Clinical Research
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Evaluation of Patients Diagnosed with Generalized Anxiety Disorder in Terms of Early Maladaptive Schemas

Year 2023, Volume: 5 Issue: 3, 567 - 72, 18.09.2023

Hanife Kocakaya Deniz Deniz Özturan

https://doi.org/10.37990/medr.1306653

Abstract

Aim: It has been reported that individuals with generalized anxiety have many interpersonal problems and these problems occur through schemas such as emotional inhibition, shyness, subjugation, self-sacrifice and intervention. In light of this information, the purpose of this study was to compare individuals with generalized anxiety disorder (GAD) and healthy controls in terms of early maladaptive schemas (EMSs).
Material and Methods: This research involved 92 participants aged 18 to 55, including 48 GAD patients and 44 healthy controls. Sociodemographic data form, Young Schema Questionnaire-Short Form-3 (YSQ-S3), Generalized Anxiety Disorder 7-item scale (GAD-7), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were administered to the participants. The study was approved by the ethics committee (KÜTF KAEK NO:2023.02.16).
Results: The patients' average age was 38.19±11.29, and 83.3% of them (n=40) were women. The average age of healthy controls was significantly lower, however, neither group differed significantly in terms of education or marital status. The mean GAD-7 score of the patients was 6.26±6.81. Emotional deprivation (p=0.024), pessimism (p<0.001), approval seeking (p=0.034), self-sacrifice (p=0.004), punitiveness (p<0.001), abandonment (p<0.001), vulnerability (p=0.042) schema scores, and BAI (p<0.001) and BDI (p<0.001) scores were significantly higher in GAD group. Moreover, there was a positive correlation (p<0.05) between GAD-7 score and early maladaptive schemas (excluding failure, insufficient self-control and defectiveness).
Conclusion: Our findings show that multiple EMSs play a role in patients with GAD. In this context, EMSs should be considered in the approach to patients with GAD, as it is one of the diseases that cause the most disability and is closely related to other psychological disorders.

Keywords

Maladaptive schema anxiety psychiatric disorders

Supporting Institution

Not

Project Number

Not

Thanks

The authors would like to appreciate the patients participation in this study.

