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Chopra R, Murthy P, Narayanan G. Early maladaptive schemas in substance use disorders in the Indian context: Theoretical and therapeutic implications. Ind Psychiatry J 2023; 32:452-455. [PMID: 38161451 PMCID: PMC10756602 DOI: 10.4103/ipj.ipj_162_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 03/01/2023] [Accepted: 03/21/2023] [Indexed: 01/03/2024] Open
Abstract
Schema theory seems to be a relevant perspective in the overall understanding of substance use disorders (SUDs). Early maladaptive schemas (EMSs) are defined as self-defeating emotional and cognitive patterns that begin early in our development, repeat throughout life, and act as risk factors for mental health problems and substance use (SU). SU behavior acts as a means by which users attempt to avoid triggering the unpleasant and negative emotions inherent in their elevated schema. Thus, SU is often seen as a coping mechanism in schema theory. This has important implications in terms of assessment, treatment, and planning of interventions. Schema therapy would be a valuable addition to the current therapy practice, which emphasizes a dual focus on both SU and EMSs and uses an integrated framework of cognitive, behavioral, and experiential techniques to target and modify EMSs.
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Affiliation(s)
- Ratnesh Chopra
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Pratima Murthy
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Gitanjali Narayanan
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
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van Dijk SDM, Veenstra MS, van den Brink RHS, van Alphen SPJ, Oude Voshaar RC. A Systematic Review of the Heterogeneity of Schema Therapy. J Pers Disord 2023; 37:233-262. [PMID: 37002933 DOI: 10.1521/pedi.2023.37.2.262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Abstract
We aimed to explore the heterogeneity of schema therapy regarding (a) patient characteristics, (b) content, and (c) way of delivering schema therapy. A search was conducted of the electronic databases EMBASE, PsycINFO, Web of Science, MEDLINE, and COCHRANE up to June 15, 2022. Treatment studies were eligible if they (a) used schema therapy as (component of) the intervention examined, and (b) reported an outcome measure quantitatively. A total of 101 studies met the inclusion criteria, including randomized controlled trials (n = 30), non-randomized controlled trials (n = 8), pre-post designs (n = 22), cases series (n = 13), and case reports (n = 28), including 4006 patients. Good feasibility was consistently reported irrespective of format (group versus individual), setting (outpatient, day-treatment, inpatient), intensity of treatment, and the specific therapeutic components included. Schema therapy was applied to various (psychiatric) disorders. All studies presented promising results. Effectiveness of the different models of schema therapy as well as application beyond personality disorders should be examined more rigorously.
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Affiliation(s)
- Silvia D M van Dijk
- University Centre of Psychiatry, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | - Martine S Veenstra
- University Centre of Psychiatry, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | - Rob H S van den Brink
- University Centre of Psychiatry, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | - Sebastiaan P J van Alphen
- Department of Clinical & Life Span Psychology, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Department of Medical & Clinical Psychology, Tilburg University, Tilburg, the Netherlands
| | - Richard C Oude Voshaar
- University Centre of Psychiatry, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
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Peeters N, van Passel B, Krans J. The effectiveness of schema therapy for patients with anxiety disorders, OCD, or PTSD: A systematic review and research agenda. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2021; 61:579-597. [PMID: 34296767 PMCID: PMC9544733 DOI: 10.1111/bjc.12324] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 07/09/2021] [Indexed: 11/30/2022]
Abstract
Objectives We reviewed the evidence regarding the effectiveness of schema therapy for anxiety disorders, obsessive‐compulsive disorder (OCD), and posttraumatic stress disorder (PTSD). Methods This systematic review followed the recommendation of the PRISMA guidelines. A database search (PsycINFO, MEDLINE, EMBASE, WEB OF SCIENCE, and Academic Search Ultimate) was conducted to identify eligible studies up until 2 April 2021. The search included the keywords (‘schema therap*’ or ‘schema group therap*’ or ‘schema mode therap*’ or ‘schema focused’ or ‘young’s model’) and (‘anxiety disorder*’ or ‘anxiety‐related disorder*’ or ‘agoraphobia’ or ‘health anxiety’ or ‘phobi*’ or ‘panic disorder’ or ‘obsessive compulsive disorder’ or ‘OCD’ or ‘posttraumatic stress’ or ‘post traumatic stress’ or ‘PTSD’ or ‘hypochondria’ or ‘axis 1’). Included studies were appraised on methodological quality according to the Psychotherapy Outcome study Methodology Rating Form. Results We identified 41 studies that were eligible based on the topic. However, only six (comprising 316 anxiety, OCD, and PTSD patients) could be included despite lenient methodological inclusion/exclusion criteria. Results showed that schema therapy can lead to beneficial effects in disorder‐specific symptoms and early maladaptive schemas. Yet, we also uncovered substantial methodological limitations in most studies. Conclusions Schema therapy is a promising treatment for anxiety, OCD, and PTSD. Yet, there is a systematic problem in the quality of research despite growing clinical interest and application. We therefore concluded with a research agenda presenting recommendations for future research that will be crucial for building a solid evidence‐base for schema therapy in chronic anxiety, OCD, and PTSD. Practitioner points A systematic review on the effectiveness of schema therapy for anxiety disorders, OCD, and PTSD. Preliminary but limited evidence that schema therapy leads to beneficial effects in disorder‐specific symptoms. Preliminary but limited evidence that schema therapy leads to beneficial effects in early maladaptive schemas in anxiety, OCD, and PTSD. More research of higher methodological quality is needed to provide more conclusive empirical support for the use of schema therapy for anxiety, OCD, and PTSD.
