Emotional Schema Therapy Improves Emotion Regulation in Individuals with a History of Child Abuse and Neglect
- 64 Downloads
Research conducted over the past decade indicates that difficulties in emotion regulation are more prevalent among those who have been abused than in individuals with no such experiences. Emotional Schema Therapy (EST), which is an integration of cognitive and metacognitive models as well as acceptance-based approaches, specifically targets content of beliefs about emotions and dysfunctional coping strategies to deal with difficult emotions. This study provides an initial evaluation of the efficacy of EST in addressing difficulties in six dimensions of emotion regulation in women with a history of child abuse or neglect. The statistical population consisted of all female residents of Isfahan, Iran, aged above 18 years. Five hundred volunteer women responded to a Child Abuse and Neglect questionnaire. Individuals who had higher scores on this questionnaire were invited to participate in the research project. Thirty volunteer participants were randomly assigned into experimental and control groups (n1 = n2 = 15). The intervention was a 15-session group therapy consisting of cognitive, behavioral, experiential, and mindfulness techniques. Participants completed the Difficulties in Emotion Regulation Scale (DERS) 2 weeks before and after the treatment and at 2 months follow-up. The same assessments were conducted with the control group. Data were analyzed by Mann-Whitney U Test, Friedman Test, and Wilcoxon Signed-Rank Test. Results showed that EST significantly improved acceptance of emotional responses, goal-directed behaviors, impulse control, and adaptive emotion regulation strategies in both post-test and follow-up assessments in the experimental group. In contrast, the control group did not have any significant changes on these variables. Significant changes were not detected for lack of emotional awareness and lack of emotional clarity in both groups. These findings indicate that EST is a potential effective treatment to improve aspects of emotion regulation in women with a history of child abuse and neglect.
KeywordsChild abuse and neglect Emotional Schema Therapy Difficulties in emotion regulation
- Becker, K. D., Stuewig, J., & McClokey, L. A. (2010). Traumatic stress symptoms of women exposed to different forms of childhood victimization and intimate partner violence. Journal of Interpersonal Violence, 25(9), 1699–1715. https://doi.org/10.1177/0886260509354578.
- Briere, J. (2002). Treating adult survivors of severe childhood abuse and neglect: further development of an integrative model. In J. E. B. Myers, L. Berliner, J. Briere, C. T. Hendrix, T. Reid, & C. Tenny (Eds.). The APSAC handbook on child maltreatment (pp. 1–26). Newbury Park: Sage Publications. https://www.ncjrs.gov/App/Publications/abstract.aspx? ID=198707.
- Choi, J. Y., Choi, Y. M., Gim, M. S., Park, J. H., & Park, S. H. (2014). The effects of childhood abuse on symptom complexity in a clinical sample: mediating effects of emotion regulation difficulties. Chlid Abuse & Neglect, 38(8), 1313–1319. https://doi.org/10.1016/j.chiabu.2014.04.016.Google Scholar
- Daneshmandi, S., Izadikhah, Z., Kazemi, H., & mehrabi, H. A. (2014). The effectiveness of emotional schema therapy on emotional schemas of female victims of child abuse and neglect. Journal of Shahid Sadoughi University of Medical Sciences, 22(5), 1481–1494.Google Scholar
- Davidson, R. J. (2000). Affective style, psychopathology, and resilience: brain mechanisms and plasticity. Am Psychol, 55(11), 1196–1214.Google Scholar
- Dryden, W. (2004). Rational-emotive-behavior group therapy. In F. W. Kaslow & T. Patterson (Eds.), Comprehensive handbook of psychotherapy, cognitive behavioral approaches (pp. 171–494). New York: John Wiley and Sons.Google Scholar
- Erfan, A., Noorbala, A. A., Mohammadi, A., & Adibi, P. (2016). The effectiveness of emotional schema therapy on the severity and frequency of physical symptoms and life quality of patients with irritable bowel syndrome: single-subject design. Daneshvar Medicine, 24(125), 77–88.Google Scholar
- Fowler, J. C., Charak, R., Elhai, J. D., Allen, J. G., Frueh, B. C., & Oldham, J. M. (2014). Construct validity and factor structure of the difficulties in Emotion Regulation Scale among adults with severe mental illness. J Psychiatr Res, 58, 175–180. https://doi.org/10.1016/j.jpsychires.2014.07.029.Google Scholar
- Gratz, K., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in Emotion Regulation Scale. J Psychopathol Behav Assess, 26(1), 41–54. https://doi.org/10.1007/s10862-008-9102-4.Google Scholar
- Howell, D. C. (2010). Statistical methods for Psychology Belmont: Cengage Wadsworth.Google Scholar
- Khanzadeh, M., Saidiyan, M., Hosseinchary, M., & Edrissi, F. (2012). Factor structure and psychometric properties of difficulties in emotional regulation scale. Journal of Behavioral Sciences, 6(1), 87–96.Google Scholar
- Leahy, R. L. (2002). A model of emotional schemas. Cogn Behav Pract, 9(3), 177–190.Google Scholar
- Leahy, R. L. (2011). Emotional schema therapy: a bridge over troubled waters. In J. D. Herbert, & E. M. Forman (Eds.). Acceptance and Mindfulness in Cognitive Behavior Therapy: Undestanding and Applying the New Theapies (pp. 109–131). John Wiley & Sons. https://doi.org/10.1002/9781118001851.ch5.
