460656 DOI: 10.1186/s40359-019-0297-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 03/29/2019] [Indexed: 11/10/2022] Open
Abstract
Background The quality of an expectant mother’s bonding to the fetus has been shown to be associated with important developmental outcomes. Previous studies suggest that bonding quality is predicted by, for example, social support, psychological well-being, and depression. However, little is known regarding the role of maternal cognition in maternal-fetal bonding. Early maladaptive schemas (EMSs) are negative and stable assumptions about oneself and one’s relationships with others that are developed during childhood and adolescence. In the present study, we examined the associations between EMSs and the quality of the bonding to the fetus in expectant mothers. Methods The present investigation is part of a larger study in which 220 pregnant women (approximately 12% of the pregnant women in the region) and 130 of their partners were recruited from October 2015 until December 2017. The sample for the current study comprised 165 pregnant women (mean age 30.8 years, SD 4.1 years). The participants completed the Young Schema Questionnaire Short Form 3 (YSQ-S3) between gestational weeks 24 and 37 and the Maternal Antenatal Attachment Scale (MAAS) and the Edinburgh Postnatal Depression Scale (EPDS) between gestational weeks 31 and 41. Results All EMS domains correlated significantly and negatively with scores for quality of maternal-fetal bonding on the MAAS. Only the Disconnection and Rejection domain correlated significantly and negatively with MAAS scores for intensity of preoccupation with the fetus. The Disconnection and Rejection domain was a significant independent predictor of the quality of maternal-fetal bonding. Symptoms of depression mediated the effect of the EMS domains on the quality of maternal-fetal bonding. The EMS domains Disconnection and Rejection, Impaired Autonomy and Performance, and Impaired Limits showed significant direct effects on bonding quality. Conclusions EMSs are related to expectant mothers’ self-reported bonding to their fetuses. This association was mediated by the mothers’ symptoms of depression. The results may have implications for the early identification of pregnant women at risk of bonding difficulties and encourage more studies on cognitive schemas and mechanisms for maternal-fetal bonding.
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Faustino B, Vasco AB. Schematic Functioning, Interpersonal Dysfunctional Cycles and Cognitive Fusion in the Complementary Paradigmatic Perspective: Analysis of a Clinical Sample. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2019. [DOI: 10.1007/s10879-019-09422-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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33
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Early maladaptive schemas in patients with obsessive-compulsive disorder, bipolar disorder, and schizophrenia: A comparative study. CURRENT PSYCHOLOGY 2019. [DOI: 10.1007/s12144-019-00195-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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34
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Khosravani V, Mohammadzadeh A, Sharifi Bastan F, Amirinezhad A, Amini M. Early maladaptive schemas and suicidal risk in inpatients with bipolar disorder. Psychiatry Res 2019; 271:351-359. [PMID: 30529318 DOI: 10.1016/j.psychres.2018.11.067] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 11/29/2018] [Accepted: 11/30/2018] [Indexed: 12/16/2022]
Abstract
The present study aimed to assess the associations of early maladaptive schemas (EMSs) and clinical factors (hypomanic/manic and depressive symptoms) with suicidal risk (current suicidal ideation and lifetime suicide attempts) in inpatients with bipolar disorder (BD). One hundred inpatients with BD completed the Young Schema Questionnaire-Short Form (YSQ-SF), the Bipolar Depression Rating Scale (BDRS), the Young Mania Rating Scale (YMRS), and the Beck Scale for Suicide Ideation (BSSI). 59% of patients had lifetime suicide attempts and 59% showed high suicidal risk (BSSI ≥ 6). BD patients with lifetime suicide attempts had higher scores on the entitlement and social isolation schemas, depression, and hypomanic/manic symptoms than those without such attempts. Patients with high suicidal risk had higher levels of depressive and hypomanic/manic symptoms as well as some EMSs than those without high suicidal risk. Logistic regression analyses revealed that hypomanic/manic symptoms as well as the entitlement and defectiveness schemas were significantly associated with current suicidal ideation. Also, the entitlement and social isolation schemas were associated with lifetime suicide attempts. These results suggest that the entitlement, social isolation, and defectiveness schemas may relate to suicidal risk in patients with BD.
