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Schema therapy was developed by Jeffery Young to treat adults with personality disorders, and has been evidenced to be effective in treating both Axis I and Axis II disorders. While Young stipulates that schemas are likely to be in place by adolescence, there is currently little agreement over the appropriateness of schema theory and therapy in understanding and treating psychopathology in adolescence. This thesis aims to explore the evidence–base and potential utility of applying schema theory to adolescent psychopathology, and consists of a systematic review and research article. The review included published studies measuring Early Maladaptive Schemas (EMS) in 12 to 18 year olds, including those exploring relationships between EMS and psychopathology. The search of relevant literature from 1990 to 2012 yielded 19 articles for review, which were then subject to assessment of methodological quality. Most studies were assessed as ‘moderate’ in quality. Good quality evidence was found for the detection of higher rates of EMS in clinical or referred adolescent populations compared to non–clinical populations, as well as some evidence for effects of age and gender on EMS. Less consistent evidence was found for specific associations between individual EMS or domains and particular types of psychopathology or problem behaviour. Common limitations of the articles reviewed included poor control of confounding variables and little testing of EMS alongside contextual constructs to provide validation of findings. The main research article used a quantitative, questionnaire–based cross– sectional design to test the dimensionality of the schema concept in a population of 12 to 18 year–olds, comparing levels of EMS between a referred and non–referred group. EMS were measured alongside attachment and interpersonal behaviours to test their unique predictive effect on psychopathology. Specific relationships between individual groups of EMS and type of psychopathology were also explored. Results showed that the referred group scored significantly higher than the non–referred group on overall schema score. Schemas were found to significantly predict level of psychopathology, over and above prediction by attachment or interpersonal behaviour scores. There was also evidence for the specific prediction of internalising and externalising problem behaviour, affective, anxiety, oppositional–defiant and conduct problems by clusters of EMS. In conclusion, EMS appear to be a valid concept in predicting and understanding psychopathology in adolescence. A conceptual model is suggested for future research to explore the adaptation of schema theory more fully within developmental psychopathology. It is hoped that future research will test other aspects of schema theory in adolescents such as coping styles and modes. It is proposed that, following further validating evidence, this may result in the development of improved interventions for a range of presenting problems in adolescence.

Food and eating are often associated with both positive and negative emotions: pleasure and enjoyment, and also worry and guilt. Guilt has the potential to have both adaptive and maladaptive consequences on health behaviours. The present study aimed to further explore the relationship between a default association of guilt with a ‘forbidden’ food item (i.e., chocolate cake) and healthy eating behaviours, attitudes, intentions, and perceived behavioural control. Individual difference variables (self-control, self-compassion, and neuroticism) and stress were also examined in relation to guilt. This study investigated the influence of a default guilt association on hypothetical and actual food choices. The findings suggest that food-related guilt can have both adaptive and maladaptive consequences on healthy eating behaviours and on individual difference variables. Individuals with chocolate cake-guilt associations reported healthier eating intentions and higher perceived behavioural control in relation to healthy eating. Those with guilt associations did not report more positive attitudes toward healthy eating nor higher self-control. They reported lower levels of self-compassion and higher levels of neuroticism and perceived stress. In regard to a hypothetical food choice, no differences were found between those with guilt or celebration associations. With one exception, guilt did not have adaptive effects during a taste test in regard to sweet and savoury food intake and post-eating guilt. Self-control appeared to be a protective factor from the maladaptive effects of guilt: self-control moderated the relationship between a guilt association and healthy eating intentions and savoury food intake. The overall findings from this research indicate that an alternative approach to promoting healthy eating and living should be considered.

Eating disorders are chronic, disabling illnesses associated with significant mortality rates (Crow et al., 2009). Body dissatisfaction has been demonstrated as a prominent risk factor for adolescent eating disorders. However few studies have examined psychological factors that predict body dissatisfaction. The present study examined maladaptive perfectionism and anxiety as possible risk factors for body dissatisfaction in adolescents with eating disorders and controls. Participants completed measures of body dissatisfaction, maladaptive perfectionism, and anxiety. Results demonstrated that maladaptive perfectionism and anxiety were significantly and positively associated with body dissatisfaction. However, these factors did not interact to predict elevated body dissatisfaction in eating disordered adolescents. These findings suggest that current body image treatments for adolescents with eating disorders and from nonclinical populations may be improved by including a focus on maladaptive perfectionism or anxiety. Future research should endeavour to conduct prospective, longitudinal studies that assess whether risk factors for body dissatisfaction are also causal factors. Finally, it is also important that researchers investigate whether body image treatments that target maladaptive perfectionism or anxiety effectively reduce body dissatisfaction in adolescents with and without eating disorders.

