Sources of Emotional Maltreatment and the Differential Development of Unconditional and Conditional Schemas

Schema theory posits that experiences of maltreatment result in the early development of maladaptive schemas (EMS; Young, Klosko, & Weishaar, 2003, Schema therapy: A practitioner's guide, The Guilford Press: New York, NY). EMS are organized by conditionality; unconditional schemas are theorized to develop early in childhood predominantly in response to experiences of parenting and conditional schemas are theorized to develop later in life in response to other relationships. Despite this distinction, minimal previous research has investigated their differential development. The current study examined the relative contributions of parental and other (peer and intimate partner) emotional maltreatment (EMT) in the differential development of unconditional and conditional schemas. Ninety-seven undergraduate students retrospectively reported their maltreatment experiences using the Lifetime Experiences Questionnaire and completed the Young Schema Questionnaire to measure EMS. Consistent with hypotheses, parental EMT was the strongest predictor of unconditional schemas. Unexpectedly, parental EMT also emerged as the strongest predictor of conditional schemas. Theoretical and clinical implications of these findings are discussed.     

Link between early maladaptive schemas and defense mechanisms

IntroductionDefense mechanism and early maladaptive schemas are two concepts distorting the perception of reality.ObjectiveThe aim of this study was to explore the link between two reality-distorting concepts from two theoretical models: early maladaptive schemas from the cognitive and behavioral model and defense mechanisms based on the psychoanalytic model.MethodTwo hundred thirty-two non-clinical participants completed the Defense Style Questionnaire and the Young Schema Questionnaire (short version). Then a Bravais Pearson correlation analysis connecting these two concepts, and a multiple regressions analysis using early maladaptive schemas as predictors for defense style mechanisms levels were conducted.ResultsThe results indicate that 2 early maladaptive schema domains (i.e. other-directedness as well as over-vigilance and inhibition) predict the frequency of use of the neurotic defense mechanism, and 3 schema domains (i.e. disconnection and rejection, impaired autonomy and performances as well as impaired limits) predict the frequency of use of the immature defense mechanism.ConclusionTo conclude, two psychological concepts based on two different theoretical models (psychoanalytic and cognitive and behavioral therapy) seem to share an important link justifying the use of integrative therapies such as schema therapy.     

Teasing Experiences,Interpersonal Sensitivity,Self-Schema and Psychological Distress in Youth: an Exploratory Study

The present study as aimed at exploring peer victimization (teasing) experiences, interpersonal sensitivity, self-schemas and psychological distress in youth. The sample consisted of 231 male and female participants who met specified criteria. Participants completed The Teasing Questionnaire-Revised, Teasing Checklist, Interpersonal Sensitivity Measure, General Health Questionnaire- 28 and Self- Schema Questionnaire. In addition, an open ended question was included to obtain data on teasing experiences. The results showed that the appearance related teasing was reported to be the highest, with more females than males reporting teasing experiences on this domain. Teasing experiences in the domains of performance, social behavior, family and appearance were positively related to psychological distress. Interpersonal sensitivity and self-schema were positively correlated with distress and there was a significant difference between distressed and non-distressed participants on these measures. On IPSM, the need for approval was higher in females whereas fragile inner self was higher in males. Self-efficacy on Self Schema Questionnaire (SSQ), Separation Anxiety (IPSM), Social behavior (TQ) and Teasing Checklist were found to be significant predictors of psychological distress, accounting for 29 % of the variation in psychological distress. Teasing experiences is a significant predisposing factor for psychological distress. Our findings have important clinical implications in understanding early teasing experiences in the development of psychological and emotional disorders.     