- Leahy, R. L. (2015). Emotional Schema Therapy. New York: Guilford.Google Scholar
- Leahy, R. L., Tirch, D. D., & Napolitano, L. A. (2011). Emotion regulation in psychotherapy. New York: The Guilford Press.Google Scholar
- Maguire, S. A., Williams, B., Naughton, A. M., Cowely, L. E., Tempest, V., Mann, M. K., Teague, M., & Kemp, A. M. (2015). A systematic review of the emotional, behavioural and cognitive features exhibited by school-aged children experiencing neglect or emotional abuse. Child Care Health Dev, 41(5), 641–653. https://doi.org/10.1111/cch.12227.Google Scholar
- Messman-Moore, T. L., & Bhuptani, P. H. (2017). A review of the long-term impact of child maltreatment on posttraumatic stress disorder and its comorbidities: an emotion dysregulation perspective. Clin Psychol Sci Pract, 1–16. https://doi.org/10.1111/cpsp.12193.
- Molavi, H. (2008). Practical guidance of the SPSS 10–13–14 in Behavioral Sciences. Isfahan: Pouyesh Andishe Publacation.Google Scholar
- Naderi Rajeh, Y., Zarghami, M., & Bagheri, M. (2017). The efficiency of emotional schema therapy with respect to anxiety and depression symptoms and signs in patiemts suffering from post-traumatic stress disorders. International Journal of Behavioral Science, 11(3), 114–120.Google Scholar
- Naderi, Y., Moradi, A. R., Hasani, J., & Noohi, S. (2015). Effectivness of emotional schema therapy on cognitive emotion regulation strategies of combat-related post traumatic stress disorder veterans. Iranian Journal of War & Public Health, 7(3), 147–155 http://ijwph.ir/article-1-492-en.html.Google Scholar
- Rezaee, M., Ghazanfari, F., & Rezaee, F. (2016). Effectiveness of emotional schema therapy on severity of depression and rumination in people with major depresssive disorder. Journal of Shahid Sadoughi University of Medical Sciences and Health Services, 24(1), 41–56.Google Scholar
- Rezaei, M., Ghadampur, E., Rezaei, M., & Kazemi, R. (2016). Effectiveness of emotional schema therapy on rumination and severity of depression in patients with major depressive disorder. J Clin Psychol, 7(4), 45–58.Google Scholar
- Stevens, N. R., Gerhart, J., Goldsmith, R. E., Heath, N. M., Chesney, S. A., & Hobfoll, S. E. (2013). Emotion regulation difficulties, low social support, and interpersonal violence mediate the link between childhood abuse and posttraumatic stress symptoms. Behav Ther, 44, 152–161. https://doi.org/10.1016/j.beth.2012.09.003.Google Scholar
- Uliman, S. E., Peter-Hagene, L. C., & Relyea, M. (2014). Effects of sexual abuse and recovery: coping, emotion regulation, and self-blame as mediators of sexual abuse and psychological symptoms in adult sexual assault. Journal of Child Sexual Abuse, 23, 74–93. https://doi.org/10.1080/10538712.2014.864747.Google Scholar
- Wastell, C. (2005). Understanding trauma and emotion: dealing with trauma using an emotion-focused approach. Australia: Allen & Unwin. http://hdl.handle.net/1959.14/74389
- Welch, S. S., & Rothbaum, B. O. (2007). Emerging treatments for PTSD. In M. J. Friedman, T. M. Keane, & P. A. Resick (Eds.), Handbook of PTSD: Science and practice (pp. 469–496). New York: The Guilford Press.Google Scholar