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Affiliation(s)
- Vahid Khosravani
- Clinical Research Development Center of Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | | | | | - Ali Amirinezhad
- Psychosocial Injuries Research Centre, Ilam University of Medical Sciences, Ilam, Iran
| | - Marziyeh Amini
- Clinical Psychology, Mohaghegh Ardebili University, Ardabil, Iran
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Körük S, Özabacı N. Şema Terapinin Depresif Bozuklukların Tedavisindeki Etkililiği: Bir Meta-Analiz. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2018. [DOI: 10.18863/pgy.361790] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Rhodes JE, Hackney SJ, Smith JA. Emptiness, Engulfment, and Life Struggle: An Interpretative Phenomenological Analysis of Chronic Depression. JOURNAL OF CONSTRUCTIVIST PSYCHOLOGY 2018. [DOI: 10.1080/10720537.2018.1515046] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- John E. Rhodes
- Department of Psychology and Sports Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Steve J. Hackney
- Department of Psychological Sciences, Birkbeck, University of London, London, United Kingdom
| | - Jonathan A. Smith
- Department of Psychological Sciences, Birkbeck, University of London, London, United Kingdom
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Chodkiewicz J, Gruszczynska E. Maladaptive Schemas Among People Addicted to Alcohol: Heterogeneity but not Specificity? Alcohol Alcohol 2018; 53:682-687. [PMID: 29982300 DOI: 10.1093/alcalc/agy047] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 06/12/2018] [Indexed: 11/12/2022] Open
Abstract
Aims Early maladaptive schemas described by Young theoretically underlie the development of psychopathology, including substance use. The key assumption is that the schemas do not act in isolation but create configurations that are, at least to a certain extent, distinctive for specific disorders. Thus, the aim of the current study was to examine whether a schema profile specific to alcohol addiction can be identified when compared to profiles obtained from a non-clinical sample. Short Summary Early maladaptive schemas are cognitive and behavioral patterns related to a wide spectrum of psychopathology, including alcohol addiction. However, the assumption that the configuration of schemas varies across disorders still needs verification. In the sample of alcohol-addicted people, only heterogeneity was noted, without any specific profile that may differentiate them from healthy adults. Methods The study included two samples: 108 alcohol-dependent patients beginning stationary treatment and 1529 healthy adults. All participants completed the Young Schema Questionnaire-Short Form 3 (YSQ-S3). Results Multiple-group latent profile analysis was used to compare clinical and non-clinical sample profiles. In both groups, four profiles were identified. These were similar in terms of schema means and variances across groups, differing only in size. Specifically, people addicted to alcohol were over-represented in the highest profile and under-represented in the lowest profile. Also, the only distinguishable difference between profiles was their height, not shape. Conclusion The findings indicate a heterogeneity but not specificity of maladaptive schema profiles within the studied sample of people addicted to alcohol.