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The first study examined the role of perceived adverse parenting and early maladaptive schemas in the development of PTSD in Australian and New Zealand Vietnam war-veterans (N = 220). Veterans diagnosed with PTSD scored higher on the Young Schema Questionnaire and had higher scores on the Measure of Parental Style (MOPS) than veterans not diagnosed with PTSD. Only three childhood negative events were associated with PTSD: witnessing domestic violence; mother unemployed; and living with a stepfather. These variables may relate to research on negative family environment being associated with PTSD, whereas schemas may relate to parenting. The finding of strong relationships between negative life events data and adverse parenting endorses the MOPS as a valid instrument. Admission to hospital in Vietnam was the only war variable related to PTSD. Schemas mediated the negative parenting - PTSD link, and the Vietnam War experience - PTSD link. The results suggest that early maladaptive schemas have an important role in the development or maintenance of PTSD in Vietnam veterans. The second study measured at baseline, termination and three months the early maladaptive schemas, PTSD, anxiety, depression, and relationships of war-veterans (n = 54) participating in a PTSD group treatment program that included schema-focused therapy. Scores on the PTSD Check List, the Hospital Anxiety and Depression Scale, and 17 schemas decreased significantly after treatment. The Abbreviated Dyadic Adjustment Scale and the Assessment of Quality of Life scores indicated that the veterans’ current relationships improved. Partners of veterans also experienced enhanced relationships. All gains were maintained at three-month follow-up. The five schema domains were associated with an improvement in PTSD symptoms, with gains on the impaired autonomy domain being associated with 26.3% of the changes in PTSD. Change scores for the schema treatment were compared to a similar earlier manualised CBT program. Pre-treatment measures were similar in both groups. Nevertheless, PTSD and anxiety improved significantly more for the schema-focused therapy group. Although the second study was not a randomised control comparison, both studies support the feasibility of schema-focused therapy to assist veterans with PTSD.

No description available.

The present study examined a psychosocial-cognitive model that integrates recent findings on the independent effects of early maladaptive cognitive schemas (EMSs; Young, 1994) and psychosocial factors/stressors; viz., social support, expressed emotion, stressful life events and daily hassles, on level of depressive symptoms in young adults. Consistent with Beck's theory of depression, the expectation was that individuals with the EMSs would be more likely to respond to psychosocial stressors with higher levels of depression. Questionnaires measuring the selected psychosocial factors and EMSs were administered to 244 (82 male and 162 female) undergraduate students, mean age 19. Previous findings on the direct relationships between stressful life events, social support and EMSs, and level of depression were replicated. Except for daily hassles, the moderator role of the EMSs was largely disconfirmed when a conservative statistical test (Bonferroni correction) was applied to moderator analyses. With regard to perceived social support received from family and friends, present results were promising for the moderator effect of the EMSs of self sacrifice, functional dependency/incompetence and abandonment. The prediction equation to the criterion of depression indicated independent contributions of stressful life events, and the EMSs of abandonment, functional dependency/incompetence, and insufficient self control, accounting for half of the variance in depression. Taken together, the present data provided little support for the moderator effect of the EMSs rather supported Young's theory (1990) that maladaptive cognitions in themselves can produce increased levels of depression regardless of the presence of triggering stressors. / Master of Science

The purpose of this experiment was to initiate research into the use of operant conditioning of autonomically mediated behavior (OCAM) in the modification of maladaptive behavior. Anxiety was chosen as a target behavior because of its apparent pervasiveness among many different maladaptive behaviors.

The current study examined whether elevations on four variables (drive for thinness, depressed mood, maladaptive cognitions, and ineffectiveness) were related to increased risk of developing an eating disorder over a 4-year prospective interval. Subjects (N = 191) were female undergraduates who were assessed with the Anorexia-Bulimia Inventory (ABI), Eating Disorder Inventory (EDI), and a structured clinical interview. Results indicated that individuals with elevated scores on each of the four variables at the initial assessment did not show higher absolute eating disorder incidence rates over the 4-year interval. However, initial scores on the four variables together lll explained approximately 13% of both anorexia and bulimia symptom severity variance at the final assessment. Changes over time in the four variables were more highly related to later symptom severity, explaining 34% of the variance in anorexic severity and 16% in bulimic severity. Thus, the findings suggest that initial scores, and especially changes in scores, on the four variables were related to severity of symptoms 4 years later. However, a large proportion of the variance in eating disorder severity remained unexplained. Examination of the role of each risk variable individually revealed that initial elevations on maladaptive cognitions and drive for thinness subscales were related to higher anorexic symptom severity at the later assessment. Of interest was the absence of significant relationships between early scores on maladaptive cognitions and drive for thinness and subsequent bulimic symptoms, suggesting that anorexia and bulimia may have somewhat different risk pathways. The pretest scores on the depressed mood and ineffectiveness subscales were not significantly correlated with symptom severity at the later assessment, and were not identified by the regression analyses as parsimonious or efficient predictors of eating disorder symptoms. This finding suggests that perhaps early difficulties with depression and low self-esteem are less related to onset of later eating disorders than previously believed. Finally, the overall 4-year incidence rate of .6% found in the current study suggests that as women move through their college years, they are departing the developmental period of high risk for onset of eating disorders, and thus, new cases become increasingly rare.