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Dempsey RC, Dodd AL, Gooding PA, Jones SH. The Types of Psychosocial Factors Associated with Suicidality Outcomes for People Living with Bipolar Disorder: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:525. [PMID: 38791740 PMCID: PMC11120682 DOI: 10.3390/ijerph21050525] [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: 02/06/2024] [Revised: 04/19/2024] [Accepted: 04/20/2024] [Indexed: 05/26/2024]
Abstract
Bipolar Disorder is associated with high rates of suicidal thoughts, behaviors, and outcomes, yet the lived experience of suicidality and Bipolar Disorder is not particularly well understood. Understanding the role of psychosocial aetiologies in suicidality outcomes for those living with Bipolar Disorder is key for developing appropriately targeted interventions focusing on factors that are amenable to change. In line with PRISMA guidance, we conducted a scoping review to identify the types of psychosocial factors studied in relation to the experience of suicidality for people living with Bipolar Disorder diagnoses. Systematic literature searches identified a sample of 166 articles from which key study data were extracted and charted. A narrative synthesis of the reviewed literature is presented ordered by the factors investigated across studies, a frequency count of the types of psychological/social aetiologies studied, and a brief overview of the key findings for each aetiology. Most of the identified literature took the form of quantitative cross-sectional studies, with only one qualitative study and 18 quantitative prospective studies. The most studied aetiologies were trauma (specifically early adverse experiences and childhood traumas) and stressful life events, impulsivity (primarily subjective self-reported trait impulsivity), social support and functioning, and personality/temperament factors. Only six studies in the final sample reported basing their research questions and/or hypotheses on an explicit theoretical model of suicide. The literature was primarily focused on using self-report measurements of key aetiologies and on factors which lead to worsened suicidality rather than focusing on potentially protective or buffering factors. Future research needs to better justify the aetiologies investigated in relation to suicidality outcomes for people living with Bipolar Disorder, including a firmer basis in theory and hypothesis testing, more prospective designs, and the use of alternative assessments of psychosocial aetiologies in addition to self-report questionnaires.
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Affiliation(s)
- Robert C. Dempsey
- Department of Psychology, Faculty of Health and Education, Manchester Metropolitan University, Manchester M15 6BH, UK
| | - Alyson L. Dodd
- Department of Psychology, Faculty of Health & Life Sciences, Northumbria University, Newcastle upon Tyne NE1 8ST, UK
| | - Patricia A. Gooding
- Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK
| | - Steven H. Jones
- Spectrum Centre for Mental Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster LA1 4YW, UK
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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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Paula Milesi I, Moreno Ferro de Araújo R, Bücker J. Suicidal Behavior and Early Maladaptive Schemas and Schema Domains. J Nerv Ment Dis 2023; 211:514-518. [PMID: 36927820 DOI: 10.1097/nmd.0000000000001642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
ABSTRACT Suicidal behavior is a risk factor for suicide attempts. Identifying the factors that increase suicidal behavior risk is paramount for overall suicide prevention efforts. One model that may contribute to our understanding of the relationship between early life experiences and suicidal behavior is the schema theory. This study aimed to examine suicidal behavior, early maladaptive schemas (EMSs), and schema domains using a large Brazilian nonclinical sample. The study included 19,060 individuals. We assessed sociodemographic variables, suicidal behavior (Suicidal Behavior Questionnaire), and EMSs (Young Schema Questionnaire) using an online, Web-based survey. Our results showed that, when comparing participants with no ideation with those with serious suicide attempts, we found significant statistical differences in all EMSs (all p 's < 0.05), with higher scores in those with serious suicide attempts. Our results suggest that specific unmet emotional needs during childhood can affect mental health and result in serious suicide attempts in adulthood.
