Early maladaptive schemas as mediators between childhood maltreatment and adult psychopathology in psychiatric inpatients

IF 3.4 2区心理学 Q1 FAMILY STUDIES Child Abuse & Neglect Pub Date : 2025-02-01 DOI:10.1016/j.chiabu.2024.107238

Zahra Azadfar , Gina Rossi , Eva Dierckx , Jesse Duenas , Carmen Diaz-Batanero , Katrien Schoevaerts , Hendrik Peuskens , Els Santens , Els Pauwels , An Haekens , Kris Baetens

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Abstract

Background

Early maladaptive schemas are well-established mechanisms between childhood maltreatment (i.e., abuse and neglect) and psychopathology in adulthood. However, research has not yet examined the unique contribution of childhood maltreatment, while controlling for the family dysfunction-related experiences, in shaping specific EMS domains and their associations with distinct psychopathological outcomes.

Objective

Our aim was to examine the unique role of childhood maltreatment, while controlling for the effects of family dysfunction on early maladaptive schemas and subsequently on personality disorders and psychological distress using structural equation modelling and network analysis.

Methods

A total of 2,011 unique inpatients aged 18 to 80 years (M = 39.7, SD = 14.18; 53.4% women) admitted to the Alexianen Zorggroep Tienen Psychiatric Hospital between 2011 and 2021 were included in this study. Self-report questionnaires were completed as part of the hospital admission process. Data were analyzed using structural equation modeling and network analysis.

Results

The results showed positive associations between childhood maltreatment, family dysfunction, early maladaptive schema domains, symptoms of personality disorders, and psychological distress. Accounting for the effects of family dysfunction-related experiences, early maladaptive schema played a significant mediating role in the association between childhood maltreatment and psychopathological outcomes. The results highlighted the central role of the domains disconnection/rejection and impaired autonomy/performance for personality disorders and psychological distress. There were no significant gender-specific differences in the network of relationships between the variables.

Conclusions

These results demonstrate the key role of EMS in the domains of disconnection/rejection and impaired autonomy/performance in the association between childhood maltreatment and personality pathology and psychological distress in psychiatric inpatients. Clinical implications, study limitations, and recommendations for future research are discussed.

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早期适应不良图式在精神科住院患者儿童虐待与成人精神病理之间的中介作用。

背景：早期适应不良图式是儿童期虐待（即虐待和忽视）与成年期精神病理之间的明确机制。然而，在控制家庭功能障碍相关经历的同时，研究尚未检查童年虐待在塑造特定的EMS域及其与不同精神病理结果的关联方面的独特贡献。目的：我们的目的是研究儿童虐待的独特作用，同时控制家庭功能障碍对早期适应不良图式的影响，随后对人格障碍和心理困扰的影响，使用结构方程模型和网络分析。方法：共2011例18 ~ 80岁住院患者(M = 39.7, SD = 14.18；2011年至2021年期间在阿列克谢连·佐格鲁普·Tienen精神病院住院的53.4%（女性）被纳入本研究。自我报告问卷是住院过程的一部分。采用结构方程建模和网络分析方法对数据进行分析。结果：儿童虐待、家庭功能障碍、早期适应不良图式域、人格障碍症状和心理困扰之间存在正相关。考虑到家庭功能障碍相关经历的影响，早期适应不良图式在儿童虐待与精神病理结果的关联中起着显著的中介作用。研究结果强调了断链/拒绝和自主性/表现受损在人格障碍和心理困扰中的核心作用。在变量之间的关系网络中没有显著的性别差异。结论：这些结果表明，在儿童虐待与精神病住院患者人格病理和心理困扰之间的关系中，EMS在断开/排斥和自主性/表现受损领域发挥了关键作用。本文讨论了临床意义、研究局限性和对未来研究的建议。

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来源期刊

Child Abuse & Neglect Multiple-

CiteScore

7.40

自引率

10.40%

发文量

397

期刊介绍： Official Publication of the International Society for Prevention of Child Abuse and Neglect. Child Abuse & Neglect The International Journal, provides an international, multidisciplinary forum on all aspects of child abuse and neglect, with special emphasis on prevention and treatment; the scope extends further to all those aspects of life which either favor or hinder child development. While contributions will primarily be from the fields of psychology, psychiatry, social work, medicine, nursing, law enforcement, legislature, education, and anthropology, the Journal encourages the concerned lay individual and child-oriented advocate organizations to contribute.