Do Early Maladaptive Schemas Mediate the Relationship Between Childhood Experiences and Avoidant Personality Disorder Features? A Preliminary Investigation in a Non-Clinical Sample

The current study tested the hypothesis that early maladaptive schemas (EMSs) mediate the relationship between retrospectively reported childhood experiences and avoidant personality disorder (AVPD) symptoms. One hundred and seventy-eight non-clinical participants completed questionnaires measuring retrospectively reported childhood experiences, a measure of EMSs, and AVPD symptoms. Path analyses showed that the EMSs of subjugation, abandonment, and emotional inhibition fully mediated the relationship between retrospectively reported childhood experiences (specifically mother overprotection & family sociability) and AVPD symptoms. The abandonment and subjugation EMSs were found to fully mediate the relationship between family sociability and AVPD symptoms while the subjugation and emotional inhibition EMSs fully mediated the relationship between mother (but not father) overprotection and AVPD symptoms. Finally, retrospective reports of childhood maltreatment were found to be associated with all EMSs within the disconnection/rejection domain apart from the abandonment EMS although these EMSs did not significantly account for AVPD symptoms. These results are consistent with cognitive-behavioural formulations of personality disorders and this study is the first to show that EMSs mediate the relationship between childhood factors and AVPD features.     

Association of daily hassles,daily uplifts,coping styles and stress-related symptoms among women exposed to sexual abuse—A cross-sectional study

Background

Women who experience physical or sexual violence report poor self-perceived health. Knowledge of daily hassles, daily uplifts and coping styles, as well as how these factors can affect health and well-being among survivors of sexual abuse, is important for healthcare professionals to understand and target their needs.

Aim

The aim of the current study was to explore the association of daily hassles, daily uplifts, coping strategies and stress-related symptoms among female survivors of sexual abuse.

Methods

A group of women (n = 57), exposed to sexual abuse, were recruited from nine support centres in Norway. Participants completed a questionnaire that addressed demographics, socioeconomic conditions, trauma history, daily hassles, daily uplifts, coping styles and stress-related symptoms. Two groups of participants were compared: one group that had above-median scores on uplifts and adaptive coping styles and one group that had above-median scores on daily hassles and maladaptive coping styles.

Results

Results indicate that women who experienced more daily hassles and used maladaptive coping styles reported significantly more stress-related symptoms, and particularly emotional symptoms, than women who experienced more daily uplifts and used adaptive coping styles. There were few differences between the two groups related to socioeconomic conditions and trauma history.

Conclusion

The results indicate that women in both groups struggle with stress-related physical, emotional, cognitive and target group-specific symptoms. However, high incidence of daily hassles and the use of maladaptive coping styles were associated with an increase in stress-related symptoms. Novell’s findings indicate that despite severe traumatic experiences, adaptive coping styles and favourable perceptions of stress in everyday life were associated with a lower frequency of stress-related symptoms. It may therefore be helpful to focus on altering maladaptive coping styles to reduce stress-related symptoms among sexual abuse survivors.     

Dysfunctional Attitudes, Coping, and Depression Among HIV-Seropositive Men Who Have Sex with Men

Several studies have documented elevated levels of psychological distress among HIV-seropositive (HIV+) symptomatic men who have sex with men (MSM). However, very little is known about the role of dysfunctional attitudes and coping strategies in maintaining and ameliorating distress levels in ways that can inform those developing psychosocial interventions for HIV+ persons. This study evaluated relations between dysfunctional attitudes and depression and examined the role of coping as a mediator of this relationship among 115 HIV+ symptomatic MSM. Higher Dysfunctional Attitude Scale scores were associated with more reported depressive symptoms. The use of adaptive coping strategies such as active coping was associated with lower depression, whereas use of maladaptive strategies such as denial was related to higher levels of depression. Both adaptive and maladaptive coping strategies mediated the relationship between dysfunctional attitudes and depression. Findings suggest that interventions aiming at reducing psychological distress in this population using cognitive restructuring and related techniques may achieve their effects by enhancing adaptive coping strategies on the one hand and reducing maladaptive strategies on the other.     

