Does Cognitive Therapy Change the Early Maladaptive Schemas in Individuals with Alcohol Dependence? Evidence from a Randomized Controlled Trial

Overview

Journal Indian J Psychol Med

Publisher Sage Publications

Specialty Psychiatry

Date 2023 Mar 17

PMID 36925491

Authors

Geeta Singh

Gauri Shanker Kaloiya

Anju Dhawan

Ashwani Kumar Mishra

Yatan Pal Singh Balhara

Affiliations

Soon will be listed here.

Abstract

Background: Although early maladaptive schemas (EMSs) have been suggested as potential vulnerability markers for alcohol dependence (AD), there is less emphasis on addressing these schemas in substance abuse treatment programs. We thus aimed to examine the change in schemas in response to cognitive therapy in individuals with AD.

Methods: In this an open-label randomized controlled study, individuals with alcohol dependence syndrome (ADS, = 84) were randomized to the intervention group ( = 45), which received six cognitive therapy sessions combined with treatment as usual (TAU), or the control group ( = 39), which was on TAU only. Participants were assessed on the measures of EMSs, alcohol use severity, and perceived stress at baseline and posttreatment.

Results: The intervention group showed significant improvement in 5 out of 18 EMSs, that is, emotional deprivation, defectiveness, self-sacrifice, unrelenting standard, and negativity, compared to the control group, at the end of the treatment. There was a significant between-group effect for perceived stress but not for alcohol use severity.

Conclusion: EMSs can be changed with cognitive therapy in individuals with AD and could be a crucial area to address in treatment programs. Further studies with long-term follow-up are warranted. The trial was registered with the Clinical Trials Registry-India (CTRI/2015/12/006441) on December 17, 2015.

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References

Hoseiny H, Jadidi M, Habiballah Nataj L, Saberi-Zafarghandi M . The effect of methadone-maintenance therapy with and without interactive treatment on improving emotion-regulation strategies and resilience among opiate-dependent clients. Int J High Risk Behav Addict. 2015; 4(1):e23526. PMC: 4360543. DOI: 10.5812/ijhrba.23526. View

Sheehan D, Lecrubier Y, Sheehan K, Amorim P, Janavs J, Weiller E . The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1999; 59 Suppl 20:22-33;quiz 34-57. View

Arfken C, Klein C, di Menza S, Schuster C . Gender differences in problem severity at assessment and treatment retention. J Subst Abuse Treat. 2001; 20(1):53-7. DOI: 10.1016/s0740-5472(00)00155-0. View

Assanangkornchai S, Srisurapanont M . The treatment of alcohol dependence. Curr Opin Psychiatry. 2007; 20(3):222-7. DOI: 10.1097/YCO.0b013e3280fa837d. View

Santos-Ruiz A, Robles-Ortega H, Perez-Garcia M, Peralta-Ramirez M . Effects of the Cognitive-Behavioral Therapy for Stress Management on Executive Function Components. Span J Psychol. 2017; 20:E11. DOI: 10.1017/sjp.2017.10. View

Mulvaney F, Alterman A, BOARDMAN C, Kampman K . Cocaine abstinence symptomatology and treatment attrition. J Subst Abuse Treat. 1999; 16(2):129-35. DOI: 10.1016/s0740-5472(98)00017-8. View

Caselli G, Gemelli A, Querci S, Lugli A, Canfora F, Annovi C . The effect of rumination on craving across the continuum of drinking behaviour. Addict Behav. 2013; 38(12):2879-83. DOI: 10.1016/j.addbeh.2013.08.023. View

Wright F, Beck A, Newman C, Liese B . Cognitive therapy of substance abuse: theoretical rationale. NIDA Res Monogr. 1993; 137:123-46. View

Connor J, Haber P, Hall W . Alcohol use disorders. Lancet. 2015; 387(10022):988-998. DOI: 10.1016/S0140-6736(15)00122-1. View

10.

Brotchie J, Meyer C, Copello A, Kidney R, Waller G . Cognitive representations in alcohol and opiate abuse: the role of core beliefs. Br J Clin Psychol. 2004; 43(Pt 3):337-42. DOI: 10.1348/0144665031752916. View

11.

Singh G, Kaloiya G, Dhawan A, Balhara Y, Mishra A . Need for evaluation of underlying dysfunctional cognition in problem drinkers. Asian J Psychiatr. 2018; 31:71-72. DOI: 10.1016/j.ajp.2018.01.007. View

12.

Khajouei Nia M, Sovani A, Sarami Forooshani G . Exploring correlation between perceived parenting styles, early maladaptive schemas, and depression among women with depressive symptoms in iran and India- role of early maladaptive schemas as mediators and moderatos. Iran Red Crescent Med J. 2015; 16(12):e17492. PMC: 4341346. DOI: 10.5812/ircmj.17492. View

13.

Shorey R, Stuart G, Anderson S, Strong D . Changes in early maladaptive schemas after residential treatment for substance use. J Clin Psychol. 2013; 69(9):912-22. PMC: 4049341. DOI: 10.1002/jclp.21968. View

14.

Hussong A, Chassin L . Substance use initiation among adolescent children of alcoholics: testing protective factors. J Stud Alcohol. 1997; 58(3):272-9. DOI: 10.15288/jsa.1997.58.272. View

15.

Funk R, McDermeit M, Godley S, Adams L . Maltreatment issues by level of adolescent substance abuse treatment: the extent of the problem at intake and relationship to early outcomes. Child Maltreat. 2003; 8(1):36-45. DOI: 10.1177/1077559502239607. View

16.

King A, Canada S . Client-related predictors of early treatment drop-out in a substance abuse clinic exclusively employing individual therapy. J Subst Abuse Treat. 2004; 26(3):189-95. DOI: 10.1016/S0740-5472(03)00210-1. View

17.

Kilpatrick D, Ruggiero K, Acierno R, Saunders B, Resnick H, Best C . Violence and risk of PTSD, major depression, substance abuse/dependence, and comorbidity: results from the National Survey of Adolescents. J Consult Clin Psychol. 2003; 71(4):692-700. DOI: 10.1037/0022-006x.71.4.692. View

18.

Smith J, Book S . Comorbidity of generalized anxiety disorder and alcohol use disorders among individuals seeking outpatient substance abuse treatment. Addict Behav. 2009; 35(1):42-5. PMC: 2763929. DOI: 10.1016/j.addbeh.2009.07.002. View

19.

McLellan A, Kushner H, Metzger D, Peters R, Smith I, Grissom G . The Fifth Edition of the Addiction Severity Index. J Subst Abuse Treat. 1992; 9(3):199-213. DOI: 10.1016/0740-5472(92)90062-s. View

20.

Shorey R, Stuart G, Anderson S . Early maladaptive schemas among young adult male substance abusers: a comparison with a non-clinical group. J Subst Abuse Treat. 2013; 44(5):522-7. PMC: 3602221. DOI: 10.1016/j.jsat.2012.12.001. View