Exploring Sexual Minority Women’s Experiences of External and Internalized Heterosexism and Sexism and their Links to Coping and Distress

This study examined experiences of external and internalized heterosexism and sexism and their links to coping styles and psychological distress among 473 sexual minority women. Using an online sample of United States lesbian and bisexual women, the findings indicated that many participants experienced heterosexist and sexist events at least once during the past 6 months, and a number of participants indicated some level of internalized oppression. Supporting an additive multiple oppression perspective, the results revealed that when examined concurrently heterosexist events, sexist events, internalized heterosexism, and internalized sexism were unique predictors of psychological distress. In addition, suppressive coping and reactive coping, considered to be maladaptive coping strategies, mediated the external heterosexism-distress, internalized heterosexism-distress, and internalized sexism-distress links but did not mediate the external sexism-distress link. Reflective coping, considered to be an adaptive coping strategy, did not mediate the relations between external and internalized heterosexism and sexism and psychological distress. Finally, the variables in the model accounted for 54 % of the variance in psychological distress scores. These findings suggest that maladaptive but not adaptive coping strategies help explain the relationship between various oppressive experiences and psychological distress.     

Self-referential schemas and attentional bias predict severity and naturalistic course of depression symptoms

Attentional bias and self-referential schemas have been observed in numerous cross-sectional studies of depressed adults and are theorised to maintain negative mood. However, few longitudinal studies have examined whether maladaptive cognition predicts the course of depressive symptoms. Fifty-seven adults with elevated depression symptoms were assessed for negative attentional bias using a dot-probe task with eye-tracking and self-referential schemas using a self-referent encoding task. Participants subsequently completed five weekly depression symptom assessments. Participants with more negative self-referential schemas had higher baseline depression symptoms (r?=?.55). However, participants who spent more time attending to negative words showed greater symptom worsening over time (r?=?.42). The findings for negative self-referential schemas replicate past research, while the findings for negative attention bias represent the first evidence showing that attentional biases predict naturalistic symptom course. This work suggests that negative attention biases maintain depression symptoms and represent an important treatment target for neurocognitive therapeutics.     

Changes in schemas of patients with severe borderline personality disorder: The Oulu BPD study

Borderline personality disorder (BPD) is a relatively common and severe psychiatric disorder that can impair quality of life in many ways. The aim of this study was to determine whether a combined treatment model for BPD patients, utilising major principles from schema‐focused therapy (SFT) and dialectical behavioral therapy (DBT), could be more effective in relieving early maladaptive schemas of BPD patients, compared to treatment as usual (TAU). This study is a part of the Oulu BPD study conducted at mental health care services run by Oulu city social and health care services. The study is a multisite, randomized controlled trial conducted over a one year period, involving two groups of patients with severe BPD: (1) Community Treatment By Experts (CTBE) patients (n = 18) receiving the combined treatment model, and 2) TAU patients (n = 27). The patients' schemas were assessed using the Young Schema Questionnaire (YSQ‐L3a) before and after one year of treatment. The results reveal that CTBE patients who attended the combined treatment model showed a statistically significant reduction in eight out of 18 early maladaptive schemas, while patients receiving treatment as usual did not demonstrate any significant changes in schemas. The cognitive therapeutic treatment model can be applied for clinical use in public mental health settings using existing professionals, and appears to produce positive changes in patients with BPD.     

Ruminative self-focus, negative life events, and negative affect

Ruminative thinking is believed to exacerbate the psychological distress that follows stressful life events. An experience-sampling study was conducted in which participants recorded negative life events, ruminative self-focus, and negative affect eight times daily over one week. Occasions when participants reported a negative event were marked by higher levels of negative affect. Additionally, negative events were prospectively associated with higher levels of negative affect at the next sampling occasion, and this relationship was partially mediated by momentary ruminative self-focus. Depressive symptoms were associated with more frequent negative events, but not with increased reactivity to negative events. Trait rumination was associated with reports of more severe negative events and increased reactivity to negative events. These results suggest that the extent to which a person engages in ruminative self-focus after everyday stressors is an important determinant of the degree of distress experienced after such events. Further, dispositional measures of rumination predict mood reactivity to everyday stressors in a non-clinical sample.     

