Schema therapy in the diagnosis of eating disorder: features of early maladaptive schemas

Abstract

The article is devoted to the study of early maladaptive schemas in patients with eating disorders. Patients with eating disorders represent a heterogeneous group, with a variety of mental pathologies, most often represented by patients’ personal characteristics. The present study analyzes deeper impairments in communication with close ones at an early age, predisposing to the onset of mental pathology. On the basis of the Psychiatric Clinical Hospital No. 1 named after N. A. Alekseev, 131 patients diagnosed with anorexia nervosa and bulimia nervosa were examined. In the course of the study, the Young Schema Questionnaire (YSQ-S3R) was utilized. Non-adaptive schemas were identified in the domain «disconnection and rejection» in all patients with eating disorders. In the patients with bulimia nervosa, the early schemas in the impaired autonomy domain were most pronounced, in contrast to the patients with anorexia nervosa. The schema of insufficient self-control in the impaired limits domain was also detected in these patients, while in the patients with anorexia nervosa, this indicator was not manifested. The hypervigilance and inhibition domain was manifested by maladaptive schemas in both groups, with the negativity schema expressed in patients with bulimia nervosa. The domain of focus on others is characteristic of all patients with eating disorders. A comparative analysis of the indicators of early maladaptive schemas in patients with anorexia nervosa and bulimia nervosa and the results of a group of healthy people was carried out. In the healthy group, the expressed early maladaptive schemas were not observed. Violations in satisfying basic needs at an early age can be triggers in the mechanism of development and maintenance of eating disorders and personality pathology in this group of patients.