A preliminary investigation of the relationship between early maladaptive schemas and compulsive sexual behaviors in a substance-dependent population

Exploring Exercise Addiction, Self-Esteem, and Early Maladaptive Schemas: A Cross-Sectional Study Among Female University Students

BACKGROUND/OBJECTIVES

Although physical exercise provides numerous health benefits, it can occasionally become addictive, leading to negative consequences for physical and mental health. Specifically, the role of maladaptive schemas in the relationship between exercise addiction and self-esteem underscores the importance of addressing these cognitive patterns in therapeutic settings to develop practical interventions that enhance exercise with healthier self-perceptions. This study aims to analyze the role of early maladaptive schemas in the relationship between exercise addiction and self-esteem.

METHODS

The design of this study is non-experimental, correlational, and cross-sectional. The sample comprised 788 university women students (mean age 20.39 years, SD = 2.28).

RESULTS

Exercise addiction is negatively associated with self-esteem and shows positive but weak correlations with most early maladaptive schemas, except for Impaired Autonomy. A mediating effect was identified for Disconnection and Rejection (β = -0.08, p = 0.008), Impaired Limits (β = -0.03, p = 0.019), Other Directedness (β = -0.04, p = 0.032), and Over-Vigilance and Inhibition (β = -0.05, p < 0.001). Full mediation was observed for Disconnection and Rejection and Over-Vigilance and Inhibition, while Impaired Limits and Other Directedness showed partial mediation.

CONCLUSIONS

These findings suggest that the decrease in self-esteem among individuals with exercise addiction could be explained by the activation of maladaptive schemas that influence exercise motivation, with Over-Vigilance and Inhibition standing out in particular. Furthermore, it is necessary to develop cognitive behavioral therapy (CBT)-based interventions focused on modifying early maladaptive schemas and strengthening self-esteem. Additionally, it would be advisable to implement educational programs in university and sports settings that promote well-being and enjoyment over the pursuit of external validation or obsession with body image. These strategies could help prevent exercise addiction and mitigate its negative effects on self-esteem.

Early maladaptive schemas and addictive behaviours: A systematic review and meta-analysis

BACKGROUND

Recently, early maladaptive schemas have been increasingly focused as the underlying factor of several psychopathologies. The primary objective is to systematically review and meta-analytically analyse the evidence on the relationship between early maladaptive schemas and types of addictive behaviours. Additionally, the secondary objective was to examine potential moderators of the effect sizes.

METHODS

The systematic search was conducted on three databases including 'Scopus', 'Web of Science' and 'PubMed'. They were searched for quantitative studies investigating the relationship between early maladaptive schemas and addictive behaviours. The studies that were non-English and had insufficient information to calculate effect sizes were excluded. The random-effect model was utilized to estimate the pool effect sizes, and the meta-regression was used for moderation analysis.

RESULTS

Thirty-three studies with 12,577 participants were included for analyses. Most of included studies were conducted in the United States (k = 12, 36.36%). The mean ages of participants varied from 13.32 to 46.09 years. The findings indicated that all of early maladaptive schemas and schema domains positively correlated with addictive behaviours. The disconnection and rejection, impaired limits and impaired autonomy were the domains with the highest association with substance addictions (pool r = 0.338, 3.26 and 3.16, respectively). Furthermore, disconnection and rejection and impaired autonomy were the schema domains with the highest association with behavioural addictions (0.310 and 0.304, respectively). The moderation analysis demonstrated that study design was the factor affecting the effect sizes between schema domain and addictive behaviours.

LIMITATION

All included studies were from peer-reviewed journals in English. Moreover, the number of research examining the relationship between early maladaptive schemas and behavioural addictions was limited.

CONCLUSION

The findings provide evidence supporting the idea that substance addictions and behavioural addictions have shared risk factors, supporting the validity of the schema model, which can be applied for targeting and preventing addictive behaviours.

Early maladaptive schemas and behavioural addictions: A systematic literature review

As observed in other mental health difficulties, behavioural addiction is a complex construct with several potential predisposing factors, which include biological factors (e.g., genetic predispositions), psychological factors (e.g., personality traits), and social factors (e.g., family, and social history). One factor that may play a significant role in both developing and perpetuating behavioural addiction is the activation of early maladaptive schemas (EMSs). The aim of the present review was to synthesize the evidence concerning the relationship between behavioural addiction and EMSs. A comprehensive literature search using keywords and subject headings was performed with three electronic databases, resulting in 20 studies that met the inclusion criteria. In relation to specific behavioural addiction, the 20 studies examined: binge-eating/food addiction (n = 6), sexual addiction/compulsive sexual behaviours (n = 3), multiple addictive behaviours (n = 2), internet addiction (n = 2), smartphone addiction (n = 2), social networking/Facebook addiction (n = 2), exercise dependence (n = 1), gambling (n = 1), and videogame addiction (n = 1). The patterns of association between EMS and behavioural addiction were examined in both clinical and non-clinical population. The 'Disconnection and Rejection' domain was the most strongly related schema domain across all addictive behaviours, followed by 'Impaired Limits'. The present review suggests a positive relationship between schema activation and several addictive behaviours, including addictions to gambling, gaming, social media use sex, exercise, and food. The clinical implications of the findings are discussed, but further research is needed to inform treatment plans and interventions for those who struggle with behavioural addictions.

