Investigating the Mediating Role of Distress Tolerance in the Relationship between Early Maladaptive Schemas and Psychiatric Symptoms among Addicts
Authors
-
Elham Fathi 1
1. Hazrat-e Masoumeh University, Qom, Iran
http://orcid.org/0000-0002-9902-201X
-
Roghayeh Abbasi 2*
2. Zanjan Branch, Islamic Azad University, Zanjan, Iran.
http://orcid.org/0000-0003-3427-3237
-
Abolfazl Hatami Varzaneh 1
1. Hazrat-e Masoumeh University, Qom, Iran
http://orcid.org/0000-0002-2351-1634
-
Maryam Soleimani 3
3. Faculty of Humanities, University of Hormozgan, Bandar Abbas, Iran
http://orcid.org/0000-0003-0809-4112
DOI:
https://doi.org/10.22100/ijhs.v7i3.852Keywords:
Distress tolerance, Early maladaptive schemas, Psychiatric symptoms, AddictsAbstract
Background: This study aimed to determine the mediating role of distress tolerance in the relationship between early maladaptive schemas and psychiatric symptoms among addicts.
Methods: The statistical population of this study consists of addicts referring to addiction treatment clinics in Zanjan city, Iran. Using the multi-stage cluster sampling method, 150 participants were selected as a sample and completed the questionnaires. Early maladaptive schema questionnaire-short form, symptom checklist-25 (SCL-25), and the distress tolerance scale were completed by participants.
Results: The findings of this study indicate a negative and significant relationship between early maladaptive schemas and distress tolerance among addicts. Also, there is a positive and significant relationship between early maladaptive schemas and psychiatric symptoms among addicts. It can be said that there is a significant negative relationship between distress tolerance and psychiatric symptoms in addicts.
Conclusions: The final results of this study show that in the relationship between early maladaptive schemas and psychiatric symptoms among addicts in Zanjan city, distress tolerance plays a mediating role and the model has a goodness of fit.
Keywords: Distress tolerance, Early maladaptive schemas, Psychiatric symptoms, Addicts.
References
1- Tsen, W. S. Exploring the multiple meanings of drug Addiction—Drug discourses in mediation, rehabilitation and local youth drug addicts (Order No. 3538888). Available from ProQuest Dissertations & Theses Global. (1346672332). Retrieved from https://www.proquest.com/dissertations-theses/exploring-multiple-meanings-drug-addiction/docview. 2012. 1346672332.
2- Abhari, M.. Social Traumas. Tehran: Pahutan.2011. [Persian].
3- 2- Dabbaghi P, Asgharnejad farida A, Atef Vahid M K, Bolharic J. Effectiveness of group cognitive therapy based on mindfulness and spiritual schema activation in the prevention of opioid abuse relapse. Iranian Journal of Psychiatry and Clinical Psychology.2008. 366-375.
4- Bergle, T. H. Patient in substance use disorder treatment: motivation for behavioral change, co-occurring disorders and problem domains. P h.D Unpublished dissertation, Norwegian university of science and technology.2015.
5- Jeffrey E. Young, Janet S. Klosko and Marjorie E. Weishaar. Schema Therapy: A Practitioner's Guide. New York: Guilford Press, 2003. pp. 436. £34.50 (hb). ISBN: 1-57230-838-9.
6- Agatsuma, S & Hiroi, N.2004. Genetic basis of Drug dependence and comorbid behavioral traits, Nihon shinkei, Jun; 24(3) : 137-45. 5. Young, Jeffrey; Closco, Janet and Margery, Wieshar. (2011). Schema therapy, a practical guide for clinicians. Translated by Hassan Hamidpour and Zahra Andouz, 2012, Tehran: Arjmand Publications.
7- Oveysi, Abbas Ali and Bakhshani, Noor Mohammad. Comparison of early maladaptive schemas in opioid-dependent and non-opioid men in Zahedan. Journal of Principles of Mental Health. 2013. 14 (2), 164-171. [in Persian].
