School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Melbourne, Australia.
Schema Therapy Institute of Australia, Melbourne, Australia.
Clin Psychol Psychother. 2022 Jan;29(1):111-130. doi: 10.1002/cpp.2630. Epub 2021 Jul 16.
Improved understanding of the specific cognitive risk factors associated with depression is needed to inform prevention and treatment approaches. Recent research has examined the relationship between early maladaptive schemas (EMSs) and depression, but the findings were yet to be integrated using meta-analytic methods. The aim of this review was to synthesize the evidence on the relationship between depression and EMS.
A systematic review and meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, by searching the PsycINFO, PubMed and CINAHL databases. Included studies were peer-reviewed journal articles that examined the relationship between one or more EMS and depression in adulthood in participants aged 18 years or older.
A total of 51 studies were included (k = 743; pooled N = 17,830). All 18 EMSs were positively correlated with depression, with effect sizes ranging from small (r = .23 [.17, .29]; Entitlement) to large (r = .53 [.46, .60]; Social Isolation; r = .50, 95% CI [.45, .54]; Defectiveness/Shame).
The evidence suggests that individuals who feel like they do not belong, or that they are flawed, bad or unlovable, report higher levels of depression. However, most studies used cross-sectional designs, and further longitudinal research is needed to establish the direction of the relationship between EMS and depression. These findings can guide preventative and treatment approaches. Focusing treatment on the Social Isolation and Defectiveness/Shame EMS may aid in relieving depressive symptoms.
为了为预防和治疗方法提供信息，需要更好地了解与抑郁相关的特定认知风险因素。最近的研究已经研究了早期适应不良模式（EMS）与抑郁之间的关系，但尚未使用荟萃分析方法整合这些发现。本综述的目的是综合有关抑郁与 EMS 之间关系的证据。
根据系统评价和荟萃分析的首选报告项目（PRISMA）声明，通过搜索 PsycINFO、PubMed 和 CINAHL 数据库进行了系统回顾和荟萃分析。纳入的研究是同行评审的期刊文章，这些文章在年龄为 18 岁或以上的参与者中研究了一个或多个 EMS 与成年期抑郁之间的关系。
共有 51 项研究（k = 743；汇总 N = 17830）被纳入。所有 18 个 EMS 均与抑郁呈正相关，效应大小从小（r =.23 [.17，.29]；Entitlement）到较大（r =.53 [.46，.60]；Social Isolation；r =.50，95% CI [.45，.54]；Defectiveness/Shame）。
证据表明，那些觉得自己不属于或有缺陷、不好或不可爱的人，报告的抑郁水平更高。然而，大多数研究使用了横断面设计，需要进一步的纵向研究来确定 EMS 与抑郁之间的关系方向。这些发现可以指导预防和治疗方法。针对社交孤立和缺陷/羞耻 EMS 的治疗可能有助于缓解抑郁症状。