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Affiliation(s)
- Nancy Peeters
- Pro Persona Overwaal Centre for anxiety, OCD and PTSD, Nijmegen, The Netherlands.,Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Boris van Passel
- Pro Persona Overwaal Centre for anxiety, OCD and PTSD, Nijmegen, The Netherlands.,Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Julie Krans
- Pro Persona Overwaal Centre for anxiety, OCD and PTSD, Nijmegen, The Netherlands.,Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.,Behaviour, Health and Psychopathology, KU Leuven, Leuven, Belgium
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Sepehry AA, Lam K, Sheppard M, Guirguis-Younger M, Maglio AS. EMDR for Depression: A Meta-Analysis and Systematic Review. JOURNAL OF EMDR PRACTICE AND RESEARCH 2021. [DOI: 10.1891/emdr-d-20-00038] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The literature on the efficacy of eye movement desensitization and reprocessing (EMDR) for treating depression is heterogeneous due to research design, quality issues, and trials methodology. The current meta-analysis seeks to examine EMDR for depression with the aim of answering the aforementioned limitations. Thirty-nine studies were included for analysis after a review of the relevant literature. Univariate meta-regressions were run to examine dose-response and the effect of moderating variables. Subanalysis for primary and secondary depression showed a large, significant, and heterogeneous effect-size estimates, where EMDR significantly improved symptoms of depression in contrast to all control types. At post hoc, data were reexamined and a significant and large, yet heterogeneous, effect-size estimate emerged between the EMDR and control arm after the removal of two outliers [Hedges' g = 0.70, 95% CI =0.50–0.89, p-value < .01, I2 = 70%, K = 37]. This is the first meta-analysis examining for the effect of EMDR comparing to various control modalities on depression with dose-response. We found (a) that studies were balanced at onset in terms of depression severity, and (b) a large and significant effect of EMDR on depression at the end of trials. Additionally, the significance of the aggregate effect-size estimate at the end of trials was unchanged by the intake of psychotropic medications, reported demographic variables, or EMDR methodology.
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Dansiger S, Chabra R, Emmel L, Kovacs J. The MET(T)A Protocol: Mindfulness and EMDR Treatment Template for Agencies. SUBSTANCE ABUSE-RESEARCH AND TREATMENT 2020; 14:1178221820977483. [PMID: 33311983 PMCID: PMC7716072 DOI: 10.1177/1178221820977483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 10/31/2020] [Indexed: 12/05/2022]
Abstract
Evidence indicating the relationship between trauma and substance use disorders (SUDs), in addition to relapse and treatment retention rates for this population, suggests there is a need for a trauma-focused solution to treat SUDs. Eye movement desensitization and reprocessing (EMDR) therapy has been studied extensively as an effective approach for treating trauma and Posttraumatic Stress Disorder (PTSD). The research evaluating its treatment for other mental health disorders such as SUDs is promising. Merging mindfulness and ethical mindfulness practices with EMDR therapy lends additional evidence-based elements to make the case for this integrative system of treatment to be studied as a trauma-focused primary psychotherapy to treat SUDs. The resulting treatment, the MET(T)A Protocol (Mindfulness and EMDR Treatment Template for Agencies), has been created to address the need for a trauma-focused solution to treat SUDs. Procedures of the MET(T)A Protocol as applied in each of the 8 phases of EMDR therapy are described in detail. Clinical examples are provided to explain the application of the MET(T)A Protocol.