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Affiliation(s)
- Jan Chodkiewicz
- Department of Preventive and Addiction Psychology, Institute of Psychology, University of Lodz, Smugowa Street 10/12, Lodz, Poland
| | - Ewa Gruszczynska
- Department of Health Psychology, Institute of Clinical Psychology, SWPS University of Social Sciences and Humanities, Chodakowska 19/31, Room N314, Warsaw, Poland
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38
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The Young Schema Questionnaire-Short Form: a Persian Version Among a Large Sample of Psychiatric Patients. Int J Ment Health Addict 2018. [DOI: 10.1007/s11469-018-9997-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Bolinski F, Hendriks GJ, Bardoel S, Hollon SD, Martell C, Huibers MJH. Cognitive Therapy or Behavioral Activation for Major Depressive Disorder in Dutch Mental Health Care: Pilot Effectiveness and Process Trial. Int J Cogn Ther 2018. [DOI: 10.1007/s41811-018-0027-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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40
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Davoodi E, Wen A, Dobson KS, Noorbala AA, Mohammadi A, Farahmand Z. Early maladaptive schemas in depression and somatization disorder. J Affect Disord 2018; 235:82-89. [PMID: 29655079 DOI: 10.1016/j.jad.2018.04.017] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 02/23/2018] [Accepted: 04/02/2018] [Indexed: 10/17/2022]
Abstract
Cognitive theories of depression posit that early maladaptive schemas (EMSs) are key vulnerability factors for psychological disorders. In this study, we investigated specific EMSs as shared or distinct cognitive vulnerability factors for depression and somatization disorder. The sample consisted of patients with Major depressive disorder (N = 30) and Somatization disorder (N = 30) from a community hospital or a psychiatric clinic. Participants completed the Structured Clinical Interview for DSM-IV (SCID), the Beck Depression Inventory-II (BDI-II), and the short form of the Young Schema Questionnaire (YSQ-SF). Depressed patients exhibited significantly higher levels of all five schema domains and specific maladaptive schemas, including emotional deprivation, mistrust and abuse, social isolation and alienation, defectiveness and shame, failure, subjugation, emotional inhibition, and insufficient self-control or self-discipline. Moreover, depressed patients exhibited significantly higher levels of social isolation, emotional inhibition, as well as the overvigilance and inhibition domain when depressive symptom severity was controlled. Our results provide preliminary evidence that specific EMSs distinguish patients with depression and somatization. Suggestions for future research include the need to have a non-psychiatric control group, to evaluate the absolute role of EMSs in Somatization Disorder.
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Affiliation(s)
- Elham Davoodi
- Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Iran
| | | | | | - Ahmad Ali Noorbala
- Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Iran
| | - Abolfazl Mohammadi
- Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Iran
| | - Zahra Farahmand
- Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Iran
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41
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Thummathai K, Sethabouppha H, Chanprasit C, Lasuka D. Depression Risk Assessment Tool for Adolescents. Arch Psychiatr Nurs 2018; 32:343-347. [PMID: 29784212 DOI: 10.1016/j.apnu.2017.11.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 11/05/2017] [Accepted: 11/18/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Kwaunpanomporn Thummathai
- Faculty of Nursing, Chiang Mai University, 110 Intawaroros Road, Muang District, Chiang Mai 50200, Thailand.
| | - Hunsa Sethabouppha
- Faculty of Nursing, Chiang Mai University, 110 Intawaroros Road, Muang District, Chiang Mai 50200, Thailand.
| | - Chawapornpan Chanprasit
- Faculty of Nursing, Chiang Mai University, 110 Intawaroros Road, Muang District, Chiang Mai 50200, Thailand.
| | - Duangrudee Lasuka
- Faculty of Nursing, Chiang Mai University, 110 Intawaroros Road, Muang District, Chiang Mai 50200, Thailand.
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Alimoradi B, Nejat H. Early Maladaptive schemas and Premenstrual syndrome in mothers with postpartum depression. PREVENTIVE CARE IN NURSING AND MIDWIFERY JOURNAL 2018. [DOI: 10.29252/pcnm.8.1.43] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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43
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Lewis G, Wen S, Pearson RM, Lewis G. The association between paternal depressogenic cognitive styles during pregnancy and offspring depressogenic cognitive styles: an 18-year prospective cohort study. J Child Psychol Psychiatry 2018; 59:604-614. [PMID: 29171666 PMCID: PMC5947551 DOI: 10.1111/jcpp.12847] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/13/2017] [Indexed: 12/04/2022]
Abstract
BACKGROUND Preventing the development of depressogenic or negative cognitive styles could also prevent the development of depression, a leading public health problem worldwide. Maternal negative cognitive styles are a modifiable risk factor for the development of negative cognitive styles in offspring. However, evidence on the role of paternal negative cognitive styles is inconclusive and there have only been a few small studies, which may also have lacked statistical power. METHODS We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC) to investigate the association between paternal negative cognitive styles, measured when mothers were 18 weeks pregnant, and offspring negative cognitive styles 18 years later (N = 6,123). Associations were calculated using linear regression models, before and after adjustment for confounders including maternal negative cognitive styles. We compared associations before and after controlling for depression in parents and offspring, and used multiple imputation to reduce biases that may have arisen due to missing data. RESULTS A two-standard deviation increase in paternal negative cognitive style was associated with a 3-point increase in offspring negative cognitive style (95% CI 1.36-4.37). This association remained after adjustment for confounders and was independent of depression in both parents and offspring. The effect size was equivalent to that of maternal negative cognitive style, and was also independent of maternal negative cognitive style. CONCLUSIONS Our results suggest that fathers should be included in individual- and family-based interventions designed to prevent the development of depressogenic cognitive styles in adolescent offspring. This could possibly also prevent the development of depression.
