背景:图式疗法对饮食失调的人很有希望,尤其是那些对认知行为疗法没有反应的人。复杂的潜在心理结构包括功能失调的模式和适应不良的模式。本研究旨在探索饮食失调者的模式模式及其对高分模式的认同和理解。
方法:16名患有持续性饮食失调而未事先接触图式疗法的女性完成了饮食失调的图式模式清单简表(SMI-ED-SF),然后参加半结构化访谈,讨论他们的高分模式。对访谈进行了专题分析。
结果:所有参与者在至少一种适应不良模式下得分高于临床关注,许多参与者在多种模式下得分较高,最常见的要求模式,脆弱的孩子和独立的自我中心。定性,出现了四个主题:1)与(a)创伤和脆弱和愤怒的孩子以及(b)不切实际的高标准有关的不良家庭环境;2)对(a)日常生活和(b)饮食失调的模式影响;3)模式在(a)通过超脱和舒缓避免情绪,(b)因遵守和放弃而取悦的人;4)帮助寻求包括(a)从饮食失调中恢复的障碍,(b)对迄今经历的干预措施不满意,(C)图式疗法作为一种有希望的替代方案。
结论:参与者认可并确定了他们的高得分模式。在经历了以前干预的负面经历之后,他们认为图式疗法是一种有希望的选择,可以理解和解决他们更深层次的心理问题。这表明模式模式是理解和处理持久饮食失调的一种有希望的方式。
适应不良模式在饮食失调的图式疗法中很重要。它们是短暂的思维模式,感觉和行为,由饮食失调的人可能过度敏感的经历引发。在儿童模式下,这个人可能会莫名其妙地幼稚。应对方式可能涉及超脱,向别人投降,或完美主义者的过度补偿。父母模式可能涉及不切实际的标准和要求。还有健康成人和快乐儿童两种健康模式,这是饮食失调的人经常缺乏的。在这项研究中,患有持久性饮食失调的女性完成了模式模式清单,然后讨论了她们的高得分模式。常见的适应不良模式是脆弱的孩子,苛刻的父母模式和完美主义的过补偿器。参与者认同他们的高分模式,并认为它们对自我理解有用,因此,图式疗法是理解持久饮食失调背后的心理病理学的一种有前途的方法。
BACKGROUND: Schema therapy is promising for people with eating disorders, especially those unresponsive to cognitive behavioural therapy. Complex underlying psychological constructs include dysfunctional schemas and maladaptive modes. This
study aimed to explore people living with eating disorders\' schema modes and their identification with and understanding of their high scoring modes.
METHODS: Sixteen women with enduring eating disorders without prior exposure to schema therapy completed the schema mode inventory for eating disorders short form (SMI-ED-SF), then participated in semi-structured interviews discussing their high scoring modes. Interviews were analysed by thematic analysis.
RESULTS: All participants scored above clinical concern on at least one maladaptive mode and many scored high on multiple modes, most commonly Demanding Mode, Vulnerable Child and Detached Self-Soother. Qualitatively, four themes emerged: 1) Adverse family environments related to (a) trauma and the vulnerable and angry child and (b) unrealistically high standards; 2) Mode effects on (a) everyday life and (b) disordered eating; 3) Modes are psychologically protective in (a) avoiding emotion by detachment and soothing, (b) people pleasing by compliance and surrender; 4) Help seeking including (a) barriers to recovery from an eating disorder, (b) dissatisfaction with interventions experienced to date, (c) schema therapy as a promising alternative.
CONCLUSIONS: Participants recognised and identified with their high scoring schema modes. After negative experiences with previous interventions, they considered schema therapy to be a promising alternative that could understand and work on their deeper psychological issues. This suggests that schema modes are a promising way of understanding and working with enduring eating disorders.
Maladaptive modes are important in Schema Therapy for eating disorders. They are momentary patterns of thought, feeling and behaviour, triggered by experiences to which people with eating disorders can be oversensitive. In a child mode the person may be inexplicably childish. A coping mode may involve detachment, surrender to others, or perfectionist overcompensation. A parent mode may involve unrealistic standards and demands. There are also two healthy modes of Healthy Adult and Happy Child, which are often lacking in people with eating disorders. In this
study women with enduring eating disorders completed the schema mode inventory and then discussed their high scoring modes. Common maladaptive modes were vulnerable child, demanding parent mode and perfectionistic over-compensator. Participants identified with their high scoring modes and thought them useful for self-understanding, so schema therapy is a promising way of understanding the psychopathology underlying enduring eating disorders.