Schema Modes Research Articles

Association of Fatigue Severity With Maladaptive Coping in Multiple Sclerosis: A Data-Driven Psychodynamic Perspective

Fatigue in persons with multiple sclerosis (PwMS) is severely disabling. However, the underlying mechanisms remain incompletely understood. Recent research suggests a link to early childhood adversities and psychological trait variables. In line with these studies, this paper took a psychodynamic perspective on MS-fatigue. It was hypothesized that fatigue could represent a manifestation of maladaptive coping with intense emotions. The schema therapeutic mode model served as a theoretical and empirically validated framework, linking psychodynamic theory and empirical research methods. The study was based on a data set of N = 571 PwMS that has also served as the basis for another publication. Data was collected online. The Schema Mode Inventory was used to quantify regulatory strategies to cope with emotionally stressful experiences. In addition, depressive symptoms (Beck's Depression Inventory - FastScreen), physical disability (Patient Determined Disease Steps), alexithymia (Toronto Alexithymia Scale-26), adverse childhood experiences (Childhood Trauma Questionnaire), and self-reported fatigue (Fatigue Scale for Motor and Cognitive Functions) were assessed. Latent profile analysis revealed three distinct groups of PwMS, based on their coping mode profiles: (1) PwMS with low maladaptive coping, (2) PwMS with avoidant/submissive coping styles, and (3) PwMS with avoidant/overcompensatory coping styles. Multivariate comparisons showed no significant difference in physical disability across the three groups. However, heightened levels of self-reported fatigue and depression symptoms occurred in PwMS with maladaptive coping styles. A path model uncovered that self-reported fatigue was robustly related to physical disability (β = 0.33) and detached/avoidant coping (Detached Protector; β = 0.34). There was no specific relation between any of the maladaptive coping modes and depression symptoms. Detached/avoidant coping was in turn predicted by childhood emotional abuse and neglect. The results indicate that childhood adversity and detached/avoidant coping styles may be associated with variability in MS-fatigue severity: PwMS that resort to detached/avoidant coping in response to negative emotions also tend to report heightened levels of fatigue, although they do not differ in their perceived disability from PwMS with low levels of fatigue and maladaptive coping. A link between MS-fatigue and the psychodynamic traumatic conversion model is discussed. The implications of these findings for therapeutic interventions require further study.

A Systematic Review of Psychometric Transactional Analysis Instruments

Since the founding of transactional analysis (TA) by Eric Berne in the 1950s, many psychometric instruments have been developed to operationalize TA concepts. Several studies have provided general reviews of these, but the studies are not systematic and do not assess the psychometric quality of the instruments. We conducted a systematic literature review of all psychometric instruments operationalizing TA concepts by searching in Pubmed, Medline, PsycInfo, APA articles, Web-of-Knowledge, and scholar.google.com. The study quality was evaluated with the consensus-based standards for the selection of health measurement instruments (COSMIN). Of the 12,287 initial search hits, we selected 56 instruments in 263 studies. Among those, the Schema Mode Inventory, the Tokyo Egogram, the Adjective Check List, the ANINT-A36, and the Life Position Scale were found to have fair to good overall COSMIN quality. Except for the Life Position Scale, they operationalize ego states (Parent, Adult, Child) and the functional analysis concepts of Critical Parent, Nurturing Parent, and Adapted/Free Child. The Life Position Scale operationalized the positive and negative positions toward self and others. Other questionnaires had poor to fair COSMIN quality, usually because of a lack of studies. Meta-analyses indicated that psychopathology and physical symptoms are associated with strong Critical Parent, strong Adapted Child, weak Integrated Adult, negative coping styles, and negative positions toward oneself and others. Many instruments need further validation and translation into more languages. The Schema Mode Inventory, the Tokyo Egogram, the Adjective Check List, and the Life Position Scale are the best validated questionnaires. These could be used by researchers to test treatment effectiveness and by psychotherapists to examine the problems and etiology of clients.

