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      Early maladaptive schemas and their relation to personality disorders: A correlational examination in a clinical population

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          Abstract

          Personality disorder (PD) pathology has been linked to early maladaptive schemas (EMSs). Because of a large heterogeneity in study populations, sample size, statistical analyses and conceptualizations in the literature, the exact relationships between PDs and EMSs are still unclear. The current study examined the relationship between borderline, dependent, avoidant and obsessive–compulsive PDs, represented dimensionally as number of traits, and 15 different EMSs as measured by the Young Schema Questionnaire (YSQ). A total of N = 130 inpatients took part in the study ( M age = 43.6, gender = 51.5% female). Stepwise regressions indicated that borderline, dependent, avoidant and obsessive–compulsive PD traits were partly characterized by specific EMSs and EMSs grouped as domains (i.e., other‐directedness domain for dependent PD and overvigilance for obsessive–compulsive PD) and that relations with a variety of domains and EMSs were overlapping for the PD dimensions (i.e., disconnection and rejection for both borderline and avoidant PDs). This suggests that PDs are reflected by a hybrid model of EMSs, with some EMSs and domains that relate to a broader vulnerability factor for PDs, and other domains that differentially relate to the independent PDs. Findings are informative for clinicians, as various EMSs per PD may be targeted in therapy.

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          Most cited references65

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          A Caution Regarding Rules of Thumb for Variance Inflation Factors

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            The Mini International Neuropsychiatric Interview (MINI). A short diagnostic structured interview: reliability and validity according to the CIDI

            The Mini International Neuropsychiatric Interview (MINI) is a short diagnostic structured interview (DSI) developed in France and the United States to explore 17 disorders according to Diagnostic and Statistical Manual (DSM)-III-R diagnostic criteria. It is fully structured to allow administration by non-specialized interviewers. In order to keep it short it focuses on the existence of current disorders. For each disorder, one or two screening questions rule out the diagnosis when answered negatively. Probes for severity, disability or medically explained symptoms are not explored symptom-by-symptom. Two joint papers present the inter-rater and test-retest reliability of the MINI the validity versus the Composite International Diagnostic Interview (CIDI) (this paper) and the Structured Clinical Interview for DSM-III-R patients (SCID) (joint paper). Three-hundred and forty-six patients (296 psychiatric and 50 non-psychiatric) were administered the MINI and the CIDI ‘gold standard’. Forty two were interviewed by two investigators and 42 interviewed subsequently within two days. Interviewers were trained to use both instruments. The mean duration of the interview was 21 min with the MINI and 92 for corresponding sections of the CIDI. Kappa coefficient, sensitivity and specificity were good or very good for all diagnoses with the exception of generalized anxiety disorder (GAD) (kappa = 0.36), agoraphobia (sensitivity = 0.59) and bulimia (kappa = 0.53). Interrater and test-retest reliability were good. The main reasons for discrepancies were identified. The MINI provided reliable DSM-III-R diagnoses within a short time frame, The study permitted improvements in the formulations for GAD and agoraphobia in the current DSM-IV version of the MINI.
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              Plate tectonics in the classification of personality disorder: shifting to a dimensional model.

              The diagnostic categories of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders were developed in the spirit of a traditional medical model that considers mental disorders to be qualitatively distinct conditions (see, e.g., American Psychiatric Association, 2000). Work is now beginning on the fifth edition of this influential diagnostic manual. It is perhaps time to consider a fundamental shift in how psychopathology is conceptualized and diagnosed. More specifically, it may be time to consider a shift to a dimensional classification of personality disorder that would help address the failures of the existing diagnostic categories as well as contribute to an integration of the psychiatric diagnostic manual with psychology's research on general personality structure. (c) 2007 APA, all rights reserved
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                Author and article information

                Contributors
                hannah.kunst@sydney.edu.au
                Journal
                Clin Psychol Psychother
                Clin Psychol Psychother
                10.1002/(ISSN)1099-0879
                CPP
                Clinical Psychology & Psychotherapy
                John Wiley and Sons Inc. (Hoboken )
                1063-3995
                1099-0879
                17 June 2020
                Nov-Dec 2020
                : 27
                : 6 ( doiID: 10.1002/cpp.v27.6 )
                : 837-846
                Affiliations
                [ 1 ] Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience Maastricht University The Netherlands
                [ 2 ] U‐Center Heerlen The Netherlands
                [ 3 ]Present address: The University of Sydney NSW Australia
                [ 4 ]Present address: Open Universiteit Epen AH The Netherlands
                Author notes
                [*] [* ] Correspondence

                Hannah Kunst, Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, The Netherlands.

                Email: hannah.kunst@ 123456sydney.edu.au

                Author information
                https://orcid.org/0000-0002-7382-0881
                Article
                CPP2467 CPP-2131.R2
                10.1002/cpp.2467
                7754466
                32358901
                91092275-c2e2-4048-8aea-62f961f89a5c
                © 2020 The Authors. Clinical Psychology & Psychotherapy published by John Wiley & Sons Ltd

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 22 September 2019
                : 28 April 2020
                : 29 April 2020
                Page count
                Figures: 0, Tables: 4, Pages: 10, Words: 8960
                Categories
                Research Article
                Research Articles
                Custom metadata
                2.0
                November/December 2020
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.9.6 mode:remove_FC converted:22.12.2020

                Clinical Psychology & Psychiatry
                borderline,dimension,early maladaptive schemas,hybrid model,personality disorder

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