Early Maladaptive Schemas as Moderators of the Impact of Stressful Events on Anxiety and Depression in University Students

The aim of this study was to test the effects of early maladaptive schemas (EMS) derived from the Schema Therapy model (Young 1999) according to the diathesis-stress paradigm. We expected that EMS would make students more vulnerable to symptoms of depression and anxiety in the presence of stressful events and that the effects of these schemas would be different for each symptom. In particular, it was hypothesised that abandonment, emotional deprivation, defectiveness, and failure schemas would interact with stressful events to predict depressive symptoms, whereas abandonment, vulnerability to harm, and dependence schemas were expected to moderate anxiety symptoms. Due to gender differences in EMS and depressive and anxiety symptoms, we also expected that sex would act as a moderator of the relationships between EMS and symptoms. A two-wave prospective study showed that the presence of EMS constitutes a vulnerability factor for both, depressive and anxiety symptoms, and this effect was also moderated by sex. Moreover, the EMS’s content specificity revealed which schemas were more relevant to each symptom, providing valuable information for prevention and intervention programmes.     

图式治疗理论与实践

由于传统认知行为疗法治疗人格障碍面临许多问题和挑战,Young在认知行为疗法的基础上创建了图式治疗。图式治疗关注患者的早期适应不良图式和适应不良的应对方式,并通过一系列治疗策略,帮助患者改变早期适应不良图式,形成更健康的行为方式。图式治疗是在传统认知行为疗法的基础上,结合依恋理论、客体关系理论、格式塔理论和建构主义理论的整合治疗模型,其整合的优势为今后的发展带来很大空间     

大学生亲密恐惧的图式干预研究

为研究图式治疗对大学生亲密恐惧的临床疗效,以54名有亲密恐惧问题的大学生为被试,采用支持咨询和图式治疗对比的实验研究,对疗效评估的各项指标进行了重复测量(前测、后测和追踪测量)的方差分析。结果表明干预后图式组亲密恐惧以及情感剥夺、缺陷/羞耻、伤害/疾病的易感性、情感抑制等四个适应不良图式都显著低于支持组,而且干预后图式组人际功能和适应功能等两项心理治疗效果评估指标都显著高于支持组。结论:图式治疗比支持支持咨询能更有效地减轻大学生亲密恐惧。     

Adjustment in aging: the roles of life stress, hassles, and self-efficacy

This study examines the relationship of life stress, daily hassles, and perceived self-efficacy to adjustment in a community sample of 32 men and 32 women between ages 65 and 75. In a structured interview, negative life change events, daily hassles, self-efficacy, depression, psychosomatic symptoms, and negative well being were assessed. Both negative life events and daily hassles were related to psychological distress and physical symptoms for men, and hassles were associated with psychological distress and physical symptoms for women. An inverse relationship between self-efficacy and maladjustment was also found. Hassles showed the most powerful relationship to distress.     

The relationship between neuroticism and night eating: exploring the mediating roles of psychological distress and maladaptive coping

Night Eating Syndrome has been shown to be associated with various negative physical and psychological consequences. This study explored the relationship between neuroticism and night eating, which had not been studied before. We also examined the possible mediating roles of psychological distress and maladaptive coping for the relationship between neuroticism and night eating. A sample of 578 Chinese college students were assessed on several measures: The Revised Eysenck Personality Questionnaire Short Scale, the Night Eating Questionnaire, the Depression Anxiety Stress Scales, and the Simplified Coping Style Questionnaire. Results indicated that neuroticism was significantly and positively related to night eating (r = .38, p < .01), and the relationship between neuroticism and night eating was partially mediated by psychological distress, but not by maladaptive coping. The results not only revealed a medium-sized relationship between neuroticism and night eating, but also pointed out the importance of psychological distress as related to the relationship between neuroticism and night eating. Unlike neuroticism, which is a personality trait, psychological distress is an emotional state, and it is much more malleable through appropriate intervention. The treatment and intervention for night eating may benefit from our attention to the psychological distress.     