References

  • 1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM 5). E. Koroglu. (Trans.) 5th Edition. Ankara: HYB publishing, 2014.
  • 2. Kessler RC, Petukhova M, Sampson NA, et al. Twelve-month and lifetime prevalence and lifetime morbid risk of anxiety and mood disorders in the United States. Int J Methods Psychiatr Res. 2012;21:169-84.
  • 3. Borkovec TD. Applied relaxation and cognitive therapy for pathological worry and generalized anxiety Disorder. In: Davey GCL, Wells A, eds, Worry and its Psychological Disorders: Theory, Assessment and Treatment. (Wiley) Chichester. 2006:273-87.
  • 4. Cabral MD, Patel DR. Risk factors and prevention strategies for anxiety disorders in childhood and adolescence. Adv Exp Med Biol. 2020;1191:543-59.
  • 5. Hoffart A. The case formulation process in schema therapy of chronic Axis I disorder (affective/anxiety disorder). In van Vreeswijk M, Broersen J, Nadort M, eds, The Wiley-Blackwell handbook of schema therapy: Theory, research, and practice. Wiley Blackwell, 2012;69-80.
  • 6. Young JE, Klosko J, Weishaar M. Schema Therapy: A practitioner’s guide. Guilford Press. 2003;254:653-8.
  • 7. Arntz A, Jacob G. Schema therapy in practice: An introductory guide to the schema mode approach. John Wiley & Sons; 2017.
  • 8. Masley SA, Gillanders DT, Simpson SG, & Taylor MA. A systematic review of the evidence base for schema therapy. Cogn Behav Ther. 2012;41:185-202.
  • 9. Hawke LD, Provencher MD. Early maladaptive schemas: Relationship with case complexity in mood and anxiety disorders. J Cogn Psychother. 2013;27:359-69.
  • 10. Bakhsh LM, Amiralsadaat F, Bakhsh FM, et al. A comparative study of attachment styles and early maladaptive schemas among tonekabon patients with generalized anxiety disorder and patients with major depression. Indian Journal of Fundamental and Applied Life Sciences. 2015:5:1943-51.
  • 11. De Martini J, Patel G, Fancher TL. Generalized anxiety disorder. Ann Intern Med. 2019;170:ITC49-64.
  • 12. Soygüt G, Karaosmanoğlu A, Cakir Z. Assessment of early maladaptive schemas: A psychometric study of the Turkish Young Schema Questionnaire-Short Form-3. Turk Psikiyatri Derg. 2009;20:75-84.
  • 13. Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166:1092-7.
  • 14. Konkan R, Senormanci O, Guclu O, Aydin E, et al. Validity and reliability study for the Turkish Adaptation of the Generalized Anxiety Disorder-7 (GAD-7) Scale. Archives of Neuropsychiatry. 2013;50:53-8.
  • 15. Beck AT, Ward CH, Mendelson M, et al. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4:561-71.
  • 16. Hisli N. Beck depresyon envanterinin geçerliği üzerine bir çalışma. Turk J Psychol. 1988;6:118-26.
  • 17. Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. An inventory for measuring clinical anxiety: Psychometric properties. Journal of Consulting and Clinical Psychology. 1988;56:893-7.
  • 18. Ulusoy M, Şahin N, Erkmen H. Turkish version of the Beck Anxiety Inventory: psychometric properties. Journal of Cognitive Psychotherapy. 1998;12:163-72.
  • 19. Delattre V, Servant D, Rusinek S, Lorette C, et al. The early maladaptive schemas: A study in adult patients with anxiety disorders. L’Encéphale. 2004;30:255-8.
  • 20. Hawke LD & Provencher MD. Schema theory and schema therapy in mood and anxiety disorders: A review. Journal of cognitive psychotherapy. 2011;25:257-76.
  • 21. Tariq A, Quayle E, Lawrie S, et al. Relationship between early maladaptive schemas and anxiety in adolescence and young adulthood: a systematic review and meta-analysis. J Affect Disord. 2021;295:1462-73.
  • 22. Young JE, Brown G. Young Schema Questionnaire. New York: Cognitive Therapy Center of New York, 2003.
  • 23. Silva MT, Caicedo Roa M, Martins SS, et al. Generalized anxiety disorder and associated factors in adults in the Amazon, Brazil: A population-based study. J Affect Disord. 2018;236:180-6.
  • 24. Shorey RC, Elmquist J, Anderson S, Stuart GL. The relationship between early maladaptive schemas, depression, and generalized anxiety among adults seeking residential treatment for substance use disorders. J Psychoactive Drugs. 2015;47:230-8.
  • 25. Schmidt NB, Joiner Jr, TE Young, Telch MJ. The schema questionnaire: Investigation of psychometric properties and the hierarchical structure of a measure of maladaptive schemas. Cognitive Therapy and Research. 1995;19:295-321.
  • 26. Calvete E, Estévez A, López de Arroyabe, Ruiz P. The schema questionnaire—short form: structure and relationship with automatic thoughts and symptoms of affective disorders. European Journal of Psychological Assessment. 2005;21:90-9.
  • 27. Yan Y, Wang J, Yu W, et al. Young schema questionnaire: factor structure and specificity in relation to anxiety in Chinese adolescents. Psychiatry Investig. 2018;15:41-8.
  • 28. Welburn KR, Coristine M, Dagg P, et al. The schema questionnaire— short form: factor analysis and relationship between schemas and symptoms. Cognitive Therapy and Research. 2002;26:519-30.
  • 29. Cooper MJ, Rose KS, Turner H. Core beliefs and the presence or absence of eating disorder symptoms and depressive symptoms in adolescent girls. Int J Eat Disord. 2005;38:60-4.
  • 30. Eng WQ, Heimberg RG. Interpersonal correlates of generalized anxiety disorder: self versus other perception. J Anxiety Disord. 2006;20:380-7.