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Affiliation(s)
| | | | - Joana Bücker
- Postgraduate Program in Medicine, Universidade do Vale do Taquari, Lajeado, Brazil
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Faustino B, Pilkington P, Pascoal PM. Dialectical Core Schemas Mediate the Relationships Between Dissociative Experiences and Symptomatology in a Community Sample. Psychol Rep 2023:332941231175065. [PMID: 37217316 DOI: 10.1177/00332941231175065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
BACKGROUND Maladaptive cognitions about the self and others are associated with a wide array of dysfunctional responses and psychopathological symptoms in non-clinical and clinical samples. Dissociative experiences (e.g., depersonalization and derealization) as a coping response to stressful situations lie on a continuum from healthy to unhealthy but are generally elevated in individuals experiencing mental illness. However, the extent to which Dialectical Core Schemas explain the relationship between dissociative experiences and symptomatology is unclear. Therefore, this study aimed to investigate the mediating role of Dialectical Core Schemas on the relationship between dissociative experiences and symptomatology. METHODS A community sample of 179 participants were recruited (Mage = 21.2 years, SD = 8.2). Data were gathered through self-report questionnaires using a cross-sectional design. RESULTS Maladaptive core schemas about self and others correlated positively with all dissociative experiences (e.g., depersonalization/derealization, amnesia), while adaptive core schemas about the self correlated negatively with depersonalization/derealization and distractibility. Maladaptive core schemas mediated the relationship between dissociative experiences and symptomatology. CONCLUSIONS The relationships between dissociative experiences and symptomatology are bi-directional. Exploring the mediating factors may help clinicians and researchers better understand how to enhance case conceptualization and clinical decision-making.
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Affiliation(s)
- Bruno Faustino
- Lusófona University, HEI-Lab: Digital Human-Environment Interaction Labs, Portugal
- Faculdade de Psicologia da Universidade de Lisboa, Lisboa, Portugal
| | | | - Patrícia M Pascoal
- Lusófona University, HEI-Lab: Digital Human-Environment Interaction Labs, Portugal
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Yang Y, Fletcher K, Murray G. A narrative review of cross-sectional and prospective associations between self-schemas and bipolar disorder. Clin Psychol Psychother 2021; 28:766-783. [PMID: 33386678 DOI: 10.1002/cpp.2547] [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: 12/01/2020] [Accepted: 12/16/2020] [Indexed: 01/03/2023]
Abstract
The role of self-concept in bipolar disorder (BD) has not been well understood. The present review utilizes the notion of self-schema and interrogates existing research concerning evidence for cross-sectional and prospective associations between four schema-like constructs (i.e. trait self-esteem, dysfunctional beliefs concerning contingent self-worth, early maladaptive schemas and implicit self-esteem) and various facets of BD. Existing findings demonstrate various types of involvement of self-schemas in BD. Of particular clinical relevance, the present review suggests that low trait self-esteem and dysfunctional beliefs concerning contingent self-worth are risk factors for ongoing BD symptoms and mood episodes. The present review also yields important yet unaddressed questions with respect to the evaluative content of self-schemas associated with the hypo/manic phase of BD.
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Affiliation(s)
- Yan Yang
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, Australia
| | - Kathryn Fletcher
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, Australia
| | - Greg Murray
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, Australia
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Pilkington P, Younan R, Bishop A. Early maladaptive schemas, suicidal ideation, and self-harm: A meta-analytic review. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2020.100051] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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Munuera C, Roux P, Weil F, Passerieux C, M'Bailara K. Determinants of the remission heterogeneity in bipolar disorders: The importance of early maladaptive schemas (EMS). J Affect Disord 2020; 277:857-868. [PMID: 33065827 DOI: 10.1016/j.jad.2020.08.079] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 07/16/2020] [Accepted: 08/25/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND A crucial health issue is to understand the remission heterogeneity of Bipolar Disorders by considering symptomatology as well as functioning. A new perspective could be elements of the construction of individual identity. This exploratory study aimed to explore the remission heterogeneity of patients with BD in terms of Early Maladaptive Schemas (EMS) by preferring a person-oriented approach. METHODS This study included euthymic patients recruited into the FACE-BD cohort. The remission was assessed by the Montgomery-Asberg Depression Rating Scale and the Young Mania Rating Scale for its symptomatic dimension and by the Functioning Assessment Short Test for its functional dimension. The activation of the eighteen EMS was assessed by the Young Schema Questionnaire 3 Short Form. Clustering was performed to identify profiles according to the patients' remission. Clusters identified were compared on the EMS activation by using analysis of variance and post-hoc tests. RESULTS Among the 100 euthymic patients included, four profiles of remission were identified: cluster 1 "Global Remission" (34%), cluster 2 "Hypomanic residual" (20%), cluster 3 "Depressive residual and functional impairment" (36%) and cluster 4 "Global handicap" (10%). Two out of three EMS discriminated against these profiles. The activation of specific EMS clarifies the singularity of each remission profile. LIMITATIONS For the symptomatic dimension, cut-offs chosen could be discussed as well as the scale assessing residual depressive symptoms. CONCLUSIONS This study participates in a comprehensive model of remission by integrating the symptomatology, the functioning, and the EMS. Identifying and treating EMS may improve patients remission to reach recovery.
