The Relationship Between Perfectionism, Early Maladaptive Schemas, Attachment Styles, and Body Image Concern by the Mediating Role of Self-esteem in Cosmetic Surgery Applicants

Background: Psychological characteristics could significantly impact applications for cosmetic surgery as well as precognition and satisfaction with surgery. The present study aimed to investigate the relationship between perfectionism, early maladaptive schemas, attachment styles, and body image concern by the mediating role of self-esteem in cosmetic surgery applicants. Methods: This was a predictive correlational study. The statistical population of the study included all female applicants for cosmetic surgery referring to cosmetic surgery centers in Tehran City, Iran, in 2020. A sample size of 400 women was selected based on Klein’s model (2016). The required data were collected by Rosenberg Self-Esteem Scale (RSES) (1989), Multidimensional Perfectionism Scale (MPS), Young Schema Questionnaire (YSQ-S3), Adult Attachment Scale (AAS), and Body Image Concern Inventory (BICI), and analyzed using Pearson correlation coefficient and structural equations in SPSS and AMOS. Results: The obtained results signified a significant relationship between perfectionism, early maladaptive schemas, attachment styles, self-esteem, and body image concerns (P<0.01). Furthermore, the modified model presented a good fit (The Root Mean Square Error of Approximation (RMSEA) =0.061, GFI=0.989, IFI=0.987, P<0.05); the indirect paths of perfectionism, early maladaptive schema, and attachment styles through self-esteem were also significant. Conclusion: The evaluated model indicated a good fit; thus, it can play an essential role in recognizing the factors affecting the body image concerns of female cosmetic surgery applicants.

Comparing Early Maladaptive Schemas and Schema Modes of Individuals with High and Low Scores in Scrupulosity and Normal Religious People

Background: Scrupulosity or religious obsession is a form of obsessive-compulsive disorder (OCD) and is recognized to be treatment-resistant. One of the most common treatments for treatment-resistant disorders is schema therapy. Objectives: This study aimed to compare the early maladaptive schemas and schema modes of individuals with high and low scores in scrupulosity, as well as religious people with no disorder. Methods: The population of this cross-sectional study consisted of all patients with OCD referred to Iran Psychiatric Hospital and the Clinic of Behavioral Sciences and Mental Health in Tehran, Iran, in 2019. The sample included 75 individuals with high score in scrupulosity, 75 individuals with low score in scrupulosity, and 75 religious people with no disorder. At first, all participants were evaluated with the structured clinical interview for DSM-5 disorders-clinical version (SCID-5-CV). Then, they completed the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Penn Inventory of Scrupulosity (PIOS), Young Schema Questionnaire-Short Form (YSQ-SF), and Schema Mode Inventory (SMI). Data were analyzed using the one-way analysis of variance (ANOVA) and Kruskal-Wallis test. Results: Individuals with high scores in scrupulosity were significantly different from normal religious people in the "disconnection and rejection" and "impaired autonomy and performance" schema domains. However, there was no significant difference between individuals with high scores in scrupulosity and those with a low score in any of the schema domains. Also, individuals with a high score in scrupulosity scored higher in almost all schema modes compared to normal religious people. Finally, the "punitive and demanding parent modes" of individuals with a high score in scrupulosity was significantly different from that of individuals with a low score. Conclusions: According to our results, it is essential to focus on "disconnection and rejection" and "impaired autonomy and performance" schema domains, as well as child and parent modes, especially the dysfunctional parent mode, to treat individuals with a high scrupulosity score. Due to limited literature, further research is needed to confirm our results.

A Multi-Faceted Evaluation of Impulsivity Traits and Early Maladaptive Schemas in Patients with Anorexia Nervosa

(1) Background: patients with Anorexia Nervosa (AN) are classified either as restrictive (ANr) or binge/purge (ANbp) according to the absence or presence of impulsive eating and compensatory behaviors. The aim of the present study was to assess the levels of impulsivity in both AN subtypes and to explore whether individual differences in impulsivity may be explained by differences in the presence of early maladaptive schemas. (2) Methods: the sample group included 122 patients with ANr, 112 patients with ANbp, and 131 healthy women (HW). All of these participants completed the UPPS-P scale for an assessment of impulsive behaviors and the Young Schema Questionnaire (YSQ-S3) for an assessment of early maladaptive schemas. (3) Results: the patients with ANbp displayed higher levels of impulsivity compared with the patients with ANr and HW. Patients with AN, especially the restrictive subtype, also reported higher levels of early maladaptive schemas than HW, and regression analyses revealed that specific maladaptive schemas partially explain the variability in impulsivity in both patients and HW. (4) Conclusions: it appears that maladaptive beliefs developed during childhood or adolescence may predict the development of impulsivity, a personality trait usually associated with maladaptive behaviors, and appears to be prevalent among ANbp patients. The clinical effects of this, as well as directions for future study, are also discussed in this paper.

