Comparing the Effectiveness of Schema Therapy and CBT on Improving Early Maladaptive Schemas in Patients with Nervous Anorexia with Weak Mother Bond

Document Type : پژوهشی

Authors

• tahereh mahmoudian dastnaee ¹
• shole amiri ²
• Hamid Taher Neshatdoost ³
• Gholamreza Manshaei ⁴

¹ khorasgan isfahan

² isfahan university

³ University of Isfahan

⁴ Islamic Azad University, Khorasgan

10.22067/ijap.v8i1.58359

Abstract

Purpose: The present study aimed at comparing the effectiveness of schema therapy and CBT on improving early maladaptive schemas in patients with nervous anorexia with weak mother bond.
Method: The study had an experimental method with pretest-posttest design and follow-up with the control group. The study population included all patients aged 16 to 23 years with eating disorders who had referred to psychiatry and psychotherapy in clinical centers in Tehran. Purposive sampling was used in this study. Twenty-one (21) patients were diagnosed to have anorexia nervosa by performing the psychological screening. Finally, the selected patients were matched in two experimental groups and one control group. Data were collected through questionnaires and diagnostic interviews based on diagnostic criteria for eating disorders and psychiatric diagnosis. Two questionnaires were used in the study including 1. Parental Bonding Questionnaire 2. Young Schema Questionnaire.
Findings: Patients in the area of disconnection and rejection, impaired autonomy and performance, Hypervigilance /inhibition, have the most damage. But, little damage to the other area, impaired limits, and other-directedness. The results also indicate that in improving schemas, schema therapy was more effective and more durable than cognitive and behavioral therapy.

Keywords

• Schema Therapy
• CBT
• Nervous Anorexia
• Weak mother bond

---

References

Agras, W. S., Lock, J., Brandt, H., Bryson, S. W., Dodge, E., Halmi, K. A., ... & Woodside, B. (2014). Comparison of 2 family therapies for adolescent anorexia nervosa: a randomized parallel trial. JAMA psychiatry, 71(11), 1279-1286.

Ahi, G. (2006). Standardization of the Young Schema Questionnaire short version. master's Desertation in Educational Psychology, Allameh Tabatabaei University, Tehran, Iran. (In Persian)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5). American Psychiatric Pub.

Brockmeyer, T., Holtforth, M. G., Bents, H., Kämmerer, A., Herzog, W., & Friederich, H. C. (2013). Interpersonal motives in anorexia nervosa: The fear of losing one's autonomy. Journal of clinical psychology, 69(3), 278-289.

Canetti, L., Kanyas, K., Lerer, B., Latzer, Y., & Bachar, E. (2008). Anorexia nervosa and parental bonding: the contribution of parent–grandparent relationships to eating disorder psychopathology. Journal of Clinical Psychology, 64(6), 703-716.

Chamay-Weber, C., Narring, F., & Michaud, P. A. (2005). Partial eating disorders among adolescents: A review. Journal of adolescent health, 37(5), 416-426.

Colman, A. M. (2015). A dictionary of psychology. Oxford University Press, USA.

Cooper, M. J., Rose K. S, & Tumer, H. M. (2005). Core beliefs and the presence or absence of eating disorder symptoms. Journal Eating Behaviors, 7, 27-35.

Dashtbozorgi, Z; Amiri, SH; Mazaheri, A; Talebi, H. (2013). Impact of intervention on attachment to overeating and obesity of girls. PhD. Desertation in General Psychology, University of Isfahan. Isfahan, Iran. (In Persian)

Fichter, M. M., & Quadflieg, N. (2016). Mortality in eating disorders‐results of a large prospective clinical longitudinal study. International Journal of Eating Disorders, 49(4), 391-401.

Goss, K., & Allan, S. (2009). Shame, pride and eating disorders. Clinical psychology & psychotherapy, 16(4), 303-316.

Grilo, C. M., & Mitchell, J. E. (Eds.). (2011). the treatment of eating disorders: A clinical handbook. Guilford Press.

Halmi, K. A., Bellace, D., Berthod, S., Ghosh, S., Berrettini, W., Brandt, H. A., ... & Kaplan, A. (2012). An examination of early childhood perfectionism across anorexia nervosa subtypes. International Journal of Eating Disorders, 45(6), 800-807.

Jones, C. J., Leung, N., & Harris, G. (2006). Father‐daughter relationship and eating psychopathology: The mediating role of core beliefs. British Journal of Clinical Psychology, 45(3), 319-330.