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Affiliation(s)
- Caroline Munuera
- Laboratoire de psychologie, EA4139, Université́ de Bordeaux, 3ter place de la Victoire, Bordeaux, France
| | - Paul Roux
- Réseau des Centres Expert des Troubles Bipolaires, Fondation FondaMental, 40 rue de Mesly, Créteil, France; Service Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie, Centre Hospitalier de Versailles, 177 rue de Versailles, 78157 Le Chesnay, France; Laboratoire HANDIReSP, EA4047, Université de Versailles Saint-Quentin-En-Yvelines, 2 Avenue de la Source de la Bièvre, 78180 Montigny-le-Bretonneux; CESP, Team "Developmental Psychiatry", Université Paris-Saclay, Inserm, 12 Avenue Paul Vaillant Couturier, 94807, Villejuif
| | - François Weil
- Réseau des Centres Expert des Troubles Bipolaires, Fondation FondaMental, 40 rue de Mesly, Créteil, France; Service Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie, Centre Hospitalier de Versailles, 177 rue de Versailles, 78157 Le Chesnay, France; Laboratoire HANDIReSP, EA4047, Université de Versailles Saint-Quentin-En-Yvelines, 2 Avenue de la Source de la Bièvre, 78180 Montigny-le-Bretonneux
| | - Christine Passerieux
- Réseau des Centres Expert des Troubles Bipolaires, Fondation FondaMental, 40 rue de Mesly, Créteil, France; Service Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie, Centre Hospitalier de Versailles, 177 rue de Versailles, 78157 Le Chesnay, France; Laboratoire HANDIReSP, EA4047, Université de Versailles Saint-Quentin-En-Yvelines, 2 Avenue de la Source de la Bièvre, 78180 Montigny-le-Bretonneux; CESP, Team "Developmental Psychiatry", Université Paris-Saclay, Inserm, 12 Avenue Paul Vaillant Couturier, 94807, Villejuif
| | - Katia M'Bailara
- Laboratoire de psychologie, EA4139, Université́ de Bordeaux, 3ter place de la Victoire, Bordeaux, France; Centre Hospitalier Charles Perrens, Pôle 3-4-7, Bordeaux, 121 rue de la Béchade, Bordeaux, France; Réseau des Centres Expert des Troubles Bipolaires, Fondation FondaMental, 40 rue de Mesly, Créteil, France.
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Munuera C, Weil F, Minois I, Zanouy L, Gard S, Roux P, M'Bailara K. [Exploring Early Maladaptative Schema (EMS) in adults with bipolar disorder: A systematic review of the scientific literature]. Encephale 2019; 46:65-77. [PMID: 31767255 DOI: 10.1016/j.encep.2019.09.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 09/10/2019] [Accepted: 09/16/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Clinical heterogeneity during euthymic states is a crucial issue in bipolar disorders. Indeed, actual data are not sufficient to understand why some patients are unharmed by subthreshold symptoms and have functional impairments whereas others have a functional remission but have subthreshold symptoms. Based on the Ball model, cognitive and schematic vulnerability interact with genetic vulnerability and trigger affective symptoms with the intervention of stressful life events. Furthermore, according to this model, adjustment and adaptation to illness assessed by functional outcome and illness experience are associated with this cognitive and schematic vulnerability. So, theoretical arguments support that childhood adversity and temperamental deregulation characterize patients with bipolar disorders. Thus, the aim of this study is to systematically review studies of Early Maladaptive Schemas in bipolar disorder, to determine whether Early Maladaptive Schemas have specificity in bipolar disorder in comparison with other populations, and to identify which Early Maladaptive Schemas could be activated. The challenge of this review is to identify if the taking of early maladaptive schemas into account could allow us to better identify, understand and manage bipolar disorders. METHODS This systematic review was led according to the Preferred Reporting Items for Systematic review and Meta-Analysis statement on the electronic databases Cochrane, PsycArticles, Psychology and Behavioral Sciences Collection, PsycInfo, PubMed, ScienceDirect and Scopus with « early maladaptive schemas » AND « bipolar disorder » as keywords. Only studies meeting eligibility criteria concerning publication status, language, population and outcomes were included after several screenings on basis of title, abstract and full-text. Then, we carried out data extraction in accordance with criteria defined in principle (about characteristics of participants, objectives, materiel and methods, principle results and bias). RESULTS Among 39 