Year 2023, Volume: 5 Issue: 3, 567 - 72, 18.09.2023

Hanife Kocakaya Deniz Deniz Özturan

https://doi.org/10.37990/medr.1306653

Abstract

Project Number

Not

References

  • 1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM 5). E. Koroglu. (Trans.) 5th Edition. Ankara: HYB publishing, 2014.
  • 2. Kessler RC, Petukhova M, Sampson NA, et al. Twelve-month and lifetime prevalence and lifetime morbid risk of anxiety and mood disorders in the United States. Int J Methods Psychiatr Res. 2012;21:169-84.
  • 3. Borkovec TD. Applied relaxation and cognitive therapy for pathological worry and generalized anxiety Disorder. In: Davey GCL, Wells A, eds, Worry and its Psychological Disorders: Theory, Assessment and Treatment. (Wiley) Chichester. 2006:273-87.
  • 4. Cabral MD, Patel DR. Risk factors and prevention strategies for anxiety disorders in childhood and adolescence. Adv Exp Med Biol. 2020;1191:543-59.
  • 5. Hoffart A. The case formulation process in schema therapy of chronic Axis I disorder (affective/anxiety disorder). In van Vreeswijk M, Broersen J, Nadort M, eds, The Wiley-Blackwell handbook of schema therapy: Theory, research, and practice. Wiley Blackwell, 2012;69-80.
  • 6. Young JE, Klosko J, Weishaar M. Schema Therapy: A practitioner’s guide. Guilford Press. 2003;254:653-8.
  • 7. Arntz A, Jacob G. Schema therapy in practice: An introductory guide to the schema mode approach. John Wiley & Sons; 2017.
  • 8. Masley SA, Gillanders DT, Simpson SG, & Taylor MA. A systematic review of the evidence base for schema therapy. Cogn Behav Ther. 2012;41:185-202.
  • 9. Hawke LD, Provencher MD. Early maladaptive schemas: Relationship with case complexity in mood and anxiety disorders. J Cogn Psychother. 2013;27:359-69.
  • 10. Bakhsh LM, Amiralsadaat F, Bakhsh FM, et al. A comparative study of attachment styles and early maladaptive schemas among tonekabon patients with generalized anxiety disorder and patients with major depression. Indian Journal of Fundamental and Applied Life Sciences. 2015:5:1943-51.
  • 11. De Martini J, Patel G, Fancher TL. Generalized anxiety disorder. Ann Intern Med. 2019;170:ITC49-64.
  • 12. Soygüt G, Karaosmanoğlu A, Cakir Z. Assessment of early maladaptive schemas: A psychometric study of the Turkish Young Schema Questionnaire-Short Form-3. Turk Psikiyatri Derg. 2009;20:75-84.
  • 13. Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166:1092-7.
  • 14. Konkan R, Senormanci O, Guclu O, Aydin E, et al. Validity and reliability study for the Turkish Adaptation of the Generalized Anxiety Disorder-7 (GAD-7) Scale. Archives of Neuropsychiatry. 2013;50:53-8.
  • 15. Beck AT, Ward CH, Mendelson M, et al. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4:561-71.
  • 16. Hisli N. Beck depresyon envanterinin geçerliği üzerine bir çalışma. Turk J Psychol. 1988;6:118-26.
  • 17. Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. An inventory for measuring clinical anxiety: Psychometric properties. Journal of Consulting and Clinical Psychology. 1988;56:893-7.
  • 18. Ulusoy M, Şahin N, Erkmen H. Turkish version of the Beck Anxiety Inventory: psychometric properties. Journal of Cognitive Psychotherapy. 1998;12:163-72.
  • 19. Delattre V, Servant D, Rusinek S, Lorette C, et al. The early maladaptive schemas: A study in adult patients with anxiety disorders. L’Encéphale. 2004;30:255-8.
  • 20. Hawke LD & Provencher MD. Schema theory and schema therapy in mood and anxiety disorders: A review. Journal of cognitive psychotherapy. 2011;25:257-76.
  • 21. Tariq A, Quayle E, Lawrie S, et al. Relationship between early maladaptive schemas and anxiety in adolescence and young adulthood: a systematic review and meta-analysis. J Affect Disord. 2021;295:1462-73.
  • 22. Young JE, Brown G. Young Schema Questionnaire. New York: Cognitive Therapy Center of New York, 2003.
  • 23. Silva MT, Caicedo Roa M, Martins SS, et al. Generalized anxiety disorder and associated factors in adults in the Amazon, Brazil: A population-based study. J Affect Disord. 2018;236:180-6.
  • 24. Shorey RC, Elmquist J, Anderson S, Stuart GL. The relationship between early maladaptive schemas, depression, and generalized anxiety among adults seeking residential treatment for substance use disorders. J Psychoactive Drugs. 2015;47:230-8.
  • 25. Schmidt NB, Joiner Jr, TE Young, Telch MJ. The schema questionnaire: Investigation of psychometric properties and the hierarchical structure of a measure of maladaptive schemas. Cognitive Therapy and Research. 1995;19:295-321.
  • 26. Calvete E, Estévez A, López de Arroyabe, Ruiz P. The schema questionnaire—short form: structure and relationship with automatic thoughts and symptoms of affective disorders. European Journal of Psychological Assessment. 2005;21:90-9.
  • 27. Yan Y, Wang J, Yu W, et al. Young schema questionnaire: factor structure and specificity in relation to anxiety in Chinese adolescents. Psychiatry Investig. 2018;15:41-8.
  • 28. Welburn KR, Coristine M, Dagg P, et al. The schema questionnaire— short form: factor analysis and relationship between schemas and symptoms. Cognitive Therapy and Research. 2002;26:519-30.
  • 29. Cooper MJ, Rose KS, Turner H. Core beliefs and the presence or absence of eating disorder symptoms and depressive symptoms in adolescent girls. Int J Eat Disord. 2005;38:60-4.
  • 30. Eng WQ, Heimberg RG. Interpersonal correlates of generalized anxiety disorder: self versus other perception. J Anxiety Disord. 2006;20:380-7.
There are 30 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Original Articles
Authors

Hanife Kocakaya 0000-0002-5907-3808

Deniz Deniz Özturan 0000-0003-3889-3652

Project Number Not
Early Pub Date August 15, 2023
Publication Date September 18, 2023
Acceptance Date August 1, 2023
Published in Issue Year 2023 Volume: 5 Issue: 3

Cite

AMA Kocakaya H, Deniz Özturan D. Evaluation of Patients Diagnosed with Generalized Anxiety Disorder in Terms of Early Maladaptive Schemas. Med Records. September 2023;5(3):567-72. doi:10.37990/medr.1306653
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Assoc. Prof. Zülal Öner
Address: İzmir Bakırçay University, Department of Anatomy, İzmir, Türkiye

Assoc. Prof. Deniz Şenol
Address: Düzce University, Department of Anatomy, Düzce, Türkiye

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