Hostname: page-component-8448b6f56d-cfpbc Total loading time: 0 Render date: 2024-04-16T19:26:29.063Z Has data issue: false hasContentIssue false
  • English
  • Français

Core Schemas in Youth at Clinical High Risk for Psychosis

Published online by Cambridge University Press:  21 April 2015

Jacqueline Stowkowy ,
Lu Liu ,
Kristin S. Cadenhead ,
Tyrone D. Cannon ,
Barbara A. Cornblatt ,
Thomas H. McGlashan ,
Diana O. Perkins ,
Larry J. Seidman ,
Ming T. Tsuang  and
Elaine F. Walker
...Show all authors
Jacqueline Stowkowy*
Affiliation:
University of Calgary, Canada
Lu Liu
Affiliation:
University of Calgary, Canada
Kristin S. Cadenhead
Affiliation:
UCSD, La Jolla, USA
Tyrone D. Cannon
Affiliation:
Yale University, New Haven, USA
Barbara A. Cornblatt
Affiliation:
Zucker Hillside Hospital, Long Island NY, USA
Thomas H. McGlashan
Affiliation:
Yale University, New Haven, USA
Diana O. Perkins
Affiliation:
University of North Carolina, Chapel Hill, USA
Larry J. Seidman
Affiliation:
Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, USA
Ming T. Tsuang
Affiliation:
UCSD, La Jolla, USA
Elaine F. Walker
Affiliation:
Emory University, Atlanta, USA
Scott W. Woods
Affiliation:
Yale University, New Haven, USA
Carrie E. Bearden
Affiliation:
UCLA, Los Angeles, USA
Daniel H. Mathalon
Affiliation:
UCSF, San Francisco, USA
Robert Heinssen
Affiliation:
National Institute of Mental Health, Bethesda, USA
Jean Addington
Affiliation:
University of Calgary, Canada
*
Reprint requests to Jacqueline Stowkowy, Mathison Centre for Mental Health Research and Education, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta T2N 4Z6, Canada. E-mail: stowkowy@ucalgary.ca
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: Schema Theory proposes that the development of maladaptive schemas are based on a combination of memories, emotions and cognitions regarding oneself and one's relationship to others. A cognitive model of psychosis suggests that schemas are crucial to the development and persistence of psychosis. Little is known about the impact that schemas may have on those considered to be at clinical high risk (CHR) of developing psychosis. Aims: To investigate schemas over time in a large sample of CHR individuals and healthy controls. Method: Sample included 765 CHR participants and 280 healthy controls. Schemas were assessed at baseline, 6 and 12 months using the Brief Core Schema Scale (BCSS). Baseline schemas were compared to 2-year clinical outcome. Results: CHR participants evidenced stable and more maladaptive schemas over time compared to controls. Schemas at initial contact did not vary amongst the different clinical outcome groups at 2 years although all CHR outcome groups evidenced significantly worse schemas than healthy controls. Although there were no differences on baseline schemas between those who later transitioned to psychosis compared to those who did not, those who transitioned to psychosis had more maladaptive negative self-schemas at the time of transition. Associations between negative schemas were positively correlated with earlier abuse and bullying. Conclusions: These findings demonstrate a need for interventions that aim to improve maladaptive schemas among the CHR population. Therapies targeting self-esteem, as well as schema therapy may be important work for future studies.

Keywords

Clinical high riskpsychosisschemasbeliefsNAPLS
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 44 , Issue 2 , March 2016 , pp. 203 - 213
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Addington, D., Addington, J. and Maticka-Tyndale, E. (1993). Assessing depression in schizophrenia: the Calgary Depression Scale. British Journal of Psychiatry, 163, 39–44.Google Scholar
Addington, J., Cadenhead, K. S., Cornblatt, B. A., Mathalon, D. H., McGlashan, T. H., Perkins, D. O., et al. (2012). North American Prodrome Longitudinal Study (NAPLS 2): overview and recruitment. Schizophrenia Research, 142, 77–82.Google Scholar
Addington, J. and Heinssen, R. (2011). Prediction and prevention of psychosis in youth at clinical high risk. Annual Review of Clinical Psychology, 8, 269–289.Google Scholar
Addington, J., Shah, H., Liu, L. and Addington, D. (2014). Reliability and validity of the Calgary Depression Scale for Schizophrenia (CDSS) in youth at clinical high risk for psychosis. Schizophrenia Research, 153 (1–3), 64–67.CrossRefGoogle ScholarPubMed
Addington, J. and Tran, L. (2009). Using the brief core schema scales with individuals at clinical high risk of psychosis. Behavioural and Cognitive Psychotherapy, 37, 227–231.Google Scholar
Barrantes-Vidal, N., Gross, G. M., Sheinbaum, T., Mitjavila, M., Ballespi, S. and Kwapil, T. R. (2013). Positive and negative schizotypy are associated with prodromal and schizophrenia-spectrum symptoms. Schizophrenia Research, 145, 50–55.Google Scholar
Bortolon, C., Capdevielle, D., Boulenger, J. P., Gely-Nargeot, M. C. and Raffard, S. (2013). Early maladaptive schemas predict positive symptomatology in schizophrenia: a cross-sectional study. Psychiatry Research, 209, 361–366.Google Scholar
Fowler, D., Freeman, D., Smith, B., Kuipers, E., Bebbington, P., Bashforth, H., et al. (2006). The Brief Core Schema Scales (BCSS): psychometric properties and associations with paranoia and grandiosity in non-clinical and psychosis samples. Psychological Medicine, 36, 739–749.CrossRefGoogle ScholarPubMed
Garety, P. A., Bebbington, P., Fowler, D., Freeman, D., and Kuipers, E. (2007). Implications for neurobiological research of cognitive models of psychosis: a theoretical paper. Psychological Medicine, 37, 1377–1391.CrossRefGoogle ScholarPubMed
Janssen, I., Krabbendam, L., Bak, M., Hanssen, M., Vollebergh, W., de Graaf, R., et al. (2004). Childhood abuse as a risk factor for psychotic experiences. Acta Psychiatrica Scandinavia, 109, 38–45.Google Scholar
Masley, S. A., Gillanders, D. T., Simpson, S. G. and Taylor, M. A. (2012). A systematic review of the evidence base for Schema Therapy. Cognitive Behavior Therapy, 41, 185–202.Google Scholar
McGlashan, T., Walsh, B. C. and Woods, S. W. (2010). The Psychosis Risk Syndrome: handbook for diagnosis and follow-up. New York: Oxford University Press.Google Scholar
Stowkowy, J. and Addington, J. (2012). Maladaptive schemas as a mediator between social defeat and positive symptoms in young people at clinical high risk for psychosis. Early Intervention Psychiatry, 6, 87–90.Google Scholar
Taylor, H. E., Stewart, S. L., Dunn, G., Parker, S., Fowler, D. and Morrison, A. P. (2013). Core schemas across the continuum of psychosis: a comparison of clinical and non-clinical groups. Behavioural and Cognitive Psychotherapy, 42, 718–730.Google Scholar
Young, J. E., Klosko, J. S. and Weishaar, M. E. (2003). Schema Therapy: a practitioner's guide. New York: Guilford Press.Google Scholar
Submit a response

Comments

No Comments have been published for this article.