Sense of coherence, negative life events and appraisal of physical health among university students

We examined the stress-buffering effects of the ‘sense of coherence' among 116 undergraduates (70 females and 46 males) with a mean age of 18.6 years. Self-reported physical well-being and psychological distress were assessed on two occasions separated by two months. Assessment of the sense of coherence occurred at time-one, whereas assessment of negative life-events for the past year occurred at time-two. Sense of coherence correlated negatively with negative life events and reported psychological symptoms of both occasions, and negative life events correlated positively with both assessments of psychological distress. Negative life events correlated positively with physical ailments reported for both occasions only among students low in sense of coherence; this significant correlation persisted after accounting for the relationship between psychological and physical symptoms. We discuss the possible salubrious effects of a sense of coherence on the health appraisals of young adults experiencing stress.     

Self-cognitions,stressful events,and the prediction of depression in children of depressed mothers

In a preliminary effort to integrate cognitive, life stress, and interpersonal approaches to vulnerability to depression, children's cognitions about themselves, their stressful life events, and the interaction of self-cognitions and life events were tested as predictors of depression. Children of normal, medically ill, and bipolar and unipolar depressed mothers were assessed initially and 6 months later for diagnostic status using the Kiddie-SADS interview. As predicted, Piers-Harris self-concept scores and interview-assessed children's stressful life events significantly predicted changes in depression status over the 6-month follow-up. Stressors and the interaction of stressors and self-concept also predicted changes in diagnosis of nonaffective disorders. A self-schema measure of accessibility of negative self-cognitions, known to be mood-dependent, failed to add to the prediction of depression severity. The results are consistent with a model of depression vulnerability that emphasizes cognition about self-worth and self-efficacy as mediators of the impact of stressful events, and we speculate that such self-schemas are acquired in part in the context of parent-child relationships. Recommendations are given for further studies of the acquisition and the mechanisms of self-schemas.This research was supported by an award from the William T. Grant Foundation. The assistance of Cheri Adrian, Dorli Burge, David Gordon, Donald Hiroto, Carol Jaenicke, our research staff, and cooperating agencies is gratefully acknowledged.     

Maladaptive Parenting,Temperament, Early Maladaptive Schemas,and Depression: A Moderated Mediation Analysis

According to the Schema Therapy Model, maladaptive parenting styles interact with a child’s unique temperament in the development of early maladaptive schemas (EMSs), which in turn increase one’s risk for developing pathology. However, few authors have examined the comprehensive model. The purpose of this study was to assess the indirect effect of perceived parenting styles on depressive symptoms through EMSs. Furthermore, a series of moderated mediation analyses were conducted to examine whether the indirect effect varies as a function of temperament. A total of 403 undergraduate students completed measures of perceived parenting experiences, temperament, EMSs, and depressive symptoms. Results indicated that the schema domains of disconnection/rejection and impaired autonomy mediated the relationship between perceived parenting styles and depressive symptoms. Moderation of the indirect effect was only found in two of the twelve tested models. This study lends partial support to the Schema Therapy model and also offers a new way of looking at the interactive nature of the constructs.     

Investigation of adaptive and maladaptive perfectionism with Turkish Almost Perfect Scale-Revised

The present study examined the factor structure of the Turkish Almost Perfect Scale-Revised to identify adaptive and maladaptive perfectionists and non-perfectionists and examined whether the participants (N= 383) in these groups differed on a measure of psychological distress. A confirmatory factor analysis of the Turkish Almost Perfect Scale-Revised yielded three subscales: High Standards, Order, and Discrepancy. A cluster analysis identified adaptive perfectionists, maladaptive perfectionists, and non-perfectionists and these groups were found to be significantly different from each other on a measure of psychological distress.     