records identified, a total of 10 studies met eligibility criteria for inclusion in this review. Synthesizing findings across the studies revealed three important topics. First, early maladaptive schemas appear as potential cognitive characteristics that clinicians have to investigate in clinical practice. Indeed, patients with bipolar disorders present greater activation of the early maladaptive schemas in comparison with people who have no disorder. This point supports the first part of Ball's theoretical model that considers schemas as a vulnerability to bipolarity. Secondly, early maladaptive schemas are relevant to distinguish bipolar disorders from unipolar depression and borderline personality disorder. A greater and a lower activation are respectively identified among bipolar disorders. Thirdly, supporting the second part of Ball's model, early maladaptive schemas play a key role in recovery regarding their impact on the course of bipolarity, in particular on suicidality and functional impairment. Finally, these dysfunctional schemas allow us to understand the clinical heterogeneity of bipolar disorder, and among others, about the type of bipolarity. These results have several implications, but there are some limits in this systematic review. First, no French study has been done. Then, reduced sample sizes in these studies increased the risk to conclude wrongly to an activation difference between groups. Furthermore, probably due to the variety of methods and populations, we could not identify an homogeneous pattern of early activated maladaptive schemas. Overall, scientific approaches used in these studies are based on statistical models using mean and standard deviation. These types of statistical analyses are the main limit because they cannot represent the heterogeneity of early maladaptive schemas profiles. CONCLUSIONS Schema theory proves to be a relevant approach in bipolar disorders, and early maladaptive schemas appear to be important to take into account in clinical practice. Nevertheless, in order to propose schemas therapy appropriately, it is necessary to specify if early maladaptive schemas are activated and to specify therapeutic indications because of clinical heterogeneity. Moreover, data do not yet allow us to understand the disparity of profiles during the inter-episode period. Indeed, a French research perspective is being considered that will prefer a person-oriented approach.
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Affiliation(s)
- C Munuera
- Laboratoire de psychologie, EA4139, Université de Bordeaux, 3(ter) place de la Victoire, 33076 Bordeaux, France
| | - F Weil
- Réseau des Centres Expert des Troubles Bipolaires, Fondation FondaMental, 40, rue de Mesly, 94000 Créteil, France; Service Universitaire de Psychiatrie d'Adultes, Centre Hospitalier de Versailles, 177, rue de Versailles, 78157 Le Chesnay, France; Laboratoire HANDIReSP, EA4047, Université de Versailles Saint-Quentin-En-Yvelines, 2, avenue de la Source de la Bièvre, 78180, Montigny-le-Bretonneux, France
| | - I Minois
- Centre Hospitalier Charles Perrens, Pôle 3-4-7, Bordeaux, 121, rue de la Béchade, 33076 Bordeaux, France; Réseau des Centres Expert des Troubles Bipolaires, Fondation FondaMental, 40, rue de Mesly, 94000 Créteil, France
| | - L Zanouy
- Centre Hospitalier Charles Perrens, Pôle 3-4-7, Bordeaux, 121, rue de la Béchade, 33076 Bordeaux, France; Réseau des Centres Expert des Troubles Bipolaires, Fondation FondaMental, 40, rue de Mesly, 94000 Créteil, France
| | - S Gard
- Centre Hospitalier Charles Perrens, Pôle 3-4-7, Bordeaux, 121, rue de la Béchade, 33076 Bordeaux, France; Réseau des Centres Expert des Troubles Bipolaires, Fondation FondaMental, 40, rue de Mesly, 94000 Créteil, France
| | - P Roux
- Réseau des Centres Expert des Troubles Bipolaires, Fondation FondaMental, 40, rue de Mesly, 94000 Créteil, France; Service Universitaire de Psychiatrie d'Adultes, Centre Hospitalier de Versailles, 177, rue de Versailles, 78157 Le Chesnay, France; Laboratoire HANDIReSP, EA4047, Université de Versailles Saint-Quentin-En-Yvelines, 2, avenue de la Source de la Bièvre, 78180, Montigny-le-Bretonneux, France
| | - K M'Bailara
- Laboratoire de psychologie, EA4139, Université de Bordeaux, 3(ter) place de la Victoire, 33076 Bordeaux, France; Centre Hospitalier Charles Perrens, Pôle 3-4-7, Bordeaux, 121, rue de la Béchade, 33076 Bordeaux, France; Réseau des Centres Expert des Troubles Bipolaires, Fondation FondaMental, 40, rue de Mesly, 94000 Créteil, France.
