Volume 7, Issue 1 (February 2020)                   Avicenna J Neuro Psycho Physiology 2020, 7(1): 55-59 | Back to browse issues page


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Moradi A, Gholami E, Hagh Talab T, Safaeirad I. Comparison of Early Maladaptive Schemas in Drug (Traditional and Industrial) Addicted and Nonaddicted Individuals in Hamadan, Iran. Avicenna J Neuro Psycho Physiology. 2020; 7 (1) :55-59
URL: http://ajnpp.umsha.ac.ir/article-1-311-en.html
1- Master of Clinical Psychology, Islamic Azad University, Hamadan Branch, Hamadan, Iran , amoradi750@gmail.com
2- Master of Clinical Psychology, Islamic Azad University, Hamadan Branch, Hamadan, Iran
3- Assistant Professor, Department of Psychology, Malayer University, Hamadan, Iran
4- PhD in Psychology, Faculty Member, Islamic Azad University, Hamadan Branch, Hamadan, Iran
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Background
 
Substance use disorder (SUD) among the most common psychiatric problems caused by the interaction of genetic and environmental factors and adverse psychosocial conditions [1]. As addiction is one of the most important social issues, the examination of the causes and factors affecting the tendency to use drugs is important. Drug abuse should not be viewed as merely a physical, psychological, or social problem; however, it is developed as a result of the interaction of several factors. As the frequency of risk factors in an individual is greater, the likelihood of drug abuse would also increase [2, 3].
A large number of addicted people have personality failures, and they are stimulated to use drugs as a result of the relationship and communication with other addicted individuals [4]. One of the theories discussed on personality, psychological pathology, and psychotherapy is Young’s schema therapy model. On the core of this theory lies the concept of early maladaptive schemas.
Early maladaptive schemas are patterns or deep themes, memories, emotions, and body emotions, developed in childhood or adolescence that continue throughout life. They are highly inefficient with severe effects on well-being and maladaptive performance [5, 6]. Young defines 18 early maladaptive schemas in 5 domains. The first and the most important domain is disconnection and rejection, including five schemas of abandonment/ instability, emotional deprivation, mistrust/abuse, social alienation/rejection, and defectiveness/shame. The individuals with these schemas expect that
their needs for safety, nurturance stability, communication, and acceptance should not be met in predictable ways.
Beck describes schemas as cognitive structures for selection, encoding, and evaluation of stimuli affecting the organism. Schemas develop during childhood and act as a model for the processing of general life experiences [7]. As they are relatively stable, they are constantly being sought as confirmatory information and can lead to one’s vulnerability to psychological disturbances [8].
In the last few decades, many attempts have been made to investigate the relationship between drug abuse and personality structures. The assumption of an addictive personality in the psychoanalytic concepts is rooted in drug dependency. An important factor to which less attention has been paid in domestic studies is early maladaptive schemes. It is thought that drug abuse is one of the coping strategies used to counter the negative effects of motivated maladaptive schemes.
Drug abuse is one of the psychiatric disorders with numerous and diverse causes involved in its development [9]. Recent studies have focused on risk factors and multiple etiologies associated with drug abuse. Although social factors are highly emphasized in the tendency toward drug abuse, it can also be related to personality traits, beliefs, and early maladaptive schemas [10, 11].
Young people are more vulnerable to drug addiction. Various factors, such as sociological and psychological issues, are involved with regard to the etiology of addiction and unsuccessful or successful quitting among addicted people. However, it seems that an individual’s response to opioids is related to the combination of the aforementioned factors. As a large number of addicted people who have successfully quitted drug returns to this maladaptive behavior, it can be concluded that drug addiction is rooted in more solid and long-lasting structures, with more determinant aspects on evident behavior [12].
The underlying symptoms of chronic disorders are most frequently substance abuse abnormalities, depression, anxiety, and mental illness [13]. The results of studies carried out by Lotfi et al. [14], Ketabi et al. [15], Wang et al. [16], and Dale et al. [17] showed that addicts suffer from more psychological damages and maladaptive schemas, compared to nonaddicts. The results of the aforementioned studies suggested that disconnection and rejection largely occurred in addicts.
 