The relation of early maladaptive schemas and behavioral inhibition/approach systems to defense styles in abusers of synthetic drug: a cross-sectional study

The aim of the study was to examine the relationship of early maladaptive schemas (EMSs) and behavioral inhibition/approach systems (BIS/BAS) with defense styles in the abusers of synthetic drug admitted at Niyayesh addiction treatment clinic in the city of Shiraz, Iran. In a cross-sectional design, we examined the relationship between EMSs (via Young Maladaptive Schemas Questionnaire —Short Form “YSQ-SF”) and BIS/BAS (via Carver & White BIS/BAS Scale) to defense styles (via Defense Style Questionnaire “DSQ-40”) for 340 abusers of synthetic drug (male = 53.5%, female = 46.5%). To analyze the relationship between the studied variables, zero-order correlation and multivariate regression were used. Also, sex differences in the means of the responses for each of EMSs, BIS/BAS, and defense styles were analyzed using the independent samples t test.

Correlational analyses revealed that all five EMSs were correlated with both neurotic and immature defense styles, and negatively with mature defense style. Also, BIS and all BAS subscales were related to both neurotic and immature and negatively to mature defense style. Finally, there were significant sex differences in BIS, BAS subscales, EMSs, and defense styles. We concluded that EMSs, excessive BIS and BAS subscales, and maladaptive defense styles (e.g., neurotic and immature styles) are important factors in understanding the causes of drug abuse in the abusers of synthetic drug.     

Parent and adolescent adjustment to pediatric cancer: Associations with coping,social support,and family function

This article presents preliminary results investigating the relationship between parental and adolescent adjustment and coping and their relationship to social support and family functioning in a sample of adolescents (ages 11-18) with cancer and one of their parents. Parents and adolescents from two pediatric oncology clinics completed measures of distress, coping, social support, and family cohesion/adaptability. Low levels of distress were reported by both children and their parents with positive correlations noted between parent and child adjustment. Adolescents reported that their parents and a close friend were the greatest sources of social support and described their families as having a high degree of cohesion and adaptability. Both adolescents and parents used more adaptive than maladaptive coping strategies, although distress was associated with reduced use of adaptive coping. Adolescents are able to adapt to cancer in the context of strong family and social supports. In addition, there is a relationship between parental and adolescents adjustment, and between greater use of adaptive coping styles and lower distress.     

Early Maladaptive Schemas and Social Phobia

The present study compares core beliefs between a group of patients with social phobia (n = 62), other anxiety disorders (n = 41) and a group of non-psychiatric controls (n = 55). Participants completed measures to assess social anxiety and the Young’s Schema Questionnaire (123-items version) that is designed to assess 15 early maladaptive schemas (EMSs). Results suggest that the schematic structure of patients with social phobia differs from the one of patients with other anxiety disorders and from normal controls’. Patients with social phobia show higher levels of EMSs particularly in the area of disconnection/rejection than patients with other anxiety disorders. Regression analysis identified the EMSs of mistrust/abuse, social undesirability/defectiveness, entitlement, emotional deprivation, unrelenting standards and shame, as the ones that explain most of the variance in our sample subject’s anxiety that they felt in social situations and on fear of negative evaluation.     

Predicting psychological distress of informal carers of individuals with major depression or bipolar disorder

Caring for someone with a mental illness is associated with high levels of burden and psychological distress. Understanding these factors could be important to prevent the development of physical and mental health problems in carers. The purpose of the present study was to determine the contribution of coping styles and social support in predicting the psychological distress reported by informal carers (IC) of individuals with major depression or bipolar disorder. IC (n = 72) of adults with a diagnosed depressive illness were recruited from mental health organizations within the community setting. Carers completed the General Health Questionnaire, Brief COPE, and Social Support Questionnaire. Multiple linear regression analysis revealed that 63% of the variance in psychological distress could be accounted for by adaptive and maladaptive coping styles and perceived quantity and satisfaction with social support. Satisfaction with social support (β = ?0.508, P < 0.001) and maladaptive coping (β = 0.369; P < 0.001) were significant predictors of psychological distress. These findings suggest that interventions should consider coping styles, specifically the interaction between maladaptive behaviours and enhancement of quality of support, to assist carers to manage psychological distress, especially earlier in the caring role.     