A pilot study of arts therapy techniques to evoke emotional states in forensic patients

There is little evidence on the effectiveness of arts therapy interventions in forensic settings. The aim of this study was to explore the effects of arts therapy in evoking emotional vulnerability in forensic patients. Participants received drama, art or psychomotor therapy. For each therapy, we used a 5-session protocol that consisted of an introduction session, an assessment session, an intervention session that deliberately aimed to evoke emotional vulnerability, a regular intervention session, and a wrap-up session. Emotional vulnerability was assessed with the Mode Observation Scale and the Schema Mode Inventory, which is a self-report. Participants showed a significant increase in emotional vulnerability in both intervention sessions. The self-report ratings indicated that there was no significant change in vulnerable emotions. Our hypothesis was only partially supported. The findings provide some support for the effectiveness of arts therapy interventions in forensic patients.

The mediating role of externalising and healthy schema modes in the relationship between early maladaptive schemata and overt behaviours in adolescent boys with offending behaviours, and a comparison of their early schemata with those of typically developing boys.

BackgroundEvidence‐based treatments in routine clinical practice often fail to achieve or sustain amelioration of severe behaviour problems in adolescents. Better understanding of mechanisms underlying such severe behaviour problems could improve treatments. Underlying schemata and schema modes may play an important role.AimsTo compare early maladaptive schemata, schema modes and behaviour problems in adolescent boys showing disruptive and offending behaviours with those in typically developing boys. We hypothesised a relationship between disconnection and rejection schemata on the one hand and behaviour problems (including offending) on the other in adolescent boys with disruptive behaviour disorders. We also hypothesised that this offending group would differ significantly from typically developing boys on these measures and that schema modes would mediate relationships between schemata and overt behaviours.MethodIn this cross‐sectional study, fifty‐five 12–19‐year‐old boys with disruptive behaviour disorders referred to an in‐ or out‐patient clinic were matched to fifty‐five typically developing boys from a previously generated school sample. Group differences on self‐reported schema related measures and externalising behaviour measures were compared using t‐tests. Mediation analyses were performed to assess the mediating role of schema modes in the relation between schemata and behaviour.ResultsBoys diagnosed with disruptive behaviour disorders and engaging in offending behaviours had higher scores on externalising modes and lower scores on healthy modes than the typically developing boys. There were no differences between these groups, however, in disconnection and rejection schemata. In the offending behaviour group, externalising modes mediated the relationship between disconnection and rejection schemata and externalising behaviours while healthy modes mediated a relationship between these schemata and overt prosocial behaviours.ImplicationsThe potential impact of healthy modes has not previously been shown in studies of schemata in young offenders. Our findings suggest that treatments for adolescents with severe behaviour problems should not only target maladaptive schemata and dysfunctional modes, but seek also to boost healthy modes.

Maladaptive schema modes as the predictor of post-traumatic stress disorder among trauma survivors.

To study the relationship between dysfunctional schema modes and post-traumatic stress disorder among trauma survivors. The cross-sectional study was conducted at the Pakistan Institute of Medical Sciences, Islamabad, Pakistan, from March to August 2019, and comprised patients of traumatic brain injury and orthopaedic trauma. Data was collected using Schema Mode Inventory and the Clinician Administered Post-Traumatic Stress Disorder Scale version 5. Data was analysed using SPSS 23. Of the 281 patients, 203(72.2%) were males, 78(27.8%) were females, and 157 (55.9%) were aged 18-40 years. Besides, 137(48.8%) had orthopaedic trauma, 96(34.2%) traumatic brain injuries, and 48(17%) had multiple injuries. Post-traumatic stress disorder symptoms and dysfunctional schema modes were higher in patients with moderate injuries with a mean of 42.14±7.36. Intentionally injured patients 42.70±6.92 and female trauma survivors 42.05±8.26 had more symptoms. Maladaptive schema mode could lead to post-traumatic stress disorder symptoms among trauma survivors with history of orthopaedic injury, traumatic brain injury and multiple injuries.

The network structure of schema modes.

