School of Health in Social Science, University of Edinburgh, United Kingdom.
School of Health in Social Science, University of Edinburgh, United Kingdom.
J Affect Disord. 2021 Dec 1;295:1462-1473. doi: 10.1016/j.jad.2021.09.031. Epub 2021 Sep 17.
Early maladaptive schemas (EMS) are self-perpetuating dysfunctional cognitive structures that have been linked with youth psychological health and play a significant role in developing and maintaining psychological distress, including anxiety symptoms.
The present meta-analysis synthesises the existing literature to evaluate the strength of association between EMS and anxiety symptoms among adolescents and young adults (aged 10-29 years). The systematic literature search was carried out in October 2019 using six different databases.
Our systematic search has identified 15 studies, comprising of 9515 participants (Mean age = 18.95, SD = 5.30). All the studies assessed were either cross-sectional or longitudinally designed. The random effect estimate for overall EMS with anxiety was r = 0.59 (95% Cl = 0.50 to 0.68, Z = 9.69, p < 0.0001), indicating a strong association between EMS and anxiety. When different schema domains were investigated separately, anxiety was shown to have significantly stronger associations with the schema domains of disconnection/rejection (r = 0.50), impaired autonomy/performance (r = 0.47) and other-directedness (r = 0.49). Further, females were found to have higher schemas of hypervigilance and other-directedness and associated anxiety symptoms compared to males.
Meta-analytical results were limited to articles published in peer-reviewed journals in English language, inducing an upward publication bias and limiting the generalizability of the findings.
The findings highlight schemas related to disconnection/rejection, impaired autonomy/performance and other-directedness as particularly salient precursors of anxiety symptoms, providing evidence for clinicians to target these particular schemas during prevention, intervention, and management of anxiety disorder.
早期适应不良模式（EMS）是自我延续的功能失调的认知结构，与青少年的心理健康有关，并在发展和维持心理困扰方面发挥重要作用，包括焦虑症状。
本荟萃分析综合了现有文献，以评估 EMS 与 10-29 岁青少年和年轻人的焦虑症状之间的关联强度。系统文献检索于 2019 年 10 月在六个不同的数据库中进行。
我们的系统搜索确定了 15 项研究，包含 9515 名参与者（平均年龄 18.95 岁，标准差 5.30 岁）。所有评估的研究均为横断面或纵向设计。EMS 与焦虑的总体随机效应估计值为 r = 0.59（95%Cl = 0.50 至 0.68，Z = 9.69，p < 0.0001），表明 EMS 与焦虑之间存在强烈关联。当分别研究不同的模式领域时，发现焦虑与不联系/拒绝（r = 0.50）、自主/表现受损（r = 0.47）和其他定向（r = 0.49）模式领域之间存在显著更强的关联。此外，与男性相比，女性被发现具有更高的警觉性和其他定向模式以及相关的焦虑症状。
荟萃分析结果仅限于发表在同行评议的英文期刊上的文章，导致向上发表偏倚，限制了研究结果的普遍性。
这些发现强调了与不联系/拒绝、自主/表现受损和其他定向相关的模式作为焦虑症状的特别突出的前驱因素，为临床医生在预防、干预和管理焦虑障碍时针对这些特定模式提供了证据。
