Early maladaptive schemas, emotion regulation difficulties and alexithymia: A systematic review and meta-analysis

IF 3.2 3区心理学 Q1 PSYCHOLOGY, CLINICAL Clinical psychology & psychotherapy Pub Date : 2023-09-21 DOI:10.1002/cpp.2914

Pamela D. Pilkington, Gery C. Karantzas, Bruno Faustino, Elizabeth Pizarro-Campagna

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Abstract

Background

Emotion regulation is an integral part of the schema therapy model. The aim of this systematic review and meta-analysis was to synthesize the evidence on the associations between early maladaptive schemas (EMSs), difficulties with emotion regulation and alexithymia.

Method

PsycINFO, PubMed and CINAHL Complete databases were searched on 28 May 2022 and 3 February 2023 in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Included studies were in English, in peer-reviewed journals and reported on the association between one or more of the 18 EMSs or five schema domains and emotion regulation difficulties or alexithymia. Methodological quality was assessed using the Appraisal Tool for Cross-Sectional Studies. Meta-analyses were conducted to examine difficulties with emotion regulation and alexithymia as correlates of each EMS and domain.

Results

A total of 19 studies published between 2008 and 2022 were included (Pooled N = 5957). Difficulties with emotion regulation were positively correlated with all 18 EMSs (range: entitlement r(7) = .28, 95% CI [.13, .42] to negativity pessimism r(5) = .53, 95% CI [.23, .74]) and schema domains (range: impaired limits r(5) = .34, 95% CI [.08, .56] to disconnection rejection r(5) = .44, 95% CI [.33, .73]). Alexithymia was positively correlated with the other-directedness domain (r(2) = .40, 95% CI [.09, .64]) and 16 of the 18 EMSs (range: unrelenting standards r(5) = .21, 95% CI [.12, .28] to emotional inhibition r(5) = .50, 95% CI [.34, .63]).

Conclusions

The findings suggested that almost all 18 EMSs are implicated in emotion regulation difficulties and alexithymia, particularly those relating to unmet needs for attachment and autonomy.

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早期适应不良图式、情绪调节困难和述情障碍：一项系统综述和荟萃分析。

背景：情绪调节是图式治疗模式的一个组成部分。这项系统综述和荟萃分析的目的是综合早期适应不良图式（EMS）、情绪调节困难和述情障碍之间关系的证据。方法：根据系统评价和荟萃分析的首选报告项目，于2022年5月28日和2023年2月3日搜索PsycINFO、PubMed和CINAHL完整数据库。纳入的研究是英文的，发表在同行评审的期刊上，并报道了18个EMS中的一个或多个或五个图式域与情绪调节困难或述情障碍之间的关系。使用横断面研究评估工具对方法学质量进行了评估。进行荟萃分析，以检查情绪调节困难和述情障碍作为每个EMS和领域的相关性。结果：2008年至2022年间共发表了19项研究（汇总N= 5957）。情绪调节困难与所有18个EMS呈正相关（范围：权利r（7） =.28，95%置信区间[13，.42]对消极悲观主义r（5） =.53,95%置信区间[23,.74]）和模式域（范围：受损极限r（5） =.34，95%CI[0.08，.56]至断开拒绝r（5） =.44，95%CI[0.33，.73]）。述情障碍与其他定向域呈正相关（r（2） =.40，95%CI[0.9，.64]）和18个EMS中的16个（范围：无情的标准r（5） =.21，95%CI[0.12，.28]对情绪抑制r（5） =.50，95%可信区间[34，.63]）。结论：研究结果表明，几乎所有18个EMS都与情绪调节困难和述情障碍有关，尤其是与依恋和自主需求未得到满足有关的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical psychology & psychotherapy PSYCHOLOGY, CLINICAL-

CiteScore

6.30

自引率

5.60%

发文量

106

期刊介绍： Clinical Psychology & Psychotherapy aims to keep clinical psychologists and psychotherapists up to date with new developments in their fields. The Journal will provide an integrative impetus both between theory and practice and between different orientations within clinical psychology and psychotherapy. Clinical Psychology & Psychotherapy will be a forum in which practitioners can present their wealth of expertise and innovations in order to make these available to a wider audience. Equally, the Journal will contain reports from researchers who want to address a larger clinical audience with clinically relevant issues and clinically valid research.