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01-10-2012 | Original Article

Identification of Child Sexual Abuse Survivor Subgroups Based on Early Maladaptive Schemas: Implications for Understanding Differences in Posttraumatic Stress Disorder Symptom Severity

Auteurs: Hilary G. Harding, Erin E. Burns, Joan L. Jackson

Gepubliceerd in: Cognitive Therapy and Research | Uitgave 5/2012

Abstract

Cognitive models have informed understanding of the development, maintenance, and treatment of posttraumatic stress disorder (PTSD). Limited research, however, has examined the relationship of early maladaptive schemas (EMS; Young in Cognitive therapy for personality disorders: A schema-focused approach (rev. ed.). Professional Resource Press, Sarasota, 1994) to PTSD among trauma survivors. The current study, using a sample of 127 female child sexual abuse (CSA) survivors, applied a model-based clustering procedure (Mclust; Fraley and Raftery in MCLUST Version 3 for R: Normal Mixture Modeling and Model-based Clustering, Technical Report No. 504, Department of Statistics, University of Washington, 2006) to the 15 subscales of the Young Schema Questionnaire-Short Form (YSQ-S; Young and Brown in Young Schema Questionnaire- short form. Cognitive Therapy Center, New York, 1994) and revealed three clusters differentiated primarily by level of schema elevation. Women in the cluster characterized by the highest schema scores reported the most severe PTSD symptoms. A discriminant analysis indicated that schemas of Mistrust/Abuse, Vulnerability to Harm, and Emotional Deprivation contributed most to distinguishing women differentiated on the basis of presumptive PTSD diagnostic status. Results underscore the importance of cognitive factors in the development and/or maintenance of PTSD symptoms and suggest possible treatment targets for cognitive therapy with CSA survivors.

vorige artikel Social Anxiety and the Interaction of Imagery and Interpretations in Children: An Experimental Test of the Combined Cognitive Biases Hypothesis

volgende artikel The Impact of Personality Disorders on Treatment Outcome for Veterans in a Posttraumatic Stress Disorder Residential Treatment Program

As an adjunctive analysis, we conducted a single-entry linear multiple regression in which all 15 schemas were entered as predictors of the continuous total PTSD symptom scores. Results suggested that the overall model significantly predicted PTSD symptom severity, F(15, 106) = 4.21, p < .001, adjusted R ² = .29, and indicated that Vulnerability to Harm (β = .31, p = .003) and Mistrust/Abuse (β = .27, p = .03) emerged as the only unique predictors of PTSD symptom severity when controlling for the collinearity among the schema subscales. Thus, results are largely consistent with the discriminant analysis findings which revealed that these two schema subscales were most strongly correlated with the discriminant function differentiating women with and without a presumptive PTSD diagnosis.

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.

Banfield, J. D., & Raftery, A. E. (1993). Model-based Gaussian and non-Gaussian clustering. Biometrics, 49, 803–821. doi:10.2307/2532201.CrossRef

Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for beck depression inventory-II. San Antonio, TX: Psychological Corporation.

Bernstein, D. P., & Fink, L. (1998). Childhood trauma questionnaire: A retrospective self report: Manual. San Antonio, TX: Psychological Corporation.

Breslau, N., Kessler, R. C., Chilcoat, H. D., Schultz, L. R., Davis, G. C., & Andreski, P. (1998). Trauma and posttraumatic stress disorder in the community: The 1996 Detroit area survey of trauma. Archives of General Psychiatry, 55, 626–632. doi:10.1001/archpsyc.55.7.626.PubMedCrossRef

Brewin, C. R., & Holmes, E. A. (2003). Psychological theories of posttraumatic stress disorder. Clinical Psychology Review, 23, 339–376. doi:10.1016/S0272-7358(03)00033-3.PubMedCrossRef

Briere, J. (1995). Trauma symptom inventory professional manual. Lutz, FL: Psychological Assessment Resources, Inc.

Briere, J., & Jordon, C. E. (2004). Violence against women: Outcome complexity and implications for assessment and treatment. Journal of Interpersonal Violence, 19, 1252–1276. doi:10.1177/0886260504269682.PubMedCrossRef

Bromet, E., Sonnega, A., & Kessler, R. C. (1998). Risk factors for DSM-III-R posttraumatic stress disorder: Findings from the National Comorbidity Survey. American Journal of Epidemiology, 147, 353–361.PubMedCrossRef

Cahill, S. P., & Foa, E. B. (2007). Psychological theories of PTSD. In M. J. Friedman, T. M. Keane, & P. A. Resick (Eds.), Handbook of PTSD: Science and practice (pp. 55–77). New York: Guildford Press.