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Azadi S, Khosravani V, Naragon-Gainey K, Bastan FS, Mohammadzadeh A, Ghorbani F. Early Maladaptive Schemas Are Associated with Increased Suicidal Risk among Individuals with Schizophrenia. Int J Cogn Ther 2019. [DOI: 10.1007/s41811-019-00046-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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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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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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Frías Á, Navarro S, Palma C, Farriols N, Aliaga F, Salvador A, Aluco E, Martínez B, Solves L. Early maladaptive schemas associated with dimensional and categorical psychopathology in patients with borderline personality disorder. Clin Psychol Psychother 2017; 25:e30-e41. [DOI: 10.1002/cpp.2123] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 07/06/2017] [Accepted: 07/18/2017] [Indexed: 01/19/2023]
Affiliation(s)
- Álvaro Frías
- Facultad de Psicologia, Ciencias de la Educación y el Deporte Blanquerna; University of Ramon-Llull; Barcelona Spain
- Consorci Sanitari del Maresme. Department of Psychiatry; Hospital of Mataró; Mataró Spain
| | - Sara Navarro
- Facultad de Psicologia, Ciencias de la Educación y el Deporte Blanquerna; University of Ramon-Llull; Barcelona Spain
| | - Carol Palma
- Facultad de Psicologia, Ciencias de la Educación y el Deporte Blanquerna; University of Ramon-Llull; Barcelona Spain
- Consorci Sanitari del Maresme. Department of Psychiatry; Hospital of Mataró; Mataró Spain
| | - Núria Farriols
- Facultad de Psicologia, Ciencias de la Educación y el Deporte Blanquerna; University of Ramon-Llull; Barcelona Spain
- Consorci Sanitari del Maresme. Department of Psychiatry; Hospital of Mataró; Mataró Spain
| | - Ferrán Aliaga
- Facultad de Psicologia, Ciencias de la Educación y el Deporte Blanquerna; University of Ramon-Llull; Barcelona Spain
- Consorci Sanitari del Maresme. Department of Psychiatry; Hospital of Mataró; Mataró Spain
| | - Ana Salvador
- Facultad de Psicologia, Ciencias de la Educación y el Deporte Blanquerna; University of Ramon-Llull; Barcelona Spain
- Consorci Sanitari del Maresme. Department of Psychiatry; Hospital of Mataró; Mataró Spain
| | - Elena Aluco
- Facultad de Psicologia, Ciencias de la Educación y el Deporte Blanquerna; University of Ramon-Llull; Barcelona Spain
| | - Bárbara Martínez
- Consorci Sanitari del Maresme. Department of Psychiatry; Hospital of Mataró; Mataró Spain
| | - Laia Solves
- Consorci Sanitari del Maresme. Department of Psychiatry; Hospital of Mataró; Mataró Spain
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Early maladaptive schemas of emotional deprivation, social isolation, shame and abandonment are related to a history of suicide attempts among patients with major depressive disorders. Compr Psychiatry 2017. [PMID: 28636896 DOI: 10.1016/j.comppsych.2017.05.008] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Patients with psychiatric disorders have an exceptionally high risk of completed or attempted suicide. This holds particularly true for patients with major depressive disorders. The aim of the present study was to explore whether patients with major depressive disorders (MDD) and a history of suicide attempts differed in their early maladaptive schemas from patients with MDD but without such a history or from healthy controls. METHOD Ninety participants took part in the study. Of these, 30 were patients with MDD who had made a recent suicide attempt; 30 were patients with MDD but no suicide attempts, and 30 were gender- and age-matched healthy controls. Participants completed questionnaires covering socio-demographic characteristics and the Young Schema Questionnaire (YSQ- RE2R) to assess early maladaptive schemas. Experts rated patients' MDD with the Montgomery-Asberg Depression Rating Scale. RESULTS Patients did not differ in experts' ratings of symptoms of depression. Compared to healthy controls, patients with MDD recorded higher scores on maladaptive schemas such as recognition seeking, negativity/pessimism, and insufficient self-control. Compared to patients without suicide attempts and healthy controls, those who had made a suicide attempt had higher scores on dimensions such as failure, mistrust, emotional inhibition, social isolation, and abandonment/instability. CONCLUSION Compared to healthy controls, patients with MDD had more pronounced maladaptive schemas, but this was more marked in patients with a history of suicide attempts. The results suggest that suicide attempts and poorer psychological functioning are related.
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Flink N, Lehto S, Koivumaa-Honkanen H, Viinamäki H, Ruusunen A, Valkonen-Korhonen M, Honkalampi K. Early maladaptive schemas and suicidal ideation in depressed patients. EUROPEAN JOURNAL OF PSYCHIATRY 2017. [DOI: 10.1016/j.ejpsy.2017.07.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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