The network structure of schema modes

Abstract

A fundamental question in psychotherapy is whether interventions should target client problems (i.e., problem‐focused approaches) or client strengths (i.e., strength‐focused approaches). In this study, we first propose to address this question from a network perspective on schema modes (i.e., healthy or dysfunctional patterns of co‐occurring emotions, cognitions, and behaviours). From this perspective, schema modes mutually influence each other (e.g., healthy modes reduce dysfunctional modes). Recent evidence suggests that changes in modes that are strongly associated to other modes (i.e., central modes) could be associated with greater treatment effects. We therefore suggest research should investigate the relative centrality of healthy and dysfunctional modes. To make an exploratory start, we investigated the cross‐sectional network structure of schema modes in a clinical (comprising individuals diagnosed with paranoid, narcissistic, histrionic, and Cluster C personality disorders) and non‐clinical sample. Results showed that, in both samples, the Healthy Adult was significantly less central than several dysfunctional modes (e.g., Undisciplined Child and Abandoned and Abused Child). Although our study cannot draw causal conclusions, this finding could suggest that weakening dysfunctional modes (compared to strengthening the Healthy Adult) might be more effective in decreasing other dysfunctional modes. Our study further indicates that several schema modes are negatively associated, which could suggest that decreasing one might increase another. Finally, the Healthy Adult was among the modes that most strongly discriminated between clinical and non‐clinical individuals. Longitudinal and experimental research into the network structure of schema modes is required to further clarify the relative influence of schema modes.

Systematic review of machine learning utilization within outpatient psychodynamic psychotherapy research

“…Nine of the 27 studies were conducted by a research group under Professor Atkins, who successfully created an automatic transcription and evaluation tool for short term psychotherapy, namely motivational interviewing ( 21 – 29 ). Ten of the 27 excluded studies either tried to predict the outcome of cognitive behavior therapy by using natural language processing, or tried to predict optimal therapeutic interventions with sociodemographic data ( 30 – 40 ). Another 16 studies excluded were reviews about machine learning and its utilization within psychotherapy, psychopharmacotherapy, and diagnostics ( 19 , 27 , 38 , 41 – 51 ).…”

Understanding the reparative effects of schema modes: an in-depth analysis of the healthy adult mode

“…It has been empirically shown that although the HA is not central to the network of maladaptive modes, it is still the most important predictor to differentiate people with personality disorder problems from those without a diagnosis of PD ( 30 ). Moreover, it plays an important role in the change process during treatment ( 28 ).…”

“…Thus, the function of the HA is argued to be central to change in schema therapy ( 16 , 27 , 28 ). Similarly, the importance and centrality of the vulnerable child (VC) mode were established both theoretically ( 21 , 22 ) and empirically ( 28 – 30 ). The VC contains emotionally painful experiences and distressing emotions, and it can be very painful to stay in contact with the VC.…”

“…In a recent study, the network of schema modes was studied, and although VC was central in the network, HA was not central. However, although the HA was not central in the network of maladaptive modes, it was the most important schema mode to differentiate people with personality disorders from healthy participants ( 30 ). This is in line with Louis et al's ( 17 ) claim that positive schemas are not necessarily mere opposites of maladaptive schemas.…”

Narcissistic personality syndrome in relation to emotional states: Preliminary findings in a Dutch psychiatric outpatient sample

“…Aside from the small sample size, another possible explanation is that individuals with narcissism successfully block the awareness of vulnerable emotions rather than adopt self-soothing behaviours (Bamelis et al, 2011). In fact, recent network analysis on modes (Aalbers, 2021) showed a positive association between lonely child SM and detached self-soother SM in individuals without PDs, but not in individuals with PDs (Aalbers, 2021). They hypothesize that people without a PD are able to adopt self-soothing measures as adequate coping and people with a PD are not.…”