Desire thinking and craving as predictors of problematic Internet pornography use in women and men

INTRODUCTION

According to the recent adaptation of the I-PACE model, desire thinking and craving might be closely related to problematic Internet pornography use. The overall aim of the present study was to investigate the role of two components of desire thinking (imaginal prefiguration and verbal perseveration) and craving in problematic Internet pornography use. Furthermore, we examined gender differences in the underlying mechanism linking desire thinking to problematic Internet pornography use.

METHOD

A total of 414 Italian adults (mean age = 27.55 years, SD = 6.13; age range = 18-58; 53.6 % men) participated in this study. Participants completed an online survey to assess problematic Internet pornography use, pornography craving, desire thinking and problematic Internet use. Path analyses and a multi-group approach were used to test the relationships among variables and to explore gender differences.

RESULTS

Imaginal prefiguration was associated to pornography craving which, in turn, was associated to verbal perseveration as proximal antecedent of problematic Internet pornography use, above and beyond the effect of age, relationship status, and problematic Internet use. Two paths significantly differed between men and women: the path between verbal perseveration and problematic Internet pornography, which for women was weaker and did not reach significance; and the path between problematic Internet use and problematic Internet pornography use that was not significant for women.

CONCLUSIONS

In line with the I-PACE model, the present study provided support for the potential role of desire thinking in problematic Internet pornography use as a specific Internet-use disorder and expanded the literature in the field by testing unexplored gender differences. Preventive and clinical implications are discussed.

Is Compulsive Sexual Behavior Different in Women Compared to Men?

The inclusion of Compulsive Sexual Behavior Disorder (CSBD) in the ICD-11 has sparked research interest on this topic in recent years. This review aims to investigate gender differences in Compulsive Sexual Behavior (CBD) and persons with CSBD. While impulsivity and psychiatric comorbidity play a role in persons with CSBD regardless of gender, some gender differences can be identified. CSBD is more prevalent in men, with a higher rate of reported sexual behaviors and higher scores on questionnaires measuring CSBD related symptoms. Neuroticism and stress vulnerability seem to play a more important role in the symptomatology of CSBD in women. While it seems plausible that childhood adversities play a role in the development of CSB, the manner with respect to how these adversities affect men and women differently is still to be explored. More clinical studies including the female CSBD population are required to infer clinical implications.

Early Maladaptive Schemas Are Highly Indicative of Compulsive Sexual Behavior

Unlike the consequences of compulsive sexual behavior (CSB) and the profile of people with CSB that were extensively studied, the cognitive distortions that might be responsible to the development and maintenance of CSB are less understood. In Study 1 (n = 68), we examined intercorrelations between CSB and early maladaptive schemas among a sample with clinical CSB (Sexaholic Anonymous; SAs). In Study 2 (sex offenders; n = 103, and violence offenders; n = 81), we examined the intercorrelations between CSB and early maladaptive schemas among a sample with a sexual deviance but non-clinical levels of CSB. Results revealed that early maladaptive schemas are highly indicative of CSB severity. We discuss the implication of the study for the study and therapy of CSB.

Spotlight on Compulsive Sexual Behavior Disorder: A Systematic Review of Research on Women

PURPOSE OF REVIEW

World Health Organization recently included compulsive sexual behavior disorder (CSBD) to the upcoming 11th edition of International Classification of Diseases (6C72). Despite the potential benefits of this decision (eg, the acceleration of research in the field will allow the development of effective treatments), previous research focused mainly on men, and as a result, we do not have an accurate clinical picture of compulsive sexual behavior (CSB) among women. Therefore, in this systematic review, we aim to present available knowledge on this topical subject. Literature search was conducted in the guideline of PRISMA methodology. Studies were identified from multiple databases including Academic Search Ultimate, SocINDEX, PsycARTICLES, PsycINFO, PubMed, and MEDLINE. Out of a total of 10,531 articles identified and screened, 58 were included in this review. Included studies covered the following topics: prevalence and etiology of CSB, behavioral and cognitive processes involved, comorbidities, personality traits, psychosocial and interpersonal difficulties, traumatic experiences, and treatments.