A preliminary investigation of the relationship between early maladaptive schemas and compulsive sexual behaviors in a substance-dependent population

Past research has consistently demonstrated high co-occurrence between substance use disorders (SUDs) and compulsive sexual behaviors (CSBs). Numerous studies have also indicated that maladaptive core beliefs and early maladaptive schemas (EMS) are prevalent among individuals with SUDs and CSBs. However, research has yet to examine the relationship between EMS and CSBs among substance-dependent populations. Thus, the purpose of the current study was to examine this relationship in a sample of 198 men and 62 women in residential treatment for SUDs. Findings demonstrated that the five EMS domains were positively associated with CSBs. Results further demonstrated that patients meeting the cutoff score for CSBs scored significantly higher than patients not meeting the cutoff score for CSBs on the EMS domains of disconnection/rejection, impaired autonomy, and impaired limit. These findings suggest that there is an important and significant relationship between EMS and CSBs among adults in substance use treatment. Results from the current study indicate that EMS may provide a potentially important focus for treatment, particularly among individuals with co-morbid CSBs and SUDs. Given the preliminary nature of this study, continued research is needed to replicate and extend the findings from the current study.     

Early maladaptive schemas,behavioral inhibition/approach systems,and defense styles in the abusers of opiate,stimulant, and cannabis drugs and healthy subjects

The aim of the present study was to study the comparison of early maladaptive schemas (EMSs), behavioral inhibition/approach systems (BAS/BIS), and defense styles among the Iranian users of opiate, stimulant, and cannabis drugs and healthy subjects since July 2014 to August 2015. In a cross-sectional comparative design, 962 participants including 762 users of opiate (males = 256, females = 142), stimulant (males = 136, females = 112), and cannabis (males = 84, females = 32) drugs and 200 healthy subjects (males = 112, females = 88) were selected and completed the demographic questionnaire, Young Maladaptive Schemas Questionnaire-Short Form (YSQ-SF), Carver and White BIS/BAS scale, and Defense Style Questionnaire (DSQ-40). The results indicated that in EMSs, BIS, BAS-reward responsiveness (BAS-RR), BAS-drive (BAS-D), and defense styles there were significant differences among four groups including opiate, stimulant, and cannabis drugs and healthy subjects. Also, the users of opiate in EMSs, BIS, and immature defense style, the stimulant users in BAS-D, BAS-RR, and neurotic defense style, and the healthy subjects in mature defense style revealed higher means. It is concluded that there were significant differences among the four groups in EMSs, BIS, BAS subscales, as well as maladaptive defense styles.     

Parental Perceptions, Early Maladaptive Schemas, and Depressive Symptoms in Young Adults

Cognitive models of depression propose that negative schemas contribute to depressive symptoms. Early experiences, particularly parenting, have been proposed to influence cognitive schemas and have also been shown to correlate with depression. This study explores the concurrent relationship between retrospective reports of parenting, Early Maladaptive Schemas (EMSs) described by J. E. Young (1994), and symptoms of depression in a sample of undergraduate students (N = 194). The EMSs of defectiveness/shame, insufficient self-control, vulnerability, and incompetence/inferiority were associated with perceptions of parenting and depressive symptomatology. There was evidence that these four EMSs partially mediate the relationship between parental perceptions and depressive symptomatology. Results are discussed in relation to previous findings, theory, and the measurement of EMSs.     

NEWS SECTION

Different types of integrated management programmes have lately been introduced in the treatment of Whiplash Associated Disorders (WAD). In this study regular primary care physiotherapy and physiotherapy management with integrated components of cognitive-behavioural origin was compared in an experimental group study. The predictive value of self-efficacy was also addressed. Thirty-three patients with chronic WAD were included in the trial. Results revealed no significant differences between groups in self-ratings of disability or pain intensity. However, among the self-reported benefits of treatment, patients in the experimental group reported significantly less pain than did the comparison group. At three months follow-up the experimental group also reported better performance of daily activities. Between group differences in the coping repertoire were found at pre-, post-, and three-month follow-up. Generally, patients with high self-efficacy reported less use of "maladaptive" and passive coping style than patients with low self-efficacy, at all times. In conclusion cognitive behavioural components can be useful in physiotherapy treatment for patients with chronic WAD, but their contributions are not yet fully understood. Self-efficacy is related to patients' use of different coping styles. Positive long-term outcomes in WAD-patients could therefore be improved by enhancing patients' self-efficacy and by teaching them to use active, adaptive coping strategies.     

