Pilkington Pamela D, Karantzas Gery C, Faustino Bruno, Pizarro-Campagna Elizabeth
School of Behavioural and Health Sciences, Australian Catholic University, Fitzroy, Victoria, Australia.
School of Psychology, Deakin University, Burwood, Victoria, Australia.
Clin Psychol Psychother. 2023 Sep 21. doi: 10.1002/cpp.2914.
Emotion regulation is an integral part of the schema therapy model. The aim of this systematic review and meta-analysis was to synthesize the evidence on the associations between early maladaptive schemas (EMSs), difficulties with emotion regulation and alexithymia.
PsycINFO, PubMed and CINAHL Complete databases were searched on 28 May 2022 and 3 February 2023 in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Included studies were in English, in peer-reviewed journals and reported on the association between one or more of the 18 EMSs or five schema domains and emotion regulation difficulties or alexithymia. Methodological quality was assessed using the Appraisal Tool for Cross-Sectional Studies. Meta-analyses were conducted to examine difficulties with emotion regulation and alexithymia as correlates of each EMS and domain.
A total of 19 studies published between 2008 and 2022 were included (Pooled N = 5957). Difficulties with emotion regulation were positively correlated with all 18 EMSs (range: entitlement r(7) = .28, 95% CI [.13, .42] to negativity pessimism r(5) = .53, 95% CI [.23, .74]) and schema domains (range: impaired limits r(5) = .34, 95% CI [.08, .56] to disconnection rejection r(5) = .44, 95% CI [.33, .73]). Alexithymia was positively correlated with the other-directedness domain (r(2) = .40, 95% CI [.09, .64]) and 16 of the 18 EMSs (range: unrelenting standards r(5) = .21, 95% CI [.12, .28] to emotional inhibition r(5) = .50, 95% CI [.34, .63]).
The findings suggested that almost all 18 EMSs are implicated in emotion regulation difficulties and alexithymia, particularly those relating to unmet needs for attachment and autonomy.
情绪调节是图式疗法模型的一个重要组成部分。本系统评价和荟萃分析的目的是综合关于早期适应不良图式（EMSs）、情绪调节困难和述情障碍之间关联的证据。
于2022年5月28日和2023年2月3日检索了PsycINFO、PubMed和CINAHL Complete数据库，检索过程符合系统评价和荟萃分析的首选报告项目。纳入的研究为英文、发表于同行评审期刊且报告了18种EMSs中的一种或多种或五个图式领域与情绪调节困难或述情障碍之间的关联。使用横断面研究评估工具评估方法学质量。进行荟萃分析以检验情绪调节困难和述情障碍作为每种EMS和领域的相关因素。
共纳入2008年至2022年间发表的19项研究（合并样本量N = 5957）。情绪调节困难与所有18种EMSs呈正相关（范围：特权感r(7) = .28，95%置信区间[.13, .42]至消极悲观r(5) = .53，95%置信区间[.23, .74]）以及图式领域（范围：受损的界限r(5) = .34，95%置信区间[.08, .56]至分离拒绝r(5) = .44，95%置信区间[.33, .73]）。述情障碍与他人导向领域呈正相关（r(2) = .40，95%置信区间[.09, .64]）以及18种EMSs中的16种呈正相关（范围：严苛标准r(5) = .21，95%置信区间[.12, .28]至情绪抑制r(5) = .50，95%置信区间[.34, .63]）。
研究结果表明，几乎所有18种EMSs都与情绪调节困难和述情障碍有关，尤其是那些与未满足的依恋和自主需求相关的EMSs。