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Affiliation(s)
- Gemma Lewis
- Division of PsychiatryFaculty of Brain SciencesUniversity College LondonLondonUK
| | - Siying Wen
- Division of PsychiatryFaculty of Brain SciencesUniversity College LondonLondonUK
| | | | - Glyn Lewis
- Division of PsychiatryFaculty of Brain SciencesUniversity College LondonLondonUK
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44
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Saggino A, Balsamo M, Carlucci L, Cavalletti V, Sergi MR, da Fermo G, Dèttore D, Marsigli N, Petruccelli I, Pizzo S, Tommasi M. Psychometric Properties of the Italian Version of the Young Schema Questionnaire L-3: Preliminary Results. Front Psychol 2018; 9:312. [PMID: 29636710 PMCID: PMC5880909 DOI: 10.3389/fpsyg.2018.00312] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 02/26/2018] [Indexed: 11/29/2022] Open
Abstract
Schema Therapy (ST) is a well-known approach for the treatment of personality disorders. This therapy integrates different theories and techniques into an original and systematic treatment model. The Young Schema Questionnaire L-3 (YSQ-L3) is a self-report instrument, based on the ST model, designed to assess 18 Early Maladaptive Schemas (EMSs). During the last decade, it has been translated and validated in different countries and languages. This study aims to establish the psychometric properties of the Italian Version of the YSQ-L3. We enrolled two groups: a clinical (n = 148) and a non-clinical one (n = 918). We investigated the factor structure, reliability and convergent validity with anxiety and depression between clinical and non-clinical groups. The results highlighted a few relevant findings. Cronbach's alpha showed significant values for all the schemas. All of the factor models do not seem highly adequate, even if the hierarchical model has proven to be the most significant one. Furthermore, the questionnaire confirms the ability to discriminate between clinical and non-clinical groups and could represent a useful tool in the clinical practice. Limitations and future directions are discussed.
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Affiliation(s)
- Aristide Saggino
- School of Medicine and Health Sciences, Università degli Studi 'G. d'Annunzio' Chieti - Pescara, Chieti, Italy.,Center for the Study of Personality, Napoli, Italy
| | - Michela Balsamo
- School of Medicine and Health Sciences, Università degli Studi 'G. d'Annunzio' Chieti - Pescara, Chieti, Italy
| | - Leonardo Carlucci
- School of Medicine and Health Sciences, Università degli Studi 'G. d'Annunzio' Chieti - Pescara, Chieti, Italy
| | - Veronica Cavalletti
- IPSICO - Istituto di Psicologia e Psicoterapia Comportamentale e Cognitiva, Firenze, Italy
| | - Maria R Sergi
- School of Medicine and Health Sciences, Università degli Studi 'G. d'Annunzio' Chieti - Pescara, Chieti, Italy
| | - Giorgio da Fermo
- Azienda USL di Pescara, Pescara, Italy.,Centro di Psicologia Clinica, Pescara, Italy
| | - Davide Dèttore
- Department of Health Sciences, Florence University, Florence, Italy
| | - Nicola Marsigli
- IPSICO - Istituto di Psicologia e Psicoterapia Comportamentale e Cognitiva, Firenze, Italy
| | - Irene Petruccelli
- Department of Human Sciences and Society, Enna "Kore" University, Enna, Italy
| | - Susanna Pizzo
- Cognitive and Behavioral Therapy Institute, Padua, Italy
| | - Marco Tommasi
- School of Medicine and Health Sciences, Università degli Studi 'G. d'Annunzio' Chieti - Pescara, Chieti, Italy.,Center for the Study of Personality, Napoli, Italy
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Flink N, Honkalampi K, Lehto SM, Leppänen V, Viinamäki H, Lindeman S. Comparison of early maladaptive schemas between borderline personality disorder and chronic depression. Clin Psychol Psychother 2018; 25:532-539. [PMID: 29542265 DOI: 10.1002/cpp.2188] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 01/30/2018] [Accepted: 02/04/2018] [Indexed: 11/06/2022]
