The Structural Model of Panic Disorder Based on Early Maladaptive Schemas with the Mediating Role of Anxiety Sensitivity and Mentalization

Document Type : Research Paper

Author

Ph.D. in Psychology, Department of Psychology, Faculty of Literature and Humanities, Lorestan University, Khorramabad, Iran.

Abstract

The aim of the present study was to present a structural model of panic disorder based on early maladaptive schemas with the mediating role of anxiety sensitivity and mentalization. The research design was correlational and structural equations. The statistical population of the research included all people suffering from panic disorder who visited psychological and counseling clinics in Tehran in 2023. The statistical sample of the research consisted of 132 of these people who were selected by available sampling method. To collect data, Yang's (2005) primary maladaptive schema questionnaires, Reiss and Peterson's (1985) anxiety sensitivity, Dimitrovich's mentalization (2017) and Leibowitz's panic disorder (1984) were used. In order to analyze the obtained data, SPSS26 and AMOS24 software were used. The predictor variable of primary maladaptive schemas directly (β = 0.39) and indirectly with the mediation of anxiety sensitivity and mentalization (β = 0.15), (β = 0.12) on panic disorder. The effect was positive and significant (p < 0.01). Also, anxiety sensitivity and mentalization had a direct effect (β=0.45), (β=0.49) on panic disorder (p<0.01). The results of the research indicated that the initial maladaptive schemas can be a strong predictor of panic disorder, and anxiety sensitivity and mentalization as mediating variables are part of the influencing process in the formation of panic disorder symptoms. It is recommended to hold training workshops in the field of primary maladaptive schemas, anxiety sensitivity and mentalization, and also therapeutic interventions should address these factors.