Adaptive and Maladaptive Behaviour in Children with Cri-du-Chat Syndrome

Twenty children with cri-du-chat syndrome were assessed on the Vineland Adaptive Behavioural Scales. Strengths within rather than between the adaptive domains were identified with posthoc analyses revealing the main differences to lie within the domains of Communication and Daily-living Skills. In the former domain, Receptive Skills were significantly more developed than Expressive and Written skills; and in the latter domain, Personal skills were significantly more developed than Community-based Skills. The core behavioural problems were Hyperactivity, poor Concentration span and Impulsivity. The implications of the present findings are discussed with reference to the development of effective remedial programmes that take into account the strengths and weaknesses in the adaptive and maladaptive profile of children with cri-du-chat syndrome.     

Early maladaptive schemas,behavioral inhibition/approach systems,and defense styles in the users of natural and synthetic substances and healthy subjects

Factors contributing to abusing various substances may be different. The aim of the present study was to study the comparison of early maladaptive schemas (EMSs), behavioral inhibition system (BIS)/behavioral approach system (BAS), and defense styles among Iranian natural and synthetic substance users at the start of their treatment and healthy subjects in Shiraz, Iran, since July 2014 to September 2015. In a cross-sectional comparative design, 1056 participants including 704 users of natural (n = 352) and synthetic (n = 352) substances (mean_age = 29) and healthy subjects (n = 352, mean_age = 29) were selected and they completed the demographic questionnaire, Young Maladaptive Schemas Questionnaire-Short Form, Carver & White BIS/BAS scale, and Defense Style Questionnaire. Results revealed that there were significant differences between the natural and synthetic substance users with healthy subjects in EMSs, BIS, BAS subscales, and defense styles. Also, the users of natural substances showed higher means in EMSs, BIS, and immature defense style, while the synthetic substance users earned higher scores on BAS subscales and neurotic defense style, and healthy subjects gained higher scores on mature defense style than natural and synthetic substances. We concluded that there were significant differences among two groups in EMSs, BIS, BAS subscales, and defense styles.     

康复期精神分裂症患者幽默感与应对方式的相关研究

目的：探讨精神分裂症患者幽默感和应对方式的关系,为开发更有针对性干预方案提供依据。方法：运用多维度幽默感量表、幽默风格量表与压力情景应对方式问卷对94例精神分裂症康复期患者进行问卷调查。结果：①不同性别患者攻击性幽默类型亚量表得分有统计学意义（t=3.125,P〈0.05）;94例患者应对方式与性别、年龄、病程及文化程度差异均无统计学意义。②整体幽默感与回避应对、任务应对（r=0.272、r=0.363,P〈0.01）成正相关;亲和幽默与情绪应对呈负相关（r=-0.230,P〈0.01）;攻击幽默与情绪应对成正相关（r=0.419,P〈0.01）。结论：性别对精神分裂症患者攻击幽默类型有影响;幽默感强的患者更可能采用回避应对与任务应对方式;擅长使用亲和幽默的患者更不经常使用情绪应对方式,而喜欢使用攻击幽默的患者更经常采用情绪应对方式。     

The Structure of Maladaptive Schemas: A Confirmatory Factor Analysis and a Psychometric Evaluation of Factor-Derived Scales

One thousand and thirty-seven psychiatric patients and non-patients from six different sites completed the 205-item Young Schema Questionnaire or its shortended form, the 75-item Young Schema Questionnaire-S. Among 888 of the subjects, who all were patients, a confirmatory factor analysis (CFA) of the 75 items included in both forms of the questionnaire clearly yielded the 15 Early Maladaptive Schema (EMS) factors rationally developed by J. E. Young (1990). Confirmatory factor analyses, testing three models of the higher-order structure of the 15 EMSs, indicated that a four-factor model was the best alternative. The results slightly favored a correlated four second-order factor model over one also including a third-order global factor. The four factors or schema domains were Disconnection, Impaired Autonomy, Exaggerated Standards, and Impaired Limits. Scales derived from the four higher-order factors had good internal and test–retest reliabilities and were related to DSM-IV Cluster C personality traits, agoraphobic avoidance behavior, and depressive symptoms.     

