Schema modes and childhood abuse in borderline and antisocial personality disorders

Department of Medical, Clinical and Experimental Psychology, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands.
Journal of Behavior Therapy and Experimental Psychiatry (Impact Factor: 2.23). 09/2005; 36(3):240-53. DOI: 10.1016/j.jbtep.2005.05.006
Source: PubMed


Complex personality disorders (PDs) have been hypothesized to be characterized by alternating states of thinking, feeling and behavior, the so-called schema modes (Young, Klosko, & Weishaar (2003). Schema therapy: A practioner's guide. New York: Guilford). The present study tested the applicability of this model to borderline personality disorders (BPD) and antisocial personality disorders (APD), and related it to a presumed common etiological factor, childhood trauma. Sixteen patients with BPD, 16 patients with APD and 16 nonpatient controls (all 50% of both sexes) completed a Schema Mode Questionnaire assessing cognitions, feelings and behaviors characteristic of six schema modes. Participants were interviewed to retrace abusive sexual, physical and emotional events before the age of 18. BPD as well as APD participants were characterized by four maladaptive modes (Detached Protector, Punitive Parent, Abandoned/Abused Child and Angry Child). APD displayed most characteristics of the Bully/Attack mode, though not significantly different from BPD. The Healthy Adult mode was of low presence in BPD and of high presence in APD and the nonpatients. Frequency and severity of the three kinds of abuse were equally high in both PD groups, and significantly higher than in nonpatients.

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Available from: Arnoud Arntz, Jan 08, 2014
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    • "Family environments that are unsafe and unstable, depriving, harshly punitive and rejecting, or subjugating are believed to contribute to the disorder (Young et al. 2003). While a significant number of patients with BPD report a history of childhood emotional, physical and/or sexual abuse, it is not always a contributing factor (Lobbestael et al. 2005). An emotionally and temperamentally labile child may simply be a mismatch with the parents' rearing style, resulting in patterns of anger and frustration, which exacerbate underlying difficulties of the child (Kellogg and Young 2006). "
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    ABSTRACT: This paper adds to the existing body of literature by examining two different therapeutic approaches to the treatment of borderline personality disorder (BPD), namely: (1) dialectical behavior therapy (DBT), and (2) schema therapy. DBT is an evidence-based treatment for BPD while schema therapy is gaining ground as an effective therapy for BPD. Treatment approaches and etiological conceptualizations of each therapeutic modality are compared and contrasted. Theoretical underpinnings of each therapy are cognitive and behavioural but each therapy has developed its own techniques and rationale. Mentalization is discussed as an important mechanism of change in the successful treatment of BPD that is seen to underlie both DBT and schema therapy. To conclude DBT efficacy studies and schema therapy effectiveness studies are briefly reviewed.
    Full-text · Article · Jul 2015 · Journal of Contemporary Psychotherapy
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    • "Table 1 depicts the hypothesized PD–mode correlations. These are based on theoretical presumptions (Arntz & Young, 2007; Young et al., 2003) and earlier studies by Arntz et al. (2005) and Lobbestael et al. (2005). "

    Full-text · Dataset · Jan 2014
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    • "Cognitive - behavioural interventions for the treatment of personality disorder have increased in sophistication and impact over the last decade ( Livesley , 2008 ) . Schema - based therapies hold promise with offenders ( Bernstein , Arntz , & de Vos , 2007 ; Lobbestael , Arntz , & Sieswerda , 2005 ; Richardson , 2005 ; Tarrier et al . , 2010 ) , because of their potential to alter deeply entrenched belief systems that underpin both personality disorder and offending , thus bringing together in treatment the key risk factors identified by Hanson and Morton - Bourgon ( 2005 ) . "
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    ABSTRACT: The focus of this article is on the pilot development and implementation of a prison-based intensive treatment programme for high-risk adult-victim rape offenders in New Zealand. Advances in actuarial risk assessment enabled the identification of a group of high-risk adult sex offenders for whom no dedicated treatment programme existed. Based on a review of the treatment literature for rapists, a pilot programme was developed called the Adult Sex Offender Treatment Programme (ASOTP). The programme, based on the risk–need–responsivity and cognitive behavioural therapy principles, also used an adaptation of Young's schema therapy to address personality responsivity issues and specific idiosyncratic schema associated with participant offence pathways identified by the Massachusetts Treatment Centre classification (Version 3 for rapists). Measures of responsivity and dynamic risk administered in the ASOTP indicated some success in addressing treatment needs for the pilot participants (n=10). The programme has subsequently been expanded across prison specialist treatment unit sites and delivered to a further 52 participants. Although intermediate measures continue to indicate change in dynamic risk, recidivism outcome evaluations have not yet been possible, due to low numbers of paroled participants.
    Full-text · Article · Jun 2013 · Psychology Crime and Law
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