Singh Geeta, Kaloiya Gauri Shanker, Dhawan Anju, Mishra Ashwani Kumar, Balhara Yatan Pal Singh
Dept. of Psychiatry, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
National Drug Dependence Treatment Centre (NDDTC), All India Institute of Medical Sciences (AIIMS), New Delhi, India.
Indian J Psychol Med. 2023 Mar;45(2):124-131. doi: 10.1177/02537176221105529. Epub 2022 Jul 11.
Although early maladaptive schemas (EMSs) have been suggested as potential vulnerability markers for alcohol dependence (AD), there is less emphasis on addressing these schemas in substance abuse treatment programs. We thus aimed to examine the change in schemas in response to cognitive therapy in individuals with AD.
In this an open-label randomized controlled study, individuals with alcohol dependence syndrome (ADS, = 84) were randomized to the intervention group ( = 45), which received six cognitive therapy sessions combined with treatment as usual (TAU), or the control group ( = 39), which was on TAU only. Participants were assessed on the measures of EMSs, alcohol use severity, and perceived stress at baseline and posttreatment.
The intervention group showed significant improvement in 5 out of 18 EMSs, that is, emotional deprivation, defectiveness, self-sacrifice, unrelenting standard, and negativity, compared to the control group, at the end of the treatment. There was a significant between-group effect for perceived stress but not for alcohol use severity.
EMSs can be changed with cognitive therapy in individuals with AD and could be a crucial area to address in treatment programs. Further studies with long-term follow-up are warranted. The trial was registered with the Clinical Trials Registry-India (CTRI/2015/12/006441) on December 17, 2015.
尽管早期适应不良图式（EMSs）已被认为是酒精依赖（AD）的潜在易感性标志物，但在药物滥用治疗项目中对解决这些图式的重视程度较低。因此，我们旨在研究AD患者在认知治疗后图式的变化。
在这项开放标签随机对照研究中，酒精依赖综合征（ADS，n = 84）患者被随机分为干预组（n = 45），接受六次认知治疗并结合常规治疗（TAU），或对照组（n = 39），仅接受TAU。在基线和治疗后，对参与者进行EMSs、酒精使用严重程度和感知压力的测量评估。
与对照组相比，干预组在治疗结束时18种EMSs中的5种，即情感剥夺、缺陷感、自我牺牲、严苛标准和消极性方面有显著改善。在感知压力方面存在显著的组间效应，但在酒精使用严重程度方面没有。
AD患者的EMSs可通过认知治疗改变，并且可能是治疗项目中需要解决的关键领域。有必要进行长期随访的进一步研究。该试验于2015年12月17日在印度临床试验注册中心（CTRI/2015/12/006441）注册。