PSIHOLOŠKA NEFLEKSIBILNOST KAO MEDIJATOR ODNOSA IZMEĐU RANIH MALADAPTIVNIH SHEMA I MANIFESTACIJA DEPRESIVNOSTI, ANKSIOZNOSTI I STRESA

Although the link between Early Maladaptive Schemas and many psychopathological manifestations has been confirmed, there is still not enough research examining the mechanism by which this link is realized. The aim of this study was to examine whether psychological inflexibility could be a mediator of the relationship between early maladaptive schemas grouped in schema domains and problems in current functioning, manifested through depression, anxiety and stress symptoms. Among the instruments used were the Young’s Schema Questionnaire, the Acceptance and Action Questionnaire and Depression, Anxiety, and Stress Scales. The sample included 320 subjects (Nfemales = 215; M = 33.5; SD = 9.6). The results indicate significant connections of psychological inflexibility with all scheme domains and all criterion variables, with this connection being the strongest in relation to depression (r = .74, p < .01) and autonomy impairment domain (r = .74, p < .01). Schema domains are important predictors of criterion variables, provided that the highest percentage of explained variance is in relation to depression. Psychological inflexibility has been shown to be a partial mediator of all relations between all schema domains and manifestations of depression, anxiety and stress. Although schema domains still have a significant direct effect on psychopathological manifestations, in the case of impaired limits when it comes to anxiety (b = .045; p<.05, 95% BCa CI [.03, .05]) and depression (b = .06, p<.05, 95% BCa CI [.04, .07]) the difference between the indirect and direct effect is most evident, while in the case of stress the greatest difference between the effects is in relation to the domain of autonomy impairment (b = .07, p < .05, 95% BCa CI [.05, .08]). The implications for the integration of schema therapy and third wave cognitive-behavioral therapy are discussed. Keywords: early maladaptive schemas, schema domains, psychological flexibility, depression, stress, anxiety

Attitudes Toward Love, Emotional Maturity, and Early Maladaptive Schemas as Predictors of Spouse Selection in People on the Verge of Marriage

Background: In every culture, different criteria are considered for choosing a spouse, and some psychological factors predict spouse selection in people on the verge of marriage. Objectives: This study aimed to investigate the role of attitudes toward love, emotional maturity, and early maladaptive schemas in predicting spouse selection in a sample of people on the verge of marriage. Methods: This cross-sectional study was conducted from June to September 2018. After applying inclusion and exclusion criteria, participants were selected using the convenience sampling method and evaluated by the Love Attitudes Scale, the Emotional Maturity Scale, the Young Early Maladaptive Schema Scale-short form, and the preference criteria of spouse selection inventory. Results: The results showed that Pragma love, lack of independence, and disconnection and rejection were the best predictors of the spouse selection process (R2 = 0.50; F = 11.62; P < 0.001). Also, Eros love, lack of independence, and impaired autonomy and performance were the best predictors of content spouse selection (R2 = 0.66; F = 15.38; P < 0.001). Conclusions: Young people have criteria for selecting a spouse. Pragma love, which is rational love, predicts the spouse selection process, and if content spouse selection is used, Eros love, which is hedonic, is the best predictor. Thus, all family therapists and counselors need to know about this criterion in each area they work.

Role of attachment and early maladaptive schemas in the impulsive behaviour of adolescents

Introducción/objetivo: Son escasos los estudios que abordan la relación entre el apego y la impulsividad en la adolescencia. Por ello, los objetivos del estudio han sido estudiar la relación entre el apego, las estructuras inadaptadas tempranas y la impulsividad, así como comprobar el papel predictivo de los dos primeros sobre la impulsividad. Por último, se estudia el papel mediador de los esquemas inadaptados tempranos en la relación entre el apego y la impulsividad. Métodos: La muestra es de 1533 adolescentes de Ecuador (826 hombres y 707 mujeres), con edades entre los 14 y 18 años (M = 15.76, DT = 1.25). Se emplearon los siguientes cuestionarios para medir las variables de estudio: CaMir-R, YSQ-S3, BIS 11. Resultados: Los resultados reflejan como la seguridad, el valor a la autoridad parental, la permisividad parental, la autosuficiencia y rencor contra los padres, el traumatismo infantil y el esquema negatividad/ pesimismo predicen la conducta impulsiva. Asimismo, se confirma el papel mediador de los esquemas inadaptados tempranos. Conclusiones: El conocimiento del papel que cumplen los esquemas inadaptados tempranos y los estilos de apego como factores de riesgo o vulnerabilidad implicados en el establecimiento de la conducta impulsiva resulta de gran utilidad de cara a implementar estrategias preventivas y un enfoque terapéutico adecuado.