Abstract
Borderline personality disorder (BPD) and chronic depression (CD) are common and challenging mental disorders. Maladaptive cognitive schemas have been proposed to increase vulnerability to both disorders. In order to elucidate the role of maladaptive cognitive schemas in BPD and CD, this study compared psychiatric outpatients with BPD (N = 30) and CD (N = 30) in terms of early maladaptive schemas (EMSs). The groups were compared using the Young Schema Questionnaire short form-extended (YSQ-S2-extended) and the 15D health status questionnaire. BPD patients showed higher endorsement on the majority of EMSs, poorer social functioning, and greater concurrent distress than CD patients. However, after controlling for concurrent effects of psychological distress, the groups did not differ in 14 out of the 18 EMSs. These findings point to significant similarities in maladaptive beliefs between the 2 disorders and do not support broad, specific patterns of EMSs associated with either disorder. The results highlight the need for further study of the role of maladaptive schemas in the development and treatment of chronic mental disorders.
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Affiliation(s)
- Niko Flink
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland
| | - Kirsi Honkalampi
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland
| | - Soili M Lehto
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Virpi Leppänen
- City of Oulu, Social and Health Services, Mental Health Services, Oulu, Finland
| | - Heimo Viinamäki
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland
| | - Sari Lindeman
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Central Finland Health Care District, Jyväskylä Central Hospital, Jyväskylä, Finland
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46
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Are Schemas Passed on? A Study on the Association Between Early Maladaptive Schemas in Parents and Their Offspring and the Putative Translating Mechanisms. Behav Cogn Psychother 2018; 46:738-753. [DOI: 10.1017/s1352465818000073] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Background: According to Young's schema theory, Early Maladaptive Schemas (EMSs) arise due to the violation of core emotional needs during childhood. It seems likely that parents have difficulties in satisfying their children's emotional needs if they have high levels of EMSs themselves. Aims: This study investigated whether the extent of EMSs in parents is associated with the extent of EMSs in their offspring. Moreover, we tested for two putative mechanisms that account for this association: parental coping styles and parenting behaviour. Methods: Sixty dyads of parents (mother or father) and their adult children (N = 120), recruited from the general population, completed the Young Schema Questionnaire. The parents rated their schema coping styles and the children retrospectively rated the parenting of the participating parent. Results: As expected, parents' EMSs were significantly associated with EMSs in their offspring. This association was accounted for by the parental coping style Overcompensation and the adverse parenting that the child remembered. The parental coping style Avoidance did not account for the association. Conclusions: This study provides preliminary evidence for the notion that EMSs are passed on from one generation to the next via parental coping and parenting. Our findings thus support the assumption of schema theory that EMSs are connected to the family environment in terms of adverse parenting. If further confirmed, this has relevant implications for family-based interventions.
