Zamirinejad Somayeh, Hojjat Seyed Kaveh, Moslem Alireza, MoghaddamHosseini Vahideh, Akaberi Arash
1 Addiction and Behavioral Sciences Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran.
2 Iranian Research Center on Healthy Aging, Sabzevar University of Medical Sciences, Sabzevar, Iran.
Am J Mens Health. 2018 Mar;12(2):202-209. doi: 10.1177/1557988317742230. Epub 2017 Nov 17.
Substance use is a globally devastating social problem. Early maladaptive schemas (EMSs) are inefficient mechanisms leading directly or indirectly to psychological distress. The current study aimed to assess the role of EMSs in predicting opioid use disorder. The cross-sectional study was conducted in 2013 in Bojnurd at northeast of Iran on 60 male opioid users who received Methadone Maintenance Treatment (MMT) and 60 control males. The opioid users were selected randomly from MMT clinics and control subjects were selected and matched with opioid users using demographic variables. The subjects completed the Young Schema Questionnaire-Short Form (YSQ-SF). Except for SS (self-sacrifice), EG (entitlement/grandiosity), US (unrelenting standards), and FA (Failure to Achieve), the mean of other maladaptive schemas in the opioid user group were significantly higher than that of the control group, adjusted for multiple comparisons. Multivariate analysis of variance (MANOVA) indicated significant differences in maladaptive schemas between the two groups. Logistic regression identified that Emotional Deprivation, Mistrust/Abuse, and Unrelenting Standards can predict opioid use. As a result, the risk of opioid-related disorders in people with higher YSQ-SF scores in these schemas is higher. The findings conclude that the existence of underlying EMS may constitute a vulnerability factor for developing opioid use disorders later on in life. Provided the vast amount of scientific literature in evidence-based treatments focusing on EMSs, maladaptive schemas and related core beliefs can be detected and treated in adolescence to prevent the enactment of the schema and psychological distress likely to induce opioid use.
物质使用是一个全球性的毁灭性社会问题。早期适应不良图式（EMSs）是直接或间接导致心理困扰的低效机制。本研究旨在评估EMSs在预测阿片类物质使用障碍中的作用。2013年在伊朗东北部的博季努尔德对60名接受美沙酮维持治疗（MMT）的男性阿片类物质使用者和60名对照男性进行了横断面研究。阿片类物质使用者从MMT诊所中随机选取，对照对象则根据人口统计学变量进行选取并与阿片类物质使用者进行匹配。研究对象完成了青少年图式问卷简表（YSQ-SF）。除了自我牺牲（SS）、权利/夸大（EG）、严苛标准（US）和成就缺失（FA）外，在进行多重比较校正后，阿片类物质使用者组中其他适应不良图式的平均值显著高于对照组。多变量方差分析（MANOVA）表明两组之间在适应不良图式方面存在显著差异。逻辑回归分析确定情感剥夺、不信任/虐待和严苛标准可以预测阿片类物质使用。因此，在这些图式中YSQ-SF得分较高的人患阿片类物质相关障碍的风险更高。研究结果表明，潜在EMSs的存在可能构成日后生活中发展为阿片类物质使用障碍的一个易患因素。鉴于大量基于证据的治疗方法的科学文献都聚焦于EMSs，在青少年时期可以检测并治疗适应不良图式及相关核心信念，以防止图式的形成以及可能诱发阿片类物质使用的心理困扰。