A fundamental question in psychotherapy is whether interventions should target client problems (i.e., problem‐focused approaches) or client strengths (i.e., strength‐focused approaches). In this study, we first propose to address this question from a network perspective on schema modes (i.e., healthy or dysfunctional patterns of co‐occurring emotions, cognitions, and behaviours). From this perspective, schema modes mutually influence each other (e.g., healthy modes reduce dysfunctional modes). Recent evidence suggests that changes in modes that are strongly associated to other modes (i.e., central modes) could be associated with greater treatment effects. We therefore suggest research should investigate the relative centrality of healthy and dysfunctional modes. To make an exploratory start, we investigated the cross‐sectional network structure of schema modes in a clinical (comprising individuals diagnosed with paranoid, narcissistic, histrionic, and Cluster C personality disorders) and non‐clinical sample. Results showed that, in both samples, the Healthy Adult was significantly less central than several dysfunctional modes (e.g., Undisciplined Child and Abandoned and Abused Child). Although our study cannot draw causal conclusions, this finding could suggest that weakening dysfunctional modes (compared to strengthening the Healthy Adult) might be more effective in decreasing other dysfunctional modes. Our study further indicates that several schema modes are negatively associated, which could suggest that decreasing one might increase another. Finally, the Healthy Adult was among the modes that most strongly discriminated between clinical and non‐clinical individuals. Longitudinal and experimental research into the network structure of schema modes is required to further clarify the relative influence of schema modes.

Evaluating schema modes and cognitive distortions in borderline personality disorder: A mixed-method approach.

Cognitive processes, such as schema modes and cognitive distortions, may playa role in the genesis and maintenance of affective, interpersonal, and behavioral difficulties in individuals with Borderline Personality Disorder (BPD). Thisstudy aimed at exploring the schema modes and cognitive distortions in individuals with BPD. Using a mixed-methodapproach, 30 individuals with BPD and 30 healthy participants were assessed on the Borderline Personality Questionnaire, the Schema Mode Inventory, the Cognitive Distortions Scale, and a semi-structured interview schedule. The BPD group had higher scores than the control group on all the maladaptive schema modes and cognitive distortions subscales. The child modes were the commonest and were also the strongest correlate of BPD symptomatology. Qualitative analysis of the content of the semi-structured interview also corroborated these findings. There could be many schema modes and cognitive distortions operating behind the diverse psychopathology seen in BPD.

Towards a Reformulated Theory Underlying Schema Therapy: Position Paper of an International Workgroup

BackgroundA central construct in Schema Therapy (ST) is that of a schema mode, describing the current emotional-cognitive-behavioral state. Initially, 10 modes were described. Over time, with the world-wide increasing and broader application of ST to various disorders, additional schema modes were identified, mainly based on clinical impressions. Thus, the need for a new, theoretically based, cross-cultural taxonomy of modes emerged.MethodsAn international workgroup started from scratch to identify an extensive taxonomy of modes, based on (a) extending the theory underlying ST with new insights on needs, and (b) recent research on ST theory supporting that modes represent combinations of activated schemas and coping.ResultsWe propose to add two emotional needs to the original five core needs that theoretically underpin the development of early maladaptive schemas (EMSs), i.e., the need for Self-Coherence, and the need for Fairness, leading to three new EMSs, i.e. Lack of a Coherent Identity, Lack of a Meaningful World, and Unfairness. When rethinking the purpose behind the different ways of coping with EMS-activation, we came up with new labels for two of those: Resignation instead of Surrender, and Inversion instead of Overcompensation. By systematically combining EMSs and ways of coping we derived a set of schema modes that can be empirically tested.ConclusionsWith this project, we hope to contribute to the further development of ST and its application across the world.