Castille, K., Prout, M., Marczyk, G., Shmidheiser, M., Yoder, S., & Howlett, B. (2007). The early maladaptive schemas of self-mutilators: Implications for therapy. Journal of Cognitive Psychotherapy, 21(1), 58–71. doi:10.1891/088983907780493340.CrossRef

Dalgleish, T. (2004). Cognitive approaches to posttraumatic stress disorder: The evolution of multirepresentational theorizing. Psychological Bulletin, 130(2), 228–260. doi:10.1037/0033-2909.130.2.228.PubMedCrossRef

Dingemans, A. E., Spinhoven, P., & van Furth, E. F. (2007). Predictors and mediators of treatment outcome in patients with binge eating disorder. Behaviour Research and Therapy, 45(11), 2551–2562. doi:10.1016/j.brat.2007.06.003.PubMedCrossRef

Ehlers, A., & Clark, D. M. (2000). A cognitive model of persistent posttraumatic stress disorder. Behaviour Research and Therapy, 38, 319–345. doi:10.1016/S0005-7967(99)00123-0.PubMedCrossRef

Fink, L. A., Bernstein, D., Handelsman, J., & Lovejoy, M. (1995). Initial reliability and validity of the childhood trauma interview: A new multidimensional measure of childhood interpersonal trauma. The American Journal of Psychiatry, 152, 1329–1335.PubMed

Foa, E. B., & Rothbaum, B. O. (1998). Treating the trauma of rape: Cognitive-behavioral therapy for PTSD. New York: Guildford Press.

Fraley, C., & Raftery, A. E. (1998). How many clusters? Which clustering method? Answers via model-based cluster analysis. The Computer Journal, 41, 578–588. doi:10.1093/comjnl/41.8.578.CrossRef

Fraley, C., & Raftery, A. E. (2006). MCLUST Version 3 for R: Normal Mixture Modeling and Model-based Clustering, Technical Report No. 504, Department of Statistics, University of Washington (revised December 2009).

Gibb, B. E. (2002). Childhood maltreatment and negative cognitive styles: A quantitative and qualitative review. Clinical Psychology Review, 22, 223–246. doi:10.1016/S0272-7358(01)00088-5.PubMedCrossRef

Gratz, K. L., Bornovalova, M. A., Delany-Brumsey, A., Bettina, N., & Lejuez, C. W. (2007). A laboratory-based study of the relationship between childhood abuse and experiential avoidance among inner-city substance users: The role of emotional nonacceptance. Behavior Therapy, 38, 256–268. doi:10.1016/j.beth.2006.08.006.PubMedCrossRef

Harris, A. E., & Curtin, L. (2002). Parental perceptions, early maladaptive schemas, and depressive symptoms in young adults. Cognitive Therapy and Research, 26, 405–416. doi:10.1023/A:1016085112981.CrossRef

Hicks, B. M., Markon, K. E., Patrick, C. J., Krueger, R. F., & Newman, J. P. (2004). Identifying psychopathy subtypes on the basis of personality structure. Psychological Assessment, 16(3), 276–288. doi:10.1037/1040-3590.16.3.276.PubMedCrossRef

Horowitz, M. (2001). Stress response syndromes (4th ed.). Northvale, NJ: Aronson.

Hyman, S. M., Gold, S. N., & Cott, M. A. (2003). Forms of social support that moderate PTSD in childhood sexual abuse survivors. Journal of Family Violence, 18, 295–300.CrossRef

Janoff-Bulman, R. (1992). Shattering assumptions: Toward a new psychology of trauma. New York: Free Press.

Kessler, R. C., McGonagle, K. A., Zhao, S., Nelson, C. B., Hughes, M., Eshleman, S., et al. (1994). Lifetime and 12-month prevalence of psychiatric disorders in the United States: Results from the National Comorbidity Survey. Archives of General Psychiatry, 51, 8–19.PubMedCrossRef

Lane, A., Young, R. L., Baker, A. E., & Angley, M. (2010). Sensory processing subtypes in Autism: Association with adaptive behavior. Journal of Autism and Developmental Disorders, 40, 112–122. doi:10.1007/s10803-009-0840-2.PubMedCrossRef

Lauterbach, D., & Vrana, S. (1996). Three studies on the reliability and validity of a self-report measure of posttraumatic stress disorder. Assessment, 3, 17–25.