Objectives
Since combative and preventive approaches to substance abuse have not been complete during past decades, the impact of maladaptive schemas and evaluation of their various aspects on turning into addiction have remained obscure. In addition, since mental health promotion plays an important role in the prevention of drug addiction, the present study attempted to examine the maladaptive schemas in addicts and nonaddicts hoping for helping addiction planners and therapists in the prevention of addiction.
Materials and Methods
This causal-comparative study was conducted on all individuals with and without SUD referring to five addiction treatment centers in Hamadan, Iran, during 2016. A total of 20 subjects were selected from each center using stratified random sampling. Accordingly, 140 individuals were chosen as the study population out of which 100 participants were selected as the study subjects through the Morgan table.
The Young’s Schema Questionnaire Short Form [18] was designed for the measurement of early maladaptive schemes. The short form of the questionnaire has been developed to measure 15 early maladaptive schemas based on the original form. Each item is scored on a 5-point Likert scale (i.e., Totally false, Almost false, Slightly correct, Almost correct, and Completely correct). In this questionnaire, a higher score indicates more early maladaptive schemas.
Baranov et al. reported the Cronbach’s alpha coefficients of this questionnaire as 0.94 and 0.96 for the two groups of Australian and Korean subjects, respectively [19]. In Iran, Zolfaghari et al. implemented the short form of the questionnaire for 70 couples. In the aforementioned study, the Cronbach’s alpha coefficients were reported as 0.94, 0.91, 0.90, 0.73, 0.67, and 0.78 for the whole questionnaire disconnection and rejection, impaired autonomy and performance, impaired limits, other-directedness (0.91), hypervigilance, and inhibition, respectively [20].
Data analysis was performed at descriptive and inferential levels. At the descriptive level, statistical analyses, such as means, standard deviations, tables, and graphs, were used for the analysis of the data. At the inferential level, Pearson’s correlation coefficient, path analysis, and independent t-test were used in SPSS software (version 22).
 
Results
The obtained data from the questionnaire and frequency of the subjects in terms of number, age, and education level are shown in Table 1.The independent samples t-test was performed to compare the scores of psychological schemas in drug (i.e., industrial and traditional) addicted individuals and those reported for nonaddicted subjects (Table 2).
As shown in Table 2, it can be stated that in current study, the mean scores of all the subscales of early maladaptive schemas are lower in the nonaddicted group (15/405) than those reported for the addicted group (23/815). The significance of these differences was examined using the independent t-test (Table 3).
 
 
Table 1. Frequency of subjects in terms of number, age, and education level
Characteristics Nonaddicted individuals Addicted individuals Total
n % n % n %
Number 100 100 100 100 200 100
Age            
20-30 years 36 36 31 31 67 33.5
31-40 years 40 40 42 42 82 41
41-50 years 24 24 27 27 51 25.5
Educational level            
Below high school 26 26 30 30 56 28
High school 44 44 47 47 91 45.5
Bachelor and higher 30 30 23 23 53 26.5
 
Table 2. Comparison of the scores of psychological schemas in drug (i.e., industrial and traditional) addicted individuals and those of nonaddicted subjects using independent t-test
Schema Group M n Standard deviation Standard error of the mean
Average scores of 15 subscales of early maladaptive schemas Addicted individuals 23/815 100 4.761 0.477
Nonaddicted individuals 15/405 100 5.779 0.552
 