The effectiveness of adapted schema therapy for cluster C personality disorders in older adults – integrating positive schemas

IntroductionSchema therapy (ST) is an efficacious psychotherapy for personality disorders (PDs) in adults. The first empirical support for the effectiveness of ST in older adults with cluster C PDs was provided recently. ST partly focusses on the positive, but there is an increasing awareness of imbalance in the ST community because of the emphasis on negative schemas versus attention to positive schemas. Positive schemas may be important vehicles of therapeutic change in psychotherapy with older people, as it may help strengthen the healthy adult mode, and it might also help change a negative life review. Suggestions were made to increase the efficacy and feasibility of ST in older adults, including adjusting the case conceptualisation, modifying the experiential techniques, making use of the patient's wisdom and reactivating positive schemas. The aim of the current study is to investigate the feasibility and effectiveness of adapted individual ST for older adults. Methods/designA multiple baseline design is used with positive and negative core beliefs as primary outcome measures. Ten older adults (age > 60 years) with cluster C PDs are treated with schema therapy, with weekly sessions during one year. This treatment phase is preceded by a baseline phase varying randomly from 4 to 8 weeks. After treatment, there is a 6-month follow-up phase with monthly booster sessions. Symptomatic distress, schema modes, early maladaptive schemas (EMS) and early adaptive schemas (EAS) are secondary outcome measures. PD will be diagnosed before baseline and after treatment phase. EAS are assessed with the Dutch version of the Young Positive Schema Questionnaire (YPSQ). DiscussionTo the best of our knowledge, this is the first empirical study in which positive schemas are integrated in ST treatment to examine the efficacy of an adapted form of ST for older adults. This is in line with wider developments supporting the integration of positive schema's into ST. It offers the possibility to improve the effectiveness of ST in older adults. Trial registrationThe Netherlands National Trial Register NL8346, registered 1 February 2020.

Adapting group schema therapy for older adults with personality disorders: lessons learnt

Abstract A first empirical study into group schema therapy in older adults with mood disorders and personality disorder (PD) features has shown that brief group schema therapy has potential to decrease psychological distress and to change early maladaptive schemas (EMS). Effect sizes however were smaller than those found in similar studies in younger adults. Therefore, we set out to adapt the treatment protocol for older adults in order to enhance its feasibility and outcome in this age group. We examined this adapted protocol in 29 older adults (mean age 66 years) with PDs from four Dutch mental health institutes. The primary outcome was symptomatic distress, measured by the Brief Symptom Inventory. Secondary outcomes were measured by the Young Schema Questionnaire, the Schema Mode Inventory, and the short version of the Severity Indices of Personality Problems. Contrary to our expectations, the adapted treatment protocol yielded only a small effect size in our primary outcome, and no significant improvement in EMS, modes and personality functioning. Patients pointed out that they were more aware of their dysfunctional patterns, but maybe they had not been able yet to work on behavioural change due to this schema therapy treatment being too brief. We recommend more intensive treatment for older patients with PDs, as they might benefit from more schema therapy sessions, similar to the treatment dosage in younger PD patients. They might also benefit from a combination of group therapy and individual treatment sessions. Key learning aims (1) How to adapt group schema therapy for older adults. (2) How to explore feasibility and outcome. (3) Treat older personality disorder patients as intensively as younger adults.

Schema therapy with exposure and response prevention for the treatment of chronic anxiety with comorbid personality disorder.

Background and objectivesA considerable group of patients with anxiety disorders do not respond to guideline CBT treatment, possibly due to comorbid personality disorder (PD) traits. Schema therapy (ST) is an integrative treatment for personality disorders, and preliminary evidence suggests that it also affects anxiety. The present study examined the effects of a combination treatment (‘SCHerp’: ST + exposure and response prevention) in a non‐responsive outpatient group suffering from chronic anxiety and comorbid cluster C personality disorder.MethodsPsychological malfunction (n = 42), and adaptive and maladaptive schema modes (n = 49) were assessed pre‐ and post‐treatment.ResultsPatients showed statistically significant decreases in psychological malfunction and maladaptive modes, and significant increases in adaptive modes from pre‐ to post‐treatment. Changes in modes were correlated with changes in psychological malfunction.LimitationsNo control group or follow‐up measurements were included.ConclusionsThe combination of ST and exposure with response prevention may be a viable avenue for research and treatment for this subpopulation. However, further research is needed to confirm and enhance effectiveness and identify working mechanisms of SCHerp.Practitioner points The SCHerp programme combines schema therapy with exposure and response prevention to tackle chronic anxiety in patients with comorbid personality disorderSCHerp significantly reduced psychological malfunction and maladaptive modes, and increased adaptive modesChanges in schema modes correlated with changes in psychological malfunction, suggesting that schema modes are an appropriate treatment target in this populationNo active control group was included so no therapy‐specific factors can be determined at this stage