Coping strategies in individuals after traumatic brain injury: associations with health-related quality of life

Abstract

Purpose: This study investigates coping strategies after traumatic brain injury (TBI) and their associations with health-related quality of life (HRQoL). Methods: Participants were 141 adults followed up 3 months to 15 years after TBI of all severity degrees. Coping was assessed by the Freiburg Questionnaire of Coping with Illness (FQCI) and HRQoL by the Quality of Life after Brain Injury (QOLIBRI) scale and the Short Form-36 Health Survey (SF-36). Coping dimensions were extracted by principal component analysis. Multiple linear regression analysis was used to identify predictors of coping strategies. Results: Two factors for coping after TBI were extracted: Action/Distraction and Trivialisation/Resignation. The Trivialisation/Resignation strategy was negatively correlated with all aspects of HRQoL, while relationships with the Action/Distraction strategy were positive and significant for two domains. These two factors also showed significant associations with anxiety, depression, recovery, cognitive status, mood states and trauma severity. Multiple regression analysis identified recovery status as a predictor for the maladaptive Trivialisation/Resignation strategy. Conclusion: Two coping factors were identified, which were differentially associated with HRQoL. Maladaptive coping strategies play a particularly important role, and less reliance on such strategies is associated with better HRQoL; use of adaptive strategies should correspondingly be fostered.

• Implications for Rehabilitation

• This study highlights the relationship of coping strategies and HRQoL after TBI.

• For the assessment of HRQoL a novel disease-specific instrument was applied, that provides in detail TBI-relevant aspects of well-being and HRQoL.

• Individuals after TBI use two main sets of coping strategies that are differentially associated with HRQoL (and clinical variables). One is adaptive and the other maladaptive for HRQoL after TBI.

• Maladaptive and adaptive coping strategies used by the individual should be identified and considered in rehabilitation efforts to improve HRQoL after TBI.

     

Coping in Women With Polycystic Ovary Syndrome: Implications for Practitioners

Polycystic ovary syndrome (PCOS) occurs in 6%-15% of women. Some international studies have demonstrated that women with PCOS use maladaptive coping to manage stress. In this study we examined coping strategies used to manage stressful situations in 72 women with PCOS in the United States. Most women used adaptive coping, including social support, problem-solving, and positive reappraisal. A subset of women with increased psychological severity scores used maladaptive coping, including increased escape-avoidance coping and less problem-solving and positive reappraisal coping. Nurse practitioners have a valuable role in assessing coping skills in women with PCOS and intervening with adaptive coping interventions.     

Obsessive–Compulsive Disorder is Characterized by a Lack of Adaptive Coping Rather than an Excess of Maladaptive Coping

The present study aimed to elucidate the profile of coping in patients with obsessive–compulsive disorder (OCD) in order to discern whether the disorder is characterized by an excess of maladaptive coping skills and/or a lack of adaptive coping skills. Sixty individuals with OCD were compared with 110 individuals with depression and 1050 nonclinical controls on the Maladaptive and Adaptive Coping Styles Questionnaire (MAX). Psychopathology was assessed with the Obsessive–Compulsive Inventory-Revised (OCI-R), the Yale-Brown Obsessive–Compulsive Scale (Y-BOCS), and the Patient Health Questionnaire-9 for depression (PHQ-9). Individuals with OCD and depression displayed more maladaptive coping and avoidance as well as less adaptive coping than nonclinical controls. Importantly, adaptive coping was significantly lower in individuals with OCD than in those with depression at a medium effect size, whereas the clinical groups were indistinguishable on maladaptive coping and avoidance. Lack of adaptive coping was strongly correlated with resistance to symptoms and poor insight in OCD (Y-BOCS), even after controlling for depression. Lack of adaptive coping skills may represent a specific pathogenetic factor in OCD. Longitudinal studies need to clarify whether strengthening adaptive skills during childhood and adolescence may help to prevent the progression from subclinical to manifest OCD.