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Renner F, DeRubeis R, Arntz A, Peeters F, Lobbestael J, Huibers MJH. Exploring mechanisms of change in schema therapy for chronic depression. J Behav Ther Exp Psychiatry 2018; 58:97-105. [PMID: 29035800 DOI: 10.1016/j.jbtep.2017.10.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 09/13/2017] [Accepted: 10/03/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND OBJECTIVES The underlying mechanisms of symptom change in schema therapy (ST) for chronic major depressive disorder (cMDD) have not been studied. The aim of this study was to explore the impact of two potentially important mechanisms of symptom change, maladaptive schemas (proxied by negative idiosyncratic core-beliefs) and the therapeutic alliance. METHODS We drew data from a single-case series of ST for cMDD. Patients with cMDD (N = 20) received on average 78 repeated weekly assessments over a course of up to 65 individual sessions of ST. Focusing on repeated assessments within-individuals, we used mixed regression to test whether change in core-beliefs and therapeutic alliance preceded, followed, or occurred concurrently with change in depressive symptoms. RESULTS Changes in core-beliefs did not precede but were concurrently related to changes in symptoms. Repeated goal and task agreement ratings (specific aspects of alliance) of the same session, completed on separate days, were at least in part associated with concurrent changes in symptoms. LIMITATIONS By design this study had a small sample-size and no control group. CONCLUSIONS Contrary to what would be expected based on theory, our findings suggest that change in core-beliefs does not precede change in symptoms. Instead, change in these variables occurs concurrently. Moreover, alliance ratings seem to be at least in part colored by changes in current mood state.
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Affiliation(s)
- Fritz Renner
- MRC Cognition and Brain Sciences Unit, Cambridge, United Kingdom; Department of Clinical Psychological Science, Maastricht University, The Netherlands.
| | - Robert DeRubeis
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, United States
| | - Arnoud Arntz
- Department of Clinical Psychology, University of Amsterdam, The Netherlands
| | - Frenk Peeters
- Department of Psychiatry and Neuropsychology, University Hospital Maastricht, The Netherlands; School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands
| | - Jill Lobbestael
- Department of Clinical Psychological Science, Maastricht University, The Netherlands
| | - Marcus J H Huibers
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, United States; Department of Clinical Psychology, VU University Amsterdam, The Netherlands
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Popa CO, Rus AV, Skinner C, Jakab ZS. The Relation of Dysfunctional Cognitive Schemas and Personality Dimensions in Generalized Anxiety Disorder. ACTA MEDICA MARISIENSIS 2017. [DOI: 10.1515/amma-2017-0035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Objective: This study investigated whether differences exist in the structural personality dimensions and eighteen maladaptive cognitive schemas among in- and out-patients (Clinical Group) diagnosed with Generalized Anxiety Disorder (GAD) and people from the general population without any psychiatric diagnostic (Control Group).
Methods: The Generalized Anxiety Disorder (GAD) sample (N = 100) included 35 (35%) men and 65 (65%) women, with a mean age of 36.4 years (SD = 10.86; age range 18-69). The control sample (N = 100), included 28 (28%) men and 72 (72%) women, with a mean age of 27.1 years (SD = 9.8; age range 19-60). Data were simultaneously analyzed with one-way multivariate analysis of covariance (MANCOVA) to measure the effect of group membership on personality dimensions and on dysfunctional cognitive schemas, controlling for participants' age. Next, univariate analyses of covariance (ANCOVAs) were done on each item with covariate-adjusted post-hoc comparisons.
Results: The results indicate that the Clinical Group participants had unfavorable scores on all five personality dimensions (i.e., Openness, Extraversion; Conscientiousness; Agreeability; and Emotional Stability - Neuroticism) and for almost all of the dysfunctional cognitive schemas in comparison with participants in the Control Group.
Conclusions: These results have general implications in understanding Generalized Anxiety Disorder (GAD) clients and their personality characteristic's profile and dysfunctional/maladaptive cognitive schemas.