8- Ghadimi, Hadith; Qasemi Motlagh, Mehdi. The relationship between early maladaptive schemas and addiction tendencies. The Second International Conference on New Approaches in Science, Engineering and Technology, Tehran. 2016. [in Persian].
9- Zeinali, Ali; Unity, Roghayeh; Hamednia, Safar: A Study of Pre-Addictive Fields of Addicts and Its Comparison with Healthy Non-Addicted People, Knowledge and Research in Psychology, Islamic Azad University, Khorasgan Branch (Isfahan), No. 33, Fall 2007, pp. 168-149. [in Persian].
10- Ahmadi Tahoor Soltani, Mohsen; Najafi, Mohammad: Comparison of Metacognitive Beliefs and Ambiguity in Addicted, Smokers and Normal People, Journal of Clinical Psychology / ISC, Winter 2011, No. 120, pp. 59-68[in Persian].
11- Kaplan H, Sadock B. Synopsis of psychiatry. 9th ed, New York, Williams and Wilkins, 2002. [in Persian].
12- Zahiruddin, Alireza. Seif Elahi, Masoumeh. Iranipour, Genghis. Evaluation of the rate of mental disorders in drug addicts referred to two medical centers in Tehran. Research in medicine. Shahid Beheshti University of Medical Sciences and Health Services. Dori 31, No. 3, Summer 2007. [in Persian].
13- Heidari Pahlavan, Ahmad. Mahjoub, Hussein Rahimi, Alireza. Comparison of the prevalence of various mental disorders in addicts and non-addicts living in Hamadan. Scientific Journal of Hamadan University of Medical Sciences and Health Services. Volume 18, Number 3, Fall 2011. [in Persian].
14- Zvolensky, M., Lejuez. C.W. Distress tolerance and early adolescent externalizing and internalizing symptoms: The moderating role of gender and ethnicity. Behavior Research and Therapy. 2009. 47,198-205.
15- Simons JS, Gaher RM. The Distress Tolerance Scale: Development and validation of a self-report measure. Motivation & Emotion. 2005; 29(2):83–102. doi: 10.1007/s11031-005-7955-3.
16- Brown, R. A., Lejuez, C. W., Kahler, C. W., et al. Distress tolerance and duration of past smoking cessation attempts. Journal of Abnormal Psychology.2002. 111: 180-185.
17- Rajabi, F. Nezami Pakdehi, M. Investigating the role of early maladaptive schemas on the tolerance of first grade high school students in Gonabad. Conference on Psychology, Educational Sciences and Lifestyle, Qazvin, Takestan Institute of Higher Education, Payame Noor University, Qazvin Province. 2015. [in Persian].
18- Leyro TM, Zvolensky MJ, Bernstein A. Distress tolerance and psychopathological symptoms and disorders: a review of the empirical literature among adults. Psychol Bull. 2010 Jul;136(4):576-600. doi: 10.1037/a0019712. PMID: 20565169; PMCID: PMC2891552.
19- Simons RM, Sistad RE, Simons JS, Hansen J. The role of distress tolerance in the relationship between cognitive schemas and alcohol problems among college students. Addict Behav. 2018 Mar;78:1-8. doi: 10.1016/j.addbeh.2017.10.020. Epub 2017 Oct 27. PMID: 29121527; PMCID: PMC5989717.
20- David Koppers, Henricus Van, Jaap Peen & Jack J.M. Dekker. Psychological symptoms, early maladaptive schemas and schema modes: predictors of the outcome of group schema therapy in patients with personality disorders, Psychotherapy Research. 2020. DOI: 10.1080/10503307.1852482.
21- Waller, G., Meyer, C., & Ohanian, V. Psychometric properties of the long and short versions of the Young Schema Questionnaire: Core beliefs among bulimic and comparison women. Cognitive Therapy and Research. 2001. 25(2), 137-147.