Table 3. Results of independent t-test for 15 subscales of psychological schemas
Subscales Levene’s test for homogeneity
variances
T-test for mean
F-value P-value T-value d.f P-value (2 domains) Mean of differences Standard error differences Differences in mean with 0.95
Min Max
Self-sacrifice Assumption of equality of variances 8/ 091 0/005 13/658 198 0/000 9/704 0/71 8/303 11/105
Assumption of inequality of variances     13/658 187/441 0/000 9/704 0/71 8/303 11/105
Emotional inhibition Assumption of equality of variances 18/72 0/000 12/177 198 0/000 6/642 0/545 5/566 7/718
Assumption of inequality of variances     12/177 177/398 0/000 6/642 0/545 5/566 7/718
Unrelenting standards Assumption of equality of variances 1/877 0/172 10/372 198 0/000 7/169 0/691 5/806 8/532
Assumption of inequality of variances     10/372 195/857 0/000 7/169 0/691 5/806 8/532
Entitlement/
Grandiosity
Assumption of equality of variances 2/366 0/126 13/007 198 0/000 8/885 0/683 7/538 10/232
Assumption of inequality of variances     13/007 195/389 0/000 8/885 0/683 7/538 10/232
Self-discipline/
Insufficient self-control
Assumption of equality of variances 4/117 0/000 8/968 198 0/000 5/963 0/665 4/652 7/275
Assumption of inequality of variances     8/968 159/469 0/000 5/963 0/665 4/65 7/276
Emotional deprivation Assumption of equality of variances 3/411 0/066 10/217 198 0/000 8/793 0/861 7/096 10/49
Assumption of inequality of variances     10/217 189/596 0/000 8/793 0/861 7/095 10/491
Abandonment/
Instability
Assumption of equality of variances 1/382 0/241 11/671 198 0/000 8/964 0/768 7/45 10/479
Assumption of inequality of variances     11/671 196/654 0/000 8/964 0/768 7/45 10/479
Mistrust/Abuse Assumption of equality of variances 1/014 0/315 13/775 198 0/000 9/476 0/688 8/119 10/833
Assumption of inequality of variances     13/775 197/209 0/000 9/476 0/688 8/119 10/833
Social alienation/Rejection Assumption of equality of variances 0/725 0/395 11/825 198 0/000 8/692 0/735 7/243 10/142
Assumption of inequality of variances     11/825 197/375 0/000 8/692 0/735 7/243 10/142
Defectiveness/
Shame
Assumption of equality of variances 5/853 0/016 11/586 198 0/000 8/498 0/733 7/052 9/945
Assumption of inequality of variances     11/586 189/371 0/000 8/498 0/733 7/052 9/945
Failure Assumption of equality of variances 3/207 0/075 12/809 198 0/000 9/528 0/744 8/061 10/995
Assumption of inequality of variances     12/809 195/436 0/000 9/528 0/744 8/061 10/995
Dependency/
Incompetency
Assumption of equality of variances 0/373 0/542 10/106 198 0/000 7/478 0/74 6/018 8/937
Assumption of inequality of variances     10/106 196/934 0/000 7/478 0/74 6/018 8/937
Vulnerability Assumption of equality of variances 0/376 0/54 10/609 198 0/000 8/303 0/783 6/76 9/847
Assumption of inequality of variances     10/609 194/765 0/000 8/303 0/783 6/76 9/847
Enmeshment/
Undeveloped self
Assumption of equality of variances 2/567 0/111 10/926 198 0/000 8/265 0/756 6/773 9/757
Assumption of inequality of variances     10/926 195/018 0/000 8/265 0/756 6/773 9/757
Subjugation Assumption of equality of variances 12/87 0/000 11/312 198 0/000 9/782 0/865 8/077 11/488
Assumption of inequality of variances     11/312 176/525 0/000 9/782 0/865 8/076 11/489
 
 
According to Table 3 and results of the independent t-test, it can be concluded that there is a significant difference between the scores of the two groups. Accordingly, the frequency of the early maladaptive schemas of the participants with SUD was generally greater than that reported for the subjects without SUD (df=198; p-value of the first column<0.05; the lowest and highest p-values of Levene’s test reported as 0.000 and 0.542, respectively).
 
