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一项关于青少年和青年期早期适应不良模式与抑郁之间关系的元分析。

A meta-analysis of the relationship between early maladaptive schemas and depression in adolescence and young adulthood.

机构信息

School of Health in Social Science, University of Edinburgh, Edinburgh, UK.

Chancellery, Victoria University, Melbourne, Australia.

出版信息

Psychol Med. 2021 Jun;51(8):1233-1248. doi: 10.1017/S0033291721001458. Epub 2021 Jun 10.

Abstract

Early maladaptive schemas (EMS) are broad, pervasive themes and patterns of emotions, memories, cognition and physical sensations that impede the goal of individuals. Maladaptive behaviours can occur as a response to maladaptive or negative schemas, often culminating in depression or anxiety. The current meta-analysis integrates the existing literature to estimate the magnitude of effect of association between EMS and depression among adolescents and young adults. A systematic search of seven different databases including Embase, CINAHL, Medline, ASSIA, Psych INFO, Scopus and Web of Science was carried out identifying 24 relevant studies of adolescents (10-18 years) and young adults (19-29 years). The random-effect model estimate for association between overall EMS and depression was = 0.56 (95% CI 0.49-0.63, = 12.88, ≤ 0.0001), suggesting higher predominant EMS significantly linked to higher levels of depressive symptoms, with a large effect size. Separate meta-analytical results with schema domains indicated moderately stronger associations between schemas of disconnection/rejection, impaired autonomy/performance and other-directedness with depression. Age and gender were not found to have any significant moderating effect on the associations. The findings suggest that it is vital for clinicians to identify specific maladaptive schemas contributing towards depression, to have a better understanding of underlying cognitive processes and in turn promote psychological health, well-being and resilience in adolescents and young adults. Furthermore, findings will also assist clinicians to focus more on the content of three significant schema domains, which emerged as particularly salient factors underlying adolescent depression.

摘要

早期适应不良模式(EMS)是广泛存在的、普遍的情绪、记忆、认知和身体感觉的主题和模式,这些模式会阻碍个人的目标。适应不良行为可能是对适应不良或负面模式的反应,通常最终会导致抑郁或焦虑。目前的荟萃分析整合了现有文献,以估计 EMS 与青少年和年轻人抑郁之间关联的效应大小。通过对包括 Embase、CINAHL、Medline、ASSIA、PsychINFO、Scopus 和 Web of Science 在内的七个不同数据库进行系统搜索,确定了 24 项关于青少年(10-18 岁)和年轻人(19-29 岁)的相关研究。EMS 与抑郁之间总体关联的随机效应模型估计值为 = 0.56(95%CI 0.49-0.63, = 12.88, ≤ 0.0001),表明更高的 EMS 与更高水平的抑郁症状显著相关,具有较大的效应量。针对模式领域的单独荟萃分析结果表明,与脱节/拒绝、自主性/表现受损和指向他人的模式之间的关联更强。年龄和性别均未发现对这些关联有任何显著的调节作用。研究结果表明,对于临床医生来说,识别出导致抑郁的特定适应不良模式至关重要,以便更好地理解潜在的认知过程,并相应地促进青少年和年轻人的心理健康、幸福和适应能力。此外,这些发现还将帮助临床医生更关注三个重要模式领域的内容,这些领域是青少年抑郁的重要因素。

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