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References

اسدنیا، سعید؛ علیلو، مجید؛ بیرامی، منصور و بخشیپور، عباس. (1402). تأثیر ابعاد سرشت بر اختلال اضطراب فراگیر، وحشتزدگی و وسواس اجباری: با واسطه‌گری حساسیت انزجاری در دانشجویان دانشگاه ارومیه. دانش و پژوهش در روانشناسی کاربردی. 24(2)، 108-94.
تقی پور، بهزاد؛ بشرپور، سجاد؛ حاجلو، نادر؛ نریمانی، محمد. (1400). اثر بخشی آموزش تنظیم هیجان بر حساسیت اضطرابی و نگرانی زنان مبتلا به اختلال پانیک. مطالعات روان‌شناختی. 17(1)، 160-145.
محمودزاده، سپیده؛ پاکیزه, علی. (1402). بررسی مقایسه‌ای راهبردهای تنظیم هیجان و طرحواره‌های ناسازگار اولیه در افراد مبتلا و غیر مبتلا به اختلال وحشتزدگی. روان شناسی بالینی، 15(1)، 78-69.
میرز، لاورنس؛ گامست، گلن؛ گارینو، جی.(2006). پژوهش چندمتغیره کاربردی. ترجمه حسن‌پاشا شریفی و همکاران، انتشارات رشد؛ چاپ پنجم: پاییز 1396.
Ahmady, M., and Bagheri, M. (2013). Mediating role of cognitive distortions In the relationship between body image and social anxiety in adolescents. Journal of Behavioral Sciences; 7 (6): 321-330. (in persian)
Atalay, H., Atalay, F., Bağdaçiçek, S. (2011). Effect of short-term antidepressant treatment on early maladaptive schemas in patients with major depressive and panic disorder. Int J Psychiatry Clin Pract; 15(2):97-105. doi: 10.3109/13651501.2010.549234.
Bandelow, B., Broocks, A., Pekrun, G., George, A., Meyer, T., Pralle, L., Bartmann, U., Hillmer-Vogel, U., Rüther, E. (2000). the use of the Panic and Agoraphobia Scale (P&A) in a controlled clinical trial. Pharmacopsychiatry, 33(5), 174-81.
Barloo, D.H. (2014). Clinical handbook of psychological disorders: A step-by-step treatment manual. Guilford Publications.
Bateman, A., Fonagy, P. (2012). Handbook of mentalizing in mental health practice. Washington, DC: American Psychiatric Publishing.
Bonifacio, S., Carmen, S., Paloma, C., Rosa, M. (2015). Anxiety sensitivity, catastrophic misinterpretations and panic selfefficacy in the prediction of panic disorder severity: Towards a tripartite cognitive model of panic disorder. Behaviour Research and Therapy. 67, 30-40.
Campbell-Sills, L., Barlow, D. H. (2007). Incorporating Emotion Regulation into Conceptualizations and Treatments of Anxiety and Mood Disorders. In J. J. Gross (Ed.), Handbook of emotion regulation (pp. 542-59). New York, NY, US: The Guilford Press.
Capron, D.W., Noor, A.M., Allan, N.P., Schmidt, N.B. (2017). Combined top-down and bottom-up intervention for anxiety sensitivity: Pilot randomized trial testing the additive effect of interpretation bias modification. Journal of Psychiatric Research, 85, 75-82.
Dimitrovich, A., Hanak, N., Dimitrijevi, A., Marjanovi, Z. (2017). The Mentalization Scale (MentS): A Self-Report Measure for the Assessment of Mentalizing Capacity. Journal of Personality Assessment, 1-14. doi.org/10.1080/00223891.2017.1310730.
Hald-Poschardt, D., Sterzer, P., Schlagenhauf, F., Pehrs, C., Wittmann, A., Stoy, M., & et al. (2018). Reward and loss anticipation in panic disorder: An fMRI study. Journal of Psychiatry Research: Neuroimaging, 271, 111-117.
Hawke, L. D., and Provencher, M. D. (2011). Schema theory and schema therapy in mood and anxiety disorders: A review. J Cogn Psychother. 25(4): 257-76.
Karterud, S., Kongerslev, M. T. (2019). Case formulations in mentalization-based treatment (MBT) for patients with borderline personality disorder. In Case formulation for personality disorders (pp. 41–60). Academic Press.
Kaya, Y., Aydin, A. (2021). The mediating role of early maladaptive schemas in the relationship between attachment and mental health symptoms of university students. Journal of Adult Development. 28(1):15-24.
Khalsa, S.S., Feinstein, J.S., Li, W., Feusner, J.D., Adolphs, R., Hurlemam, R. (2016). Panic anxiety in human with bilateral amygdale lesions: pharmacological induction via cardiorespiratory interoceptive pathways. Journal Neuroscience, 36, 3559-3566.
Kong, T., He, Y., Auerbach, R. P., McWhinnie, C. M. & Xiao, J. (2015). Rumination and depression in chinese university students: The mediating role of over general autobiographical memory. Personality and Individual Differences, 77(1), 221-224.
Kreans, N., Villareal, D., Clouteria, R., Baxely, C., Carey, C and Blumenthal, H. (2018). Perceive control of anxiety as a moderator in the relationship between anxiety sensivity and problematic alchol among adolecsents. Journal of adolescent. 63, 41-50.
Kwak, K. H., Lee, S. J. (2015). A comparative study of early maladaptive schemas in obsessive-compulsive disorder and panic disorder. Psychiatry Res; 230(3):757-62.
Lyyra, P., Parviainen, T. (2018). Behavioral inhibition underlies the link between interoceptive sensitivity and anxiety-related temperamental traits. Front Psychology, 9, 1026.
Mashhadi, A., Ghasempour, A., Akbari, E., Ilbaygi, R., Hassanzadeh, S. (2017). The role of anxiety sensitivity and emotion regulation in prediction of social anxiety disorder in students. Knowledge & Research in Applied Psychology, 14(52), 89-99.
Meuret, A. E., Ritz, T., Wilhelm, F. H., Roth, W. T., Rosenfield, D. (2018). Hypoventilation Therapy alleviates panic by repeated induction of dyspnea. Journal Biological psychiatry: cognitive neuroscience and neuroimaging, 3(6), 539-546.
Nazzaro, M. P., Boldrini, T., Tanzilli, A., Muzi, L. (2017). Does re fl ective functioning mediate the relationship between attachment and personality? Psychiatry Research, 256, 169–175. doi: 10.1016/j.psychres.2017.06.045.
Reiss, S., Peterson, R. A., Gursky, D. M., McNally, R. J. (1986). Anxiety sensitivity, anxiety frequency and the prediction of fearfulness. Behavior Research and Therapy, 4(3), 241-248.
Poletti, S.,  Radaelli, D., Cucchi, M., Ricci, L., Vai B., Smeraldi, E., Benedetti, F. (2015). Neural correlates of anxiety sensitivity in panic disorder: A functional magnetic resonance imaging study. Psychiatry Research: Neuroimaging, 233(2),95-101.
Sawchuk, C., Roy-Byme, P., Noonan, C., Craner, J., Goldberg, J., Manson, S., & Buchwald, D. (2017). Panic attacks and panic disorder in the American Indian Community. Journal of Anxiety Disorders, 48, 6-12.
Sklyarov, O. (2020). The Impact of Adverse Childhood Experiences on Attachment and Mentalization in Sex Offenders. degree of Doctor of Psychology in Clinical Psychology. George Fox University.
Steen, S., Marie, S., Günter S., Morten, K., Sune, V. (2021). Mentalization-based therapy for a patient suffering from panic disorder: a systematic single case study. Psychoanalytic Psychotherapy, 35(1). https://doi.org/10.1080/02668734.2021.1920454.
Yang, J. (2005). Cognitive therapy of personality disorders, schema-driven approach. Translated by Ali Sahib and Hassan Hamidpour. 1nd ed. Tehran: Agah Pub, 124.
Zeynel, Z., Uzer, T. (2020). Adverse childhood maladaptive schemas. Child abuse & neglect; 99:104-235.

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History

  • Receive Date: 11 February 2024
  • Revise Date: 03 March 2024
  • Accept Date: 08 April 2024

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