图式心理疗法述评

图式疗法也称图式聚焦疗法,是在整合了认知疗法、行为疗法、客体关系、格式塔理论的有利元素基础上,而形成的一个统一性、系统性、创新性的心理疗法.图式疗法包括两个主要的阶段,一是评定阶段,这一阶段主要用来识别、评定来访者的图式;二是改变阶段,在这一阶段来访者由消极、适应不良的思维和行为习惯转变为积极、健康的认知和行动.图式疗法对治疗人格障碍、慢性抑郁症等长期的心理问题有很好的效果.     

童年期创伤对大学生抑郁的影响:早期适应不良图式和负性生活事件的作用

目的:考察早期适应不良图式、负性生活事件在童年期创伤与大学生抑郁间的影响机制。方法:采用童年期创伤问卷、Young图式问卷短版中文修订版、青少年生活事件量表及90项症状自评量表对1423名大学生进行调查,结果表明:(1)童年期创伤既可以直接正向预测大学生抑郁,也可以通过早期适应不良图式中的分离和拒绝、自主性及能力受损两大图式类别间接地正向预测大学生抑郁;(2)负性生活事件调节了早期适应不良图式在童年期创伤与抑郁间的中介作用     

大学生早期适应不良图式、焦虑与拖延的关系

为探讨大学生早期适应不良图式、焦虑与拖延的关系, 并考察焦虑在早期适应不良图式与拖延之间的中介效应, 采用一般拖延量表、Young图式问卷—简版、状态—特质焦虑问卷和自编一般人口学情况调查表, 对广东一高校559名大学生进行调查研究。研究结果发现:(1)"分离和拒绝"、"自主性和能力不足"、"缺乏自控/自律不足"图式均能显著正向预测焦虑和拖延;(2)特质焦虑能显著正向预测拖延, 而状态焦虑对拖延无显著预测作用;(3)特质焦虑在"分离和拒绝"、"自主性和能力不足"、"缺乏自控/自律不足"图式与拖延之间起部分中介作用。     

儿童期创伤对特质抑郁和特质焦虑的影响：图式中介特异性研究

根据Beck的认知内容特异性假说(Cognitive Content Specificity Hypothesis, CCSH), 本研究假设早期适应不良图式(EMSs)在儿童期创伤与特质抑郁和特质焦虑间存在中介效应的特异性。然后对668名大学生施以儿童期创伤问卷(CTQ-SF), Young图式问卷短版(YSQ-SF), 特质抑郁问卷(T-DEP)以及特质焦虑问卷(T-AI), 经中介效应检验程序分析, 结果表明：(1)三类儿童期创伤：情感虐待、情感忽视和躯体忽视与特质抑郁和特质焦虑相关均显著, 且三类创伤与特质抑郁和特质焦虑的相关系数差异不显著; (2)针对三类创伤的中介分析均表明情感剥夺、羞耻、社交孤立/疏离和自我牺牲等与没价值、无能力有关的图式在儿童期创伤和特质抑郁间起中介作用, 而不信任/虐待和对疾病/伤害易感性等与危险有关的图式在儿童期创伤和特质焦虑间起中介作用。结论：早期适应不良图式在儿童期创伤与特质抑郁和特质焦虑间存在中介效应的特异性。     

图式心理疗法的新观察

从图式心理疗法发展历程的角度探讨其起源与发展,对图式概念的提出以及早期适应不良图式和应对方式进行梳理,凸显了图式疗法的优势与传统逻辑。深入探讨简化的图式疗法——模式模型,突出模式模型是一个或多个激活的图式与相关应对方式的组合。强调模式模型的治疗机制包括了儿童模式、内在批评模式、适应不良的应对模式和健康成人模式四种模式,它们之间互相联系、互相影响。通过对现有案例及学术研究成果的梳理,证明模式模型治疗对各种精神障碍的有效性,且在国内的心理学治疗方面有较好的应用前景,应得到更多的重视、推广和应用。     

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。     

4—8岁儿童解决算术应用题认知加工过程的实验研究(Ⅱ)

本研究采用个别交谈和口语分析技术,对100名4─8岁儿童解决合并题的认知加工过程进行了探讨.结果表明:儿童解决合并题的认知加工过程可以划分出三个水平,其认知加工图式有两种:合并图式和部总关系推理图式;两种图式对问题的加工方式不同,反映出儿童对加减法概念的理解程度和发展水平.     