22- Sadughi, Z., & Agilar Vafaei, M. Factor Analysis of Short Version of Yang Schema Questionnaire in Iranian Non-clinical Sample, Iranian of Psychiatry and Clinical Psychology. 2008. 21, 214-219. [In Persian].
23- Divandari, H., Ahi, G. H., Akbari, H., & Mahdian, H. The young Schema Questionnaire–Short Form (SQ-SF): Investigation psychometric properties and factor structure between students In Islamic Azad University, Kashmar Branch. 2009.
24- Najarian B, Davoodi I. Construction and validation of a short form of the scl-90-r (scl-25). J Psychol 2001; 5: 139-49.
25- Leyro, T. M., Bernstein, A., Vujanovic, A. A., McLeish, A. C., & Zvolensky, M. J. Distress tolerance scale: A confirmatory factor analysis among daily cigarette smokers. Journal of Psychopathology and Behavioral Assessment. 2011. 33, 47-57.
26- Azizi, Alireza; Mirzaei, Azadeh; Jamal, Shams: The relationship between disturbance tolerance and emotional regulation with students' dependence on smoking, Hakim Research Journal. 2011. 13(1).
27- Ismaili Nasab, Maryam; Ireza, dry body; Halo, Azarmi; Amir, Samarrokhi: The role of difficult predictors in regulating emotion and distress tolerance in students' addiction, Quarterly Journal of Addiction Research. 2014., No. 29, p.52-
28- Zargar M , kakavand AR , Jalali MR . Comporison of Maladaptiv Early schemas of avoidance Behaviours in opioid Dependent men and non- dependent men. JA plipsychol 2011, 1(17):69-84.[in Persian].
29- Sunde T, Hummelen B, Himle JA, Walseth LT, Vogel PA, Launes G, Haaland V, Haaland ÅT. Early maladaptive schemas impact on long-term outcome in patients treated with group behavioral therapy for obsessive-compulsive disorder. BMC Psychiatry. 2019.
30- Renner, Fritz & Lobbestael, Jill & Peeters, Frenk & Arntz, Arnoud & Huibers, Marcus. Early maladaptive schemas in depressed patients: Stability and relation with depressive symptoms over the course of treatment. Journal of affective disorders.2011. 136. 581-90. 10.1016/j.jad.10.027.
31- Shariatzadeh M, Vaziri S, Mirhashemi M. Comparison of Early Maladaptive Schemas in Patients with Dysthymic Mood Disorder, Major Depression and Healthy Control Subjects. PCP. 2014; 2 (2) :91-100.
32- 32- Ahmadpanah, M., Astinsadaf, S., Akhondi, A., Haghighi, M., Bahmani, D. S., Nazaribadie, M., ... & Brand, S.. Early maladaptive schemas of emotional deprivation, social isolation, shame and abandonment are related to a history of suicide attempts among patients with major depressive disorders. Comprehensive psychiatry. 2017. 77, 71-
33- Lynch TR, Bronner LL. Mindfulness and dialectical behavior therapy (DBT): Application with depressed older adults with personality disorders. In: Baer RA, editor. Mindfulness-based treatment approaches: Clinician's guide to evidence base and applications. San Diego: Elsevier Academic Press; 2006. pp. 217–236.
34- Mennin DS, Heimberg RG, Turk CL, Fresco DM. Applying an emotion regulation framework to integrative approaches to generalized anxiety disorder. Clinical Psychology: Science and Practice. 2002;9:85–90. doi:10.1093/clipsy/9.1.85
35- Zvolensky MJ, Otto MW. Affective intolerance, sensitivity, and processing: Advances in clinical science introduction. Behavior Therapy. 2007;38:228–233. doi:10.1016/j.beth.2007.01.002.