A new integrative model for the co-occurrence of non-suicidal self-injury behaviours and eating disorder symptoms

Objective The high co-occurrence of non-suicidal self-injury (NSSI) behaviours and eating disorder (ED) symptoms suggests these conditions share common aetiological processes. We assessed a new integrative model of shared factors for NSSI and ED symptoms, where affect dysregulation, impulsivity, self-esteem, and body dissatisfaction mediated the relationship between insecure attachment and maladaptive schemas and NSSI and ED symptoms. A further aim of the study was to assess whether the model behaved similarly across a clinical eating disorder (ED) and a community sample. Method 123 females with a lifetime ED diagnosis and 531 female individuals from the community completed an online survey, which included measures assessing the variables of interest. A cross-sectional single time point analysis was used. Results Invariance testing indicated that the model was structurally non-invariant (different across groups). The proposed integrative model was a good fit for the ED group, but for the community sample only a revised model reached an acceptable fit. Both attachment and maladaptive schemas, included early in the model, were implicated in the pathways leading to ED and NSSI symptoms in the ED and community groups. In the community group, impulsivity, a mediator, was a shared predictor for NSSI and bulimic symptoms. No other mediating variables were shared by NSSI and ED symptoms in the two groups. Overall, the proposed model explained slightly more variance for the ED group relative to the community group in drive for thinness (R2 = .57 vs .51) and NSSI (R2 = .29 vs .24) but less variance in bulimic symptoms (R2 = .33 vs .39). Conclusion We conclude that the current model provides only limited support for explaining the comorbidity between NSSI and ED symptoms. It is vital to consider both common (e.g., attachment and maladaptive schemas) and specific factors (e.g., impulsivity) to better understand the pathways that lead to the co-occurrence of NSSI and ED symptoms. A new integrative model assessed whether emotion dysregulation, impulsivity, self-esteem, and body dissatisfaction were mediators in the relationship between insecure attachment and maladaptive beliefs about the world and the self and subsequent eating disorder and self-harm symptoms. A further aim was to assess whether the proposed model differed between a clinical eating disorder and a community sample. All participants were female and included 123 patients with a lifetime eating disorder and 531 individuals from the community. Participating individuals completed an online survey at one timepoint, which included measures assessing the variables of interest. The findings of the current study indicated that the proposed model was a good match for the clinical eating disorder sample, but for the community sample only a revised model yielded acceptable statistical fit. Both insecure attachment and maladaptive beliefs about the world and the self, included early in the model, were indirectly related to eating disorder and self-harm symptoms for both the eating disorder and the community groups. Impulsivity, a mediator, was the only shared predictor for self-harm, and bulimic symptoms in the community group. We conclude that the current model provides only limited support for explaining the comorbidity between self-harming behaviours and disordered eating symptoms.

Negative symptoms: associations with defeatist beliefs, self-efficacy, and maladaptive schemas in youth and young adults at-risk for psychosis

Background: Investigations into possible mechanisms that may contribute to the development, maintenance, and exacerbation of negative symptoms are needed. Defeatist beliefs, self-efficacy, and early maladaptive schemas have been shown to contribute to negative symptoms in schizophrenia. Likewise, negative symptoms occur in those at clinical high-risk (CHR) for psychosis. Aims: The aim of this study was to determine if negative symptoms were associated with defeatist beliefs, self-efficacy, and early maladaptive schemas in CHR participants of a group therapy intervention study. Method: All CHR participants (n = 203; 99 males, 104 females) were recruited as part of a three-site randomized control trial: Recovery through Group Study (ReGroup). Negative symptoms, defeatist beliefs, self-efficacy and early maladaptive schemas were assessed by trained clinical raters. Mediation analyses were conducted to examine the relationship between defeatist beliefs, self-efficacy, functioning, and negative symptoms. Results: The majority of CHR youth (72.9%) had at least one negative symptom of moderate to above moderate severity at baseline. In multiple mediation analyses, both asocial beliefs and social self-efficacy mediated the effects of social functioning on negative symptoms. Finally, defeatist performance attitudes significantly mediated the effects of role functioning on negative symptoms. Conclusions: These results highlight the importance of considering beliefs and attitudes in relation to functioning and severity of negative symptoms. Psychosocial interventions may wish to target beliefs and attitudes in effort to reduce negative symptoms and improve functioning in CHR youth.