Psychological symptoms, early maladaptive schemas and schema modes: predictors of the outcome of group schema therapy in patients with personality disorders

Objective: This naturalistic study examined the outcomes of group schema therapy for patients with personality disorders (PD) and the effect of psychological symptoms, early maladaptive schemas (EMS) and schema modes on outcome. Method: Assessments were made of 194 patients at baseline, during treatment, at treatment termination and at three-month follow-up. We used the Symptom Checklist-General Severity Index (SCL-GSI) to measure the remission-rate of global psychological distress and as a dependent variable in a multilevel model to conduct univariate and multiple variate analyses. Results: The research sample achieved medium symptom reduction (pre–post d = 0.65, 95% CI [0.39–0.91]) and the remission rate was about 30% after 60 sessions. These results remained stable at three-month follow-up (pre-follow-up d = 0.61, 95% CI [0.29–0.94]; 28.9%). Higher baseline scores on the SCL scale interpersonal sensitivity, the EMS defectiveness/shame and all the maladaptive schema modes together predicted improvements in global psychological distress after treatment. Conclusions: A long-term form of group schema therapy proved effective for a broad group of patients with PD. Internalizing symptoms seems predictive for improvement at outcome. Almost a third of the patients achieved remission. There is therefore room for improvement, possibly by increasing dose or intensity in combination with individual sessions.

Dysfunctional Parenting and Psychological Symptomatology: An Examination of the Mediator Roles of Anger Representations in the Context of the Schema Therapy Model.

In this study, we investigated the mediator roles of anger-related schema modes in the relationship between dysfunctional parent modes and psychological symptoms. We focused on specific schema modes (i.e., punitive and demanding parent modes; vulnerable, angry, and enraged child modes; and the angry protector mode). The study included 297 college students (159 women), with the average age of the sample being 19.66 years (SD = 1.53, range = 18 to 29 years). All participants completed self-report questionnaires on schema modes and psychological symptoms, as well as a demographic form. We evaluated two different mediational models to understand two different dysfunctional parenting styles. The results suggest that all variables significantly correlated with each other and almost all the direct paths in the models were significant. However, the mediator analysis revealed that some of the anger-related modes had very low but significant mediator roles in the models (i.e., the angry child mode for both models and the enraged child mode for the demanding parenting model). The vulnerable child mode played a central and key role in the relationship between dysfunctional parenting and psychological symptoms. The study suggests that anger representations might be windows to understand and intervene in unmet core emotional needs.

Effectiveness of brief schema group therapy for borderline personality disorder symptoms: a randomized pilot study

Background and objectives Schema group therapy is a potentially cost-effective treatment for borderline personality disorder (BPD). We piloted the feasibility and effectiveness of a 20-session schema group therapy without individual therapy among psychiatric BPD outpatients in a randomized pilot study registered as a clinical trial (ISRCTN76381242). Methods Altogether 42 psychiatric outpatients diagnosed with BPD were randomized 2:1 to a 20-session weekly schema group therapy plus treatment as usual (TAU) (n = 28) vs. a control group with TAU alone (n = 14). The primary outcome was decline of BPD symptoms in the short Borderline Symptom List (BSL-23) score. Secondary outcomes were decline in symptoms of anxiety, depression, alcohol use, and improvement in functioning and schema modes. Two external experts evaluated validity of the intervention based on videotaped sessions. Results Overall, 23 schema group therapy patients (82%) and 12 controls (86%) completed their treatment. Treatment validity good or very good. However, no significant differences emerged in the primary outcome mean BSL-23 decline (6.95 [SE 5.91] in group schema therapy vs. 12.55 [4.85] in TAU) or in any of the secondary outcome measures. Limitations Despite randomization, the TAU subgroup had non-significantly higher baseline scores in most measures. Small sample size predisposing to type II errors; reliance on self-reported outcomes. Conclusions Schema group therapy was feasible for psychiatric outpatients with BPD. However, in this small pilot study we did not find it more effective than TAU. Effectiveness of this short intervention remains open.