36- Brown RA, Lejuez CW, Kahler CW, Strong DR, Zvolensky MJ. Distress tolerance and early smoking lapse (theory and clinical implications) Clinical Psychology Review. 2005;25:713–733. doi:10.1016/j.cpr.2005.05.003
37- Otto MW, Powers MB, Fischmann D. Emotional exposure in the treatment of substance use disorders: Conceptual model, evidence, and future directions. Clinical Psychology Review. 2005;25:824–839. doi:10.1016/j.cpr.2005.05.002.
38- Cisler JM, Olatunji BO, Feldner MT, Forsyth JP. Emotion Regulation and the Anxiety Disorders: An Integrative Review. J Psychopathol Behav Assess. 2010 Mar;32(1):68-82. doi: 10.1007/s10862-009-9161-1. PMID: 20622981; PMCID: PMC2901125.
39- Marshall-Berenz, E. C., Vujanovic, A. A., MacPherson, L. Impulsivity and alcohol use coping motives in a trauma-exposed sample: The mediating role of distress tolerance. Personality and Individual Differences. 2011. 50, 588-592.
2- Abhari, M.. Social Traumas. Tehran: Pahutan.2011. [Persian].
3- 2- Dabbaghi P, Asgharnejad farida A, Atef Vahid M K, Bolharic J. Effectiveness of group cognitive therapy based on mindfulness and spiritual schema activation in the prevention of opioid abuse relapse. Iranian Journal of Psychiatry and Clinical Psychology.2008. 366-375.
4- Bergle, T. H. Patient in substance use disorder treatment: motivation for behavioral change, co-occurring disorders and problem domains. P h.D Unpublished dissertation, Norwegian university of science and technology.2015.
5- Jeffrey E. Young, Janet S. Klosko and Marjorie E. Weishaar. Schema Therapy: A Practitioner's Guide. New York: Guilford Press, 2003. pp. 436. £34.50 (hb). ISBN: 1-57230-838-9.
6- Agatsuma, S & Hiroi, N.2004. Genetic basis of Drug dependence and comorbid behavioral traits, Nihon shinkei, Jun; 24(3) : 137-45. 5. Young, Jeffrey; Closco, Janet and Margery, Wieshar. (2011). Schema therapy, a practical guide for clinicians. Translated by Hassan Hamidpour and Zahra Andouz, 2012, Tehran: Arjmand Publications.
7- Oveysi, Abbas Ali and Bakhshani, Noor Mohammad. Comparison of early maladaptive schemas in opioid-dependent and non-opioid men in Zahedan. Journal of Principles of Mental Health. 2013. 14 (2), 164-171. [in Persian].
8- Ghadimi, Hadith; Qasemi Motlagh, Mehdi. The relationship between early maladaptive schemas and addiction tendencies. The Second International Conference on New Approaches in Science, Engineering and Technology, Tehran. 2016. [in Persian].
9- Zeinali, Ali; Unity, Roghayeh; Hamednia, Safar: A Study of Pre-Addictive Fields of Addicts and Its Comparison with Healthy Non-Addicted People, Knowledge and Research in Psychology, Islamic Azad University, Khorasgan Branch (Isfahan), No. 33, Fall 2007, pp. 168-149. [in Persian].
10- Ahmadi Tahoor Soltani, Mohsen; Najafi, Mohammad: Comparison of Metacognitive Beliefs and Ambiguity in Addicted, Smokers and Normal People, Journal of Clinical Psychology / ISC, Winter 2011, No. 120, pp. 59-68[in Persian].
11- Kaplan H, Sadock B. Synopsis of psychiatry. 9th ed, New York, Williams and Wilkins, 2002. [in Persian].
12- Zahiruddin, Alireza. Seif Elahi, Masoumeh. Iranipour, Genghis. Evaluation of the rate of mental disorders in drug addicts referred to two medical centers in Tehran. Research in medicine. Shahid Beheshti University of Medical Sciences and Health Services. Dori 31, No. 3, Summer 2007. [in Persian].