Jones, C., Harris, G., & Leung, N. (2005). Parental rearing behaviours and eating disorders: The moderating role of core beliefs. Journal of Eating behaviors, 6(4), 355-364.

Leung, N., Waller, G., & Thomas, G. (1999). Core beliefs in anorexic and bulimic women. Journal of nervous and mental disease, 187(12), 736-741.

Lewis, J. A. (2005). Early maladaptive schemas and personality dysfunction in adolescence: An investigation of the moderating effects of coping styles. ETD Collection for Fordham University.

Lock, J., & Le Grange, D. (2015). Treatment manual for anorexia nervosa: A family-based approach. Guilford Publications.

Mącik, D., & Sas, E. (2015). Therapy of anorexia and Young’s early maladaptive schemas. Longitudinal study. Current Issues in Personality Psychology, 3(4), 203-213.

Mehler, P. S., & Brown, C. (2015). Anorexia nervosa–medical complications. Journal of eating disorders, 3(1), 11.

Meyer, C., & Gillings, K (2004). Parental bonding and bulimic psychopathology: The mediating role of mistrust/abuse beliefs. International Journal of Eating Disorders, 35(2), 229-233.

Murphy, C. M., Stojek, M. K., & MacKillop, J. (2014). Interrelationships among impulsive personality traits, food addiction, and body mass index.Appetite, 73, 45-50.

Wilhelm, K., Niven, H., Parker, G., & Hadzi-Pavlovic, D. (2005). The stability of the Parental Bonding Instrument over a 20-year period. Psychological medicine, 35(3), 387-393.

Pugh, M. (2015). A narrative review of schemas and schema therapy outcomes in the eating disorders. Clinical psychology review, 39, 30-41.

Rommel, D., Nandrino, J. L., Antoine, P., & Dodin, V. (2013). Emotional differentiation and parental bonding in inpatients suffering from eating disorders. British Journal of Clinical Psychology, 52(2), 215-229.

Sadock, B. J., & Sadock, V. A. (2008). Kaplan & Sadock's concise textbook of clinical psychiatry. Lippincott Williams & Wilkins.

Shayeqian, Z., Agilard Vafaii, M., and Rasoulzadeh Tabatabaei, S.K. (2011). Examining schemas and parental bonding among adolescent females with normal weight, obese females or those having symptoms of anorexia nervosa. Research Journal of Shahid Beheshti University of Medical Sciences, (M SCI) 16(1), 30-38. (In Persian)

Simpson, S. G., Morrow, E., & Reid, C. (2010). Group schema therapy for eating disorders: a pilot study. Frontiers in psychology, 1, 182.

Stice, E., Presnell, K., & Spangler, D. (2002). Risk factors for binge eating onset in adolescent girls: a 2-year prospective investigation. Journal Health Psychology, 21(2), 131.

Tasca, G. A., & Balfour, L. (2014). Attachment and eating disorders: A review of current research. International Journal of Eating Disorders, 47(7), 710-717.

Tetley, A., Moghaddam, N. G., Dawson, D. L., & Rennoldson, M. (2014). Parental bonding and eating disorders: A systematic review. Journal Eating behaviors, 15(1), 49-59.

Turner, H. M., Rose, K. S., & Cooper, M. J. (2005). Parental bonding and eating disorder symptoms in adolescents: The meditating role of core beliefs .Journal Eating Behaviors, 6(2), 113-118.

Turner, H., Marshall, E., Stopa, L., & Waller, G. (2015). Cognitive-behavioural therapy for outpatients with eating disorders: Effectiveness for a transdiagnostic group in a routine clinical setting. Journal Behaviour research and therapy, 68, 70-75.

Unoka, Z., Tölgyes, T., Czobor, P., & Simon, L. (2010). Eating disorder behavior and early maladaptive schemas in subgroups of eating disorders. Journal of nervous and mental disease, 198(6), 425-431

Watson, H. J., & Bulik, C. M. (2013). Update on the treatment of anorexia nervosa: review of clinical trials, practice guidelines and emerging interventions. Journal of Psychological medicine, 43(12), 2477-2500.

Wilson, G. T., Fairburn, C. C., Agras, W. S., Walsh, B. T., & Kraemer, H. (2002). Cognitive-behavioral therapy for bulimia nervosa: Time course and mechanisms of change. Journal of consulting and clinical psychology, 70(2), 267.

Young, J. E., Klosko, J. S., & Weishaar, M. E. (2003). Schema therapy: A practitioner's guide. Guilford Press.