Discussion
The present study aimed to compare the early maladaptive schemas between individuals with and without SUD in Hamadan. The obtained findings showed there was a significant difference between the scores of the early maladaptive schemas of individuals with and without SUD. Therefore, the frequency of the maladaptive schemas of individuals with SUD was generally greater than that reported for those without SUD. This finding was in line with the results of previous studies conducted by Lotfi et al. [14], Cicero et al. [21], and Lumley et al. [22].
According to Young’s theory, maladaptive behaviors are developed in response to maladaptive schemas, and then they are triggered by schemas themselves. When maladaptive schemas are triggered, people experience usually high levels of negative emotions, such as anger, anxiety, sadness, or feelings of guilt. Consequently, most people show maladaptive behaviors, such as drug abuse, to avoid being triggered by schemas [22,23].
In addition, it can be stated that people use drugs since they believe that drugs can reduce their negative emotions and moderate the situation; however, drug abuse causes the next negative mood in drug users leading to continued drug abuse. Therefore, it can be concluded that one of the reasons for individuals’ tendency toward drug abuse is the existence of early maladaptive schemas. These early maladaptive schemas cause individuals to use drugs to compensate for personal deficiencies and join groups in which drugs are consumed because early drug abuse covers all these defects and arouses better feelings in drug users. However, it not only makes them feel good but also disrupts all the aspects of an individual’s life.
 
Conclusions
According to the obtained results, there was a significant difference between the scores of early maladaptive schemas in individuals with and without SUD. Accordingly, the frequency of early maladaptive schemas of the individuals with SUD was generally greater than that reported for those without SUD. Considering the importance and effect of schemas on life, it is recommended to recognize and correct them during childhood and adolescence with the help of associated specialists. Moreover, given the obtained results of the current study, it is suggested to give schema-based psychotherapies regarding SUD in treatment centers in addition to other psychological services. Finally, it is also recommended to carry out supplementary studies on schemas with larger sample sizes and in different regions.
 
Compliance with ethical guidelines
All ethical principles were considered in this article. The participants were informed about the purpose of the study and implementation of the stages. Furthermore, informed consent was obtained from all the subjects. They were also assured of the confidentiality of their information. Moreover, the participants were allowed to withdraw from the study at any time, and the results of the study would be available to them if desired.
 
Acknowledgments
The authors would like to appreciate all the staff of Hamadan addiction treatment centers and their clients, who helped in conducting this study. It should be noted that this article was extracted from a master thesis in clinical psychology, approved by reviewers at Islamic Azad University of Hamadan 2016/4/12; reference no.:17120701942040)
 
Funding/Support
The present study did not receive any specific grant from funding agencies in public, commercial, or not-for-profit sectors.
Conflicts of Interest
The authors declare that there is no conflict of interest.
 