13- Heidari Pahlavan, Ahmad. Mahjoub, Hussein Rahimi, Alireza. Comparison of the prevalence of various mental disorders in addicts and non-addicts living in Hamadan. Scientific Journal of Hamadan University of Medical Sciences and Health Services. Volume 18, Number 3, Fall 2011. [in Persian].
14- Zvolensky, M., Lejuez. C.W. Distress tolerance and early adolescent externalizing and internalizing symptoms: The moderating role of gender and ethnicity. Behavior Research and Therapy. 2009. 47,198-205.
15- Simons JS, Gaher RM. The Distress Tolerance Scale: Development and validation of a self-report measure. Motivation & Emotion. 2005; 29(2):83–102. doi: 10.1007/s11031-005-7955-3.
16- Brown, R. A., Lejuez, C. W., Kahler, C. W., et al. Distress tolerance and duration of past smoking cessation attempts. Journal of Abnormal Psychology.2002. 111: 180-185.
17- Rajabi, F. Nezami Pakdehi, M. Investigating the role of early maladaptive schemas on the tolerance of first grade high school students in Gonabad. Conference on Psychology, Educational Sciences and Lifestyle, Qazvin, Takestan Institute of Higher Education, Payame Noor University, Qazvin Province. 2015. [in Persian].
18- Leyro TM, Zvolensky MJ, Bernstein A. Distress tolerance and psychopathological symptoms and disorders: a review of the empirical literature among adults. Psychol Bull. 2010 Jul;136(4):576-600. doi: 10.1037/a0019712. PMID: 20565169; PMCID: PMC2891552.
19- Simons RM, Sistad RE, Simons JS, Hansen J. The role of distress tolerance in the relationship between cognitive schemas and alcohol problems among college students. Addict Behav. 2018 Mar;78:1-8. doi: 10.1016/j.addbeh.2017.10.020. Epub 2017 Oct 27. PMID: 29121527; PMCID: PMC5989717.
20- David Koppers, Henricus Van, Jaap Peen & Jack J.M. Dekker. Psychological symptoms, early maladaptive schemas and schema modes: predictors of the outcome of group schema therapy in patients with personality disorders, Psychotherapy Research. 2020. DOI: 10.1080/10503307.1852482.
21- Waller, G., Meyer, C., & Ohanian, V. Psychometric properties of the long and short versions of the Young Schema Questionnaire: Core beliefs among bulimic and comparison women. Cognitive Therapy and Research. 2001. 25(2), 137-147.
22- Sadughi, Z., & Agilar Vafaei, M. Factor Analysis of Short Version of Yang Schema Questionnaire in Iranian Non-clinical Sample, Iranian of Psychiatry and Clinical Psychology. 2008. 21, 214-219. [In Persian].
23- Divandari, H., Ahi, G. H., Akbari, H., & Mahdian, H. The young Schema Questionnaire–Short Form (SQ-SF): Investigation psychometric properties and factor structure between students In Islamic Azad University, Kashmar Branch. 2009.
24- Najarian B, Davoodi I. Construction and validation of a short form of the scl-90-r (scl-25). J Psychol 2001; 5: 139-49.
25- Leyro, T. M., Bernstein, A., Vujanovic, A. A., McLeish, A. C., & Zvolensky, M. J. Distress tolerance scale: A confirmatory factor analysis among daily cigarette smokers. Journal of Psychopathology and Behavioral Assessment. 2011. 33, 47-57.
26- Azizi, Alireza; Mirzaei, Azadeh; Jamal, Shams: The relationship between disturbance tolerance and emotional regulation with students' dependence on smoking, Hakim Research Journal. 2011. 13(1).
27- Ismaili Nasab, Maryam; Ireza, dry body; Halo, Azarmi; Amir, Samarrokhi: The role of difficult predictors in regulating emotion and distress tolerance in students' addiction, Quarterly Journal of Addiction Research. 2014., No. 29, p.52-
28- Zargar M , kakavand AR , Jalali MR . Comporison of Maladaptiv Early schemas of avoidance Behaviours in opioid Dependent men and non- dependent men. JA plipsychol 2011, 1(17):69-84.[in Persian].