Lee, Z., Salekin, R. T., & Iselin, A. R. (2010). Psychopathic traits in youth: Is there evidence of primary and secondary subtypes? Journal of Abnormal Child Psychology, 38, 381–393. doi:10.1007/s10802-009-9372-7.PubMedCrossRef

Lumley, M. N., & Harkness, K. L. (2007). Specificity in the relations among childhood diversity, early maladaptive schemas, and symptom profiles in adolescent depression. Cognitive Therapy and Research, 31, 639–657. doi:10.1007/s10608-006-9100-3.CrossRef

Mason, O., Platts, H., & Tyson, M. (2005). Early maladaptive schemas and adult attachment in a UK clinical population. Psychology and Psychotherapy: Theory, Research and Practice, 78(4), 549–564. doi:10.1348/147608304X21374.CrossRef

McGinn, L. K., Cukor, D., & Sanderson, W. C. (2005). The relationship between parenting style, cognitive style, and anxiety and depression: Does increased early adversity influence symptom severity through the mediating role of cognitive style? Cognitive Therapy and Research, 29, 219–242. doi:10.1007/s10608-005-3166-1.CrossRef

Messman-Moore, T. L., & Coates, A. A. (2007). The impact of childhood psychological abuse on adult interpersonal conflict: The role of early maladaptive schema patterns of interpersonal behavior. Journal of Emotional Abuse, 7(2), 75–92. doi:10.1300/J135v07n02_05.CrossRef

Molnar, B. E., Buka, S. L., & Kessler, R. C. (2001). Child sexual abuse and subsequent psychopathology: Results from the National Comorbidity Survey. American Journal of Public Health, 91, 753–760. doi:10.2105/AJPH.91.5.753.PubMedCrossRef

Mun, E. Y., Windle, M., & Schainker, L. M. (2008). A model-based cluster analysis approach to adolescent problem behaviors and young adult outcomes. Development and Psychopathology, 20, 291–318. doi:10.1017/S095457940800014X.PubMedCrossRef

Nurius, P. S., & Macy, R. J. (2008). Heterogeneity among violence-exposed women: Applying person-oriented research methods. Journal of Interpersonal Violence, 23, 389–415. doi:10.1177/0886260507312297.PubMedCrossRef

O’Dougherty Wright, M., Crawford, E., & Del Castillo, D. (2009). Childhood emotional maltreatment and later psychological distress among college students: The mediating role of maladaptive schemas. Child Abuse and Neglect, 33, 59–68. doi:10.1016/j.chiabu.2008.12.007.CrossRef

Petrocelli, J. V., Glaser, B. A., Calhoun, G. B., & Campbell, L. F. (2001). Personality and affect characteristics of outpatients with depression. Journal of Personality Assessment, 77(1), 162–175. doi:10.1207/S15327752JPA7701_11.PubMedCrossRef

Pinto-Gouveia, J., Castilho, A., & Cunha, M. (2006). Early maladaptive schemas and social phobia. Cognitive Therapy and Research, 30, 571–584. doi:10.1007/s10608-006-9027-8.CrossRef

Price, J. P. (2007). Cognitive schemas, defense mechanisms and post-traumatic stress symptomatology. Psychology and Psychotherapy: Theory, Research and Practice, 80, 343–353. doi:10.1348/147608306X144178.CrossRef

Raftery, A. E. (1995). Bayesian model selection in social research. Sociological Methodology, 25, 111–163. doi:10.2307/271063.CrossRef

Resick, P. A., & Schnicke, M. K. (1993). Cognitive processing therapy for rape victims: A treatment manual. Thousand Oaks, CA: Sage Publications.

Rose, D. T., Abramson, L. Y., Hodulik, C. J., Halberstadt, L., & Leff, G. (1994). Heterogeneity of cognitive style among depressed inpatients. Journal of Abnormal Psychology, 103, 419–429. doi:10.1037/0021-843X.103.3.419.PubMedCrossRef

Schmidt, N. B., & Joiner, T. E. (2004). Global maladaptive schemas, negative life events, and psychological distress. Journal of Psychopathology and Behavioral Assessment, 26, 65–72. doi:10.1023/B:JOBA.0000007457.95008.d2.CrossRef

Schmidt, N. B., Joiner, T. E., Young, J. E., & Telch, M. J. (1995). The schema questionnaire: Investigation of psychometric properties and the hierarchical structure of a measure of maladaptive schemas. Cognitive Therapy and Research, 19, 295–301. doi:10.1007/BF02230402.CrossRef

Skeem, J. L., Johansson, P., Andershed, H., Kerr, M., & Eno Louden, J. (2007). Two subtypes of psychopathic violent offenders that parallel primary and secondary variants. Journal of Abnormal Psychology, 116, 395–409. doi:10.1037/0021-843X.116.2.395.PubMedCrossRef

Steer, R. A., & Clark, D. A. (1997). Psychometric characteristics of the Beck Depression Inventory-II with college students. Measurement and Evaluation in Counseling and Development, 30, 128–136.