A trait emotional intelligence perspective on schema modes.

Schema modes (or modes) are a key concept in the theory underlying schema therapy. Modes have rarely been related to established models of personality traits. The present study thus investigates the associations between trait emotional intelligence (TEI) and 14 modes, and tests a global TEI-mode factors-general psychological distress mediation model. The study draws on self-report data from 173 inpatients from a German clinic for psychosomatic medicine. Global TEI correlated positively with both healthy modes (happy child and healthy adult) and negatively with 10 maladaptive modes. When modes were regressed on the four TEI factors, six (emotionality), five (well-being), four (sociability), and four (self-control) significant partial effects on 10 modes emerged. In the parallel mediation model, the mode factors internalization and compulsivity fully mediated the global TEI-general psychological distress link. Implications of the results for the integration of modes with traits in general and with TEI in particular as well as implications of low TEI as a transdiagnostic feature of personality malfunctioning are discussed.

Healthy emotions, lower risk? The relationship between emotional states and violence risk among offenders with Cluster B personality disorders

ABSTRACT Personality disorders (PDs) are ingrained dysfunctional patterns of cognition, emotion, and behavior. PDs, especially Cluster B PDs, are related to an increased violence risk and are highly prevalent in offender populations. Patients with PDs may suffer from dysregulated affect in a sense that they experience many maladaptive emotional states and relatively few healthy emotional states. It was therefore hypothesized that violence risk can be predicted by emotional states. It was expected that a decrease in maladaptive emotional states or an increase in healthy emotional states would precede a decrease in violence risk. The study sample consisted of 103 male offenders with a Cluster B PD, hospitalized in the Netherlands. We used the Schema Mode Inventory-Revised (SMI-R) to assess healthy and maladaptive emotional states and the Short-Term Assessment of Risk and Treatability (START) to assess short-term violence risk and to monitor changes thereof. Assessments were repeated after 6 months, 12 months, and 18 months. We conducted hierarchical regression analyses with START Risks or Strengths as outcome variables, predicted by START scores, SMI healthy, and maladaptive total scores at an earlier time point and the change over time. Results show that all models were highly significant, but neither the healthy and maladaptive emotional states nor the change over time was a significant predictor. The exception was at 6 and 12 months of START Strengths, where an SMI healthy score was a significant predictor in the model. Our hypothesis was only partially supported, which is likely explained by limitations of the study.

A schema mode model of repetitive negative thinking

BackgroundSchema Therapy mode formulations have recently been extended to a range of chronic, treatment‐resistant psychological disorders.AimThe aim of this study was to examine whether two forms of repetitive negative thinking (rumination and worry) can be conceptualised as a maladaptive coping mode, we term the “over‐analysing” mode, consistent with Young's schema mode model, which serves to distance individuals from distressing emotional states.MethodologyTwo online survey studies were conducted in community populations: study one (n = 109) investigated the relationship between schema modes, worry, and experiential avoidance. Study two (n = 129) extended the findings to include, in addition to schema modes and experiential avoidance, rumination and repetitive negative thinking.ResultsCorrelational analyses supported all hypothesised relationships across both studies. Mediation analyses across both studies identified a model in which the relationship between angry and vulnerable child modes, and worry, rumination, and repetitive negative thinking, respectively, was mediated by experiential avoidance.ConclusionThese findings conceptually support the addition of a new “over‐analysing” coping mode, which serves an avoidant function through repetitive negative thinking (a central component of mood and anxiety disorders) to the schema mode model. Generalisability of results is limited through the use of a cross‐sectional design and a heterogeneous, nonclinical sample. Further examination of the “over‐analysing” mode may enhance Schema Therapy conceptualisations, particularly in the treatment of mood and anxiety disorders. Moreover, emotion‐focused techniques found to be successful in Schema Therapy for personality disorders (e.g., imagery rescripting, chair‐techniques) may be relevant to modifying maladaptive schemas thoughts to underlie repetitive negative thinking processes such as worry and rumination.