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Joboory SA, Soulan X, Lavandier A, Bouchard JP. [Psychological traumas in adults (2/2)]. REVUE DE L'INFIRMIERE 2020; 69:36-38. [PMID: 32838865 DOI: 10.1016/s1293-8505(20)30185-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
When they are exposed to potentially traumatic events, adults can develop psychological trauma of varying degrees of severity. For preventive and therapeutic purposes, this psychological trauma must be assessed and treated by psychologists and/or psychiatrists with adequate training and experience in dealing with these complex cases.
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Affiliation(s)
- Samantha Al Joboory
- Centre d'accueil spécialisé dans le repérage et le traitement des traumatismes psychiques (Caspertt), centre hospitalier de Cadillac, 31, rue des Cavaillès, 33310 Lormont, France; Institut psycho-judiciaire et de psychopathologie (IPJP), centre hospitalier de Cadillac, 10, avenue Joseph-Caussil, 33410 Cadillac, France; Centre de recherche Inserm-U1219, Université de Bordeaux, ISPED, 146, rue Léo-Saignat, 33076 Bordeaux cedex, France
| | - Xavier Soulan
- Centre d'accueil spécialisé dans le repérage et le traitement des traumatismes psychiques (Caspertt), centre hospitalier de Cadillac, 31, rue des Cavaillès, 33310 Lormont, France; Institut psycho-judiciaire et de psychopathologie (IPJP), centre hospitalier de Cadillac, 10, avenue Joseph-Caussil, 33410 Cadillac, France; Cellule d'urgence médico-psychologique (CUMP) de Bordeaux, centre hospitalier Charles-Perrens, 121, rue de la Béchade, CS 81285, 33 076 Bordeaux 33076 Bordeaux cedex, France
| | - Alix Lavandier
- Centre d'accueil spécialisé dans le repérage et le traitement des traumatismes psychiques (Caspertt), centre hospitalier de Cadillac, 31, rue des Cavaillès, 33310 Lormont, France; Institut psycho-judiciaire et de psychopathologie (IPJP), centre hospitalier de Cadillac, 10, avenue Joseph-Caussil, 33410 Cadillac, France
| | - Jean-Pierre Bouchard
- Institut psycho-judiciaire et de psychopathologie (IPJP), centre hospitalier de Cadillac, 10, avenue Joseph-Caussil, 33410 Cadillac, France; Unité pour malades difficiles (UMD), pôle de psychiatrie médico-légale (PPML), centre hospitalier de Cadillac, 10, avenue Joseph-Caussil, 33410 Cadillac, France.
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Tapia G. Review of EMDR Interventions for Individuals With Substance Use Disorder With/Without Comorbid Posttraumatic Stress Disorder. JOURNAL OF EMDR PRACTICE AND RESEARCH 2019. [DOI: 10.1891/1933-3196.13.4.345] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A large proportion (11%–60%) of people with posttraumatic stress disorder (PTSD) also suffer from substance use disorder (SUD). As the high cooccurrence of PTSD and SUD leads to a worsening of psychopathological severity, development and evaluation of integrated treatments become highly valuable for individuals presenting with both diagnoses. Eye movement desensitization and reprocessing (EMDR) therapy may fit these needs. This article summarized all studies that investigated EMDR treatment for SUD, to clarify whether EMDR might be a useful approach. A comprehensive Title/Abstract/Keyword search was conducted on PsycInfo, PsychArticle, PubMed, and Scopus databases. A total of 135 articles were retrieved, and 8 articles met inclusion/exclusion criteria. One RCT and one case study evaluated trauma-focused EMDR; one clinical RCT, one non-clinical RCT, one cross-over study, and one case study evaluated addiction-focused EMDR; and one quasi-experimental and one multiphase case study evaluated the combination of addiction-focused and trauma-focused EMDR. Results show that EMDR treatment consistently reduces posttraumatic symptoms, but that its effects on SUD symptoms are less evident. Although EMDR should be considered as a promising tool for this population due to its possible potential to improve SUD outcomes, further research is needed to see whether EMDR therapy, either trauma-focused or addiction-focused, is effective for SUD. We conclude with suggestions for future research and clinical practice in this area.
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Lecigne M, Tapia G. The mediating role of early maladaptive schemas on relations between post-traumatic stress disorder symptom severity and illicit substance use disorder. JOURNAL OF SUBSTANCE USE 2018. [DOI: 10.1080/14659891.2018.1489005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Marion Lecigne
- Faculté de Psychologie, Université de Bordeaux, Bordeaux Cedex, France
| | - Géraldine Tapia
- EA4139, Laboratoire Psychologie, Santé et Qualité de Vie, Université de Bordeaux, Bordeaux Cedex, France
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