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Core Schemas in Youth at Clinical High Risk for Psychosis

Published online by Cambridge University Press:  21 April 2015

Jacqueline Stowkowy ,
Lu Liu ,
Kristin S. Cadenhead ,
Tyrone D. Cannon ,
Barbara A. Cornblatt ,
Thomas H. McGlashan ,
Diana O. Perkins ,
Larry J. Seidman ,
Ming T. Tsuang  and
Elaine F. Walker
...Show all authors
Jacqueline Stowkowy*
Affiliation:
University of Calgary, Canada
Lu Liu
Affiliation:
University of Calgary, Canada
Kristin S. Cadenhead
Affiliation:
UCSD, La Jolla, USA
Tyrone D. Cannon
Affiliation:
Yale University, New Haven, USA
Barbara A. Cornblatt
Affiliation:
Zucker Hillside Hospital, Long Island NY, USA
Thomas H. McGlashan
Affiliation:
Yale University, New Haven, USA
Diana O. Perkins
Affiliation:
University of North Carolina, Chapel Hill, USA
Larry J. Seidman
Affiliation:
Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, USA
Ming T. Tsuang
Affiliation:
UCSD, La Jolla, USA
Elaine F. Walker
Affiliation:
Emory University, Atlanta, USA
Scott W. Woods
Affiliation:
Yale University, New Haven, USA
Carrie E. Bearden
Affiliation:
UCLA, Los Angeles, USA
Daniel H. Mathalon
Affiliation:
UCSF, San Francisco, USA
Robert Heinssen
Affiliation:
National Institute of Mental Health, Bethesda, USA
Jean Addington
Affiliation:
University of Calgary, Canada
*
Reprint requests to Jacqueline Stowkowy, Mathison Centre for Mental Health Research and Education, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta T2N 4Z6, Canada. E-mail: stowkowy@ucalgary.ca
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Abstract

Background: Schema Theory proposes that the development of maladaptive schemas are based on a combination of memories, emotions and cognitions regarding oneself and one's relationship to others. A cognitive model of psychosis suggests that schemas are crucial to the development and persistence of psychosis. Little is known about the impact that schemas may have on those considered to be at clinical high risk (CHR) of developing psychosis. Aims: To investigate schemas over time in a large sample of CHR individuals and healthy controls. Method: Sample included 765 CHR participants and 280 healthy controls. Schemas were assessed at baseline, 6 and 12 months using the Brief Core Schema Scale (BCSS). Baseline schemas were compared to 2-year clinical outcome. Results: CHR participants evidenced stable and more maladaptive schemas over time compared to controls. Schemas at initial contact did not vary amongst the different clinical outcome groups at 2 years although all CHR outcome groups evidenced significantly worse schemas than healthy controls. Although there were no differences on baseline schemas between those who later transitioned to psychosis compared to those who did not, those who transitioned to psychosis had more maladaptive negative self-schemas at the time of transition. Associations between negative schemas were positively correlated with earlier abuse and bullying. Conclusions: These findings demonstrate a need for interventions that aim to improve maladaptive schemas among the CHR population. Therapies targeting self-esteem, as well as schema therapy may be important work for future studies.

Keywords

Clinical high riskpsychosisschemasbeliefsNAPLS
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 44 , Issue 2 , March 2016 , pp. 203 - 213
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2015 

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