认知负荷理论在网络教育中的应用及启示

过去十年间,认知负荷理论（Cognitive Load Theory,以下简称CLT）已成为学习、教学领域中公认的指导理论之一。认知负荷理论以工作记忆理论和图式加工理论为基础,综合考虑学习材料的性质、学习者的知识水平及教学设计等多方面因素。本文在分析认知负荷理论的基础上,重点介绍了近期网络教育、教学中有关认知负荷研究的新成果,以期对当前网络教育的发展带来些许启示。     

儿童图式特征的认知发展研究

采用三角验证法对长春180名10.1-15.3岁儿童进行研究,以自然范畴的事物、家庭内外事件和熟悉的文本为测验材料,探测了儿童对图式特征的认知特点。结果发现:(1)儿童对自然范畴、事件、文本图式特征的认知存在三级水平:①成分水平,②成分与整体水平,③整体水平。这三级水平与儿童思维特点相一致并受生活经验或事件的制约。(2)儿童对三类图式特征认知是随年龄的升高而不断提升的,其标志是对图式本质的理解、概括与把握不断加深,到13岁以后儿童对三类图式特征的认知发展迅速。     

大学新生图式匹配、应对方式与心理健康的关系

在大学生心理健康与发展研究中,适应性问题越来越受到人们的关注。已有的心理健康研究认为:心理健康的主要特征是社会适应性良好,因此,在心理健康研究中,适应性研究具有非常重要的地位,从认知心理学的研究视角和以认知理论为依据的心理治疗实践看。适应性与社会图式的关系也已引起研究者的关注,社会图式已成为一个不容忽视的心理要素.并在认知心理咨询方法中得到验证。本研究关注的焦点是:从认知心理学的视角对大学新生进行有关大学的社会图式构成的调查,通过调查比较其入校前后大学图式的构成变化,这种图式构成的变化程度是否对他们的心理健康产生影响,以及他们后来使用的应对方式在图式构成变化与心理健康之间的中介作用。     

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.     

Addicted patients with personality disorders: traits, schemas, and presenting problems

We evaluated the association of Structure Clinical Interview for the DSM-IV Axis II (SCID-II) severity and personality traits, early maladaptive schemas, and presenting symptoms in 41 methadone-maintained patients meeting criteria for either antisocial, borderline, avoidant, or depressive personality disorder. Correlational analyses indicated that the severity of each personality disorder was associated with a unique profile of presenting problems and underlying traits and schemas. The evaluation of multiple psychological indicators appears to be a useful method for case conceptualization and planning interventions within a promising individual therapy model that focuses both on substance abuse and psychiatric symptoms and maladaptive schemas and coping styles.     

A new look at the schema therapy model: organization and role of early maladaptive schemas

This study reexamined the organization of Young’s 18 early maladaptive schemas and their hypothesized associations with experiences of need-thwarting parental experiences in childhood and the “vulnerable child” mode of emotional distress in adulthood. A large Danish sample (N = 1054) of 658 clinical- and 391 nonclinical adults completed measures of early maladaptive schemas, parenting styles, and the vulnerable child mode. We identified four higher-order schema domains as most appropriate in terms of interpretability and empirical indices (“Disconnection & Rejection”, “Impaired Autonomy & Performance”, “Excessive Responsibility & Standards”, and “Impaired Limits”). All four schema domains were differentially associated with conceptually relevant need-thwarting parental experiences. Apart from “Impaired Limits”, the schema domains meaningfully accounted for the association between need-thwarting parental experiences in childhood and emotional states of feeling like a “vulnerable child” in adulthood. We conclude that four domains of early maladaptive schemas are empirically and conceptually consistent with Young’s schema therapy model of personality pathology and longstanding emotional disorders. Findings warrant replication using different populations and if possible a prospective multi-method design. A scoring key for computing the four schema domains is provided.     