Early maladaptive schemas in personality disordered individuals

The present study aimed to examine the specificity of schema domains in three personality disorder (PD) groups, namely borderline (BPD), obsessive-compulsive (OCPD), and avoidant PD (AvPD), and to correctly identify the three PD groups on the basis of these schemas. The sample consisted of 48 clinical participants diagnosed with PDs and assigned to 1 of 3 groups on the basis of their Axis II diagnoses (BPD: n = 13; OCPD: n = 13; AvPD: n = 22). High scores on Dependence/Incompetence, Defectiveness/ Shame and Abandonment were found for the BPD group. Such pattern appears to be most consistent with Young's theory of BPD. Consistent with the theory and empirical findings of Beck et al. (1990, 2001), OCPD was associated with elevations on the Unrelenting Standards schema domain, but not on Emotional Inhibition, which was found to be elevated for AvPD. In conclusion, the present study suggests that there are different patterns of schema domains across different PDs and that the Schema Questionnaire (SQ) is potentially useful in differentiating between these PDs.     

Different Associations of Health Related Quality of Life with Pain,Psychological Distress and Coping Strategies in Patients with Irritable Bowel Syndrome and Inflammatory Bowel Disorder

The primary aim of this study was to measure psychological distress, pain severity, health related quality of life (QOL) and pain coping strategies in patients with irritable bowel syndrome (IBS) and ulcerative colitis (UC). A second aim was to determine the influence of somatic and psychological variables on health related QOL. Eighty-eight IBS and 66 UC patients completed the Irritable Bowel Syndrome Quality of Life Questionnaire (IBSQOL), Pain Severity Scale of West Haven Yale Multidimensional Pain Inventory (WHYMPY), Symptom Checklist-90-R (SCL-90-R) and Coping Strategies Questionnaire (CSQ). T-tests and GLM Analysis of Covariance were used for statistical analysis. IBS patients had significantly higher levels of psychological distress, pain severity and maladaptive pain coping strategies (catastrophization), and lower QOL than UC patients. Variance of QOL in IBS was explained for the most part by catastrophization (15%), then by psychological distress (8%), and for the less part by pain severity (5%). In UC, pain severity explained 21%, psychological distress 8%, and catastrophization 3% of the variance of QOL. These results suggest there are differences between IBS and UC patients in the role of physical and psychological factors in QOL and emphasize the importance of cognitive processes in IBS.     

Self-schemas and risk for depression: a prospective study

The role of depressive self-schemas in vulnerability to depression was explored in a longitudinal design. Five groups of subjects hypothesized to be at differential risk for depression according to a schema model were identified: depressed schematic, depressed nonschematic, nondepressed schematic, nondepressed nonschematic, and a psychopathology control. They were followed regularly for 4 months with self-report and clinical interview measures of depression. There was no evidence of risk for depression associated with schema status apart from initial mood and no interaction of life stress events and schemas. In a second experiment with the same subjects, it was shown that depressive self-schemas do not exert an ongoing, active influence on everyday information processing; instead current mood affected information processing. Remitted depressed persons resembled nondepressed rather than depressed ones. The results support Kuiper and colleagues' distinction between concomitant and vulnerability schemas, and help to clarify differences between cognitions that are symptoms or correlates of depression and those that may play a causal role under certain conditions.     

Mothers' Psychological Adjustment Following Disaster Affecting Their Children

The authors investigated the psychological adjustment of 37 British women whose adolescent children survived the cruise ship Jupiter's sinking in 1988, about 6 years previously. They compared these women with a group of widows (N = 18) and a group of women who had suffered no major negative life event (N = 15). Psychological adjustment of the 37 women was assessed with the Schedule for Affective Disorders and Schizophrenia Lifetime Version (SADS-L; R. L. Spitzer & J. Endicott, 1975) and various standard questionnaires. The women whose children had been involved in the disaster were found to have suffered a greater number of incidents of psychological distress in the period since the disaster than the women who had suffered no major negative life events but fewer incidents of psychological distress than the widows. The significance of these findings and clinical implications are discussed.