Schematherapie

Schema therapy is a cognitive behavioral therapy (CBT) development mainly for the treatment of personality disorders and other chronic mental disorders. It is characterized by an integration of cognitive, emotional and behavioral intervention methods derived from different therapeutic approaches with an emphasis on a specifically supportive therapeutic relationship. The original approach focused mainly on early maladaptive schemas. Current developments, however, concentrate on the concept of schema modes, describing different schema-associated emotional states. The schema mode approach is also used for specific case concepts for personality disorders. Effectiveness of schema therapy has been shown for borderline personality disorder. Current studies investigate the effectiveness of schema therapy for patients with other chronic mental conditions and as a group therapy approach. This paper provides an overview about case conceptualization and treatment, presents main research findings and discusses open questions and problems.     

On the relationship between sources of within- and between-group differences and measurement invariance in the common factor model

Investigating sources of within- and between-group differences and measurement invariance (MI) across groups is fundamental to any meaningful group comparison based on observed test scores. It is shown that by placing certain restrictions on the multigroup confirmatory factor model, it is possible to investigate the hypothesis that within- and between-group differences are due to the same factors. Moreover, the modeling approach clarifies that absence of measurement bias implies common sources of within- and between-group variation. It is shown how the influence of background variables can be incorporated in the model. The advantages of the modeling approach as compared with other commonly used methods for group comparisons is discussed and illustrated by means of an analysis of empirical data.     

Abstract: A Comparison of the Factor Mixture Model and Taxometric Procedures

Taxometric procedures and the Factor Mixture Model (FMM) have a complimentary set of strengths and weaknesses. Both approaches purport to detect evidence of a latent class structure. Taxometric procedures, popular in psychiatric and psychopathology literature, make no assumptions beyond those needed to compute means and covariances. However, Taxometric procedures assume that observed items are uncorrelated within a class or taxon. This assumption is violated when there are individual differences in the trait underlying the items (i.e., severity differences within class). FMMs can model within-class covariance structures ranging from local independence to multidimensional within-class factor models and permits the specification of more than two classes. FMMs typically rely on normality assumptions for within-class factors and error terms. FMMs are highly parameterized and susceptible to misspecifications of the within-class covariance structure.

The current study compared the Taxometric procedures MAXEIG and the Base-Rate Classification Technique to the FMM in their respective abilities to (1) correctly detect the two-class structure in simulated data, and to (2) correctly assign subjects to classes. Two class data were simulated under conditions of balanced and imbalanced relative class size, high and low class separation, and 1-factor and 2-factor within-class covariance structures. For the 2-factor data, simple and cross-loaded factor loading structures, and positive and negative factor correlations were considered. For the FMM, both correct and incorrect within-class factor structures were fit to the data.

FMMs generally outperformed Taxometric procedures in terms of both class detection and in assigning subjects to classes. Imbalanced relative class size (e.g., a small minority class and a large majority class) negatively impacted both FMM and Taxometric performance while low class separation was much more problematic for Taxometric procedures than the FMM. Comparisons of alterative FMMs based on information criteria generally resulted in correct model choice but deteriorated when small class separation was combined with imbalanced relative class size.     

Schematherapie bei antisozialem Verhalten und Psychopathie

In the Netherlands schema therapy is the first evidence-based treatment to be recommended for patients with personality disorders in forensic settings. Initial results show that schema therapy can even be effective in cases of “psychopathy”. The central concept in schema therapy are schema modes which can also be seen as emotional states or “parts of the personality”, which dominate temporary thoughts, emotions and behavior. Schema modes are the basis of individual mode models, which guide understanding and treatment of the disorder throughout the complete therapy. The schema therapeutic analysis of delinquency is part of the schema mode model and connects the sequences of the crime with the offender’s schema modes. With respect to the mode treatment, emotion-focused techniques and the therapeutic relationship are of special importance. The schema therapeutic treatment plan combines short-term behavior-related therapeutic goals with the underlying themes (needs and modes) in order to plan concrete interventions based on this. This has to be embedded into the individual structure of therapeutic options in the respective institutions (e.?g. individual psychotherapy, nursing staff, occupational therapy). This article demonstrates the practice of the schema therapeutic approach with a forensic case study and discusses resources and limits of the schema therapeutic approach in a forensic setting.