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.     

Cognitive and coping mechanisms in the interplay between intimate partner violence and depression

This study examined the association between intimate partner violence, maladaptive cognitive schemas, coping, and depression in a sample of 298 battered women. The results indicated that maladaptive cognitive schemas were associated with less use of primary and secondary engagement coping, and higher use of disengagement coping. In particular, cognitive schemas reflecting disconnection and rejection accounted for the association between psychological abuse and percentage of disengagement coping. In addition, disengagement coping partially mediated between cognitive schemas and depressive symptoms. Finally, the role of cognitive schemas as personal constraints that affect the choice of coping and the implications for interventions with victims are discussed.     

Thérapie cognitive et schémas cognitifs : un aspect du paradoxe

On one hand, schemas responsible for psychopathologies are said to be slowly formed during the childhood which means they become stable, rigid and practically non-modifiable structures. On the other hand, cognitive therapy aims at modifying these schemas, sometimes a few appointments are enough for the shortest techniques. To explain this paradox, we have measured the activity of 13 early maladaptive schemas among 36 patients (20 men and 16 women), suffering from panic disorders with agoraphobia, before and after a 10 weekly session group therapy—the symptoms being totally reduced. We compare these measures with those made on subjects free from any psychiatric disorders. Our results indicate that if therapy modifies symptoms, it has no immediate effect on early maladaptive schemas.     

Cognitive-behavioral Strategies for Parkinson’s Disease: A Report of Three Cases

Three patients diagnosed with idiopathic Parkinson’s disease (PD) were treated with cognitive-behavioral therapy (CBT): a 43-year-old woman suffering from depression and social anxiety, a 45-year-old man with sexual problems and maladaptive coping strategies, and a 78-year-old man with freezing of gait. On the basis of functional analyses, interventions were selected, including cognitive methods, social skills training, paradoxical instructions and strategies to improve management of freezing. The interventions were related to improved adaptation to motor impairments and better ability to cope with the disease. These case presentations suggest that CBT can improve quality of life in PD by modifying maladaptive cognitive, emotional and behavioral reactions to the disease and its symptoms.     

Predictors and mediators of treatment outcome in patients with binge eating disorder

A randomized controlled trial (N=52) was conducted comparing cognitive-behavioral therapy with a waiting list control group to identify mediators and predictors of treatment outcome. Reduction of weight concerns mediated abstinence of binge eating at post-treatment. Abstinence was marginally mediated by changes in eating and shape concerns, depressive symptoms and global severity of general psychopathology. Neither treatment outcome nor status at 1-year follow-up could be predicted by severity of eating disorder, comorbid psychopathology or maladaptive core beliefs at baseline or at post-treatment. The only predictor for abstinence at both post-treatment and 1-year follow-up was the coping style palliative reacting: higher scores predicted less favorable outcomes. Lower expression of emotions at post-treatment predicted more reduction of eating disorder psychopathology at follow-up. No other patient characteristics allowing treatment-patient matching could be identified.     

Early maladaptive schemas and non-suicidal self-injury among young adults: A preliminary investigation

Non-suicidal self-injury (NSSI) represents a critical mental health issue among young adults. Accordingly, it is important to understand potentially modifiable processes involved in its enactment. The current investigation built on previous work to better understand the nature of early maladaptive schemas (EMS) in the context of NSSI. One hundred and thirty young adults completed questionnaires assessing NSSI history, EMS and depressive symptoms. Results indicate that EMS may play a role in NSSI engagement after controlling for depressive symptoms. Specifically, higher scores on social isolation and emotional inhibition and possibly lower scores on entitlement/grandiosity schemas may differentiate those who self-injure from those who do not. Furthermore, higher levels of dependence/incompetence schema may differentiate those who report a higher NSSI frequency and those who report a less frequent NSSI history. Although a nascent area of study, our findings suggest that it may be fruitful to consider conceptualizing NSSI within a schema therapy framework.