Predicting the Risk of Opioid Use Disorder Based on Early Maladaptive Schemas

Abstract

Substance use is a globally devastating social problem. Early maladaptive schemas (EMSs) are inefficient mechanisms leading directly or indirectly to psychological distress. The current study aimed to assess the role of EMSs in predicting opioid use disorder. The cross-sectional study was conducted in 2013 in Bojnurd at northeast of Iran on 60 male opioid users who received Methadone Maintenance Treatment (MMT) and 60 control males. The opioid users were selected randomly from MMT clinics and control subjects were selected and matched with opioid users using demographic variables. The subjects completed the Young Schema Questionnaire-Short Form (YSQ-SF). Except for SS (self-sacrifice), EG (entitlement/grandiosity), US (unrelenting standards), and FA (Failure to Achieve), the mean of other maladaptive schemas in the opioid user group were significantly higher than that of the control group, adjusted for multiple comparisons. Multivariate analysis of variance (MANOVA) indicated significant differences in maladaptive schemas between the two groups. Logistic regression identified that Emotional Deprivation, Mistrust/Abuse, and Unrelenting Standards can predict opioid use. As a result, the risk of opioid-related disorders in people with higher YSQ-SF scores in these schemas is higher. The findings conclude that the existence of underlying EMS may constitute a vulnerability factor for developing opioid use disorders later on in life. Provided the vast amount of scientific literature in evidence-based treatments focusing on EMSs, maladaptive schemas and related core beliefs can be detected and treated in adolescence to prevent the enactment of the schema and psychological distress likely to induce opioid use.

The Effects of Group Schema Therapy on Psychological Wellbeing and Resilience in Patients Under Substance Dependence Treatment

“…Negative automatic thoughts are the most accessible aspect of cognition originating from inefficient fundamental beliefs. Inefficient fundamental beliefs and negative automatic thoughts are the targets of classical CBT (Zamirinejad et al 2018).…”

“…As a cognitive infrastructure, these schemas contain inefficient central beliefs with cognitive, emotional, and behavioral dimensions that, when activated, can lead to psychological distress, substance abuse, and other dysfunctions. Studies reported that the intensity and frequency of EMSs are higher in individuals with SD than in the general population (Shorey, Anderson & Stuart 2012;Shorey, Anderson & Stuart 2013;Zamirinejad et al 2018). Shorey, Anderson and Stuart (2013) signified that EMSs can be altered during the short-term treatment of SD.…”

Avaliação da relação entre esquemas iniciais desadaptativos e o coping em indivíduos com transtorno por uso de substâncias

“…Nesse sentido, um crescente número de estudos tem investigado a prevalência de EIDs em indivíduos com problemas de abuso de substâncias (Ball & Cecero, 2001;Brotchie, Meyer, Copello, Kidney & Waller, 2004;Lima & Ferreira, 2015;Janson, 2015;Shorey et al, 2012c;Shorey, Stuart, & Anderson, 2012d;Shorey et al, 2013b;2013c) (Jalali et al, 2011;Karimi, 2013;Roper et al, 2010;Shorey et al, 2011;2012a;2012b;2013a;2013d;Silva et al, 2012;Zamirinejad et al, 2018). (Ball, 2007;Brotchie et al, 2004;Elmquist, et al, 2015;Moradi & Yarahmadi, 2014;Roper et al, 2010;Shorey et al 2013b).…”

“…Além disso, indivíduos com o esquema padrões inflexíveis buscam atingir altos níveis de desempenho a fim de evitar comportamentos que possam resultar em desaprovação e vergonha. No entanto, caso tais padrões irrealistas e inflexíveis falhem em serem alcançados, eles experimentarão sofrimento psicológico e emoções negativas associadas (Zamirinejad et al, 2018). Consequentemente, é provável que estes indivíduos façam uso de substâncias como uma estratégia de lidar com este sofrimento.…”

“…Quanto ao EID desconfiança/abuso, ainda apresentando escore relativamente alto na amostra investigada, estudos anteriores também revelaram altos níveis para este esquema em amostras clínicas (Roper et al, 2010;Shorey et al 2012a;2012b;2012d;2013b). Zamirinejad et al (2018), ainda, em uma amostra de usuários de opióides em tratamento, identificaram este EID com grande poder de predição do uso dessa substância.…”