RECENT FINDINGS

Available studies indicate that CSB symptom severity is lower in women than in men. Overall, women reported consuming pornography less often than men and exhibit lower rates of feeling urges to these materials. CSB symptoms (including problematic pornography use) have been found to be positively related to trait psychopathy, impulsivity, sensation seeking, attention-deficit/hyperactivity disorder symptoms, obsessive-compulsive disorder, pathological buying, sexual dysfunctions, general psychopathology, child sexual abuse, while negatively related to dispositional mindfulness.

SUMMARY

Conclusions that can be drawn from prior studies are considerably limited. There are no accurate estimates of the CSB prevalence or severity among women, and studies have been mostly conducted on non-clinical populations, which has limited application for women diagnosed with CSBD.

The Potential Role of the Early Maladaptive Schema in Behavioral Addictions Among Late Adolescents and Young Adults

Background

Behavioral addiction (BA) is a recent concept in psychiatry. Few studies have investigated the relationship between BA and early maladaptive schemas (EMSs). EMS is the core of Schema Therapy (ST). According to the ST model, psychiatric disorders result from the development of EMSs in response to unmet emotional needs in childhood. Bach et al. (2018) grouped the 18 EMSs into four domains: (1) disconnection and rejection; (2) impaired autonomy and performance; (3) excessive responsibility and standards; and (4) impaired limits. This study aims to assess the possible association of the most frequent BAs with EMSs in a large group of late adolescents and young adults and to evaluate their self-perceived quality of life (QoL).

Methods

A battery of psychological tests assessing food addiction (FA), gambling disorder (GD), internet addiction (IA), and QoL was administered to 1,075 late adolescents and young adults (N = 637; 59.3% women). A forward-stepwise logistic regression model was run to identify which variables were associated with BAs.

Results

Food addiction was more frequent among women and GD among men, while IA was equally distributed. Regarding the EMSs, participants with FA or IA showed significantly higher scores on all four-schema domains, whereas those with GD exhibited higher scores on impaired autonomy and performance and impaired limits. Besides, average scores of all domains increased with the association of two or more comorbid BAs. Self-perceived QoL was lower for participants with FA and IA, but not for those with GD; the presence of comorbid BAs was associated with lower Physical Component Summary (PCS) and Mental Component Summary (MCS) scores. Finally, specific EMS domains and demographic variables were associated with each BA.

Conclusion

Late adolescents and young adults with FA or IA have a lower perception of their mental and physical health. The most striking result is that FA appears to be associated with the disconnection and rejection schema domain, IA with all the schema domains (except for impaired autonomy and performance), and GD with impaired autonomy and performance schema domain. In conclusion, our findings suggest that EMS should be systematically assessed during psychotherapy of patients with BAs.

Online Porn Addiction: What We Know and What We Don't-A Systematic Review

In the last few years, there has been a wave of articles related to behavioral addictions; some of them have a focus on online pornography addiction. However, despite all efforts, we are still unable to profile when engaging in this behavior becomes pathological. Common problems include: sample bias, the search for diagnostic instrumentals, opposing approximations to the matter, and the fact that this entity may be encompassed inside a greater pathology (i.e., sex addiction) that may present itself with very diverse symptomatology. Behavioral addictions form a largely unexplored field of study, and usually exhibit a problematic consumption model: loss of control, impairment, and risky use. Hypersexual disorder fits this model and may be composed of several sexual behaviors, like problematic use of online pornography (POPU). Online pornography use is on the rise, with a potential for addiction considering the "triple A" influence (accessibility, affordability, anonymity). This problematic use might have adverse effects in sexual development and sexual functioning, especially among the young population. We aim to gather existing knowledge on problematic online pornography use as a pathological entity. Here we try to summarize what we know about this entity and outline some areas worthy of further research.

The Association between Food Addiction and Early Maladaptive Schemas in Overweight and Obese Women: A Preliminary Investigation

In recent years, there has been a growing focus on early maladaptive schemas (EMSs) as core features associated with eating psychopathology. The aims of the present study were to assess in overweight and obese women: (i) the association between dysfunctional eating patterns (i.e., food addiction and binge eating) and EMSs, and (ii) the association between food addiction and EMSs after controlling for potential confounding variables (i.e., binge eating severity and psychopathology). Participants were 70 overweight and obese women seeking low-energy-diet therapy. The patients were administered self-report measures investigating food addiction, binge eating, EMSs, anxiety symptoms, and depressive symptoms. Food addiction severity was strongly associated with all main schema domains. Binge eating severity was positively related to disconnection/rejection (r = 0.41; p < 0.01), impaired limits (r = 0.26; p < 0.05), and other-directedness domains (r = 0.27; p < 0.05). The disconnection/rejection schema was independently associated with food addiction severity, after controlling for the presence of other potential confounding variables (i.e., binge eating severity and psychopathology) suggesting that this domain may be a crucial factor for the development of food addiction.