29- Sunde T, Hummelen B, Himle JA, Walseth LT, Vogel PA, Launes G, Haaland V, Haaland ÅT. Early maladaptive schemas impact on long-term outcome in patients treated with group behavioral therapy for obsessive-compulsive disorder. BMC Psychiatry. 2019.
30- Renner, Fritz & Lobbestael, Jill & Peeters, Frenk & Arntz, Arnoud & Huibers, Marcus. Early maladaptive schemas in depressed patients: Stability and relation with depressive symptoms over the course of treatment. Journal of affective disorders.2011. 136. 581-90. 10.1016/j.jad.10.027.
31- Shariatzadeh M, Vaziri S, Mirhashemi M. Comparison of Early Maladaptive Schemas in Patients with Dysthymic Mood Disorder, Major Depression and Healthy Control Subjects. PCP. 2014; 2 (2) :91-100.
32- 32- Ahmadpanah, M., Astinsadaf, S., Akhondi, A., Haghighi, M., Bahmani, D. S., Nazaribadie, M., ... & Brand, S.. Early maladaptive schemas of emotional deprivation, social isolation, shame and abandonment are related to a history of suicide attempts among patients with major depressive disorders. Comprehensive psychiatry. 2017. 77, 71-
33- Lynch TR, Bronner LL. Mindfulness and dialectical behavior therapy (DBT): Application with depressed older adults with personality disorders. In: Baer RA, editor. Mindfulness-based treatment approaches: Clinician's guide to evidence base and applications. San Diego: Elsevier Academic Press; 2006. pp. 217–236.
34- Mennin DS, Heimberg RG, Turk CL, Fresco DM. Applying an emotion regulation framework to integrative approaches to generalized anxiety disorder. Clinical Psychology: Science and Practice. 2002;9:85–90. doi:10.1093/clipsy/9.1.85
35- Zvolensky MJ, Otto MW. Affective intolerance, sensitivity, and processing: Advances in clinical science introduction. Behavior Therapy. 2007;38:228–233. doi:10.1016/j.beth.2007.01.002.
36- Brown RA, Lejuez CW, Kahler CW, Strong DR, Zvolensky MJ. Distress tolerance and early smoking lapse (theory and clinical implications) Clinical Psychology Review. 2005;25:713–733. doi:10.1016/j.cpr.2005.05.003
37- Otto MW, Powers MB, Fischmann D. Emotional exposure in the treatment of substance use disorders: Conceptual model, evidence, and future directions. Clinical Psychology Review. 2005;25:824–839. doi:10.1016/j.cpr.2005.05.002.
38- Cisler JM, Olatunji BO, Feldner MT, Forsyth JP. Emotion Regulation and the Anxiety Disorders: An Integrative Review. J Psychopathol Behav Assess. 2010 Mar;32(1):68-82. doi: 10.1007/s10862-009-9161-1. PMID: 20622981; PMCID: PMC2901125.
39- Marshall-Berenz, E. C., Vujanovic, A. A., MacPherson, L. Impulsivity and alcohol use coping motives in a trauma-exposed sample: The mediating role of distress tolerance. Personality and Individual Differences. 2011. 50, 588-592.
Published
2021-05-09
Issue
Section
Articles
License
The Copyright Form should be downloaded and signed by corresponding author in the fourth step "upload supplementary files" during submission process.
After acceptance, copyright form should be downloaded and signed by all authors one by one ( "summery --> supp. file" part and click on "add a supplementary file" link).
How to Cite
Investigating the Mediating Role of Distress Tolerance in the Relationship between Early Maladaptive Schemas and Psychiatric Symptoms among Addicts. (2021). International Journal of Health Studies, 7(3), 38-43. https://doi.org/10.22100/ijhs.v7i3.852