Validity of the Korean Version of the Schema Mode Inventory (SMI)

This study investigated whether the schema modes have validity in Korean adults. We examined the validity and reliability of the Schema Mode Inventory (SMI) in a Korean adult sample (N = 768; Mean age = 22.29 years; range = 19-55 years; 69.3% Males). Psychometric properties, such as factor structure, internal reliability, as well as intercorrelations among subscales were assessed. Confirmatory factor analyses yield satisfying fits for a 61-item Korean Schema Mode Inventory. Thirteen Schema Mode Inventory scales were found to have adequate reliability of the original 14 schema factors. Furthermore, the SMI scales differentiated between depressed and non-depressed participants as theoretically predicted. These findings imply that the SMI is a sound instrument to measure the schema mode model in a Korean setting for assessment prior to schema therapy.

Comparison of Schema Modes in Clinical and Non-Clinical Individuals: A Preliminary Finding

This study compares the schema modes between the clinical and non-clinical individuals. A purposive convenient sampling technique was used for the data collection from one hundred and fifty healthy community volunteers, and sixty diagnosed psychiatric patients. The "Schema Mode Inventory (SMI)" was utilized for the mode assessment and group comparison. A series of independent sample t-test depicted that, the clinical group had a significantly higher score on ten out of twelve dysfunctional schema modes and significantly lesser score on both functional schema modes. Identically, Fisher's r-to-z transformation confirmed that the association between dysfunctional schema modes was significantly higher in clinical individuals in comparison to non-clinical individuals. Thus, the present study describes a tendency of individuals with psychiatric disorders to rely more on dysfunctional schema modes in comparison to non-clinical individuals. These findings strengthen the empirical provision of the "schema mode model" for the assessment and treatment of psychiatric disorders.

Tryby schematów i modele trybów w zaburzeniach osobowości z klastra B i C

Terapia schematów stworzona przez Jeffreya Younga i współpracowników jest stosunkowo nowym integracyjnym podejściem w psychoterapii. Choć wyrasta bezpośrednio z koncepcji poznawczej, łączy w sobie również elementy teorii przywiązania Bowlby’ego, analizy transakcyjnej Berne’a, teorii relacji z obiektem, Gestalt oraz terapii skoncentrowanych na osobie. W zaproponowanym przez Younga i współpracowników modelu kluczowym pojęciem są wczesne nieadaptacyjne schematy, rozumiane jako ogólne, wszechogarniające motywy lub wzorce składające się ze wspomnień, emocji, przekonań oraz doznań cielesnych. Początkowo opisany model schematów okazał się mieć pewne ograniczenia w pracy klinicznej z pacjentami o poważnych zaburzeniach osobowości. Young zaproponował Model Trybów Schematów jako bardziej efektywną i możliwą do zastosowania alternatywę w leczeniu tych zaburzeń. Po rozwoju modelu trybów dla osobowości borderline i narcystycznej, opracowano także modele dla innych zaburzeń osobowości. Celem artykułu jest przedstawienie trybów schematów oraz wypracowanych modeli trybów dla osób z zaburzeniami osobowości. Zaprezentowano modele trybów dla zaburzeń osobowości z klastra B (z pogranicza/borderline, narcystycznego, histrionicznego, antyspołecznego) oraz zaburzeń osobowości z klastra C (unikającego, zależnego, obsesyjno-kompulsyjnego).