References
  1. Asadi Z, Amiri S, Pourkamali A. A comparison of early maladaptive schemas in crystal addicted individuals and normal individuals. Journal of Research on Addiction. 2011; 4(16):85-92.
  2. Maskani K, Jafarzadeh Fakhar M. The prevalence of risk factors in addiction and leaving the drug by self-revealing addicted people. Journal of Sabzevar University of Medical Sciences and Health Services. 2008; 15(3):176-81.
  3. Rush BR, Wild TC. Substance abuse treatment and pressures from the criminal justice system: data from a provincial client monitoring system. Addiction. 2003; 98(8):1119-28. [DOI:10.1046/j.1360-0443.2003.00420.x] [PMID]
  4. Jazayeri AR, Pourshahbaz A, Hajir F, Rezayee M. Relationship between anti-social and borderline personality disorder and addiction in Kermanshahi men (18-35 years old) Hakim Research Journal. 2004; 7(1):49-54. 
  5. Young JE. Cognitive therapy for personality disorders: a schema-focused approach. Sarasota FL: Professional Resource Press; 1990.
  6. Young JE, Klosko JS. Reinventing your life. New York: Penguin; 1994.
  7. Young JE, Coloseco J, Wishar M. Therapeutic schema. Guideline for clinical specialists. Trans: Hamidpour A Tehran: Arjmand Publications; 2010.
  8. McGinn LK, Young JE. Schema-focused therapy. New York: Guilford; 1996. P. 182-207.
  9. Wylie MS. Family therapy's neglected prophet. Family Therapy Networker. 1991; 15(2):24-37.
  10. Beck AT. Cognitive therapy and the emotional disorders. New York: Penguin; 1979.
  11. Glantz MD. Vulnerability to drug abuse introduction and overview. Washington DC: American Psychological Association; 1992.
  12. Khoshlahjeh A, Abolmaali K, Khoshlahjeh Z, Alizadeh F, Imani E. The comparison schema in the successful addiction, unsuccessful addiction and non-addiction popular. Research on Addiction. 2010; 4(14):77-88.
  13. Young JE, Klosko JS, Weishaar ME. Schema therapy: a practitioner's guide. New York: Guilford Press; 2006
  14. Lotfi R, Donyavi V, Khosravi Z. Comparison of early maladaptive schemas between personality disorder (cluster B) and normal subjects. Annals of Military and Health Sciences Research. 2006; 5(2):1261-6.
  15. Ketabi S, Maher F, Borjali A. Survey of personality status of addicted persons to opiate by two personality systems of Izeng and Kloninjer. Addiction. 2008; 2(7):45-54.
  16. Wang CE, Halvorsen M, Eisemann M, Waterloo K. Stability of dysfunctional attitudes and early maladaptive schemas: a 9-year follow-up study of clinically depressed subjects. Journal of Behavior Therapy and Experimental Psychiatry. 2010; 41(4):389-96. [DOI:10.1016/j.jbtep.2010.04.002] [PMID]
  17. Dale R, Power K, Kane S, Stewart AM, Murray L. The role of parental bonding and early maladaptive schemas in the risk of suicidal behavior repetition. Archives of 2010; 14(4311-28. [DOI:10.1080/13811118.2010.524066] [PMID]
  18. Young JE, Brown G. Young schema questionnaire-short form; version 3. Washington, DC: Psychological Assessment; 2005.
  19. Baranoff J, Oei TP, Cho SH, Kwon SM. Factor structure and internal consistency of the Young schema questionnaire (short form) in Korean and Astralian samples. Journal of Affective Disorders. 2006; 93(1-3):133-40. [DOI:10.1016/
    j.jad.2006.03.003]
    [PMID]
  20. Zolfaghari M, Fatehizadeh M, Abedi M. Determining the relationship between early maladaptive schemes and marital intimacy dimensions of couples in Isfahan city. Family Quarterly Journal. 2008; 4(15):247-61.
  21. Cecero JJ, Nelson JD, Gillie JM. Tools and tenets of schema therapy: toward the construct validity of the early maladaptive schema questionnaire–research version (EMSQ‐R). Clinical Psychology & Psychotherapy: An International Journal of Theory & Practice. 2004; 11(5):344-57.[DOI:10.1002/cpp.401]
  22. Lumley MN, Harkness KL. Specificity in the relations among childhood adversity, early maladaptive schemas, and symptom profiles in adolescent depression. Cognitive Therapy and Research. 2007; 31(5):639-57. [DOI: 10.1007/s10608-006-9100-3]
  23. Brotchie J, Meyer C, Copello A, Kidney R, Waller G. Cognitive representations in alcohol and opiate abuse: the role of core beliefs. The British Journal of Clinical Psychology. 2004; 43(Pt 3):337-42. [DOI:10.1348/014
    4665031752916]
    [PMID]
Article Type: Research Article | Subject: Physiology
Received: 2020/08/12 | Accepted: 2020/08/20 | Published: 2020/08/20

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