Stein, M. B., & Walker, J. R. (2000). Gender differences in susceptibility to posttraumatic stress disorder. Behavior Research & Therapy, 38(6), 619–628. doi:10.1016/S0005-7967(99)00098-4.CrossRef

Timmons-Mitchell, J., Chandler-Holtz, D., & Semple, W. E. (1996). Post-traumatic stress symptoms in mothers following children’s reports of sexual abuse: An exploratory study. American Journal of Orthopsychiatry, 66, 463–467. doi:10.1037/h0080196.PubMedCrossRef

Tull, M. T., Barrett, H. M., McMillan, E. S., & Roemer, L. (2007). A preliminary investigation of the relationship between emotion regulation difficulties and posttraumatic stress symptoms. Behavior Therapy, 38, 303–313. doi:10.1016/j.beth.2006.10.001.PubMedCrossRef

Ullman, S. E., & Filipas, H. H. (2005). Ethnicity and child sexual abuse experiences of female college students. Journal of Child Sexual Abuse, 14, 67–89. doi:10.1300/J070v14n03_04.PubMedCrossRef

Waller, G., Kennerley, H., & Ohanian, V. (2007). Schema-focused cognitive behavioral therapy with eating disorders. In L. P. Riso, P. L. du Toit, D. J. Stein, & J. E. Young (Eds.), Cognitive schemas and core beliefs in psychiatric disorders: A scientist-practitioner guide (pp. 139–175). New York, NY: American Psychological Association. doi:10.1037/11561-007.

Waller, G., Meyer, C., & Ohanian, V. (2001). Psychometric properties of the long and short version of the Young Schema Questionnaire: Core beliefs among bulimic women and comparison women. Cognitive Therapy & Research, 25, 137–147. doi:10.1023/A:1026487018110.CrossRef

Waller, G., Ohanian, V., Meyer, C., & Osman, S. (2000). Cognitive content among bulimic women: The role of core beliefs. International Journal of Eating Disorders, 28, 235–241. doi:10.1037/11561-007.PubMedCrossRef

Young, J. E. (1994). Cognitive therapy for personality disorders: A schema-focused approach. Sarasota, FL: Professional Resource Press. Revised edition.

Young, J. E. (1999). Cognitive therapy for personality disorders: A schema-focused approach (3rd ed.). Sarasota, FL: Professional Resource Press.

Young, J. E., & Brown, G. (1994). Young Schema Questionnaire- short form. New York, NY: Cognitive Therapy Center.

Young, J. E., Klosko, J. S., & Weishar, M. E. (2003). Schema therapy: A practitioner’s guide. New York: Guilford Press.

Zinzow, H. M., & Jackson, J. L. (2009). Attributions for different types of traumatic events and post-traumatic stress among women. Journal of Aggression, Maltreatment, and Trauma, 18, 499–515. doi:10.1080/10926770903051025.CrossRef

Zlotnick, C., Zatriski, A. L., Shea, M. T., Costello, E., Begin, A., Pearlstein, T., et al. (1996). The long-term sequelae of sexual abuse: Support for a complex posttraumatic stress disorder. Journal of Traumatic Stress, 9, 195–205. doi:10.1002/jts.2490090204.PubMedCrossRef

Titel: Identification of Child Sexual Abuse Survivor Subgroups Based on Early Maladaptive Schemas: Implications for Understanding Differences in Posttraumatic Stress Disorder Symptom Severity
Auteurs: Hilary G. Harding
Erin E. Burns
Joan L. Jackson
Publicatiedatum: 01-10-2012
Uitgeverij: Springer US
Gepubliceerd in: Cognitive Therapy and Research / Uitgave 5/2012
Print ISSN: 0147-5916
Elektronisch ISSN: 1573-2819
DOI: https://doi.org/10.1007/s10608-011-9385-8

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