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抑郁和躯体化障碍中的早期适应不良图式。

Early maladaptive schemas in depression and somatization disorder.

机构信息

Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Iran.

University of Notre Dame, USA.

出版信息

J Affect Disord. 2018 Aug 1;235:82-89. doi: 10.1016/j.jad.2018.04.017. Epub 2018 Apr 3.

Abstract

Cognitive theories of depression posit that early maladaptive schemas (EMSs) are key vulnerability factors for psychological disorders. In this study, we investigated specific EMSs as shared or distinct cognitive vulnerability factors for depression and somatization disorder. The sample consisted of patients with Major depressive disorder (N = 30) and Somatization disorder (N = 30) from a community hospital or a psychiatric clinic. Participants completed the Structured Clinical Interview for DSM-IV (SCID), the Beck Depression Inventory-II (BDI-II), and the short form of the Young Schema Questionnaire (YSQ-SF). Depressed patients exhibited significantly higher levels of all five schema domains and specific maladaptive schemas, including emotional deprivation, mistrust and abuse, social isolation and alienation, defectiveness and shame, failure, subjugation, emotional inhibition, and insufficient self-control or self-discipline. Moreover, depressed patients exhibited significantly higher levels of social isolation, emotional inhibition, as well as the overvigilance and inhibition domain when depressive symptom severity was controlled. Our results provide preliminary evidence that specific EMSs distinguish patients with depression and somatization. Suggestions for future research include the need to have a non-psychiatric control group, to evaluate the absolute role of EMSs in Somatization Disorder.

摘要

抑郁的认知理论假设,早期适应不良模式(EMSs)是心理障碍的关键脆弱性因素。在这项研究中,我们研究了特定的 EMSs 是否是抑郁和躯体化障碍的共同或独特的认知易损因素。该样本包括来自社区医院或精神病诊所的重性抑郁障碍(N=30)和躯体化障碍(N=30)患者。参与者完成了DSM-IV 结构临床访谈(SCID)、贝克抑郁量表第二版(BDI-II)和 Young 模式问卷简表(YSQ-SF)。抑郁患者表现出所有五个模式领域和特定的适应不良模式的显著更高水平,包括情感剥夺、不信任和虐待、社会孤立和疏远、缺陷和羞耻、失败、屈从、情感抑制以及不足的自我控制或自律。此外,当控制抑郁症状严重程度时,抑郁患者表现出显著更高水平的社会孤立、情感抑制以及过度警觉和抑制领域。我们的结果初步表明,特定的 EMSs 可以区分抑郁和躯体化障碍患者。未来研究的建议包括需要有非精神病对照组,以评估 EMSs 在躯体化障碍中的绝对作用。

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