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Affiliation(s)
- Cosmin Octavian Popa
- University of Medicine and Pharmacy Tirgu Mures , Romania , Department of Ethics and Social Sciences
| | - Adrian V. Rus
- Southwestern Christian University , Department of Social and Behavioral Sciences , Bethany , OK, USA
| | - Cathleen Skinner
- Southwestern Christian University , Department of Social and Behavioral Sciences , Bethany , OK, USA
| | - Zsolt S. Jakab
- University of Medicine and Pharmacy Tirgu Mures , Department of Counseling and Career Guidance , Romania
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Bortolon C, Seillé J, Raffard S. Exploration of trauma, dissociation, maladaptive schemas and auditory hallucinations in a French sample. Cogn Neuropsychiatry 2017; 22:468-485. [PMID: 29023198 DOI: 10.1080/13546805.2017.1387524] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The main goal of the present study was to explore the associations between several key variables that have been shown to partially mediate the link between specific trauma exposure and auditory hallucinations (AH), that is, maladaptive schemas and dissociation in the general population. METHODS In total, 425 voluntary participants were recruited from the general population and completed online the Childhood Trauma Questionnaire, the Young schema questionnaire, the Dissociative Experiences Scale, and the Launay-Slade Hallucination Scale. Data were analysed using Partial Least Squares Structural Equation Modelling. RESULTS Our model showed that: (1) sexual and emotional abuse impact on AH both through the effect of maladaptive schemas and dissociation; (2) physical abuse impact on AH only through the effect of dissociation. More specifically, we found that four maladaptive schemas impact on AH: Abandonment, Vulnerability, Self-sacrifice and Subjugation. CONCLUSIONS Overall, our findings indicate that specific early maladaptive schemas may play a fundamental role in the association between exposure to trauma and auditory hallucination together with dissociation symptoms in the general population. Consequently, our study suggest considering maladaptive schemas as an important therapeutic target when working with individuals experiencing AH with or without a psychiatry disorder.
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Affiliation(s)
- Catherine Bortolon
- a Univ. Paul Valéry Montpellier 3 , Univ. Montpellier , Montpellier , EPSYLON EA 4556, F34000 , France.,b Department of Adult Psychiatry , CHU Montpellier , Montpellier , France
| | - Jade Seillé
- a Univ. Paul Valéry Montpellier 3 , Univ. Montpellier , Montpellier , EPSYLON EA 4556, F34000 , France
| | - Stéphane Raffard
- a Univ. Paul Valéry Montpellier 3 , Univ. Montpellier , Montpellier , EPSYLON EA 4556, F34000 , France.,b Department of Adult Psychiatry , CHU Montpellier , Montpellier , France
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50
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Khosravani V, Sharifi Bastan F, Samimi Ardestani M, Jamaati Ardakani R. Early maladaptive schemas and suicidal risk in an Iranian sample of patients with obsessive-compulsive disorder. Psychiatry Res 2017; 255:441-448. [PMID: 28686949 DOI: 10.1016/j.psychres.2017.06.080] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 06/23/2017] [Accepted: 06/26/2017] [Indexed: 12/22/2022]
Abstract
There are few studies on suicidal risk and its related factors in patients diagnosed with obsessive-compulsive disorder (OCD). This study investigated the associations of early maladaptive schemas, OC symptom dimensions, OCD severity, depression and anxiety with suicidality (i.e., suicidal ideation and suicide attempts) in OCD patients. Sixty OCD outpatients completed the Scale for Suicide Ideation (SSI), the Young Schema Questionnaire-Short Form (YSQ-SF), the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Dimensional Obsessive-Compulsive Scale (DOCS) and the Depression Anxiety Stress Scales (DASS-21). 51.7% of patients had lifetime suicide attempts and 75% had suicidal ideation. OCD patients with lifetime suicide attempts exhibited significantly higher scores on early maladaptive schemas than those without such attempts. Logistic regression analysis revealed that the mistrust/abuse schema and the OC symptom dimension of unacceptable thoughts explained lifetime suicide attempts. The mistrust/abuse schema, unacceptable thoughts and depression significantly predicted suicidal ideation. These findings indicated that the mistrust/abuse schema may contribute to high suicidality in OCD patients. Also, patients suffering from unacceptable thoughts need to be assessed more carefully for warning signs of suicide.
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Affiliation(s)
- Vahid Khosravani
- Clinical Research Development Center of Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | | | - Mehdi Samimi Ardestani
- Departments of Psychiatry, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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