Park Chanhee, Park C Hyung Keun
Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea.
Department of Psychiatry, Asan Medical Center, Seoul, Republic of Korea.
Clin Psychol Psychother. 2025 Mar-Apr;32(2):e70069. doi: 10.1002/cpp.70069.
Although early maladaptive schemas (EMSs) have been linked to suicidal ideation, their heterogeneous nature has not been fully explored in this relationship. This study sought to identify distinct latent profiles based on 18 EMSs in a clinical sample and examine how these profiles differ in relation to suicidal ideation and suicide risk factors, such as perceived burdensomeness, thwarted belongingness and fearlessness about death.
Data from routine clinical assessments of 799 outpatients with mood disorders (aged 18-49 years, 513 female, 286 male, M = 28.71) were analysed. Latent profile analysis was performed to identify distinct EMS profiles, and their associations with suicide risk factors were examined using the Bolck-Croon-Hagenaars method.
Five distinct EMS profiles emerged: Low, Below Average, Above Average, Specific Elevation and High Risk. The Specific Elevation profile demonstrated specifically elevated levels of social isolation/alienation, defectiveness/shame, failure, dependence/incompetence and insufficient self-control/self-discipline, while the levels of most other schemas were similar to the Above Average profile. The High Risk profile showed elevated levels across all schemas. Both the Specific Elevation profile and the High Risk profile exhibited the highest levels of perceived burdensomeness, thwarted belongingness and suicidal ideation, with no significant differences between them. Fearlessness about death did not differ among the profiles.
The identified EMS profiles offer unique utility in predicting perceived burdensomeness, thwarted belongingness and suicidal ideation. The specific schemas that showed elevation in the Specific Elevation profile may serve as promising targets for mitigating suicide risk in patients with mood disorders.
尽管早期适应不良图式（EMSs）与自杀观念有关，但其异质性在这种关系中尚未得到充分探讨。本研究旨在基于18种EMSs在临床样本中识别不同的潜在类别，并研究这些类别在自杀观念及自杀风险因素（如感知到的负担感、归属感受挫和对死亡的无畏感）方面有何差异。
分析了799名情绪障碍门诊患者（年龄18 - 49岁，女性513名，男性286名，平均年龄M = 28.71岁）常规临床评估的数据。进行潜在类别分析以识别不同的EMS类别，并使用Bolck - Croon - Hagenaars方法检验它们与自杀风险因素的关联。
出现了五个不同的EMS类别：低、低于平均水平、高于平均水平、特定升高和高风险。特定升高类别表现出社会隔离/疏离、缺陷感/羞耻感、失败、依赖/无能以及自我控制/自律不足等方面的水平特别升高，而大多数其他图式的水平与高于平均水平类别相似。高风险类别在所有图式上的水平都升高。特定升高类别和高风险类别均表现出最高水平的感知负担感、归属感受挫和自杀观念，二者之间无显著差异。各类别在对死亡的无畏感方面没有差异。
所识别的EMS类别在预测感知负担感、归属感受挫和自杀观念方面具有独特作用。在特定升高类别中显示出升高的特定图式可能成为减轻情绪障碍患者自杀风险的有希望的靶点。
